While it is true that health care costs are straining personal and governmental budgets, it does appear to be a manageable problem. There are tools available to moderate costs, efforts are already underway to control costs by modifying the financing of health care. Whether or not these will be effective remains to be seen. There also are efforts to control costs by modifying unhealthy habits. These efforts are showing notable success. Moreover, there are efforts underway to reduce health care costs (...) by altering the overall context of people's lives. This latter effort—to improve the health of whole communities—holds the greatest promise. (shrink)

ObjectiveCochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation.Data sourcesWe address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community.Review methodsA systematic review using (...) three scientific online databases was performed. Included articles addressed the benefits and/or complications of cochlear implantation in young children, CI explantation with or without revision surgery and the ethical debate between the medical and Deaf communities on cochlear implantation and explantation.ConclusionsThe medical and audiological perspectives identify a host of risks related to implant removal without reimplantation, including risk from surgery, general anaesthesia, cochlear ossification and poor audiometric outcomes. The member of the deaf community and bioethicist argue that physicians need to guide the principles of beneficence, non-maleficence and patient autonomy. Taken together, patient desires should be seen as paramount, if the patient is otherwise fit for surgery and well informed.Implications for practiceSimilar to the case of device implantation, device explantation should be a multidisciplinary and collaborative decision with the patient and the family’s desires at the centre. While every case is different, we offer a CI explantation discussion to assist in clinical decision-making, patient counselling and education. (shrink)

Zhuangzi chooses a butterfly as a metaphor for transformation, a sighted creature whose inherent nature contains, and symbolizes, the potential for transformation from a less valued state to a more valued state. If transformation is not to be valued; if, according to a recent article by Jung Lee, 'there is no implication that it is either possible or desirable for the living to awake from their dream', why not tell a story of a mole awakening from a dream? This would (...) be a more perfect story. There would be no point of a mole awakening since (setting aside tactile, olfactory, auditory and taste sensations for the purpose of the example), there is no way to distinguish between the world of the mole's imagination and the real world that is forever unavailable to a mole. In addition, Zhuangzi relates the story of the coming of a great sage in which it is clearly stated that 'Only at the ultimate awakening shall we know that this is the ultimate dream'. Such textual evidence both from the choice of metaphors and evidential passages indicates that the message of the Zhuangzi is not epistemological relativity, but one of transformation from a state of intellectual blindness to a state of true understanding. (shrink)

Abortion is the central issue in the conscientious objection debate. In this article I demonstrate why this is so for two philosophical viewpoints prominent in American culture. One, represented by Patrick Lee and Robert P. George, holds that the fundamental moral value of being human can be found in bare life and the other, represented by Tom Beauchamp and James Childress, holds that this fundamental value is found in the life that can choose and determine itself. First, I articulate Lee (...) and George’s philosophical theory and demonstrate how the fundamental moral value of their theory, personhood, is represented in the issue of abortion. Second, I examine Beauchamp and Childress’ theoretical vision and demonstrate how their fundamental moral value, the right to autonomous self-determination, is represented in abortion. Third, I sketch the theoretical and practical dynamics of the conscientious objection debate as well as each author’s understanding of conscience. Fourth, I demonstrate how abortion, which represents their respective fundamental value, shapes each perspectives’ approach to the conscientious objection debate. I conclude that because each theory finds its fundamental value represented in the issue of abortion, each perspective is bound to engage the conscientious objection debate in a way that centers on the issue of abortion. (shrink)

Environmentalist philosophers often paint a holistic picture, stressing such things as the continuity of humanity with wider nature and our membership of the 'natural community' . The implication seems to be that a non-anthropocentric philosophy requires that we strongly identify ourselves with nature and therefore that we downplay any human/non-human distinction. An alternative view, I think more interesting and plausible, stresses the distinction between humanity and a nature valued precisely for its otherness. In this article I discuss some of its (...) main elements, and some of the difficulties involved with keeping nature's otherness in focus. Firstly (in sections 1-5), I try to clarify what I take to be the otherness-based position by distinguishing it from the apparently similar views of John Passmore, Robert Elliott and Keekok Lee, and some opposed holistic views, especially of J. Baird Callicott. Then, in the second half of the article (sections 6-7), I argue that if nature is valued in virtue of its otherness, this value is best thought of as an extrinsic, final and objective good, where 'objectivity' is a 'method of understanding', in Thomas Nagel's sense. Although I give some reasons for preferring an otherness account to certain alternative positions, I make no overall attempt to 'prove' that nature is valuable for its otherness. My aim is to show that, if it is, then this seems the best way to understand that value. (shrink)

Traditional analyses of the curve fitting problem maintain that the data do not indicate what form the fitted curve should take. Rather, this issue is said to be settled by prior probabilities, by simplicity, or by a background theory. In this paper, we describe a result due to Akaike [1973], which shows how the data can underwrite an inference concerning the curve's form based on an estimate of how predictively accurate it will be. We argue that this approach throws light (...) on the theoretical virtues of parsimoniousness, unification, and non ad hocness, on the dispute about Bayesianism, and on empiricism and scientific realism. * Both of us gratefully acknowledge support from the Graduate School at the University of Wisconsin-Madison, and NSF grant DIR-8822278 (M.F.) and NSF grant SBE-9212294 (E.S.). Special thanks go to A. W. F. Edwards.William Harper. Martin Leckey. Brian Skyrms, and especially Peter Turney for helpful comments on an earlier draft. (shrink)

Throughout the New Testament, the Gospel stories, the sayings of Jesus, and the writings of Paul not only teach a way of life that requires individuals to be moral but they demonstrate how. In biblical studies, character ethics has been one of the fastest-growing areas of interest. Whereas ethics usually studies rules of behavior, character ethics focuses on how people are formed to be moral agents in the world. Here editor Robert Brawley presents the most up-to-date academic work in New (...) Testament character ethics, covering topics throughout the Gospels and Paul, as well as focusing on the essential topics of forgiveness, reconciliation, politics, and peacemaking. In addition to Brawley, contributors are C. Clifton Black, Neil Elliott, Jens Herzer, L. Ann Jervis, Sylvia C. Keesmat, Jae Won Lee, J. Clinton McCann Jr., Elna Mouton, C. Drew Smith, Glen Stassen, Willard M. Swartley, Allen Verhey, and Jinseong Woo. (shrink)

Altruism has both an evolutionary and a psychological meaning. As the term is used in evolutionary theory, a trait is deemed altruistic if it reduces the fitness of the actor and enhances the fitness of someone else. In its psychological sense, the thesis that we have altruistic ultimate motives asserts that we care about the welfare of others, not just as a means of enhancing our own well-being, but as an end in itself. In Unto Others (hereafter UO), we consider (...) both evolutionary altruism (Part I) and psychological altruism (Part II) from an evolutionary perspective. We propose a multilevel selection theory to explain how altruism can evolve from group selection, based on Darwin’s solution to the problem. Our presentation of multilevel selection theory expands the range of topics beyond altruism in other respects as well. In Part I1 of UO, we evaluate the arguments, both conceptual and empirical, that philosophers and psychologists have advanced in an attempt to choose between psychological egoism and motivational pluralism. We conclude that these arguments are inconclusive. (shrink)

We argue elsewhere that explanatoriness is evidentially irrelevant . Let H be some hypothesis, O some observation, and E the proposition that H would explain O if H and O were true. Then O screens-off E from H: Pr = Pr. This thesis, hereafter “SOT” , is defended by appeal to a representative case. The case concerns smoking and lung cancer. McCain and Poston grant that SOT holds in cases, like our case concerning smoking and lung cancer, that involve frequency (...) data. However, McCain and Poston contend that there is a wider sense of evidential relevance—wider than the sense at play in SOT—on which explanatoriness is evidentially relevant even in cases involving frequency data. This is their main point, but they also contend that SOT does not hold in certain cases not involving frequency data. We reply to each of these points and conclude with some general remarks on screening-off as a test of evidential relevance. (shrink)

The disjunction problem and the distality problem each presents a challenge that any theory of mental content must address. Here we consider their bearing on purely probabilistic causal theories. In addition to considering these problems separately, we consider a third challenge—that a theory must solve both. We call this “the hard problem.” We consider 8 basic ppc theories along with 240 hybrids of them, and show that some can handle the disjunction problem and some can handle the distality problem, but (...) none can handle the hard problem. This is our main result. We then discuss three possible responses to that result, and argue that though the first two fail, the third has some promise. (shrink)

All extant purely probabilistic measures of explanatory power satisfy the following technical condition: if Pr(E | H1) > Pr(E | H2) and Pr(E | ∼H1) < Pr(E | ∼H2), then H1’s explanatory power with respect to E is greater than H2’s explanatory power with respect to E. We argue that any measure satisfying this condition faces three serious problems—the Problem of Temporal Shallowness, the Problem of Negative Causal Interactions, and the Problem of Nonexplanations. We further argue that many such measures (...) face a fourth problem—the Problem of Explanatory Irrelevance. (shrink)

Sober [2011] argues that some causal statements are a priori true and that a priori causal truths are central to explanations in the theory of natural selection. Lange and Rosenberg [2011] criticize Sober's argument. They concede that there are a priori causal truths, but maintain that those truths are only ‘minimally causal’. They also argue that explanations that are built around a priori causal truths are not causal explanations, properly speaking. Here we criticize both of Lange and Rosenberg's claims.

Current attention directed at ethical dimensions of data and Artificial Intelligence have led to increasing recognition of the need to secure and maintain public support for uses of people’s data. This is essential to establish a “Social Licence” for current and future practices. The notion of a “Social Licence” recognises that there can be meaningful differences between what is legally permissible and what is socially acceptable. Establishing a Social Licence entails public engagement to build relationships of trust and ensure that (...) practices align with public values. While the concept of the Social Licence is well-established in other sectors – notably in relation to extractive industries – it has only very recently begun to be discussed in relation to digital innovation and data-intensive industries. This article therefore draws on existing literature relating to the Social Licence in extractive industries to explore the potential approaches needed to establish a Social Licence for emerging data-intensive industries. Additionally, it draws on well-established literature relating to trust to examine the relevance of trust, and trustworthiness, for emerging practices in data-intensive industries. In doing so the article considers the extent to which pursuing a Social Licence might complement regulation and inform codes of practice to place ethical and social considerations at the heart of industry practice. We focus on one key industry: Financial Technology. We demonstrate the importance of combining technical and social approaches to address ethical challenges in data-intensive innovation and to establish relationships of trust to underpin a Social Licence for Financial Technology. Such approaches are needed across all areas and industries of data-intensive innovation to complement regulation and inform the development of ethical codes of practice. This is important to underpin culture change and to move beyond rhetorical commitments to develop best practice putting ethics at the heart of innovation. (shrink)

The Zhuangzi begins with Peng, a soaring bird transformed from a bounded fish, which is the first metaphor that points beyond limited standpoints to a higher point of view. The transformation is one-way and symbolizes that there is a higher viewpoint to attain which affords mental freedom and the clarity and scope of great vision. Under the alternate thesis of constant transformation, values and understandings must ceaselessly transform and collapse. All cyclical transformations must collapse into skeptical relativism and confusion. But (...) Peng does not turn back into a fish, and the awakened sage does not fall into a slumber of ignorance and confusion. It is only the thesis of a one-way transformation that leaves the sage in a state of knowledge. (shrink)

About a week after Maran Wolston was prescribed Copaxone, a drug for multiple sclerosis, she got a phone call from a nurse at an organization called Shared Solutions. The organization was familiar to Wolston; when her neurologist had asked permission to share her health information with Shared Solutions, Wolston had agreed, assuming it was connected to her health insurance.The nurse who called Wolston was checking in to see how the treatment was going. It was not going well. While Copaxone is (...) not typically associated with some of the unpleasant side effects of other MS drugs, it does have at least one serious drawback: the drug must be injected every day. The injections can be brutally painful. “No matter where I injected the drug each day, the injection site swelled up into a huge welt and felt like a gigantic bee sting,” Wolston writes. (shrink)

“Hooking up,” a popular type of sexual behavior among college students, has become a pathway to dating relationships. Based on open-ended narratives written by 273 undergraduates, we analyze how students interpreted a vignette describing a heterosexual hookup followed by a sexless first date. In contrast to the sexual script which holds that women want relationships more than sex and men care about sex more than relationships, students generally accorded women sexual agency and desire in the hookup and validated men’s post-hookup (...) relationship interest. However, in explaining the sexless date, students typically reasoned the woman was being chaste and withholding sex to redeem her reputation whereas they often characterized the man’s abstinence in terms of a pity date. The findings underscore the tenacity of gendered sexual scripts around heterosexual dates and hookups but also reveal fissures and contradictions that suggest some changes to the sexual double standard. (shrink)

A phylogeny that allows for lateral gene transfer (LGT) can be thought of as a strictly branching tree (all of whose branches are vertical) to which lateral branches have been added. Given that the goal of phylogenetics is to depict evolutionary history, we should look for the best supported phylogenetic network and not restrict ourselves to considering trees. However, the obvious extensions of popular tree-based methods such as maximum parsimony and maximum likelihood face a serious problem—if we judge networks by (...) fit to data alone, networks that have lateral branches will always fit the data at least as well as any network that restricts itself to vertical branches. This is analogous to the well-studied problem of overfitting data in the curve-fitting problem. Analogous problems often have analogous solutions and we propose to treat network inference as a case of model selection and use the Akaike Information Criterion (AIC). Strictly tree-like networks are more parsimonious than those that postulate lateral as well as vertical branches. This leads to the conclusion that we should not always infer LGT events whenever it would improve our fit-to-data, but should do so only when the improved fit is larger than the penalty for adding extra lateral branches. (shrink)

"We are omniscient but confused," says Leibniz. He also says that we live in the best of all possible worlds, yet do not causally interact. So what are we? Leibniz is known for many things, including the ideality of space and time, calculus, plans for a universal language, theodicy, and ecumenism. But he is not known for his ideas on the self and personal identity. This book shows that Leibniz offers an original, internally coherent theory of personal identity, a theory (...) that stands on its own even next to Locke's contemporaneous and more famous version. This book will appeal not only to students of Leibniz's thought but also to philosophers and psychologists interested in methodological problems in understanding or formulating theories of self and personal identity. (shrink)

In September 2006, a small start-up company in Cambridge, MA called Sermo, Inc., launched a social networking site with an unusual twist: only physicians practicing medicine in the United States would be allowed to participate. Sermo, which means “conversation” in Latin, marketed its website as an online community exclusively for doctors that would allow them to talk openly about a range of topics, from challenging and unusual medical cases to the relative merits of one treatment versus another. “Sermo enables the (...) private and instant exchange of knowledge among MDs,” the company announced in its first press release. Even better, participation was free and the site carried no advertising. (shrink)

This chapter describes how Buddhist economics can proactively contribute to the concept of conscious capitalism by importing Buddhist ethical principles to give concrete content to the aspirational idea of conscious capitalism. Conscious capitalism becomes ethically conscious capitalism with its Buddhist complement. For Buddhism, the central motivation for human behavior is deep compassion for all sentient beings. In Buddhist economics, compassion is translated into compassion for the poorest. Hunger, thirst, homelessness, lack of medical care and education are the needs of a (...) huge percentage of the human population on earth who exist in continuing poverty. The argument of this chapter is that poverty is not a cause; it is an effect. It is only by altering our economic motivations and practices that we can apply Buddhist ethics to addressing the problem of world inequality. Seeing ourselves as consumers is a key to the problem. If we identify ourselves as consumers, we cannot be thinking of others. We are thinking of what we can acquire and accumulate for ourselves. It is this primal attitude that is the source of the philosophical problems that are at the root of inequality and inequity in the world. A frequent interpretation of Buddhist economics is to counsel us to be minimalist in our consumption needs. In this chapter, it is argued that we need to focus on ourselves as ethical producers. We should focus on producing economic goods and services that better the life conditions of the global poor. Such a focus considers the consequences of our economic production of goods and services and meets the definition of practicing capitalism with mindful awareness. Such an alteration of economic motivation and action fulfills the principal ethics of Buddhism and gives concrete design and purpose to the idea of conscious capitalism. Ethically conscious Buddhist economics enables universal compassion to reach all human beings. (shrink)

I propose to elucidate and enlarge upon Professor Janusz Kuczyński’s writings on universalism via modifying the word “humanism” by adding the prefix “post” to enlarge the concept of humanism to include all present and future sentient and non-sentient life and by emphasizing the ethical thread that is the guidepost for dialogue in general and intercultural dialogue in particular. If one is to conduct a genuine dialogue, no relevant points of view should be excluded and so universalism is a necessary condition (...) for genuine dialogue that seeks the truth, and not the better of the other in argument. Indeed, this affords us a clue to Kuczyński’s subtitle of his work, Dialogue and Universalism as a New Way of Thinking. If one thinks of thinking as a search for truth, then genuine dialogue or in sensu stricto, polylogue is, to augment Kuczyński’s notion of dialogue, the only way of thinking. Debate or eristic is not thinking. It is not a search for truth. It is an attempt to defeat the other in argument. If one is to discover the truth, then that truth must be universal. (shrink)