Comatose survivors of cardiac arrest may die following withdrawal of life-sustaining therapy (WLST) due to poor neurologic prognosis. Family members, acting as surrogate decision makers, are frequently asked to decide whether the patient should continue to receive ongoing life-sustaining therapy such as mechanical ventilation in this context of risk of death following removal. Sometimes, physicians and family members disagree about what is in the patient's best interest, and this conflict causes distress for both families and medical personnel. This article examines (...) themes recorded in the medical records of 24 cardiac arrest patients at Columbia University Medical Center (CUMC) whose families chose to pursue continued life support despite physician recommendations for withdrawal. In documented conversations between patients' families and their providers, the most prominent themes included faith in miracles, the inappropriateness of "playing God," the value of more time with the patient, and differences in how providers and family members perceived the patient's status. (shrink)

Rachel Cohon offers an original interpretation of the moral philosophy of David Hume, focusing on two areas.

This book is about the norms of the speech act of assertion. This is a topic of lively contemporary debate primarily carried out in epistemology and philosophy of language. Suppose that you ask me what time an upcoming meeting starts, and I say, “4 p.m.” I’ve just asserted that the meeting starts at 4 p.m. Whenever we make claims like this, we’re asserting. The central question here is whether we need to know what we say, and, relatedly, whether what we (...) assert must be true. If the meeting is really at 3:30 p.m., you’ll be late, and probably rather upset that I told you the wrong time. In some sense, it seems like I’m on the hook for having said something false. This sense that I’ve done something wrong suggests that there are certain standards of evaluating assertions: a way of distinguishing between good and bad, appropriate and inappropriate. We call these standards norms. And so the debate about what, if any, norms govern the linguistic practice of assertion is known as the norms of assertion debate. When one’s assertion satisfies the norm, we say that the assertion is warranted. -/- Various philosophers have typically focused their views of the norms of assertion on articulating the level of epistemic support required for properly asserting. Some argue, for example, that one must know what one asserts. Others argue that one merely needs to justifiably believe what one asserts–an epistemic standing weaker than knowledge. The purpose of this book is to defend what I propose as the central norm governing our practice of assertion, which I call the Supportive Reasons Norm. Here’s what it looks like: -/- One may assert that p only if: One has supportive reasons for p, The relevant conventional and pragmatic elements of the context are present, and One asserts that p at least in part because the assertion that p satisfies and. -/- In rough outline, the standards for warrantedly asserting shift with changes in context, although knowledge is never required for warrantedly asserting. In fact, in some special contexts, speakers may warrantedly lie. This latter feature particularly sets apart my view from others in the debate. This also means that truth, knowledge, and even belief aren’t necessary conditions for warrantedly asserting. (shrink)

Three plausible views—Presentism, Truthmaking, and Independence—form an inconsistent triad. By Presentism, all being is present being. By Truthmaking, all truth supervenes on, and is explained in terms of, being. By Independence, some past truths do not supervene on, or are not explained in terms of, present being. We survey and assess some responses to this.

Identity Economics provides an important and compelling new way to understand human behavior, revealing how our identities--and not just economic incentives--influence our decisions. In 1995, economist Rachel Kranton wrote future Nobel Prize-winner George Akerlof a letter insisting that his most recent paper was wrong. Identity, she argued, was the missing element that would help to explain why people--facing the same economic circumstances--would make different choices. This was the beginning of a fourteen-year collaboration--and of Identity Economics. The authors explain how (...) our conception of who we are and who we want to be may shape our economic lives more than any other factor, affecting how hard we work, and how we learn, spend, and save. Identity economics is a new way to understand people's decisions--at work, at school, and at home. With it, we can better appreciate why incentives like stock options work or don't; why some schools succeed and others don't; why some cities and towns don't invest in their futures--and much, much more. Identity Economics bridges a critical gap in the social sciences. It brings identity and norms to economics. People's notions of what is proper, and what is forbidden, and for whom, are fundamental to how hard they work, and how they learn, spend, and save. Thus people's identity--their conception of who they are, and of who they choose to be--may be the most important factor affecting their economic lives. And the limits placed by society on people's identity can also be crucial determinants of their economic well-being. (shrink)

If musical works are abstract objects, which cannot enter into causal relations, then how can we refer to musical works or know anything about them? Worse, how can any of our musical experiences be experiences of musical works? It would be nice to be able to sidestep these questions altogether. One way to do that would be to take musical works to be concrete objects. In this paper, we defend a theory according to which musical works are concrete objects. In (...) particular, the theory that we defend takes musical works to be fusions of performances. We defend this view from a series of objections, the first two of which are raised by Julian Dodd in a recent paper and the last of which is suggested by some comments of his in an earlier paper. (shrink)

Upon hearing a scalar adjective in a definite referring expression such as “the big…,” listeners typically make anticipatory eye movements to an item in a contrast set, such as a big glass in the context of a smaller glass. Recent studies have suggested that this rapid, contrastive interpretation of scalar adjectives is malleable and calibrated to the speaker's pragmatic competence. In a series of eye‐tracking experiments, we explore the nature of the evidence necessary for the modulation of pragmatic inferences in (...) language comprehension, focusing on the complementary roles of top–down information ‐ (knowledge about the particular speaker's pragmatic competence) and bottom‐up cues (distributional information about the use of scalar adjectives in the environment). We find that bottom‐up evidence alone (e.g., the speaker says “the big dog” in a context with one dog), in large quantities, can be sufficient to trigger modulation of the listener's contrastive inferences, with or without top‐down cues to support this adaptation. Further, these findings suggest that listeners track and flexibly combine multiple sources of information in service of efficient pragmatic communication. (shrink)

Much recent philosophical work argues that power constrains speech—pornography silences women, testimonial injustice thwarts a speaker’s transmission of knowledge, bias distorts the performative force of subordinated speech. Though the constraints that power places on speech are serious, power also enables some speech. Power doesn’t just keep us from speaking—it also makes us speak. In this paper I explore how power produces, rather than constrains, speech. I discuss a kind of speech I call extracted speech: speech that is unjustly elicited from (...) an agent. I discuss examples of coerced confession, intimidated “consent,” and mandatory self-disclosure as instances of extracted speech, and theorize a bit about what significance this speech has more generally for philosophy of language and political philosophy. (shrink)

This study offers a ckomprehensive new interpretation of one of Plato's dialogues, the _Cratylus_. Throughout, the book combines analysis of Plato's arguments with attentiveness to his philosophical method.

In this study, we examine investor and firm response to the California Transparency in Supply Chains Act of 2010. The CTSCA requires large retail and manufacturing firms to disclose efforts to eradicate slavery and human trafficking from their supply chains and is a rare example of mandated corporate social responsibility disclosure. Based on a sample of 105 retail companies subject to the CTSCA, we find a significant negative market reaction to the passing of the CTSCA. Furthermore, we find that the (...) reaction is significantly more negative for larger firms and companies facing greater supply chain risks, suggesting that investors place a negative value on exposure to legitimacy threats in the social domain. With respect to company disclosure response, we document relatively high compliance with the legislation, although we also find that the disclosure response appeared to be more symbolic than substantive in nature. Finally, our analysis indicates that both disclosure choice and disclosure extensiveness were significantly higher for the high-supply chain risk companies, suggesting that the response was influenced by concerns with strategic legitimation. Overall, the limited quality of disclosure suggests that, without additional rules and guidance, mandates alone may not lead to meaningful social disclosure. (shrink)

Thanks to David Kaplan (1989a, 1989b), we all know how to handle indexicals like ‘I’. ‘I’ doesn’t refer to an object simpliciter; rather, it refers to an object only relative to a context. In particular, relative to a context C, ‘I’ refers to the agent of C. Since different contexts can have different agents, ‘I’ can refer to different objects relative to different contexts. For example, relative to a context cwhose agent is Gottlob Frege, ‘I’ refers to Frege; relative to (...) a context 0* whose agent is Alexius.. (shrink)

Plato's account of the tripartite soul is a memorable feature of dialogues like the Republic, Phaedrus and Timaeus: it is one of his most famous and influential yet least understood theories. It presents human nature as both essentially multiple and diverse - and yet somehow also one - divided into a fully human 'rational' part, a lion-like 'spirited part' and an 'appetitive' part likened to a many-headed beast. How these parts interact, how exactly each shapes our agency and how they (...) are affected by phenomena like erôs and education is complicated and controversial. The essays in this book investigate how the theory evolves over the whole of Plato's work, including the Republic, Phaedrus and Timaeus, and how it was developed further by important Platonists such as Galen, Plutarch and Plotinus. They will be of interest to a wide audience in philosophy and classics. (shrink)

Kant is often considered a key figure in a modern transition from social and political systems based on honour to those based on dignity, where “honour” is understood as a hierarchical measure of social value, and “dignity” is understood as the inherent and equal worth of every individual. The essay provides a richer account of Kant’s contribution to the “politics of equal dignity” by examining his understanding of dignity and honour, and the interaction between these concepts. The essay argues that (...) Kant appeals to multiple varieties of dignity and honour, that he does not reject honour in favour of dignity, and that he sees some versions of honour as conducive to respect for dignity. Furthermore, the complexity of Kant’s views on dignity and honour has implications for the theory and practice of human rights in the current day. (shrink)

The concepts of health and disease play pivotal roles in medicine and the health professions This volume brings together the requisite literature for understanding current discussions and debates these concepts. The selections in the volume attempt to present a wide range of views concerning the nature of the concepts of health and issues using both historical and contemporary sources -- Back cover.

What consciousness exactly is remains an unsettled issue among both philosophers and biologists. Three aspects of consciousness are generally recognized: awareness consciousness (through connection...

This book derives from Annas’s 1997 Townsend Lectures at Cornell University, and it retains the invigorating clarity and fast pace of a first-rate lecture series. In it Annas discusses assorted topics in Plato’s ethics and their ancient interpretation: her unifying theme is that we have much to learn from ancient readings of Plato, and those of the Middle Platonists in particular.

The movement to try to close the ever-widening gap between demand and supply of organs has recently arrived at the prison gate. While there is enthusiasm for using executed prisoners as sources of organs, there are both practical barriers and moral concerns that make it unlikely that proposals to use prisoners will or should gain traction. Prisoners are generally not healthy enough to be a safe source of organs, execution makes the procurement of viable organs difficult, and organ donation post-execution (...) ties the medical profession too closely to the act of execution. (shrink)

Must the state handle the adjudication of disputes? Researchers of different perspectives, from heterodox scholars of law who advocate legal pluralism to libertarian economists who advocate the privatization of law, have increasingly questioned the idea that the state is, or should be, the only source of law. Both groups point out that government law has problems and that non-state alternatives exist. This Article discusses some problems with the public judicial system and several for-profit alternatives. Public courts lack both incentives to (...) embrace customer orientation and pricing mechanisms, plus they face problems associated with the bureaucratic provision of services. When parties are able to choose their tribunals, in contrast, those tribunals must provide service to customers and be mindful about conserving resources. Competition between arbitrators also can allow for experimentation and the provision of customized services rather than a centrally planned, one-size-fits-all system. Contracts with arbitration clauses can easily stipulate the choice of tribunal, and we argue that if government courts simply refused to overrule binding arbitration agreements, de facto privatization could easily take place. This Article discusses how the private adjudication of disputes could enable the market to internalize externalities and provide services that customers desire. (shrink)

Biomedical science suffered a loss of trust during the Covid‐19 pandemic. Why? One reason is a crisis fueled by confusion over the epistemology of science. Attacks on biomedical expertise rest on a mistaken view of what the justification is for crediting scientific information. The ideas that science is characterized by universal agreement and that any evolution or change of beliefs about facts and theories undermines trustworthiness in science are simply false. Biomedical science is trustworthy precisely because it is fallible, admits (...) error, adjusts to new information, and, most importantly, is practical. Successful diagnosis and cure demarcate the boundaries of warranted knowledge. The other reason is sociological. As the pandemic made all too clear, the loss of faith in scientific experts was due to the failure of most of them to engage in regular public dialogue, reflecting a failure to recognize the obligation that science has to bolster trust in its work and findings by concerted public engagement. (shrink)

A major goal of this work is to specify some steps of the process by which participants maintain coherency in their conversations.The underlying element of the analysis is a construct called a “context space.” Roughly, a group of utterances that refers to a single issue or episode forms the basis for a context space. Superficially, a conversation is a sequence of utterances; at a deeper level it is a structured entity whose utterances can be parsed into hierarchically related context spaces.As (...) a conversation proceeds, each conversant builds a discourse model that includes the conversation's context space structure, a notion of the present discourse topic, and a list of items being focused upon. Conversational coherency depends upon a lack of conflict between the respective models of the participants. Conflicts are prevented by speakers following high level syntactic and semantic relational rules that enable listeners to identify their discourse models. These rules, given in the study, are highly integrated with the view of conversation presented here—a hierarchy of related context spaces. (shrink)

Amidst the climate of crisis surrounding the rise in opioid-related overdose in the USA, early in 2019, Google and Deloitte launched ‘Opioid360’. Here came a platform combining browser histories, credit, insurance, social media, and traditional survey data to sell the service of risk calculation in population health. Opioid360's approach to automating risk calculation not only promised to identify persons ‘at risk’ of opioid dependence, but also paved the way for broader applications anticipating common chronic diseases and coordinating logistical operations involved (...) in pandemic response. Beginning with this experimental platform, this paper develops an analysis of the Big Data mode of risk calculation - an epistemological and political shift that involves technology companies, investors, insurers, governments, and public health institutions. The analysis focuses on the re-emergence of ‘social determinants of health’ in the rhetoric accompanying novel analytic platforms that estimate, calculate, and compute individual health risks. While the treatment of SDOH has always been a site of political contestation within the discipline of public health, powerful interests are crystallising around the concept and instrumentalising it in platforms that sell algorithmic prediction. Silicon Valley's breed of asset-oriented technoscience appears not only to be amplifying the behaviouralist elements of public health. Among the stakes of the Big Data mode is the paradoxical retreat from changing social conditions that contribute to the prevalence of health and illness in populations; and instead, the promotion of an apparatus for pricing and exchanging individual risk or excluding from services those who bear risk most acutely. (shrink)

Whistleblowers remain essential as complainants in allegations of research misconduct. Frequently internal to the research team, they are poorly protected from acts of retribution, which may deter the reporting of misconduct. In order to perform their important role, whistleblowers must be treated fairly. Draft regulations for whistleblower protection were published for public comment almost a decade ago but never issued. In the face of the growing challenge of research fraud, we suggest vigorous steps, to include: organizational responsibility to certify the (...) accuracy of research including audit, required whistleblower action in the face of imminent or grave harm to subjects, strengthened legal protections against retaliation including prompt enactment of Federal whistleblower protections and consideration of criminalizing the most egregious cases of research misconduct. (shrink)

This book considers the arguments for and against the implementation of in vitro meat technology. Rachel Robison-Greene argues that in light of emerging technology, we should rethink the ethical dimensions of what makes something “edible.”.

This article describes a new prenatal genetic test that is painless, early, and increasingly available. State legislatures have reacted by prohibiting abortion for reason of fetal sex or of fetal diagnosis and managing genetic counseling. This article explores these legislative responses and considers how physicians and genetic counselors currently communicate post-testing options. The article then examines the challenges ahead for genetic counseling, particularly in light of the troubling grip of abortion politics on conversations about prenatal diagnosis.

This paper explores ways in which experiential learning theories, in particular transformative learning theory, can inform farmer participatory research and extension (PR&E). I identify and discuss three key elements of experiential learning theory – second-order experiences, reflection, and dialogue – that are particularly pertinent to PR&E practice. I then turn to one experiential learning theorist – Mezirow, and examine his theory of transformative learning to assess how it may inform the PR&E process. I outline the basic components and stages of (...) transformative learning and summarize the main criticisms of the theory. Following this, parallels are drawn between transformative learning and what actually takes place in PR&E, and examples are given of the ways in which scientists and rural people may undergo transformative learning through the PR&E process. Ways in which transformative learning can be encouraged within the PR&E context are discussed. I conclude that Mezirow’s work can provide PR&E practitioners and theorists with additional insights into how adults learn and especially how they – researchers, extensionists and rural people – can transform their ways of thinking to accommodate a shift from conventional research and extension to PR&E. (shrink)

Millianism and Fregeanism agree that a sentence that contains a name expresses a structured proposition but disagree about whether that proposition contains the object that the name refers to (Millianism) or rather a mode of presentation of that object (Fregeanism). Various problems – about simple sentences, propositional‐attitude ascriptions, and sentences that contain empty names – beset each view. To solve these problems, Millianism can appeal to modes of presentation, and Fregeanism can appeal to objects. But this raises a further problem: (...) namely, to explain why the proposition expressed by a sentence that contains a name matters in some cases but not in others. (shrink)

This article examines how federal law enforcement has responded to the opioid epidemic nationally and in a variety of locales. We focus in depth on two initiatives, including prosecution in opioid-death cases, undertaken by the U.S. Attorney's Office in Connecticut.

Wiggins and his colleagues (2004) are to be commended for their willingness to raise the question of the ethics of undertaking the world's first face transplant prior to initiating the experiment....

Gathers medical and legal documents, opinions from various perspectives, and a timeline of events in the Terri Shiavo case to provide a resource for examining the moral and ethical issues surrounding end-of-life decisions.

Serial issues closely marry the major anthropological questions that a society asks itself… or is about to ask itself; here unfolds “the infinite possibility of possibilities”, and we will see that the theme of the extended human gradually increases in power, often from the angle of a transhumanism gone mad. Anchoring the theme of technological increase in the sexual imagination makes it possible to immediately focus on the intimate fantasy of each reader/viewer; this “situated” motif also singles out the subject, (...) who is nevertheless doomed to the stereotypy of the gender product, post-fordist but necessarily subject to identifiable patterns. The dissensus between the obscure desirability of the process and the horror of the underlying ideologies will therefore form the framework of this statement; the dystopian colouring in fact affects the essence of the device, but without the absence of a form of shameful fascination for this technological, or even epistemocratic, « immortality » that science seems to promise—to the wealthiest in any case. (shrink)

This study identified a range of pedagogies developed to promote global citizenship within a university Latin American dance unit. It implemented changes to teaching and learning approaches in the...

This essay considers how an “intimacy contract,” as a conceptual tool and a political reality, extends existing critiques of the social contract tradition by accounting for the privatized nature of the post-9/11 US empire. Examining critiques by Carole Pateman and Charles Mills, I argue that an intimacy contract uncovers the coercive power relations underlying neoliberal discourses of entrepreneurial freedom. Focusing on migrant labor on US military bases, I provide an overview of the racial, sexual, and settler contracts and the need (...) to extend Mills’s and Pateman’s critiques of embodiment and spatiality. Next, I suggest how the intimacy contract generates a transnational, embodied account of the labors upholding US empire; a lens into the shifting significance of these labors under neoliberal imperialism; and a chronicling of desire and workers’ interests. In conclusion, I suggest how the intimacy contract exposes multiple resistances to US empire and neoliberal capitalism. (shrink)

Debates continue to surround the system in the United States for allocating transplantable cadaveric organs, due in large part to the scarcity of such organs in relation to the number of individuals waiting to undergo transplantation. Candidates awaiting transplantation gain access to cadaveric organs by being placed by individual transplant programs on the national list of the Organ Procurement and Transplantation Network, overseen by the United Network for Organ Sharing. In recent years, the UNOS board has visited the issue of (...) multiple listing, that is, allowing one candidate to be registered on the waiting lists of two or more transplant programs, and has continued to permit multiple listing. (shrink)

This book will also inform the general public, patients, and family members as they seek answers to the bioethical issues of the day.

These two lectures by Jacques Derrida, "Foreigner Question" and "Step of Hospitality/No Hospitality," derive from a series of seminars on "hospitality" conducted by Derrida in Paris, January 1996. His seminars, in France and in America, have become something of an institution over the years, the place where he presents the ongoing evolution of his thought in a remarkable combination of thoroughly mapped-out positions, sketches of new material, and exchanges with students and interlocutors. As has become a pattern in Derrida's recent (...) work, the form of this presentation is a self-conscious enactment of its content. The book consists of two texts on facing pages. "Invitation" by Anne Dufourmantelle appears on the left, clarifying and inflecting Derrida's "response" on the right. The interaction between them not only enacts the "hospitality" under discussion, but preserves something of the rhythms of teaching. The volume also characteristically combines careful readings of canonical texts and philosophical topics with attention to the most salient events in the contemporary world, using "hospitality" as a means of rethinking a range of political and ethical situations. "Hospitality" is viewed as a question of what arrives at the borders, in the initial surprise of contact with an other, a stranger, a foreigner. For example, Antigone is revisited in light of the question of impossible mourning; _Oedipus at Colonus_ is read via concerns that also apply to teletechnology; the trial of Socrates is brought into conjunction with the televised funeral of François Mitterrand. (shrink)

BackgroundThe Pacific Islander population is the second fasting growing population in the United States and Arkansas is home to the largest Marshallese population in the continental US. The Marshal...