Ronit Stahl and Ezekiel Emanuel have recently issued a stark challenge to conscience protections in medical law and ethics. Their argument is flawed, however. They misrepresent the nature and relevance of conscientious protection in the military, misinterpret the scope of consent tendered by modern medical professionals, and offer no reason to think either that conscientious objection harms patient well-being or that such harm should solely determine the permissibility of conscientious objection. Moreover, and most fundamentally, Stahl and Emanuel do not recognize (...) that conscience protections promote moral integrity, a basic aspect of human well-being that justifies protective action. (shrink)

Book reviewed in this article: Long Term Care: Principles, Programs and Policies. By Rosalie A. Kane and Robert L. Kane. Long Term Health Care: providing a Spectrum of Services to the Aged. By Philip W. Brickner, Anthony J. Lechich, Roberta Lipsman, and Linda K. scharer.

Many important decisions depend on unknown states of the world. Society is increasingly relying on statistical predictive models to make decisions in these cases. While predictive models are useful, previous research has documented that (a) individual decision makers distrust models and (b) people’s predictions are often worse than those of models. These findings indicate a lack of awareness of how to evaluate predictions generally. This includes concepts like the loss function used to aggregate errors or whether error is training error (...) or generalisation error. To address this gap, we present three studies testing how lay people visually evaluate the predictive accuracy of models. We found that (a) participant judgements of prediction errors were more similar to absolute error than squared error (Study 1), (b) we did not detect a difference in participant reactions to training error versus generalisation error (Study 2), and (c) participants rated complex models as more accurate when comparing two models, but rated simple models as more accurate when shown single models in isolation (Study 3). When communicating about models, researchers should be aware that the public’s visual evaluation of models may disagree with their method of measuring errors and that many may fail to recognise overfitting. (shrink)

In a recent article, Director makes the case that many individuals with bipolar disorder have the capacity to consent to many decisions while acutely manic, even when those decisions are out of character and cause harm. Referring to recent qualitative evidence, I argue that Director overlooks a key mechanism of manic incapacity, an inflexible experience of the future that impairs one’s ability to value. Without attention to the illness-specific experience of decision-making, capacity assessments risk false negatives in people with mania.

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of (...) capacity, we previously developed a descriptive typology of justifications used in the application of the Mental Capacity Act criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA. No data are available. This paper does not report any original data. (shrink)

Research using mHealth apps has the potential to positively impact health care management and outcomes. However, choosing an appropriate mHealth app may be challenging for the health researcher. The author team used existing evaluation tools, checklists, and guidelines to assess selected mHealth apps to identify strengths, challenges, and potential gaps within existing evaluation tools. They identified specific evaluation tool components, questions, and items most effective in examining app content, usability, and features, including literacy demand and cultural appropriateness; technical information; practical (...) aspects of app functionality; and evolving capabilities of mobile medical apps. Challenges included the subjective nature of the results, time required to complete the evaluation, lack of emphasis on evidence‐based content, and inadequate tool flexibility. Health researchers considering the integration of mobile apps into research will benefit from evaluation tools that assess both evidence‐based content and the ability of the mobile app to securely integrate with other digital technologies involved in patient care. Next steps will include the involvement of health care providers and professionals, including nurses a wide range of expertise, to develop an mHealth evaluation tool that focuses on identifying quality, evidence‐based mobile apps into patient outcomes research. (shrink)

This chapter turns to the second and the more important criterion for free will, namely, ultimate responsibility. A series of theses are defended that explain what this criterion entails and why it is incompatible with determinism. In the process, the chapter critically examines new compatibilist accounts of free will, such as the “hierarchical theories” of Harry Frankfurt and others. The chapter also discusses the notion of “covert non‐constraining control,” the kind of hidden control of human behavior that one encounters in (...) scientific utopias like that described in B. F. Skinner's Walden Two. The notion of “self‐forming actions” is defined and shown to be pivotal to understanding what it means to say that something is done “of one's own free will.”. (shrink)

Background: The concept of conscientious objection is well described; however, because of its nature, little is known about real experiences of nursing professionals who apply objections in their practice. Extended roles in nursing indicate that clinical and value-based dilemmas are becoming increasingly common. In addition, the migration trends of the nursing workforce have increased the need for the mutual understanding of culturally based assumptions on aspects of health care delivery. Aim: To present (a) the arguments for and against conscientious objection (...) in nursing practice, (b) a description of current regulations and practice regarding conscientious objection in nursing in Poland and the United Kingdom, and (c) to offer a balanced view regarding the application of conscientious objection in clinical nursing practice. Design: Discussion paper. Ethical considerations: Ethical guidelines has been followed at each stage of this study. Findings: Strong arguments exist both for and against conscientious objection in nursing which are underpinned by empirical research from across Europe. Arguments against conscientious objection relate less to it as a concept, but rather in regard to organisational aspects of its application and different mechanisms which could be introduced in order to reach the balance between professional and patient’s rights. Discussion and conclusion: Debate regarding conscientious objection is vivid, and there is consensus that the right to objection among nurses is an important, acknowledged part of nursing practice. Regulation in the United Kingdom is limited to reproductive health, while in Poland, there are no specific procedures to which nurses can apply an objection. The same obligations of those who express conscientious objection apply in both countries, including the requirement to share information with a line manager, the patient, documentation of the objection and necessity to indicate the possibility of receiving care from other nurses. Using Poland and the United Kingdom as case study countries, this article offers a balanced view regarding the application of conscientious objection in clinical nursing practice. (shrink)

Despite the fact that the requirement to obtain informed consent for medical procedures is deeply enshrined in both U.S. moral and legal doctrine, empirical studies and anecdotal accounts show that women's rights to informed consent and refusal of treatment are routinely undermined and ignored during childbirth. For example, citing the most recent Listening to Mothers survey, Marianne Nieuwenhuijze and Lisa Kane Low state that "a significant number of women said they felt pressure from a caregiver to agree to having (...) an intervention that they did not want during birth". Specifically, Nieuwenhuijze and Low cite that "19% of women who did not have epidural analgesia felt... (shrink)

This is an extremely lucid analysis of free will, the relativity of values, and the relationship between them, based on the “dignity of the individual … because one is the ultimate originator of one’s own ends”. It is an analysis which avoids “mystery at all costs … [and] … appeals to mysterious forms of agency”. Kane’s theory neither requires nor rules out mind/body dualism, the appeal to noumenal selves, or other nonoccurrent causes.

This chapter talks about the first season of the TV series Veronica Mars. Additionally, the chapter explores the significance of Veronica Mars's photography. Veronica has found her life irrevocably altered in multiple ways. Her best friend, Lilly Kane, was murdered, her father, Keith Mars, lost his job as sheriff as the result of an apparently bungled investigation into Lilly's death, and Veronica lost her social status and former friends. Subsequently her mother, Lianne Mars, left home, apparently unable to deal (...) with the stress of it all. In addition to all this misfortune, Veronica, had attended a party at which she was drugged and then raped. She states in a voiceover, that she is a marshmallow, ironically though. But at the end of the season she has broken through to a new self‐understanding, which is illustrated in the final scene. (shrink)

Treatises on Indian philosophy have multiplied in the last thirty years, in the “West as well as in India itself. And in spite of the demanding nature of this subject—it exacts, so to speak, a uniform presentation; it entails a whole succession of systems, each one of which is elaborated in a more or less independent manner—this abundance is nonetheless profitable. Each author makes his contribution in the detailed account of new views and strives to rejuvenate a somewhat refractory material, (...) even if this involves the taking up of old views, discarded or neglected by the new generation of scholars. (shrink)

Positions taken in the current debate over free will can be seen as responses to the following conditional: -/- If every action is caused solely by another event and a cause necessitates its effect, then there is no action to which there is an alternative (C). -/- The Libertarian, who believes that alternatives are a requirement of free will, responds by denying the right conjunct of C’s antecedent, maintaining that some actions are caused, either mediately or immediately, by events whose (...) effects could be different, even if they were to recur under identical circumstances. We have here a denial of Laplacian Determinism (LD), according to which the condition of the world at any instant makes only one state possible at any other instant. One prominent defender of this view, Robert Kane, holds that unless an agent’s neural mechanisms operated indeterministicly in forming her character she is not responsible for its manifestations. This requirement is entailed by the principle of “ultimate responsibility” (UR) according to which an act is freely willed only if (a) its agent is personally responsible for its performance in the sense of having caused it to occur by voluntarily doing something that was avoidable and (b) there is no sufficient condition for its performance for which its agent is not personally responsible. The orthodox Compatibilist, adducing counterexamples to UR, argues that even if C and its antecedent are true, free will is possible. Ned Markosian has provided the Compatibilist with yet another response to UR-based objections to her view, wedding it to the notion of agent causation: here the deterministic causing of an act by its agent is necessary and sufficient for its being “morally free.” I criticize this view as inconsistent with the agent causalist's belief that moral responsibility precludes causation of a choice by any power other than the maker thereof: he being its efficient cause. (shrink)

This article articulates and defends an indeterministic weightings model of libertarian free will. It begins by defining the conception of free will at issue and then goes on to present versions of the luck objection which is often made against theories of LFW. It is argued that the sort of indeterministic weightings model of LFW which has been defended in the recent literature by Storrs McCall and E.J. Lowe and John Lemos has the resources to answer such luck objections while (...) possessing virtues which some other libertarian views lack. According to the indeterministic weightings model of LFW, in making undetermined free-willed choices between two courses of action, A or B, the reasons for choosing each option don’t come with pre-established evaluative weights. During the process of deliberation, the agent assigns weight in an undetermined way to the reasons for each option and this typically leads to the choice of the option that has been assigned a greater value. In the paper, it is not only argued that this theory can resolve worries about luck but also that the view has virtues which certain other libertarian views lack, as such the view is contrasted with the modest libertarian models of LFW from Daniel Dennett and Alfred Mele as well as Robert Kane’s view. (shrink)

I first adumbrate pertinent aspectsof Robert Kane''s libertarian theory of free choice oraction and an objection of luck that has been levelledagainst the theory. I then consider Kane''s recentresponses to this objection. To meet these responses,I argue that the view that undetermined choices (ofthe sort implied by Kane''s theory) are a matter ofluck is associated with a view about actionexplanation, to wit: when Jones does A and hisdoing of A is undetermined, and when hiscounterpart, Jones*, in the (...) nearest possibleworld in which the past and the laws are held constantuntil the moment of choice does B instead, thereis no explanation (deterministic or indeterministic)of the difference in outcome – Jones''s A-ing butJones*''s B-ing – in terms of prior reasonsor motives of either agent. Absence of such anexplanation is one crucial factor that underliesthe charge that Jones''s A-ing and Jones*''sB-ing are matters of luck. I argue that thissort of luck is incompatible with responsibility. (shrink)

Free will and determinism have recently attracted the attention of Buddhist scholars who have defended conflicting views on this issue. I argue that there is no reason to think that this problem cannot arise in Buddhist philosophy, since there are two senses of ‘free will’ that are compatible with the doctrine of non-self. I propose a reconstruction of a problem of free will and determinism in Early Buddhism, given a) the assumption that Buddhist causation entails universal causal determinism, and b) (...) a crucial passage suggesting that Early Buddhism is committed to the principle of alternative possibilities which is arguably incompatible with a determinist interpretation of causation. This passage suggests that Early Buddhism must leave room for a robust, incompatibilist form of free will, and that a conception of indeterminist free will in the spirit of Robert Kane’s theory allows us to make sense of that notion. (shrink)

Despite being eminently forgettable from the literary point of view, B. F. Skinner’s novel, Walden Two , provides us with an excellent opportunity, not so much to show what is wrong with mainstream accounts of free will, as Robert Kane thinks, but rather to explore another key and importantly neglected condition for genuine agency; namely, that properly lived human lives are those that are and must continue to be vulnerable to unforseable reversals, as Aldous Huxley speculates in his Brave (...) New World . In short, I argue, perhaps scandalously, that one of the central conditions for genuine agency is that our lives are and must continue to be, to a large extent, out of our personal control. The promise of too much personal control, not too little (as Kane thinks), is what is wrong with Skinner’s social utopia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Free Will’s Value: Criminal Justice, Pride, and Love by John LemosJohn DavenportLEMOS, John. Free Will’s Value: Criminal Justice, Pride, and Love. New York: Routledge, 2023. 284 pp. Cloth, $160.00It is a pleasure to read John Lemos’s latest work on moral free will, understood as the control needed for us to be morally responsible in “the just deserts sense.” Lemos is a clear writer who carefully lays out the (...) positions that he reviews and critiques. This book would be wonderful as a main text in a graduate seminar: The first six chapters critically address most of the main theories and moves in this wide field during the last twenty to twenty-five years, providing a very helpful overview while setting up Lemos’s own position. He advances an “indeterministic weightings” version of leeway-libertarianism about moral freedom that builds on both Robert Kane’s event-causal account and Robert Nozick’s older account of fixing the weight of practical considerations in the moment of choice. Lemos’s new account significantly refines the position that he defended against hard incompatiblism in his 2018 book. [End Page 721]Free Will’s Value also discusses responsibility in applied contexts, such as criminal justice and loving relationships. There are two chapters arguing that hard incompatibilists cannot save the “just deserts” aspect of criminal punishment or explain all the wrongness of taking the liberty of innocent persons mistakenly convicted. Their “public health quarantine” account of criminal justice will be utilitarian, and thus have a hard time justifying the beyond-reasonable-doubt standard for conviction. And, building on the critiques of compatibilism that he develops partly from Derk Pereboom and Bruce Waller, Lemos includes three chapters arguing that “axiological/pragmatist reasons” provide more evidence for libertarian free will than psychological evidence alone can.The final chapter in particular offers a novel argument that valuable sorts of interhuman loves need to involve self- or character-forming initiatives that are not primarily determined by factors beyond our control. The intrinsic value of some types of love, such as deep friendships—including romantic friendships—involve their being autonomous (my term), which in turn requires a kind of leeway-control. This involves arguing that “our will, effort, or a decision to love” is important to values achieved in sustaining loving relationships.Lemos’s own theory contends that Kane’s account of “self-forming actions” (SFAs) and “willings” (SFWs) in terms of dual “tryings” (or decisions) to do A or B in a fraught situation suffers from the “phenomenological problem” stated by Laura Ekstrom and Marc Balaguer, namely, that we do not normally experience fraught choices as involving such opposed tryings. This is even more evident, I believe, if we consider choices involving three or more salient options. Lemos is not convinced by Kane’s reply that the dual or multiple simultaneous efforts are usually unconscious, because he thinks responsibility for unconscious mental processes will (normally) trace to patterns of conscious choices made earlier in life. In fact, unconscious efforts, Lemos says, cannot meet even “plausible minimal compatibilist standards of responsibility” for elements of agency.I’m not convinced by this last claim, because it seems that an unconscious choice, C, could be responsive to (or counterfactually guided by) reasons relevant to C that the agent has considered in the past. Perhaps the problem is that “trying” is normally associated with attempting to act on an intention, but Kane uses it to describe the more elusive processes of agency involved in forming an intention via decision in the face of competing relevant options, which thereby incorporates motives into the intention. This sheds light on the further problem that it appears irrational to try to do multiple incompatible things at once. Pace Lemos, I think that Kane is right that “will-settling” is a special context in which it is not irrational for a single person’s agency to be engaged along dual pathways. Even if we do not call this “trying,” the agent’s interactions with the salient options are not like those of a detached spectator; they are volitional as well as evaluative. [End Page 722]Lemos’s account recognizes three loci... (shrink)

Joel Feinberg : In Memoriam. Preface. Part I: INTRODUCTION TO THE NATURE AND VALUE OF PHILOSOPHY. 1. Joel Feinberg: A Logic Lesson. 2. Plato: "Apology." 3. Bertrand Russell: The Value of Philosophy. PART II: REASON AND RELIGIOUS BELIEF. 1. The Existence and Nature of God. 1.1 Anselm of Canterbury: The Ontological Argument, from Proslogion. 1.2 Gaunilo of Marmoutiers: On Behalf of the Fool. 1.3 L. Rowe: The Ontological Argument. 1.4 Saint Thomas Aquinas: The Five Ways, from Summa Theologica. 1.5 Samuel (...) Clarke: A Modern Formulation of the Cosmological Argument. 1.6 William L. Rowe: The Cosmological Argument. 1.7 William Paley: The Argument from Design. 1.8 Michael Ruse: The Design Argument. 1.9 David Hume: Dialogues Concerning Natural Religion. 2. The Problem of Evil. 2.1 Fyodor Dostoyevsky: Rebellion. 2.2 J. L. Mackie: Evil and Omnipotence. 2.3 Peter van Inwagen: The Argument from Evil. 2.4 Michael Murray and Michael Rea: The Argument from Evil. 2.5 B. C. Johnson: God and the Problem of Evil. 3. Reason and Faith. 3.1 W. K. Clifford: The Ethics of Belief. 3.2 William James: The Will to Believe. 3.3 Kelly James Clark: Without Evidence or Argument. 3.4 Blaise Pascal: The Wager. 3.5 Lawrence Shapiro: Miracles and Justification. 3.6 Simon Blackburn: Infini-Rien. Part III. HUMAN KNOWLEDGE: ITS GROUNDS AND LIMITS. 1. Skepticism. 1.1 John Pollock: A Brain in a Vat. 1.2 Michael Huemer: Three Skeptical Arguments. 1.3 Robert Audi: Skepticism. 2. The Nature and Value of Knowledge. 2.1 Plato: Knowledge as Justified True Belief. 2.2 Edmund Gettier: Is Justified True Belief Knowledge? 2.3 James Cornman, Keith Lehrer, and George Pappas: An Analysis of Knowledge. 2.4 Gilbert Ryle: Knowing How and Knowing That. 2.5 Plato: "Meno". 2.6 Linda Zagzebski, Epistemic Good and The Good Life. 3. Our Knowledge of the External World. 3.1 Bertrand Russell: Appearance and Reality and the Existence of Matter. 3.2 René Descartes: Meditations on First Philosophy. 3.3 John Locke: The Causal Theory of Perception. 3.4 George Berkeley: Of the Principles of Human Knowledge. 3.5 G. E. Moore: Proof of an External World. 4. The Methods of Science. 4.1 David Hume: An Inquiry Concerning Human Understanding. 4.2 Wesley C. Salmon: An Encounter with David Hume. 4.3 Karl Popper: Science: Conjectures and Refutations. 4.4 Philip Kitcher: Believing Where We Cannot Prove. Part IV: MIND AND ITS PLACE IN NATURE. 1. The Mind-Body Problem. 1.1 Brie Gertler: In Defense of Mind--Body Dualism. 1.2 Frank Jackson: The Qualia Problem. 1.3 David Papineau: The Case for Materialism. 1.4 Paul Churchland: Functionalism and Eliminative Materialism. 2. Can Non-Humans Think? 2.1 Alan Turing: Computing Machinery and Intelligence. 2.2 John R. Searle: Minds, Brains, and Programs. 2.3 William G. Lycan: Robots and Minds. 3. Personal Identity and the Survival of Death. 3.1 John Locke: The Prince and the Cobbler. 3.2 Thomas Reid: Of Mr. Locke’s Account of Our Personal Identity. 3.3 David Hume: The Self. 3.4 Derek Parfit: Divided Minds and the Nature of Persons. 3.5 Shelly Kagan: What Matters. 3.6 John Perry: A Dialogue on Personal Identity and Immortality. Part V: DETERMINISM, FREE WILL, AND RESPONSIBILITY. 1. Libertarianism: The Case for Free Will and Its Incompatibility with Determinism. 1.1 Roderick M. Chisholm: Human Freedom and the Self. 1.2 Robert Kane: Free Will: Ancient Dispute, New Themes. 2. Hard Determinism: The Case for Determinism and its Incompatibility with Its Incompatibility with Any Important Sense of Free Will. 2.1 James Rachels: The case against Free Will. 2.2 Derk Pereboom: Why We Have No Free Will and Can Live Without It. 3. Compatibilism: The Case for Determinism and Its Compatibility with the Most Important Sense of Free Will. 3.1 David Hume: Of Liberty and Necessity. 3.2 Helen Beebee: Compatibilism and the Ability to do Otherwise. 4. Freedom and Moral Responsibility. 4.1 Galen Strawson: Luck Swallows Everything. 4.2 Harry Frankfurt: Alternate Possibilities and Moral Responsibility. 4.3 Thomas Nagel: Moral Luck. 4.4 Susan Wolf: Sanity and the Metaphysics of Responsibility. Part VI: MORALITY AND ITS CRITICS. 1. Changes to Morality. 1.1 Joel Feinberg: Psychological Egoism. 1.2 Plato: The Immoralist’s Challenge. 1.3 Friedrich Nietzche: Master and Slave Morality. 1.4 Richard Joyce: The Evolutionary Debunking of Morality. 2. Proposed Standards and Right of Conduct. 2.1 Russ Shafer-Landau: Ethical Subjectivism. 2.2 Mary Midgley: Trying Out One’s New Sword. 2.3 Aristotle: Virtue and the Good Life. 2.4 Thomas Hobbes: Leviathan. 2.5 Plato: Euthyphro. 2.6 Immanuel Kant: The Good Will and the Categorical Imperative. 2.7 J.S. Mill: Utilitarianism, Chapters 2 and 4. 2.8 W. D. Ross: What Makes Right Acts Right? 2.9 Hilde Lindemann: What Is Feminist Ethics? 3. Ethical Problems. 3.1 Kwame Anthony Appiah: What Will Future Generations Condemn Us For? 3.2 Peter Singer: Famine, Affluence and Morality. 3.3 John Harris: The Survival Lottery. 3.4 James Rachels: Active and Passive Euthanasia. 3.5 Mary Anne Warren: The Moral and Legal Status of Abortion. 3.6 Don Marquis: Why Abortion Is Immoral. 4. The Meaning of Life. 4.1 Epicurus: Letter to Menoeceus. 4.2 Richard Taylor: The Meaning of Life. 4.3 Richard Kraut: Desire and the Human Good. 4.4 Leo Tolstoy: My Confession. 4.5 Susan Wolf: Happiness and Meaning. 4.6 Thomas Nagel: The Absurd. (shrink)

In speaking of Demosthenes' conduct in the period between his return to Athens after the peace agreement with Macedon and Philip's death Aeschines refers to only one specific incident, the attempt by Demosthenes to have himself elected What this position was has never been satisfactorily explained.

The interplay between emotion and learning is a continuing source of debate and inquiry in organization studies, attracting an increasing number of important contributions. However, a detailed understanding of the interaction between emotion and learning remains elusive. In an effort to extend the existing debate, this article offers an alternative approach that draws on the tradition of pragmatist philosophy, where emotion and learning can both be defined as dynamic processes that emerge in the relational context of social transactions. The mutually (...) constructing interplay between these two processes is then illustrated with an example of a collaborative project in which anxiety, love, guilt, and hostility are all entangled in the learning process. (shrink)