Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

Community Partnered Participatory Research is grounded in the ethical principle of respect for persons participating in the research enterprise. The critical importance of respect for person...

Background: The field of clinical ethics is examining ways of determining competency. The Assessing Clinical Ethics Skills (ACES) tool offers a new approach that identifies a range of skills necessary in the conduct of clinical ethics consultation and provides a consistent framework for evaluating these skills. Through a training website, users learn to apply the ACES tool to clinical ethics consultants (CECs) in simulated ethics consultation videos. The aim is to recognize competent and incompetent clinical ethics consultation skills by watching (...) and evaluating a videotaped CEC performance. We report how we set a criterion cut score (i.e., minimally acceptable score) for judging the ability of users of the ACES tool to evaluate simulated CEC performances.Methods: A modified Angoff standard-setting procedure was used to establish the cut score for an end-of-life case included on the ACES training website. The standard-setting committee viewed the Futility Case and estimated the probability that a minimally competent CEC would correctly answer each item on the ACES tool. The committee further adjusted these estimates by reviewing data from 31 pilot users of the Futility Case before determining the cut score.Results: Averaging over all 31 items, the proposed proportion correct score for minimal competency was 80%, corresponding to a cut score that is between 24 and 25 points out of 31 possible points. The standard-setting committee subsequently set the minimal competency cut score to 24 points.Conclusions: The cut score for the ACES tool identifies the number of correct responses a user of the ACES tool training website must attain to “pass” and reach minimal competency in recognizing competent and incompetent skills of the CECs in the simulated ethics consultation videos. The application of the cut score to live training of CECs and other areas of practice requires further investigation. (shrink)

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

For forty years, Harvey Mansfield has been worth reading. Whether plumbing the depths of MachiavelliOs Discourses or explaining what was at stake in Bill ClintonOs impeachment, MansfieldOs work in political philosophy and political science has set the standard. In Educating the Prince, twenty-one of his students, themselves distinguished scholars, try to live up to that standard. Their essays offer penetrating analyses of Machiavellianism, liberalism, and America., all of them informed by MansfieldOs own work. The volume also includes a bibliography of (...) MansfieldOs writings. (shrink)

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

A review of Arthur Goldhammer's 1988 translation of Georges Canguilhem's Idéologie et rationalité dans l’histoire des sciences de la vie.

Two problems in the paper by EGR are considered. One is the lack of any direct confirmatory evidence for the elegant rational reconstruction. The second is a significant gap in the historical account, just at the critical point in Einstein's discovery process -- namely, the reanalysis of simultaneity. In addition, the EGR account appears in danger of being overly focused on the electrodynamical aspect of special relativity to the exclusion of optical null experiments, and in particular to the exclusion of (...) the role of the 1887 Michelson-Morely interferometer experiment. The author disagrees with Miller on the Kantian aspects of Poincare, and on the role of Anschauungen, preferring to sketch instead a more important role for a Mach-like analysis of fundamental scientific concepts. It is argued that Miller has misconstrued the difference between an axiomatic theory and a "theory of principle" in Einstein's approach. Finally, some suggestions are made as to how the gap in our analysis of Einstein's revolution in simultaneity might be reexamined. (shrink)

This narrative symposium examines the relationship of bioethics practice to personal experiences of illness. A call for stories was developed by Tod Chambers, the symposium editor, and editorial staff and was sent to several commonly used bioethics listservs and posted on the Narrative Inquiry in Bioethics website. The call asked authors to relate a personal story of being ill or caring for a person who is ill, and to describe how this affected how they think about bioethical questions and the (...) practice of medicine. Eighteen individuals were invited to submit full stories based on review of their proposals. Twelve stories are published in this symposium, and six supplemental stories are published online only through Project MUSE. Authors explore themes of vulnerability, suffering, communication, voluntariness, cultural barriers, and flaws in local healthcare systems through stories about their own illnesses or about caring for children, partners, parents and grandparents. Commentary articles by Arthur Frank, Bradley Lewis, and Carol Taylor follow the collection of personal narratives. (shrink)

Conscience and Conscientious Objection of Health Care Professionals Refocusing the Issue Content Type Journal Article Pages 351-364 DOI 10.1007/s10730-009-9113-x Authors Natasha T. Morton, The University of Western Ontario Ontario Canada N6A 5B9 Kenneth W. Kirkwood, Arthur and Sonia Labatt Health Sciences Building London Ontario Canada N6A 5B9 Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4.

This volume presents a selection of new articles examining the state of Irish philosophy during the lifetime of Ireland's most famous philosopher, Bishop George Berkeley (1685-1753). The thinkers examined include Berkeley, Robert Boyle, William King, William Molyneux, Robert Molesworth, Peter Browne, Jonathan Swift, John Toland, Thomas Prior, Samuel Madden, Arthur Dobbs, Francis Hutcheson, Mary Barber, Constantia Grierson, Laetitia Pilkington, Elizabeth Sican, and John Austin. This interdisciplinary collection includes attention both to local Irish concerns and to Ireland's relation to the (...) broader European context, and discusses philosophical reflections on topics as diverse as religion, economics, laughter, and motherhood. (shrink)

The contributions that the philosophy of medicine can make to both the philosophy of science and the practice of science have been obscured in recent years by an overemphasis on personalities rather than critical themes. Two themes have dominated general discussion within contemporary philosophy of science: methodological essentialism and dynamic gradualism. These themes are defined and considered in light of Kenneth Schaffner's argument that theories in biomedicine have a structure and logic unlike that found in theories of the natural (...) sciences. Schaffner's arguments are suggestive but not definitive as a refutation of methodological essentialism. I argue that a primary reason for differences in the logic and structure of theories in biomedicine is not, as some philosophers have suggested, a product of ontological differences, but rather a product of the practical and pragmatic concerns of scientific theorizing in many areas of science, such as medicine. Keywords: philosophy of medicine, philosophy of science, logic of medicine, medical theory, methodological essentialism, dynamic gradualism CiteULike Connotea Del.icio.us What's this? (shrink)

Résumé Cet article a pour objectif d’introduire la géoesthésique, une approche des sciences de la culture traitant des interactions entre l’espace et la réception sémiotique. Le tournant spatial des arts et des sciences de la fin du vingtième a inspiré la création de plusieurs nouvelles approches liées à l’espace et au territoire. La Géopoétique de Kenneth White, la Géocritique de Westphal et plus tard de Prieto et Tally, la Géoesthétique de Quirós et Imhoff et éventuellement même la géosymbolique travaillée (...) par Mario Bédard et Christiane Lahaie (2008). C’est en remarquant l’absence, parmi toutes ces approches, d’une approche dont le point central serait, non pas l’espace, mais la réception, et son lien avec l’espace, que Louis Hébert nous a suggérer de concevoir et de rédiger les prémisses d’une telle approche. La géoesthésique serait ainsi une approche pratique et expérimentale grâce à laquelle on pourrait observer l’impact que peut avoir l’espace sur la réception sémiotique d’un élément donné ou l’influence d’une réception sémiotique donnée sur la perception d’un espace fixe. (shrink)

INTRODUCTION In an age of specialists, Kenneth Burke's writings offend those who are content with a partial view of human motivation. ...

Biologists seems to hold two fundamental beliefs: Organisms are organized into levels and the individuals at these levels differ in their properties. Together these suggest that there will be massive multiple realization, i.e. that many human psychological properties are multiply realized at many neurobiological levels. This paper provides some documentation in support of this suggestion.

The central unifying element in the philosophy of Peter Browne is his theory of analogy. Although Browne's theory was originally developed to deal with some problems about religious language, Browne regards analogy as a general purpose cognitive mechanism whereby we substitute an idea we have to stand for an object of which we, strictly speaking, have no idea. According to Browne, all of our ideas are ideas of sense, and ideas of sense are ideas of material things. Hence we can (...) conceive of spiritual things – including even our own spirit – only by analogy. One interesting application Browne makes of his theory is an account of how concepts such as knowledge can be correctly applied to beings that have no intrinsic properties in common, such as non-human animals, humans, angels, and God. I argue that this is best understood as what, in the contemporary literature, is known as a ‘multiple realizability’ problem and that Browne's solution to this problem has important similarities to functionalist theories in recent philosophy of mind. (shrink)

This book is a fundamental and unique masterpiece which reflects the discussions on business and economic ethics over decades in German-speaking countries, and ...

F. D. Maurice was a distinguished Christian theologian, much respected by academics and artists of his day and afterwards. This volume, originally published in 1951, contains the text of seven lectures delivered in his honour in 1942 by Arthur Ramsey, later Archbishop of Canterbury, and covers Maurice's career and his impact on later students of theology. This book will be of value to anyone with an interest in Christian socialism or in Maurice's wider work.

Within the philosophy of sport, the phenomenon of practising has received very little attention, whereas other related aspects of sport such as excellence and competition have been subjected to many and thorough studies. This essay will attempt to clarify this particular phenomenon of practising through the notion of athletic ascetics, which will be analysed as a special variant of askēsis. Drawing especially on Foucault’s lectures on ascetics in ancient philosophy and Sloterdijk’s anthropology of the practising life, the essay outlines and (...) interrogates the potential relevance of an ascetological understanding of sport. Through both descriptive and normative analysis, it is argued that athletic ascetics can refine our understanding of performance in sport and comprise an embodied account of the formative aspect of ethics, with implications for ethical considerations related to performance enhancement. (shrink)

This lucid and wide-ranging volume constitutes a self-contained introduction to the elements and key issues of the philosophy of language.

This volume of translations unites three shorter works by Arthur Schopenhauer that expand on themes from his book The World as Will and Representation. In On the Fourfold Root he takes the principle of sufficient reason, which states that nothing is without a reason why it is, and shows how it covers different forms of explanation or ground that previous philosophers have tended to confuse. Schopenhauer regarded this study, which he first wrote as his doctoral dissertation, as an essential (...) preliminary to The World as Will. On Will in Nature examines contemporary scientific findings in search of corroboration of his thesis that processes in nature are all a species of striving towards ends; and On Vision and Colours defends an anti-Newtonian account of colour perception influenced by Goethe's famous colour theory. This is the first English edition to provide extensive editorial notes on the different published versions of these works. (shrink)

The New Orleans catastrophe and the subsequent allegation of homicides at Memorial Medical Center have complicated our thinking about end-of-life care. Can the conditions in a collapsed health care system ever excuse euthanasia? Following a review of current legal and ethical standards for the causation of death in the clinical setting, and an assessment of the most common argument for euthanasia — the argument from intractable suffering — a different argument is set out for the excusability of euthanasia, one based (...) on forced abandonment. While more familiar in battlefield medicine, this line of reasoning may have applied in post-Katrina New Orleans. When health care professionals are compelled to leave a hazardous clinical setting, and where it is impossible to evacuate patients who are not expected to survive, clinicians must choose between abandoning these patients to die unattended and unmedicated, or euthanizing them before leaving themselves. Because each of these options stands as an egregious violation of an important health care norm, and because there is no third option, neither violation can be rightly condemned. (shrink)

If scientists can successfully clone sheep, will humans be next? Today's headlines read like a science fiction novel! Due Consideration takes a poignant look at the rapidly changing field of biomedicine and the consequences it will have on our lives. Arthur Caplan, one of this nation's leading bioethicists, explores these issues and analyzes moral questions including: * Will we retain our essential humanity if we modify our biological blueprint? * Would it be irresponsible to procreate without a thorough genetic (...) examination? * Who will decide if physical traits like short stature and baldness are considered diseases? * Can biomedicine make our lives better? You'll also learn about the most current and controversial topics such as: * Cloning, abortion and assisted suicide. * Genetically engineering a human to be immune from infectious diseases. * The ability to "design" our children from head to toe. * Diagnosing and treating illnesses during fetal development. * Programs to prevent the transmission of HIV. No other book on the market today combines this analytic clarity with the latest from medical journals and media headlines. Now, you can decide for yourself what the future ought to hold in store. (shrink)

The overall subject of the essays in _The Body/Body Problem_ is the traditional one of what our ultimate makeup is, as creatures with minds and bodies. The central thesis is that we are beings who represent—and misrepresent—actual and possible worlds. Addressing philosophical questions of mental representation, Danto presents his distinctive approach to some of the most enduring topics in philosophy. He is concerned with the nature of description, the status of the external world, action theory, the philosophy of history, and (...) the philosophical status of psychoanalytic explanation. Representation is a central concept in philosophy, says Danto, with differences among philosophers arising in the ways they account for how representations connect to the world or to the individuals possessing them, and how they connect with one another to form systems of beliefs, feelings, and attitudes. In these essays Danto's own voice, with his arguments and speculations, provides rich philosophical pleasures that will endure, to borrow from Santayana, "under whatever sky." Arthur C. Danto is one of the most original and multitalented philosophers writing today, a thinker whose interests traverse the boundaries of traditional understandings of philosophy. Best known for his contributions to the philosophy of art and aesthetics, Danto is also esteemed for his work in the history of philosophy, the philosophy of history, philosophical psychology, and action theory. These two volumes, each with an introduction by the author, contain essays spanning more than twenty-five years that have been selected to highlight the inseparability of philosophy and art in Danto's work. Together they present the thinking of Arthur C. Danto at his very best. (shrink)

This essay argues that the affective component inherent in the enthymeme is the essence of aristotle's concept of the enthymeme as practical reasoning. 'affective component' refers to emotions and feelings. The three proofs of the thesis are the etymology of 'enthymeme', Aristotle's works on human action and practical wisdom, And aristotle's rhetoric. These sources show the inherent relation between enthymemes and phronesis, Or practical reasoning, Not nous, Or abstract intellect.

But as Harvard ethicist Arthur J. Dyck shows in this powerful work, there are solid moral and practical bases for the existing laws against assisted suicide in ...