Introduction -- Healing justice and whole self-care -- Oppression, trauma, and healing justice -- Stress and the self-care revolution -- The whole self -- A skillful path of healing justice -- Holistic self-care practices and skills -- Connecting to the body -- Befriending the mind-heart -- Rediscovering spirit -- In the fabric of community -- Cultivating connections between person and planet -- Where the rubber meets the road -- The healing justice organization -- Healing justice on the frontlines -- Widening (...) the circle and coming home -- Notes -- Index. (shrink)

‘That's true-for-you, but not true-for-me.’ Are there any truths for which this is, indeed, true?

Consider an object or property a and the predicate F. Then a is vague if there are questions of the form: Is a F? that have no yes-or-no answers. In brief, vague properties and kinds have borderline instances and composite objects have borderline constituents. I'll use the expression "borderline cases" as a covering term for both. ;Having borderline cases is compatible with precision so long as every case is either borderline F, determinately F or determinately not F. Thus, in addition (...) to borderline cases, vagueness requires "fuzzy borders". A has fuzzy borders if there is no sharp line between a's borderline cases, a's determinate cases and a's determinate non-cases. To illustrate, loudness is vague because in a continuum of gradually increasing volume, there is no fact about where the last definite loud noise is and where the first borderline noise is. ;Actual borderline cases are not required for vagueness. Suppose actual noises are either ear-shatteringly loud or silent. Even so, loudness is vague since it could have borderline instances. Just so for objects. Suppose a table is cleanly bounded such that there is a sharp break between the table and its surroundings. Still, that table is vague since there are worlds at which it is indeterminate whether some wood molecule a is, or is not, part of that table. ;There are three views about which things can be vague. On the linguistic view, vagueness is solely a feature of expressions. On the nihilistic view, nothing is vague because vagueness is incoherent. Pitted against these views is the ontological conception of vagueness according to which borderline instances and constituents arise due to genuine indeterminacy in nature. ;My dissertation defends the ontological conception. I argue against the adequacy of the theory's rivals, disarm a damaging objection and demonstrate the causal superiority of vague events. Anyone familiar with the literature on vagueness will notice that only a subset of issues are discussed. What I offer is preliminary--I hope only to make the theory of ontological vagueness attractive enough to merit future work. (shrink)

Nicolas Malebranche is one of the most important philosophers of the seventeenth century after Descartes. A pioneer of rationalism, he was one of the first to champion and to further Cartesian ideas. Andrew Pyle places Malebranche's work in the context of Descartes and other philosophers, and also in its relation to ideas about faith and reason. He examines the entirety of Malebranche's writings, including the famous The Search After Truth, which was admired and criticized by both Leibniz and Locke. Pyle (...) presents an integrated account of Malebranche's central theses, occasionalism and 'vision in God', before exploring and assessing Malebranche's contribution to debates on physics and biology, and his views on the soul, self-knowledge, grace and the freedom of the will. This penetrating and wide-ranging study will be of interest to not only philosophers, but also to historians of science and philosophy, theologians, and students of the Enlightenment or seventeenth century thought. (shrink)

When the atomic theory was revived in the seventeenth century, the atomists faced a problem concerning the status of the laws of nature. On the face of it, the postulation of absolutely hard, rigid, and impenetrable atoms seems to entail the existence of natural necessities and impossibilities: Atoms A and B cannot interpenetrate, so atom A must push atom B when they collide. The properties of compound bodies are to be explained in terms of their “textures” (i.e., the arrangements of (...) their constituent atoms) on the famous lock-and-key model. Once again, it looks as if we have a domain of natural necessities depending on the textures of compound bodies. But the atomists seem to think of the laws of nature as radically contingent, not the sorts of things that could in principle be known a priori. This article seeks to address this tension between what the atomists seem committed to by their matter theory (real necessary connections in nature) and what they in fact say (that all the laws are contingent). In my Atomism (1995) I sought to resolve the tension by appealing to a sharp distinction between the atomists’ metaphysics and their epistemology. On this interpretation, they remain committed to natural necessity, but insist that we can never do Natural Philosophy in the “high priori” manner, by discovering real essences and their necessary connections. Our sciences of nature must remain empirical. Since publication of Atomism, however, this possible solution of the problem has come to seem more doubtful. Reflection on the work of my three “dissenting voices” (Margaret Osler, Peter Anstey and Rae Langton) has forced a radical rethink, focussing on the problematic relation between the intrinsic properties of the atoms and their (dynamic) powers. If there is no discoverable intelligible connection between what the atom is in itself (its intrinsic properties) and what it does (its powers), then my earlier solution will turn out to be untenable. (shrink)

When making decisions for adults who lack decision-making capacity and have no discernable preferences, widespread support exists for using the Best Interests Standard. This policy appeals to adults and is compatible with many important recommendations for persons facing end-of-life choices.Common objections to the policy are discussed as well as different meanings of this Standard identified, such as using it to express goals or ideals and to make practical decisions incorporating what reasonable persons would want. For reasons of consistency, fairness, and (...) compassion, this standard should be used for all incapacitated persons. (shrink)

ABSTRACT A complex problem exists about how to promote the best interests of children as a group through research while protecting the rights and welfare of individual research subjects. The Nuremberg Code forbids studies without consent, eliminating most children as subjects, and the Declaration of Helsinki disallows non-therapeutic research on non-consenting subjects. Both codes are unreasonably restrictive. Another approach is represented by the Council for the International Organizations of Medical Science, the U.S. Federal Research Guidelines, and many other national policies. (...) They allow research ethics committees or institutional review boards to authorize studies with acceptable balances of likely benefits and harms, but neither clarify how to balance them nor explain the meaning of pivotal concepts, like “minimal risk.” Paths to the improvement of balancing or consequentialist approaches include improving standardizing of risk assessment, rejecting crude utilitarianism, identifying and justifying normative or moral judg-ments, and acknowledging extra-regulatory thresholds and deontological or non-negotiable duties to children. (shrink)

Classifying research proposals by risk of harm is fundamental to the approval process and the most pivotal risk category in most regulations is that of “minimal risk.” If studies have no more than a minimal risk, for example, a nearly worldwide consensus exists that review boards may sometimes: (1) expedite review, (2) waive or modify some or all elements of informed consent, or (3) enroll vulnerable subjects including healthy children, incapacitated persons and prisoners even if studies do not hold out (...) direct benefits to them. The moral and social purposes behind this threshold are discussed along with relevant views from the National Commission, NBAC, NHRPAC, Grimes v. Kennedy Krieger Institute, The Nuremberg Code, and The WMA's Declaration of Helsinki. Representative policies from Australia, Canada, South Africa, the U.S., and CIOMS are reviewed revealing different understandings of this sorting threshold. Six of nine frequently cited interpretations of “minimal risk” are untenable. The “absolute” interpretation of the “routine examination” standard is defended as best. (shrink)

A substantial and in-depth study of the history of the atomic theory of matter between the time of Democritus and that of Newton. It is the first to emphasize the continuity of the atomic debate and the debt owed by the seventeenth-century "moderns" to the medieval critique of Aristotle.

Robert Boyle thought that his scientific achievements in pneumatics and chemistry depended on, and thus provided support for, his mechanical philosophy. In a recent article in this journal, Alan Chalmers has challenged this view. This paper consists of a reply to Chalmers on two fronts. First it tries to specify precisely what ‘the mechanical philosophy’ meant for Boyle. Then it goes on to defend, against Chalmers, the view that Boyle's science does support his natural philosophy.Keywords: Robert Boyle; Mechanical philosophy; Reductionism.

The American Journal of Bioethics, Volume 12, Issue 1, Page 32-34, January 2012.

Twitter, an online application, allows users to post microblog statements in real time. Have psychologists in leadership positions adopted Twitter? What ethical standards are navigated in doing so? Little research has examined the adoption rate of Twitter within a sample of psychologists. This article outlines a series of case vignettes depicting ethical dilemmas encountered by psychologists who adopt Twitter. Data reviewing Twitter adoption by professional psychologists who served as president within psychology advocacy organizations reveal higher adoption rates from student group (...) leaders than professional organization advocacy presidents. Implications for ethical standards and professional development are discussed. (shrink)

A dispute exists about whether bioethics should become a new discipline with its own methods, competency standards, duties, honored texts, and core curriculum. Unique expertise is a necessary condition for disciplines. Using the current literature, different views about the sort of expertise that might be unique to bioethicists are critically examined to determine if there is an expertise that might meet this requirement. Candidates include analyses of expertise based in "philosophical ethics," "casuistry," "atheoretical or situation ethics," "conventionalist relativism," "institutional guidance," (...) "regulatory guidance and compliance," "political advocacy," "functionalism," and "principlism." None succeed in identifying a unique area of expertise for successful bioethicists that could serve as a basis for making it a new discipline. Rather expertise in bioethics is rooted in many professions, disciplines and fields and best understood as a second-order discipline. (shrink)

"Applied" is a technical term describing a variety of new philosophical enterprises. The author examines and rejects the view that these fields are derivative. Whatever principles, judgments, or background theories that are employed to solve problems in these areas are either changed by how they are used, or at least the possibility exists of their being changed. Hence we ought to stop calling these endeavors "applied", or agree that the meaning of "apply" will have to include the possibility that what (...) is applied may be changed. The socalled applied fields of philosophy, therefore, are not derivative. The strongest cases to the contrary are the foundationalist views that what we apply is epistemically privileged. Different foundationalist views take different principles, judgments, or background theories to be epistemically privileged. Strong and weak versions of each of these foundationalist views are considered but none establish these fields as derivative. Keywords: applied ethics, background theories, casuistry, epistemic privilige, foundationalism, principles, reflective equilibrium CiteULike Connotea Del.icio.us What's this? (shrink)

Edmund Pellegrino and David Thomasma’s writings have had a worldwide impact on discourse about the philosophy of medicine, professionalism, bioethics, healthcare ethics, and patients’ rights. Given their works’ importance, it is surprising that commentators have ignored their admission of an unresolved and troubling dilemma and inconsistency in their theory. The purpose of this article is to identify and state what problems worried them and to consider possible solutions. It is argued that their dilemma stems from their concerns about how to (...) justify professional rules restricting colleagues from performing acts they view as direct, active, and formal killings, such as physician-assisted suicide, mercy killing, and abortion. It is further argued that their inconsistency is that they both assert and deny that professional colleagues should not use their moral or theological values to impose professional restrictions on other colleagues without adequate philosophical grounds. At risk are their arguments about the nature of an internal morality for medicine, a secular and multicultural basis for medical ethics, and a nonarbitrary way to determine what acts fall outside the ends of medicine. These are arguments they claim also apply to other healthcare professions. The article begins with a brief overview of their key positions to provide the context in which they make their admission. (shrink)

In a recent paper, Keith Hutchison has advanced the thesis that the Mechanical Philosophy represents a shift towards supernaturalism in our conception of the physical world. This paper concentrates on one of the great problems of seventeenth-century biological theory — animal generation — to illustrate (and modify) Hutchison's thesis, thereby also serving to locate one role of the life sciences in the Scientific Revolution. This choice of focus enables us to draw heavily on Jacques Roger's seminal work on animal generation (...) to illuminate the change that occurs, within the Mechanical Philosophy, between Descartes and Malebranche. Once the necessary distinctions have been drawn, it is argued, it will be seen that (in one important sense) this is a shift from naturalism to supernaturalism, brought about largely by problems native to the life sciences. (shrink)

A new analysis of the Best Interests Standard is given and applied to the controversy about testing children for untreatable, severe late-onset genetic diseases, such as Huntington's disease or Alzheimer's disease. A professional consensus recommends against such predictive testing, because it is not in children's best interest. Critics disagree. The Best Interests Standard can be a powerful way to resolve such disputes. This paper begins by analyzing its meaning into three necessary and jointly sufficient conditions showing it: is an "umbrella" (...) standard, used differently in different contexts, has objective and subjective features, is more than people's intuitions about how to rank potential benefits and risks in deciding for others but also includes evidence, established rights, duties and thresholds of acceptable care, and can have different professional, medical, moral and legal uses, as in this dispute. Using this standard, support is given for the professional consensus based on concerns about discrimination, analogies to adult choices, consistency with clinical judgments for adults, and desires to preserve of an open future for children. Support is also given for parents' legal authority to decide what genetic tests to do. (shrink)

Two incompatible policies exist for guiding medical decisions for extremely premature, sick, or terminally ill infants, the Best Interests Standard and the newer, 20-year old "Baby Doe" Rules. The background, including why there were two sets of Baby Doe Rules, and their differences with the Best Interests Standard, are illustrated. Two defenses of the Baby Doe Rules are considered and rejected. The first, held by Reagan, Koop, and others, is a "right-to-life" defense. The second, held by some leaders of the (...) American Academy of Pediatrics, is that the Baby Doe Rules are benign and misunderstood. The Baby Doe Rules should be rejected since they can thwart compassionate and individualized decision-making, undercut duties to minimize unnecessary suffering, and single out one group for treatment adults would not want for themselves. In these ways, they are inferior to the older Best Interests Standard. A "negative" analysis of the Best Interests Standard is articulated and defended for decision-making for all incompetent individuals. (shrink)

John Locke has a good claim to the title of the greatest ever English philosopher, and was a founding father of both the empiricist tradition in philosophy and the liberal tradition in politics. This new book provides an accessible introduction to Locke’s thought. Although its primary focus is on the Essay Concerning Human Understanding, it also discusses the Two Treatises on Government, the Essay on Toleration, and the Reasonableness of Christianity, and draws on materials from Locke’s correspondence and notebooks to (...) shed light on the contexts of these major works. Locke’s arguments for his central claims are subjected to close scrutiny, and his replies to his main critics evaluated. A.J. Pyle takes as his guiding theme Locke’s own maxim, that God has given humans enough knowledge for our needs. The philosopher who emerges from these pages is a strikingly modern figure, anti-metaphysical in his attitude both to science and to theology, anti-authoritarian in his politics, and cautiously optimistic about human progress. Locke is indeed one of the founding figures of the Enlightenment, but for Pyle the Lockean Enlightenment is a modest affair of slow and hesitant groping towards the light. As well as serving as an introduction to Locke for students, the book also helps to correct a number of significant errors and misunderstandings that have marred our understanding of Locke and will spark discussion and debate amongst scholars of his work. (shrink)

In Grimes v. Kennedy Krieger Institute, the Maryland Court of Appeals considered whether it is possible for investigators or research entities to have a special relationship with subjects, thereby creating a duty of care that could, if breached, give rise to an action in negligence. The research under review, the Lead Abatement and Repair & Maintenance Study, was conducted from 1993 to 1996 by investigators at the Kennedy Krieger Institute, an affiliate of Johns Hopkins University.After briefly discussing the case at (...) the center of this ruling, I consider how ambiguities within the federal research regulations at 45 C.F.R. § 46 contribute to disagreements among reasonable and informed people of good will about what studies should be approved. I argue that Grimes may be understood as placing restrictions on how these regulations may be interpreted and used. (shrink)

Many pediatric research regulations, including those of the United States, the Council for International Organizations of Medical Science, and South Africa, offer similar rules for review board approval of higher hazard studies holding out no therapeutic or direct benefit to children with disorders or conditions. Authorization requires gaining parental permissions and the children’s assent, if that is possible, and showing that these studies are intended to gain vitally important and generalizable information about children’s conditions; it also requires limiting the risks (...) of harm to no more than a “minor increase over minimal risk” and showing the study is commensurable with the children’s experiences. For convenience, these investigations will be called “no benefit, higher hazard” studies.Despite the existence of these policies for decades, studies show that review boards’ judgments vary about what “no benefit, higher hazard” studies should be approved. (shrink)

ABSTRACT The Universal Draft Declaration on Bioethics and Human Rights seeks to provide moral direction to nations and their citizens on a series of bioethical concerns. In articulating principles, it ranks respect for human rights, human dignity and fundamental freedoms ahead of respect for cultural diversity and pluralism. This ranking is controversial because it entails the rejection of the popular theory, conventionalist ethical relativism. If consistently defended, this theory also undercuts other United Nations activities that assume member states and people (...) around the world can reach trans‐cultural judgments having moral authority about health, pollution, aggression, rights, slavery, and so on. To illustrate problems with conventionalist ethical relativism and the importance of rejecting it for reasons of health, human rights, human dignity and fundamental freedoms, the widespread practice of female genital circumcision or cutting is discussed. These surgeries are virtually a test case for conventionalist ethical relativism since they are widely supported within these cultures as religious and health practices and widely condemned outside them, including by the United Nations. (shrink)

Bioethics and humanities (inclusive of medical ethics, health care ethics, environmental ethics, research ethics, philosophy and medicine, literature and medicine, and so on) seems like one field; yet colleagues come from different academic disciplines with distinct languages, methods, traditions, core curriculum and competency examinations. The author marks six related "framework" features that unite and make it one distinct field. It is a commitment to (1) work systematically on some of the momentous and well-defined sets of problems about the human condition (...) that drive our field (such as death and dying, disability, confidentiality, professionalism, informed consent, abortion, euthanasia, assisted suicide, personhood, health-care resource allocation and environmental ethics, as well as the impact of new technologies, including genetic and reproductive); (2) use interdisciplinary approaches to unravel them; (3) employ cases and practical reasoning to understand problems and solve answers; (4) apply teaching methods and goals associated with John Dewey to make students better problem-solvers; (5) find morally justifiable solutions to the problems driving our field; and (6) seek interdisciplinary and collaborative scholarship, service or teaching. (shrink)