The increasing age of the patient population around the globe and in the United States has resulted in a growing number of patients with dementia. In this manuscript, we examined the role of the ethics consultation service in patients who have dementia and associated cognitive and neuropsychiatric sequelae. We addressed a particularly challenging case presenting with behavioral and psychological symptoms of dementia. We discussed the ethical questions and challenges considered by the ethics consultation service and compared these with current suggestions (...) and expectations from the research literature regarding the role of ethics consultation service in dementia management. We demonstrated two potentially useful approaches of clinical ethical analysis, the principalist theorem and Jonsen's four quadrants approach. While the number of consults in patients with behavioral and psychological symptoms of dementia is likely to increase in clinical ethics, the role of the ethics consultation service in this cohort of patients still remains to be determined. There are significant gaps in understanding of the ethics consultation service role in dementia management, and much work remains to be undertaken on the part of regulatory and healthcare systems in clarifying their roles, expectations, and competencies. (shrink)

How far has the Darwinian revolution come? To what extent have evolutionary ideas penetrated into the social sciences and humanities? Are the “science wars” over? Or do whole blocs of disciplines face off over an unbridgeable epistemic gap? To answer questions like these, contributors to top journals in 22 disciplines were surveyed on their beliefs about human nature, culture, and science. More than 600 respondents completed the survey. Scoring patterns divided into two main sets of disciplines. Genetic influences were emphasized (...) in the evolutionary social sciences, evolutionary humanities, psychology, empirical study of the arts, philosophy, economics, and political science. Environmental influences were emphasized in most of the humanities disciplines and in anthropology, sociology, education, and women's or gender studies. Confidence in scientific explanation correlated positively with emphasizing genetic influences on behavior, and negatively with emphasizing environmental influences. Knowing the current actual landscape of belief should help scholars avoid sterile debates and ease the way toward fruitful collaborations with neighboring disciplines. (shrink)

Contemporary conversations about religion and culture are framed by two reductive definitions of secularity. In one, multiple faiths and nonfaiths coexist free from a dominant belief in God. In the other, we deny the sacred altogether and exclude religion from rational thought and behavior. But is there a third way for those who wish to rediscover the sacred in a skeptical society? What kind of faith, if any, can be proclaimed after the ravages of the Holocaust and the many religion-based (...) terrors since? Richard Kearney explores these questions with a host of philosophers known for their inclusive, forward-thinking work on the intersection of secularism, politics, and religion. An interreligious dialogue that refuses to paper over religious difference, these conversations locate the sacred within secular society and affirm a positive role for religion in human reflection and action. Drawing on his own philosophical formulations, literary analysis, and personal interreligious experiences, Kearney develops through these engagements a basic gesture of hospitality for approaching the question of God. His work facilitates a fresh encounter with our best-known voices in continental philosophy and their views on issues of importance to all spiritually minded individuals and skeptics: how to reconcile God's goodness with human evil, how to believe in both God and natural science, how to talk about God without indulging in fundamentalist rhetoric, and how to balance God's sovereignty with God's love. (shrink)

Mental control refers to the ability we have to control our own minds. Its primary expression—attention—has become a popular topic for philosophers in the past few decades, generating the need for a primer on the concept. It is related to self-control, which typically refers to the maintenance of preferred behavior in the face of temptation. While a distinct concept, criticisms of self-control can also be applied to mental control, such as that it implies the existence of an unscientific homunculus-like agent (...) or is not a natural kind. Yet, as this Element suggests, a scientifically-grounded account of mental control remains possible. The manuscript is organized into five main sections, which cover 1) the concept of mental control, 2) the relationship between mental control and attention, 3) the phenomena of meditation and mindwandering, 4) attention deficit hyperactivity disorder, and 5) emergence-based accounts of mental control, including an original account by the author. (shrink)

Conducting research with vulnerable populations involves careful attention to the interests of individuals. Although it is generally understood that informed consent is a necessary prerequisite to research participation, it is less clear how to proceed when potential research participants lack the capacity to provide this informed consent. The rationale for assessing the assent or dissent of vulnerable individuals and obtaining informed consent by authorized representatives is discussed. Practical guidelines for recruitment of and data collection from people in the middle or (...) late stage of dementia are proposed. These guidelines were used by research assistants in a minimal risk study. (shrink)

In the fall of 1996 I taught a course at Fudan University in Shanghai dealing with medical ethics in America. As part of the course we spent some time on the heated American debate about abortion. The reaction of Chinese students was revealing.

History's judgment on the success of bioethics will not depend solely on the conceptual creativity and innovation in the field at the level of ethical and political theory, but this intellectual work is not insignificant. One important new development is what I shall refer to as the relational turn in bioethics. This development represents a renewed emphasis on the ideographic approach, which interprets the meaning of right and wrong in human actions as they are inscribed in social and cultural practices (...) and in structures of lived meaning and interdependence; in an ideographic approach, the task of bioethics is to bring practice into theory, not the other way around. The relational turn in bioethics may profoundly affect the critical questions that the field asks and the ethical guidance it offers society, politics, and policy. The relational turn provides a way of correcting the excessive atomism of many individualistic perspectives that have been, and continue to be, influential in bioethics. Nonetheless, I would argue that most of the work reflecting the relational turn remains distinctively liberal in its respect for the ethical significance of the human individual. It moves away from individualism, but not from the value of individuality.In this review essay, I shall focus on how the relational turn has manifested itself in work on core concepts in bioethics, especially liberty and autonomy. Following a general review, I conclude with a brief consideration of two important recent books in this area: Jennifer Nedelsky's Law's Relations and Rachel Haliburton's Autonomy and the Situated Self. (shrink)

This is a comprehensive study of the English word 'or', and the logical operators variously proposed to present its meaning. Although there are indisputably disjunctive uses of or in English, it is a mistake to suppose that logical disjunction represents its core meaning. 'Or' is descended from the Anglo-Saxon word meaning second, a form which survives in such expressions as "every other day." Its disjunctive uses arise through metalinguistic applications of an intermediate adverbial meaning which is conjunctive rather than disjunctive (...) in character. These conjunctive uses have puzzled philosophers and logicians, and have been discussed extensively under such headings as "free choice permission." This study examines the textbook myths that have clouded our understanding of how or and other "logical" vocabulary comes to have something approaching its logical meaning in natural languages. It considers the various historical conceptions of disjunction and its place in logic from the Stoics to the present day. (shrink)

The absence of a common understanding of attention plagues current research on the topic. Combining the findings from three domains of research on attention, this paper presents a univocal account that fits normal use of the term as well as its many associated phenomena: attention is a process of mental selection that is within the control of the subject. The role of the subject is often excluded from naturalized accounts, but this paper will be an exception to that rule. The (...) paper aims to show how we might reinstate the subject into the act of attention, endorsing the ordinary notion that attention is a direction of the mind by the subject, rather than a mere occurrence or happening. To do so, it lays out the best work of phenomenology, psychology, and neuroscience on specifying the nature of attention and, in finding them individually wanting, combines them into a unified view that avoids the problems of each. (shrink)

Philosophers of science are becoming more sensitive to the claims about truth and rationality being made by sociologists of science. There is a tendency among some of these philosophers to dismiss such claims as irrelevant to philosophy of science and as self-refuting. Larry Laudan, in his 'arationality assumption', has captured the essence of positions which argue that sociology of science can only be concerned with scientific claims which are not rational (or, in some versions, 'not true'). I show that the (...) arguments he gives in support of the arationality assumption are not sound, that the arationality assumption has absurd consequences, and I argue that the arationality assumption undermines the possibility of fruitful cooperation between philosophers and sociologists of science. I conclude that the arationality assumption should be rejected. (shrink)

How important is the concept of solidarity in our society's calculus of consent as regards the legitimacy and ethical and political support for public health, health policy, and health services? By the term “calculus of consent,” we refer to the answer that people give to rationalize and justify their obedience to laws, rules, and policies that benefit others. The calculus of consent answers questions such as, Why should I care? Why should I help? Why should I contribute to the public (...) provision of others? Consent here does not have to be a deliberate, explicit act of informed agreement. And a calculus does not have to be a quantifiable, quasimathematical operation; more often, such a calculus takes narrative form in stories that a society tells about itself and that individuals tell about their place in it. One vital function of bioethics is to inform and shape those stories. Bioethics has the potential to offer society a keener insight into and perception of what is ethically at stake in controversies concerning health, science, and society. This insight is what we shall refer to as a “moral imagination,” by which we do not mean make-believe or fantasy but, rather, the capacity to take a critical distance from the given, to think reality otherwise. The moral imagination enables one to see connections between factors at work in history, in large social and communal structures, and in the shape of one's own life, thoughts, and feelings. Here we are especially concerned with the contribution that the concept of solidarity can make to the moral imagination of bioethics. We contend that solidarity must become more widely active and explicit in bioethics analysis and argumentation as it endeavors to shape reasons for obeying norms and rules of common benefit in an open, diverse society. (shrink)

During 1995, there was a major shift in the United Kingdom in the debate of whether it is right for nurses to strike. The Royal College of Nursing, the former advocate of a non-industrial action policy, moved towards the UNISON position that industrial action is ethical in some circumstances, as well as the necessary thing to do. The authors, both nurses and UNISON officials, look at the reasons for this change and why UNISON’s historical position sees industrial action as an (...) effective weapon in defending services, as well as wages and jobs. It can be right to strike. (shrink)

This article defends ‘relational theorizing’ in bioethics and public health ethics and describes its importance. It then offers an interpretation of solidarity and care understood as normatively patterned and psychologically and socially structured modes of relationality; in a word, solidarity and care understood as ‘practices.’ Solidarity is characterized as affirming the moral standing of others and their membership in a community of equal dignity and respect. Care is characterized as paying attention to the moral being of others and their needs, (...) suffering, and vulnerability. The wager of relational theorizing in health care and public health is that substantive ethical visions of solidarity and care will provide support for more just and egalitarian health care and public health policies. (shrink)

The social sciences playa variety of multifaceted roles in the policymaking process. So varied are these roles, indeed, that it is futile to talk in the singular about the use of social science in policymaking, as if there were one constant relationship between two fixed and stable entities. Instead, to address this issue sensibly one must talk in the plural about uses of dif ferent modes of social scientific inquiry for different kinds of policies under various circumstances. In some cases, (...) the influence of social scientific research is direct and tangible, and the connection between the find ings and the policy is easy to see. In other cases, perhaps most, its influence is indirect-one small piece in a larger mosaic of politics, bargaining, and compromise. Occasionally the findings of social scientific studies are explicitly drawn upon by policymakers in the formation, implementation, or evaluation of particular policies. More often, the categories and theoretical models of social science provide a general background orientation within which policymakers concep tualize problems and frame policy options. At times, the in fluence of social scientific work is cognitive and informational in nature; in other instances, policymakers use social science primarily for symbolic and political purposes in order to le gitimate preestablished goals and strategies. Nonetheless, amid this diversity and variety, troubling general questions persistently arise. (shrink)

As doctoral students from New Zealand and Australia, advised by supervision teams with a diversity of critical realist experience from limited to none, we came independently to the 2018 Critical Re...

During his lifetime, Sir Ivor Jennings was well known as the author of several standard books on constitutional law. He acted as constitutional adviser to the governments of Ceylon and Pakistan and was Vice-Chancellor of the University of Ceylon. This 1956 book followed in the tradition of his earlier The British Constitution and is a clear statement by an expert with a characteristically practical point of view. It is principally concerned with a practical problem: what constitution shall be given (...) to a new country about to govern itself for the first time? Published at a time when colonial empires were moving more or less peaceably towards self-government, it was based on a series of broadcast talks originally commissioned by the BBC in the belief that the experiences gained in Asia were in principle applicable to other countries approaching self-government. (shrink)

Experimental philosophers advocate expansion of philosophical methods to include empirical investigation into the concepts used by ordinary people in reasoning and action. We propose also including methods of qualitative social science, which we argue serve both moral and epistemic goals. Philosophical analytical tools applied to interdisciplinary research designs can provide ways to extract rich contextual information from subjects. We argue that this approach has important implications for bioethics; it provides both epistemic and moral reasons to use the experiences and perspectives (...) of diverse populations to better identify underlying concepts as well as to develop effective interventions within particular communities. (shrink)

Discussions of research involving vulnerable populations have left the homeless comparatively ignored. Participation by these subjects in drug studies has the potential to be upsetting, inconvenient, or unpleasant. Participation occasionally produces injury, health emergencies, and chronic health problems. Nonetheless, no ethical justification exists for the categorical exclusion of homeless persons from research. The appropriate framework for informed consent for these subjects of pharmaceutical research is not a single event of oral or written consent, but a multi-staged arrangement of disclosure, dialogue, (...) and permission-giving. Payments and other rewards in biomedical research raise issues of whether it is ethical to offer inducements to the homeless in exchange for participation in drug studies. Such inducements can influence desperate persons who are seriously lacking in resources. The key is to strike a balance between a rate of payment high enough that it does not exploit subjects by underpayment and low enough that it does not create an irresistible inducement. This proposal does not underestimate the risks of research, which are often overestimated and need to be appraised in light of the relevant empirical literature. (shrink)

Timm Triplett argues (Inquiry 29 [1986], no. 4) that David Bloor does not succeed in justifying a relativistic interpretation of mathematics. It is objected that Triplett has focused his attention on the wrong chapter of Bloor's Knowledge and Social Imagery, and that the examples which Triplett demands Bloor provide to make the case do appear in the subsequent chapter. Moreover, Bloor has anticipated and refuted Triplett's brief criticism of the examples that make Bloor's case for the relativism of mathematics. Finally, (...) Triplett's own example of a basic mathematical truth can be shown to be socially relative. (shrink)

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

Sexual realism has traditionally held that our categories of sex refer to something real about our biology. Sexual non-realism, on the other hand, either partially or wholly rejects this position. Sexual non-realists typically point to intersexuality as evidence that our categories of sex are not inherent to nature but are culturally constructed. This paper makes use of the work of Carrie Hull in her book The Ontology of Sex to explore the philosophical backgrounds of sexual non-realism and to make a (...) general case for sexual realism from a Thomistic framework. (shrink)

Forces including extreme economic inequality, cultural polarization, and the monetizing and privatizing of persons as commodities are undermining the forms of moral recognition and mutuality upon which democratic practices and institutions depend. These underlying factors, together with more direct modes of political corruption, manipulation, and authoritarian nationalism, are undoing Western democracies. This essay identifies and explores some vital underpinnings of democratic citizenship and civic learning that remain open to revitalization and repair. Building care structures and practices from the ground up (...) and developing inclusive and egalitarian modes of solidarity in a pluralistic society are the focus of discussion. The essay argues that solidarity and care are essential relationships and practices of moral recognition upon which democratic political agency and freedom rest. The social‐relational lifeworld and the democratic lifeworld are interdependent. Democratic citizenship is itself a relational practice that supports other practices. Democratic governance properly carried out fosters an underlying social solidarity and care and in turn draws moral and political legitimacy upward from them. (shrink)

Is Leo Strauss truly an intellectual forebear of neoconservatism and a powerful force in shaping Bush administration foreign policy? _The Truth about Leo Strauss_ puts this question to rest, revealing for the first time how the popular media came to perpetuate an oversimplified view of a complex and wide-ranging philosopher. In doing so, it corrects our perception of Strauss, providing the best general introduction available to the political thought of this misunderstood figure. Catherine and Michael Zuckert—both former students of (...) Strauss—guide readers here to a nuanced understanding of how Strauss’s political thought fits into his broader philosophy. Challenging the ideas that Strauss was an inflexible conservative who followed in the footsteps of Nietzsche, Heidegger, and Carl Schmitt, the Zuckerts contend that Strauss’s signature idea was the need for a return to the ancients. Through their work, they conclude that Strauss was a sober defender of liberal democracy, aware of both its strengths and its weaknesses. Balanced and accessible, _The Truth about Leo Strauss_ is a must-read for anyone who wants to more fully comprehend this enigmatic philosopher and his much-disputed legacy. “_The Truth about Leo Strauss_ is the most balanced and insightful book yet written about Strauss’s thought, students, and political influence. It dispels myths promulgated by both friends and foes and persuasively traces the conflicting paths that American thinkers indebted to Strauss have taken.”—William Galston, Brookings Institution. (shrink)

Attention is the basis of our free will, allowing us to direct our minds as we choose. Technology poses a threat to this individual agency, writes Carolyn Dicey Jennings, but may also yield new rewards. Social media harnesses our attention for incentives that aren’t our own, sublimating it into the interests of the group. We are trading our individual power for collective power, and we need to understand the risks and benefits of doing this.

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)

This study examines how occupational sex segregation affects women’s and men’s perceptions of the availability of workplace support. Drawing on theories of gender and empirical studies of workplace tokenism, the author develops the concept of an occupational minority. Although the notion of tokenism was developed to describe processes at the level of the workplace, the author explores how being a minority at the occupational level affects workers. Using nationally representative data, she finds that in mixed-sex occupations, women report higher levels (...) of workplace support than men; in male-dominated occupations, they perceive relatively low levels of support. Men, by contrast, perceive relatively high levels of workplace support in female-dominated occupations. That is, being a member of a numerical minority in one’s occupation is an advantage for men and a disadvantage for women. (shrink)

Academic Placement Data and Analysis (APDA) has released its complete 2017 Final Report, an 81-page document that collects data on PhD-granting philosophy programs (including ratings by former students, placement rates, and diversity) and the discipline as a whole (including hiring networks, placement maps, cluster analyses of programs, job descriptions, non-academic hiring). The report was created by Carolyn Dicey Jennings, Patrice Cobb, Pablo Contreras Kallens, and Angelo Kyrilov, all of University of California, Merced. (from Daily Nous).

Is it possible to apply a theoretical approach to ethics? The French philosopher Catherine Chalier addresses this question with an unusual combination of traditional ethics and continental philosophy. In a powerful argument for the necessity of moral reflection, Chalier counters the notion that morality can be derived from theoretical knowledge. Chalier analyzes the positions of two great moral philosophers, Kant and Levinas. While both are critical of an ethics founded on knowledge, their criticisms spring from distinctly different points of (...) view. Chalier reexamines their conclusions, pitting Levinas against (and with) Kant, to interrogate the very foundations of moral philosophy and moral imperatives. She provides a clear, systematic comparison of their positions on essential ideas such as free will, happiness, freedom, and evil. Although based on a close and elegant presentation of Kant and Levinas, Chalier's book serves as a context for the development of the author's own reflections on the question "What am I supposed to do?" and its continued importance for contemporary philosophy. (shrink)