We present the perspective of a Bioethics Consultation Service operating in an urban hospital in Dayton, Ohio, USA, as it adapted to treating Sars-CoV-2 patients throughout 2020. Since the first case of COVID-19 was reported in Ohio on 9 March 2020, until 1 January 2021, the Bioethics Consultation Service was consulted 60 times, a 22.5% increase from the same period of 2019. The most common diagnoses requiring consultation included end-stage renal disease requiring dialysis, out-of-hospital cardiac arrest, and sepsis. Only 10% (...) of consultations were for patients hospitalized with COVID-19. This is a qualitative analysis of the cases we saw and a discussion of factors that affected our service while adapting to COVID-19 standards of care. (shrink)

In Book 2 of The Peloponnesian War, the ancient Greek historian Thucydides describes the Plague of Athens which killed an estimated 75,000 people in 430 BC, the second year of the war. Thucydides i...

Although many physicians have been using the internet for both clinical and social purposes for years, recently concerns have been raised regarding blurred boundaries of the profession as a whole. In both the news media and medical literature, physicians have noted there are unanswered questions in these areas, and that professional self-regulation is needed. This report discusses the ethical implications of physicians’ nonclinical use of the internet, including the use of social networking sites, blogs, and other means to post content (...) online. It does not address the clinical use of the internet, such as telemedicine, e-prescribing, online clinical consultations, health-related websites, use of electronic media for clinical collaboration, and e-mailing patients (some of which are already covered in the AMA’s Code of Medical Ethics). (shrink)

Healing Emotions is the record of an extraordinary series of encounters between the Dalai Lama and prominent Western psychologists, physicians, and meditation teachers that sheds new light on the mind-body connection. Edited by Pulitzer Prize nominee and best-selling author Daniel Goleman.

This article argues that outbreak preparedness and response should implement a ‘family presence’ policy for infected patients in isolation that includes the option of physical visits and care within the isolation facility under some conditions. While such a ‘physical family presence’ policy could increase infections during an outbreak and may raise moral dilemmas, we argue that it is ethically justified based on the least infringement principle and the need to minimize the harms and burdens of isolation as a restrictive measure. (...) Categorical prohibition of PFP during the course of an outbreak or epidemic is likely to result in unnecessary harms to patients and families, and violate values such as the moral commitments of families to care for each other. Supporting the option of PFP under particular circumstances, on the other hand, will least infringe these moral considerations. An additional reason for a family presence policy is that it may facilitate voluntary cooperation with isolation and other restrictive measures. We provide an analysis of these considerations for supporting modes of family presence during an outbreak emergency, before defending the riskier option of PFP in the isolation facility from plausible objections and concerns. (shrink)

An experiment designed to test the highly speculative hypothesis of photon consciousness was executed. It was found that, within the accuracy attainable with the apparatus, there is no empirical justification for the hypothesis.

This article examines the current state of end-of-life care in internal medicine wards in Israel, through an analysis of medical practice and the existing legal framework. The authors demonstrate the processes that lead chronically ill, elderly patients to perceive death as an unexpected phenomenon that is to be avoided at all costs. This perception stems, among other things, from the lack of public debate on questions relating to the end of life and the dominant cultural expectation that physicians provide curative (...) interventions. This results in a dearth of palliative care for the elderly along with a growing number of medical interventions that are of questionable value. The authors propose an alternative approach that highlights individual well-being and that demonstrates the potential areas of intervention by which death can be transformed into an expected and acceptable occurrence for the old and infirm. This approach allows patients to avoid unnecessary interventions and to reduce the burden of responsibility on family members and physicians, who are currently being called on to make end-of-life choices under exigent circumstances. We present these dilemmas by focusing on typical cases of incompetent elderly patients when there is no clear documentation of their wishes regarding treatment, and when their families do not have a coherent perception of what they may have wanted or of the care that would be most appropriate for them. We conclude with a call to action that highlights the need for greater awareness—through public discourse and private discussions—of end-of-life medical choices before the onset of ill-health and incompetence. (shrink)

The lottery paradox has been discussed widely. The standard solution to the lottery paradox is that a ticket holder is justified in believing each ticket will lose but the ticket holder is also justified in believing not all of the tickets will lose. If the standard solution is true, then we get the paradoxical result that it is possible for a person to have a justified set of beliefs that she knows is inconsistent. In this paper, I argue that the (...) best solution to the paradox is that a ticket holder is not justified in believing any of the tickets are losers. My solution avoids the paradoxical result of the standard solution. The solution I defend has been hastily rejected by other philosophers because it appears to lead to skepticism. I defend my solution from the threat of skepticism and give two arguments in favor of my conclusion that the ticket holder in the original lottery case is not justified in believing that his ticket will lose. (shrink)

Communication is an integral part of nursing practice—with patients and their relatives, other nurses and members of the healthcare team, and ancillary staff. Through interaction with the ‘other’, language and silence creates and recreates social realities. Acceptance, rejection or modification of social realities depends on what is expressed and by whom. Narratives that are offered can tell of some experiences and not others. Some nurses choose to be silent while others are silenced. In nursing situations recognising and allowing silence to (...) speak is a challenging but uniquely personal experience that embraces reflection in and on experiences, practice and self as a person and a professional. If enabled and truly heard, silence can speak more loudly than the hubbub of daily practice, allowing us to collectively question and challenge inherent assumptions and biases as professionals, and as a profession. Through a microcosm of Newly Graduated Nurses' lived experiences of nursing situations and expressions of silence individuals' discomfort and private efforts to ascribe meaning to experiences are reflected on. Returning to silence is to return to a constant process of professional transformation that can enable ways of knowing and being that can reform our profession from within and enable us to cast off shackles that bind us to a shameful cultural underbelly. (shrink)

It is currently fashionable to take Putnamian model-theoretic worries seriously for mathematics, but not for discussions of ordinary physical objects and the sciences. However, I will argue that (under certain mild assumptions) merely securing determinate reference to physical possibility suffices to rule out the kind of nonstandard interpretations of our number talk Putnam invokes. So, anyone who accepts determinate reference to physical possibility should not reject determinate reference to the natural numbers on Putnamian model-theoretic grounds.

Moral philosphy, in both the Kantian and Utilitarian traditions, has it as an ideal to provide a set of principles which dominate all other considerations and which will consistently resolve all moral problems. This is often taken to imply that guilt or remorse is irrational if it occurs in circumstances in which one does ones duty but also harms others. This essay explores the possibility of giving up this ideal in favor of a more complex view of morality in which (...) resolutions of conflict are worked out affectively rather than logically. (shrink)

Since the outbreak of COVID-19, governments have turned their attention to digital contact tracing. In many countries, public debate has focused on the risks this technology poses to privacy, with advocates and experts sounding alarm bells about surveillance and mission creep reminiscent of the post 9/11 era. Yet, when Apple and Google launched their contact tracing API in April 2020, some of the world’s leading privacy experts applauded this initiative for its privacy-preserving technical specifications. In an interesting twist, the tech (...) giants came to be portrayed as greater champions of privacy than some democratic governments. This article proposes to view the Apple/Google API in terms of a broader phenomenon whereby tech corporations are encroaching into ever new spheres of social life. From this perspective, the advantage these actors have accrued in the sphere of the production of digital goods provides them with access to the spheres of health and medicine, and more worrisome, to the sphere of politics. These sphere transgressions raise numerous risks that are not captured by the focus on privacy harms. Namely, a crowding out of essential spherical expertise, new dependencies on corporate actors for the delivery of essential, public goods, the shaping of public policy by non-representative, private actors and ultimately, the accumulation of decision-making power across multiple spheres. While privacy is certainly an important value, its centrality in the debate on digital contact tracing may blind us to these broader societal harms and unwittingly pave the way for ever more sphere transgressions. (shrink)

Although ‘warrant’ has been used to mean something like ‘justified to the degree required for knowledge’, it has recently come to mean something else. Alvin Plantinga has recently used the word ‘warrant’ to mean “that, whatever precisely it is, which makes the difference between knowledge and mere true belief.” So, in Plantinga’s sense of the word, warrant is the justification condition plus some other condition designed to rule out Gettier examples. In almost all cases, reliabilists, foundationalists, and coherentists have not (...) been giving theories about ‘warrant’ in Plantinga’s sense. They have been busy giving theories about justification. In his paper, “Warrant Entails Truth,” Trenton Merricks argues that warrant, in Plantinga’s sense, entails truth. In this paper, I will show that Merricks has not succeeded in showing that warrant entails truth. (shrink)

In this essay, Sharon Subreenduth explores how social justice policies have both global–local and historical dynamics and maintains that, as a result, dominant Western models of social justice limit engagement with alternative modes of understanding social justice in non-Western locations. She uses the South African experience as a case study for examining the complexities of social justice policy in the context of the decolonizing efforts that undergird national policy in South Africa as it simultaneously negotiates neoliberal globalizing dynamics. The (...) essay specifically analyzes the neoliberal concept of choice and how it figures within the discourse and practice of race and education within society. Moving beyond binaries, Subreenduth highlights the murky areas of social justice and articulates what they tell us about meta-analysis, narrative, resistance, complicities, infiltration, and the neoliberal il/logic of local–global histories. (shrink)

The datafication and digitalization of health and medicine has engendered a proliferation of new collaborations between public health institutions and data corporations like Google, Apple, Microsoft and Amazon. Critical perspectives on these new partnerships tend to frame them as an instance of market transgressions by tech giants into the sphere of health and medicine, in line with a “hostile worlds” doctrine that upholds that the borders between market and non-market spheres should be carefully policed. This article seeks to outline the (...) limitations of this common framing for critically understanding the phenomenon of the Googlization of health. In particular, the mobilization of a diversity of non-market value statements in the justification work carried out by actors involved in the Googlization of health indicates the co-presence of additional worlds or spheres in this context, which are not captured by the market vs. non-market dichotomy. It then advances an alternative framework, based on a multiple-sphere ontology that draws on Boltanski and Thevenot’s orders of worth and Michael Walzer’s theory of justice, which I call a normative pragmatics of justice. This framework addresses both the normative deficit in Boltanski and Thevenot’s work and provides an important emphasis on the empirical workings of justice. Finally, I discuss why this framework is better equipped to identify and to address the many risks raised by the Googlization of health and possibly other dimensions of the digitalization and datafication of society. (shrink)

This article begins with the author at a crucial juncture in her own theological thinking, challenged by Isasi-Díaz’ book, La Lucha Continues. She finds herself turning away from the polarizing logic of prophetic denunciation which has nurtured her, to a fresh understanding of justice in the context of true reconciliation. The article explores this in the context of multicultural education in an American university.

In many ways set theory lies at the heart of modern mathematics, and it does powerful work both philosophical and mathematical – as a foundation for the subject. However, certain philosophical problems raise serious doubts about our acceptance of the axioms of set theory. In a detailed and original reassessment of these axioms, Sharon Berry uses a potentialist approach to develop a unified determinate conception of set-theoretic truth that vindicates many of our intuitive expectations regarding set theory. Berry further (...) defends her approach against a number of possible objections, and she shows how a notion of logical possibility that is useful in formulating Potentialist set theory connects in important ways with philosophy of language, metametaphysics and philosophy of science. Her book will appeal to readers with interests in the philosophy of set theory, modal logic, and the role of mathematics in the sciences. (shrink)

Contemporary realist theories of value claim to be compatible with natural science. In this paper, I call this claim into question by arguing that Darwinian considerations pose a dilemma for these theories. The main thrust of my argument is this. Evolutionary forces have played a tremendous role in shaping the content of human evaluative attitudes. The challenge for realist theories of value is to explain the relation between these evolutionary influences on our evaluative attitudes, on the one hand, and the (...) independent evaluative truths that realism posits, on the other. Realism, I argue, can give no satisfactory account of this relation. On the one hand, the realist may claim that there is no relation between evolutionary influences on our evaluative attitudes and independent evaluative truths. But this claim leads to the implausible skeptical result that most of our evaluative judgements are off track due to the distorting pressure of Darwinian forces. The realist’s other option is to claim that there is a relation between evolutionary influences and independent evaluative truths, namely that natural selection favored ancestors who were able to grasp those truths. But this account, I argue, is unacceptable on scientific grounds. Either way, then, realist theories of value prove unable to accommodate the fact that Darwinian forces have deeply influenced the content of human values. After responding to three objections, the third of which leads me to argue against a realist understanding of the disvalue of pain, I conclude by sketching how antirealism is able to sidestep the dilemma I have presented. Antirealist theories of value are able to offer an alternative account of the relation between evolutionary forces and evaluative facts —
an account that allows us to reconcile our understanding of evaluative truth with our understanding of the many non-rational causes that have played a role in shaping our evaluative judgements. (shrink)

This Special Issue addresses two interrelated themes that have emerged both from within philosophy and from within education. The first has to do with reading across philosophical traditions in order to address what educational and contemplative practices have to say to one another; the second concerns the recent ‘contemplative turn’ in education, with its focus on mindfulness and other forms of mind/body work that are incorporated into the curriculum based on scientific research, on the one hand, and their spiritual origins, (...) on the other. (shrink)

Processing the various features from different feature maps and modalities in coherent ways requires a dedicated integration mechanism . Many authors have related feature binding to conscious awareness but little is known about how tight this relationship really is. We presented subjects with asynchronous audiovisual stimuli and tested whether the two features were integrated. The results show that binding took place up to 350 ms feature-onset asynchronies, suggesting that integration covers a relatively wide temporal window. We also asked subjects to (...) explicitly judge whether the two features would belong to the same or to the different events. Unsurprisingly, synchrony judgments decreased with increasing asynchrony. Most importantly, feature binding was entirely unaffected by conscious experience: features were bound whether they were experienced as occurring together or as belonging to a separate events, suggesting that the conscious experience of unity is not a prerequisite for, or a direct consequence of binding. (shrink)

A newly revised edition of the International Best-Seller, Making the Brain/Body Connection hit the book stores in June. This book has people raving about its user friendly approach and its solid research based information. Explore and experience how your brain, body and senses interrelate. Sharon Promislow's approach makes the brain research almost fun. Learn about your body's defence mechanism for stress and how you can adapt them to defuse stress instead of allowing it to accumulate into a full blown (...) stress attack. In her lively and entertaining book, Sharon blends cutting edge stress and brain research with practical exercises and techniques that have you moving beyond your current limitations and into a life you only imagined you could have. Her Quick Six stress buster techniques can be used on the street, in the board room, wherever you are when stress hits.Follow along with this step-by-step guide as she leads you through a model for change that unlocks hidden "stress circuits." Clear away mental, emotional and physical blocks to success with simple movements from the 10 Step Change Process, that make change fun. Illustrated with humorus new cartoon characters by Cathrine Levan. (shrink)

Most agree that when it comes to so-called 'first-order' normative ethics and political philosophy, constructivist views are a powerful family of positions. When it comes to metaethics, however, there is serious disagreement about what, if anything, constructivism has to contribute. In this paper I argue that constructivist views in ethics include not just a family of substantive normative positions, but also a distinct and highly attractive metaethical view. I argue that the widely accepted 'proceduralist characterization' of constructivism in ethics is (...) inadequate, and I propose what I call the 'practical standpoint characterization' in its place. I then offer a general taxonomy of constructivist positions in ethics. Since constructivism's standing as a family of substantive normative positions is relatively uncontested, I devote the remainder of the paper to addressing skeptics' worries about the distinctiveness of constructivism understood as a metaethical view. I compare and contrast constructivism with three other standard metaethical positions with which it is often confused or mistakenly thought to be compatible: realism; naturalist reductions in terms of an ideal response; and expressivism. In discussing the contrast with expressivism, I explain the sense in which, according to the constructivist, the distinction between substantive normative ethics and metaethics breaks down. I conclude by distinguishing between two importantly different debates about the mind-dependence of value. I argue that a failure to make this distinction is part of what explains why the possibility of constructivism as a metaethical view is often overlooked. (shrink)

Political science research, particularly in international relations and comparative politics, has increasingly become dominated by statistical and formal approaches. The promise of these approaches shifted the methodological emphasis away from case study research. In response, supporters of case study research argue that case studies provide evidence for causal claims that is not available through statistical and formal research methods, and many have advocated multimethod research. I propose a way of understanding the integration of multiple methodologies in which the causes sought (...) in case studies are treated as singular causation and contingent on a theoretical framework. (shrink)