In contemporary Anglo-American political philosophy, perfectionism is widely understood as the idea that the state may, or should, promote valuable conceptions of the good life and discourage conceptions that are worthless or bad. As such, debates over perfectionism occupy a central place in contemporary political philosophy because political philosophers are deeply concerned about whether or not a liberal state is permitted to promote any particular ethical or religious doctrine or impose it on its citizens. -/- In general, contemporary perfectionists do (...) not argue for the state’s pursuit of any religious doctrine. They only maintain that the state is permitted to make a wide range of public policies with the aim of promoting the good life. These policies, commonly found in liberal democratic societies, may include subsidizing museums and art galleries, preserving cultural heritage, setting up public libraries and providing free access to reading materials, encouraging athletic excellence, conserving nature and biodiversity, and educating citizens about the harm of recreational drugs. Nevertheless, perfectionism remains controversial among philosophers and political scientists. -/- It might be beneficial to take a sympathetic view of perfectionism and consider how perfectionists might defend their position against some of the common objections. These objections mainly include: (a) that the state does not possess legitimate authority to make decisions about the good life and seek to promote it; (b) that perfectionist policies are generally illiberal and paternalistic; and (c) that conceptions of the good life are objects of reasonable disagreement and hence cannot legitimately be promoted by the state. In addition, the nature and importance of perfectionist policies and politics will be discussed. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE SUMMA CONTRA GENTILES RECONSIDERED: ON THE CONTRIBUTION OF THE DE TRINITATE OF HILARY OF POITIERS JOSEPH WAWRYKOW University of Notre Dame Notre Dame, Indiana 0 NE OF THE most difficult and puzzling of Aquinas's works, the Summa contra Gentiles, has occasioned much controversy among scholars.1 Who are the gentiles against whom Thomas is writing? Is the work principally philosophical or theological in character? Why has Thomas delayed (...) discussion of the central Christian truths of Trinity and Incarnation to the fourth and final book of the contra Gentiles? How much credence should be given to the slightly later story (that is, post-Thomas) that Thomas composed the Summa contra Gentiles for "missionary purposes"?-these, and other such questions, have exercised the imagination of numerous students of Aquinas. In the recent literature, Mark Jordan's " The Protreptic Structure of the Summa contra Gentiles,, without doubt offers the most 1 Thomas Aquinas, Liber de Veritate Catholicae Fidei contra errores Infidelium seu 'Summa contra Geiitiles' Vols. II-III. Edited by C. Pera, P. Marc and P. Caramello (Turin: Marietti, 1961). References to the ScG list the book, chapter, and section numbers according to the Marietti edition. P. Marc in Volume I of this edition (Turin: Marietti, 1967), provides an indispensable introduction to the principal issues in the scholarship, with a strong emphasis on the problem of dating; see especially chapter I, article 3. For an English translation, see A. Pegis et al., Summa contra Gentiles, Vols. IIV (Notre Dame: University of Notre Dame Press, 1975). I would like to express my gratitude to the Institute for Scholarship in the Liberal Arts, University of Notre Dame, for a summer stipend that has supported the writing of this atricle. 617 618 JOSEPH WAWRYKOW innovative and promising approach to this controversial work.2 Jordan has raised the study of the contra Gentiles to a new level by identifying its genre through careful analysis. As his title indicates, for Jordan Thomas's Summa contra Gentiles is a protreptic work, an invitation to wisdom, to be precise, an invitation to Christian wisdom. Issued by one Christian to other Christians, the contra Gentiles in this view is a recommendation of the more serious and sustained pursuit of the Christian form of life, a recommendation that includes in its survey of the different layers of Christian wisdom the depiction of the failings of alternative, non-Christian, versions of truth.3 In the hands of Aquinas, this protreptic, moreover, itself becomes a schooling in wisdom (Jordan, p. 209) : in following Thomas in the numerous discrete arguments that constitute the contra Gentiles, the Christian reader will in fact become imbued in Christian wisdom, thus anticipating in the present life the completion of this pursuit of wisdom that will be provided in the beatific vision in the next. Jordan's is a powerful study and, on the basis of its structural observations about the contra Gentiles, both large and local, would seem in its core insight to be fundamentally correct. His recognition of the protreptic structure permits a balanced assessment of the traditional questions addressed to the contra Gentiles (for details, see the article), while highlighting the positive, Christian-theological intentions of Aquinas in composing this work. Yet, by observing two points at which his analysis flags, it will be possible to add to Jordan's genuine contribution. The first of these observations concerns Jordan's treatment of 2 Mark D. Jordan, "The Protreptic Structure of the Summa contra Gentiles," The Thomist 50 (1986) : 173-209. I have benefitted greatly from extended conversations with Professor Jordan about his work on the contra Gentiles. 3 Jordan specifies the term "protreptic" as follows (p. 192): "A protreptic was originally a persuasion to the study and practice of some art or skill; for philosophic writers, it became an exhortation to the practice of the philosophic art, which required virtues of inquiry and contemplation." Later (p. 194), Jordan indicates the ways in which Thomas has transformed ancient protreptic in offering this Christian protreptic. HILARY'S DE TRINITATE AND AQUINAS 619 Aquinas's approach to scripture in the fourth book of the Summa contra Gentiles. That the analysis of Thomas's approach here to scripture needs... (shrink)

Joseph Beuys was one of the most significant artists of the 20th century. He was a gunner and radio operator in the German Air Force during World War II, and was severely injured several times. In March 1943 he had a life-changing experience after the dive bomber he was assigned to crashed in the Crimean peninsula. This trauma influenced Beuys' entire artistic career, and is known in art history as the ’Tartar Legend’ or ’Tartar Myth’. Profoundly affected by the (...) crash, the severe trauma, the near-death experience and his rescue, which he perceived as a “rebirth”, Beuys no longer saw himself, other people or society as a whole in the same way as previously. With his new consciousness, he ignored boundaries and created visions whereby all mankind could experience the healing he had undergone. Beuys did not bring society far enough for the turning point towards “the healing of the world” to be visible, yet today it is important to keep his work alive as a record of his extraordinary strength, which arose from trauma and severe injury, and was carried by a passionate commitment to mankind and to life itself. (shrink)

This work is largely based on Reimers’s doctoral dissertation, written under Rocco Buttiglione, an Italian philosopher and close collaborator of Wojtyla. In essence, however, it is less a focussed study of the thought of Karol Wojtyla than an attempt to insert that thought into a different conceptual context and to illuminate it by way of comparison and synthesis. The analogue to Wojtyla’s thought, in this case, is that of C. S. Peirce. Peirce’s analysis of habit, as a kind of major (...) premise or a sign of the meaning of an action, is compared to Wojtyla’s more dynamic approach to the relationship between act and meaning, in Reimers’s characterization, “as the moment of experience of choice”. (shrink)

The essay examines the proper treament of (i) naming (ii) necessity. (A) It argues their mutual independence (B) provides a treatment of naming separately from any idea of “designation” (C) gives treatment of de re modality without any use of possible worlds, essences, concepts, rigid designators (D) it argues an ultimate asymmetry–naming/referring is a key real notion of semantics; necessity should not be the central idea in the metaphysics of nature.

In lieu of an abstract, here is a brief excerpt of the content:AQUINAS'S FOURTH WAY AND THE APPROXIMATING RELATION HERE IS, IT CAN BE SAID, at least one troubleome premise (to some, unacceptable) in each of the Five Ways recorded by Aquinas in the Summa Theologiae (S.T., I, q.2, a.3, c.). Three of the W·ays, i.e., the First and the Second and the Fifth, have a premise which describes God-Prime Mover (Primum Movens, quod a nullo movetur), First Efficient Cause (Causa (...) Efficiens Prima), Intelligent Orderer (Aliquid Intelligens, a quo omnes res naturales ordinantur in finem), respectively-in a way which falls short of a proper or adequate (unmistakable, unquestionable, unique) identification of God. That is, it is not necessary that the Prime Mover be God, or that the First Efficient Cause be God, or that the Intelligent Orderer be God. For, whatever else God is, God is the Creator, and the Prime Mover is not. And neither is the First Efficient Cause; nor is the Intelligent Orderer. This happens because the empirical point of departure of each of these three Ways gives the causality of the Prime Mover, of the First Efficient Cause, and of the Intelligent Orderer an effect and a scope which make it impossible to identify them with the effect and the scope of the causality of the Creator. The two remaining ways, though providing a description of God which quite properly or adequately identifies God-SelfNecessary Being (Ens per se necessarium), Most a Being (Maxime Ens), respectively-make an analytic claim which is troublesome (to some unacceptable), in any case difficult to understand. In the Third Way, it is the analytic claim that "... si... omnia sunt possibilia non esse, aliquando nihil fuit in rebus;" and in the Fourth Way, it is the analytic claim that 17 18 JOSEPH BOBIK ". [si]... magis et minus dicuntur de diversis secundum quod appropinquant diversimode ad aliquid quod maxime est...,... est... aliquid quod est verissimum et optimum et nobilissimum... et... maxime ens." There are three parts in the argument of the Fourth Way,1 and it is the first of these which is difficult to understand. The first part moves from the observed existence of the more and the less good, true, noble, etc. to the concluded existence of the most good, true, noble, etc.-the simpliciter good, true, noble, etc., as it is called in the Contra Gentiles formul,ation of an argument (S.G., I, cap. 13) which is similar to (though also quite different from) the Fourth Way of the Summa Theologiae.2 The second part argues that the most true or verissimum 1 It will be of help to the reader to have the text of the Fourth Way in hand, and to have its three parts explicitly distinguished. Quarta via sumitur ex gradibus qui in rebus inveniuntur. First part: Invenitur enim in rebus aliquid magis et minus bonum, et verum, et nobile: et sic de aliis huiusmodi. Sed magis et minus dicuntur de diversis secundum quod appropinquant diversimode ad aliquid quod maxime est: sicut magis calidum est, quod magis appropinquat maxime calido. Est igitur aliquid quod est verissimum et optimum et nobilissimum, Second part: et per consequens maxime ens: nam quae sunt maxime vera, sunt maxime entia, ut dicitur II Metaphys. Third part: Quod autem dicitur maxime tale in aliquo genere, est causa omnium quae sunt illius generis: sicut ignis, qui est maxime calidus, est causa omnium calidorum, ut in eodem libro dicitur. Ergo est aliquid quod omnibus entibus est causa esse, et bonitatis, et cuiuslibet perfectionis: et hoc dicimus Deum. 2 Whereas the Fourth Way uses the approximating relation to move to the existence of the Maxime Ens from the fact that there are real things which are more and less, the way of the G.G. uses the approximating relation to move to the existence of the Maxime Ens from the fact that there are propositions such that one is more false than the other (and so, less true than the other) more puzzling still than the Fourth Way. Here is the text of the G.G. argument: Potest etiam alia ratio colligi ex verbis Aristotelis. In II enim Metaphys. ostendit quod ea quae sunt maxime vera, sunt et... (shrink)

La cuestión de si los lenguajes intensionalesson más expresivos que los lenguajes nointensionalessurge en el marco de unaperspect i va semánt i ca de l as t eorí as.Desde esta perspectiva, la cuestión esesta. ¿Hay clases modelo que se puedencaracterizar mediante teorías que usanconceptos intensionales que no se puedencaracterizar mediante teorías que no usanconceptos intensionales? Se sugiere unaformulación precisa de esta cuestión, perono se ofrece una respuesta.Para aproxi marse a est a cuest i ón, seresume la teoría de modelos de (...) primerorden [II] y se revisa el enfoque semánticode las teorías que emplea incrementost eóri cos, no i nt ensi onal es, de pri merorden [III].Los i nc r e me nt os t e ór i c os de pr i me rorden se bosquejan pero no se definenr i g u r o s a me n t e [ I V] . E s t e l e n g u a j ei n t e n s i o n a l pr o po r c i o n a e l a p a r a t op a r a a t r i b u i r u s o d e l l e n g u a j e yact i t udes i nt ens i onal es a i ndi vi duoscuyo comportami ento es el obj eto deinvestigación. También proporciona elaparato para habl ar sobre traducci óndel lenguaj e atribuido al lenguaj e delinvestigador.La cuestión inicial se convierte entoncesen si hay clases modelo que se puedanc a r a c t e r i z a r me d i a n t e i n c r e me n t o sintencionales de lógica de primer ordenq ue n o pue de n s e r c a pt ur a do s po rincrementos teóricos no-intensionales [V].The ques t i on of whet her i nt ens i onallanguages are more expressive than nonintensional languages is raised within the framework of a semantic view of theories. Fromthis perspective, the question isthis. Are there model classes that can becharacterized by theories using intensionalconcepts that cannot be characterizedby theories that do not use intensionalconcepts? A precise formulation of thisquestion is suggested, but no answer isgiven.To approach this question, model theory offirst order theories is summarized [II] andthe semantic approach to theories usingnon-intensional, theoretical augmentationsof first order theories is reviewed [III].I n t e n s i o n a l a u g me n t a t i o n s o f f i r s torder theories are sketched [IV] but notr i gor ous l y de f i ne d. Thi s i nt e ns i onall anguage provi des t he apparat us f orattributing language use and intensionalattitudes to individuals whose behavioris the object investigation. It also providesapparatus for talking about translationf r om t he at t r i but e d l anguage t o t heinvestigator’s language.T h e i n i t i a l q u e s t i o n t h e n b e c o me swhet her t here are model cl asses t hatc a n be c ha r a c t e r i z e d by i nt e ns i ona laugmentations of first order logic thatcannot be captured by non-intensionaltheoretical augmentations [V]. (shrink)

Machine generated contents note: Contributors ix -- Foreword by Douglas A. Boyd andJoseph D. Straubhaar xiii -- Preface byMariaHenson xv -- Acknowledgments xvii -- Part I. Introduction 1 -- Chapter 1. Journalism as a Mission: Ethics and Purpose -- from an International Perspective -- by Joseph B. Atkins 3 -- Chapter 2. Chaos and Order: Sacrificing the Individual for the -- Sake of Social Harmony -- by John C. Merrill 17 -- Part II. In the United States and Latin (...) America 37 -- Chapter 3. Ways of a Muckraker -- by Jerry Mitchell 39 -- Chapter 4. A Sinister Zone of Likeness: Journalists as Heroes and -- Villains in the U.S. South and in Central and Eastern -- Europe -- by Joseph B. Atkins 45 -- Chapter 5. From Collusion to Independence: The Press, The Ruling -- Party, and Democratization in Mexico -- byMichaelSnodgrass 55 -- Chapter 6. The Outspoken Journalist Is an Expression, a Symbol -- of Colombia -- by Stephen E Jackson 69 -- Part III. In Europe 77 -- Chapter 7. The Stranger: Minorities and Their Treatment -- in the German Media -- by Georg Ruhrmann 79 -- Chapter 8. Between State Control and the Bottom Line: -- Journalism and Journalism Ethics in Hungary -- by Ildiko Kaposi and Eva Vajda 91 -- Chapter 9. SITA: Slovakia's First Independent News Service and -- Its Battles with the Huey Long of the Danube -- byPavol Mudry 101 -- Chapter 10. Holding Politicians' Feet to the Fire in Slovenia -- by Bernard Nezmah 111 -- Part IV. In the Middle East and Africa 121 -- Chapter 11. Lebanese Television: Caught Between the -- Government and the Private Sector -- by Nabil Dajani 123 -- Chapter 12. Press Freedom and the Crisis of Ethical Journalism -- in Southern Africa -- by Regina Jere-Malanda 143 -- Chapter 13. Nigerian Press Ethics and the Politics of Pluralism -- by Minabere Ibelema 153 -- Part V. In South and East Asia 169 -- Chapter 14. The Indian Press: Covering an Enigma -- byJayanti Ram-Chandran 171 -- Chapter 15. Palace Intrigue in Katmandu and the Press in Nepal -- byAkhilesh Upadhyay 181 -- Chapter 16. The Press in Japan: Job Security versus -- Journalistic Mission -- by Takehiko Nomura 187 -- Part VI. Three Journalists and Their Missions 201 -- Chapter 17. A Journey in Journalism: From Idealism -- to Bankruptcy -- by Neil White III 203 -- Chapter 18. Reclaiming Responsibility: A Journalist and Artist -- in the Catholic Worker Movement -- by Chuck Trapkus 211 -- Chapter 19. Ryszard Kapuscinski: The Empathetic Existentialist -- by Joseph B. Atkins and Bernard Nezmah 217 -- Postscript The White Rose: On the Martyrdom of Student Pamphleteers in -- Nazi Germany and Their Legacy -- by Joseph B. Atkins 227 -- References 233 -- Index 243. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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This book’s goal is to give an intellectual context for the following manuscript. -/- Includes bibliographical references and an index. Pages 1-123. 1). Philosophy. 2). Metaphysics. 3). Philosophy, German. 4). Philosophy, German -- 18th century. 5). Philosophy, German and Greek Influences Metaphysics. I. Hegel, Georg Wilhelm Friedrich -- 1770-1831 -- Das älteste Systemprogramm des deutschen Idealismus. II. Rosenzweig, Franz, -- 1886-1929. III. Schelling, Friedrich Wilhelm Joseph von, -- 1775-1854. IV. Hölderlin, Friedrich, -- 1770-1843. V. Ferrer, Daniel Fidel, 1952-. (...) [Translation from German into English of the-- Das älteste Systemprogramm des deutschen Idealismus.]. -/- Note: the manuscript is in the handwriting of G.W.F. Hegel, but the actual authorship is disputed. No date is given. Franz Rosenzweig made up the title as it is known today. He published the text in 1917. At that time, F. Rosenzweig thought F.W.J. Schelling was the author. No one has read this book for errors. As always, any errors, mistakes or oversights etc. are mine alone. Given a couple more years, I could improve this book. This is a philosophical translation and not a philological translation. Martin Luther who did the famous early translation of the Bible into German wrote in a letter, “If anyone does not like my translation, they can ignore it… (September 15, 1530)”. There are no ‘correct’ translations. Some are just better than other translations. -/- The Oldest Systematic Program of German Idealism. The German title is: Das Älteste Systemprogramm Des Deutschen Idealismus. This title was made up by Franz Rosenzweig in 1917, when he first published the manuscript. He found the manuscript in the Royal Library in Berlin in 1913. The manuscript suggested date is around 1796 and was done by handwriting research. However, the manuscript is not dated. The Prussian State Library auctioned in March 1913 from the auction of the house Liepmannssohn in Berlin a single sheet on the front and back with Hegel's cursive handwriting. The manuscript was lost during WWII. But Dieter Henrich found it again in 1979 in the “Biblioteka Jagiellonska” in Krakow (Poland), where it is today. Address: Jagiellonian Library, Jagiellonian University, al. Mickiewicza 22, 30-059 Cracow, Poland. Later research suggests that manuscript had come from the estate of Hegel’s student Friedrich Christoph Förster (1791-1868). He was one of the editors of Hegel’s posthumous works and most likely had access to a number of Hegel’s manuscripts. This text actually being one of them. Hegel traveled around Bohemia with Marie and Friedrich Christoph Förster around the year 1820-21 (see Klaus Vieweg). -/- Philosophical mystery -- who is the author or authors of this text? -/- Take a plunge into the deep and cold waters. Maybe a quagmire or quandary, but decidedly interesting. This project is to contextualize an old handwritten manuscript which is about 225 years old. The actual author is a mystery. I offer my own assessment. You can make your own assessments. The mystery has continued to unfold since 1917. There is plenty to read. Otherwise, think about the authorship and read more of the German philosophers and authors from this period and enjoy the depth of thinking and philosophizing. On one hand, there is just the sheer fun in the puzzle of the authorship questions; and on the other hand, these are the alluring thoughts that lead to the nascent stage of German Idealism and our intellectual heritage. There is no end to the accolades for this group of philosophers. A heritage that we still hear in in our attempts to move forward into our future. -/- Do your own astute exegesis (ἐξήγησις) as all paths are still open. Let your thought take to the wings of what is called thinking with this text. Critical encounters (Auseinandersetzung, or a Gegenüberstellung) with at least: Friedrich Hölderlin (1770-1843) Friedrich Wilhelm Joseph Schelling (1775-1854), and Georg Wilhelm Friedrich Hegel (1770-1831) --- starts here! German Idealism. We are not going to study this situation endlessly, instead we make some broad strokes and provide you a general context. You are allowed to read between the lines too. Goal: to understand the overall affinity and differences between the intellectuals of this period in German history; and to come to grips with this demanding text within its large scholarly context in the last 100 years. There are no final answers. (shrink)

The question of the nature of Hegel’s metaphysics is a continuing one. In the last few decades the idea that Hegel even has a metaphysics has been challenged. Recently Stephen Houlgate has responded to this latter idea and tried to show not only that Hegel has a metaphysics, but of what sort it is. In my view Houlgate is right about Hegel having a metaphysics and also right generally about what sort of metaphysics it is. However, it seems to me (...) that he has made too weak a case for the metaphysics in his presentation of what he takes to be Hegel’s arguments, and as a consequence cannot escape a charge that Hegel might still be either a Kantian or some sort of subjective idealist. What I mean by this is that, to the extent that we are simply limited in our metaphysics to what we can think being to be, there may still be an absolute other which we simply cannot know. Houlgate has made things very clear concerning the conclusion to which we should come about the nature of Hegel’s metaphysics, but has not, in my view, made his argument leading to his conclusions quite strong enough. (shrink)

Preliminary Material --Foreword /Samuel M. Natale --Acknowledgements /Samuel M. Natale, Brian M. Rothschild, Joseph W. Sora, and Tara M. Madden --Introduction /William O'Neill and Samuel M. Natale --Section I /Samuel M. Natale, Brian M. Rothschild, Joseph W. Sora, and Tara M. Madden --The Working Class Spirituality /Joseph M. McShane --Comparative Christian Perspectives on the Meaning of Work /Joseph W. Ford --Work, Spirituality, and the Moral Point of View /Kenneth E. Goodpaster --Can Christian Ethics Inform Business Practice?: (...) A Typological Road Map and Criteria of Adequacy for an Ethic of Capitalism /David A. Krueger --The American and Catholic Models of Worker Rights: A Comparison and Appraisal /Michael A. Zigarelli --Section II /Samuel M. Natale, Brian M. Rothschild, Joseph W. Sora, and Tara M. Madden --The Work Ethic and Notions of Character in Scottish Education /W. A. Gatherer --The Multidimensionality of Values Conflicts in the Organizational Life /Michel Dion --New Organizational Structures: A Chance for Workers or a New Mode of Control? /Jacques Delcourt --Defining Forces in Work Attitudes: Cultural Values and Economic Environment /Eduardo S. Paderon and Charles F. O'Donnell --The Growing Dilemma of Loyalty to the Firm /John C. SJ. Haughey --Section III /Samuel M. Natale, Brian M. Rothschild, Joseph W. Sora, and Tara M. Madden --Values/Work/Education: Definitions and Context /Lee J. Richmond --Six Questions for Ethical Educational Management /Michael Bottery --Values Education: A More Effective Route to Managerial Competence? /W. M. Robb --The Educative Dimensions of Workplace Democracy /W.J. Toth --Influences on the Value-Mediating Work of Educational Leaders /K.D. Walker --Personal and Social Education in Vocational Preparation /Richard Pring --Contributors /Samuel M. Natale, Brian M. Rothschild, Joseph W. Sora, and Tara M. Madden --Index /Samuel M. Natale, Brian M. Rothschild, Joseph W. Sora, and Tara M. Madden --VIBS /Samuel M. Natale, Brian M. Rothschild, Joseph W. Sora, and Tara M. Madden. (shrink)

Modal collapse arguments are all the rage in certain philosophical circles as of late. The arguments purport to show that classical theism entails the absurdly fatalistic conclusion that everything exists necessarily. My first aim in this paper is bold: to put an end to action-based modal collapse arguments against classical theism. To accomplish this, I first articulate the ‘Simple Modal Collapse Argument’ and then characterize and defend Tomaszewski’s criticism thereof. Second, I critically examine Mullins’ new modal collapse argument formulated in (...) response to the aforementioned criticism. I argue that Mullins’ new argument does not succeed. Third, I critically examine a powers-based modal collapse argument against classical theism that has received much less attention in the literature. Fourth, I show why God’s being purely actual, as well God’s being identical to each of God’s acts, simply cannot entail modal collapse given indeterministic causation. This, I take it, signals the death of modal collapse arguments. But not all hope is lost for proponents of modal collapse arguments—for the death is a fruitful one insofar as it paves the way for new inquiry into at least two new potential problems for classical theism. Showing this is my paper’s second aim. (shrink)

We examine two competing solutions to Benardete paradoxes: causal finitism, according to which nothing can have infinitely many causes, and the unsatisfiable pair diagnosis (UPD), according to which such paradoxes are logically impossible and no metaphysical thesis need be adopted to avoid them. We argue that the UPD enjoys notable theoretical advantages over causal finitism. Causal finitists, however, have levelled two main objections to the UPD. First, they urge that the UPD requires positing a ‘mysterious force’ that prevents paradoxes from (...) arising. Since such a force is implausible, the UPD is in trouble. Second, they employ recombination or patchwork principles to argue that paradoxical situations would be possible if causal finitism were false. Since such situations are not possible, causal finitism is true, and so a substantive metaphysical thesis is needed to avoid the paradoxes. We argue that the UPD proponent can successfully respond to these objections. (shrink)

This book aims to spell out the consequences of taking the technologies behind the doing of science seriously.

Social exclusion influences how expressions are perceived and the tendency of the perceiver to mimic them. However, less is known about social exclusion’s effect on one’s own facial expressions. The aim of the present study was to identify the effects of social exclusion on Duchenne smiling behaviour, defined as activity of both zygomaticus major and the orbicularis oculi muscles. Utilising a within-subject’s design, participants took part in the Cyberball Task in which they were both included and excluded while facial electromyography (...) was measured. We found that during the active experience of social exclusion, participants showed greater orbicularis oculi activation when compared to the social inclusion condition. Further, we found that across both conditions, participants showed greater zygomaticus major muscle activation the longer they engaged in the Cyberball Task. Order of condition also mattered, with those who experienced social exclusion before social inclusion showing the greatest overall muscle activation. These results are consistent with an affiliative function of smiling, particularly as social exclusion engaged activation of muscles associated with a Duchenne smile. (shrink)

We argue that there is a conflict among classical theism's commitments to divine simplicity, divine creative freedom, and omniscience. We start by defining key terms for the debate related to classical theism. Then we articulate a new argument, the Aloneness Argument, aiming to establish a conflict among these attributes. In broad outline, the argument proceeds as follows. Under classical theism, it's possible that God exists without anything apart from Him. Any knowledge God has in such a world would be wholly (...) intrinsic. But there are contingent truths in every world, including the world in which God exists alone. So, it's possible that God contingently has wholly intrinsic knowledge. But whatever is contingent and wholly intrinsic is an accident. So, God possibly has an accident. This is incompatible with classical theism. Finally, we consider and rebut several objections. (shrink)

The question is how do Scanning Electron Microscopes (SEMs) give us access to the nano world? The images these instruments produce, I argue, do not allow us to see atoms in the same way that we see trees. To the extent that SEMs and STMs allow us to see the occupants of the nano world it is by way of metaphorical extension of the concept of “seeing”. The more general claim is that changes in scientific instrumentation effect changes in the (...) concepts central to our understanding of scientific results. (shrink)

Benardete paradoxes involve a beginningless set each member of which satisfies some predicate just in case no earlier member satisfies it. Such paradoxes have been wielded on behalf of arguments for the impossibility of an infinite past. These arguments often deploy patchwork principles in support of their key linking premise. Here I argue that patchwork principles fail to justify this key premise.

Since the publication of Carl Hempel and Paul Oppenheim's ground-breaking work "Studies in the Logic of Explanation," the theory of explanation has remained a major topic in the philosophy of science. This valuable collection provides readers with the opportunity to study some of the classic essays on the theory of explanation along with the best examples of the most recent work being done on the topic. In addition to the original Hempel and Oppenheim paper, the volume includes Scriven's critical reaction (...) to it, Wilfrid Sellars's discussion of the problem of theoretical explanation, and pieces by Salmon, Railton, van Fraassen, Friedman, Kitcher, and Achinstein in which they demonstrate the vitality of the subject by extending the scope of the inquiry. (shrink)

Universities are generally understood as organizations that extend knowledge based on codified bodies of work developed from systematic research and scholarship. This article examines the emergence of an organizational form that increasingly competes in contemporary higher education: the therapeutic university. A recent phenomenon, the therapeutic university is predicated on emotion in which the goal is to make the experience as a student as comfortable as possible. The article discusses organizational morphology of the therapeutic university by identifying practices within it. The (...) practices establish a contest between a rational-universalistic orientation of the university on the one hand and an emotion-particularistic orientation on the other. The article provides an explanation for why this organizational form arose and what it purports to accomplish. Its operations are ensnared by major paradox: as its identity implies, the therapeutic university postures to do good, but its practices, it is argued, debilitate students and higher learning. The mandate that the broader society gives to higher education is thereby susceptible to lost confidence. The article concludes by discussing a way in which universities may be inoculated from the conditions that support their present-day therapeutic proclivities. (shrink)

What do appeals to case studies accomplish? Consider the dilemma: On the one hand, if the case is selected because it exemplifies the philosophical point, then it is not clear that the historical data hasn't been manipulated to fit the point. On the other hand, if one starts with a case study, it is not clear where to go from there—for it is unreasonable to generalize from one case or even two or three.

What explains change? Edward Feser argues in his ‘Aristotelian proof’ that the only adequate answer to these questions is ultimately in terms of an unchangeable, purely actual being. In this paper, I target the cogency of Feser’s reasoning to such an answer. In particular, I present novel paths of criticism—both undercutting and rebutting—against one of Feser’s central premises. I then argue that Feser’s inference that the unactualized actualizer lacks any potentialities contains a number of non-sequiturs.

At the intersection of meta-ethics and philosophy of science, Nicholas Sturgeon’s “Moral Explanation” ([1985] 1988), Richard Boyd’s “How to be a Moral Realist” (1988), and David Brink’s Moral Realism and the Foundations of Ethics (1989) inaugurated a sustained argument for the claim that moral kinds like right action and virtuous agent are scientifically investigable natural kinds. The corresponding position is called “non-reductive ethical naturalism,” or “NEN.” Ethical nonnaturalists, by contrast, argue that moral kinds are genuine and objective, but not natural. (...) This dissertation is largely a challenge to non-reductive ethical naturalism from the viewpoint of ethical nonnaturalism. An introduction, four fairly independent chapters, and a conclusion comprise this dissertation. The introduction (chapter one) situates and summarizes the arguments in the four chapters that immediately follow, and the concluding chapter (chapter six) describes future work related to the arguments in this dissertation. I now turn to chapters two through five. In chapter two, I shore up what I believe are weakness in Derek Parfit’s Triviality Objection to reductive ethical naturalism and then present a challenge to the NEN theorist, which, I argue, the NEN theorist must but ultimately cannot meet. The challenge is to sketch an empirical experiment whereby we can adjudicate between competing moral hypotheses. I explain in terms of experimental design and evaluation why the challenge cannot be met. Chapters three and four focus on the semantics and reference relations of kind terms. In chapter three, I defend the Causal Externalist (CE) theory of semantics and reference against an objection distilled from two articles by Åsa Marie Wikforss. The objection is that CE implies a paradox, escape from which forces the CE theorist upon the horns of a dilemma. I show how the CE theorist can avoid the dilemma by allowing that the intensions of some artificial-kind terms (e.g., ‘jade’) are not given by descriptions associated with the terms. One consequence of this move, however, is that it casts doubt upon the coherence of the claim that moral-kind terms (e.g., ‘morally required action’) are natural-kind terms. In chapter four, I defend Terence Horgan and Mark Timmons’s Moral-Twin Earth argument from three critical responses put forward in recent paper by David Merli. NEN theorists claim that CE can account for the semantics and reference of moral-kind terms. As per Horgan and Timmons (H&T), however, our responses to the Moral-Twin Earth thought experiment give us reason to doubt the NEN theorists’ claim. Against H&T’s argument, however, Merli presents three independent, critical responses, and in this chapter I defend H&T’s argument in a way that is friendly to the ethical nonnaturalist. One upshot is, I contend, that the ethical nonnaturalist can and indeed should co-opt H&T’s argument for his own use. In chapter five, I return to kinds themselves, specifically those in biology. I first point out that ethical nonnaturalism appeals to a metaphysical thesis about nonnatural value, which need not be limited to the moral domain. Then, I argue that biological naturalism alone cannot give a satisfying realist account of biological kinds like HEART and NEURON. Finally, I show that by conjoining the concept of Cummins functions as recently defended by Paul Davies, a thesis about nonnatural value, and Ned Block’s Disney Principle regarding structural properties, the nonnaturalist, unlike the naturalist, can offer a satisfying realist account of biological kinds. (shrink)