Kant actively struggles with the problem of how to conceive of God's creative action in relation to human freedom. He comes to the view that human freedom can only be protected if God withdraws in certain ways from the created world. The two pillars of Kant's mature philosophy - transcendental idealism and freedom - are in part shaped and motivated by Kant's need to provide a solution to his theological problem. The medieval and early modern theological tradition conceives of divine (...) action as unlike the action of any created being. When the creature acts, God directly causes this action, but without reducing the creature's freedom. Kant explicitly discusses and rejects this account of divine and human concursus. This rejection has significant and surprising ramifications for Kant's wider philosophy, explaining otherwise incomprehensible claims in his critical philosophy. Christopher J. Insole presents a definitive study in the history of ideas, engaging with a wide range of Kant's texts from 1749 until the early 1800s. Many of these texts have received little or no attention in Kant studies to date. Insole places Kant's thought in relation to numerous historical and traditional positions and illuminates these positions by a close engagement with recent debates in analytical philosophy and systematic theology. Kant is unrelentingly honest when grappling with the difficulty of relating divine and human freedom. This study, of Kant's theological struggle and legacy, goes to the heart of the problem in the modern reception of what the Christian tradition has affirmed about human freedom. As such, the book throws light on one of the defining fault-lines in modern theology and philosophy. (shrink)

Lying to one’s patients is wrong. So obvious as to border on a platitude, this truism is one that bioethicists have heartily endorsed for several decades. Deception, the standard line holds, underc...

In the United States, food banks served an estimated 46 million people in 2015. A combination of government policy reforms and political economic trends contributed to the rising numbers of individuals relying on private food assistance in the US, the United Kingdom and other high-income countries. Although researchers frequently map urban food environments, this project is one of the first to map private food assistance and potential need at the census-tract scale. We utilize Geographic Information Systems, demographic data, and food (...) assistance locations to develop a rapid assessment tool that could support food banks, pantries, soup kitchens, and government agencies that seek to answer the question of whether people with the greatest need have food distribution sites in close proximity. We define access based on distance and then calculate potential food insecurity using either poverty rates or a food insecurity index. We apply these methods in a case study analysis of Santa Clara County, California. Our findings suggest that food assistance distribution locations match the areas of potential need in more than 80% of urban census tracts. However, there are several potentially underserved locations and populations that could benefit from new food assistance operations. The poverty and index-based approaches show significant spatial overlap in mapped areas of high food insecurity and low access. The poverty only approach produces a higher estimate of food insecurity rates, is easier to calculate, and draws attention to the need to address poverty as a root cause of hunger. (shrink)

Many philosophers hold that for various reasons there must be psychological laws governing beliefs and desires. One of the few serious examples that they offer is the _belief-desire law_, which states, roughly, that _ceteris paribus_ people do what they believe will satisfy their desires. This paper argues that, in fact, there is no such law. In particular, decision theory does not support the contention that there is such a law.

BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs (HCEPs) that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online survey, 97% (...) of hospitals have HCEPs. Their scope includes clinical ethics functions in virtually all hospitals, but includes other functions in far fewer hospitals: ethical leadership (35.7%), regulatory compliance (29.0%), business ethics (26.2%), and research ethics (12.6%). HCEPs are responsible for providing ongoing ethics education to various target audiences including all staff (77.0%), nurses (59.9%), staff physicians (49.0%), hospital leadership (44.2%), medical residents (20.3%) and the community/general public (18.4%). HCEPs staff are most commonly involved in policy work through review of existing policies but are less often involved in development of new policies. HCEPs have an ethics representative in executive leadership in 80.5% of hospitals, have representation on other hospital committees in 40.7%, are actively engaged in community outreach in 22.6%, and lead large-scale ethics quality improvement initiatives in 17.7%. In general, major teaching hospitals and urban hospitals have the most highly integrated ethics programs with the broadest scope and greatest number of activities. Larger hospitals, academically affiliated hospitals, and urban hospitals have significantly more individuals performing HCEP work and significantly more individuals receiving financial compensation specifically for that work. Overall, the most common greatest challenge facing HCEPs is resource shortages, whereas underutilization is the most common greatest challenge for hospitals with fewer than 100 beds. Respondents’ strategies for managing challenges include staff training and additional funds.ConclusionsWhile this study must be cautiously interpreted due to its limitations, the findings may be useful for understanding the characteristics of HCEPs in US hospitals and the factors associated with these characteristics. This information may contribute to exploring ways to strengthen HCEPs. (shrink)

Compared with children, adults are widely assumed to possess more mature moral understanding thus justifying deference to their moral authority and testimony. This paper examines philosophical discussions regarding this child-adult moral relation and its implications for moral education, particularly accounts suggesting that the moral status of children constitute grounds for treating them paternalistically. I contend that descriptions and justifications of this paternalistic attitude towards children are either unacceptably crude or mistaken. While certain instances justify paternalistic treatment towards children, in the (...) context of moral education the paternalistic attitude is largely irrelevant and even counterproductive. I make a case that children can readily meet minimal standards for moral understanding and engagement. Even when children have no final say, there is still a significant normative difference between deferring paternalistically to the adult's moral testimony and interacting with the child in moral conversation. These considered, I defend a social-contextualist account of moral education that incorporates a participatory (over a paternalistic) pedagogical attitude. Further, instead of portraying moral education in terms of stages (as argued by Kohlberg), moral education should be characterized more as a gradual appreciation of and sensitivity to normative demands that apply in various shared contexts and spheres of human concern. (shrink)

Christopher Winch launches a vigorous Wittgensteinian attack on both the "romantic" Rousseauian and the "scientific" cognitivist traditions in learning theory. These two schools, he argues, are more closely related than is commonly realized.

This article questions a common reading of Section 230 of Beyond Good and Evil as containing a canonical statement of Nietzsche’s naturalism. The section cannot be read simply as the programmatic statement of an investigative task, and is relatively vague as to its nature. Nietzsche’s aim is aporetic. He presents the naturalist task as involving mental self-cruelty and a struggle with unconscious vanity, suggesting that thinkers have found no way to justify why they choose this task, unless they invoke self-descriptions (...) which are false and belong to a metaphysical conception of truth and inquiry that naturalism must resist. In the Genealogy, Nietzsche revisits this theme and announces his task as that of calling into question these justifications of naturalist inquiry. (shrink)

Aristotle admits the possibility of many vices opposed to one virtue, but insists that there are always at least two, related as deficiency and excess. The doctrine that "virtue is in a mean" is thus both true and useful.

Can the use of psychedelic drugs induce lasting changes in metaphysical beliefs? While it is popularly believed that they can, this question has never been formally tested. Here we exploited a large sample derived from prospective online surveying to determine whether and how beliefs concerning the nature of reality, consciousness, and free‑will, change after psychedelic use. Results revealed significant shifts away from ‘physicalist’ or ‘materialist’ views, and towards panpsychism and fatalism, post use. With the exception of fatalism, these changes endured (...) for at least 6 months, and were positively correlated with the extent of past psychedelic‑use and improved mental‑health outcomes. Path modelling suggested that the belief‑shifts were moderated by impressionability at baseline and mediated by perceived emotional synchrony with others during the psychedelic experience. The observed belief‑shifts post‑psychedelic‑use were consolidated by data from an independent controlled clinical trial. Together, these findings imply that psychedelic‑use may causally influence metaphysical beliefs—shifting them away from ‘hard materialism’. We discuss whether these apparent effects are contextually independent. (shrink)

A paradigm-breaking exploration of how collective intelligence functions in groups with practical guidelines for teachers.

The philosopher Kant is a key thinker in shaping our contemporary concept of morality, freedom, and happiness. This book argues that Kant believes in God, but that he is not a Christian, and that this opens up an important and neglected dimension of Western Philosophy.

Applied ethics is home to numerous productive subfields such as procreative ethics, intergenerational ethics and environmental ethics. By contrast, there is far less ethical work on ageing, and there is no boundary work that attempts to set the scope for ‘ageing ethics’ or the ‘ethics of ageing’. Yet ageing is a fundamental aspect of life; arguably even more fundamental and ubiquitous than procreation. To remedy this situation, I examine conceptions of what the ethics of ageing might mean and argue that (...) these conceptions fail to capture the requirements of the desired subfield. The key reasons for this are, first, that they view ageing as something that happens only when one is old, thereby ignoring the fact that ageing is a process to which we are all subject, and second that the ageing person is treated as an object in ethical discourse rather than as its subject. In response to these shortcomings I put forward a better conception, one which places the ageing person at the centre of ethical analysis, has relevance not just for the elderly and provides a rich yet workable scope. While clarifying and justifying the conceptual boundaries of the subfield, the proposed scope pleasingly broadens the ethics of ageing beyond common negative associations with ageing. (shrink)

BackgroundEvaluation of decision-making capacity to consent to medical treatment has proved to be difficult in patients with dementia. Studies showed that physicians are often insufficiently trained in the evaluation of decision-making capacity. In this study, we present findings from a secondary analysis of a qualitative interviews with physicians. These interviews were initially used to assess usability of an instrument for the evaluation of decision-making capacity. By looking at difficult cases of decision-making capacity evaluation in patients with dementia, we provide recommendations (...) for such evaluations in clinical practice.MethodsWe used thematic coding to analyse physicians’ narratives of problematic decision-making capacity evaluations in patients with dementia to uncover challenging issues of decision-making capacity evaluation.ResultsIn this study, decision-making capacity evaluations in patients with dementia were mainly perceived as challenging when they pertained to treatment refusals and treatment unrelated circumstances, such as psychiatric consultation, advance directives, and new living arrangements. Furthermore, the physicians reported training needs regarding situation-independent challenges with decision-making capacity evaluation.ConclusionsUpon further examining self-reported training needs and challenging cases, we have developed recommendations to improve decision-making capacity evaluations in clinical practice. In these recommendations, we argue that being able to evaluate decision-making capacity is an integral part of the informed consent process. (shrink)

Despite scholars’ early emphasis on the role people play in fostering firms’ absorptive capacity, research has not deeply explored the individual-level antecedents of this important capability. We draw on adaptive-innovative theory to explain how top decision makers’ cognitive styles can influence the degree to which their firms develop AC. Top decision makers who have high adaptive cognitive style prefer to adhere to existing norms, follow established procedures, and rely on current knowledge, and we argue that these attributes will strengthen those (...) dimensions of AC based on firms’ existing knowledge and knowledge-assimilation abilities. Top decision makers who have high innovative cognitive style are more likely to reframe information, experiment with new problem-solving approaches, and take risks by violating norms, and we argue that these attributes may strengthen those dimensions of AC based on firms’ acquisition of new knowledge and the assimilation of knowledge throughout the firm. We also argue that gender differences may moderate these effects. Empirical results support our hypotheses. (shrink)

New techniques for modifying the genomes of agricultural organisms create difficult ethical challenges. We provide a novel framework to replace worn-out ethical lenses relying on ‘naturalness’ and ‘crossing species lines.’ Thinking of agricultural intervention as a ‘negotiation’ of ‘integrity’ and ‘agency’ provides a flexible framework for considering techniques such as genome editing with CRISPR/Cas systems. We lay out the framework by highlighting some existing uses of integrity in environmental ethics. We also provide an example of our lens at work by (...) looking at the creation of ‘cisgenic’ potatoes to resist late potato blight. We conclude by highlighting three distinct advantages offered by the integrity framework. These include a more fitting way to look at the practice of scientific researchers, a more inclusive way to consider ethics around agriculture, and a more flexible way to provide the ethical grounds for regulation in different cultural contexts. (shrink)

The relatively recent increase in empirical research conducted in business ethics has been accompanied by a growing literature which addresses its present shortcomings and continuing challenges. Particular attention has been focused on the difficulties of obtaining valid and reliable primary data. However, little or no attention has been paid to the use of secondary data. The aim of this paper is to stimulate the interest of business ethics researchers in using secondary data, either as a substitute or complement for primary (...) data, bearing in mind both the benefits and shortcomings of doing so. It is suggested that secondary data not only offer advantages in terms of cost and effort, as conventionally described in research methods books, but also that in certain cases their use may overcome some of the difficulties that particularly afflict business ethics researchers in the gathering of primary data. In order to help business ethicists respond to this call for greater consideration of the potential offered by secondary data, the wide variety of forms that such data may take is indicated and a number of themes regarding their use discussed. (shrink)

Gibt es eine Erfahrung des Denkens und der Gedanken? Wenn ja, wie ist sie aufzufinden und wie zu beschreiben? Eine Antwort wird ausgehend von Husserls Phanomenologie gegeben, wobei die Cognitive Phenomenology-Debatte und auch Hegels Ansatz zum Denken wichtige Erganzungen erlauben. Nach einer Analyse des gedanklichen Anteils im Empfinden und im naturlichen Welterleben wird das Verhaltnis von Denken, Sprechen und Urteilen erarbeitet. Indem dabei ein phanomenologisches Vorurteil entlarvt wird, kann schliesslich der Bereich des reinen Denkens betreten und seine Erfahrung beschrieben werden.

Canada’s rapid rise in deaths from euthanasia and physician assisted suicide, termed Medical Assistance in Dying (MAID) in the country, now ranks it second only to the Netherlands in terms of MAiD deaths as percentage of overall deaths, with one province already hosting the highest rate of all jurisdictions in the world. Analyzing Health Canada’s annual MAID reports, which show that up to 336 out of 1837 providers are likely responsible for the majority of MAID deaths in a given year, (...) we discuss how the rapid increase likely reflects not a broad Canadian consensus but the capture of a policy-making and implementation process by a small group of activists and clinicians colonizing medicine to become an ideologically driven vehicle for expanding MAID access and delivery. As a remedy and to reprioritize patient safety and protection against premature death, a more transparent, relevant, and safeguarded compliance regime based on evidence-based, multi-perspective policy-making is needed. (shrink)

Hope is important in Thomas Aquinas’s account of the emotions: it is one of the four primary emotions and the first of the irascible emotions. Yet his account of hope as a movement of the sensory appetite toward a future possible good that is arduous to attain appears to be overly restrictive, for people often hope for things that are not cognized as arduous. This paper examines Aquinas’s reasons for limiting hope to arduous goods.

first-order HMM, the current tag t0 is predicted based on the previous tag t−1 (and the current word).1 The back- We present a new part-of-speech tagger that ward interaction between t0 and the next tag t+1 shows demonstrates the following ideas: (i) explicit up implicitly later, when t+1 is generated in turn. While unidirectional models are therefore able to capture both use of both preceding and following tag con-.

This chapter suggests that descriptive epidemiological studies like the Global Burden of Disease Study can usefully be divided into four tasks: describing individuals’ health states over time, assessing their health states under a range of counterfactual scenarios, summarizing the information collected, and then packaging it for presentation. The authors show that each of these tasks raises important and challenging ethical questions. They comment on some of the philosophical issues involved in measuring health states, attributing causes to health outcomes, choosing the (...) counterfactual against which to assess causes, aggregating and summarizing complex information across multiple domains, discounting, age-weighting, handling fetal deaths, measuring health inequalities, representing uncertainty, and assessing personal responsibility for health outcomes. (shrink)

The increasing demands placed on private welfare services and calls for business to fulfil its social responsibilities have heightened interest in corporate charitable donations in the United Kingdom. Adjustments to the corporation tax system have been made to encourage companies to give more. The article outlines the legal and fiscal background to company giving, examines its magnitude and reports on a survey of company practice.