This report explores the relationship between philosophy and medicine in the U.K. We note that medical training involves very little formal instruction in philosophy and ethics, and that, with few exceptions, philosophers in the U.K. do not contribute to the instruction of physicians or the philosophy of medicine. However, reviewing the problems arising out of recent developments within scientific medicine we find a pressing need for future philosophical analysis in the following areas: psychiatry, organ transplantation, abortion, euthanasia, experiments on living (...) subjects, consent, confidentiality, the relationship between medicine and political authority, and the provisions for social justice in medicine. (shrink)

BackgroundPalliative sedation and analgesia are employed in patients with refractory and intractable symptoms at the end of life to reduce their suffering by lowering their level of consciousness. The doctrine of double effect, a philosophical principle that justifies doing a “good action” with a potentially “bad effect,” is frequently employed to provide an ethical justification for this practice. Main textWe argue that palliative sedation and analgesia do not fulfill the conditions required to apply the doctrine of double effect, and therefore (...) its use in this domain is inappropriate. Furthermore, we argue that the frequent application of the doctrine of double effect to palliative sedation and analgesia reflects physicians’ discomfort with the complex moral, intentional, and causal aspects of end-of-life care. ConclusionsWe are concerned that this misapplication of the doctrine of double effect can consequently impair physicians’ ethical reasoning and relationships with patients at the end of life. (shrink)

For half a century, Ernest Fortin's scholarship has charmed and educated theologians and philosophers with its intellectual search for the best way to live. Written by friends, colleagues, and students of Fortin, this book pays tribute to a remarkable thinker in a series of essays that bear eloquent testimony to Fortin's influence and his legacy. A formidable commentator on Catholic philosophical and political thought, Ernest Fortin inspired others with his restless inquiries beyond the boundaries of conventional scholarship. With essays on (...) subjects ranging across philosophy, political science, literature, and theology Gladly to Learn and Gladly to Teach reflects the astonishing depth and breadth of Fortin's contribution to contemporary thought. (shrink)

For half a century, Ernest Fortin's scholarship has charmed and educated theologians and philosophers with its intellectual search for the best way to live. Written by friends, colleagues, and students of Fortin, this book pays tribute to a remarkable thinker in a series of essays that bear eloquent testimony to Fortin's influence and his legacy. A formidable commentator on Catholic philosophical and political thought, Ernest Fortin inspired others with his restless inquiries beyond the boundaries of conventional scholarship. With essays on (...) subjects ranging across philosophy, political science, literature, and theology Gladly to Learn and Gladly to Teach reflects the astonishing depth and breadth of Fortin's contribution to contemporary thought. (shrink)

Background In end-of-life situations, the phrase “do everything” is sometimes invoked by physicians, patients, or substitute decision-makers, though its meaning is ambiguous. We examined instances of the phrase “do everything” in the archive of the Ontario Consent and Capacity Board in Canada, a tribunal with judicial authority to adjudicate physician–patient conflicts in order to explore its potential meanings. Methods We systematically searched the CCB’s online public archive from its inception to 2018 for any references to “do everything” in the context (...) of critical care medicine and end-of-life care. Two independent assessors reviewed decisions, collected characteristics, and identified key themes. Results Of 598 cases in the archive, 41 referred to “do everything” in end-of-life situations. The phrase was overwhelmingly invoked by SDMs, typically to advocate for life-prolonging measures that contradicted physician advice. Physicians generally related “doing everything” to describe the interventions they had already performed, using it to recommend focusing on patients’ quality of life. SDMs were generally reluctant to accept death, whereas physicians found prolonging life at all costs to be morally distressing. The CCB did not interpret appeals to “do everything” legally but followed existing laws by deferring to patients’ prior wishes whenever known, or to concepts of “best interests” when not. The CCB generally recommended against life-prolonging measures in these cases, focusing on patients’ “well-being” and “best interests.” Conclusions In this unique sample of cases involving conflict surrounding resuscitation and end-of-life care, references to “do everything” highlighted conflicts over quantity versus quality of life. These appeals were associated with signs of cognitive distress on the behalf of SDMs who were facing the prospect of a patient’s death, whereas physicians identified moral distress related to the prolongation of patients’ suffering through their use of life-sustaining interventions. This divergence in perspectives on death versus suffering was consistently the locus of conflict. These findings support the importance of tools such as the Serious Illness Conversation Guide that can be used by physicians to direct conversations on the patients’ goals, wishes, trade-offs, and to recommend a treatment plan that may include palliative care. Trial Registration Not applicable. (shrink)

Jablonka & Lamb (J&L) reject but memetics can explain human uniqueness and culture (as a product of the ability to imitate) without depending on their slippery notion of symbolism. Modern memes show the beginnings of a division into replicators and vehicles, and the replacement of reconstructive processes with systems of blind copying, variation, and selection.

Dolly is a lamb that was cloned by Dr. Ian Wilmut, a Scottish embryologist. But she is also a Rorschach test. The public response to the production of a lamb by cloning a cultured cell line reflects the futuristic fantasies and Frankenstein fears that have more broadly surrounded research in genetics and especially genetic engineering. Cloning was a term originally applied to a botanical technique of asexual reproduction. But following early experiments in the manipulation of the hereditary and (...) reproductive process during the mid-1960s, the term became associated with human biological engineering. It also became a pervasive theme in horror films and science fiction fantasies. Appearing to promise both amazing new control over nature and terrifying dehumanization, cloning has gripped the popular imagination. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Response to Susan Laird, “Musical Hunger: A Philosophical Testimonial of Miseducation”Estelle R. JorgensenSusan Laird’s lament of her “musical under-education,” her youthful lack of opportunity for the sorts of experiences for which she hungered and its life-long after-effects, and her invocation of hunger as a metaphor for music education raise compelling questions. In a feminized field such as music, particularly piano playing, her hunger is particularly poignant. Also, (...) the notion of “musical taste” takes on new meaning, and the musical, educational, and ethical questions this metaphor evokes reveal its richness as a means of thinking about music education. This metaphor joins others such as Barbara Thayer Bacon’s metaphor of the quilt, Jane Roland Martin’s metaphor of the home, Iris Yob’s metaphor of pilgrimage, Elizabeth Gould’s metaphor of the nomad, Virginia Richardson’s metaphor of the steward, and Randall Allsup’s metaphor of the garage band, each of which illumines music education differently.1 Without one, we miss important insights into the thought and practice of music education; when taken together, they offer a richer view than were we to see music education in terms of one alone. [End Page 75]Although metaphor evokes imaginative thought and practice in music education, it is also limited. As Nelson Goodman aptly puts it, metaphor is a “matter of teaching an old word new tricks” and an “expedition abroad in which associations with one realm are applied in another.”2 Its power lies in its evocative and imaginative quality as it startles and surprises, challenges familiar ways of thinking and doing, and opens new possibilities for how we might think, act, and be differently. Although Laird would not want to literalize musical hunger or equate it with physical hunger—physical and spiritual realms intersect but they are not equivalent—it is possible to freeze a metaphor or literalize the vitality out of it. Testing it systematically, we enter the ground between metaphor and model, or what Iris Yob thinks of as the metaphorical model.3 While metaphor may prompt an intellectual journey, it cannot take us the entire way. In its particularistic and imaginative appeal, it opens reflection though it cannot suffice. A metaphor may also have a dark side. For example, envisaging the teacher’s role as salvific in providing bread for the hungry or preventing gluttony or food addictions may foster a paternalistic view that substitutes the teacher’s view of a student’s long term interests for the student’s directly-known and immediately perceived needs and interests, thereby subverting Laird’s expressed interest in the student’s desires. The educational “sin” of addiction may also be “redeemed” in Schefflerian fashion by pointing to important contributions of musicians who were doubtless excessive in their musical engagements.4 These possibilities suggest that we shall need to examine critically the metaphor and what it means for music education and move beyond the metaphor to its related models of music education.One of the interesting questions that Laird’s metaphor of hunger raises is the possibility of spiritual hunger, especially in a pervasively materialistic world. Matters related to spirituality have been addressed variously by writers in music education, whether it be the “healing” and ecologically-oriented approach of June Boyce-Tillman, the evolutionary and anthropologically grounded holistic approach of Anthony Palmer, the ethically-based approach of David Carr, the introspective and politically-charged writing of Cathy Benedict and Randall Allsup, the feminist perspectives of Elizabeth Gould, Charlene Morton, Roberta Lamb, and Deanne Bogdan, or the religiously grounded work of Iris Yob.5 Notions of spiritual hunger might be seen differently within the various lenses that these writers bring to music education but they all underscore the importance of knowing that goes beyond the literal, utilitarian, generalizable, and vocational to address the life of mind and body that Susanne Langer terms “feeling” and with which the arts, myths, rituals, and religions have to do.6 As such, they rebuke general education that is limited to reading, writing, and arithmetic, and driven by tests, standards, and mandates that often give short shrift to matters of human spirituality. Still, as the recent unanimous resolution in favor of... (shrink)

The concept of "fitness" is a notion of central importance to evolutionary theory. Yet the interpretation of this concept and its role in explanations of evolutionary phenomena have remained obscure. We provide a propensity interpretation of fitness, which we argue captures the intended reference of this term as it is used by evolutionary theorists. Using the propensity interpretation of fitness, we provide a Hempelian reconstruction of explanations of evolutionary phenomena, and we show why charges of circularity which have been levelled (...) against explanations in evolutionary theory are mistaken. Finally, we provide a definition of natural selection which follows from the propensity interpretation of fitness, and which handles all the types of selection discussed by biologists, thus improving on extant definitions. (shrink)

'...a challenging and useful book, both because it provokes a careful scrutiny of one's own basic ideas regarding evolutionary theory, and because it cuts across so many biological disciplines.' -The Quarterly Review of Biology 'In my view, this work exemplifies Theoretical Biology at its best...here is rampant speculation that is consistently based on cautious reasoning from the available data. Even more refreshing is the absence of sloganeering, grandstanding, and 'isms'.' -Biology and Philosophy 'Epigenetics is fundamental to understanding both development and (...) gene expression, and not surprisingly, evolutionary biologists have long been fascinated with its proper place in evolutionary theory...Enter Jablonka and Lamb, who provide a thoughtful review of the recent molecular literature and suggest a number of potential consequences.' -EvolutionSince first publication of this controversial book, much of the initial opposition to the ideas it contained has been replaced by a general, although often grudging, acceptance of them. Advances in knowledge, especially at the molecular level, have enhanced general awareness and interest in epigenetics and the evolution of systems that store and transmit information and put any of the authors' speculations on a more solid basis. This paperback edition contains a new Preface that sets out the major changes in the scientific world and in the authors' own thinking that have occurred since the book was published. A new Appendix provides a selected bibliography of the many books and articles about epigenetic inheritance and its role in evolution that have appeared since first publication. (shrink)

I argue that an ecologically distributed conception of instrumental rationality can and should be extended to a socially distributed conception of instrumental rationality in social environments. The argument proceeds by showing that the assumption of exogenously fixed units of activity cannot be justified; different units of activity are possible and some are better means to independently given ends than others, in various circumstances. An important social heuristic, the mirror heuristic, enables the flexible formation of units of activity in game theoretic (...) situations, including collective units where these are instrumentally effective. In effect, the mirror heuristic makes the formation of units of activity endogenous to instrumental rationality. Moreover, the mirror heuristic is a conditional metaheuristic, which depends on mind reading of the heuristics of other players rather than on predictions of their behavior. Such mind reading can be regarded as emerging from an arms race between behavioral mimicry and ever smarter behavior reading. Even though unilateral mind reading may have benefits, the mirror metaheuristic illustrates that mutual mind reading has distinctive functions in responding to the challenges of social complexity. If simple heuristics can make us smart in the right environments, then social heuristics can make us smarter still. (shrink)

No one denies that people adapt what they say and how they interpret what is said to them, depending on their interactive partners. What is controversial is when and how they do so. Several psycholinguistics research programs have found what appear to be failures to adapt to partners in the early moments of processing and have used this evidence to argue for modularity in the language processing architecture, claiming that the system cannot take into account a partner’s distinct needs or (...) knowledge early in processing. We review the evidence for both early and delayed partner‐specific adaptations, and we identify some challenges and difficulties with interpreting this evidence. We then discuss new analyses from a previously published referential communication experiment (Metzing & Brennan, 2003) demonstrating that partner‐specific effects need not occur late in processing. In contrast to Pickering and Garrod (2004) and Keysar, Barr, and Horton (1998b), we conclude that there is no good evidence that early processing has to be be “egocentric,”“dumb,” or encapsulated from social knowledge or common ground, but that under some circumstances, such as when one partner has made an attribution about another’s knowledge or needs, processing can be nimble enough to adapt quite early to a perspective different from one’s own. (shrink)

This research paper explores the implications of emotional intelligence and the Big Five personality model on virtual team effectiveness. It illustrates how emotional intelligence and Big Five personality traits help team members better understand interpersonal relationships and develop constructive virtual teams. The widespread use of virtual team meetings for collaborative work over in-person interaction with diverse personalities creates discord and trust among team members, limiting overall productivity. A quantitative analysis approach is used, with hypotheses tested and a series of multiple (...) linear regression analyses performed on data collected from relevant industries using convenient sampling. The findings show that the Big Five personality affects the virtual team's trust and collaboration parameters. However, the relationship between personality traits and team effectiveness is mediated by emotional intelligence. Also, it is explored that having control over emotional intelligence or developing emotional intelligence would improve team performance while managing and working with a diverse group of people. (shrink)

A Teacher's Manual for this book will be available online at www.temple.edu/tempress.

In his essay, ‘The Question of Machiavelli’, Isaiah Berlin notes the depth of Machiavelli's pluralism. Taking my cue from Berlin, I argue that much modern liberal political philosophy neglects this deep pluralism and, as a result, misunderstands modern political problems such as the phenomenon of religiously-motivated terrorism.

Why Theories of Concepts Should Not Ignore the Problem of Acquisition.

In responding to three reviews of Evolution in Four Dimensions (Jablonka and Lamb, 2005, MIT Press), we briefly consider the historical background to the present genecentred view of evolution, especially the way in which Weismann’s theories have influenced it, and discuss the origins of the notion of epigenetic inheritance. We reaffirm our belief that all types of hereditary information—genetic, epigenetic, behavioural and cultural—have contributed to evolutionary change, and outline recent evidence, mainly from epigenetic studies, that suggests that non-DNA heritable (...) variations are not rare and can be quite stable. We describe ways in which such variations may have influenced evolution. The approach we take leads to broader definitions of terms such as ‘units of heredity’, ‘units of evolution’, and ‘units of selection’, and we maintain that ‘information’ can be a useful concept if it is defined in terms of its effects on the receiver. Although we agree that evolutionary theory is not undergoing a Kuhnian revolution, the incorporation of new data and ideas about hereditary variation, and about the role of development in generating it, is leading to a version of Darwinism that is very different from the gene-centred one that dominated evolutionary thinking in the second half of the twentieth century. (shrink)

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse—an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was (...) to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities. (shrink)

A response to Maryann Ayim's "In Praise of Clutter as a Necessary Part of the Feminist Perspective.".

We propose that the generalizations of linguistic theory serve to ascribe beliefs to humans. Ordinary speakers would explicitly (and sincerely) deny having these rather esoteric beliefs about language--e.g., the belief that an anaphor must be bound in its governing category. Such ascriptions can also seem problematic in light of certain theoretical considerations having to do with concept possession, revisability, and so on. Nonetheless, we argue that ordinary speakers believe the propositions expressed by certain sentences of linguistic theory, and that linguistics (...) can therefore teach us something about belief as well as language. Rather than insisting that ordinary speakers lack the linguistic beliefs in question, philosophers should try to show how these empirically motivated belief ascriptions can be correct. We argue that Stalnaker's (1984) "pragmatic" account--according to which beliefs are dispositions, and propositions are sets of possible worlds--does just this. Moreover, our construal of explanation in linguistics motivates (and helps provide) responses to two difficulties for the pragmatic account of belief: the phenomenon of opacity, and the so-called problem of deduction. (shrink)

The focus here is Robert L. Heilbroner's critique, in the last chapter of the 7th edition of The Worldly Philosophers, of the idea that economics is, or should be, scientific. Heilbroner's conception of economics as essentially tied to capitalism is too narrow, and at odds with his own commentary on the rise of pauperism after the English common-land enclosures; and his critique of contemporary economics-as-social science is overdrawn. Nevertheless, there is indeed an important role for the “visionary” economics for which (...) Heilbroner hankers: assessing the benefits and drawbacks of different ways of ordering the production and distribution of goods and services. (shrink)

The rotating spot method of timing subjective events involves the subject’s watching a rotating spot on a computer and reporting the position of the spot at the instant when the subjective event of interest occurs. We conducted an experiment to investigate factors that may impact on the results produced by this method, using the subject’s perception of when they made a simple finger movement as the subjective event to be timed. Seven aspects of the rotating spot method were investigated, using (...) a factorial experiment. Four of these aspects altered the physical characteristics of the computer generated spot or clock face and the remaining three altered the instructions given to the participant. We found compelling evidence that one factor, whether the subject was instructed to report the instant when the finger movement was initiated or the instant when it was completed, resulted in a systematic shift in the response. Evidence that three other factors affect the observed variability in the response was also found. In addition, we observed that there are substantial systematic differences in the responses made by different subjects. We discuss the implications of our findings and make recommendations about the optimal way of conducting future experiments using the rotating spot method. Our overall conclusion is that our results strongly validate the rotating spot method of timing at least the studied variety of subjective event. (shrink)

Brentano's thoughts on unity of consciousness are of central importance to an understanding of his psychology and of his ontology. By means of a reistic interpretation of his views on unity of consciousness, and in contrast with the Aristotelian approach to unity of consciousness, one begins to see the paradoxically objective and realistic spirit of Brentano's subjectivism in psychology.

Health care reform proposals threaten to exacerbate tensions physicians already face in trying to balance traditional duties to individual patients against increasing pressure to serve broader societal and institutional goals. To cope with reform, medical ethics must clarify physicians' moral obligations, change existing ethical codes, and develop an ethics of institutions.

This essay looks at the way in which the end of the world syndrome manifests itself regularly as a form of human consciousness. It makes us alert to the possibility of our own instant expiry, causing us both to introspect, as well as to imagine the future of the species. Digitalization and digitization of trauma permits us to see the normality of death as an every present occurrence. Within this context, words have tremendous power, showing us that at each moment (...) we are being ushered into a space not necessarily of our own making. While it frightens us, yet the choices we have are limited to the class and ethnic locations of our everyday survival. While we live, we dream. Negation does not end ambition, it only proves the ephemerality of individual existence and makes us seek to use time as best as our imagination and survival capabilities allow. Our sadness about corporeality is mitigated by the dream we have of species continuity. (shrink)

The current explosion of genetic knowledge and the rapid proliferation of genetic tests has rightly provoked concern that we are approaching a future in which people will be labeled and disadvantaged based on genetic information. Indeed, some have already suffered harm, including denial of health insurance. This concern has prompted an outpouring of analysis. Yet almost all of it approaches the problem of genetic disadvantage under the rubric of “genetic discrimination.”This rubric is woefully inadequate to the task at hand. It (...) ignores years of commentary on race and gender demonstrating the limits of antidiscrimination analysis as an analytic framework and corrective tool. Too much discussion of genetic disadvantage proceeds as if scholars of race and gender had not spent decades critiquing and developing antidiscrimination theory.Indeed, there are multiple links among race, gender, and genetics. Dorothy Roberts has discussed the historical links between racism and genetics, while she and others have begun to map connections between gender and genetics. (shrink)

Some may be convinced that, whether or not Lewis’ defense is successful, realism about possible worlds is unavoidable if sense is to be made of modal locutions. To show that this view is—as I believe-mistaken would be a more ambitious project than I can undertake here. But some brief comments may serve to show how extreme a view this is. If one rejects realism about possible worlds, one has at least these options: to accept that conventional modal logic can be (...) made intelligible only by way of possible worlds, but to try to construe possible worlds syntactically or conceptually; to deny that conventional modal logic can be made intelligible only by way of possible worlds; to retreat from conventional modal calculi to variant systems. I observe that, since the usual systems are wholly insensitive to the differences of tense and mood which are crucial to natural language modal locutions, there is some motivation for scepticism about the adequacy of conventional modal logics. So I resist the suggestion that there is no alternative to thoroughgoing realism. (shrink)

At the turn of the 21st century, Susan Leigh Anderson and Michael Anderson conceived and introduced the Machine Ethics research program, that aimed to highlight the requirements under which autonomous artificial intelligence systems could demonstrate ethical behavior guided by moral values, and at the same time to show that these values, as well as ethics in general, can be representable and computable. Today, the interaction between humans and AI entities is already part of our everyday lives; in the near (...) future it is expected to play a key role in scientific research, medical practice, public administration, education and other fields of civic life. In view of this, the debate over the ethical behavior of machines is more crucial than ever and the search for answers, directions and regulations is imperative at an academic, institutional as well as at a technical level. Our discussion with the two inspirers and originators of Machine Ethics highlights the epistemological, metaphysical and ethical questions arising by this project, as well as the realistic and pragmatic demands that dominate artificial intelligence and robotics research programs. Most of all, however, it sheds light upon the contribution of Susan and Michael Anderson regarding the introduction and undertaking of a main objective related to the creation of ethical autonomous agents, that will not be based on the “imperfect” patterns of human behavior, or on preloaded hierarchical laws and human-centric values. (shrink)

Poorly understood, linked in complex ways to ideas about race and European identity, and the focus today of an ethically vexed and rapidly expanding testing industry, cystic fibrosis is a relatively common life-threatening genetic disorder in the United States, the United Kingdom, and the European Union. Many genetic diseases are invisible to the general public, but CF is a high-profile genetic disease, often characterized as a “white” disease though it occurs in many populations. Over the last five years it has (...) become the focus of genetic screening programs of many kinds, but especially for newborns, all over the world. CF is also a scientifically interesting genetic disease. By the simple if imperfect .. (shrink)