The Case Study Method of Instruction (CSMI) is an excellent vehicle for achieving many instructional goals, including employing critical thinking to facilitate learning. The best results occur when instructors have a clear understanding of the CSMI and critical thinking. In this article, the author describes the evolution of the CSMI, its notable characteristics, and its instructional benefits. The author also presents five detailed definitions of critical thinking, and explains how case studies can be used to lead students to think critically (...) and subsequently learn. (shrink)

While many have suggested that to withdraw medical interventions is ethically equivalent to withholding them, the moral complexity of actually withdrawing life supportive interventions from a patient cannot be ignored. Utilizing interplay between expository and narrative styles, and drawing upon our experiences with patients, families, nurses, and physicians when life supports have been withdrawn, we explore the changeable character of boundaries in end-of-life situations. We consider ways in which boundaries imply differences – for example, between cognition and performance – and (...) how the encounter with boundaries can generate altered meanings important for understanding decisions and actions in these contexts. We conclude that the reliance on mere roles to support the moral weight of withdrawing medical interventions is inadequate. Roles that lead us to such moments are exceeded by the responsibility encountered in such moments. And here, we suggest, is the momentous character of withdrawal: it presents the grave astonishment, the trembling awe, in the not-being-there of the other in death. (shrink)

This study explores the ways in which adolescents, even so-called “mature minors”, lack adequate development of the intellectual, affective, and emotional capacities necessary morally to consent to medical research on their own behalf. The psychological and neurophysiological data regarding brain maturation supports the conclusion that adolescents are qualitatively different types of agents than mature adults. They lack full adult maturity and personal agency. As a result, in addition to the usual requirements for IRB approval, one or both parents, or a (...) legal guardian, should provide informed consent for minor children to participate in medical research. (shrink)

Brain transplants have long been no more than the subject of science fiction and engaging thought experiments. That is no longer true. Neuroscientists have announced their intention to transplant the head of a volunteer onto a donated body. Response has been decidedly mixed. How should we think about the moral permissibility of head transplants? Is it a life-saving/life-enhancing opportunity that appropriately expands the boundaries of medical practice? Or, is it a bioethical morass that ought not to be attempted? For the (...) purposes of this paper, I set aside questions regarding the surgical operation’s technological plausibility so as to focus on very basic questions regarding personal identity and the morality of head transplantation. The analysis begins with an exploration of the embodiment of persons. It considers whether persons can be conceptually distinguished from all parts of their body, even if they cannot be physically separated from some parts without loss of personhood. It argues that in most cases replacing body parts with reasonably similar parts will not destroy the conditions for sustaining personhood. However, as I explore, the phenomenology of personhood is such that some physical changes may prove to be too significant to maintain personal identity successfully over time. Given such complexity and the significance of the costs involved, the moral permissibility of head transplantation likely depends on recognizing that persons may give permission to collaborate in common activities, including projects with which others deeply disagree, provided that they only utilize the services and resources of free and consenting others. (shrink)

Mark J. Cherry; Searching for the Truly Human: Standing at the Precipice of a Post-Christian Age, Christian bioethics: Non-Ecumenical Studies in Medical Moralit.

Dubourg and Baumard's paper takes a different, and fruitful, approach to the study of imaginary worlds than what is usually found in Media Studies, but omits certain circumstances and influences that shaped their history; this article argues that psychological or behavioral factors are not enough to explain the growth of imaginary worlds, even as they may be important influences.

Bioethics functions within a world of deep moral pluralism; a universe of discourse debating ethical analysis, public policy, and clinical practice in which a common, generally accepted morality does not exist. While religious thinkers are often approached within a hermeneutic of suspicion for assuming moral standards that cannot be justified in rational terms, secular bioethicists routinely find themselves in exactly the same intellectual predicament. That ethical theory, proposed values, or normative content is secular, that it does not invoke God or (...) any particular religious perspective, does not mean that it is rationally grounded, necessarily true, or universally binding. As the authors in this issue of The Journal of Medicine and Philosophy make clear, this normative reality directly impacts debates regarding concepts of health, illness, and disease, accounts of socially acceptable health-risky behaviors, and the political frameworks that shape public policy. As a result, honest discussion of diverse moral, religious, and political perspectives remains essential in clarifying the intellectual challenges, ethical intuitions, and ideological judgments that shape clinical practice and healthcare policy. Depending on which moral, political, or scientific concepts are guiding bioethical analysis, careful scrutiny will tend to support rather different policies and practices, each of which is likely to be worth careful consideration. (shrink)

We investigate differences between a simple Dominance Principle applied to sums of fair prices for variables and dominance applied to sums of forecasts for variables scored by proper scoring rules. In particular, we consider differences when fair prices and forecasts correspond to finitely additive expectations and dominance is applied with infinitely many prices and/or forecasts.

Power tends to corrupt and absolute power corrupts absolutely. To be clear, I do not think that blood transfusions necessarily...

The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: What are the direct and indirect health care costs and benefits of such a voucher system in human organs? Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? Do vouchers contribute to the inappropriate commodification (...) of human body parts? Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges, would save more lives and further reduce human suffering. (shrink)

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical (...) students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless. (shrink)

It has long been known that the practice of testing all hypotheses at the same level , regardless of the distribution of the data, is not consistent with Bayesian expected utility maximization. According to de Finetti’s “Dutch Book” argument, procedures that are not consistent with expected utility maximization are incoherent and they lead to gambles that are sure to lose no matter what happens. In this paper, we use a method to measure the rate at which incoherent procedures are sure (...) to lose, so that we can distinguish slightly incoherent procedures from grossly incoherent ones. We present an analysis of testing a simple hypothesis against a simple alternative as a case‐study of how the method can work. (shrink)

The Abolition of Man, C. S. Lewis's masterpiece in ethics and the philosophy of science,warns of the danger of combining modern moral skepticism with the technological pursuit of human desires. The end result is the final destruction of human nature. From Brave New World to Star Trek, from Steampunk to starships, science fiction film has considered from nearly every conceivable angle the same nexus of morality, technology, and humanity of which C. S. Lewis wrote. As a result,science fiction film has (...) unintentionally given us stunning depictions of Lewis's terrifying vision of the future. In Science Fiction and the Abolition of Man: Finding C. S. Lewis in Sci-Fi Film and Television, scholars of religion, philosophy, literature, and film explore the connections between sci-fi film and the three parts of Lewis's book:how sci-fi portrays "Men Without Chests" incapable of responding properly to moral good, how it teaches the Tao or "The Way," and how it portrays "The Abolition of Man.". (shrink)

Review article on Philipp Höfele's book "Wollen und Lassen: Zur Ausdifferenzierung, Kritik und Rezeption des Willensparadigmas in der Philosophie Schellings" (Freiburg: Alber, 2019). The book demonstrates why Schelling is not an uncritical predecessor of Nietzsche and the will to power, as Heidegger alleges. Instead, Schelling displays an ambivalent attitude toward willing—affirming it in some forms, critiquing or rejecting it in others. Above all, Schelling’s thought on the will has many layers of complexity: it includes not only a variety of forms (...) of willing, but also “fringe phenomena” like non-willing or Gelassenheit that are ordinarily placed in opposition to will. Moreover, Schelling’s philosophy of will is distinctive in not conceiving willing and letting-be as either-or alternatives, as Heidegger tends to do. Especially in the late lectures, Schelling brings them together, showing how non-voluntary phenomena like Gelassenheit make an authentic willing possible. (shrink)

In the Freedom Essay, Schelling provides four different accounts of the copula, two of which are largely implicit. In this paper, I focus on the first of these accounts, which I call the "mediated account." I argue that this explanation of the copula articulates a fundamental ontological structure in Schelling's philosophy. In the first half of the paper, I analyze the structural features of the account, drawing on Schelling's more extensive treatment in the Ages of the World. In the second (...) half of the paper, I argue that Schelling's fundamental distinction between that-which-exists and the ground of existence exhibits the same structure as the mediated account of the copula. This has implications for understanding the enigmatic relationship of these two principles to the Ungrund. I conclude by briefly suggesting other applications of this fundamental structure in Schelling's philosophy. (shrink)

Jerry Fodor is one of the most important philosophers of mind in recent decades. He has done much to set the agenda in this field and has had a significant influence on the development of cognitive science. Fodor's project is that of constructing a physicalist vindication of folk psychology and so paving the way for the development of a scientifically respectable intentional psychology. The centrepiece of his engagement in this project is a theory of the cognitive mind, namely, the computational (...) theory of mind, which postulates the existence of a language of thought. Fodor: Language, Mind and Philosophy is a comprehensive study of Fodor's writings. Individual chapters are devoted to each of the major issues raised by his work and contain extensive discussion of his relationships to key developments in cognitive science and to the views of such philosophical luminaries as Dennett, Davidson and Searle. (shrink)

The question I investigate concerns the ethics of clinical ethics consultation. To begin, I reconstruct and critically assess a widespread understanding of clinical medical ethics, one most prominently advanced by Mark Siegler. That examination reveals an overtly political strategy designed to reinforce physician authority. Next, John La Puma's work is discussed. Arguably the most prominent of Siegler's students, and certainly the most prolific, La Puma appears attentive to the problems in Siegler's view regarding clinical judgment. I conclude, however, that (...) La Puma assumes a relatively flexible system of formal rules and more extensive informal codes which define the concepts and procedures of medical consultation and which he simply transcribes for ethics consultation. ;Albert Jonsen and Stephen Toulmin have apparently endorsed this medicalized strategy. They contend that the view of ethics advocated by these physicians represents a "new" casuistry consistent if not identical to their own theory. I show that the casuist method of clinical ethical decision making simply appropriates features of the diagnostic apparatus embedded in the political economy of the enterprise of medicine and makes the role of ethicist parasitic on that of the physician as expert. Their casuistry, I argue, merely serves as a means to reinforce the standardized apparatus of professional authority exercised in medical procedures and concepts. ;Finally, I sketch an alternative way to think about how experience with other persons informs ethical decision making. On the basis of an extensive and nuanced account of an ethics consultation, I argue that to consult as a clinical philosopher in any situation is, necessarily, to be focused on that individual situation for its own sake. Clinical philosophy, as a result, must be done by attending strictly to what appears as it appears: the issues, concerns, and questions expressed, in their own terms, by those individuals whose situation it is. (shrink)

Mark J. Cherry; The Body for Charity, Profit and Holiness: Commerce in Human Body Parts, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume.

In this essay, I give an analysis of the account of non-being in the Weltalter, focusing on the ways in which this account reflects Schelling’s new ontology of revelation. I begin by discussing the connection between non-being and the fundamental distinction between the principles in God. I then turn to the relationship of non-being to being in the Weltalter and show how a new meaning of being allows Schelling to distinguish non-being from nothing. The new meaning of being also makes (...) possible a distinction between essential non-being and de facto non-being; this distinction allows for the temporal sequence of revelation and the possibility of evil. I conclude by showing the implications of Schelling’s theory of non-being for his understanding of creation. (shrink)

Stereological techniques allow biologists to create quantitative, three-dimensional descriptions of biological structures from two- dimensional images of tissue viewed under the microscope. For example, they can accurately estimate the size of a particular organelle, the total length of a mass of capillaries, or the number of neurons or synapses in a particular region of the brain. This book provides a practical guide to designing and critically evaluating stereological studies of the nervous system and other tissues. It explains the basic concepts (...) behind design-based stereology and how to get started. Also included are detailed descriptions of how to prepare tissue appropriately, perform pilot studies and decide on the appropriate sampling strategy, and account for phenomena such as tissue shrinkage. Numerous examples of applications of stereological methods that are applicable to studies of the central system and a wide variety of other tissues are explained. The book is therefore essential reading for neurobiologists and cell biologists interested in generating accurate representations of cell and tissue architecture. (shrink)

At first glance, Schopenhauer’s account of human freedom looks strikingly similar to Schelling’s account of formal freedom in the Freiheitsschrift. Despite the clear similarities, I argue that there is a decisive difference between the two accounts—a difference that has to do with the ultimate grounding of freedom. For Schelling, the intelligible deed is a radical self-grounding of the eternal essence of the human being. For Schopenhauer, the eternal essence of the human being is groundless. Moreover, I argue that this difference (...) has decisive consequences for two sets of issues. On the one hand, Schelling’s concept of self-grounding allows him to preserve the universal application of the principle of ground. On the other hand, self-grounding is the only way that human beings can be responsible for who they are. Schelling thus anticipates a key insight of Galen Strawson: ultimate moral responsibility is only possible for a causa sui. (shrink)

Several axiom systems for preference among acts lead to a unique probability and a state-independent utility such that acts are ranked according to their expected utilities. These axioms have been used as a foundation for Bayesian decision theory and subjective probability calculus. In this article we note that the uniqueness of the probability is relative to the choice of whatcounts as a constant outcome. Although it is sometimes clear what should be considered constant, in many cases there are several possible (...) choices. Each choice can lead to a different "unique" probability and utility. By focusing attention on statedependent utilities, we determine conditions under which a truly unique probability and utility can be determined from an agent's expressed preferences among acts. Suppose that an agent's preference can be represented in terms of a probability P and a utility U.That is, the agent prefers one act to another iff the expected utility of that act is higher than that of the other. There are many other equivalent representations in terms of probabilities Q, which are mutually absolutely continuous with P, and state-dependent utilities V, which differ from U by possibly different positive affine transformations in each state of nature. We describe an example in which there are two different but equivalent state-independent utility representations for the same preference structure. They differ in which acts count as constants. The acts involve receiving different amounts of one or the other of two currencies, and the states are different exchange rates between the currencies. It is easy to see how it would not be possible for constant amounts of both currencies to have simultaneously constant values across the differentstates. Savage (1954, sec. 5.5) discovered a situation in which two seemingly equivalent preference structures are represented by different pairs of probability and utility. He attributed the phenomenon to the construction of a "small world." We show that the small world problem is just another example of two different, but equivalent, representations treating different actsas constants. Finally, we prove a theorem (similar to one of Karni 1985) that shows how to elicit a unique state-dependent utility and does not assume that there are prizes with constant value. To do this, we define a new hypothetical kind of act in which both the prize to be awarded and the state of nature are determined by an auxiliary experiment. (shrink)

With rare exception, Roman Catholic moral theologians condemn the sale of human organs for transplantation. Yet, such criticism, while rhetorically powerful, often over-simplifies complex issues. Arguments for the prohibition of a market in human organs may, therefore, depend on a single premise, or a cluster of dubious and allied premises, which when examined cannot hold. In what follows, I will examine the ways in which such arguments are configured. For example, Thomas Aquinas’(1224-1274) understandings of embodiment and moral uses of the (...) body are usually interpreted as, and cited in support of, foreclosing a market in human organs. Aquinas’ principle of totality requires that one preserve the wholeness of the human body. In approaching Aquinas’ texts, I will assume the role of a revisionist who takes seriously his core commitments, while at the same time indicating that one can further develop his understanding of the body in ways which are supportive of the sale of human organs while remaining in conformity with the author's core concerns. Such considerations will provide significant grounds for concluding that a market in human organs for transplantation appreciates the embodied nature of the human person, respects the body and its parts as personal, rather than as mere things, is consistent with acknowledging God’s dominion over our lives and bodies, and constitutes an appropriate utilization of God's gifts to us. Moreover, such a market would likely create significant opportunities charitably to help others, to enhance human dignity and to protect against the serious dehumanization of current national bureaucratic procedures for organ donation. (shrink)

The success of the early music movement has long raised questions about performing historical works: Should musicians perform on period instruments and try to reconstruct the original style? If a historically “authentic” performance is impossible or undesirable, what should be the goal of the early music movement? I turn to Gadamer to answer these questions by constructing the outlines of a hermeneutics of early music performance. In the first half of the paper, I examine Gadamer’s critique of historical reconstruction and (...) argue that this critique sheds light on mistaken tendencies and misunderstandings within the early music movement, but it does not discredit the movement as such. In the second half of the paper, I attempt to show how Gadamer’s dialogical account of historical consciousness provides a framework for understanding what historically informed performance is seeking to accomplish, as well as its advantage over a Nietzschean approach. (shrink)

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

The most important philosophy course that contemporary undergraduates may take is ethics. Concerned with how to live a human life, ethics becomes ever more urgent as life unfolds. As the teacher, a philosopher likely wonders about the interaction in the classroom. This paper explores that interaction. Taking a cue from Aristotle, it is argued that the teaching of ethics is an invitation to self-reflection and self-responsibility, more so than a passing on of a set of ethical principles or laws.

The day-to-day work of clinical ethics consultants and healthcare ethics committees can easily become overly routine. Too much routine, however, comes with a risk that morally important practices will be reduced to mere bureaucratic formalities, while practitioners become desensitized to ethically significant distinctions between cases. Clinical ethics consultation and organizational ethics must be set within the broader social and cultural context of the healthcare environment. This practice requires looking beyond mere legal compliance and the routinely false assumption that there are (...) unambiguous ethical norms that easily govern clinical ethics and hospital policy formation. Together the essays in this issue of HEC Forum challenge readers to rethink taken-for-granted assumptions regarding patient care, physician obligation, clinical ethics consultation, and organizational ethics. (shrink)

The scope of this book is to revisit the ancient Aristotelian and Plotinian philosophical and metaphysical problem of dualism and monism with respect to the first principle. Essentially, it defends Aristotle’s position of the primacy of an intelligible first principle over the Plotinian philosophical move to affirm a principle above Intellect.

In the “Principles of the Civil Code,” Jeremy Bentham identifies four “principles subsidiary to utility”: subsistence, abundance, equality, and security. Whereas these subsidiary principles form part of the bedrock of classical liberalism, in this essay I show that in the hands of his friend and disciple William Thompson, they are transformed into the foundations for socialism. Where Bentham prioritizes security over equality, and security of property takes a preeminent role, Thompson shows that the system of individual competition and private property—his (...) way of describing capitalism—is best characterized by the “inequality of security.” Based on the labor theory of property, Thompson argues that the system that assigns ownership to the providers of capital violates the workers’ security—the right to have the full produce of their labor secured to them. Thompson then reconciles security and equality, understanding them as mutually constitutive instead of in conflict. From his work... (shrink)

This paper suggests several summa genera for the various meanings of intentio in Aquinas and briefly outlines the genera of cognitive intentiones. It presents the referential and existential nature of intentions of harm or usefulness as distinguished from external sensory or imaginary forms in light of Avicenna’s threefold sensory abstraction. The paper offers a terminological clarification regarding the quasi-immaterial existential status of intentions. Internal sensory intentions account for a way in which one perceives something, as is best seen in light (...) of the distinction between formal and material objects. Against the imagist account of intentions that denies the memorative power an immanent object, it shows that the memorative’s proper and immediate object is the intention of the past, while its extrinsic mediate object is the imaginary phantasm. (shrink)

The biotechnology industry's intellectual property claims contribute to a subtle but not insignificant encroachment of commodification within health care. Drawing on the conceptual framework of Margaret Jane Radin, I argue that patent claims on human biological materials may commodify that with which our personhood and individuality is intertwined but that such commodification is broad and incomplete. Patents on nonhuman biological organisms contribute to a more materialistic understanding of them but do not significantly change our relationship to them. The systemic effects (...) of biotechnology's commodification within health care are various and may compromise the goal of good health. The morally problematic aspects of patent claims entail certain obligations to inhibit commodification from becoming more egregious, but on balance, those aspects are currently insufficient to justify denying the benefits the patent system promotes. (shrink)

This article reports findings of a survey of college students in 3 educational settings regarding student perceptions of mass media ethics pedagogy, including course objectives, value systems examined, the use of civil law and/or ethics codes as standards of media ethics, and teaching techniques used in media ethics instruction. Of particular interest was how closely student expectations correlate with previous research findings indicating instructor techniques and goals. The results revealed several areas in which instructor goals and the student rankings were (...) not in accordance, including marked discrepancies between professor and student views on ethical standards employed, values systems examined, and teaching techniques preferred. The study concluded that most students would respond well to a stand-alone media ethics course employing a variety of teaching methods. Respondents felt the course should not emphasize universal ethics, but should respect pluralistic principles and examine various cultural interpretations of media ethics. (shrink)

The degree of incoherence, when previsions are not made in accordance with a probability measure, is measured by either of two rates at which an incoherent bookie can be made a sure loser. Each bet is considered as an investment from the points of view of both the bookie and a gambler who takes the bet. From each viewpoint, we define an amount invested (or escrowed) for each bet, and the sure loss of incoherent previsions is divided by the escrow (...) to determine the rate of incoherence. Potential applications include the treatment of arbitrage opportunities in financial markets and the degree of incoherence of classical statistical procedures. We illustrate the latter with the example of hypothesis testing at a fixed size. (shrink)