While sympathetic to Tilley’s call for a practical philosophy of religion, I raise three questions: Does Tilley think that one can do philosophy of religion from a position other than that of a committed believer? Does Tilley’s description of the ordinary believer disburden most people from doubt and answerability? Does Tilley’s description of the role of the theologian place too much trust in the theologian? I suggest that some insights from contemporary phenomenology and hermeneutics would lead to a clearer understanding (...) of the role that philosophy of religion can play in the development of a practical philosophy of religion. (shrink)

In 1785, George Washington described a “knowing farmer” as “one who can convert every thing he touches into manure, as the first transmutation towards Gold.” With these words, Washington linked the “knowing farmer” to the alchemist who endeavored to transform base metals into gold with the aid of a philosopher's stone. In each instance, the challenge was to convert raw materials into something new and precious.Today, the “knowing bioethicist” is in a similar position. American bioethics harbors a variety of ethical (...) methods that emphasize different ethical factors, including principles, circumstances, character, interpersonal needs, and personal meaning. Each method reflects an important aspect of ethical experience, adds to the others, and enriches the ethical imagination. (shrink)

Because of historical mistreatment of ethnic minorities by research and medical institutions, it is particularly important for researchers to be mindful of ethical issues that arise when conducting research with ethnic minority populations. In this article, we focus on the ethical issues related to the inclusion of ethnic minorities in clinical trials of psychosocial treatments. We highlight 2 factors, skepticism and mistrust by ethnic minorities about research and current inequities in the mental health care system, that researchers should consider when (...) developing psychosocial interventions studies that include ethnic minorities. (shrink)

This paper explores the complex meanings of paizein and its compound sumpaizein used in connection with young girls and/or Eros in archaic Greek poetry. My basic question is whether the verb necessarily implies a knowing eroticism on the part of the character whom it describes, or whether it is the poet's way of inviting the audience to share his knowledge at the expense of the character, a kind of "wink" of complicity. I argue that there are fundamental ambiguities in this (...) particular use of paizein and that the instability of its semantic field is linked to the liminality of the stage of life to which it commonly refers. When Eros "plays," we know we should be on guard, but a young girl's "play" is somewhat more difficult to interpret. In this context, I suggest that Greek poetry can represent the liminality of a girl's sexual status through the physical setting in which the action takes place: the "players" are placed in a natural environment that reflects their stage in life, namely, the moments just before the loss of innocence, and that locus itself is open to divergent interpretations dependent on the sexual "knowledge" of the viewer. The notion "girls at play" thus resists any single interpretation, as the girls' sexual status always contains within it the potential for rapid and drastic change. (shrink)

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)

Faculty in a large, urban school of engineering designed a longitudinal study to assess the critical thinking skills of undergraduate students as they progressed through the engineering program. The Paul-Elder critical thinking framework was used to design course assignments and develop a holistic assessment rubric. This paper presents the analysis of the freshman course artifacts (baseline and course critical thinking assignments) and associated faculty scoring sessions for all three cohorts. A total of 649 first semester freshman students at least 18 (...) years old agreed to participate in the study. The majority were white males with a mean high school grade point average of 3.73, ACT composite score of 28.33, and final freshman engineering course grade of 3.57. There was a statistically significant positive relationship between the freshman course artifacts and the faculty scores. Data from the study are being used to enhance the critical thinking experiences for undergraduate engineering students. (shrink)

Richard C. Atkinson’s eight-year tenure as president of the University of California reflected the major issues facing California itself: the state’s emergence as the world’s leading knowledge-based economy and the rapidly expanding size and diversity of its population. As this selection of President Atkinson’s speeches and papers reveals, his administration was marked by innovative approaches that deliberately shaped U.C.’s role in this changing California. These writings tell the story of the national controversy over the SAT and Atkinson’s successful challenge to (...) the dominance of the seventy-five-year-old college entrance examination. They also highlight other issues with national significance: U.C.’s experiments with race-neutral admissions programs; the challenges facing academic libraries and the University’s pioneering activities with the California Digital Library; and the University’s involvement in new paradigms of industry-university research. Together, these speeches and papers open a window on an eventful period in the history of the nation’s leading public research university and the history of American higher education. (shrink)

Clinical next generation sequencing is a term that refers to a variety of technologies that permit rapid sequencing of large numbers of DNA segments, up to and including entire genomes. As an approach that is playing an increasingly important role in obtaining genetic information from patients, it may be viewed by public and private payers either positively, as an enabler of the promised benefits of personalized medicine, or as “the perfect storm” resulting from the confluence of high market demand, an (...) uproven technology, and an unprepared delivery system. A number of recent studies have noted that coverage and reimbursement will be critical for clinical integration of NGS, yet the evidentiary pathway for payer decision-making is unclear. Although there are multiple reasons for this uncertain reimbursement environment, the situation stems in large part from a long-standing lack of alignment between the information needs of regulators and post-regulatory decision-makers such as payers. (shrink)

A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. (...) I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry. (shrink)

Hegel says that the task of the philosopher in history is to follow the trace of Reason in history, to discern the realization of the freedom which Spirit is. Hegel’s own discerning of Reason in history is tinged with a teleological optimism which is unconfirmed and perhaps even denied by history. This does not mean that the task which Hegel presents should be set aside. Today’s philosopher must still attempt to understand history. The question which seems to focus present attempts (...) to do so is: How can an understanding of history provide us with a grasp of the world in which we live so that we can do what is possible to provide that world with a future? This question reflects a strong sense of finitude. Yet, the questions which guide Hegel are very similar: What is the relation of the finite and the infinite? How does this relation appear on the scene in history? (shrink)

This paper attempts to determine what the.Characteristics of post-modernity, found within the work process, are, based on reflections on Latin America. In order to do this we look at post-modernity not as a context in and of itself, but as characteristics superimposed on these new forms of l..

. Current debates concerning the concept of mental disorder involve many different philosophical issues. However, it is not always clear from these discussions how, or whether, these issues relate to one another, or in exactly what way they are important for the definition of disorder. This article aims to sort through some of the philosophical issues that arise in the current literature and provide a clarification of how these issues are related to one another and whether they are necessary for (...) defining disorder. I argue that the main concern in defining disorder, namely demarcation, is obscured by a number of these other philosophical issues and that a focus on demarcation gives us a means of placing these other issues in a clarifying context. (shrink)

Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

In lieu of an abstract, here is a brief excerpt of the content:The Fact Value Dichotomy in Demarcating DisorderPatricia A. Ross (bio)Keywordsdemarcation, values, ontology, epistemologyHaving read numerous articles on the concept of mental disorder, I find it useful to approach new articles on the topic by first sketching out the conceptual framework within which each author places the problem. The goal in doing this is not merely to be able to compare ideas within a remarkably diverse discussion, but also to (...) be able to uncover any presuppositions that underlie the account, as well as assumptions necessary for the argument, which may or may not be warranted. By approaching each new offering in this way, I often find that the solutions proposed depend a great deal on these undisclosed features, and that such presuppositions and assumptions are often questionable, at best, and are sometimes simply unwarranted. Brülde's discussion of mental disorder and values provides a useful example of this method.To determine how we should draw the line between disorder and nondisorder (henceforth, I refer to this as demarcation), Brülde claims that we need to address four questions. We need to determine (1) the extent to which demarcation depends on values and the extent to which it is descriptive, (2) the kinds of values we need to make use of (aesthetic, moral, pragmatic), (3) whether there is an implicit reference to some specific evaluative standard, and (4) whether the value judgments used to demarcate are ontological or epistemological. In putting forth these questions, Brülde identifies what he takes to be the generally agreed upon claim that there are two components necessary for demarcation: a factual component and an evaluative component. These components are distinct from each other and both are necessary—the demarcation cannot be made "by objective means alone," nor is it purely evaluative. Thus, demarcation necessarily involves a distinct value component, and the answers to Brülde's four questions are intended to shed light on how values are involved in determining the evaluative component of demarcation.Working under the assumption that they are distinct, Brülde sets aside discussion of the factual component to focus on the value component. He also tables the first of his four questions (the extent to which demarcation depends on values and the extent to which it is descriptive), citing an over-abundance of literature on the matter. Having thus framed the problem, Brülde turns his full attention to questions two through four, ultimately providing us with the answer that the values needed to demarcate disorders from nondisorders are of several types; mental disorder is both implicitly and explicitly an evaluative term, as well as value laden in both the ontological and epistemic senses. This [End Page 107] framing of the problem provides us with insight into the underlying presuppositions and assumptions that lead to Brülde's conclusion.The first aspect of this framework to consider is the division of demarcation into two distinct components, and the setting aside of the factual component as distinct from, and inconsequential to, the questions concerning values. By proceeding in this way, Brülde's argument rests on the presupposition that we can, and want, to consider the value component in isolation from the factual component. This presupposition raises a number of questions. Is there nothing about the factual component that may help us in our consideration of the value component, or vice versa? Does the factual component confine what we can say or know about the value component in any way. Overall, some justification is needed for accepting that there are two distinct and independent components, as well as for believing that the factual component can be disregarded in this way.Brülde also makes the (explicit) assumption that there is some internal state or process underlying all mental disorders about which we have or will gain factual knowledge that is objective. Implicit in this is the further assumption that this knowledge (regarding internal states or processes) will be all there is to say, scientifically, about the disorder—that is, knowledge concerning internal states and processes are what will comprise the "factual component." But if we can have sociological facts and psychological facts (and I think it is... (shrink)

We examined differences in the knowledge and beliefs that exist among nurse researchers in the USA (n = 119) regarding informed consent and the use of data from patients’ medical records. Using a mail survey, two domains of ethical knowledge and beliefs were assessed: the legal right to privacy and the moral right to privacy. More than half of the participants were very confident in their knowledge of institutional review board procedures, research ethics, informed consent, the legal right to privacy, (...) and the moral right to privacy. In contrast, most rated themselves as uncertain about US federal research regulations and there was wide variation in knowledge about current federal guidelines. Those who were more confident in their knowledge of or had more practical experience with research ethics, were no more likely to answer correctly a question about current federal guidelines regulating the use of patient data from medical records than those who reported less confidence or experience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Truth Will Set You Free, or How a Troubled Philosophical Theory May Help to Understand How People Talk About Their AddictionPatricia A. Ross (bio)Keywordsveridicality of narrative, contingency of theories, belief-behavior, causal connectionConsider the following proposition: If one were to recognize the unsatisfactory implications of maintaining a certain theoretical position, one would thereby be motivated to accept a more adequate theory, which would alter one's beliefs and, in turn, (...) alter the behaviors that are based upon those beliefs. Faith in this proposition is what motivates many of us to teach. But, alas...Allison Mitchell's argument for rethinking addiction intervention—in particular, rethinking twelve-step programs—is premised on this proposition. According to her argument, addicts function with an impoverished sense of self that is reflective of a grossly simplified form of philosophical materialism. By recognizing the limitations of this philosophically unconvincing view, and by, in effect, accepting a better, more complete materialism, addicts can come to modify their self-conception. This modification is instrumental to recovery.A careful consideration of the chain of events being proposed, and the problems with it, is helpful for understanding the limitations of her argument. There are four points that I consider in turn: (1) considering narratives can tell us something about the self-conception of addicts, (2) philosophical materialism can help us to understand and explain something about an addict's self-conception and how it is inadequate, (3) this sense of self is distinct from nonusers and the way in which it is distinct helps to understand the problem of addiction, and (4) a change in self-conception with respect to materialism helps recovery and, thus, our best intervention is one based on having addicts accept a full materialist theory of the self and not a pretheoretic one. [End Page 227]With respect to the first point, it should be noted that Mitchell's overall argument does not depend on whether or not it is true that narratives of addiction tell us something veridical about the self-conception of addicts. Such narratives may simply provide us with a potential theory—a possible worlds scenario—of how addicts conceive of themselves. Mitchell points this out herself. The narratives and the interpretation that she provides of these narrative, "are meant only to highlight a certain pattern of self-expression and conception that may in fact be common in persons who use mind-altering substances; the readings do not establish any empirical matters of fact or philosophical truths, nor do they prove any conclusions about how such persons (must) express themselves or conceive their nature" (Mitchell 2006, 214).Thus, what the argument is actually concerned with are the theoretical claims about the self-conception of addicts that are garnered from these narratives. Nevertheless, because the narratives provide the starting point for Mitchell's argument, it is worth thinking carefully about the epistemic status of this body of literature. In particular, could a consideration of such literature lead us astray in our endeavors to understand how addicts might misconceive of themselves and, if so, in what way? What sort of epistemic status does this information hold?Mitchell is motivated by Wittgensteinian analyses of the relationship between thought and language. The particular idea that she employs from Wittgenstein is that every act of self-expression, whether it is verbal or written narrative, reveals something about the conceptual framework with which the author is working. Thus, one can learn about the author of a narrative—one can acquire a sense of how that individual conceives of him- or herself—by looking at the language that is employed to talk about and describe him- or herself.Mitchell enumerates some problems with this approach. She mentions that the author may fail to make his or her intended sense clear to readers; that the reader's narrative expectations determine the interpretation given to the narrative; that literary narrative may be less direct, less ordinary than everyday uses of language; and that interpreting such narrative via philosophical framework may ascribe to people positions that are more precise and sophisticated than they actually intend (p. 213).Aside from these quite serious problems, it is necessary to recognize... (shrink)

In many ways, Roe v. Wade marked a new chapter in American life. By assuring women of greater reproductive freedom., It gave women greater economic and social freedom, Inflamed a partisan battle between pro-life and pro-choice camps, and provoked a public debate regarding the proper sphere of judicial action. Hence, just as Roe has been critical to the changing politics of gender, it has been the focus of a political debate about the meaning of personhood and morality of abortion, the (...) scope of individual freedom, and the judiciary's role in effecting social change. (shrink)

A proof of pragmatism is proposed in Peirce's 1903 lecture series on Pragmatism as a Principle and Method of Right Thinking. It is necessary first to define what pragmatism is, a task for which a practitioner of the pragmatic maxim would be fitted, but which, however, must be highly problematic to a potential practitioner who does not yet know its full meaning. In order to clarify its meaning, Peirce uses a method he recommends for such conundrums in his 1891 article, (...) “The Architecture of Theories,” that is, “to make a systematic study of the conceptions out of which a philosophical theory may be built, in order to ascertain what place each conception may fitly occupy in such a theory and to what uses it is adapted”. Peirce's systematic study of the basis of logic and pragmatism in relation to it begins to appear around 1898 and peaks in 1903 when pragmatism's definition and role within the sciences is established in these lectures. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Credibility, Persuasiveness, and EffectivenessPatricia A. King (bio)Since the early 1970s, complex ethical, social, legal, and scientific controversies generated by biomedicine have been referred to governmentally created commissions, committees, boards, and panels that are commonly referred to as “ethics” committees. The Advisory Committee on Human Radiation Experiments is the most recent example of such a group. Although it is too early to know the full impact of the Committee’s work, (...) it is important to reflect on aspects of its deliberations that shed light on the public policy role of ethics bodies. Specifically, I will reflect on matters that go to the credibility, persuasiveness, and effectiveness of these committees.The point should be made at the outset that these ethics committees are, first and foremost, public policy groups. Governmentally created bodies of all types, including ethics committees, are established to provide pragmatic advice to governments about specific problems and controversies or to complete specified tasks on behalf of governments. What distinguishes ethics committees from other advisory groups is that the issues assigned to them are presumed to be primarily ethical, as opposed to, say, economic, in nature. It is expected that ethical analyses and premises will play a significant, albeit not exclusive, role in the committee’s deliberations. 1 As with other advisory groups, the primary responsibility of ethics committees is to respond to the branches of government that were instrumental in their creation as well as to the public at large. Since political concerns undoubtedly play a role in the creation of these groups, it is understandable that political concerns have some impact on the committee’s work. Thus, ethics committees are generally cognizant of the need to ensure that their processes and substantive conclusions are credible, persuasive, and effective.In my experience, members of ethics commissions understand the need to offer principled arguments that are factually accurate to justify their recommendations and conclusions. They also appreciate the need for consensus and rightly worry about disagreement among members. I believe, however, that committee members are less attentive than they should be to the social and political contexts in which they operate. This is not surprising. Members of these committees, and often their staffs as well, are typically experts drawn from the academy. [End Page 313] Scholars traditionally offer advice or influence policy through articles and scholarly work undertaken individually or in cooperation with like-minded individuals who do not need to be persuaded about the merits of a specific position. Moreover, scholarly articles are often pitched at a level of abstraction that may be of limited utility in the context of concrete decision making.Scholarly efforts are important. Particularly in bioethics, these scholarly efforts often have furnished the conceptual frameworks that are critical to the efforts of those who grapple with complex matters, the appropriate resolution of which pose moral disagreement and genuine perplexity. Policy formulation by its very nature, however, requires more. Attention must be paid to competing moral and social frameworks. Logical, rational arguments and risk/benefit assessments are important, but emotion, passion and values grounded in experience also demand consideration. Policy formulation as a result can be a quite messy process.Members of the academy are often uncomfortable in this environment. Pursuing the messy details can be threatening and at times at odds with values that academics prize highly. I believe this discomfort was evident in the reluctance of several Advisory Committee members to obtain security clearances that were required in order to see classified material related to the Committee’s work. Secrecy may have seemed at odds with cherished values of openness. As a result the perusal of classified materials was left to those with clearances. Fortunately, the Committee was successful in having relevant information declassified so all committee members read and deliberated about the same information. Committees needing to see more contemporaneous classified information might not be so fortunate.Ethics commission members correctly worry about disagreement. The ability to reach consensus helps to give recommendations a compelling quality. Morris Abram, chairman of the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, makes this point powerfully. He states that “a commission requires agreement that is as... (shrink)