BackgroundThis study aimed to identify the healthcare providers’ experience and perspectives toward end-of-life care decisions focusing on end-of-life discussion and physician’s order of life-sustaining treatment documentation in Korea which are major parts of the Life-Sustaining Treatment Act.MethodsA cross-sectional survey was conducted using a questionnaire developed by the authors. A total of 474 subjects—94 attending physicians, 87 resident physicians, and 293 nurses—participated in the survey, and the data analysis was performed in terms of frequency, percentage, mean and standard deviation using the (...) SPSS 24.0 program.ResultsStudy results showed that respondents were aware of terminal illness and physician’s order of life-sustaining treatment in Korea well enough except for some details. Physicians reported uncertainty in terminal state diagnosis and disease trajectory as the most challenging. Study participants regarded factors (related to relationships and communications) on the healthcare providers’ side as the major impediment to end-of-life discussion. Study respondents suggested that simplification of the process and more staff are required to facilitate end-of-life discussion and documentation.ConclusionBased on the study results, adequate education and training for better end-of-life discussion are required for future practice. Also, a simple and clear procedure for completing a physician’s order of life-sustaining treatment in Korea should be prepared and legal and ethical advice would be required. Since the enactment of the Life-Sustaining Treatment Act, several revisions already have been made including disease categories, thus continuous education to update and support clinicians is also called for. (shrink)

Emmanuel Levinas’s doubts about the ethical value of artistic beauty have been widely acknowledged by the vast majority of Levinas’s commentators. However, though it is true that in “Reality and Its Shadow” Levinas persistently rebukes artistic beauty for its nonethicality, it is undeniable that he at least upholds the value of artistic criticism and modern literature. In this article I intend to relate Levinas’s exploration of the possibility of spiritual–ethical teaching in literature to Immanuel Kant’s reflections on the relation between (...) the feeling of beauty, that of sublimity, and sensible feeling in his third Critique. This up-close comparative examination fosters understanding of Levinas’s religious and philosophical approach to the sublime elements in some literary works, especially those of Fyodor Dostoevsky. (shrink)

Realism and surrealism claim, respectively, that a scientific theory is successful because it is true, and because the world operates as if it is true. Lyons :891–901, 2003) criticizes realism and argues that surrealism is superior to realism. I reply that Lyons’s criticisms against realism fail. I also attempt to establish the following two claims: Realism and surrealism lead to a useful prescription and a useless prescription, respectively, on how to make an unsuccessful theory successful. Realism and surrealism give the (...) credit for the success of a theory to an appropriate factor and to an inappropriate factor, respectively. Finally, I point out that surrealism is vulnerable to my pessimistic induction :3–21, 2014a) against antirealism. (shrink)

Philosophers have long debated whether, if determinism is true, we should hold people morally responsible for their actions since in a deterministic universe, people are arguably not the ultimate source of their actions nor could they have done otherwise if initial conditions and the laws of nature are held fixed. To reveal how non-philosophers ordinarily reason about the conditions for free will, we conducted a cross-cultural and cross-linguistic survey (N = 5,268) spanning twenty countries and sixteen languages. Overall, participants tended (...) to ascribe moral responsibility whether the perpetrator lacked sourcehood or alternate possibilities. However, for American, European, and Middle Eastern participants, being the ultimate source of one’s actions promoted perceptions of free will and control as well as ascriptions of blame and punishment. By contrast, being the source of one’s actions was not particularly salient to Asian participants. Finally, across cultures, participants exhibiting greater cognitive reflection were more likely to view free will as incompatible with causal determinism. We discuss these findings in light of documented cultural differences in the tendency toward dispositional versus situational attributions. (shrink)

Bird argues that scientific progress consists in increasing knowledge. Dellsén objects that increasing knowledge is neither necessary nor sufficient for scientific progress, and argues that scientific progress rather consists in increasing understanding. Dellsén also contends that unlike Bird’s view, his view can account for the scientific practices of using idealizations and of choosing simple theories over complex ones. I argue that Dellsén’s criticisms against Bird’s view fail, and that increasing understanding cannot account for scientific progress, if acceptance, as opposed to (...) belief, is required for scientific understanding. (shrink)

Dawes (2013) claims that we ought not to believe but to accept our best scientific theories. To accept them means to employ them as premises in our reasoning with the goal of attaining knowledge about unobservables. I reply that if we do not believe our best scientific theories, we cannot gain knowledge about unobservables, our opponents might dismiss the predictions derived from them, and we cannot use them to explain phenomena. We commit an unethical speech act when we explain a (...) phenomenon in terms of a theory we do not believe. (shrink)

Many realists argue that present scientific theories will not follow the fate of past scientific theories because the former are more successful than the latter. Critics object that realists need to show that present theories have reached the level of success that warrants their truth. I reply that the special theory of relativity has been repeatedly reinforced by unconceived scientific methods, so it will be reinforced by infinitely many unconceived scientific methods. This argument for the special theory of relativity overcomes (...) the critics’ objection, and has advantages over the no-miracle argument and the selective induction for it. (shrink)

Scientific realists and antirealists believe that a successful scientific theory is true and merely empirically adequate, respectively. In contrast, epistemic reciprocalists believe that realists’ positive theories are true, and that antirealists’ positive theories are merely empirically adequate, treating their target agents as their target agents treat other epistemic agents. Antirealists cannot convince reciprocalists that their positive theories are true, no matter how confident they might be that they are true. In addition, reciprocalists criticize antirealists’ positive theories exactly in the way (...) that antirealists criticize their epistemic colleagues’ theories. Reciprocalism is a better epistemic policy than realism and antirealism in the epistemic battleground in which we strive to be epistemically safe vis-à-vis our epistemic colleagues’ theories and strive to convince our epistemic colleagues that our theories are true. (shrink)

Background Over the past few decades, moral distress has been examined in the nursing literature. It is thought to occur when an individual has made a moral decision but is unable to act on it, often attributable to constraints, internal or external. Varying definitions can be found throughout the healthcare literature. This lack of cohesion has led to complications for study of the phenomenon, along with its effects to nursing practice, education and targeted policy development. Objectives The aim of this (...) analysis was to uncover unique definitions of moral distress as found in the nursing literature and to examine the relationship between these definitions. Research Design and Context Morse’s method of concept clarification was applied given the large body of literature which includes definitions, descriptions and measurements of the concept in research. The steps include (a) conducting a literature review; (b) analysing the literature; and (c) identifying, describing, comparing, and contrasting attributes, antecedents and consequences of each category. Findings Each of the 18 included studies described constraints in their definition of moral distress, whether implied or explicitly stated. External constraints are widely described as obstacles outside of the individual, whether institutional, systemic or situational, while internal constraints are located within the individuals themselves and are described as personal limitations, failings or weakness of will. Conclusion Upon reviewing these definitions, we determined that the term ‘internal constraints’ is problematic due to the emphasis of responsibility on the individual experiencing moral distress. We propose an alteration to ‘internal characteristics’ that will assume less responsibility of change from the individual to place a heavier onus on systemic and institutional constraints. (shrink)

Sample (2015) argues that scientists ought not to believe that their theories are true because they cannot fulfill the epistemic obligation to take the diachronic perspective on their theories. I reply that Sample’s argument imposes an inordinately heavy epistemic obligation on scientists, and that it spells doom not only for scientific theories but also for observational beliefs and philosophical ideas that Samples endorses. I also delineate what I take to be a reasonable epistemic obligation for scientists. In sum, philosophers ought (...) to impose on scientists only an epistemic standard that they are willing to impose on themselves. (shrink)

The present research examines whether identity essentialism, an important component of psychological essentialism, is a fundamental feature of human cognition. Across three studies (Ntotal = 1723), we report evidence that essentialist intuitions about the identity of kinds are culturally dependent, demographically variable, and easily malleable. The first study considered essentialist intuitions in 10 different countries spread across four continents. Participants were presented with two scenarios meant to elicit essentialist intuitions. Their answers suggest that essentialist intuitions vary dramatically across cultures. Furthermore, (...) these intuitions were found to vary with gender, education, and across eliciting stimuli. The second study further examined whether essentialist intuitions are stable across different kinds of eliciting stimuli. Participants were presented with two different scenarios meant to elicit essentialist intuitions—the “discovery” and “transformation” scenarios. Their answers suggest that the nature of the eliciting stimuli influences whether or not people report essentialist intuitions. Finally, the third study demonstrates that essentialist intuitions are susceptible to framing effects. Keeping the eliciting stimulus (i.e., the scenario) constant, we show that the formulation of the question eliciting a judgment influences whether or not people have essentialist intuitions. Implications of these findings for identity essentialism and psychological essentialism, in general, are discussed. (shrink)

Selectivism holds that some theoretical contents of most present theories will be preserved in future theories. By contrast, optimistic realism holds that most theoretical contents of most present theories will be preserved in future theories. I construct a pessimistic induction over selectivists to undermine selectivism, and an optimistic induction over optimistic realists to support optimistic realism. The former holds that since the selectivists of the early twentieth century were overly cautious about their present theories, those of the early twenty-first century (...) are also overly cautious about their present theories. The latter holds that since the optimistic realists of the early twentieth century were right about their present theories, those of the early twenty-first century are also right about their present theories. (shrink)

After decades of intense debate over the old pessimistic induction (Laudan, 1977; Putnam, 1978), it has now become clear that it has at least the following four problems. First, it overlooks the fact that present theories are more successful than past theories. Second, it commits the fallacy of biased statistics. Third, it erroneously groups together past theories from different fields of science. Four, it misses the fact that some theoretical components of past theories were preserved. I argue that these four (...) problems entitle us to construct what I call the grand pessimistic induction that since the old pessimistic induction has infinitely many hidden problems, the new pessimistic induction (Stanford, 2006) also has infinitely many hidden problems. (shrink)

Extensional scientific realism is the view that each believable scientific theory is supported by the unique first-order evidence for it and that if we want to believe that it is true, we should rely on its unique first-order evidence. In contrast, intensional scientific realism is the view that all believable scientific theories have a common feature and that we should rely on it to determine whether a theory is believable or not. Fitzpatrick argues that extensional realism is immune, while intensional (...) realism is not, to the pessimistic induction. I reply that if extensional realism overcomes the pessimistic induction at all, that is because it implicitly relies on the theoretical resource of intensional realism. I also argue that extensional realism, by nature, cannot embed a criterion for distinguishing between believable and unbelievable theories. (shrink)

The problem of unconceived alternatives can be undermined, regardless of whether the possibility space of alternatives is bounded or unbounded. If it is bounded, pessimists need to justify their assumption that the probability that scientists have not yet eliminated enough false alternatives is higher than the probability that scientists have already eliminated enough false alternatives. If it is unbounded, pessimists need to justify their assumption that the probability that scientists have not yet moved from the possibility space of false alternatives (...) to the possibility space of true alternatives is higher than the probability that scientists have already moved from the former to the latter space. (shrink)

If scientists embrace scientific realism, they can use a scientific theory to explain and predict observables and unobservables. If, however, they embrace scientific antirealism, they cannot use a scientific theory to explain observables and unobservables, and cannot use a scientific theory to predict unobservables. Given that explanation and prediction are means to make scientific progress, scientists can make more scientific progress, if they embrace scientific realism than if they embrace scientific antirealism.

Both the pessimistic inductions over scientific theories and over scientists are built upon what I call proportional pessimism: as theories are discarded, the inductive rationale for concluding that the next theories will be discarded grows stronger. I argue that proportional pessimism clashes with the fact that present theories are more successful than past theories, and with the implications of the assumptions that there are finitely and infinitely many unconceived alternatives. Therefore, the two pessimistic inductions collapse along with proportional pessimism.

Van Fraassen (2007, 2017) consistently uses the English view of rationality to parry criticisms from scientific realists. I assume for the sake of argument that the English view of rationality is tenable, and then argue that it has disastrous implications for van Fraassen’s (1980) contextual theory of explanation, for the empiricist position that T is empirically adequate, and for scientific progress. If you invoke the English view of rationality to rationally disbelieve that your epistemic colleagues’ theories are true, they might, (...) in turn, invoke it to rationally disbelieve that your positive theories are true. (shrink)

Individual realism asserts that our best scientific theories are (approximately) true. In contrast, selective realism asserts that only the stable posits of our best scientific theories are true. Hence, individual realism recommends that we accept more of what our best scientific theories say about the world than selective realism does. The more scientists believe what their theories say about the world, the more they are motivated to exercise their imaginations and think up new theories and experiments. Therefore, individual realism better (...) fosters scientific creativity than selective realism. (shrink)

Scientific antirealists run the argument from underconsideration against scientific realism. I argue that the argument from underconsideration backfires on antirealists’ positive philosophical theories, such as the contextual theory of explanation (van Fraassen, 1980), the English model of rationality (van Fraassen, 1989), the evolutionary explanation of the success of science (Wray, 2008; 2012), and explanatory idealism (Khalifa, 2013). Antirealists strengthen the argument from underconsideration with the pessimistic induction against current scientific theories. In response, I construct a pessimistic induction against antirealists that (...) since antirealists generated problematic philosophical theories in the past, they must be generating problematic philosophical theories now. (shrink)

Localism is the view that the unit of evaluation in the scientific realism debate is a single scientific discipline, sub-discipline, or claim, whereas individualism is the view that the unit of evaluation is a single scientific theory. Localism is compatible, while individualism is not, with a local pessimistic induction and a local selective induction. Asay presents several arguments to support localism and undercut globalism, according to which the unit of evaluation is the set of all scientific disciplines. I argue that (...) some of his arguments clash with localism as well as with globalism and support individualism, and that individualism goes hand in hand, while localism does not, with the basic rule of how to evaluate an argument. (shrink)

In contemporary philosophy of science, the no-miracles argument and the pessimistic induction are regarded as the strongest arguments for and against scientific realism, respectively. In this paper, I construct a new argument for scientific realism which I call the anti-induction for scientific realism. It holds that, since past theories were false, present theories are true. I provide an example from the history of science to show that anti-inductions sometimes work in science. The anti-induction for scientific realism has several advantages over (...) the no-miracles argument as a positive argument for scientific realism. (shrink)

Scientific realists argue that present theories are more successful than past theories, so present theories will not be superseded by alternatives, even though past theories were superseded by alternatives. Alai (2016) objects that although present theories are more successful than past theories, they will be replaced by future theories, just as past theories were replaced by present theories. He contends, however, that past theories were partly true, and that present theories are largely true. I argue that Alai’s discrimination between past (...) and present theories is subject to his own criticism against realists’ discriminations between past and present theories, and also subject to other criticisms that philosophers have raised against scientific realism and pessimism. (shrink)

Scientific realists believe both what a scientific theory says about observables and unobservables. In contrast, scientific antirealists believe what a scientific theory says about observables, but not about unobservables. I argue that scientific realism is a more useful doctrine than scientific antirealism in science classrooms. If science teachers are antirealists, they are caught in Moore’s paradox when they help their students grasp the content of a scientific theory, and when they explain a phenomenon in terms of a scientific theory. Teachers (...) ask questions to their students to check whether they have grasped the content of a scientific theory. If the students are antirealists, they are also caught in Moore’s paradox when they respond positively to their teachers’ questions, and when they explain a phenomenon in terms of a scientific theory. Finally, neither teachers nor students can understand phenomena in terms of scientific theories, if they are antirealists. (shrink)

Dellsén (2016a) argues that understanding requires neither justification nor belief. I object that ridding understanding of justification and belief comes with the following costs. (i) No claim about the world can be inferred from what we understand. (ii) We run into either Moore’s paradox or certain disconcerting questions. (iii) Understanding does not represent the world. (iv) Understanding cannot take the central place in epistemology. (v) Understanding cannot be invoked to give an account of scientific progress. (vi) It is not clear (...) how misunderstanding arises. (shrink)

We examined nurses’ perceptions of the ethical climate of their workplace and the relationships among the perceptions, medical error experience and intent to leave through a cross-sectional survey of 1826 nurses in 33 Korean public hospitals. Ethical climate was measured using the Hospital Ethical Climate Survey. Although the sampled nurses perceived their workplace ethical climate positively, 19% reported making at least one medical error during the previous year, and 25% intended to leave their jobs in the near future. Controlling for (...) individual and organizational characteristics, we found that nurses with a more positive perception of the ‘patient’ dimension of ethical climate were less likely to have made medical errors. Nurses with a more positive perception of the ‘patient’, ‘manager’, ‘hospital’ and ‘physician’ dimensions of ethical climate were less likely to leave their current job. Enhancing workplace ethical climate could reduce medical errors and improve nurses’ retention in public hospitals. (shrink)

In this paper, I reply to Markus Arnold’s comment and Amanda Bryant’s comment on my work “Can Kuhn’s Taxonomic Incommensurability be an Image of Science?” in Moti Mizrahi’s edited collection, The Kuhnian Image of Science: Time for a Decisive Transformation?. Philosophers and scientists are social epistemic agents. As such, they ought to behave in accordance with epistemic norms governing the behavior of social epistemic agents.

Unlike adjunct wh’s-in-situ, argument wh’s-in-situ do not seem to be subject to island constraints in Chinese and other East Asian languages. This difference in island sensitivity between argument and adjunct wh’s-in-situ is known as argument–adjunct asymmetry in the theoretical literature. Recently, this long-established asymmetry is challenged by a formal judgment study. It was claimed in the study that this asymmetry is an illusion and both argument and adjunct wh’s-in-situ are subject to island constraints. The present study demonstrates that such a (...) claim is not convincing because it is based on problematic experimental design. We designed two experiments to test the island effects on Chinese wh’s-in-situ. The results reaffirm that the argument–adjunct asymmetry in Chinese wh’s-in-situ is indeed present, contrary to the findings of previous formal judgment study, and they also corroborate our assumption that when object wh’s-in-situ like shénme ‘what’ are located inside a relative clause, they are subject to a pragmatic constraint, suggesting that the VP in the relative clause tends to describe the prominent/salient feature of the relativized nominal head. (shrink)

Is behavioral integration a necessary feature of belief in folk psychology? Our data from over 5,000 people across 26 samples, spanning 22 countries suggests that it is not. Given the surprising cross-cultural robustness of our findings, we argue that the types of evidence for the ascription of a belief are, at least in some circumstances, lexicographically ordered: assertions are first taken into account, and when an agent sincerely asserts that p, nonlinguistic behavioral evidence is disregarded. In light of this, we (...) take ourselves to have discovered a universal principle governing the ascription of beliefs in folk psychology. (shrink)

The way many human rights advocates frame the international norm against child, early, and forced marriage (CEFM) has shifted in the past decade. While CEFM has historically been framed as driven by poverty and underdevelopment, advocates have more recently discussed the problem with a feminist sexuality frame. What leads advocates to change their framing about an international norm? We build an argument that stresses how (a) the nature of the frame, (b) the characteristics of the advocates, and (c) the characteristics (...) of the discursive environment interact to determine whether and to what extent advocates will adopt an alternative frame. We use a multi-methods approach (machine-learning text analysis, process tracing, and interviews) to examine the process of frame adoption around an international norm. Our theoretical understanding of international norms requires a better grasp on the role of framing, especially framing among the very norm entrepreneurs that are critical to international norm diffusion. (shrink)

Lyons (2016, 2017, 2018) formulates Laudan’s (1981) historical objection to scientific realism as a modus tollens. I present a better formulation of Laudan’s objection, and then argue that Lyons’s formulation is supererogatory. Lyons rejects scientific realism (Putnam, 1975) on the grounds that some successful past theories were (completely) false. I reply that scientific realism is not the categorical hypothesis that all successful scientific theories are (approximately) true, but rather the statistical hypothesis that most successful scientific theories are (approximately) true. Lyons (...) rejects selectivism (Kitcher, 1993; Psillos, 1999) on the grounds that some working assumptions were (completely) false in the history of science. I reply that selectivists would say not that all working assumptions are (approximately) true, but rather that most working assumptions are (approximately) true. (shrink)

Callard (2007) argues that it is metaphysically possible that a mathematical object, although abstract, causally affects the brain. I raise the following objections. First, a successful defence of mathematical realism requires not merely the metaphysical possibility but rather the actuality that a mathematical object affects the brain. Second, mathematical realists need to confront a set of three pertinent issues: why a mathematical object does not affect other concrete objects and other mathematical objects, what counts as a mathematical object, and how (...) we can have knowledge about an unchanging object. (shrink)

I defend a new position in philosophy of mathematics that I call mathematical inferentialism. It holds that a mathematical sentence can perform the function of facilitating deductive inferences from some concrete sentences to other concrete sentences, that a mathematical sentence is true if and only if all of its concrete consequences are true, that the abstract world does not exist, and that we acquire mathematical knowledge by confirming concrete sentences. Mathematical inferentialism has several advantages over mathematical realism and fictionalism.

Scientific antirealism, the view that successful theories are empirically adequate, is untenable in light of the problem of unobserved anomalies that since past scientists could not observe the anomalies that caused the replacement of past theories with present theories, present scientists also cannot observe the anomalies that will cause the replacement of present theories with future theories. There are several moves that antirealists would be tempted to make to get around the problem of unobserved anomalies. All of them, however, are (...) problematic. (shrink)