Starting with the puzzlement M O.C. Drury and Rush Rhees felt about Wittgenstein's admonition that believers ought not to pick and choose among the passages of the bible, this paper seeks to clarify the sense of scriptural authority in the Judeo-Christian traditions. This paper argues that (1) picking and choosing, imposing certain criteria external to the Scripture, is grammatically constitutive of accepting the authority of Scripture and (2) such a picking and choosing is guided by a tradition and its grammar. (...) It notes that Wittgenstein's stance on Scripture is itself based on (1) and (2). (shrink)

Some forty years ago, Norman Malcolm and Charles Hartshorne, philosophers from two distinctive schools of thought, championed, independently of each other, a form of ontological argument based on chapter III of Anselm’s Proslogion as well as on various chapters of Reply to Gaunilo.1 While different aspects of the argument are emphasized by Malcolm and Hartshorne, this second form of the ontological argument hinges on the following two points: (1) necessary existence is constitutive of the concept of God,2 and (2) therefore, (...) in understanding the concept of God, one understands that God necessarily exists in fact or in actuality. Whereas Malcolm vacillates between affirming only (1) and both (1) and (2),3 Hartshorne affirms both (1) and (2); however, he holds that Anselm’s formulation of the actual existence of God is somewhat confused. My argument here is that while (1) has some sense, (2) is a confusion arising from confounding the logical or conceptual existence of God with the actual existence of God.4. (shrink)

BackgroundBiobanks are considered to be key infrastructures for research development and have generated a lot of debate about their ethical, legal and social implications. While the focus has been on human genomic research, rapid advances in human microbiome research further complicate the debate.DiscussionWe draw on two cystic fibrosis biobanks in Toronto, Canada, to illustrate our points. The biobanks have been established to facilitate sample and data sharing for research into the link between disease progression and microbial dynamics in the lungs (...) of pediatric and adult patients. We begin by providing an overview of some of the ELSI associated with human microbiome research, particularly on the implications for the broader society. We then discuss ethical considerations regarding the identifiability of samples biobanked for human microbiome research, and examine the issue of return of results and incidental findings. We argue that, for the purposes of research ethics oversight, human microbiome research samples should be treated with the same privacy considerations as human tissues samples. We also suggest that returning individual microbiome-related findings could provide a powerful clinical tool for care management, but highlight the need for a more grounded understanding of contextual factors that may be unique to human microbiome research.ConclusionsWe revisit the ELSI of biobanking and consider the impact that human microbiome research might have. Our discussion focuses on identifiability of human microbiome research samples, and return of research results and incidental findings for clinical management. (shrink)

Donors to biobanks are typically asked to give blanket consent, allowing their donation to be used in any research authorized by the biobank. This type of consent ignores the evidence that some donors have moral, religious, or cultural concerns about the future uses of their donations – concerns we call “non-welfare interests”. The nature of non-welfare interests and their effect on willingness to donate to a biobank is not well understood. In order to better undersand the influence of non-welfare interests, (...) we surveyed a national sample of the US population using a probability-based internet panel. Logistic regression models assessed the demographic and attitudinal characteristics associated with participants’ willingness to give consent for unspecified future uses of their donation when presented with 7 research scenarios that raised possible non-welfare interest concerns. Most people had non-welfare interests that significantly affect their willingness to donate to a biobank using blanket consent. Some non-welfare interests are associated with subgroups but others are not. A positive attitude toward biomedical research in general was associated with increased willingness to donate, while concerns about privacy and being African American were associated with decreased willingness. Non-welfare interests matter and can diminish willingness to donate to a biobank. Our data suggest that trust in research promotes willingness to donate. Ignoring non-welfare interests could erode this trust. Donors’ non-welfare interests could be accommodated through greater transparency and easier access to information about the uses of donations. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

Background: The demand for autonomy in medical decision making is increasing among Korean people, but it is not well known why some people prefer autonomy in decision making but others do not. Research objectives: The aim of this study was to determine the extent to which Korean adults wished to exercise autonomy in the process of decision making regarding end-of-life treatment and to determine whether economic issues and family functioning, in particular, were associated with preferences for participation in decision making (...) in Korean people. Research design: This study was a cross-sectional correlational study using a survey. Participants and research context: Data were collected using structured questionnaires from 354 patients or their families who visited ambulatory departments at two general hospitals in South Korea, recruited by the proportionate quota sampling method. Data analysis was performed using multinomial logistic regression analyses. Ethical considerations: The study was approved by the hospitals’ directors and the ethics committee of Kyungpook National University Hospital. Written informed consent was given by all participants. Findings: A majority of Korean people wanted to make autonomous decisions regarding treatment at the end of life. Preferences for autonomous decision making regarding end-of-life treatment, rather than relying on family, showed a significant increase in association with poor family functioning and low income. Discussion: Results of this study suggested the necessity for development of alternatives to a dominant traditional “family-centered” approach in Korean people, in order to enhance end-of-life decision making for people who wish to take an active role in the decision-making process. Conclusion: Healthcare providers need to examine not only patients’ preferred decision-making style but also any reasons for their choice, in particular, family conflict and financial burden. (shrink)

While stigmatisation is universal, stigma research in low- and middle-income countries (LMIC) is limited. LMIC stigma research predominantly concerns health-related stigma, primarily regarding HIV/AIDS or mental illness from an adult perspective. While there are commonalities in stigmatisation, there are also contextual differences. The aim of this study in DR Congo (DRC), as a formative part in the development of a common stigma reduction intervention, was to gain insight into the commonalities and differences of stigma drivers (triggers of stigmatisation), facilitators (factors (...) positively or negatively influencing stigmatisation), and manifestations (practices and experiences of stigmatisation) with regard to three populations: unmarried mothers, children formerly associated with armed forces and groups (CAAFAG), and an indigenous population. Group exercises, in which participants reacted to statements and substantiated their reactions, were held with the ‘general population’ (15 exercises, n = 70) and ‘populations experiencing stigma’ (10 exercises, n = 48). Data was transcribed and translated, and coded in Nvivo12. We conducted framework analysis. There were two drivers mentioned across the three populations: perceived danger was the most prominent driver, followed by perceived low value of the population experiencing stigma. There were five shared facilitators, with livelihood and personal benefit the most comparable across the populations. Connection to family or leaders received mixed reactions. If unmarried mothers and CAAFAG were perceived to have taken advice from the general population and changed their stereotyped behaviour this also featured as a facilitator. Stigma manifested itself for the three populations at family, community, leaders and services level, with participation restrictions, differential treatment, anticipated stigma and feelings of scapegoating. Stereotyping was common, with different stereotypes regarding the three populations. Although stigmatisation was persistent, positive interactions between the general population and populations experiencing stigma were shared as well. This study demonstrated utility of a health-related stigma and discrimination framework and a participatory exercise for understanding non-health related stigmatisation. Results are consistent with other studies regarding these populations in other contexts. This study identified commonalities between drivers, facilitators and manifestations—albeit with population-specific factors. Contextual information seems helpful in proposing strategy components for stigma reduction. (shrink)

Selected response items and constructed response items are often found in the same test. Conventional psychometric models for these two types of items typically focus on using the scores for correctness of the responses. Recent research suggests, however, that more information may be available from the CR items than just scores for correctness. In this study, we describe an approach in which a statistical topic model along with a diagnostic classification model was applied to a mixed item format formative test (...) of English and Language Arts. The DCM was used to estimate students’ mastery status of reading skills. These mastery statuses were then included in a topic model as covariates to predict students’ use of each of the latent topics in their written answers to a CR item. This approach enabled investigation of the effects of mastery status of reading skills on writing patterns. Results indicated that one of the skills, Integration of Knowledge and Ideas, helped detect and explain students’ writing patterns with respect to students’ use of individual topics. (shrink)

Imagination comes with varying degrees of sensory accompaniment. Sometimes imagining is phenomenologically lean (cognitive imagining); at other times, imagining involves or requires sensory presentation such as mental imagery (sensory imagining). Philosophers debate whether contradictions can obtain in fiction and whether cognitive imagining is robust enough to explain our engagement with fiction. In this paper, I defend the Principle of Poetic License by arguing for the Permissive View of fictional truth: we can have fictions in which a contradiction is true, everything (...) is true, or nothing is true. I show that imagination-based worries about impossible, unlimited, and empty fictions can be shown to be about sensory imagination and that sensory imagination isn’t necessary for fictional truth. (shrink)

The language $L_A$ is formed by adding the quantifier $\Finv x$ , "few x", to the infinitary logic L A on an admissible set A. A complete axiomatization is obtained for models whose universe is the set of ordinals of A and where $\Finv x$ is interpreted as there exist A-finitely many x. For well-behaved A, every consistent sentence has a model with an A-recursive diagram. A principal tool is forcing for $L_A$.

There is a growing trend of refusal of blood transfusions from COVID-19 vaccinated donors. We highlight three cases where parents have refused blood transfusions from COVID-19 vaccinated donors on behalf of their children in the setting of congenital cardiac surgery. These families have also requested accommodations such as explicit identification of blood from COVID-19 vaccinated donors, directed donation from a COVID19 unvaccinated family member, or use of a non-standard blood supplier. We address the ethical challenges posed by these issues. We (...) describe the current screening and safety processes for standard blood donation and explore the importance of donor anonymity and challenges with directed donation and non-standard blood suppliers. We present an ethical framework using the Best Interest Standard, the Zone of Parental Discretion, and the Harm Principle when considering these refusals. Finally, we provide recommendations for how to approach these requests as they potentially become more commonplace in pediatrics. (shrink)

The spatial dynamics of the optical emission from an array of 50 times 50 individual microcavity plasma devices is investigated. The array is operated in argon and argon-neon mixtures close to atmospheric pressure with an ac voltage. The optical emission is analysed with phase and space resolution. It has been found that the emission is not continuous over the entire ac period, but occurs once per half period. Each of the observed emission phases shows a self-pulsing of the discharge, with (...) several bursts of emission of fixed width and repetition rate. The number of emission bursts depends on applied voltage and frequency. Spatially resolved measurements prove that the emission bursts are formed by overlapping emission pulses from single discharge cavities. Intensity differences between positive and negative half-wave can be interpreted through spatially resolved measurements of single discharge cavities. (shrink)

The modern legal and ethical movement against traditional welfare paternalism in medical decision-making extends to how decisions are made for patients lacking decisional capacity, prioritising surrogates’ judgment about what patients would have decided over even their best interests. In England and Wales, the Mental Capacity Act 2005 follows this trend of prioritising the patient’s prior wishes, values and beliefs but the dominant interpretation in life-sustaining treatment cases does so by in effect calling those values the ‘best interests’ of the patient (...) and focusing nearly exclusively on the ‘subjective’ viewpoint of the patient. In this article, we examine the recent Court of Protection judgment inBarnsley Hospitals NHS Foundation Trust v MSP[2020] EWCOP 26, which adhered closely to this approach, to suggest that it could have unexpected negative consequences. These include insufficient information gathering about and attention to patients’ objective medical interests, inadequacy of the evidentiary standard used for the substituted decision-making and, in some cases, even prioritising a surrogate’s current substituted judgment over the potential for an actual judgment by the patient. (shrink)

In euthanasia and/or assisted suicide of persons with dementia, the controversy has mostly focused on decisionally incapable persons with very advanced dementia for whom the procedure must be based on a written advance euthanasia directive. This focus on advance euthanasia directive-based EAS has been accompanied by scant attention to the issue of decision-making capacity assessment of persons with dementia who are being evaluated for concurrent request EAS. We build on a previous analysis of concurrent request EAS cases from the Netherlands, (...) which showed that many such cases involve persons with significant cognitive impairment. We use illustrative cases to describe the difficulty of determining decisional capacity in persons whose stage of dementia falls between severely impaired and mildly impaired. We show that the Dutch practice of capacity assessment in such dementia cases is difficult to reconcile with the widely accepted functional model of capacity—a model explicitly endorsed by the Dutch euthanasia review committees. We discuss why such deviations from the standard functional model might be occurring, as well as their ethical implications for dementia EAS policy and practice. (shrink)

In the history of Chinese philosophy, Mozi calls music a “waste of resources,” considering it an aristocratic extravagance that does not benefit the everyday people. In its defense, Confucians highlight music’s moral and metaphysical qualities, arguing that music aids in moral cultivation and that music’s form mimics the structure of reality. The aim of this paper is to show that Korean philosophers provide yet another reason to think music is important. Music, and art in general, was used to express a (...) national identity at a time Korean philosophers were beginning to develop their own aesthetic consciousness in the seventeenth and eighteenth centuries. A cultural movement called Joseonpoong (조선풍), “Joseon wind”, marked a shift away from Sinocentrism and towards Korea’s own unique value and practices. The new attempt to justify art’s value apart from its relationship to morality or metaphysics set Joseon thinkers apart from their Chinese predecessors. Using art for identity expression allowed the Koreans to reconceive art’s value while Sinocentric cosmological and cultural views were being challenged with the introduction of western knowledge. Art also became a tool for reversing hermeneutic injustice as new artistic practices and standards allowed the Koreans to meaningfully engage with previously neglected aspects of their lived lives. (shrink)

It is widely agreed that more is true in a work of fiction than explicitly said. In addition to directly stipulated fictional content (explicit truth), inference and background assumptions give us implicit truths. However, this taxonomy of fictional truths overlooks an important class of fictional truth: those generated by literary formal features. Fictional works generate fictional content by both semantic and formal means, and content arising from formal features such as italics or font size are neither explicit nor implicit: not (...) explicit since formal features don’t say anything; and not implicit since content generated from formal features doesn’t rely on other truths or background assumptions. In addition to showing that our current classification is incomplete, the new class of fictional truths provides four further upshots for definitions of fictional truth, story and work identity conditions, and the relationship between literary interpretation and fictional truth. (shrink)

How can we have a sense of the presence of ordinary three-dimensional objects (e.g., an apple on my desk, a partially occluded cat behind a picket fence) when we are only presented with some parts of objects perceived from a particular egocentric viewpoint (e.g., the facing side of the apple, the unoccluded parts of the cat)? This paper presents and defends a novel answer to this question by incorporating insights from two prominent contemporary theories of perception, naïve realism and sensorimotor (...) theory. Naïve realism is the view that perception is fundamentally a matter of obtaining a relation of ‘acquaintance’ with some mind-independent entities (e.g., objects, properties, events). Sensorimotor theory holds that perception involves implicit practical understanding or ‘anticipation’ of the covariance between movements and sensory changes. I argue that perceptual presence is best accounted for in terms of the combination of our direct ‘acquaintance’ with some parts of perceived objects and sensorimotor ‘anticipations’ of how the objects would look different depending on some movements and actions. (shrink)

In this article, I aim to do two things: first, introduce Juche, the official philosophy of the Democratic People’s Republic of Korea (“North Korea”), and second, defend Juche against Alzo David-West’s allegation that it is a nonsensical philosophy. I organize David-West’s complaints into two major strands—that Juche’s axiom is too vague to be of philosophical use and that Juche makes too stark a distinction between human vs. everything else—and offer responses to both strands. My goal isn’t to defend the regime, (...) but to present its ideology in the most charitable way so its merits and demerits can be seen more clearly in future engagements. (shrink)

Should the assessment of decision‐making capacity (DMC) be risk sensitive, that is, should the threshold for DMC vary with risk? The debate over this question is now nearly five decades old. To many, the idea that DMC assessments should be risk sensitive is intuitive and commonsense. To others, the idea is paternalistic or incoherent, or both; they argue that the riskiness of a given decision should increase the epistemic scrutiny in the evaluation of DMC, not increase the threshold for DMC. (...) We respond to the critics’ main concerns by providing a comprehensive account of how risk‐sensitive DMC is coherent, avoids paternalism, and best fulfills the epistemic goal of DMC evaluations. (shrink)

The Patient Preference Predictor (PPP) proposal places a high priority on the accuracy of predicting patients’ preferences and finds the performance of surrogates inadequate. However, the quest to develop a highly accurate, individualized statistical model has significant obstacles. First, it will be impossible to validate the PPP beyond the limit imposed by 60%–80% reliability of people’s preferences for future medical decisions—a figure no better than the known average accuracy of surrogates. Second, evidence supports the view that a sizable minority of (...) persons may not even have preferences to predict. Third, many, perhaps most, people express their autonomy just as much by entrusting their loved ones to exercise their judgment than by desiring to specifically control future decisions. Surrogate decision making faces none of these issues and, in fact, it may be more efficient, accurate, and authoritative than is commonly assumed. (shrink)

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of (...) capacity, we previously developed a descriptive typology of justifications used in the application of the Mental Capacity Act criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA. No data are available. This paper does not report any original data. (shrink)

We are grateful to Jongsma et al 1 for their interest in our article analysing the case of ‘Mrs A’, a Dutch woman with Alzheimer’s disease who received euthanasia based on her advance euthanasia directive.2 Their commentary criticises two elements of our analysis. First, the authors believe our reasons for doubting that Mrs A had the capacity to write and revise an AED rely on ‘partial’ empirical data and rest on normative errors. Second, they use two of our statements to (...) suggest we must endorse some implausible claims, for example, that ‘… in all situations and for all people, current well-being should always take precedence over all other values’. Jongsma et al assert: ‘Miller et al argue that people with dementia are impaired to make decisions.’ This casts our probabilistic claim about Mrs A’s capacity as an absolute claim about persons with dementia in general. It also implies we are using an outdated diagnosis-based view of capacity. The accusation then becomes explicit : > … several empirical studies have shown that patients with dementia are able to actively participate in qualitative studies and can respond to open questions in a meaningful way,[2-8] as well that they are able to complete an advance directive in the early phases of dementia.[9, 10] One can therefore not simply conclude on the basis of the diagnosis of dementia …. (shrink)

A metaphor is an effective way to show how something is to be conceived. In this article, I look at two Neo-Confucian Korean philosophical contexts—the Four-Seven debate and Book of the Imperial Pivot—and suggest that metaphors are philosophically expedient in two further contexts: when both intellect and emotion must be addressed; and when the aim of philosophizing is to produce behavioral change. Because Neo-Confucians had a conception of the mind that closely connected it to the heart (心 xin), metaphor’s empathy-inducing (...) and perspective-giving capacities made it an especially helpful mode of philosophizing in the history of Korean philosophy. (shrink)

Considering questions at the intersection of time and fiction deepens our understanding of fiction, introduces new questions for philosophy of time, and brings analytic philosophy in discussion with narratology. Philosophers debate whether fictional time can be tensed, whether fictional time can branch, repeat, pause, rewind, or skip and whether fictional time travel is possible. Much of the way we answer these questions will depend on our overall commitment to the nature of fiction. It’s also unclear what, if anything, we can (...) learn about the metaphysics of time from fiction. This chapter will introduce readers to discussions that are shaping the debates in this domain. (shrink)

This paper defends the idea that phenomenological approaches to self-consciousness can enrich the current analytic philosophy of perception, by showing how phenomenological discussions of minimal self-consciousness can enhance our understanding of the phenomenology of conscious perceptual experiences. As a case study, I investigate the nature of the relationship between naïve realism, a contemporary Anglophone theory of perception, and experiential minimalism (or, the ‘minimal self’ view), a pre-reflective model of self-consciousness originated in the Phenomenological tradition. I argue that naïve realism is (...) not only compatible with, but can be supplemented with experiential minimalism in a novel way. The suggestion is that there are reasons to combine naïve realism and experiential minimalism. My focus here will be on drawing a connection between the notion of minimal self and two core theoretical commitments of naïve realism, relationalism and transparency. (shrink)

Comic is one of the paradigmatic forms of hybrid media, and coming up with a satisfactory definition for it has been difficult. Sam Cowling and Ley Cray (2022) take a functional approach and offer an Intentional Picture-Reading View which defines comics as something that is “aptly intended to be picture-read.” I show that the view is extensionally inadequate as is because formally ambitious prose and concrete poetry, too, are aptly intended to be picture-read. The way forward, I argue, is to (...) look at more medium-specific non-depictive images (such as speech balloons and panels) to set comics apart from other hybrid media. (shrink)

A chapter in an edited volume discussing philosophy and Ted Chiang's short stories. In this chapter, I show how philosophical debates about imaginative resistance and what can/can't be fictionally true influence our interpretation of "Division by Zero.".