The moral expertise of clinical ethicists is not a question of mastering codelike theories and lawlike principles. Rather, ethicists are architects of moral space within the health care setting, as well as mediators in the conversations taking place within that space.

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

Spells out the power and renewed relevance of Kant's thinking: a genuinely objective, absolute basis for a modern moral law.

It is widely accepted that only the victim of a wrong can forgive that wrong. Several philosophers have recently defended “third-party forgiveness,” the scenario in which A, who is not the victim of a wrong in any sense, forgives B for a wrong B did to C. Focusing on Glen Pettigrove's argument for third-party forgiveness, I will defend the victim's unique standing to forgive, by appealing to the fact that in forgiving, victims must absorb severe and inescapable costs of distinctive (...) kinds, a plight that third parties do not share. There are, nonetheless, significant, even essential, roles played by third parties in making forgiveness possible, reasonable, or valuable for victims of serious wrongs. I take a closer look at the links between victims, wrongdoers, resentment, and forgiveness in showing why the victim alone can forgive. (shrink)

The attention paid to the influence of organizational philanthropy on consumer responses has precipitated a shift in the role this practice plays in organizational dynamics—with philanthropy becoming an increasingly strategic marketing tool. The authors develop and test a model predicting that: (1) perceived organizational credibility will mediate the relationship between awareness of philanthropy and the outcomes of advocacy and financial sacrifice; (2) consumer social consciousness will moderate the relationship between awareness of philanthropy and firm credibility, and between credibility and the (...) outcome variables; and (3) these moderated relationships will be mediated by perceived credibility. Data obtained from a sample of professional golf patrons support our assertions. Notably, the findings implicate perceived credibility as a key intervening variable in the hypothesized relationships for the PGA Tour. (shrink)

Background Ethical and scientific principles require that clinical trials address an important question and have the resources needed to complete the study. However, there are no clear standards for review that would ensure that these principles are upheld.Methods We conducted semi-structured interviews with a convenience sample of nineteen experts in clinical trial design, conduct, and/or oversight to elucidate current practice and identify areas of need with respect to ensuring the scientific value and feasibility of clinical trials prior to initiation and (...) while ongoing. We used a priori and grounded theory to analyze the data and constant comparative method to induce higher order themes.Results Interviewees perceived determination of scientific value as the responsibility of the investigator and, secondarily, other parties who review or oversee research. Interviewees reported that ongoing trials are rarely reevaluated due to emerging evidence from external sources, evaluation is complex, and there would be value in the development of standards for monitoring and evaluating evidence systematically. Investigators, IRBs, and/or data monitoring committees (DMCs) could undertake these responsibilities. Feasibility assessments are performed but are typically inadequate; potential solutions are unclear.Conclusions There are three domains where current approaches are suboptimal and in which further guidance is needed. First, who has the responsibility for conducting scientific review, whether it be the investigator, IRB, and/or DMC is often unclear. Second, the standards for scientific review (e.g., appropriate search terms, data sources, and analytic plan) should be defined. Third, guidance is needed on the evaluation of ongoing studies in light of potentially new and evolving evidence, with particular reference to evidence from outside the trial itself. (shrink)

Reasoning about bedrock abstract concepts such as time, number, and valence relies on spatial metaphor and often on multiple spatial metaphors for a single concept. Previous research has documented, for instance, both future-in-front and future-to-right metaphors for time in English speakers. It is often assumed that these metaphors, which appear to have distinct experiential bases, remain distinct in online temporal reasoning. In two studies we demonstrate that, contra this assumption, people systematically combine these metaphors. Evidence for this combination was found (...) in both directly elicited and spontaneous co-speech gestures about time. These results provide first support for the hypothesis that the metaphorical representation of time, and perhaps other abstract domains as well, involves the continuous co-activation of multiple metaphors rather than the selection of only one. (shrink)

Principlism aims to provide a framework to help those working in medicine both to identify moral problems and to make decisions about what to do. For it to meet this aim, the principles included within it must express values that all morally serious people share (or ought to share), and there must be no other values that all morally serious people share (or ought to share). This paper challenges the latter of these claims. I will argue that as a descriptive (...) claim about what values morally serious people do in fact share, principlism is inadequate; more principles would be needed to make this claim true. Furthermore, I will argue that while, taken as a claim about what principles we ought to share, principlism could turn out to be correct, it is either unsupported or unable to meet its aims. The only way in which principlists can avoid these problems is to add to the current four principles. (shrink)

In a health service with limited resources we must make decisions about who to treat first. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don't know in a particular (...) case that the illness is self-inflicted, that it seems that all illness is self-inflicted in the sense used in my argument, and finally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like fire-fighters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections. (shrink)

This essay analyses discussions of national versus international or transnational science, with an emphasis on the journal Osiris from 1986 to 2009, including the concepts of national science, national styles and characters in science, scientific internationalism, transfer of science and scientists from one nation to another, and comparison of different national examples. The author argues that perceiving science as a ‘national’ activity has not only been persistent, it is also perhaps inevitable. This special issue on transnational histories of science raises (...) the question of what is gained and lost by such an approach. First of all, what is the distinction between ‘transnational’ and ‘international’? The dictionary defines the latter as something existing, occurring, or carried on between two nations, while the former extends or operates across national boundaries. Thus ‘international’ implies some sort of commerce. In contrast, transnational is a loosely defined term. (shrink)

Philosophical discussions of akrasia over the last fifteen years have focused on certain skeptical arguments which purport to question the possibility of a kind of akratic action which, following Pears, I call 'last ditch akrasia' (Pears [38]). An agent, succumbing to last ditch akrasia, freely, knowingly, and intentionally performs an action A against his better judgment that an incompatible action B is the better thing to do. (See Audi [1] for a detailed analysis.) Last ditch akrasia is not the only (...) kind that has been discussed. Some philosophers (Mele [32], Scaltas [48]) have been concerned with a more extreme form of akratic action, viz. one in which the agent not only judges that action B is best, but in addition intends (chooses, decides) to B. Some have even questioned whether freely acting against one's better judgment is sufficient for akratic action (Schiffer [49]: 201-3).1 Weaker types of akratic action have been discussed, though to a much lesser extent, since they are thought less problematic. Pears distinguishes last ditch akrasia from what he calls, "motivated irrational action" ([38]: 160). In cases of the latter, the akrates' rebellious desire infects his prior reasoning and thinking in such a way that his contemplated action seems to him warranted, and he acts accordingly. (For a taxonomy of cases of akratic action, see Rorty ([44])). Nor has the discussion of akrasia been restricted to akratic action. Philosophers have discussed whether akrasia can be exhibited in the formation of intentions, wants (See Audi [1]: 181-185), and beliefs (Mele [32]: ch. 8; Heil [19]). The primary focus in this paper is on last ditch akratic action. (shrink)

We examine three assumptions commonly held in the corporate reputation literature: (1) reputation ratings of owners and investors are generally representative of all stakeholders; (2) stakeholders will generally provide a higher reputation rating to firms that emphasize corporate social responsibility versus firms that do not; and (3) profitability is the primary criterion of importance to all stakeholders when rating a firm's reputation. Using an exploratory in‐class exercise, our findings suggest that: (1) there are significant differences among stakeholder groups in their (...) reputation ratings; (2) firms that emphasize corporate social responsibility are not rated more highly across all stakeholder groups; and (3) for all stakeholder groups, the ethicality criterion explained more of the variance in firms' reputation ratings than the profitability criterion. (shrink)

We construct a class of relations on computable structures whose degree spectra form natural classes of degrees. Given any computable ordinal and reducibility r stronger than or equal to m-reducibility, we show how to construct a structure with an intrinsically invariant relation whose degree spectrum consists of all nontrivial r-degrees. We extend this construction to show that can be replaced by either or.

ANDREA: sincerity, conceptual review, philosophy.

Evidence‐based practice (EBP) first appeared on the healthcare horizon just over a decade ago. In 2003 its presence has intensified and extended beyond its initial relation to medicine embracing as it does now, nursing and the allied health disciplines. In this paper, I contend that its appearance and subsequent growth and development are the effects of potent ‘regimes of truth’, four of which bear the names: positivism, empiricism, pragmatism and economic rationalism. My aim is to show how EBP generates the (...) controversy it does because its nature and methods are inextricably interwoven with the way it has become politicised and professionalised. This exegesis is an attempt to outline how the combined effects of the four forms of rationality mentioned above allow for both the methods and objectives of EBP to be constructed as they are, while at the same moment producing the particular effects of knowledge and power in terms of who sells and who buys the idea of EBP in the culture of contemporary healthcare. (shrink)

Gallup surveys consistently show that nine in 10 Americans express a belief in God (Nash, Business, religion, and spirituality: A new synthesis, 2003 ), while more than 45 % claim to have some awareness of God on the job (Nash and McLellan, Church on Sunday, Work on Monday: The Challenges of Fusing Christian Values with Business Life, 2001 ). Recently, Lynn et al. (Journal of Business Ethics 85:227–243, 2009 ) argued that the ability to integrate the specific beliefs and practices (...) of one’s faith with the work one does represent an important although neglected area of research. As such, they developed and demonstrated convergent validity for the faith at work scale, designed to measure the extent to which individuals believe they are able to integrate their Judaeo-Christian beliefs and practices and their work. In a subsequent study, Lynn et al. (Human Relations 64:675–701, 2010 ) demonstrated that the faith at work scale was related to faith maturity, church attendance, age, and denominational strictness, and negatively associated with organizational size. No research, however, has examined the possible positive benefits of integrating faith and work. I therefore developed and tested hypotheses concerning the relationship between the faith at work scale and seven important life and work outcomes (satisfaction with life, intent to leave one’s job, self-rated job performance, job satisfaction, and three forms of organizational commitment). In all, four of seven hypotheses were confirmed. (shrink)

I contend that while at least one of the arguments advanced by Bernard Williams in his paper ‘Deciding To Believe’ does establish that beliefs, or more precisely, judgements cannot be decided upon ‘at will’, the notion of truth‐aimedness presupposed by that argument also, ironically, provides the key to understanding why judgements are necessarily voluntary.

Objections to uploading may be parsed into substrate issues, dealing with the computer platform of upload and personal identity. This paper argues that the personal identity issues of uploading are no more or less challenging than those of bodily transfer often discussed in the philosophical literature. It is argued that what is important in personal identity involves both token and type identity. While uploading does not preserve token identity, it does save type identity; and even qua token, one may have (...) good reason to think that the preservation of the type is worth the cost. (shrink)

This memorable essay offers in lay language a profound criticism of the limitations of modern thought as based on Descartes, Darwin, and Freud. It highlights the decissive role of Peirce's approach to language and human activity in order to close the modern rift between matter and mind, between biology and grammar.

Alain Badiou’s theoretical work maintains an ambiguous relation to Marx’s critique of political economy. In seemingly refusing the Marxian analytical strategy of displacement and referral across the fields of politics and economy, Badiou is frequently seen to be lacking a rigorous theoretical grasp of capitalism itself. In turn, this is often seen as a consequence of his understanding of political subjectivity. But the origins of this ‘lack’ of analysis of the social relation called ‘capital’ in his work can also be (...) investigated by means of a detour into the economic writings of theUnion des communistes de France marxiste-léniniste, the political organisation in which Badiou played a leading rôle throughout the 1970s in particular. By excavating this theoretical work of the 1970s, we can identify more precisely the historical and political reasons behind Badiou’s ambiguous relation to Marx and specifically to Marx’s systematic grasp of the logic of capital. This excavation will consequently lead us to a reflection on the limits and openings in Badiou’s thought for the Marxian critique of political economy. (shrink)

In this article I consider the uses of the concepts ‘society’ and ‘culture’ in various sociological and anthropological traditions, arguing that sociology needs to learn from the division between social anthropology and cultural anthropology. First I distinguish the social and the cultural sciences: the former use ‘society’ as leading concept and ‘culture’ as a subordinate concept; the latter do the contrary. I discuss the origins of the terms société and Kultur in the classical French and German traditions respectively, and their (...) subsequent uptake in Anglo-American sociology and anthropology, ‘society’ becoming the leading concept for sociology and social anthropology, ‘culture’ the leading concept for cultural anthropology. I contrast the sociology of culture with the cultural anthropological consideration of society. I next examine the terms for ‘society’ in the classical German tradition, especially Weber, pointing to interpretivism as a cultural theory of society. I then consider Weber’s Kultursoziologie, arguing that it is culture (Kultur) not society (Gesellschaft) that is the ultimate object of Weber’s sociology. I conclude that sociology needs to identify classical German sociology and its derivatives as cultural science not social science, and to make comprehensive adjustments to its methodological debates accordingly. The implications of this for the problem of sociology’s encounter with the natural world are noted. (shrink)

A diagnosis of fetal abnormality presents parents with a difficult – even tragic – moral dilemma. Where this diagnosis is made in the context of surrogate motherhood there is an added difficulty, namely that it is not obvious who should be involved in making decisions about abortion, for the person who would normally have the right to decide – the pregnant woman – does not intend to raise the child. This raises the question: To what extent, if at all, should (...) the intended parents be involved in decision-making? In commercial surrogacy it is thought that as part of the contractual agreement the intended parents acquire the right to make this decision. By contrast, in altruistic surrogacy the pregnant woman retains the right to make these decisions, but the intended parents are free to decide not to adopt the child. We argue that both these strategies are morally unsound, and that the problems encountered serve to highlight more fundamental defects within the commercial and altruistic models, as well as in the legal and institutional frameworks that support them. We argue in favour of the professional model, which acknowledges the rights and responsibilities of both parties and provides a legal and institutional framework that supports good decision-making. In particular, the professional model acknowledges the surrogate's right to decide whether to undergo an abortion, and the intended parents' obligation to accept legal custody of the child. While not solving all the problems that arise in surrogacy, the model provides a framework that supports good decision-making. (shrink)

A simple model, illustrating the transition from a population of free swimming, solitary cells to one consisting of small colonies serves as a basis to discuss the evolution of the cooperative group. The transition is the result of a mutation of the dynamics of cell division, delayed cell separation leads to colonies of four cells. With this mutation cooperative features appear, such as synchronised cell divisions within colonies and coordinated flagellar function which enables the colony to swim in definite directions. (...) The selective advantages under given, environmental conditions are defined and the periods necessary for complete allelic replacement in small populations are calculated for asexual and sexual reproduction. The assumption of a steady-state population during allelic substitution is critically considered, particularly under conditions of competition. It is shown that density-dependent population control must operate in the process of selection. Sexual reproduction slows down the rate of selection even though all cells dre haploid. This phenomenon can be explained in general terms of `organizational dominance', where individual units coordinate the function of their neighbours which may be of a different allelotype.Cooperativity is pointed out as an a priori systemic feature which resides in the sub-units of systems, group formation and coordination appears thus as an almost inevitable event. A particular type of system described as ‘closed cycle of positive fitness interaction’ is discussed in more detail. It has the remarkable feature that its members cannot compete with each other; selection takes place between whole cycles .Gonium has a wide spectrum of `somatic plasticity' which enables it to assume various colonial configurations depending on physiological and environmental conditions. This feature can be explained as the result of dynamic flexibilities on the macro-molecular level. The particular relationship between the vast, molecular complexity and the relative simple dynamics of the cell cycle must lead eventually to the genetic fixation of an environmentally induced phenotype. (shrink)

Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence-based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surgery relating to this lack (...) of fit, and investigate how resources from feminist epistemology can help to characterize them. We point to ways in which these epistemic challenges may be addressed by gathering and disseminating evidence about what works in surgery using methods that are contextual, pluralistic, and sensitive to hierarchies. (shrink)

Anatomists of criminal justice systems usually ignore the tiny organ called ‘mercy’ or ‘clemency’. Its name and shape may vary from one body politic to another, but its nature and function are uninterestingly obvious.It merely allows benign interference when the programming of the system seems to be having unacceptable effects in special cases.

In this article, I criticize environmental sociology’s conventional diagnosis of its methodological situation and overly narrow definition of its field. I argue for a greater engagement with the natural science base and consideration of anthropological approaches. I start with conceptual analysis, identifying the human-environment relationship as a pro-active two-way interaction. I then present an outline of global environmental dynamics, highlighting the unequal size of human activities on geosphere and biosphere scale, and the role of the biosphere as manager of the (...) geosphere, this as context for the human population problem. Three types of environmental problems are next identified: urban-industrial, rural-agrarian, and high hazard exposure. These are seen as forming a continuum, with anthropogenic and natural factors synergizing at the centre. I comment on their geographic distribution, noting Europe’s limited and specific environmental experience. Lastly I attempt an overview without biological metaphors of the humanenvironment relationship through time, commenting on its inherent imbalances and how these might be diagnosed. I conclude that sociology’s bias to modernity and the West renders it inadequate to the global environmental question. A wider and deeper spacio-temporal consideration is needed, with the whole continuum of environmental problems considered. For this, environmental sociology should seek a synthesis with cultural anthropology centring on the anthropological concept of culture, an approach, I argue, that is accessible through the sociology of Max Weber. (shrink)

The theory is presented that the sexual process is a repair mechanism which maintains redundancy within the sub-structure of hierarchical, self-reproducing organisms. In order to keep the problems within mathematically tractable limits , a simple model is introduced: a wheel with 6 spokes, 3 of them vital and 3 redundant, symbolizes the individual . Random accidents destroy spokes; the wheels replicate at regular cycles and engage periodically in pairing and repair phases during which missing spokes are copy-reproduced along the intact (...) spokes of the partner wheel.The hierarchical structure of such a system is analysed and an ‘autonomous unit’ is defined: this is the unit of minimal hierarchical complexity which is capable of perpetuating autonomously all higher and all lower levels of the hierarchy; this is the central unit of selection.Four basic, physical parameters are isolated which determine the essential features of any eucaryotic life cycle: 1. The number of levels of the hierarchy ; 2. the relation between the phases of replication and repair ; 3. the duration of potential repair ; 4. the position of the sexual partners within the hierarchy .The evaluation of fitness components is considered in relation to trends of reproductive patterns in evolution. (shrink)

Exact definitions in physical and biological terms of the coefficients in Volterra's (1926, 1931) original competition equations are indispensable for the understanding of the system. In agreement with Volterra's own, but not quite sufficient specifications, it is tried in this paper to give more precise definitions of the parameters used by Volterra. This leads to some consequences; i.a. that there does not exist a principle of competitive exclusion. In order to allow for competitive exclusion — or for stabilization — the (...) Volterra equations need additional biophysical specifications and mathematical modifications. Some such modifications are proposed, for instance for aggressive interference as a function of population numbers. (shrink)