Following up on a 1989 paper on the subject, this essay revisits the question of ethical expertise in the court room. Informed by recent developments in the use of ethics experts, the authors argue 1) that the adversarial nature of court proceedings challenges the integrity of the ethicist's pedagogical role; 2) that the use of ethics experts as normative authorities remains dubious; 3) that clarification of the State's interest in “protecting the ethical integrity of the medical profession” is urgently required; (...) and 4) that the expertise of the ethicist may be more appropriately used in advising the legislature than in influencing the court. (shrink)

Background: Despite the expansion of ethics consultation services, questions remain about the aims of clinical ethics consultation, its methods and the expertise of those who provide such services.Objective: To describe physicians’ expectations regarding the training and skills necessary for ethics consultants to contribute effectively to the care of patients in intensive care unit .Design: Mailed survey.Participants: Physicians responsible for the care of at least 10 patients in ICU over a 6-month period at a 921-bed private teaching hospital with an established (...) ethics consultation service. 69 of 92 eligible physicians responded.Measurements: Importance of specialised knowledge and skills for ethics consultants contributing to the care of patients in ICU; need for advanced disciplinary training; expectations regarding formal-training programmes for ethics consultants.Results: Expertise in ethics was described most often as important for ethics consultants taking part in the care of patients in ICU, compared with expertise in law , religious traditions , medicine and conflict-mediation techniques . When asked about the formal training consultants should possess, however, physicians involved in the care of patients in ICU most often identified advanced medical training as important.Conclusions: Although many physicians caring for patients in ICU believe ethics consultants must possess non-medical expertise in ethics and law if they are to contribute effectively to patient care, these physicians place a very high value on medical training as well, suggesting a “medicine plus one” view of the training of an ideal ethics consultant. As ethics consultation services expand, clear expectations regarding the training of ethics consultants should be established. (shrink)

Recent work in political philosophy and the history of ideas presents Spinoza and Hegel as the most powerful living alternatives to mainstream Enlightenment thought. Yet, for many philosophers and political theorists today, one must choose between Hegel or Spinoza. As Deleuze's influential interpretation maintains, Hegel exemplifies and promotes the modern "cults of death," while Spinoza embodies an irrepressible "appetite for living." Hegel is the figure of negation, while Spinoza is the thinker of "pure affirmation". Yet, between Hegel and Spinoza there (...) is not only opposition. This collection of essays seeks to find the suppressed kinship between Hegel and Spinoza. Both philosophers offer vigorous and profound alternatives to the methodological individualism of classical liberalism. Likewise, they sketch portraits of reason that are context-responsive and emotionally contoured, offering an especially rich appreciation of our embodied and historical existence. The authors of this collection carefully lay the groundwork for a complex and delicate alliance between these two great iconoclasts, both within and against the Enlightenment tradition. (shrink)

Alongside concerns for animal welfare, concerns for land, water, and climate are undermining established food identities in many parts of the world. In Aotearoa New Zealand, agrifood relations are bound tightly into national identities and the materialities of export dependence on dairying and agriculture more widely. Dairy/ing identities have been central to national development projects and the politics that underpin them for much of New Zealand’s history. They are central to an intransigent agrifood political ontology. For the last decade, however, (...) they have been challenged by the identity politics of ethical food consumption. This paper explores the ensuing contests and asks how they are reshaping agrifood identities. We draw on interviews with 15 participants in Aotearoa New Zealand who have made dietary transitions that reduce or exclude dairy products. Our aim is not to identify a new post-dairying identity or claim a reconfigured national identity, but to examine the collision of production-consumption values in the context of a dominant place-based food identity. We ask how participants navigate contradictory commitments to becoming ‘good environmental citizens’ whilst remaining ‘good national citizens’. The paper offers insights for examining similar struggles elsewhere and the potential to shift agrifood relations and undermine entrenched political ontologies through ethical food consumption values. (shrink)

Empirical bioethics research has become an established field of study, with its own unique goals, vocabulary, and methods, and wi...

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

Good listening is an essential element in the provision of quality healthcare (Attree 2001). Good listening also supports accurate diagnosis, patient adherence to medical recommendations, and stron...

Hastings Center Report, Volume 52, Issue 1, Page 51-58, January/February 2022.

This book brings together scholars from a variety of epistemological perspectives to explore the multiple ways in which sexuality does indeed matter in the arena of public education.

Carol Gilligan has identified two orientations to moral understanding; the dominant justice orientation and the under-valued care orientation. Based on her discernment of a voice of care, Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the (...) liberal ideal. My analysis of justice -oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others. (shrink)

Engaging citizens with digital technology to co-create data, information and knowledge has widely become an important strategy for informing the policy response to COVID-19 and the ‘infodemic’ of misinformation in cyberspace. This move towards digital citizen participation aligns well with the United Nations’ agenda to encourage the use of digital tools to enable data-driven, direct democracy. From data capture to information generation, and knowledge co-creation, every stage of the data lifecycle bears important considerations to inform policy and practice. Drawing on (...) evidence of participatory policy and practice during COVID-19, we outline a framework for citizen ‘e-participation’ in knowledge co-creation across every stage of the policy cycle. We explore how coupling the generation of information with that of social capital can provide opportunities to collectively build trust in institutions, accelerate recovery and facilitate the ‘e-society’. We outline the key aspects of realising this vision of data-driven direct democracy by discussing several examples. Sustaining participatory knowledge co-creation beyond COVID-19 requires that local organisations and institutions incorporate adaptive learning mechanisms into their operational and governance structures, their integrated service models, as well as employing emerging social innovations. (shrink)

Just as it is impossible to understand the American religious landscape without some familiarity with evangelicalism, one cannot grasp the shape of contemporary Christian ethics without knowing the contributions of evangelical Protestants. This newest addition to the Library of Theological Ethics series begins by examining the core dynamic with which all evangelical ethics grapples: belief in an authoritative, inspired, and unchanging biblical text on the one hand, and engagement with a rapidly evolving and increasingly post-Christian culture on the other. It (...) explores the different roles that scholars and popular figures have played in forming evangelicals' understandings of Christian ethics. And it draws together the contributions of both senior and emerging figures in painting a portrait of this diverse, vibrant, and challenging theological and ethical tradition. This book represents the breadth of evangelical ethical voices, demonstrating that evangelical ethics involves nuance and theological insight that far transcend any political agenda. Contributors include David P. Gushee, Carl F. H. Henry, Jennifer McBride, Stephen Charles Mott, William E. Pannell, John Perkins, Soong-Chan Rah, Gabriel Salguero, Francis Schaeffer, Ron Sider, Helene Slessarev-Jamir, Glen H. Stassen, Eldin Villafañe, Allen Verhey, Jim Wallis, Nicholas Wolterstorff, and John Howard Yoder. The Library of Theological Ethics series focuses on what it means to think theologically and ethically. It presents a selection of important, and otherwise unavailable, texts—English-language texts and translations that have fallen out of print, new translations, and collections of significant statements about problems and themes of special importance—in an easily accessible form. This series enables sustained dialogue on new and classic works in the field. (shrink)

The lines come from the messenger's speech describing the attack of the Delphians on Neoptolemus, a passage which I have discussed elsewhere in connexion with the tradition of Neoptolemus as inventor of the armed Pyrrhic dance. LSJ seem to be in several minds about the meaning and connexion of some of the words describing the missiles used by the Delphians. S.v. ‘σφαγεύς’, they give ‘sacrificial knife, spit’ uniquely of a word elsewhere meaning ‘slayer, murderer’, etc.. S.v. ‘βουπόρος’, they cite ἀμφωβόλοι (...) σφαγῆς … βουπόροι ‘spitst fit to pierce an ox's throat’—i.e. taking σφαγῆς as gen. sing., rather oddly dependent on βουπόροι. S.v. ‘ἔκλυτος’, they quote this passage, again uniquely, in the sense ‘easy to let go, light, buoyant, of missiles’. This last seems even less likely than Wecklein's ohne Riemen or the Budé's doubles dards sans poignée, which presumably invoke a rather frigid contrast of the true javelins fitted with thongs and the spits, sharp at both ends, which were pressed into service of a similar sort, but of course had to be thrown without this attachment: but these implements could hardly be described as ἔκλυτοι of thongs which they never had at all in the first place!With Murray's punctuation, since a combination of a, b, c τε, d is scarcely credible, σφαγῆς βουπόροι is presumably not to be taken as the description of a separate type of weapon, but as an explanatory appositional phrase with ἀμφώβολοι. This interpretation is found in the schol, ὀβελίσκοι σφάττειν δυνάμενοι and followed by Hermann and Paley. (shrink)

Oncogenic hyperplasia is the first and inevitable stage of formation of a (solid) tumor. This stage is also the core of many other proliferative diseases. The present work proposes the first minimal model that combines homeorhesis with oncogenic hyperplasia where the latter is regarded as a genotoxically activated homeorhetic dysfunction. This dysfunction is specified as the transitions of the fluid of cells from a fluid, homeorhetic state to a solid, hyperplastic-tumor state, and back. The key part of the model is (...) a nonlinear reaction-diffusion equation (RDE) where the biochemical-reaction rate is generalized to the one in the well-known Schlögl physical theory of the non-equilibrium phase transitions. A rigorous analysis of the stability and qualitative aspects of the model, where possible, are presented in detail. This is related to the spatially homogeneous case, i.e. when the above RDE is reduced to a nonlinear ordinary differential equation. The mentioned genotoxic activation is treated as a prevention of the quiescent G0-stage of the cell cycle implemented with the threshold mechanism that employs the critical concentration of the cellular fluid and the nonquiescent-cell-duplication time. The continuous tumor morphogeny is described by a time-space-dependent cellular-fluid concentration. There are no sharp boundaries (i.e. no concentration jumps exist) between the domains of the homeorhesis- and tumor-cell populations. No presumption on the shape of a tumor is used. To estimate a tumor in specific quantities, the model provides the time-dependent tumor locus, volume, and boundary that also points out the tumor shape and size. The above features are indispensable in the quantitative development of antiproliferative drugs or therapies and strategies to prevent oncogenic hyperplasia in cancer and other proliferative diseases. The work proposes an analytical-numerical method for solving the aforementioned RDE. A few topics for future research are suggested. (shrink)

Chefs have been recognized as potentially important partners in efforts to promote local food systems. Drawing on the diffusion of innovation framework we (a) examine the characteristics of chefs and restaurants that have adopted local foods; (b) identified local food attributes valued by restaurants; (c) examine how restaurants function as opinion leaders promoting local foods; (d) explored network linkages between culinary and production organizations; and (e) finally, we consider some of the barriers to more widespread adoption of local foods in (...) the culinary community. Analyzing quantitative and qualitative data collected from interviews with individuals from 71 restaurants, we compare and contrast restaurants that utilize relatively large amounts of locally-produced ingredients with restaurants using few, if any, local products. Results reveal that chefs are most interested in intrinsic food qualities, such as taste and freshness, and less interested in production standards. As opinion leaders, chefs utilize signage, wait staff, and cooking classes to promote local foods; however, the diffusion process across restaurants, and between restaurants and producers, is limited by network associations. Structural barriers such as distribution problems and lack of convenience were identified as limiting more widespread use of locally-grown foods. We offer several implications of this research for further work that seeks to engage chefs as opinion leaders who are important to building greater support for local food systems. (shrink)

Studies in philosophy: I. Tufts, J.H. On moral evolution. II. Willcos, W.F. The expansion of Europe in its influence upon population. III. Woods, R.A. Democracy a new unfolding of human power. IV. Sharp, F.C. An analysis of the moral judgment. V. Woodbridge, F.J.E. The problem of consciousness. VI. Norton, E.L. The intellectual element in music. VII. Raub, W.L. Pragmatism and Kantianism. VIII. Lyman, E.W. The influence of pragmatism upon the status of theology.--Studies in psychology: IX. Delabarre, E.B. Influence of surrounding (...) objects on the apparent direction of a line. X. Swift, E.J. Beginning a language; a contribution to the psychology of learning. XI. Pierce, A.H. An appeal from the prevailing doctrine of a detached subconsciousness. XII. Woodworth, R.S. The cause of a voluntary movement. XIII. Burnett, C.T. An experimental test of the classical theory of volition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 41.4 (2003) 565-566 [Access article in PDF] Kai Hammermeister. The German Aesthetic Tradition. New York: Cambridge University Press, 2002. Pp. xv + 259. Cloth, $60.00. Paper, $22.00. This history of German (or more accurately, Germanic) aesthetics surveys the tradition stretching from Alexander Baumgarten to Theodor Adorno. The author has divided his survey into three thematic parts. In the first, "The Age of Paradigms," (...) Baumgarten, Mendelssohn, Kant, Schiller, Schelling, and Hegel establish the principal approaches to aesthetics and the philosophy of art that will structure the tradition. In the second part, "Challenging the Paradigms," Schopenhauer, Kierkegaard, and Nietzsche raise critical problems with the positions of their forebears. In the final part, "Renewing the Paradigms," Cassirer, Lukács, Heidegger, Gadamer, Marcuse, and Adorno revive elements of the classical tradition for twentieth-century purposes. As one might expect, covering fifteen complex figures in a relatively short book makes for a survey primarily of the surfaces of their thought. Even so, the exercise may be useful for those with no knowledge of German aesthetics who would like a quick introduction.From the outset the author establishes a plan to consider each philosopher's work in terms of his ontological treatment of art, the epistemic role he attributes to art and beauty, and the practical functions he assigns art. In the early chapters the author dutifully addresses these matters at the end of each chapter, but from Hegel on, the author's commitment to this structure seems to wane. It becomes more difficult to discern these assessments of each philosopher as the book progresses. It is an odd feature of the book that its [End Page 565] author announces these "principles of comparison" so explicitly in the introduction, but does not consistently apply them.There is also inconsistency in the author's choices regarding whose theories to directly criticize. In some cases (with Hegel, Schopenhauer, Nietzsche, and Cassirer, for example), Hammermeister offers quite global criticisms of the philosophers' views, while in other cases (with Kant, Schiller, Schelling, Heidegger, and Gadamer) he provides very little criticism. The book does not advance a philosophical position from which to understand why some figures in this tradition, but not others, warrant sharp criticisms that on occasion (with Kierkegaard, for example) amount to blanket dismissals.The second part of the book, "Challenging the Paradigms," stands in an uncertain relationship to the first part, "The Age of Paradigms." Hammermeister advertises Schopenhauer, Kierkegaard, and Nietzsche as thinkers intent on dismantling the aesthetic-theoretical systems of their predecessors, and there is no doubt much truth in this assertion. Yet these chapters offer little in the way of explicit elaboration of precisely which views of which prior thinkers each of these rebels seeks to undermine. Schopenhauer, for example, is presented as a champion of Kantian aesthetic disinterestedness, while his delirious antipathy for Hegel is hardly discussed. Kierkegaard's famous disagreements with Hegel receive little attention, either.The third part, "Renewing the Paradigms," advances one of the author's principal claims in the book: that twentieth-century German(ic) philosophers recapitulate the sequence of positions in the classical Kant-Schiller-Schelling-Hegel development. Cassirer revives Kant; Lukács and other neo-Marxist thinkers revive Schiller; Heidegger is far more indebted to Schelling than he acknowledges. To some extent the author's proposal is a useful heuristic, especially regarding Cassirer and Lukács. With Heidegger problems begin to arise. Hammermeister argues that Heidegger shares with Schelling a view of art as a "truth-event," but this, of course, would be a view that Heidegger also shares with Hegel. When Hammermeister notes (189) that for Heidegger truth can happen in practices other than art, this strengthens a comparison to Hegel (despite the profound differences between Heidegger and Hegel), rather than to Schelling (for whom art alone is the organon of truth, at least in the System of Transcendental Idealism that Hammermeister treats as the most Schellingian of Schelling's texts).As with the author's other overarching structures for the book, the paradigm-renewal claim also loses momentum halfway through. Hammermeister appropriately presents... (shrink)

Political decision theory provides a framework for evaluating three approaches to military research and development: offensive weaponry intended for deterrence, the Strategic Defense Initiative and other weaponry intended fordefense, and cutbacks designed to slow the research and development treadmill. Large-scale R&D does not protect against most of the risks facing national security. Nor does an R&D-intensive approach provide the flexibility necessary to adjust military policy in light of rapidly changing international conditions. Considering all factors together, there is a strong theoretical (...) case for placing sharp constraints on military innovation, not just on the quantities of weapons deployed. (shrink)

Knowledge about ethical judgments has not advanced appreciably after decades of research. Such research, however, has rarely addressed the possible importance of the content of such judgments; that is, the material appearing in the brief vignettes or scenarios on which survey respondents base their evaluations. Indeed, this content has seemed an afterthought in most investigations. This paper closely examined the vast array of vignettes that have appeared in relevant research in an effort to reduce this proliferation to a more concise (...) set of overarching vignette themes. Six generic themes emerged from this process, labeled here as Dilemma, Classic, Conspiracy, Sophie’s Choice, Runaway Trolley, and Whistle Blowing. Each of these themes is characterized by a unique combination of four key factors that include the extent of protagonist personal benefit from relevant vignette activities and victim salience in vignette descriptions. Theme identification enabled inherent ambiguities in vignettes that threaten construct validity to come into sharp focus, provided clues regarding appropriate vignette construction, and may help to make sense of patterns of empirical findings that heretofore have seemed difficult to explain. (shrink)

The question of political sovereignty must at all times be of acute academic interest, since it is practically impossible to say anything about the state without implying something about sovereignty, or vice versa. Political theory has very generally found this conception central to its inquiry; but in recent years the notion has been thrown into sharp relief by political events . In Fascism and Nazism the doctrine of state sovereignty is “made flesh” in startlingly substantial forms. These modern incarnations of (...) Leviathan , and their threat to much which has come to be deeply valued, give unprecedented importance to an age-long discussion. Political theory is not to-day, if it has ever seemed, a simply academic issue, or an “arm-chair” branch of philosophy. Not all of those who carry through revolutions, who build barricades and defend them with their lives, have a clear philosophical theory of the state; but powerful beliefs and motives they certainly have; and it daily becomes more manifest that unless the world is content to allow its political future to be determined more and more by obscure visceral impulses or crude economic motives a more intense effort to achieve and to apply true beliefs in the political field is imperative. (shrink)

Johann Gottfried Herder initiated the modern disciplines of philosophical anthropology and cultural history, including the study of popular culture. He is also remembered as a sharp critic of colonialism and imperialism. But what types of social, economic and political arrangements did Herder envision for modern European societies? Herder and Enlightenment Politics provides a radically new interpretation of Herder's political thought, situating his ideas in Enlightenment debates on modern patriotism, commerce and peace. By reconstructing Herder's engagement with Rousseau, Montesquieu, Abbt, Ferguson, (...) Möser, Kant and many other contemporary authors, Eva Piirimäe shows that Herder was deeply interested in the potential for cultural, moral and political reform in Russia, Germany and Europe. Herder probed the foundations of modern liberty, community and peace, developing a distinctive understanding of human self-determination, natural sociability and modern patriotism as well as advocating a vision of Europe as a commercially and culturally interconnected community of peoples. (shrink)

This paper contains a logic enabling us to reason in the presence of vague- ness phenomena. We consider an epistemological vagueness of concepts caused by the unavailability of total information about a continuous world which we describe in observational terms. Lack of information is manifested by the existence of borderline cases for concepts. Since we are unable to perceive concepts exactly, we cannot establish a sharp boundary between an extension of a concept and its complement. Some results for reasoning about (...) vague concepts are already known in the literature [1], [2], [3], [4], [10]. Usually, a semantics of vague concepts is developed within the theory of fuzzy sets or the theory of supertruth [9]. Following the idea that reasoning about vague concepts requires a special logic, we introduce a propositional language with sentential operators en- abling us to dene positive, negative, and borderline regions of any vague concept. A semantics of the language is rened within a framework of the theory of rough sets . The admitted semantics provides means for dening extensions of concepts in a formal way. We show that these extensions re ect properly our intuition connected with vagueness. For ex- ample, the law of excluded middle is not valid on the level of extensions. Moreover, for any concept, the extensions of formulas representing its pos- itive, negative, and borderline regions provide a partition of a universe of discourse. (shrink)

This paper is a response to Christopher Boorse's recent defense of hisBiostatistical Theory (BST) of health and disease. Boorse maintains that hisconcept of theoretical health and disease reflects the ``consideredusage of pathologists.'' I argue that pathologists do not use ``disease'' inthe purely theoretical way that is required by the BST. Pathology does notdraw a sharp distinction between theoretical and practical aspects ofmedicine. Pathology does not even need a theoretical concept of disease. Itsfocus is not theoretical, but practical; pathology's goal is (...) to contribute tothe healing of patients. Pathology, even experimental pathology, is notvalue-free. Not only ``disease'' but also such terms as ``nerve'' and ``organ''are laden with conceptual values. (shrink)