Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

Boyer suggests that laws cannot account for ownership intuitions, but there may be situations when intuitions hew to laws almost perfectly. Laws granting governments taxation powers provide an interesting case study. We report data here suggesting that people's intuitions track law very closely, and are unaffected by manipulating a P() tag input. We propose two hypotheses to explain this finding.

Psychologists' emerging interest in spirituality and religion as well as the relevance of each phenomenon to issues of psychological importance requires an understanding of the fundamental characteristics of each construct. On the basis of both historical considerations and a limited but growing empirical literature, we caution against viewing spirituality and religiousness as incompatible and suggest that the common tendency to polarize the terms simply as individual vs. institutional or ′good′ vs. ′bad′ is not fruitful for future research. Also cautioning against (...) the use of restrictive, narrow definitions or overly broad definitions that can rob either construct of its distinctive characteristics, we propose a set of criteria that recognizes the constructs' conceptual similarities and dissimilarities. Rather than trying to force new and likely unsuccessful definitions, we offer these criteria as benchmarks for judging the value of existing definitions. (shrink)

McCullough et al. argue that humans possess evolved computational systems for implementing retaliatory behavior that both deters aggression and promotes subsequent reconciliation. However, they do not apply this analysis to the sphere of intergroup relations. We believe their model can be usefully extended to this domain and discuss why this would be possible, pertinent, and productive.

It is not without a certain emotion that one opens this book devoted to the memory of a great scholar of medieval thought who worked and lived in the certainty that there cannot be a conflict between the Christian faith and science. In a significant essay, Benedict M. Ashley defends the idea of the philosophy of nature as continuous or identical with natural science. Ashley does allow, however, for so many divergences between philosophy of nature and natural science due to (...) later developments in science that this identification must be qualified. Steven E. Baldner points out some of the contradictions of Hartshorne's atomism: Hartshorne denies change and real causality. Anthony J. Celano recalls that Robert Kilwardby was very much aware that happiness as described by Aristotle is quite different from the beatitude promised by the Christian faith. The order of the divine entitative attributes in the Summa theologiae I, qq. 3-11 has baffled many a commentator. Lawrence Dewan connects it with some texts of Aristotle's Metaphysics. Jeremiah Hackett studies Roger Bacon's Moralis philosophia. Dealing with Luther's attitude toward St. Thomas, Denis R. Tanz accepts Erasmus's verdict that the weight given to Thomas in theology was an important factor in propelling Luther out of the Roman Catholic orbit. This opinion, however, confounds appearances with the real reason for leaving, namely, estrangement from several central positions of Catholic doctrine. It is a tribute to the Catholicity of Thomas that after 1519 Luther came to identify the Pope, the Church and all scholastic doctors with the Thomists and said that the Church had become the synagogue of the papists and the Thomists: Thomas had been made the arbiter of heresy. Mark F. Johnson stresses the sapiential character of the sacra doctrina. Mark D. Jordan wrestles with the question why Thomas wrote his Aristotelian commentaries. Arguing in the line of Owens's interpretation he reduces their importance with regard to Thomas's own positions. Jordan seems to think that Thomas's philosophy cannot be formulated without his theology, an explanation which is hardly satisfactory. Armand Maurer submits some reflections on St. Thomas's notion of presence. The question to what extent Albert the Great contributed to Aquinas's treatises of the morality of human acts and of natural law is examined by Ernest J. McCullough. Walter H. Principe points out how, according to Aquinas, food is assimilated into the veritas humanae naturae. Eric A. Reitan retraces Weisheipl's analysis of Aristotle's Physics and of St. Thomas' Commentary: the axiom, "whatever is moved, is moved by another" can be understood only within the context of the general science of nature. In his Liber de causis et processu universitatis Albert came to hold the same position as Thomas on the demonstrability of creation and of its beginning in time. Two final articles concern the difficulties underlying Aristotle's arguments in Physics 7 and 8, and Aquinas and Newton on causality: William Wallace connects Newton's universal gravitation with the axiom that nothing acts on itself. (shrink)

This commentary discusses dozens of ecologically powerful social-psychological experiments from the1960s and 1970s, which are highly relevant especially for predicting the consequences of revenge. McCullough et al. omitted this work catharsisni's anger-aggression bidirectional-causation (AABC) model and can be usefully incorporated in an adaptationist view of revenge.

McCullough et al. hypothesize that evolution has selected mechanisms for revenge to deter harms and for forgiveness to preserve valuable relationships. However, in highly dependent relationships, the more adaptive course of action may be to remain unaware of the initial harm rather than risk alienating a needed other. We present a testable model of possible victim responses to interrelational harm.

This volume consists of fourteen chapters selected from papers presented at the conference 'Ethics, Medicine and Health Care: An Appraisal of the Thought of H. Tristram Engelhardt, Jr.' along with a response to those chapters by Engelhardt and a Foreword by Laurence B. McCullough. The chapters direct primary attention to various aspects of Engelhardt's philosophy of medicine and bioethics as presented in The Foundations of Bioethics and Bioethics and Secular Humanism: The Search for a Common Morality. Among the topics (...) treated are the economics of health care and the medical profession, the libertarian and communitarian aspects of Engelhardt's thought, the moral status of children, abortion, the moral foundations for a health care system, feminism and clinical epistemology, and the relation between secular and religious moralities. In response to the various challenges posed by the authors, Engelhardt considers the implications of the failure of the modern philosophical project, the role of reason in ethics, and the resolution of conflict among communities that do not share the same moral vision. The book will be of interest to professionals in medicine, philosophy, theology, health policy, and law, and to graduate students in those disciplines. (shrink)

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of (...) ethical reasoning, namely ethical analysis informed by pertinent prior work, followed by identifying the implications of clearly articulated ethical concepts, to meet these goals. The professional virtue of civility and the related concept of professional etiquette was first described by the English physician-ethicist Thomas Percival (1740–1804). Based on a historically informed philosophical account, we propose that the professional virtue of civility has cognitive, affective, behavioural and social components based on a commitment to excellence in scientific and clinical reasoning. Its practice prevents a dysfunctional organisational culture of incivility and sustains a civility-based organisational culture of professionalism. Medical educators and academic leaders are in a pivotal and powerful position to role model, promote and inculcate the professional virtue of civility as essential to an organisational culture of professionalism. Academic leaders should hold medical educators accountable for discharge of this indispensable professional responsibility. (shrink)

Minimizing the costs that others impose upon oneself and upon those in whom one has a fitness stake, such as kin and allies, is a key adaptive problem for many organisms. Our ancestors regularly faced such adaptive problems (including homicide, bodily harm, theft, mate poaching, cuckoldry, reputational damage, sexual aggression, and the infliction of these costs on one's offspring, mates, coalition partners, or friends). One solution to this problem is to impose retaliatory costs on an aggressor so that the aggressor (...) and other observers will lower their estimates of the net benefits to be gained from exploiting the retaliator in the future. We posit that humans have an evolved cognitive system that implements this strategy – deterrence – which we conceptualize as a revenge system. The revenge system produces a second adaptive problem: losing downstream gains from the individual on whom retaliatory costs have been imposed. We posit, consequently, a subsidiary computational system designed to restore particular relationships after cost-imposing interactions by inhibiting revenge and motivating behaviors that signal benevolence for the harmdoer. The operation of these systems depends on estimating the risk of future exploitation by the harmdoer and the expected future value of the relationship with the harmdoer. We review empirical evidence regarding the operation of these systems, discuss the causes of cultural and individual differences in their outputs, and sketch their computational architecture. (shrink)

The best things in my Ufe have come to me by accident and this book results from one such accident: my having the opportunity, out of the blue, to go to work as H. Tristram Engelhardt, Jr. 's, research assistant at the Institute for the Medical Humanities in the University of Texas Medi cal Branch at Galveston, Texas, in 1974, on the recommendation of our teacher at the University of Texas at Austin, Irwin C. Lieb. During that summer Tris "lent" (...) me to Chester Bums, who has done important schol arly work over the years on the history of medical ethics. I was just finding out what bioethics was and Chester sent me to the rare book room of the Medical Branch Library to do some work on something called "medical deontology. " I discovered that this new field of bioethics had a history. This string of accidents continued, in 1975, when Warren Reich (who in 1979 made the excellent decisions to hire me to the faculty in bioethics at the Georgetown University School of Medicine and to persuade Andre Hellegers to appoint me to the Kennedy Institute of Ethics) took Tris Engelhardt's word for it that I could write on the history of modem medical ethics for Warren's major new project, the Encyclopedia of Bioethics. Warren then asked me to write on eighteenth-century British medical ethics. (shrink)

The clinical ethics literature is striking for the absence of an important genre of scholarship that is common to the literature of clinical medicine: systematic reviews. As a consequence, the field of clinical ethics lacks the internal, corrective effect of review articles that are designed to reduce potential bias. This article inaugurates a new section of the annual "Clinical Ethics" issue of the Journal of Medicine and Philosophy on systematic reviews. Using recently articulated standards for argument-based normative ethics, we provide (...) a systematic review of the literature on concealed medication for the management of psychiatric disorders. Four steps are completed: identify a focused question; conduct a literature search using key terms relevant to the focused question; assess the adequacy of the argument-based methods of the papers identified; and identify conclusions drawn in each paper and whether they apply to the focused question. We identified seven papers and provide an assessment of them. While none of the papers fully meet the standards of argument-based ethics, they did provide rationales for the use of concealed medications, with the important requirement such a practice be accountable in explicit organizational policy to prevent abuse of patients with mental illness or dementia. (shrink)

According to standard accounts of mathematical representations of physical phenomena, positing structure-preserving mappings between a physical target system and the structure picked out by a mathematical theory is essential to such representations. In this paper, I argue that these accounts fail to give a satisfactory explanation of scientific representations that make use of inconsistent mathematical theories and present an alternative, robustly inferential account of mathematical representation that provides not just a better explanation of applications of inconsistent mathematics, but also a (...) compelling explanation of mathematical representations of physical phenomena in general. 1Inconsistent Mathematics and the Problem of Representation2The Early Calculus3Mapping Accounts and the Early Calculus3.1Partial structures3.2Inconsistent structures3.3Related total consistent structures4A Robustly Inferential Account of the Early Calculus in Applications 4.1The robustly inferential conception of mathematical representation4.2The robustly inferential conception and inconsistent mathematics4.3The robustly inferential conception and mapping accounts5Beyond Inconsistent Mathematics. (shrink)

Research to improve the health of pregnant and fetal patients presents ethical challenges to clinical investigators, institutional review boards, funding agencies, and data safety and monitoring boards. The Common Rule sets out requirements that such research must satisfy but no ethical framework to guide their application. We provide such an ethical framework, based on the ethical concept of the fetus as a patient. We offer criteria for innovation and for Phase I and II and then for Phase III clinical trials (...) to improve the health of pregnant patients and of fetal patients and also criteria to responsibly manage the transition from investigation to clinical practice. Basing ethical criteria for research involving pregnant women on the ethical concept of the fetus as a patient insulates the proposed ethical framework and therefore research on pregnant women from the divisive and politicized concepts and discourses of personhood, fetal rights, and unborn child. (shrink)

Despite its prominence in the abortion debate and in public policy, the discourse of 'unborn patient' has not been subjected to critical scrutiny. We provide a critical analysis in three steps. First, we distinguish between the descriptive and normative meanings of 'unborn child.' There is a long history of the descriptive use of 'unborn child.' Second, we argue that the concept of an unborn child has normative content but that this content does not do the work that opponents of abortion (...) want it to do, namely, to establish the independent moral status of fetuses and their rights, the right to life in particular. Third, we argue that the normative content of 'unborn child' should be dependent moral status, not independent moral status. We conclude that the ethical concept of the fetus as a patient should replace the discourse of “unborn child” when that phrase is used normatively. (shrink)

Bioethics has a founding story in which medical paternalism, the interference with the autonomy of patients for their own clinical benefit, was an accepted ethical norm in the history of Western medical ethics and was widespread in clinical practice until bioethics changed the ethical norms and practice of medicine. In this paper I show that the founding story of bioethics misreads major texts in the history of Western medical ethics. I also show that a major source for empirical claims about (...) the widespread practice of medical paternalism has been misread. I then show that that bioethics based on its founding story deprofessionalizes medical ethics. The result leaves the sick exposed to the predatory power of medical practitioners and healthcare organizations with only their autonomy-based rights to non-interference, expressed in contracts, to protect them. The sick are stripped of the protection afforded by a professional, fiduciary relationship of physicians to their patients. Bioethics based on its founding story reverts to the older model of a contractual relationship between the sick and medical practitioners not worthy of intellectual or moral trust (because such trust cannot be generated by what I call ‘deprofessionalizing bioethics’). On closer examination, bioethics based on its founding story, ironically, eliminates paternalism as a moral category in bioethics, thus causing bioethics to collapse on itself because it denies one of the necessary conditions for medical paternalism. Bioethics based on its founding story should be abandoned. (shrink)

Volume 20, Issue 7, July 2020, Page 9-12.

In this response, we address eight issues concerning our proposal that human minds contain adaptations for revenge and forgiveness. Specifically, we discuss (a) the inferences that are and are not licensed by patterns of contemporary behavioral data in the context of the adaptationist approach; (b) the theoretical pitfalls of conflating proximate and ultimate causation; (c) the role of development in the production of adaptations; (d) the implications of proposing that the brain's cognitive systems are fundamentally computational in nature; (e) our (...) preferred method for considering the role of individual differences in computational systems; (f) applications of our proposal to understanding conflicts between groups; (g) the possible implications of our views for understanding the operation of contemporary criminal justice systems; and (h) the question of whether people ever “genuinely” forgive. (shrink)

Leibniz's earliest philosophy and its importance for his mature philosophy have not been examined in detail, particularly in the level of detail that one can achieve by placing Leibniz's philosophy in the context of the sources for two of the most basic concerns of his philosophical career: his metaphysics of individuals and the principle oftheir individuation. In this book I provide for the first time a detailed examination of these two Leibnizian themes and trace its implications for how we should (...) interpret other major Leibnizian themes and for how we should read Leibniz and other philosophers of the sixteenth and later centuries as 'modem' philosophers. Leibniz began his philosophical career more than 300 years ago, a fact that shapes fundamentally my attempt in the pages that follow to come to terms now with the texts that he left us. Leibniz's did not do philosophy in a way wholly congenial to twentieth century philosophical methodologies, especially those that have enjoyed some prominence in recent Anglo-American philosophy. Moreover, as we shall see, Leibniz is not a modem philosopher, when 'modem' is understood to mean making a sharp break with medieval philosophy. Indeed, I shall argue, scholars should discard such terms as 'modem' from historical philosophical scholarship, so that old texts can be allowed to remain old - to stand on their own in and from times now long past. (shrink)

Volume 20, Issue 3, March 2020, Page 65-68.

This paper considers ethical decision making by blending three streams of related research: cognitive moral development of the decision maker, rational choice theory and a subjective expected utility model. Ethical dilemmas can be defined as situations where moral certainty is compromised by rational cognition. In this paper, the authors assume that some people use a morality-first perspective and others a rationality-first perspective. Ethical scenarios were written and used to test hypotheses derived from this perspective. The instrument developed was shown to (...) be in need of further refinement. Results are discussed in terms of relationships between participant-characteristics variables overall and subscale responses to the ethical scenarios. (shrink)

The concept of medicine as a profession in the English-language literature of medical ethics is of recent vintage, invented by the Scottish physician and medical ethicist, John Gregory (1724-1773). Gregory wrote the first secular, philosophical, clinical, and feminine medical ethics and bioethics in the English language and did so on the basis of Hume's principle of sympathy. This paper provides a brief account of Gregory's invention and the role that Humean sympathy plays in that invention, with reference to key texts (...) in Gregory's work. The paper also considers two interesting and perhaps provocative ways in which Hume can be read through Gregory: first, sympathy as a principle of scientific discovery in Hume's science of man and moral physiology; and sympathy as gendered feminine in Hume's moral philosophy. Hume's principle of sympathy is at the core of Gregory's medical ethics and the histories of Western medical ethics and bioethics pivot on Gregory - and, therefore, on Hume - as it does on few other figures. (shrink)

David McCullough never expected that his commencement speech in 2012 would go viral and be talked about all over the world. Now he gives insights to that speech, school, family, and life in general in a witty and poignant way that is good for parents and teens.

Reality and contradiction -- The paradox of desire -- God and the world -- Necessity and obedience -- Grace and decreation -- Conclusion : Weil's theological coherence.

The papers in the 2010 “Clinical Ethics” number of the Journal of Medicine and Philosophy explore issues along La Frontera, the borders and boundaries of clinical ethics. The first three papers in this “Clinical Ethics” number of the Journal explore borders and boundaries drawn within clinical ethics, concerning the moral standing of complementary and alternative medicine, palliative sedation, and induced abortion and feticide. The fourth and fifth papers explore the borders and boundaries between research ethics and clinical ethics.

In his Disrupted Dialogue: Medical Ethics and the Collapse of Physician-Humanist Communication Robert Veatch presents a scholarly tour de force of eighteenth- and nineteenth-century Anglophone medical ethics to demonstrate how the easy communication between physicians and humanists in the Scottish Enlightenment progressively dissipated as medicine became detached from humanistic disciplines. In this paper I offer two comments—that the discourse of medical ethics in the Scottish Enlightenment was a discourse of Baconian moral science and that nineteenth-century medical ethics in the United (...) States became detached from that discourse. The result was that a principal resource for physicians at the birth of bioethics, the American Medical Association’s Principles of Medicine Ethics of 1957, did not equip physicians with the conceptual tools they needed to formulate and address the ethical challenges that became the agenda of bioethics. The paper opens with a brief portrait of Robert Veatch, the author’s connections to him, and his little-known role as an impresario of the classical music of the Blue Ridge and Appalachia. (shrink)

Rosamond Rhodes makes a persuasive case for the view that medical ethics does not derive from common morality.1 Rhodes identifies the challenge that immediately arises and its corollary: Whence the origin of medical ethics? And, should we understand medical ethics as autonomous? From the perspective of professional ethics in medicine, the first question can now be restated: Whence the origin of the ethical concept of medicine as a profession, the basis of the ethical obligations of physicians in patient care, research, (...) medical education, and in advocacy and healthcare policy? The history of Western philosophy offers us two pathways to address this question. The first is the quest for certainty,2 a quest fulfilled by using methods designed to discover concepts that are independent of human thought and judgement and thus intellectually and morally authoritative for everyone. Such concepts are timeless and therefore transcultural, transreligious and transnational. Examples include Plato’s Forms,3 PF Stawson’s (1919–2006) ‘our conceptual structure’,4 Edmund Pellegrino’s (1920–2003) ‘fact of illness’ and the ‘act of profession’ in response to the vulnerability that illness creates,5 and common morality.6 Thought experiments, using what Rhodes characterises as ‘the hypethetico-deductive method’,1 aim to discover timeless concepts. Discovering timeless concepts must address their ontological and epistemological status. Plato’s ontology of Forms,2 for example, is not clear, as …. (shrink)

THIS PAPER IS A COMMENTARY ON LUDWIK FLECK'S ESSAY ON THE CONNECTION BETWEEN WHAT HE CALLS "THOUGHT-STYLES" AND SCIENTIFIC AND MEDICAL CONCEPTS. THE IDEA OF A "THOUGHT-STYLE" APPLIED TO CONCEPTS OF DISEASE IS THAT THEY ARE NOT ONLY VALUE-LADEN IN THE SENSE OF INCLUDING NORMATIVE DIMENSIONS. THEY ALSO EMBRACE BROAD SOCIAL FACTORS, AS WELL. I ARGUE THAT THOUGHT-STYLES SHOULD BE UNDERSTOOD TO BE "OPEN-TEXTURED," ADMITTING A PLURALITY OF VALUE CONSIDERATIONS TO CONCEPTS OF DISEASE.