Background: Prior research has explored reasons why health care providers may or may not choose to seek an ethics consultation. Although low-quality communication is evident in many ethics consultations, it is unknown whether poor communication in clinical settings is related to health care providers' requests for ethics involvement. Objective: To assess the relationship between self-reported ratings of health care providers' inter- and intraprofessional communication and ethics consultation requests. Method: This cross-sectional survey was conducted using a self-administered questionnaire of physicians and (...) nurses in six intensive care units at one academic medical center in the United States. The questionnaire assessed perceptions about requesting ethics consultations and how health care providers perceive communication. Results: Two hundred sixty-two participants (228 nurses and 34 physicians) responded to the survey (response rate 55%; 59% for nurses and 41% for physicians). Requests for an ethics consult were positively associated with perceived quality of interprofessional communication (r =.13, p <.05), but perceptions of the number of ethical dilemmas that occur on participants' units each month were negatively associated with the perceived quality of intra-professional communication (r = −.17, p <.01). Conclusion: The relationship that was hypothesized between perceived poor communication and increased number of ethics consultations was not borne out by these data. Indeed, we found the opposite; these finding suggests that good inter- and intraprofessional communication may promote the use of outside resources, such as ethics, when they are needed. (shrink)

Substituted judgment has increasingly become the accepted standard for rendering decisions for incapacitated adults in the USA. A broad exception exists with regard to patients with diminished capacity secondary to depressive disorders, as such patients’ previous wishes are generally not honoured when seeking to turn down life-preserving care or pursue aid-in-dying. The result is that physicians often force involuntary treatment on patients with poor medical prognoses and/or low quality of life as a result of their depressive symptoms when similarly situated (...) incapacitated patients without such depressive symptoms would have their previous wishes honoured via substituted judgment. This commentary argues for reconsidering this approach and for using a substituted judgment standard for a subset of EMP/LQL patients seeking death. (shrink)

Objective: Deep brain stimulation targeted to the ventral intermediate nucleus of the thalamus is effective for motor symptoms in essential tremor, but there is limited data on cognitive outcomes. We examined cognitive outcomes in a large cohort of ET DBS patients.Methods: In a retrospective analysis, we used repeated-measures ANOVA testing to examine whether the age of tremor onset, age at DBS surgery, hemisphere side implanted with lead, unilateral vs. bilateral implantations, and presence of surgical complications influenced the cognitive outcomes. Neuropsychological (...) outcomes of interest were verbal memory, executive functioning, working memory, language functioning, visuospatial functioning, and general cognitive function.Results: We identified 50 ET DBS patients; 29 males; the mean age of tremor onset was 35.84 years with a median age of 38 years. The mean age at DBS was 68.18 years. There were 37 unilateral 30 left, seven right, and 13 bilateral brain implantations. In the subgroup analysis, there was a significant interaction between assessment and age of tremor onset ; F = 4.47; p = 0.043 for working memory. The post hoc testing found improvements for younger onset ET. Similarly, there was a significant interaction between assessment and complications vs. no complications subgroups; F = 4.34; p = 0.043 for verbal memory with worsening scores seen for ET patients with complications. The remaining tests were not significant.Conclusion: In this large cohort of ET patients with, DBS was not accompanied by a significant decline in many cognitive domains. These outcomes were possibly related to the selection of patients with normal cognitive functioning before surgery, unilateral DBS implantations for the majority, and selection of patients with optimal response to DBS. (shrink)

Two basic theses underlie this work. The first, the specificity theorem, signifies that logic is essentially concerned with specific events and not with universal and transcendent systems. The second, the interbehavioral theorem, implies that no matter how logic is defined, it entails a psychological dimension that must be taken into account.

Traditional scholarly attention to human tragedy has been confined mainly within the artificial world of drama and literature. It has neglected to recognize the significant recurrence of tragedy throughout the entire realm of nature. This book attempts to place tragedy within the larger context of natural events, and to view it against a background of scientific philosophy and psychology.

A consequence relation \ is monotonic iff for premise sets \ and conclusion \, if \, \, then \; and non-monotonic if this fails in some instance. More plainly, a consequence relation is monotonic when whatever is entailed by a premise set remains entailed by any of its supersets. From the High Middle Ages through the Early Modern period, consequence in theology is assumed to be monotonic. Concomitantly, to the degree the argument formulated by Anselm at Proslogion 2–4 is taken (...) up by later commentators, it is accepted or rejected in accordance with a monotonic notion of consequence. Examining Anselm’s use of parallelism in the Proslogion, I show Anselm embeds his famous argument in Proslogion 2–4 in a non-monotonic context. The results here presented challenge some deeply ingrained ideas governing the historiography of the long twelfth century, particularly concerning how the theology of the later eleventh through the twelfth century relates to the scholasticism of the thirteenth. (shrink)

The integrity of the patient–physician relationship depends on maintaining professional boundaries. While ethicists and professional organisations have devoted significant consideration to the subject of sexual boundary transgressions, the subject of non-sexual boundaries, especially outside the mental health setting, has been largely neglected. While professional organisations may offer guidance on specific subjects, such as accepting gifts or treating relatives, as well as general guidance on transparency and conflict of interest, what is missing is a principle-based method that providers can use to (...) assess non-sexual interactions with patients that transcend norms of practice. This paper attempts to offer an operational model for such assessment that considers not only the traditional emphasis on beneficence, but also incorporates concerns over entanglement and concordance. (shrink)

The “Goldwater rule,” a policy adopted by the American Psychiatry Association in 1973, prohibits organization members from diagnosing or offering professional opinions regarding the mental health of public figures without both first-hand evaluation and authorization. Initially developed in response to a controversial survey of APA members during the 1964 Presidential election campaign, the ethics rule faced few large scale challenges until the election of Donald Trump in 2016. Since that time, a significant number of psychiatrists have either violated or criticized (...) the rule openly. This paper argues that whatever the initial merits of the rule, the prohibition has since been rendered obsolete by the combined lack of professional consensus supporting the policy, absence of a meaningful enforcement mechanism, and the credible statements of non-APA members in the mental health professions regarding public figures. (shrink)

_ Source: _Volume 56, Issue 3-4, pp 292 - 319 With William of Ockham and John Buridan, Walter Burley is often listed as one of the most significant logicians of the medieval period. Nevertheless, Burley’s contributions to medieval logic have received notably less attention than those of either Ockham or Buridan. To help rectify this situation, the author here provides a comprehensive examination of Burley’s account of consequences, first recounting Burley’s enumeration, organization, and division of consequences, with particular attention to (...) the shift from natural and accidental to formal and material consequence, and then locating Burley’s contribution to the theory of consequences in the context of fourteenth-century work on the subject, detailing its relation to the earliest treatises on consequences, then to Ockham and Buridan. (shrink)

Priority for solid organ transplant generally does not consider the underlying cause of the need for transplantation. This paper argues that a distinctive set of factors justify assigning lower priority to willfully unvaccinated individuals who require transplant as a result of suffering from COVID‐19. These factors include the personal responsibility of the patients for their own condition and the public outrage likely to ensue if willfully unvaccinated patients receive organs at the expense of vaccinated ones. The paper then proposes a (...) three‐prong test for similar deviations from the current allocation standard that incorporates patient responsibility, foreseeability and avoidability, and the frequency of the occurrence. (shrink)

On February 24, 2022, Russia invaded its neighboring nation, Ukraine, in what is widely regarded in the West as a grave breach of international law. Since that time, the Russian military has been i...

Physicians expressing opinions on medical matters that run contrary to the consensus of experts pose a challenge to licensing bodies and regulatory authorities. While the right to express contrarian views feeds a robust marketplace of ideas that is essential for scientific progress, physicians advocating ineffective or dangerous cures, or actively opposing public health measures, pose a grave threat to societal welfare. Increasingly, a distinction has been made between professional speech that occurs during the physician-patient encounter and public speech that transpires (...) beyond the clinical setting, with physicians being afforded wide latitude to voice empirically false claims outside the context of patient care. This paper argues that such a bifurcated model does not sufficiently address the challenges of an age when mass communications and social media allow dissenting physicians to offer misleading medical advice to the general public on a mass scale. Instead, a three-tiered model that distinguishes between citizen speech, physician speech and clinical speech would best serve authorities when regulating physician expression. (shrink)

Since several landmark legal decisions in the 1970s and 1980s, substituted judgment has become widely accepted as an approach to decision‐making for incapacitated patients that incorporates their autonomy and interests. Two notable exceptions have been cases involving minors and those involving cognitively or psychiatrically impaired individuals who never previously possessed the ability to contemplate the medical decisions involved in their care. While a best interest standard may have universal merit in pediatric cases, this paper argues that substituted judgement has been (...) rejected too broadly for “never‐capacitated” patients. It then lays out a three‐condition test for using substituted judgment in these cases. For a subset of “never‐capacitated” patients who belong to distinctive religious or cultural communities with clear medical values and have an appropriate surrogate, these values may prove helpful in vindicating the interests of the never‐capacitated and should not be blanketly dismissed. (shrink)

James Bond 007 strode into the human imagination in the novel Casino Royale in 1953 and hit the movie screens with Dr. No in 1962. He has become one of the best-known personalities, real or imagined, in global history. One out of every four people in the entire world has now seen a Bond movie, and every month thousands of new readers become addicted to Ian Fleming’s original Bond stories. In James Bond and Philosophy, seventeen scholars examine hidden philosophical issues (...) in the hazardous, deceptive, glamorous world of Double-0 Seven. Is Bond a Nietzschean hero who graduates "beyond good and evil"? Does Bond paradoxically break the law in order, ultimately, to uphold it like any "stupid policeman"? What can Bond’s razor-sharp reasoning powers tell us about the scientific pursuit of truth? Does 007’s license to kill help us understand the ethics of counterterrorism? What motivates all those despicable Bond villains—could it be a Hegelian quest for recognition? (shrink)

Religion scheint auf den ersten Blick eine besondere Anfälligkeit für Dogmatismus zu besitzen. Religiöse Überzeugungen sind häufig tief im Leben der Menschen verankert und religiöse Hingabe scheint in Spannung zu jedem Zweifel an dem Inhalt der jeweiligen Religion zu stehen. Auf der Basis von Ernst Cassirers Überlegungen kann im Gegensatz zu diesem Anschein eine Konzeption von Religion entwickelt werden, wonach sich diese gerade durch eine kritische Reflexion auf die eigenen Inhalte auszeichnet und im Gegensatz zu Aberglauben, Irrglaube und Wahnglaube, zu (...) immer größerer Entfaltung von Freiheit führt. (shrink)

Like Aristophanes’ Frogs, Plato’s Symposium stages a contest between literary genres. The quarrel between Socrates and Aristophanes constitutes the primary axis of this contest, and the speech of Alcibiades echoes and extends that of Aristophanes. Alcibiades’ comparison of Socrates with a satyr, however, contains the key to understanding Socrates’ implication, at the very end of the dialogue, that philosophy alone understands the inner connectedness, and hence the proper nature, of both tragedy and comedy. I argue that Plato reflects in the (...) character of Socrates the primordial wisdom embodied in satyric drama. I conclude with a brief consideration of Nietzsche’s challenge to Plato’s Dionysian wisdom. (shrink)

Jerry Fodor argued for an account of belief attribution very close to the theory of direct reference. I argue that his account conflicts with constraints on psychological explanation which he ought to accept.

This dissertation studies how Aristotle understands and justifies his Rhetorical Art. It proceeds by explicating the Art in its intellectual context. Rhetoric emerges as a dynamic investigation of human affairs working through the "given" in speech and thought to a plausible account, while giving consideration to the opinions and characters of both speaker and audience within the horizon of a particular occasion. The basic dynamic determines a structure which is comparable to Socrates' requirements in the Phaedrus. That this is the (...) structure and dynamic is supported by considering the fundamentally contingent nature of human experience, understanding the inference types , common sense principles and starting points by which such experience is explicated, and placing such experience in three mutually exclusive genres. Aristotle's art is essentially the resulting plausible account while actual composition is supplementary. ;Aristotle limits the art by reference to dialectic and ethical life. When it is seen that Aristotle's Organon is not a science of logic and the Posterior Analytics is a rarely applicable mode of presentation, the point of dialectic becomes accessible. It too involves strenuous grappling with speech and thought, but its highest purpose lies in peirastic. Peirastic and sophistry are uses of dialectic which have a contrasting moral color. Peirastic aims at the discovery of ignorance and, at the same time, the difference between accident and essence and knowledge and opinion: Being educated is essentially knowing what one does not know. ;What Socrates only alludes to as political art, Aristotle attempts to expound as praxis perfected into phronesis. Even Aristotle does no more than suggest the nature of phronesis negatively as simultaneously a seeking, a finding and an act which is both self-determination and self-knowledge, and none of these separately; it is profoundly disruptive of existing opinion and most clearly to be seen in the rejection of the laws and rules upon which, as deliberation, it is dependent. The Art differs from Gorgias' rhetoric in its emphasis on the plausible and in its subordination to an ethical self-determination that gains the weight of experience appropriated by intelligence and virtue. (shrink)

The complexities of Henry More's eclectic Neoplatonism and his recklessly energetic poetic style have hitherto deterred scholars from undertaking a complete study of his long philosophical poem, A Platonick Song of the Soul . The aim of my dissertation is to study the Platonick Song in its entirety. I attempt to unravel the different strands of thought that it is woven of and reveal the consistency of thought and architectonic scheme of the work. ;The major themes of the Platonick Song (...) are the immateriality of the soul, its immortality, and its unfailing consciousness. I begin my study with an appraisal of More's work as an answer to Lucretius's De Rerum Natura, which had proclaimed the corporeality and mortality of the soul. The first poem of the Platonick Soul, "Psychozoia" is studied as an allegorical prelude to the work, and the Plotinian and Chaldean origins of More's systems are examined. The five poems after "Psychozoia" are divided into three sections dealing with the immortality of the soul , the macrocosmic manifestation of the soul and the alert soul "Antipsychophannychia," "The Praeexistency of the Soul" and "Antimonopsychia"). In the course of these three chapters, I have occasion to demonstrate More's reliance on the arguments of Ficino and Galileo. In the final chapter of my study, I reveal the importance of the Platonick Song for an understanding of the metaphysics, psychology and ethics of More's mature philosophy. In addition, I analyze the ways in which More's concepts of spirit, matter, space and the Deity resembled and differed from those of his Cambridge friend, Isaac Newton. (shrink)

I examine two views of Professor Von Wright's: in the philosophy of action and in the philosophy of perception. I partly agree and partly disagree with him.

THE FREEHOF INSTITUTE OF PROGRESSIVE HALAKHAH The Freehof Institute of Progressive Halakhah is a creative research center devoted to studying and defining the progressive character of the halakhah in accordance with the principles and theology of Reform Judaism. It seeks to establish the ideological basis of Progressive halakhah, and its application to daily life. The Institute fosters serious studies, and helps scholars in various portions of the world to work together for a common cause. It provides an ongoing forum through (...) symposia, and publications including the quarterly newsletter, HalakhaH, published under the editorship of Walter Jacob, in the United States. The foremost halakhic scholars in the Reform, Liberal, and Progressive rabbinate along with some Conservative and Orthodox colleagues as well as university professors serve on our Academic Council. This collection of essays is the product of the symposia held in Atlanta and Pittsburgh in 1995 and 1996. This book follows the volumes DYNAMIC JEWISH LAW; Progressive Halakhah - Essence and Application (1991), RABBINIC -LAY RELATIONS IN JEWISH LAW (1993), CONVERSION TO JUDAISM IN JEWISH LAW (l994), DEATH AND EUTHANASIA INJEWISH LAW (1995) and THE FETUS AND FERTILITY IN JEWISH LAW (1995), ISRAEL AND THE DIASPORA IN JEWISH LAW (1997). It is part of a series whose subjects are diverse and the approaches taken by the authors are equally so. We wish to encourage wide ranging discussions of contemporary and historic themes. (shrink)

Dire que le discours moral de l'Eglise est mal recu est un euphemisme. Il est en verite heretique. Critique par ceux qui l'ignorent comme par ceux qui devraient le connaitre, parfois deforme et rarement defendu, il n'esquive pas le debat rationnel. Mais qui se soucie de raison tandis que partout et sans partage regne l'emotion? Peu osent s'ecarter du dogme selon lequel le l'individu ne doit avoir que deux maitres: le desir tout-puissant, createur d'un univers virtuel et ephemere, et l'hygiene, (...) ultime etalon du rapport a autrui. Peu resistent aux sirenes du relativisme ambiant, meme parmi d'eminents moralistes chretiens persuades du fait meme d'avoir eu raison trop tot dans une Eglise trop frileuse. Il se pourrait pourtant que la critique philosophique decouvre dans la reflexion morale chretienne une vraie sagesse, qui n'est pas la veuve du temps qui passe, dont l'ambition est seulement de raviver la flamme fragile de notre conscience morale. Pascal Jacob ne se limite pas pour autant a une critique d'une certaine theologie contemporaine, il expose avec pedagogie la rationalite de la pensee chretienne ainsi que les positions de l'Eglise, en particulier sur des questions controversees. L'auteur: Pascal Jacob, Agrege de philosophie, Professeur a l'IPC - Facultes libres de philosophie et de psychologie, enseigne egalement l'Ethique en licence de psychologie et en Institut de soins Infirmiers (IFSI) et la philosophie en lycee. (shrink)

Over the past century, the “right to health” has been recognized by medical organizations and governments across the globe. This essay calls for recognition of a parallel “right to be sick” intended to reframe physician attitudes toward patient autonomy and the right to refuse care. Rather than seeking to discourage allopathic medicine or to question laws requiring involuntary treatment when indicated by the collective welfare, the goal is to have the medical and public health communities reconceptualize their attitudes toward individuals (...) who reject unsought guidance and care. (shrink)

A counterpossible conditional, or counterpossible for short, is a conditional proposition whose antecedent is impossible. The filioque doctrine is a dogma of western Christian Trinitarian theology according to which the Holy Spirit proceeds from the Father and the Son. The filioque doctrine was the principal theological reason for the Great Schism, the split between Eastern Orthodoxy and western Christianity, which continues today. In the paper, I review one of the earliest medieval defenses of the doctrine in Anselm of Canterbury, and (...) I show that Anselm’s treatment of counterpossible conditionals concerning the procession of the spirit from the son in Trinitarian theology represent an early foray into default logic. Thus, the mutual estrangement of eastern and western positions on the matter may not lie fundamentally in a change in dogma, but rather in a change in logic. (shrink)

The series offers a publication forum for innovative works on all topics of analytic philosophy. The focus is on the disciplines of theoretical philosophy: metaphysics, ontology, epistemology, philosophy of language, logic. Furthermore, works that additionally include contributions to the history of philosophy are also welcome.

Because we humans speak a public language, there has always been a special reason to suppose that we have a language of thought. For nonhuman animals, this special reason is missing, and the issue is less straightforward. On the one hand, there is evidence of various types of nonlinguistic representations, such as analog magnitude representations, which can explain many types of intelligent behavior. But on the other hand, the mere fact that some aspects of animal cognition can be explained by (...) nonlinguistic representations hardly suffices to show that animal minds are bereft of any sentence-like representations. This paper explores these complexities and argues that empirical research into the logical abilities of nonhuman animals provides a more direct way of evaluating whether they have a language of thought. Along the way, I offer a novel suggestion of how the hypothesis that animals draw disjunctive syllogisms can be empirically distinguished from the hypothesis, defended by Michael Rescorla, that animals reason probabilistically in accordance with Bayes’ Law. (shrink)