Clinical Ethics Consultations (CECs) are used by healthcare systems to offer healthcare practitioners a structured level of support to approach ethical questions. The objective of this study was to detail the elements of surveyed CECs and offer guidance in the approach to future ethics consultations at a regional healthcare system. This cohort study has a qualitative and quantitative retrospective approach, surveying ethics consultations through the dates of 4/27/22 to 4/26/24. A documentary sheet was created, and information was entered via online (...) data-gathering forms. The cases are from a range of specialties within a regional healthcare system servicing Minnesota, Wisconsin, and North Dakota. 103 CECs were performed within the study period across the regional healthcare system. Consultations were identified through retrospective review of the internal CEC database, and patient information was collected through the medical record. Decision-making was often performed by a substitute decision-maker (N = 54), occurring in 70.1% of cases with known decision makers. CECs were documented in an ethics-specific note in the patient medical record in 37 of 82 (45.1%) documented patient cases. It was common for physicians to mention the ethics consultation in their patient notes, occuring in 51 of 82 (62.2%) of documented patient cases. Age was recorded in 92.0% (N = 91) of unique patient cases; the median age was 62 years. Ethical questions concerning end-of-life care were the most common cause for consultation (N = 35, 34%), and CECs were most commonly requested in general medicine or hospitalist departments (N = 38, 45.2%). Most consultations resulted in resolution at time of initial consultation with the ethics call team. Recommendations for increased frequency and timing of policy review are given based on the results of the data presented. Using interpretation of the CECs in this study, we offer recommendations towards the use and documentation of ethics consultations in the era of open notes, open the door towards areas of future research, and ultimately promote use of CECs for more favorable patient outcomes. (shrink)

The suspension of major sporting competitions due to the global COVID-19 pandemic had a substantial negative impact on the sporting industry. As such, a successful and sustainable return to sport will require extensive modifications to the current operations of sporting organizations. In this article we argue that methods from the realm of sociotechnical systems theory are highly suited for this purpose. The aim of the study was to use such methods to develop a model of an Australian Football League club’s (...) football department. The intention was to identify potential modifications to the club’s operations to support a return to competition following the COVID-19 crisis. Subject Matter Experts from an AFL club participated in three online workshops to develop Work Domain Analysis and Social Organization and Cooperation Analysis models. The results demonstrated the inherent complexity of an AFL football department via numerous interacting values, functions and processes influencing the goals of the system. Conflicts within the system were captured via the modeling and included pursing goals that may not fully reflect the state of the system, a lack of formal assessment of core values, overlapping functions and objects, and an overemphasis on specialized roles. The current analysis has highlighted potential areas for modification in the football department, and sports performance departments in general. (shrink)

The Paradox of the Knower was originally presented by Kaplan and Montague [26] as a puzzle about the everyday notion of knowledge in the face of self-reference. The paradox shows that any theory extending Robinson arithmetic with a predicate K satisfying the factivity axiom K → A as well as a few other epistemically plausible principles is inconsistent. After surveying the background of the paradox, we will focus on a recent debate about the role of epistemic closure principles in the (...) Knower. We will suggest this debate sheds new light on the concept of knowledge which is at issue in the paradox – i.e. is it a “thin” notion divorced from concepts such as evidence or justification, or is it a “thick” notion more closely resembling mathematical provability? We will argue that a number of features of the paradox suggest that the latter option is more plausible. Along the way, we will provide a reconstruction of the paradox using a quantified extension of Artemovʼs [2] Logic of Proofs, as well as a series of results linking the original formulation of the paradox to reflection principles for formal arithmetic. On this basis, we will argue that while the Knower can be understood to motivate a distinction between levels of knowledge, it does not provide a rationale for recognizing a uniform hierarchy of knowledge predicates in the manner suggested by Anderson. (shrink)

Although risky decision-making has been posited to contribute to the maladaptive behavior of individuals with psychopathic tendencies, the performance of psychopathic groups on a common task of risky decision-making, the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994), has been equivocal. Different aspects of psychopathy (personality traits, antisocial deviance) and/or moderating variables may help to explain these inconsistent findings. In a sample of college students (N = 129, age 18–27), we examined the relationship between primary and secondary (...) psychopathic features and IGT performance. A measure of impulsivity was included to investigate its potential as a moderator. In a joint model including main effects and interactions between primary psychopathy, secondary psychopathy and impulsivity, only secondary psychopathy was significantly related to risky IGT performance, and this effect was not moderated by the other variables. This finding supports the growing literature suggesting that secondary psychopathy is a better predictor of decision-making problems than the primary psychopathic personality traits of lack of empathy and remorselessness. (shrink)

Trata-se de mostrar como a “colisão” da lógica com sua aplicação, no cenário do Tractatus Logico-Philosophicus de Wittgenstein, pode ser enxergada a partir do problema da incompatibilidade das cores. Exploraremos algumas soluções nos moldes tractarianos, verificando em que medida elas não satisfazem algumas exigências da obra. Também apresentaremos uma tentativa de solução do próprio Wittgenstein para o problema, mostrando como o filósofo percebe que tal solução não é satisfatória.

In order to formulate hypotheses about the evolutionary underpinnings that preceded the first glimmerings of language, mother-infant gestural and vocal interactions are compared in chimpanzees and humans and used to model those of early hominins. These data, along with paleoanthropological evidence, suggest that prelinguistic vocal substrates for protolanguage that had prosodic features similar to contemporary motherese evolved as the trend for enlarging brains in late australopithecines/early Homo progressively increased the difficulty of parturition, thus causing a selective shift toward females that (...) gave birth to relatively undeveloped neonates. It is hypothesized that hominin mothers adopted new foraging strategies that entailed maternal silencing, reassuring, and controlling of the behaviors of physically removed infants (i.e., that shared human babies' inability to cling to their mothers' bodies). As mothers increasingly used prosodic and gestural markings to encourage juveniles to behave and to follow, the meanings of certain utterances (words) became conventionalized. This hypothesis is based on the premises that hominin mothers that attended vigilantly to infants were strongly selected for, and that such mothers had genetically based potentials for consciously modifying vocalizations and gestures to control infants, both of which receive support from the literature. Key Words: bipedalism; brain size; chimpanzees; foraging; gestures; hominins; infant riding; motherese; prosody; protolanguage. (shrink)

The question at issue is whether moral defects of artworks can be aesthetic defects. Noël Carroll claims they can be, Berys Gaut claims they are, and James Anderson and Jeffrey Dean claim they are not. I side with Anderson and Dean and produce additional arguments against Carroll and Gaut. Triumph of the Will serves as an example that all five of us agree is a morally flawed artwork. I argue and conclude that its horrible moral defects (...) are not aesthetic ones. Its triumph is the sum total of its aesthetic merits. (shrink)

This article outlines a training activity that can enable both business and governmental professionals to translate the principles in a code of ethics to a specific list of company-related behaviors ranging from highly ethical to highly unethical. It also explores how this list can become a concrete model to follow in making ethical decisions. The article begins with a discussion as to what will improve ethical decision making in business and government. This leads us to explore the factors that can (...) most easily lead to improvement, namely a comprehensive code of conduct and employee training. From there we look at the Critical Incident Technique as a training strategy that has the potential for identifying those behaviors that distinguish really outstanding behaviors from those that go by the book, and can be used to encourage more independent thinking and to set expectations for future decisions. If employees are given the skills and examples that will enable them to make better decisions, they can apply them to any situation. (shrink)

This article details day-to-day ethics issues facing MBAs who occupy entry-level and mid-level management positions and offers defined examples of the stressors these managers face. The study includes lower-level managers, essentially excluded from extant literature, and focuses on workplace behaviors both undertaken and observed. Results indicate that pressures from internal organization sources, and ambiguity in letter versus spirit of rules, account for over a third of the most frequent unethical situations encountered, and that most managers did not expect to face (...) those issues. Various contextual factors accounted for 32% of the organizational factors that affected decisions. We discuss implications for the workplace, especially the unique ethics challenges for newer managers. (shrink)

Countering claims of its impossibility, this paper argues for economic theology as an intelligible figure of contemporary political rationality and organization, and a distinctive analytical strategy in relation to forms of liberal and neoliberal governmentality and the contemporary management of social life. As an analytical strategy, it has two arms: an institutional one, drawing upon Michel Foucault’s work on the pastorate; and a conceptual one, following from Giorgio Agamben on oikonomia, order and providence. Economic theology was the arcana of 20th-century (...) debates on both political theology and governmentality and a condition for their emergence. It formed the horizon of Carl Schmitt’s intervention of a political theology in response to Max Weber, and, as the pastorate, it was for Foucault the historical background of the emergence of the liberal arts of government. While appearing as a new paradigm, it thus has a measure of priority over our more established ones. Furthermore, to the extent that economic theology comes to occupy the place of political rationality in contemporary liberal-democratic societies, the political becomes less a rational public sphere and more a form of public liturgy. (shrink)

We say that a real X is n-generic relative to a perfect tree T if X is a path through T and for all $\Sigma _{n}^{0}(T)$ sets S, there exists a number k such that either X|k ∈ S or for all σ ∈ T extending X|k we have σ ∉ S. A real X is n-generic relative to some perfect tree if there exists such a T. We first show that for every number n all but countably many reals (...) are n-generic relative to some perfect tree. Second, we show that proving this statement requires ZFC− + "∃ infinitely many iterates of the power set of ω". Third, we prove that every finite iterate of the hyperjump. ${\cal O}^{(n)}$ , is not 2-generic relative to any perfect tree and for every ordinal α below the least λ such that supβ<i (βth admissible) = λ, the iterated hyperjump ${\cal O}^{(\alpha)}$ is not 5-generic relative to any perfect tree. Finally, we demonstrate some necessary conditions for reals to be 1-generic relative to some perfect tree. (shrink)

The authors examine the nature of the relationship between social science and philosophy and address the sort of work social science should do, and the role and sorts of claims that an accompanying philosophy should engage in. In particular, the authors reintroduce the question of ontology, an area long overlooked by philosophers of social science, and present a cricital engagement with the work of Roy Bhaskar. The book argues against the excesses of philosophising and commits itself to a philosophical approach (...) more deeply grounded in the social sciences. (shrink)

In this paper I propose a new argument for moderate autonomism. I call this the ‘critical argument’ to distinguish it from the empirical argument of James C. Anderson and Jeffrey T. Dean, and the no-error argument of James Harold. My strategy is to first employ the criticism of Matthew Arnold and F.R. Leavis to demonstrate the moralist failure to account for the complexity of the relationship between literature and morality, and then offer a more promising alternative. I set (...) out the autonomist, moralist, and immoralist positions in the value interaction debate in §1, and identify problems with classifying the two critics in contemporary terms. In §2 I discuss Arnold’s cultural criticism as both a part of – and a reaction to – the public moralist tradition that dominated Britain in the nineteenth century, drawing attention to his criterion of ‘seriousness’. §3 examines Leavis’ literary criticism, focusing on his conception of the relationship between composition and life, and his criterion of ‘maturity’. Drawing on the similarities between Arnold and Leavis, I demonstrate that their concern with morality differs from that of the contemporary moralists in §4. In §5 I employ John Gibson’s distinction between normative and informative values to complete the argument for moderate autonomism. I test my argument against an extreme case, a hypothetical literary equivalent to The Birth of a Nation, in §6, and conclude that moderate autonomism provides the most compelling solution to the value interaction debate. (shrink)

There seems to be something wrong with passing moralistic judgments on others’ moral character. Immanuel Kant’s ethics provides insight into an underexplored way in which moralistic judgments are problematic, namely, that they are both a sign of fundamentally poor character in the moralistic person herself and an obstacle to that person’s own moral self-improvement. Kant’s positions on these issues provide a basically compelling argument against moralistic judgment of others, an argument that can be detached from the most controversial elements of (...) Kantian ethics to stand as plausible and instructive in its own right. (shrink)

Kant emphasizes that moral philosophy must be divided into two parts, a metaphysics of morals, and an empirical application to individuals, which Kant calls 'moral anthropology'. But Kant gives humanity (die Menschheit) a prominent role even in the purely rational part of ethics – for example, one formulation of the categorical imperative is a demand to treat humanity as an end in itself. This paper argues that the only concepts of humanity suited to play such a role are the rational (...) idea of humanity, and the rational ideal derived from this idea, which Kant discusses in Critique of Practical Reason and other texts. (shrink)

ObjectiveTo determine the effects of learning interventions aimed at optimizing the quality of physical education on psychomotor, cognitive, affective and social learning outcomes in children and adolescents.DesignA systematic review and meta-analysis.Data SourcesAfter searching PsycInfo, ERIC, and SportDiscus electronic databases, we identified 135 eligible studies published between January 1, 1995 to May 1, 2021.Eligibility Criteria for Selecting StudiesWe included randomized controlled trials, quasi-experimental studies, and controlled trials that assessed the effect of a PE-based intervention against one of the four identified learning (...) domains in youth at school.ResultsOne hundred and thirty five studies with over 42,500 participants and 193 calculated effect sizes were included in the study. The mean effect across all the learning and development outcomes was small to medium. When adjusted for publication bias using the Duval and Tweedie Trim and Fill Method, this mean effect size increased to d = 0.40. Effect sizes varied significantly based on learning and development outcomes. Interventions that consistently report above or below the mean d = 0.40 effect are identified based on learning outcome. The greatest effects across interventions were witnessed in psychomotor learning outcomes followed by affective, social, and cognitive learning outcomes. A minority of PE interventions captured by this systematic review and meta-analysis reported having a negative effect on student learning and development.ConclusionThe interventions with the greatest effects on student learning and development were dependant on the learning domains. Some PE interventions with a pedagogical focus such as games-based approaches, TARGET/Mastery Teaching, and Sport Education were found to be strong investments across multiple domains. The evidence is limited however by consistency in intervention dosage, study design, and data collection instruments. The study received no internal or external funding and was not prospectively registered. (shrink)

To read any book by Paul Weiss is to enter into an ongoing philosophical discussion. Emphatics is no exception. Here Weiss takes up some issues from previous work but from a new angle of vision. Much of what he says also moves beyond the content of earlier writings, which is as it should be. "A creative, systematic philosopher," Weiss says, "is somewhat like a poet rewriting a long poem, preserving some parts of earlier versions in later ones. What has been (...) done is not invalidated, but moved beyond" (37). Another characteristic Weissian feature marks Emphatics: it is difficult to read. The ideas themselves are difficult, and Weiss doesn't go out of his way to coddle his reader. Serving as... (shrink)

_Sigmund Freud and His Impact on the Modern World_, volume 29 of The Annual of Psychoanalysis, is a comprehensive reassessment of the influence of Sigmund Freud. Intended as an unofficial companion volume to the Library of Congress's exhibit, "Sigmund Freud: Conflict and Culture," it ponders Freud's influence in the context of contemporary scientific, psychotherapeutic, and academic landscapes. Beginning with James Anderson's biographical remarks, which are geared specifically to the objects on display in the Library of Congress exhibit, and Roy (...) Grinker Jr.'s more personal view of Freud, the volume branches out in various directions in an effort to comprehend the multidimensional and multidisciplinary richness of Freud's contribution. In section II, we find authoritative summaries of Freud's scientific contributions, of his continuing impact as a thinker, of his notion of symbolization in the context of recent neuroscientific findings, and of his status as a "cultural subversive". In section III, contributors hone in on more specific aspects of Freud's legacy, such as an experimental method to review how Freud's idea of childhood sexuality has fared and a look at the women who became analysts in the United States. In the concluding section of the volume, contributors turn to Freud's influence in various humanistic disciplines: literature, drama, religious studies, the human sciences, the visual arts, and cinema. With this scholarly yet highly accessible compilation, the Chicago Institute provides another service to its own community and to the wider reading public. Sure to enhance the experience of all those attending "Sigmund Freud: Conflict and Culture," _Sigmund Freud and His Impact on the Modern World_ will appeal to anyone desirous of an up-to-date overview of the man whose work shaped the psychological sensibility of the century just past and promises to reverberate throughout the century just born. (shrink)

Gifts have served as a fundamental aspect of the human experience across time, even as their precise roles and functions have shifted. In the past, bioethicists and others have drawn upon anthropol...