The question of whether Do Not Resuscitate orders should be sustained in the operating room was brought to our ethics committee by a pulmonologist and involved one of his patients for whom he serves as a primary care physician. His patient, a woman with chronic obstructive lung disease was electing, for comfort purposes, to have a hip pinning following a fracture. At the same time, she wished to have a DNR order covering her entire hospital stay. The anesthesiologist described her (...) direction as “improper” and refused to participate in surgical procedures if DNR orders extended to the operating room. The patient refused to rescind the order during surgery. As a result, the surgery was canceled to the great chagrin of the patient. (shrink)

Roads to Health was published just a few months before the outbreak of the Covid-19 pandemic and the subsequent re-emergence into public consciousness of how health issues may impact all of society...

In an intriguing essay, G. A. Cohen has defended a conservative bias in favour of existing value. In this paper, we consider whether Cohen’s conservatism raises a new challenge to the use of human enhancement technologies. We develop some of Cohen’s suggestive remarks into a new line of argument against human enhancement that, we believe, is in several ways superior to existing objections. However, we shall argue that on closer inspection, Cohen’s conservatism fails to offer grounds (...) for a strong sweeping objection to enhancement, and may even offer positive support for forms of enhancement that preserve valuable features of human beings. Nevertheless, we concede that Cohen’s arguments may suggest some plausible and important constraints on the modality of legitimate and desirable enhancements. (shrink)

Cohen Kadosh & Walsh (CK&W) discuss the limitations of the behavioral, imaging, and single-cell studies related to number representation in human parietal cortex. The limitations of the imaging studies are grossly underestimated, particularly those using adaptation paradigms, and the problem of establishing a link between single-cell studies and imaging is not even addressed. Monkey functional magnetic resonance imaging (fMRI), however, provides a solution to these problems.

This article explores the potential utility of certain features of Friedrich Nietzsche’s philosophical concepts for philosophical counselling. Central to the philosophical counseling process is philosophical counsellors applying the ideas of philosophers or philosophical system to inspire, educate, and guide their counselees in dealing with life problems. For example, the philosophical practice methodology of Logic-based Therapy, developed by American philosopher Elliot Cohen, provides a rational framework for confronting problems of living, where the counselor helps the counselee find an uplifting philosophy (...) that promotes a guiding virtue to act as an antidote to unrealistic and often self-defeating conclusions derived from irrational premises. I present the argument that Nietzsche’s analysis of suffering, is one such uplifting philosophy which can be of utility to philosophical counselors. According to Bernard Reginster, suffering forms the bedrock of Nietzsche’s life-affirming concept of the ‘will to power.’ Nietzsche’s notion of the will to power radically alters our conception of, and the significance we assign to suffering, where the will to power is best understood as an individual’s desire for the activity of overcoming resistance. Nietzsche’s analysis implies that the fundamental human impulse is not to avoid suffering, but rather to embrace suffering as an unavoidable existential given of life itself: the meaning to be found in suffering is tantamount to affirming life itself. (shrink)

“Bioconservatives” in the human enhancement debate endorse the conservative claim that we should reject the use of biotechnologies that enhance natural human capacities. However, they often ground their objections to enhancement with contestable claims about human nature that are also in tension with other common tenets of conservatism. We argue that bioconservatives could raise a more plausible objection to enhancement by invoking a strain of conservative thought developed by G.A. Cohen. Although Cohen’s conservatism is not sufficient to fully (...) revive the bioconservative objection, we argue that it can be supplemented by an account of reasonable partiality for humanity in a way that provides further support to the bioconservative position in a manner congruous with broader conservatism. We propose that the idea of partiality to humanity can buttress the bioconservative objection into its strongest possible form. However, we conclude by arguing that, even in this form, the objection cannot do all the work that bioconservatives expect of it. (shrink)

This article explores the potential utility of the theory of Holism as developed by South African philosopher, British Commonwealth statesman and military leader, Jan Smuts, for philosophical counselling or practice. Central to the philosophical counseling process is philosophical counsellors or practitioners applying the work of philosophers to inspire, educate and guide their counselees in dealing with life problems. For example, Logic-Based Therapy, a method of philosophical counselling developed by Elliot Cohen, provides a rational framework for confronting problems of living, (...) where the counselor helps the counselee find an uplifting philosophy that promotes a guiding virtue that acts as an antidote to unrealistic and often self-defeating conclusions derived from irrational premises. We present the argument that Holism is one such uplifting philosophy which can be of utility to philosophical counselors or practitioners to help their counselees with confronting problems of living. Furthermore, we argue that Smuts’ articulation of freedom can act as a guiding virtue within this uplifting philosophy of Holism in accordance with the methodology of LBT. Smuts’ contribution to philosophy and psychology is arguably inadequately credited, and for this reason, and to the best of our knowledge, Smuts’ theory of Holism has yet to be discussed in the context of philosophical counseling or practice. Given these omissions, we begin this article with a discussion of his influence on 20th Century Anglo-American psychology. We then provide a brief historical context, and an introduction to the central argument of Smuts’ Holism, as well as a brief overview of the origins of Smut’s Holism and an introduction to his book Holism and Evolution. In the remainder of the article, we discuss several foundational concepts that underlie Smuts’ theory of Holism, as articulated and developed in his book Holism and Evolution, to substantiate our arguments. We conclude by highlighting the limitations of our article, limitations to Smuts’ model, and the challenges inherent in the use of a now largely antiquated theory, even by Smuts’ own admission nineteen years after its publication, for the purposes of contextualizing and substantiating the arguments and recommendations presented herein. (shrink)

Dass sich Hegel und Hermann Cohen trotz scheinbarer Gegensatze miteinander versohnen lassen, ist eine Grunduberzeugung des Werkes von Myriam Bienenstock, welches sich stets durch die doppelte Ausrichtung auf Hegel und das judische Denken auszeichnete. Mit diesem Band wird Myriam Bienenstock, seit 1997 Professorin fur Philosophie an der Universitat Francois Rabelais in Tours, anlasslich ihres 70. Geburtstages geehrt. Mit Beitragen von Dominque Bourel, Bernard Bourgeois, Christophe Bouton, Pierfrancesco Fiorato, Jean-Francois Goubet, Dana Hollander, Helmut Holzhey, Gerhard Kurz, Claudia Melica, Wolfdietrich Schmied-Kowarzik, (...) Ludwig Siep, Guy Stroumsa und Norbert Waszek. (shrink)

Can knowledge be defined? We expound an argument of John Cook Wilson's that it cannot. Cook Wilson's argument connects knowing with having the power to inquire. We suggest that if he is right about that connection, then knowledge is, indeed, indefinable.

This book presents G. A. Cohen's Gifford Lectures, delivered at the University of Edinburgh in 1996. Focusing on Marxism and Rawlsian liberalism, Cohen draws a connection between these thought systems and the choices that shape a person's life. In the case of Marxism, the relevant life is his own: a communist upbringing in the 1940s in Montreal, which induced a belief in a strongly socialist egalitarian doctrine. The narrative of Cohen's reckoning with that inheritance develops through a (...) series of sophisticated engagements with the central questions of social and political philosophy. In the case of Rawlsian doctrine, Cohen looks to people's lives in general. He argues that egalitarian justice is not only, as Rawlsian liberalism teaches, a matter of rules that define the structure of society, but also a matter of personal attitude and choice. Personal attitude and choice are, moreover, the stuff of which social structure itself is made. Those truths have not informed political philosophy as much as they should, and Cohen's focus on them brings political philosophy closer to moral philosophy, and to the Judeo-Christian ethical tradition, than it has recently been. (shrink)

Neokantismes: la marque du pluriel indique d'emblee que le mot d'ordre des annees 1865 Retour a Kant! regroupe differentes ecoles. Les auteurs dont les textes inedits en francais se trouvent ici rassembles et traduits, appartiennent en effet soit a l'ecole de Marbourg (H. Cohen, P. Natorp et E. Cassirer) soit a l'ecole de Bade (W. Windelband, H. Rickert, E. Lask, J. Cohn). Le point commun du neokantisme logique des premiers et du neokantisme axiologique des seconds consiste en une volonte (...) d'asseoir le positivisme sur un fondement philosophique respectueux de l'attitude phenomenologique. Kant apparut donc a tous ces penseurs comme science rigoureuse a condition toutefois de ne considerer le sujet transcendantal que comme une fonction logique de la pensee qui elabore la forme et le contenu de la connaissance. A condition egalement de ne pas limiter l'entreprise critique a la physique, mais de l'etendre au fondement de toutes les sciences de l'esprit. (shrink)

Access to a deep pool of talent is essential to the success of every professional services firm. The supply of that talent is contingent upon the available rewards for the exercise of that talent, and both the existence of the potential rewards and the beliefs that individuals hold about the existence of the rewards affect the decision to remain in the field. One structural factor that may affect the judgment about whether to remain in a profession concerns promotions based on (...) the gender of the employee. In this study, we examine the “glass ceiling” within the context of the accounting profession. While advances have been made within the accounting profession to address the glass ceiling, the continued existence—and perceptions about the continued existence—of the issue exert adverse effects upon the available talent pool and may create long-term problems for the profession. In this study, we investigate glass ceiling perceptions among a large sample of female accounting professionals employed in accounting; the sample includes both public accountants, and those employed in industry accounting. Our study yields the finding of beliefs in bias-driven effects, structural effects, and cultural effects among these accounting professionals. Glass ceiling perceptions are also influenced by several demographic factors. Furthermore, accounting professionals employed by industry are more likely to report a glass ceiling within their firms than accounting professionals employed by public accounting firms. The findings are of interest to researchers who explore gender-related issues in professional service firms such as the field of accounting, and to senior members of practice who are tasked with ensuring the integrity and quality of the talent pool and the equitable distribution of rewards to employees. (shrink)

One result of successful argumentation – able arguers presenting cogent arguments to competent audiences – is a transfer of credibility from premises to conclusions. From a purely logical perspective, neither dubious premises nor fallacious inference should lower the credibility of the target conclusion. Nevertheless, some arguments do backfire this way. Dialectical and rhetorical considerations come into play. Three inter-related conclusions emerge from a catalogue of hapless arguers and backfiring arguments. First, there are advantages to paying attention to arguers and their (...) contexts, rather than focusing narrowly on their arguments, in order to understand what can go wrong in argumentation. Traditional fallacy identification, with its exclusive attention to faulty inferences, is inadequate to explain the full range of argumentative failures. Second, the notion of an Ideal Arguer can be defined by contrast with her less than ideal peers to serve as a useful tool in argument evaluation. And third, not all of the ways that arguers raise doubts about their conclusions are pathological. On the contrary, some ways that doubts are raised concerning our intended conclusions are an integral part of ideal argumentative practice. (shrink)

BackgroundIn the Netherlands, patients have the legal right to make a request for euthanasia to their physician. However, it is not clear what it means in a moral sense for a physician to receive a request for euthanasia. The aim of this study is to explore the moral values of physicians regarding requests for euthanasia. MethodsSemi-structured interviews were conducted with nine primary healthcare physicians involved in decision-making about euthanasia. The data were inductively analyzed which lead to the emergence of themes, (...) one of which was about values regarding end-of-life decisions.ResultsFour clusters of values related to euthanasia requests are described: values related to 1) the patient; 2) the family; 3) the physician; and 4) life and death. The data show that the participants value patient autonomy as a necessary but not sufficient condition for meeting a euthanasia request. A good relationship with the patient and the family are important. For the physician, the values physician autonomy, responsibility, understanding the patient and relief of suffering play a role. Life as an intrinsic good and a peaceful death are also important values.ConclusionThis study shows that next to patient autonomy and the relationship with the patient and the family, it is important for the participants to act in accordance with their professional values and to do justice to values related to life and death. The awareness of going against the intrinsic value of life is crucial, even if performing euthanasia may result in a feeling of relief or gratitude afterwards. (shrink)

Our thoughts depend on knowledge about objects, people, properties, and events. In order to think about where we left our keys, what we are going to make for dinner, when we last fed the dogs, and how we are going to survive our next visit with our family, we need to know something about locations, keys, cooking, dogs, survival, families, and so on. Researchers have sought to explain how our brains can store and access such general knowledge. A growing body (...) of evidence suggests that many of our concepts are grounded in action, emotion, and perception systems. We appear to think about the world by means of the same mechanisms that we use to experience it. Abstract concepts like ‘democracy,’ ‘fermion,’ ‘piety,’ ‘truth,’ and ‘zero’ represent a clear challenge to this idea. Given that they represent a uniquely human cognitive achievement, answering the question of how we acquire and use them is central to our ability to understand ourselves. This book argues that abstract concepts are heterogeneous and pose three important challenges to embodied cognition. They force us to ask: How do we generalize beyond the specifics of our experience? How do we think about things that we do not experience directly? How do we adapt our thoughts to specific contexts and tasks? It argues that a successful theory of grounding must embrace multimodal representations, hierarchical architecture, and linguistic scaffolding. Abstract concepts are the product of an elastic mind. (shrink)

I take a close look at Bernard Williams’s paper "Moral Luck," which put this notion on the philosophical agenda. Williams’s focal example is the painter Paul Gauguin. According to Williams, Gauguin’s morally dubious decision to desert his family so as to pursue an artistic career can be redeemed only by his partially fortuitous success as a painter. This is shown by the consideration that a successful Gauguin would not be able to regret his decision, whereas failure would have prompted regret. (...) I suggest that the best way to understand this claim is to see Gauguin’s decision to become an artist as a constitutive decision, which launches what for him proved to be a defining project. One cannot coherently regret the realization of such a project or the decision that gave rise to it because that would amount to wishing to be someone else: conditions of personal identity set the limits on the counterfactuals about ourselves that we can intelligibly entertain. However, not being able to regret the constitutive elements of one’s life is not the same as approving of these elements. So I disagree with Williams’s ultimate conclusion that the inability to regret a decision signals some justification for it, no matter how attenuated. (shrink)

On one view, limb transplants cross technological frontiers but not ethical ones; the only issues to be resolved concern professional competence, under the assumption of patient autonomy. Given that the benefits of limb transplant do not outweigh the risks, however, the autonomy and rationality of the patient are not necessarily self‐evident. In addition to questions of resource allocation and informed consent, limb, and particularly hand, allograft also raises important issues of personal identity and bodily integrity. We present two linked schemas (...) for exploring ethical issues in limb transplants. The first, relying on conventional concepts in biomedical ethics, asks whether the procedure is research or therapy, whether the costs outweigh the benefits, and whether it should be up to the patient to decide. The second introduces more speculative and theoretically challenging questions, including bodily integrity, the argument from unnaturalness, and the function of the hand in expressing personal identity and intimacy. We conclude that limb transplants are not ruled out a priori, unlike some procedures that are prima facie wrong to perform, such as amputation of healthy limbs to relieve body dysmorphic disorders. However, their legitimacy is not proven by appeals to the interests of scientific research, cost‐benefit, or patient autonomy. (shrink)

Freedom of Religion, Inc.: Whose Sovereignty? This article focuses on an expansive conception of religious freedom propagated by a vocal group of American legal scholars – jurisdictional pluralists – often working with well-funded conservative foundations and influencing accommodation decisions throughout the US. I show that the proliferation of ‘accommodation’ claims in the name of church autonomy and religious conscience entailing exemption from civil regulation and anti-discrimination laws required by justice have a deep structure that has little to do with fairness (...) or inclusion or liberal pluralism. Instead they are tantamount to sovereignty claims, involving powers and immunities for the religious, implicitly referring to another, higher law and sovereign than the constitution or the people. The twenty-first century version of older pluralist ‘freedom of religion’ discourses also rejects the comprehensive jurisdiction and scope of public, civil law – this time challenging the ‘monistic sovereignty’ of the democratic constitutional state. I argue that the jurisdictional pluralist approach to religious freedom challenges liberal democratic constitutionalism at its core and should be resisted wherever it arises. (shrink)

Pedro Abelardo apresenta na sua obra uma teoria da virtude de natureza, à primeira vista, aristotélica. Ao que parece, essa concepção também contém diferentes elementos estoicos, que não se opõem necessariamente à visão do Estagirita. Todavia, o essencial da interpretação da Escola do Pórtico acerca da virtude difere da explicação dada por Aristóteles. No presente estudo, pretendemos examinar, primeiro, a índole da virtude como habitus na obra de lógica de Abelardo. Nesse caso, não há dúvida de que predomina a influência (...) aristotélica. Em seguida, indicamos outras particularidades da virtude encontradas, desta vez, em tratados éticos e teológicos do nosso protagonista, as quais se revelam antes de caráter estoico. Em suma, projetamos identificar as diferentes fontes antigas e os principais intermediários latinos usados por Abelardo para elaborar a sua própria teoria da virtude. Trata-se de deixar clara a influência filosófica dominante em Abelardo sobre essa questão da virtude, já que este lógico não pode harmonizar teses substancialmente inconciliáveis. Peter Abelard in his work presents a theory of virtue, which is, at first sight, of Aristotelian nature. It seems that this view also contains different Stoic elements, but they are not necessarily opposed to Stagirite's vision. However, the essentials of the Stoa School about virtue differ from the explanation given by Aristotle. In this paper, we intend to examine, first, the nature of virtue as habitus in Abelard's work on logic. In this case, there is no doubt that Aristotle's influence on this topic predominates. Next, we specify other features related to virtue found, this time, in ethical and theological treatises of our protagonist that appear to be basically Stoic. In short, we want to identify the different ancient sources and the main Latin mediators used by Abelard to elaborate his own theory of virtue. In other words, we would like to shed light on the predominant philosophical authority on Abelard's theory of virtue since this logician cannot harmonize theses that are fundamentally irreconcilable. (shrink)

Objective: Ethical guidelines are designed to ensure benefits, protection and respect of participants in clinical research. Clinical trials must now be registered on open-access databases and provide details on ethical considerations. This systematic survey aimed to determine the extent to which recently registered clinical trials report the use of standard of care and post-trial obligations in trial registries, and whether trial characteristics vary according to setting. Methods: We selected global randomized trials registered on http://www.clinicaltrials.gov and http://www.controlled-trials.com. We searched for intervention (...) trials of HIV/AIDS, malaria, and tuberculosis from 9 October 2004, the date of the most recent version of the Helsinki Declaration, to 10 April 2007. Results: We collected data from 312 trials. Fifty-eight percent (58%, 95% CI = 53 to 64) of trial protocols report informed consent. Fifty-eight percent (58%, 95% CI = 53 to 64) of trials report active controls. Almost no trials (1%, 95% CI = 0.5 to 3) mention post-trial provisions. Most trials measure surrogate outcomes. Twenty percent (20%, 95% CI = 16 to 25) of trials measure patient-important outcomes, such as death; and the odds that these outcomes are in a low income country are five times greater than for a developed country (odds ratio (OR) 5.03, 95% CI = 2.70 to 9.35, p = < 0.001). Pharmaceutical companies are involved in 28% (CI = 23 to 33) of trials and measure surrogate outcomes more often than nonpharmaceutical companies (OR 2.45, 95% CI = 1.18 to 5.09, p = 0.31). Conclusion: We found a large discrepancy in the quality of reporting and approaches used in trials in developing settings compared to wealthier settings. (shrink)

Chez Paul Tillich, le concept de Dieu s’oppose au modèle « interventionniste » du théisme traditionnel en Occident. Cet article se propose de déterminer si, et en quel sens, d’après Tillich, on peut dire que Dieu agit pour influencer le cours des événements historiques. On soutient que son concept de « pouvoir Spirituel » fournit une réponse à cette question. Pour clarifier cette thèse, on explore les concepts d’esprit, de pouvoir, de sens, de vocation, de kairos et de renoncement au (...) pouvoir. Selon Tillich, la vocation de groupes sociaux déterminés est animée d’un pouvoir divin conférant tout ensemble un don et une tâche. Pour les chrétiens, la vocation de Jésus le Christ, qui consiste à proclamer la venue du Royaume de Dieu comme le sens ultime de l’histoire, constitue le critère permettant de juger les vocations concrètes. Dieu agit en offrant un sens, qui doit être choisi et réalisé. (shrink)