Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the (...) effects of knowledge framing and its impact on ethical, medical, economical and legal decisions. (shrink)

Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and “knowledge framing”. While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing — which is only conceptually different from placebo — is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the (...) effects of knowledge framing and its impact on ethical, medical, economical and legal decisions. (shrink)

Playtime in urban cities has become an indoor activity for children due to limited access to natural outdoor environments. This product of urbanization makes the case for the introduction of biophilic design. However, playrooms are often neglected as a possibility in designing a natural space indoors. Interior designers and other specialists lack a reliable tool to identify and incorporate biophilic features into the design of these indoor environments in urban settings. The Biophilic Interior Design Matrix (BID-M) developed by McGee and (...) Marshall-Baker quantifies 52 of Kellert’s biophilic design attributes to assess their presence and absence within interior spaces. We expanded its use by testing the matrix in a new type of space, urban playrooms, and coded images of 45 children’s playrooms within Manhattan residential buildings in New York City, including assessing a larger sample and reliability rate compared to McGee and Marshall-Baker’s research. Inter-rater reliability of the overall design matrix and individual matrix items was measured with percent agreement and free-marginal multirater kappa. Reliability testing showed overall good reliability of the overall design matrix. Several matrix items had low reliability between raters. Our findings show that the BID-M needs to be modified to better assess urban interior spaces for children. (shrink)

Confusion surrounds Catholic teaching on the use of assisted nutrition and hydration, specifically the question of when, if ever, its refusal or removal is ethical. This paper focuses on two often-neglected considerations: the relationship between means and mechanism, and an assessment of proportionality of the mechanism from the patient’s perspective. The authors draw on two critical principles of Catholic moral teaching: only ordinary means are required, and proportionality is subject to the perspective of the patient, not just that of experts (...) or the culture. The mechanisms that provide food and water have distinct benefits and burdens. Their proportionality is properly subject to analysis by the patient or surrogate, who determines which mechanism is acceptable in the patient’s situation. (shrink)

This clinical case report illustrates the potential dilemmas that can arise from knowledge gained through genetic analysis. These conflicts require careful ethical analysis of presumed duties to protect patient privacy and maintain confidentiality, the duty to warn a second party of a health risk, and the duty of veracity. While the questions raised by genetic testing of one individual for disease that reveals potentially important information about relatives, such as risk for Huntington chorea or breast cancer, have been discussed, the (...) continuing expansion in our capacity for sophisticated genetic analysis continues to present new and challenging situations. The resolution of this case and others like it requires close collaboration among the treatment team, geneticists, and clinical ethicists. (shrink)

Peterson, Karlawish, and Largent’s “Supported Decision Making with People at the Margins of Autonomy” brings welcome attention to the rights of people with cognitive impairment and provides...

Pickering et al. argue that judgments of competence should in part be based on the harm that could result from the decision. The centerpiece of their reasoning is that it is inconsistent...

We present a theoretical and an empirical challenge to Cushman's claim that rationalization is adaptive because it allows humans to extract more accurate beliefs from our non-rational motivations for behavior. Rationalization sometimes generates more adaptive decisions by making our beliefs about the world less accurate. We suggest that the most important adaptive advantage of rationalization is instead that it increases our predictability as potential partners in cooperative social interactions.

Name der Zeitschrift: Nietzscheforschung Jahrgang: 24 Heft: 1 Seiten: 418-424.

The paper investigates the ethical decisions of Millennials, who are not only part of an expanding cohort of the workforce, but also represent potential future managers with a growing influence on work practices and employment relationships. In the conceptual model, we propose that three ethical frames of reference, represented by perceived organisational ethics, perceived employee ethics and reflective moral attentiveness, antecede ethical judgements, which further influence the ethical intentions of Millennials. Using structural equation modelling, we test the model for three (...) different business ethics scenarios: paying a consulting fee, dumping hazardous waste, and running an offensive advertising campaign. The findings confirm the link between ethical judgements and intentions across the board, while the influence of the ethical frames of reference varies among the scenarios. We propose that the differences in the predictive ability of the ethical frames of reference depend on the nature of the ethical issue, which holds important implications for today's managers in their attempts to encourage ethical behaviour of Millennial employees. (shrink)

Drawing on the principle of subsidiarity, this article develops a framework for allocating medical decision-making authority in the absence of capacity to consent and argues that decisional authority in paediatric transgender healthcare should generally lie in the patient. Regardless of patients’ capacity, there is usually nobody better positioned to make medical decisions that go to the heart of a patient’s identity than the patients themselves. Under the principle of subsidiarity, decisional authority should only be held by a higher level decision-maker, (...) such as parents or judges, if lower level decision-makers are incapable of satisfactorily addressing the issue even with support and the higher level decision-maker is better positioned to satisfactorily address the issue than all lower level decision-makers. Because gender uniquely pertains to personal identity and self-realisation, parents and judges are rarely better positioned to make complex medical decisions. Instead of taking away trans youth’s authority over their healthcare decisions, we should focus on supporting their ability to take the best possible decision for themselves. (shrink)

We will look at several theories of indicative conditionals grouped into three categories: those that base its semantics on its logical counterpart (the material conditional); intensional analyses, which bring in alternative possible worlds; and a third subgroup which denies that indicative conditionals express propositions at all. We will also look at some problems for each kind of approach.

Chronic and current epistemological controversies, with particular attention to the development of pragmatist/historicist/constructivist reconceptions of knowledge and science in the 20th century and the scandalized responses to them by defenders of more traditional rationalist/objectivist/realist conceptions. Individual chapters deal with complex and confused relations among epistemic skepticism, relativism, and constructivist epistemology ; 20th-century "postmodern" relativism and anti-relativism; Ludwik Fleck and constructivist views of truth, science, and knowledge; attacks on and disavowals of constructivism and/or relativism by established and feminist philosophers; the Science (...) Wars and fraught relations between the humanities and the sciences; the problematic claims of Evolutionary Psychology; and chronic problems and contemporary views of animal-human relations. (shrink)

Essays by Jurgen Habermas on truth, objectivity, normativity, naturalism, and realism after the linguistic turn.

SummaryCross-sectional studies in Australia and the Philippines and a longitudinal prospective study in a selected Australian sample of breast-feeding mothers have shown that basal serum prolactin concentrations are elevated during 15–21 months of lactational amenorrhoea.A predictive model of serum PRL levels and return of cyclic ovarian activity during full breast-feeding, partial breast-feeding and weaning has been developed from the results of breast-feeding behaviour and serum PRL, gonadotrophin and oestradiol measurements in 34 mothers breast-feeding on demand for a mean of 67 (...) weeks.Breast-feeding patterns influence serum PRL levels. Important factors during full breast-feeding are the age of the baby, the longest interval between feeds at night and total 24-hr suckling time, and following the introduction of supplements, the mean interval between feeds, together with the total 24-hr suckling time and the number of solid supplements per day.The precise mechanisms whereby breast-feeding regulates cyclic ovarian activity remain unknown. Gonadotrophin secretion appears to be quantitatively normal, but qualitative changes, secondary to altered hypothalamic activity, may be the most important factor. A direct inhibitory effect of PRL on ovarian follicular development and steroidogenesis remains possible.Ovulation with a normal luteal phase is probable for 30% of breast-feeding mothers before the first menses, but is unlikely before 6 months, provided breast-feeding is frequent day and night.Measurement of serum PRL is a sensitive index of the return of menstruation and fertility during lactation in the population studied. (shrink)

This collection breaks new ground in four key areas of feminist social thought: the sex/gender debates; challenges to liberalism/equality; feminist ethics; and feminist perspectives on global ethics and politics in the 21st century. Altogether, the essays provide an innovative look at feminist philosophy while making substantive contributions to current debates in gender theory, ethics, and political thought.

Evolutionary models consider hunting and food sharing to be milestones that paved the way from primate to human societies. Because fossil evidence is scarce, hominoid primates serve as referential models to assess our common ancestors’ capacity in terms of communal use of resources, food sharing, and other forms of cooperation. Whereas chimpanzees form male-male bonds exhibiting resource-defense polygyny with intolerance and aggression toward nonresidents, bonobos form male-female and female-female bonds resulting in relaxed relations with neighboring groups. Here we report the (...) first known case of meat sharing between members of two bonobo communities, revealing a new dimension of social tolerance in this species. This observation testifies to the behavioral plasticity that exists in the two Pan species and contributes to scenarios concerning the traits of the last common ancestor of Pan and Homo. It also contributes to the discussion of physiological triggers of in-group/out-group behavior and allows reconsideration of the emergence of social norms in prehuman societies. (shrink)

This volume explores the cross-linguistic diversity, and possibly inconsistency, of the span of linguistic means that signal reported speech and thought. The integration of broad linguistic (viewpoint in conversation and narrative) and cognitive (theory of mind and understanding the inner life and thought of others) strategies for handling mixed points of view will be considered.

This book is an introduction to the philosophy of Arthur Schopenhauer, written in a lively, personal style.

The organ donor shortfall in the UK has prompted calls to introduce legislation to allow for presumed consent: if there is no explicit objection to donation of an organ, consent should be presumed. The current debate has not taken in account accepted meanings of presumption in law and science and the consequences for rights of ownership that would arise should presumed consent become law. In addition, arguments revolve around the rights of the competent autonomous adult but do not always consider (...) the more serious implications for children or the disabled. (shrink)

The paper considers the legal tools that have been developed in German pharmaceutical regulation as a result of the precautionary attitude inaugurated by the Contergan decision. These tools are the notion of “well-founded suspicion”, which attenuates the requirements for safety intervention by relaxing the requirement of a proved causal connection between danger and source, and the introduction of the reversal of proof burden in liability norms. The paper focuses on the first and proposes seeing the precautionary principle as an instance (...) of the requirement that one should maximise expected utility. In order to maximise expected utility certain probabilities are required and it is argued that objective Bayesianism offers the most plausible means to determine the optimal decision in cases where evidence supports diverging choices. (shrink)

Objective This work disentangles moral tolerance from moral relativism and reveals their distinct personological meanings. Both constructs have long been of interest to moral philosophers, moral psychologists, and everyday people, and they may play prominent roles in the feasibility of modern diverse societies. However, they have been criticized as devaluing morality and as producing overly permissive societies. Moreover, although they lack necessary conceptual implications for each other, they are easily (and often) conflated. -/- Method Three studies included nine samples (total (...) N > 3,200, 40%–50% female, Mage = 38–40, 83% white). Participants completed (online) new measures of moral tolerance and moral relativism, along with measures of 40 additional constructs. -/- Results Results reveal robust psychometric quality of the new measures (the Moral Relativism Scale and the Moral Tolerance Scale), demonstrate that the constructs are empirically overlapping but separable, and highlight their distinct personological networks. Moral relativism was associated with liberal political views and a lowered valuing/enacting of moral values. Moral tolerance was weakly associated with liberal political views but was strongly related to a broad range of both liberal and conservative moral values. -/- Conclusion This work yields new tools for investigating moral character, and it reveals the differential meaning of two important moral constructs. (shrink)

Our recapitulation of the work by Howe et al. is a clear approval of the passages in which the talent concept is critically questioned. On the other hand, Howe et al. must themselves come to terms with most of the accusations they place at the door of talent researchers. The evidence they present to support the experience concept is lacking with respect to current theoretical and methodological standards.

In 1960, a relatively new ‘syndrome’ began appearing with growing frequency in psychiatric hospitals and in doctors’ offices. Eventually termed ‘delicate self-cutting’, this new model for typical self-mutilative behavior was developed in conjunction with a description of the ‘typical’ self-mutilator: young (adolescent to just post-adolescent), female, and almost always attractive. This article contends that, despite recent efforts to change the nature of research on self-mutilation, the myth of a typical mutilator, developed from a particular historical bias, continues to work in (...) popular and medical discourses on the subject. I will begin with a detailed discussion of the medical discourse in an effort to ask how the myth was made. Noting that the female body, here, is singled out as pathological at a time when, specifically in the USA, the emergent Women’s Movement was beginning to contest certain gender lines, I would like to examine how the medical discourse and material bodies interrelate and interact with each other and with the cultural narratives around them. Finally, I end with examples from the 1999 film Girl, Interrupted, as well as other recent popular and medical accounts, to illustrate not only the perpetuation of the myth of the ‘typical’ self-mutilator but also the inability or refusal to recognize the biased nature of the medical discourse in the instance on self-mutilation. (shrink)

Zsfassung in engl. Sprache u.d.T.: On responsibility adequate to the possibilities.

Everyone agrees that law is a constituent of social reality. Law seems to be a system by which conduct is governed and guided. Its usefulness consists, in part, on its ability to govern and guide conduct in its characteristic way. If laws guides the conduct of lay law subjects, then it must be (really) possible for the content of the laws governing their conduct to be known by them under standard social conditions. Moreover, if some degree of efficacy in guiding (...) and governing the conduct of lay law subjects is an existence condition for a legal system, then in existing legal systems enough of the content of directive law is epistemically accessed by enough law subjects so that they can apply it to their situations and correctly determine the act-tokens required of them. In this chapter, I argue that these modest epistemic reflections have important implications for a theory of legal content that have been largely ignored. Holistic theories of legal content, such as Greenberg’s and Dworkin’s, are inconsistent with an adequate account of epistemic access. After demonstrating the same problem in two mainstream non-holistic theories of legal content -- the view that legal content is set entirely by official interpretive conventions, and the view that legal content is set entirely by official intentions – I propose a theory of legal content that meets the epistemic access challenge. On my approach, law is, at its core, centered upon the understandings of law subjects. (This view is meant to exempt constitutional provisions.) More precisely, the legal content of statutes and judicial decisions is built around, and preserves, a core of understandings and meaning-assignments that is the province of anyone with sufficient linguistic ability and relevant socialization. The details of this view are, roughly: (1) in the case of judicial decisions in a common law system, the social salience of the example the decision sets concerning behavior sets the default legal content; (2) in the case of statutory directives, the set of socially salient applications (behavior in situations) sets the default legal content. I say `default’ because my account of legal content is a two-stage account beginning with the default content and permitting a second stage in which considerations from other sources can operate on the default. Yet if a certain amount of efficacy in guiding lay law subjects’ behavior is a requirement for the existence of a legal system, there must be a core of legal content undistorted from its default social salience by a second stage operation. There is and must be a `law of the street’. -/- . (shrink)

This paper examines nurses’ international migration within the broader context of female migration, particularly against more studied groups of women who have migrated for employment in care‐giving roles. We analyze the similarities and differences between skilled professional female migrants (nurses) and domestic workers (nannies and in‐home caretakers) and how societal expectations, meanings, and values of care and ‘women's work’, together with myriad social, cultural, economic and political processes, construct the female migrant care‐giver experience. We argue that, as the recruitment of (...) foreign workers gains visibility, strategies are introduced to better prepare female migrant care‐givers for the marketplace. Language, specifically command of English and accent modification, is highlighted as one means to assimilate migrant care‐givers to host communities. (shrink)

We investigate the complexity of isomorphisms of computable structures on cones in the Turing degrees. We show that, on a cone, every structure has a strong degree of categoricity, and that degree of categoricity is${\rm{\Delta }}_\alpha ^0 $-complete for someα. To prove this, we extend Montalbán’sη-system framework to deal with limit ordinals in a more general way. We also show that, for any fixed computable structure, there is an ordinalαand a cone in the Turing degrees such that the exact complexity (...) of computing an isomorphism between the given structure and another copy${\cal B}$in the cone is a c.e. degree in${\rm{\Delta }}_\alpha ^0\left$. In each of our theorems the cone in question is clearly described in the beginning of the proof, so it is easy to see how the theorems can be viewed as general theorems with certain effectiveness conditions. (shrink)

Imagine that our world were such that the entities, properties, laws, and relations of fundamental physics did not determine what goes on at the mental level; imagine that duplicating our fundamental physics would fail to duplicate the pleasures, feelings of joy, and experiences of wonder that we know and love; in other words, imagine that the mental realm did not supervene on the physical realm. Would our world, then, be a world in which physicalism is false? A good number of (...) philosophers who ponder such issues—perhaps all philosophers who have hitherto pondered such issues—answer “yes.” The purpose of this paper is to suggest that, despite what physicalists say, they don’t think so, either. What is it that they really think? What is the actual doctrine of physicalism? I conclude withan attempt to uncover that as well. (shrink)

A too rarely emphasized feature of modern deontological ethics is the structure of its directives. Faced with alternatives, the question for the moral agent is “which, if either, must I perform (or avoid)?” Getting it right, one is, morally speaking, done…until the next set of freighted options presents. We should wonder whether this makes sense: whether there is not a more complex structure to deontological requirements that resists the “one and done” idea. Rehabilitating the Kantian idea of duty as a (...) value-based deliberative principle, I argue for a more plausible deontology whose requirements are often temporally extended and interpersonally complex. (shrink)

This paper challenges an orthodoxy in recent philosophical discussions of grief, namely, that grief is essentially tied to the thought that a person of significance to oneself has died. As first‐person reports make clear, one can find oneself cut off from the significant other not simply in body but also in thought. This is not, moreover, an isolated difficulty but one that may have repercussions for one's capacity to form an outlook on the social world, the natural world, and the (...) world viewed from one's own scheme of ends. Taking C. S. Lewis's diary of grief as a guide, I argue that our capacity to think of our significant others depends, surprisingly enough, on our capacity to acknowledge their independence from us even in death. (shrink)