There is a well-known American legal maxim, hard cases make bad law. If we agree that Mr. J’s case is hard, what lessons follow from the application of current ECMO guidelines and what kind of supp...

The term compassion fatigue has come to be applied to a disengagement or lack of empathy on the part of care-giving professionals. Empathy and emotional investment have been seen as potentially costing the caregiver and putting them at risk. Compassion fatigue has been equated with burnout, secondary traumatic stress disorder, vicarious traumatization, secondary victimization or co-victimization, compassion stress, emotional contagion, and counter-transference. The results of a Canadian qualitative research project on nurses? experience of compassion fatigue are presented. Nurses, self-identified as (...) having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families. Time to help patients and families cope with suffering seemed unavailable, and many felt they were running on empty and, ultimately, impotent as nurses. Feelings of irritability, anger, and negativity arose, though participants described denying or ignoring these emotions as a way to try to survive their work day. Difficulties with work carried over into the nurses? personal lives, affecting their relationships with family and friends. Such experiences invariably called into question the participants? identity, causing them to reflect on the kind of nurse they were. The participants? compassion fatigue created a sense of hopelessness regarding positive change, although some nurses described strategies that seemed to help alleviate their compassion fatigue. (shrink)

Marshall et al. (2024) raise questions regarding patient refusals of care. In this commentary we address refusals of care from the lens of patient autonomy and provide suggestions for patient cente...

According to current hierarchies of evidence for EBM, evidence of correlation (e.g., from RCTs) is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a (...) causal claim. Second, evidence of mechanisms is often required in order to obtain evidence of correlation (for example, in order to set up and evaluate RCTs). Third, evidence of mechanisms is often required in order to generalise and apply causal claims. While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms. (shrink)

_Lakatos: An Introduction_ provides a thorough overview of both Lakatos's thought and his place in twentieth century philosophy. It is an essential and insightful read for students and anyone interested in the philosophy of science.

This collection presents significant contributions from an international network project on mathematical cultures, including essays from leading scholars in the history and philosophy of mathematics and mathematics education.​ Mathematics has universal standards of validity. Nevertheless, there are local styles in mathematical research and teaching, and great variation in the place of mathematics in the larger cultures that mathematical practitioners belong to. The reflections on mathematical cultures collected in this book are of interest to mathematicians, philosophers, historians, sociologists, cognitive scientists and (...) mathematics educators. (shrink)

Daly, Brendan About a month before my ordination as a priest on 7 May 1977, my diocesan bishop asked me to come and see him at his office. He said after my ordination I was going to be appointed to Mairehau parish as an assistant priest. Two weeks later I was making my pre-ordination retreat and the bishop arrived to see me. He was embarrassed and said 'We have a problem. One parish priest won't take the assistant priest that (...) I want to give him, and another assistant priest won't go where he is appointed, so the end result is that you are now going to Addington parish. Is that okay?' I replied 'Yes.' Both parishes were in Christchurch city, and I did not know either parish priest personally, so it really did not matter at all. However, two weeks later at my ordination ceremony, it came time for the promise of obedience. I knelt down before the bishop who asked me did 'I promise him and his successors obedience and respect.' At the same time as he said this I was conscious of the thought going through my mind, 'what does it all mean anyway?'. (shrink)

To explore how molecules became signs I will ask: “What sort of process is necessary and sufficient to treat a molecule as a sign?” This requires focusing on the interpreting system and its interpretive competence. To avoid assuming any properties that need to be explained I develop what I consider to be a simplest possible molecular model system which only assumes known physics and chemistry but nevertheless exemplifies the interpretive properties of interest. Three progressively more complex variants of this model (...) of interpretive competence are developed that roughly parallel an icon-index-symbol hierarchic scaffolding logic. The implication of this analysis is a reversal of the current dogma of molecular and evolutionary biology which treats molecules like DNA and RNA as the original sources of biological information. Instead I argue that the structural characteristics of these molecules have provided semiotic affordances that the interpretive dynamics of viruses and cells have taken advantage of. These molecules are not the source of biological information but are instead semiotic artifacts onto which dynamical functional constraints have been progressively offloaded during the course of evolution. (shrink)

What accounts for the capacity of ordinary speakers to comprehend utterances of their language? The phenomenology of hearing speech in one’s own language makes it tempting to many epistemologists to look to perception for an answer to this question. That is, just as a visual experience as of a red square is often taken to give the perceiver immediate justification for believing that there is a red square in front of her, perhaps an auditory experience as of the speaker asserting (...) that p gives the competent hearer immediate justification for believing that the speaker has asserted that p. My aim here is to offer reasons for resisting this temptation. I argue that the perceptual model cannot adequately account for the hearer’s justification in many cases. The arguments here also allow us to draw certain further morals about the role of phenomenology in the epistemology of perception. (shrink)

In this vivid and incisive guide, philosophy comes to life. Using the central idea of causality as a guiding principle, Brendan Wilson shows how the history of philosophy becomes a very clear and natural sequence of events. The resulting perspective reveals the deep connections between the problems of science, mind and reality, freedom and responsibility, knowledge, language, truth and religion. Newcomers to philosophy will be able to engage with the great questions and ideas of the western tradition. The writing (...) is clear and jargon-free, while the 'short-chapter' format gives the reader time to pause and think at each step along the way. Style and layout put accessibility first and the many illustrations include explanatory diagrams and drawings as well as pictures of philosophers from Aristotle to Wittgenstein. Key Features Encourages critical and independent thinking Written in an engaging, non-technical style Makes clear sense of philosophy's rich and complex history Presents a distinctive argument Provides a wide range of case studies and examples from philosophy, science and law Text Features Chapter overviews Chapter sub-headings for ease of use Carefully-chosen quotations from philosophers ancient and modern End of chapter discussion points An open and attractive page layout Lavish and relevant illustrations, including photographs, diagrams, explanatory boxes and drawings. (shrink)

Large Language Models (LLMs) have been transformative. They are pre-trained foundational models that are self-supervised and can be adapted with fine tuning to a wide range of natural language tasks, each of which previously would have required a separate network model. This is one step closer to the extraordinary versatility of human language. GPT-3 and more recently LaMDA can carry on dialogs with humans on many topics after minimal priming with a few examples. However, there has been a wide range (...) of reactions and debate on whether these LLMs understand what they are saying or exhibit signs of intelligence. This high variance is exhibited in three interviews with LLMs reaching wildly different conclusions. A new possibility was uncovered that could explain this divergence. What appears to be intelligence in LLMs may in fact be a mirror that reflects the intelligence of the interviewer, a remarkable twist that could be considered a Reverse Turing Test. If so, then by studying interviews we may be learning more about the intelligence and beliefs of the interviewer than the intelligence of the LLMs. As LLMs become more capable they may transform the way we interact with machines and how they interact with each other. Increasingly, LLMs are being coupled with sensorimotor devices. LLMs can talk the talk, but can they walk the walk? A road map for achieving artificial general autonomy is outlined with seven major improvements inspired by brain systems. LLMs could be used to uncover new insights into brain function by downloading brain data during natural behaviors. (shrink)

English mass noun phrases & count noun phrases differ only minimally grammatically. The basis for the difference is ascribed to a difference in the features +/-CT. These features serve the morphosyntactic function of determining the available options for the assigment of grammatical number, itself determined by the features +/-PL: +CT places no restriction on the available options, while -CT, in the unmarked case, restricts the available options to -PL. They also serve the semantic function of determining the sort of denotation (...) associated with demonstrative & quantified noun phrases. The feature -CT requires that the associated denotation be the set whose sole member is the greatest aggregate of which the noun phrase or noun is true; the feature +CT requires that the associated denotation be the set whose members are all & only those minimal aggregates of which the noun phrase or noun is true. At the same time, neither mass NPs nor count NPs that are arguments of a predicate have their predicate evaluated with respect to their denotations. Rather, the predicate is evaluated with respect to an aggregation, a set of aggregates constructed from the denotation of the noun phrase that is an argument of the predicate. 3 Tables, 4 Figures, 74 References. AA. (shrink)

By recourse to the fundamentals of preference orderings and their numerical representations through linear utility, we address certain questions raised in Nover and Hájek 2004, Hájek and Nover 2006, and Colyvan 2006. In brief, the Pasadena and Altadena games are well-defined and can be assigned any finite utility values while remaining consistent with preferences between those games having well-defined finite expected value. This is also true for the St Petersburg game. Furthermore, the dominance claimed for the Altadena game over the (...) Pasadena game, and that would have been claimed for the St Petersburg game over the Altadena, can be contradicted without fear of inconsistency with the axioms of utility theory. However, insistence upon dominance can be made to yield a contradiction of the Archimedean axiom of utility theory. CiteULike Connotea Del.icio.us What's this? (shrink)

Evidence-based medicine (EBM) makes use of explicit procedures for grading evidence for causal claims. Normally, these procedures categorise evidence of correlation produced by statistical trials as better evidence for a causal claim than evidence of mechanisms produced by other methods. We argue, in contrast, that evidence of mechanisms needs to be viewed as complementary to, rather than inferior to, evidence of correlation. In this paper we first set out the case for treating evidence of mechanisms alongside evidence of correlation in (...) explicit protocols for evaluating evidence. Next we provide case studies which exemplify the ways in which evidence of mechanisms complements evidence of correlation in practice. Finally, we put forward some general considerations as to how the two sorts of evidence can be more closely integrated by EBM. (shrink)

One way to challenge the substantiveness of a particular philosophical issue is to argue that those who debate the issue are engaged in a merely verbal dispute. For example, it has been maintained that the apparent disagreement over the mind/brain identity thesis is a merely verbal dispute, and thus that there is no substantive question of whether or not mental properties are identical to neurological properties. The goal of this paper is to help clarify the relationship between mere verbalness and (...) substantiveness. I first argue that we should see mere verbalness as a certain kind of discourse defect that arises when the parties differ as to what each takes to be the immediate question under discussion. I then argue that mere verbalness, so understood, does not imply that the question either party is attempting to address is a non-substantive one. Even if it turns out that the parties to the mind/brain dispute are addressing subtly different questions, these might both be substantive questions to which their respective metaphysical views provide substantive answers. One reason it is tempting to reach deflationary conclusions from the charge of mere verbalness is that we fail to distinguish it from the claim that a sentence under dispute is, in a certain sense, indisputable. Another reason is that we fail to distinguish mere verbalness from a certain sort of indeterminacy. While indisputability and indeterminacy plausibly capture forms of nonsubstantiveness, I argue that mere verbalness is insufficient to establish either indisputability or indeterminacy. (shrink)

Shared views regarding the moral respect which is owed to children in family life are used as a guide in determining the moral permissibility of nontherapeutic clinical research procedures involving children. The comparison suggests that it is not appropriate to seek assent from the preadolescent child. The analogy with interventions used in family life is similarly employed to specify the permissible limit of risk to which children may be exposed in nontherapeutic research procedures. The analysis indicates that recent writers misconceive (...) how certain moral principles, such as respect for personal autonomy, require us to act toward children. The results are also used to assess proposed federal regulations on research with children. (shrink)

This paper discusses the connection between the actual history of mathematics and Lakatos's philosophy of mathematics, in three parts. The first points to studies by Lakatos and others which support his conception of mathematics and its history. In the second I suggest that the apparent poverty of Lakatosian examples may be due to the way in which the history of mathematics is usually written. The third part argues that Lakatos is right to hold philosophy accountable to history, even if Lakatos's (...) own view of mathematics fails that test. (shrink)

The paper describes the approach by which ethics are integrated into the undergraduate curriculum at Northern Illinois University''s College of Business. Literature is reviewed to identify conceptual frameworks for, and issues associated with, the teaching of business ethics. From the review, a set of guidelines for teaching ethics is developed and proposed. The objectives and strategies implemented for teaching ethics is discussed. Foundation and follow-up coursework, measurement issues and ancillary programs are also discussed.

Professional Ethics: A Trust-Based Approach explores the unique nature of professional duty and virtue in light of the trust that professionals must invite, develop, and honor from those they intend to serve.

Daly, Brendan Pope Francis has emphasised the importance of priests and religious having a simple lifestyle since the beginning of his pontificate. Addressing seminarians and novices on 6 July 2013, Pope Francis said 'I think that cars are necessary because there is so much work to be done, and also in order to get about...but choose a more humble car! And if you like the beautiful one, only think of all the children who are dying of hunger.' The Pope (...) then quoted Saint Francis of Assisi who said 'Always proclaim the Gospel. And if necessary, with words'. Then Pope Francis asked 'What does this mean? Proclaiming the Gospel with an authentic life, with a consistent life. But in this world to which wealth does so much damage it is necessary that we priests, that we sisters, that all of us be consistent with our poverty!'. (shrink)

Daly, Brendan I am from Christchurch Diocese, a suffragan diocese of Wellington Archdiocese, a metropolitan see. During the past forty years, one diocesan bishop has resigned and was replaced by his coadjutor. This former coadjutor died soon afterwards. The next bishop resigned and was simultaneously replaced by the appointment of his auxiliary. The next two bishops died and created vacant sees. Usually there are significant time gaps between vacant sees, resulting in each vacancy being a new experience for the (...) key people involved. (shrink)

In the target article “How molecules became signs” I offer a molecular “thought experiment” that provides a paradigm for resolving the major incompatibilities between biosemiotic and natural science accounts of living processes. To resolve these apparent incompatibilities I outline a plausible empirically testable model system that exemplifies the emergence of chemical processes exhibiting semiotic causal properties from basic nonliving chemical processes. This model system is described as an autogenic virus because of its virus-like form, but its nonparasitic self-repair and reproductive (...) dynamics. The 16 commentaries responding to this proposal recognize its material plausibility but are divided on its value in resolving this basic biosemiotic challenge. In response, I have addressed some of the most serious criticisms raised and have attempted to diagnose the major sources of incompatible assumptions that distinguish the autogenic paradigm from other major paradigms. In particular, I focus on four main issues: the significance of the shift from a cellular to a viral perspective, the relevance of intrinsic versus extrinsic initiation and channeling of interpretive work, the insufficiency of molecular replication as a basis for grounding biological semiosis, and a (universal?) three step scaffolding logic that enables referential displacement of sign vehicle properties without loss of referential continuity (as exemplified by DNA-protein relations). Although I can’t conclude that this is the only way that biosemiotic properties can emerge from physical-chemical relations that otherwise lack these properties, I contend that this approach offers a biologically plausible demonstration that it is possible. (shrink)

This encyclopedia article traces the development of Richard J. Bernstein's philosophical work and provide s short biography.

It is argued in this study that (i) progress in the philosophy of mathematical practice requires a general positive account of informal proof; (ii) the best candidate is to think of informal proofs as arguments that depend on their matter as well as their logical form; (iii) articulating the dependency of informal inferences on their content requires a redefinition of logic as the general study of inferential actions; (iv) it is a decisive advantage of this conception of logic that it (...) accommodates the many mathematical proofs that include actions on objects other than propositions; (v) this conception of logic permits the articulation of project-sized tasks for the philosophy of mathematical practice, thereby supplying a partial characterisation of normal research in the field. (shrink)

The plays in this new volume were written early in Marcel’s career, and were published together under the title Le Seuil invisible (The Invisible Threshold) in 1913. The first play, Grace, explores the theme of religious conversion. The drama depicts a crisis between characters of genuine depth and sincerity, who are struggling with different interpretations of shared experiences. Similar themes are addressed but developed differently in the second play, The Sandcastle. This drama explores the confrontation between one’s beliefs and their (...) consequences when faced with challenging family and social circumstances. The play asks us to think about what happens when our beliefs and theories, especially about religion, morality and politics, come up against situations in life that can test them. Both plays illustrate one of the major themes of both Marcel’s dramatic and philosophical work: that life’s most profound, fulfilling experiences are compromised more than ever in what he describes as the modern, broken world (le monde cassé), one unfortunately characterized by alienation, loss of meaning and feelings of despair. (shrink)

Two dogmas of liberalism in the therapeutic setting are challenged: (1) that patients have a ready-made ability to act autonomously; and (2) that non-intervention by physicians is the best strategy for protecting the autonomy of patients. Recognition of the impact of illness upon autonomous behavior forms the basis of this challenge. It is suggested that autonomy is better conceived as a process of personal growth by which patients become better able to overcome the disruptive effects of illness. The physician is (...) assigned an active role in the achievement of this therapeutic goal. The implications of this new liberal theory are illustrated by reference to the informed consent issue. (shrink)

In the context of transgender health, most people are not comfortable with allowing a twelve‐year‐old child with gender dysphoria to elect to undergo gender reassignment surgery. The likelihood is too high that the child would be unable to fully comprehend the scope of a decision that carries significant, permanent consequences, particularly because the decision to surgically change gender is based upon a conception of gender that can fluctuate during adolescent years. Conversely, however, most people would not contend that this fluidity (...) is reason to wholly deny certain medical care such as hormonal treatments to transgender youth, a demographic with extremely high rates of violent behavior, self‐harm, and suicide. This paper will explore ethical considerations to this emerging debate of what therapeutic options should be offered to transgender children and adolescents.Pediatric endocrinologists have been treating gender dysphoric adolescents with puberty‐suppressing drugs and, to a lesser extent, with cross‐sex hormone therapies for more than twenty years. Clinicians and thought leaders have mentioned ethical components of this emerging practice in the few cohort studies and clinical review articles about the subject. However, ethics have generally been a secondary consideration in the medical academic literature. In this paper, I will provide a brief overview of the practice, summarize the current research on hormone treatment for transgender minors, and provide an ethical analysis of the practice. (shrink)