In order to enhance the “structural competency” of medicine—the capability of clinicians to address social and institutional determinants of their patients’ health—physicians need a theoretical lens to see how social conditions influence health and how they might address them. We consider one such theoretical lens, fundamental cause theory, and propose how it might contribute to a more structurally competent medical profession. We first describe fundamental cause theory and how it makes the social causes of disease and health visible. We then (...) outline the sorts of “fundamental interventions” that physicians might make in order to address the fundamental causes. (shrink)

In their article “Structuring a Written Examination to Assess ASBH Health Care Ethics Consultation Core Competencies” (2014), White, Jankowski, and Shelton argue that a written examination to evalu...

Thomas Reed argues that the Christian, if apprised of Plantinga's central claims in Warranted Christian Belief, should be agnostic regarding Christianity's central tenets. Reed models his argument on Plantinga's own argument against naturalism, according to which naturalists have a built-in defeater for their epistemology. Reed bases his argument on the contention that if Christian theism cannot be shown or demonstrated, rational Christians should refrain from believing. Not only does Reed's contention not follow, but he confuses logically possible defeaters with actual (...) defeaters and ignores Plantinga's claims regarding the Aquinas/Calvin model and the proper basicality of belief in God. (shrink)

Are morphological patterns learned in the form of rules? Some models deny this, attributing all morphology to analogical mechanisms. The dual mechanism model (Pinker, S., & Prince, A. (1998). On language and connectionism: analysis of a parallel distributed processing model of language acquisition. Cognition, 28, 73-193) posits that speakers do internalize rules, but that these rules are few and cover only regular processes; the remaining patterns are attributed to analogy. This article advocates a third approach, which uses multiple stochastic rules (...) and no analogy. We propose a model that employs inductive learning to discover multiple rules, and assigns them confidence scores based on their performance in the lexicon. Our model is supported over the two alternatives by new "wug test" data on English past tenses, which show that participant ratings of novel pasts depend on the phonological shape of the stem, both for irregulars and, surprisingly, also for regulars. The latter observation cannot be explained under the dual mechanism approach, which derives all regulars with a single rule. To evaluate the alternative hypothesis that all morphology is analogical, we implemented a purely analogical model, which evaluates novel pasts based solely on their similarity to existing verbs. Tested against experimental data, this analogical model also failed in key respects: it could not locate patterns that require abstract structural characterizations, and it favored implausible responses based on single, highly similar exemplars. We conclude that speakers extend morphological patterns based on abstract structural properties, of a kind appropriately described with rules. (shrink)

The clinical ethicist met with Ms. H to clarify what information she wants and does not want to know. First, she wants to receive any treatment that could prolong her life, regardless of how the treatment affects her ability to engage in activities of daily living. Second, she wants to be included in the decision‐making process as much as possible, as long as clinicians use only “positive” language. Ms. H considers the words “dying,” “chemotherapy,” “radiation,” and “cancer” to be “bad (...) words.” For conversations in which these words cannot be avoided, she wants her clinicians to talk to her son. Her desired engagement includes hearing about risks, benefits, and alternatives to treatments if clinicians use only “positive” language. Finally, she says that she rarely sees doctors and that she is “very scared” of hospitals, despite exhibiting a comfortable demeanor.Should clinicians honor Ms. H's waiver of specified information and, if so, to what degree? (shrink)

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...) implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: train-the-trainer, local capacity-building, circuit-riding, and consolidated accountability. We note each model’s benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations. (shrink)

Despite the interpersonal nature of family meetings and the frequency in which they occur, the clinical ethics literature is devoid of any rich descriptions of what clinical ethicists should actually be doing during family meetings. Here, we propose a framework for describing and understanding “transitioning” facilitation skills based on a retrospective review of our internal documentation of 100 consecutive cases wherein a clinical ethicist facilitated at least one family meeting. The internal documents were analyzed using qualitative methodologies, i.e., “codes”, to (...) identify emergent themes. We identified four different transitioning strategies clinical ethicists use to reach a meaningful resolution. These transitioning strategies serve as a jumping-off point for additional analyses, future research, evaluating clinical ethics consultation, and overall performance improvement of a consultation service. (shrink)

This study investigated attitudes toward the use of deception in negotiation, with particular attention to the distinction between deception regarding the informational elements of the interaction (e.g., lying about or misrepresenting needs or preferences) and deception about emotional elements (e.g., misrepresenting one's emotional state). We examined how individuals judge the relative ethical appropriateness of these alternative forms of deception, and how these judgments relate to negotiator performance and long-run reputation. Individuals viewed emotionally misleading tactics as more ethically appropriate to use (...) in negotiation than informational deception. Approval of deception predicted negotiator performance in a negotiation simulation and also general reputation as a negotiator, but the nature of these relationships depended on the kind of deception involved. (shrink)

Lei, a twenty‐seven‐year‐old Mandarin speaker, visits the United States seeking curative treatments for his acute myeloid leukemia. His mother, Hua, has traveled with him. Neither she nor Lei speak English, and the hospital does not have an onsite professional Mandarin‐speaking interpreter. Using a professional interpreter over the phone, Lei's oncologist, Dr. Branson, attempts to initiate a face‐to‐face goals‐of‐care conversation with Hua as the surrogate decision‐maker. Dr. Branson explains that Lei has “only weeks to months to live” and recommends initiating comfort‐care‐only (...) measures, but Hua says that she wants (and that Lei would want) continued aggressive measures. Hua says that her son might be a candidate for a phase I trial. Eventually, Dr. Branson brings in Dr. Chou, a Mandarin‐speaking resident to provide face‐to‐face interpretation. Hua insists that “there must be more standard therapies available” and says that she will wait until the trial begins. She begins crying, and the meeting disintegrates. Following this, Dr. Branson calls for an ethics consultation for “help in end‐of‐life communicating and reconciling discordance about prognostic information.”How should the ethicist use the institution's interpreter services? (shrink)

(No abstract is available for this citation).

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

Antimicrobial resistance (AMR) has become one of the defining challenges of the twenty-first century. Food production and farming are a key if troubling component of that challenge. Livestock production accounts for well over half of annual global consumption of antimicrobials, though the contribution of the sector to drug resistance is less clear. As a result, there is an injunction to act in advance of incontrovertible evidence for change. In this paper we engage with the role of market actors in the (...) precautionary regulation of farming practices and AMR threats. The paper takes the UK poultry sector as exemplary of an audit-led process that has, in recent years, achieved impressive reductions in antimicrobial use. Using qualitative interview data with farmers and veterinarians we chart the changing practices that have accompanied this reduction in treatments. We use this analysis to raise some cautions around audit-led systems of regulation. Audits can lock farms and animals into particular versions of farming and animal health; they can elevate harmful compensatory practices (including disinfectant uses); and they can reproduce an actuarial approach to an issue that does not fit the conventions of risk management. The paper presents the considerable successes that have been achieved over a short period of time in a livestock sector, while generating notes of caution concerning the audit-led management of livestock-related AMR threats. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

This is a review of Robert Merrihew Adams's book Finite and Infinite Goods (Oxford UP 1999), which provides an impressive theistic axiological and ethical theory.

The concept of civil society continues to generate considerable interest, while the concept of civilization attracts comparatively little attention. This has led to a tendency to oversimplify the relationship between civil societies and militarily powerful sovereign states. Civil societies, it is often argued, are those societies that have emerged from a successful process of domestic pacification and effective control of state power. In this paper, it will be argued that some prominent Scottish Enlightenment thinkers developed theories of civilization grounded in (...) more complex historical narratives, in which the accomplishments of civil society were tied to the achievement of state sovereignty based on the successful monopoly of military might. The purpose of this paper is to trace the role of state sovereignty and military monopolization, and the consequent prominence given to the practice of war, in the “historical” theories of civilization articulated by David Hume, William Robertson, Adam Smith and Adam Ferguson. (shrink)

Adams offers a theistically-based framework for ethics, based upon the idea of a transcendent, infinite good, which is God, and its relation to the many finite examples of good in our experience. His account shows how philosophically unfashionable religious concepts can enrich ethical thought. "...one of the two most important books in moral philosophy of the last quarter century, the other being After Virtue."--Theology Today.

I have argued elsewhere that there are facts, and possibilities, that are not purely qualitative. In a second paper, however, I have argued that all possibilities are purely qualitative except insofar as they involve individuals that actually exist. In particular, I have argued that there are no thisnesses of nonactual individuals (where the thisness of x is the property of being x, or of being identical with x), and that there are no singular propositions about nonactual individuals (where a singular (...) proposition about an individual x is a proposition that involves or refers to x directly, perhaps by having x or the thisness of x as a constituent, and not merely by way of x's qualitative properties or relations to other individuals). I am also inclined to believe that there are not yet any thisnesses of individuals that will exist but do not yet, nor any singular propositions about future individuals--and, hence, that all possibilities are purely qualitative except insofar as they involve individuals that already do exist or have existed (counting timeless individuals, if any, as already existing). This thesis about the relation of time to thisness is the subject of the present paper, in which the conclusions of my previous papers will be presupposed. (shrink)

This book presents an in-depth interpretation of three important parts of Leibniz's metaphysics: the metaphysical part of Leibniz's philosophy of logic, his essentially theological treatment of the central issues of ontology, and his theory of substance.

From nineteenth-century abolitionism to Black Lives Matter today, progressive social movements have been at the forefront of social change. Yet it is seldom recognized that such movements have not only engaged in political action but also posed crucial philosophical questions about the meaning of justice and about how the demands of justice can be met. -/- Michele Moody-Adams argues that anyone who is concerned with the theory or the practice of justice—or both—must ask what can be learned from social (...) movements. Drawing on a range of compelling examples, she explores what they have shown about the nature of justice as well as what it takes to create space for justice in the world. Moody-Adams considers progressive social movements as wellsprings of moral inquiry and as agents of social change, drawing out key philosophical and practical principles. Social justice demands humane regard for others, combining compassionate concern and robust respect. Successful movements have drawn on the transformative power of imagination, strengthening the motivation to pursue justice and to create the political institutions and social policies that can sustain it by inspiring political hope. -/- Making Space for Justice contends that the insights arising from social movements are critical to bridging the gap between discerning theory and effective practice—and should be transformative for political thought as well as for political activism. (shrink)

Traces the development of recursive functions from their origins in the late nineteenth century to the mid-1930s, with particular emphasis on the work and influence of Kurt Gödel.

Causal theories of mental content attempt to explain how thoughts can be about things. They attempt to explain how one can think about, for example, dogs. These theories begin with the idea that there are mental representations and that thoughts are meaningful in virtue of a causal connection between a mental representation and some part of the world that is represented. In other words, the point of departure for these theories is that thoughts of dogs are about dogs because dogs (...) cause the mental representations of dogs. (shrink)

This paper shows that moral progress is a substantive and plausible idea. Moral progress in belief involves deepening our grasp of existing moral concepts, while moral progress in practices involves realizing deepened moral understandings in behavior or social institutions. Moral insights could not be assimilated or widely disseminated if they involved devising and applying totally new moral concepts. Thus, it is argued, moral failures of past societies cannot be explained by appeal to ignorance of new moral ideas, but must be (...) understood as resulting from refusals to subject social practices to critical scrutiny. Moral philosophy is not the main vehicle for disseminating morally progressive insights, though it has an important role in processes that lead to moral progress. Yet we have grounds for cautious optimism, since progressive moral insights can be disseminated and can, sometimes, have constructive social effects. (shrink)

Comprehensive historical understanding is also a central element of the information we need to be responsible moral agents. It is also a critical support of the morality that makes political cooperation possible, especially in any society shaped by a history of ethnic or racial injustice, colonialism, imperialism, or sectarian conflict. Efforts to censor the teaching of history that makes one uncomfortable are thus ethically as well as epistemically indefensible.

For decades the study of social perception was largely compartmentalized by type of social cue: race, gender, emotion, eye gaze, body language, facial expression etc. This was partly due to good scientific practice, and partly due to assumptions that each type of social cue was functionally distinct from others. Herein, we present a functional forecast approach to understanding compound social cue processing that emphasizes the importance of shared social affordances across various cues. We review the traditional theories of emotion and (...) face processing that argued for dissociable and noninteracting pathways, as well as more recent evidence for combinatorial processing of social cues. We argue here that early, and presumably reflexive, visual integration of such cues is necessary for adaptive behavioral responding to others. In support of this claim, we review contemporary work that reveals a flexible visual system, one that readily incorporates meaningful contextual influences in even nonsocial visual processing, thereby establishing the functional and neuroanatomical bases necessary for compound social cue integration. Finally, we explicate three likely mechanisms driving such integration. Together, this work implicates a role for cognitive penetrability in visual perceptual abilities that have often been ascribed to direct encapsulated perceptual processes. (shrink)

Center for Humans and Nature, 109 West 77th Street, Suite 2, New York, NY 10024, USA. Tel.: 212 362 7170; Fax: 212 362 9592; Email: brucejennings{at}humansandnature.org ' + u + '@' + d + ' '//--> . Abstract A fundamental question for the ethical foundations of public health concerns the moral justification for limiting or overriding individual liberty. What might justify overriding the individual moral claim to non-interference or to self-realization? This paper argues that the libertarian justification for limiting individual (...) liberty known as the ‘harm principle’ or the ‘Millian paradigm’ is inadequate as a basis of public health ethics and policy. But simply pitting some collectivist value or utilitarian criterion over against individual liberty is not theoretically satisfactory, either. John Stuart Mill himself was not a Millian, in this sense, and his utilitarianism does not pit itself against individual liberty as a situation of balancing conflicting values. A reconsideration of Mill, particularly in light of the later work of Berlin on liberty, points toward a conception of relational liberty that is crucial for public health ethics because it contains within itself the basis for its own moral limitation. CiteULike Connotea Del.icio.us What's this? (shrink)

Since the introduction of mathematical population genetics, its machinery has shaped our fundamental understanding of natural selection. Selection is taken to occur when differential fitnesses produce differential rates of reproductive success, where fitnesses are understood as parameters in a population genetics model. To understand selection is to understand what these parameter values measure and how differences in them lead to frequency changes. I argue that this traditional view is mistaken. The descriptions of natural selection rendered by population genetics models are (...) in general neither predictive nor explanatory and introduce avoidable conceptual confusions. I conclude that a correct understanding of natural selection requires explicitly causal models of reproductive success. *Received May 2006; revised December 2006. †To contact the author, please write to: Department of Philosophy, Kansas State University, 201 Dickens Hall, Manhattan, KS 66506; e‐mail: glymour@ksu.edu . (shrink)

_The Multicultural Imagination_ is a challenging inquiry into the complex interrelationship between our ideas about race and color and the unconscious. Michael Vannoy Adams takes a fresh look at the contributions of psychoanalysis to a question which affects every individual who tries to establish an effective personal identity in the context of their received 'racial' identity. Adams argues that 'race' is just as important as sex or any other content of the unconcscious, drawing on clinical case materal from (...) contemporary patients for whom 'race' or color is a vitally significant social and political concern that impacts on them personally. He does not assume that racism or 'colorism' will simply vanish if we psychoanalyse them, but shows how a non-defensive ego and a self-image that is receptive to other-images can move us towards a more productive discourse of cultural differences. Wide-ranging in its references and scope, this is a book that provokes the reader - analyst or not - to confront personally those unconscious attitudes which stand in the way of authentic multicultural relationships. (shrink)

The idea of moral progress is a necessary presupposition of action for beings like us. We must believe that moral progress is possible and that it might have been realized in human experience, if we are to be confident that continued human action can have any morally constructive point. I discuss the implications of this truth for moral psychology. I also show that once we understand the complex nature and the complicated social sources of moral progress, we will appreciate why (...) we cannot construct a plausible comprehensive action-guiding theory of moral progress. Yet while the nature and sources of moral progress consistently thwart many theoretical hopes, the idea of moral progress is a plausible, critically important and morally constructive principle of historical interpretation. (shrink)

Robert Merrihew Adams has been a leader in renewing philosophical respect for the idea that moral obligation may be founded on the commands of God. This collection of Adams' essays, two of which are previously unpublished, draws from his extensive writings on philosophical theology that discuss metaphysical, epistemological, and ethical issues surrounding the concept of God--whether God exists or not, what God is or would be like, and how we ought to relate ourselves to such a being. (...) class='Hi'>Adams studies the relation between religion and ethics, delving into an analysis of moral arguments for theistic belief. In several essays, he applies contemporary studies in the metaphysics of individuality, possibility and necessity, and counterfactual conditionals to issues surrounding the existence of God and problems of evil. (shrink)

The concept of consensus is often appealed to in discussions of biomedical ethics and applied ethics, and it plays an important role in many influential ethical theories. Consensus is an especially influential notion among theorists who reject ethical realism and who frame ethics as a practice of discourse rather than a body of objective knowledge. It is also a practically important notion when moral decision making is subject to bureaucratic organization and oversight, as is increasingly becoming the case in medicine. (...) Two models of consensus are examined and criticized: pluralistic consensus and overlapping consensus. As an alternative to these models, the paper argues that consensus refers to the dialogic aspects of a broader normative conception of democratic moral agency. When the preconditions for that dialogic democratic practice are met, consensus has a justificatory role in ethics; when they are not, consensus, as distinct from mere agreement, does not emerge and can have no moral authority. Keywords: applied ethics, bioethics, consensus, contract theory, democracy, discourse ethics, liberalism CiteULike Connotea Del.icio.us What's this? (shrink)

Eclipse of Grace offers original insights into the roots of modern theology by introducing systematic theologians and Christian ethicists to Hegel through a focus on three of his seminal texts: Phenomenology of Spirit, Science of Logic, and Lectures on the Philosophy of Religion. Presents brilliant and original insights into Hegel’s significance for modern theology Argues that, theologically, Hegel has been misconstrued and that much more can be gained by focusing on the logic that he develops out of an engagement with (...) Christian doctrines Features an original structure organized as a set of commentaries on individual Hegel texts, and not just presenting overviews of his entire corpus Offers detailed engagement with Hegel’s texts rather than relying on generalizations about Hegelian philosophy Provides an illuminating, accessible and lucid account of the thinking of the major figures in modern German philosophy and theology. (shrink)

The essays featured in this volume embrace environmental philosophy in its broadest sense and include topics such as environmental ethics, environmental ...