BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

Dissecting Bioethics, edited by Tuija Takala and Matti Hayry, welcomes contributions on the conceptual and theoretical dimensions of bioethics. The department is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people’s actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are particularly appreciated. To submit a paper or to discuss (...) a suitable topic, contact Tuija Takala [email protected].:This article examines some of the assumptions and implications associated with the Belmont era context in which the concept of therapeutic misconception was forged. We argue that the justification of therapeutic misconception should be reconsidered based on less paternalistic and more participatory models of research. Finally, we identify conceptual and practical approaches that might better reflect contemporary research practice. (shrink)

Fairness of Artificial Intelligence decisions has become a big challenge for governments, companies, and societies. We offer a theoretical contribution to consider AI ethics outside of high-level and top-down approaches, based on the distinction between “reality” and “world” from Luc Boltanski. To do so, we provide a new perspective on the debate on AI fairness and show that criticism of ML unfairness is “realist”, in other words, grounded in an already instituted reality based on demographic categories produced by institutions. Second, (...) we show that the limits of “realist” fairness corrections lead to the elaboration of “radical responses” to fairness, that is, responses that radically change the format of data. Third, we show that fairness correction is shifting to a “domination regime” that absorbs criticism, and we provide some theoretical and practical avenues for further development in AI ethics. Using an ad hoc critical space stabilized by reality tests alongside the algorithm, we build a shared responsibility model which is compatible with the radical response to fairness issues. Finally, this paper shows the fundamental contribution of pragmatic sociology theories, insofar as they afford a social and political perspective on AI ethics by giving an active role to material actors such as database formats on ethical debates. In a context where data are increasingly numerous, granular, and behavioral, it is essential to renew our conception of AI ethics on algorithms in order to establish new models of responsibility for companies that take into account changes in the computing paradigm. (shrink)

Introduction: the figure of this world -- 1. The question of political ontology -- 2. The poetic experience of the world -- 3. The myth of the earth -- 4. The unbearable -- 5. The creature before the law -- 6. The animal for which animality is an issue -- 7. Understanding the happy -- 8. The picture and its captives -- 9. The passing of the figure of this world.

This book brings together some of the best minds in neurology and philosophy to discuss the concept of personal identity and the moral dimensions of treating ...

What are our human rights? What are their philosophical justifications and historical origins? Focusing on highly topical issues such as torture, arbitrary detention, privacy, and discrimination, this Very Short Introduction will help readers to understand for themselves the controversies and complexities behind this vitally relevant issue.

Biomimicry as a design concept is indeed revolutionary in its implications for human systems of production, but it is a concept in need of further philosophical elaboration and development. To this end certain philosophical principles underlying the organization of living systems generally are identified and it is argued that not only our systems of production but also our psychocultural patterns of desire need to be reorganized in accordance with these principles if we are collectively to achieve the integration into nature (...) to which biomimicry aspires. Even were this reorganization to be effected however, there is still an ethically momentous ambiguity in biomimicry that needs to be teased out before we can be assured that biomimicry will indeed produce the bioinclusive sustainability outcomes that it seems to promise. (shrink)

In this highly original work, Mathew A. Foust breaks new ground in comparative studies through his exploration of the connections between Confucianism and the American Transcendentalist and Pragmatist movements. In his examination of a broad range of philosophers, including Confucius, Mencius, Xunzi, Ralph Waldo Emerson, Henry David Thoreau, Charles Peirce, William James, and Josiah Royce, Foust traces direct lines of influence from early translations of Confucian texts and brings to light conceptual affinities that have been previously overlooked. Combining resources (...) from both traditions, Confucianism and American Philosophy offers fresh insights into contemporary problems and exemplifies the potential of cross-cultural dialogue in an increasingly pluralistic world. (shrink)

This article connects value-sensitive design to Gibson’s affordance theory: the view that we perceive in terms of the ease or difficulty with which we can negotiate space. Gibson’s ideas offer a nonsubjectivist way of grasping culturally relative values, out of which we develop a concept of political affordances, here understood as openings or closures for social action, often implicit. Political affordances are equally about environments and capacities to act in them. Capacities and hence the severity of affordances vary with age, (...) health, social status and more. This suggests settings are selectively permeable, or what postphenomenologists call multistable. Multistable settings are such that a single physical location shows up differently – as welcoming or hostile – depending on how individuals can act on it. In egregious cases, authoritarian governments redesign politically imbued spaces to psychologically cordon both them and the ideologies they represent. Selective permeability is also orchestrated according to business interests, which is symptomatic of commercial imperatives increasingly dictating what counts as moral and political goods. (shrink)

To evaluate the overall good/welfare of any action, policy or institutional choice we need some way of comparing the benefits and losses to those affected: we need to make interpersonal comparisons of the good/welfare. Yet sceptics have worried either: that such comparisons are impossible as they involve an impossible introspection across individuals, getting ‘into their minds’; that they are indeterminate as individual-level information is compatible with a range of welfare numbers; or that they are metaphysically mysterious as they assume the (...) existence either of a social mind or of absolute levels of welfare when no such things exist. This article argues that such scepticism can potentially be addressed if we view the problem of interpersonal comparisons as fundamentally an epistemic problem – that is, as a problem of forming justified beliefs about the overall good based on evidence of the individual good. (shrink)

In a world which can be increasingly described as a “society of organizations,” it is incumbent upon organizational researchers to account for the role of organizations in determining the well-being of societies and the individuals that comprise them. Workplace spirituality is a young area of inquiry with potentially strong relevance to the well-being of individuals, organizations, and societies. Previous literature has not examined ethical dilemmas related to workplace spirituality that organizations might expect based upon the co-existence of multiple ethical work (...) climates, nor has previous literature accounted for the relevance of the cosmopolitan source of moral reasoning in the ethical treatment of workplace spirituality. The purpose of this paper is to address these gaps by articulating two such ethical dilemmas related to workplace spirituality: the “quiet desperation” dilemma and the instrumentality dilemma. Moreover, I propose two theoretical contexts that foster “both-and” rather than “either-or” thinking, thereby mitigating the relationships between climate combinations and conflictual aspects of the ethical dilemmas. For the “quiet desperation” dilemma, I propose a person–organization fit perspective to emphasize diversity of individual preferences instead of a managerially prescribed uniformity of spirituality. For the instrumentality dilemma, I propose a multiparadigm approach to workplace spirituality research to avoid the privileging of one research interest over another. I conclude with suggestions for future research. (shrink)

The Wind Will Carry Us (1999) opens with a series of long takes of a car winding steadily down a road in the Iranian countryside. In other words, it opens with a sequence which, to anybody who knows Kiarostami's work, will be immediately recognizable as typical of it: Life and Nothing More (1992) returns repeatedly to such sequences, and ends with one; such sequences turn up in Through the Olive Trees (1994) and Taste of Cherry (1997); the protagonist of Where (...) is the Friend's Home? (1987) is too young to drive, but we see him from a distance meandering in a similar pattern on more than one occasion (and sequences of the same type return in Certified Copy (2010)). As with the other sequences, the opening of The .. (shrink)

Near the end of W. G. Sebald’s Austerlitz, the book’s eponymous protagonist recalls visiting the zoo of the Jardin des Plantes with his friend Marie.1 The zoo is in bad shape; the pair overhear children questioning their parents: “Mais il est où? Pourquoi il se cache? Pourquoi il ne bouge pas? Est-ce qu’il est mort?” Sebald writes:I recollect that I myself saw a family of fallow deer gathered together by a manger of hay near the perimeter fence of a dusty (...) enclosure where no grass grew, a living picture of mutual trust and harmony which also had about it an air of constant vigilance and alarm. Marie particularly asked me to take a photograph of this beautiful group, and as she did so, said Austerlitz, she said... (shrink)

This paper empirically re(dis)covers a moment of conjuncture within Leicester when an opportunity opened up through multicultural/anti-racist education for schools and colleges to develop their ‘multicultural capital’. It does this through the thematic analysis of the key proximate document Report of the Working Party on Multicultural Education as well as drawing on interview data provided by two important agents who helped to implement Leicester’s/Leicestershire’s moment of multicultural education. This moment generated a symbolic, ideational, and conceptual shift within Leicester’s education provision (...) toward a more culturally inclusive position that began to recognise the cultural capital of non-white students. However, this moment was to be lost in the ‘neoliberal epoch’. It is argued in this paper that neoliberal education policy/practice has become an enabling mechanism for renascent colonial ideology. By re(dis)covering this vision for the official recognition of non-white cultural capital, this paper demonstrates the possibilities for alternative directions within Leicester’s schools and colleges that can challenge neoliberal and colonial conceptions of education. It suggests that there are still spaces and structures that can be re(dis)covered in order for this vision to be enabled. (shrink)

ABSTRACT It has recently been argued that in Analects 17.21, Confucius advises a disciple to do something that he, Confucius, believes to be morally wrong. According to Frederick Choo, despite believing that it is morally wrong to not properly observe the three-year mourning ritual for a deceased parent, Confucius tells Zai Wo that he should do so. Choo offers two justifications for Confucius’s doing this. In this essay, I argue that the justifications Choo offers for Confucius’s advising Zai Wo to (...) do what he believes to be morally wrong are untenable. Indeed, I argue that Confucius does not, in fact, advise Zai Wo to do what he believes to be morally wrong. Instead, I argue that Confucius’s advice to Zai Wo in Analects 17.21 is best understood as an expression of exasperation and sarcasm. (shrink)

This book looks anew at the question of nature preservation as public policy. The philosophy of nature preservation has to date focused on whether arguments for nature preservation should be centred on the value of nature itself or derived human benefits. This book argues that this way of thinking about the problem of preservation has been counter-productive for environmental ethics. Instead we need to unite both views around a concern for the irreplaceability of natural objects.

The United States wastes approximately 40% of its food supply. This article will examine the implications of this waste for food insecurity and climate change. It will also explore how the law and social entrepreneurship can be used to confront this public health challenge.

As a virtue, loyalty has an ambiguous place in our thinking about moral judgments. We lauded the loyalty of firefighters who risked their lives to save others on 9/11 while condemning the loyalty of those who perpetrated the catastrophe. Responding to such uneasiness and confusion, Loyalty to Loyalty contributes to ongoing conversation about how we should respond to conflicts in loyalty in a pluralistic world. The lone philosopher to base an ethical theory on the virtue of loyalty is Josiah Royce. (...) Loyalty to Loyalty engages Royce's moral theory, revealing how loyalty, rather than being just one virtue among others, is central to living a genuinely moral and meaningful life. Mathew A. Foust shows how the theory of loyalty Royce advances can be brought to bear on issues such as the partiality/impartiality debate in ethical theory, the role of loyalty in liberatory struggle, and the ethics of whistleblowing and disaster response. (shrink)

: How we understand the world (our metaphysical premise) determines, to a large degree, how we treat it. How we treat our world constitutes our basic modality. Our basic modality colors everything we do—our entire culture takes its cue from it. Three basic modalities are here distinguished. The first is the modality of pre-materialist or traditional, religion-based societies. This is a modality of importuning, the seeking of assistance from supernatural sources. The second is the modality of materialist or modern, secular (...) societies. This is a modality of instrumentalism, involving mastery, control, and a will to re-make the world in accordance with human ends. The third is the modality of prospective post-materialist societies. These societies would be post-religious but not post-spiritual. Their modality would be one of letting the world unfold according to its own nature, and, by extension, finding creative synergies between human and nonhuman conativities. This modality of synergy is explicated by reference to the Daoist notion of wu wei. (shrink)

Three types of objections have been raised against sweatshops. According to their critics, sweatshops are (1) exploitative, (2) coercive, and (3) harmful to workers. In “The Ethical and Economic Case Against Sweatshop Labor: A Critical Assessment,” Powell and Zwolinski critique all three objections and thereby offer what is arguably the most powerful defense of sweatshops in the philosophical literature to date. This article demonstrates that, whether or not unregulated sweatshops are exploitative or coercive, they are, pace Powell and Zwolinski, harmful (...) to workers. (shrink)

This book brings together philosophers, literary theorists, and art historians to argue for the philosophical significance of Michael Fried's art history and criticism. It demonstrates that Fried's analyses of absorption and theatricality, and the accounts of modernism he develops from them, can throw new light on problems in aesthetics, and questions of authenticity, scepticism, modernity, and politics. Featuring an essay by Fried and articles from world-leading scholars, this collection contributes to current debates in aesthetics, modernism studies, literary studies, art theory, (...) and both analytic and continental philosophy. (shrink)

To meet the specific education needs of ethics committee members (primarily full-time healthcare professionals), the Regional Ethics Department of Kaiser Permanente Northern California (KPNCAL) and Washington State University’s Elson Floyd School of Medicine have partnered to create a one-academic year Medical Ethics Certificate Program. The mission-driven nature of the KPNCAL-WSU’s Certificate Program was designed to be a low-cost, high-quality option for busy full-time practitioners who may not otherwise opt to pursue additional education. This article discusses the specific competency-focused methodologies and (...) pedagogies adopted, as well as how the Certificate Program made permanent changes in response to the global pandemic. This article also discusses in detail one of the Program’s signature features, its Practicum—an extensive simulated clinical ethics consultation placing students in the role of ethics consultant, facilitating a conflict between family members played by paid professional actors. This article concludes with survey data responses from Program alumni gathered as part of a quality study. (shrink)