Clinical Ethics Consultations (CECs) are used by healthcare systems to offer healthcare practitioners a structured level of support to approach ethical questions. The objective of this study was to detail the elements of surveyed CECs and offer guidance in the approach to future ethics consultations at a regional healthcare system. This cohort study has a qualitative and quantitative retrospective approach, surveying ethics consultations through the dates of 4/27/22 to 4/26/24. A documentary sheet was created, and information was entered via online (...) data-gathering forms. The cases are from a range of specialties within a regional healthcare system servicing Minnesota, Wisconsin, and North Dakota. 103 CECs were performed within the study period across the regional healthcare system. Consultations were identified through retrospective review of the internal CEC database, and patient information was collected through the medical record. Decision-making was often performed by a substitute decision-maker (N = 54), occurring in 70.1% of cases with known decision makers. CECs were documented in an ethics-specific note in the patient medical record in 37 of 82 (45.1%) documented patient cases. It was common for physicians to mention the ethics consultation in their patient notes, occuring in 51 of 82 (62.2%) of documented patient cases. Age was recorded in 92.0% (N = 91) of unique patient cases; the median age was 62 years. Ethical questions concerning end-of-life care were the most common cause for consultation (N = 35, 34%), and CECs were most commonly requested in general medicine or hospitalist departments (N = 38, 45.2%). Most consultations resulted in resolution at time of initial consultation with the ethics call team. Recommendations for increased frequency and timing of policy review are given based on the results of the data presented. Using interpretation of the CECs in this study, we offer recommendations towards the use and documentation of ethics consultations in the era of open notes, open the door towards areas of future research, and ultimately promote use of CECs for more favorable patient outcomes. (shrink)

A selection of his more important writings.

Absurdist accounts of life’s meaning posit that life is absurd because our pretensions regarding its meaning conflict with the actual or perceived reality of the situation. Relationary accounts posit that contingent things gain their meaning only from their relationship to other meaningful things. I take a detailed look at the two types of account, and, proceeding under the assumption that they are correct, combine them to see what the implications of such a combination might be. I conclude that another way (...) of looking at the absurdity of life is to see it as a conflict between our dual beliefs that there exist intrinsically meaningful contingent things, and that contingent things may only gain their meaning extrinsically through their relationships to other meaningful things. In this way, I provide another lens through which feelings of life’s absurdity may be interpreted and analysed: as the conflict between the simultaneous beliefs in both intrinsically and relationally meaningful contingent things. Looking through this lens gives us an entirely different framework for analysing life’s absurdity than that which Nagel described in 1971, providing opportunity for more potential avenues of analysis and discussion. (shrink)

"The book is carefully organized and provides a clear, well-structured, and lucid expression of its theses." -- Dr. Marvin Fox, Department of Near Eastern and Judaic Studies, Brandeis University The Mishnah is the first canonical writing of Judaism after the Hebrew Scriptures of ancient Israel (the Old Testament) and the foundation of the two Talmuds and of all Judaism thereafter. According to eminent religion scholar Jacob Neusner, the key to understanding the Mishnah is to read it as philosophy, in (...) accord with the generally accepted understanding of philosophy in its time and place. In Judaism as Philosophy, Neusner studies a large sample of evidence, meticulously translated and carefully explained, and identifies the philosophical side of the Mishnah's system, method, and message alike. The philosophical tradition in which the Mishnah takes its place, Neusner explains, utilizes the Aristotelian method of hierarchical classification to demonstrate the proposition (important to Middle Platonism and profoundly expressed by Plotinus) that many things really form a single thing: many species, a single genus; many genera, an encompassing, well-crafted and cogent whole. Through the systematic and orderly hierarchical classification of the things of nature, the framers of the Mishnah illustrate the ultimate unity of all being emanating from the One on high. Arguing that the document's writers chose a legal form for a philosophical proposition, this book completely changes a centuries-old way of reading the Mishnah. Judaism emerges as a sustained demonstration of the unity of all being under one God. "What is the next phase in this ongoing history of the formation of Judaism in theclassical period[?]... The analysis of the philosophical character of the Mishnah places into perspective what I believe to be the character of the first phase, and therefore points toward the development of the second and third phases, of the Judaism of the Dual Torah. The entire characterization of the first phase of the Judaism of the Dual Torah, that is, the system attested by the Mishnah in particular, rests upon the results of this book and its two companions, on economics and politics respectively."--from the Preface. (shrink)

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This book explores the differences and similarities between Sartrean existentialism and French poststructuralism.

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...) in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

The notion of measurement plays a central role in human cognition. We measure people’s height, the weight of physical objects, the length of stretches of time, or the size of various collections of individuals. Measurements of height, weight, and the like are commonly thought of as mappings between objects and dense scales, while measurements of collections of individuals, as implemented for instance in counting, are assumed to involve discrete scales. It is also commonly assumed that natural language makes use of (...) both types of scales and subsequently distinguishes between two types of measurements. This paper argues against the latter assumption. It argues that natural language semantics treats all measurements uniformly as mappings from objects (individuals or collections of individuals) to dense scales, hence the Universal Density of Measurement (UDM). If the arguments are successful, there are a variety of consequences for semantics and pragmatics, and more generally for the place of the linguistic system within an overall architecture of cognition. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

Alva Noë’s version of the enactive conception in _Action in Perception_ is an important contribution to the study of visual perception. First, I argue, however, that it is unclear (at best) whether, as the enactivists claim, work on change blindness supports the denial of the existence of detailed visual representations. Second, I elaborate on what Noë calls the ‘puzzle of perceptual presence’. Thirdly, I question the enactivist account of perceptual constancy. Finally, I draw attention to the tensions between enactivism and (...) two trends in cognitive neuroscience: the two-visual systems model of human vision and the theory of internal forward models of action. (shrink)

Moral uncertainty and disagreement pervade our lives. Yet we still need to make decisions and act, both individually and politically. So, what should we do? Moral uncertainty theorists provide a theory of what individuals should do when they are uncertain about morality. Public reason liberals provide a theory of how societies should deal with reasonable disagreements about morality. They defend the public justification principle: state action is permissible only if it can be justified to all reasonable people. In this article, (...) we bring these two approaches together. Specifically, we investigate whether considerations of moral uncertainty support public reason liberalism: given moral uncertainty, should we favor public justification? We argue that while moral uncertainty theory cannot vindicate an exceptionless public justification principle, it supports adopting public justification as a pro tanto principle – albeit one that can be overridden when the moral stakes are high. It also provides new answers to some intramural debates among public reason liberals and new responses to some common objections. (shrink)

Despite a staggering body of research demonstrating sex differences in expressed emotion, very few theoretical models (evolutionary or non-evolutionary) offer a critical examination of the adaptive nature of such differences. From the perspective of a socio-relational framework, emotive behaviors evolved to promote the attraction and aversion of different types of relationships by advertising the two most parsimonious properties ofreciprocity potential, or perceived attractiveness as a prospective social partner. These are the individual's (a)perceived capacityor ability to provide expedient resources, or to (...) inflict immediate harm onto others, and their (b)perceived trustworthinessor probability of actually reciprocating altruism (Vigil 2007). Depending on the unique social demands and relational constraints that each sex evolved, individuals should be sensitive to advertise “capacity” and “trustworthiness” cues through selective displays of dominant versus submissive and masculine versus feminine emotive behaviors, respectively. In this article, I introduce the basic theoretical assumptions and hypotheses of the framework, and show how the models provide a solid scaffold with which to begin to interpret common sex differences in the emotional development literature. I conclude by describing how the framework can be used to predict condition-based and situation-based variation in affect and other forms of expressive behaviors. (shrink)

Although early-stage finance is critical to the growth of most ventures, it is even more important for social ventures as they face the challenges of balancing their social and commercial objectives. Drawing on institutional logics and signaling theory, this study uses a panel data set of 3,401 nascent social ventures to investigate the important role philanthropic grant funding plays in the organizational and financial development of social ventures. We find mixed results, with positive effects on employment and subsequent access to (...) debt finance, but no effects on revenues and access to equity. Our findings connect these theories by suggesting philanthropic grants provide social ventures with flexibility to invest in human capital without pushing them to pursue short-term financial objectives, and that receiving a philanthropic grant provides a signal that is interpreted differently by debt and equity financiers. These findings are especially relevant as funders increasingly use grants to support social entrepreneurship. (shrink)

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)

In his classic “Freedom and Resentment,” P. F. Strawson introduces us to an optimist who believes that our moral responsibility practices are justified by their beneficial consequences. Although many see Strawson as a staunch critic of this consequentialist position, his stated view is only that there is a gap in the optimist’s story where the reactive attitudes should be. In this paper, I fill in the gap. I show how optimism can be suitably modified to reflect an appreciation of the (...) reactive attitudes. And I argue that the ensuing position—on which our moral responsibility practices, taken as a whole, are justified both by their regulation of behavior and by their enabling of interpersonal relationships—provides us not only with a plausible justification of our moral responsibility practices, but also with a fruitful framework for evaluating potential reforms. (shrink)

Populists are often cast as deniers of rationality, creators of a climate of “post-truth,” and valuing tribe over truth and the rigors of science. Their critics claim the authority of rationality and empirical facts. Yet the critics no less than populists enable an environment of spurious claims and defective argumentation. This is especially true in the realm of science. An important case study is the account of scientific trust offered by a leading public intellectual and historian of science, Naomi Oreskes, (...) and the misapplication of that theory during the coronavirus pandemic. (shrink)

Philosophers of biology generally agree that causal specificity tracks biological importance: more specific causes are more important. I argue that this correlation does not hold in much research aimed at biomedical intervention. Applying James Woodward’s analysis of causal specificity to the development and design of HIV treatments, I show that drugs that are less causally specific produce better therapeutic outcomes and are more highly valued. Thus, I conclude that the importance of biological causes does not track their specificity but instead (...) varies depending on the biological practice we consider and the goals of that practice. (shrink)

According to the Maximin principle of distributive justice, one outcome is more just than another if the worst off individual in the first outcome is better off than the worst off individual in the second. This is often interpreted as a highly egalitarian principle, and, more specifically, as a highly egalitarian way of balancing a concern with equality against a concern with efficiency. But this interpretation faces a challenge: why should a concern with efficiency and equality lead us to a (...) concern only for the very worst off? Egalitarian proponents of Maximin tend to meet this challenge by showing that it possible to formally derive Maximin from surprisingly weak conditions relating efficiency and equality to justice. But in this paper, I argue that this reply fails. The issue is not that the proofs are invalid, but instead that every existing proof of Maximin transforms into an impossibility result as soon as we realize that any reasonable conception of equality must satisfy a certain formal property. The upshot is that even if it is possible to defend Maximin on other grounds, there is no known way to defend it on the grounds that it balances a concern with equality against a concern for efficiency. Further, more general implications of this result for egalitarian theories of distributive justice are also explored. (shrink)

This essay evaluates the moral logic of ‘liberal eugenics’: the ideal of genetic control which leaves decisions about what sort of people to produce in the hands of individual parents, absent government intervention. I argue that liberal eugenics cannot be justified on the basis of the underlying liberal theory which inspires it. I introduce an alternative to Rawls's social primary goods that might be called natural primary goods: hereditable mental and physical capacities and dispositions that are valued across a range (...) of projects and pursuits. I suggest that reproductive genetic biotechnologies like embryo selection, cellular surgery, and genetic engineering, which aim to enhance ‘general purpose’ traits in offspring are less like childrearing practices a liberal government leaves to the discretion of parents than like practices the state makes compulsory. I argue that if the liberal commitment to autonomy is important enough for the state to mandate childrearing practices such as health care and basic education, that very same interest is important enough for the state to mandate safe, effective, and functionally integrated genetic practices that act on analogous all‐purpose traits such as resistance to disease and general cognitive functioning. I conclude that the liberal case for compulsory eugenics is a reductio against liberal theory. (shrink)

On the dominant interpretation, Schopenhauer possesses a will to will view of boredom: boredom consists in the dissatisfaction of a second-order desire to pursue objects of first-order desire. I ch...

Gottfried Wilhelm Leibniz was one of the first Modern philosophers, and as such, one of the most significant. His contributions were often pathbreaking and his imprint still remains on fields such as logic, mathematics, science, international law, and ethics. While publishing relatively little during his life, he was in regular correspondence with important philosophers and even political leaders.

One of the great Jewish intellectuals of the twentieth century, Taubes published only this one book during his life, and here the English translation finally becomes available.

If Kant’s theory of justice is known for one thing, it is for offering a vision of a perfectly just society that is utterly disconnected from the imperfect societies that we occupy. The purity of Kant’s account has attracted criticism from those who claim that if a theory of justice is to be practical, it must offer more than a vision of a perfectly just society. It must also explain how existing societies mired in injustice are to be brought into (...) ever-closer conformity with the ideal that justice prescribes. In this essay, I will argue that this is exactly what Kant’s mature legal and political theory offers. To discern this feature of Kant’s theory, a neglected component must be integrated into his broader framework. This component is what Kant refers to in Toward Perpetual Peace as a permissive law of public right. (shrink)

Peter singer and tom regan claim that the only characteristic humans possess universally and which is relevant to the question of assigning moral rights is the capacity to enjoy and suffer. Since animals also have this capacity, There is no justification for denying that they also have rights. I try to show, By a critical examination of their views, That it makes no sense to ascribe rights to animals because rights exist only within the context of our moral community, And (...) animals lack certain crucial capacities required for membership therein. Animals' capacity to enjoy and suffer, I conclude, Provides a ground for humans' obligation to treat them humanely; but this is an obligation without a correlated right. (shrink)

Professors Hildt (2023), Shepherd (2023), and Zilio and Lavazza (2023) jointly considered the ethical and philosophical implications of acknowledging non-human (e.g., machine) consciousness. Althou...

Barbara McClintock (1902–1992), the renowned American maize geneticist, received the 1983 Nobel Prize “for her discovery of mobile genetic elements,” becoming the seventh woman scientist to receive a Nobel Prize. However, Nathaniel Comfort points out that McClintock viewed her primary contribution as the elucidation of control systems, rather than the discovery of mobile elements. McClintock’s interest in control systems dates back to the 1940s, and this paper investigates her 1961 conversation with François Jacob and Jacques Monod, where she sought (...) to shape the interpretation of her work by drawing parallels between maize control systems and a bacterial system they had recently discovered. Despite McClintock’s efforts, Jacob and Monod rejected her parallels and suggested that her contribution was limited to mobile elements. Through an examination of their published papers, I argue that Jacob and Monod’s rejection stemmed from their failure to fully comprehend maize control systems. Disciplinary discrepancy helps explain Jacob and Monod’s lack of comprehension: they were molecular geneticists working on bacteria, while McClintock was a classical geneticist studying maize. I further argue that gender played a role, as McClintock experienced the Matilda effect—the under-recognition of her contribution, reinforced by the reactions of two male geneticists, and ironically, by the award of the Nobel Prize. Control systems, stemming from McClintock’s reverence for organisms, embodied what Evelyn Fox Keller defines as “gender-neutral science.” This divergent view of science provides insight into why Jacob and Monod failed to grasp McClintock’s work in 1961. (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)

Embodied simulation and the epistemic motivation to search for the of other people's behaviors are not necessary for specific and functional responding to, and hence processing of, human facial expressions. Rather, facial expression processing can be achieved through lower-cognitive, heuristical perceptual processing and expression of prototypical morphological musculature movement patterns that communicate discrete trustworthiness and capacity cues to conspecifics.

In legal orders around the world, commitments to democracy, liberalism and constitutionalism are increasingly eroding. Although political and constitutional theorists often lament this trend, they invariably adopt frameworks that are indifferent to these commitments. My aims in this article are both critical and constructive. As a critical matter, I will expose the indifference of the leading political and constitutional theories to the emergence, maintenance and refinement of liberal democratic constitutional orders. As a constructive matter, I will draw on Immanuel Kant’s (...) constitutional theory to explain why realizing such a form of governance is a public duty and why receding from it is a public wrong. (shrink)

From 1687, the year when Newton published his Principia, to the Crystal Palace Exhibition of 1851, science gradually became central to Western thought and economic development. The book examines how, despite powerful opposition on the Continent, a Newtonian understanding gained acceptance and practical application.

A sample of 460 low-income women completed a mate preference questionnaire and surveys that assessed family background, life history, conscientiousness, sexual motives, self-ratings (e.g., looks), and current circumstances (e.g., income). A cluster analysis revealed two groups of women: women who reported a strong preference for looks and money in a short-term mate and commitment in a long-term mate, and women who reported smaller differences across mating context. Group differences were found in reported educational levels, family background, sexual development, number of (...) children, and motives for having sex. Implications for understanding individual differences in women’s mate-preference trade-offs are discussed. (shrink)

I try to reconcile Dretske's representational theory of conscious mental states with Rosenthal's higher-order thought (HOT) theory of conscious mental states by arguing that Rosenthal's HOT can make room for the notion of a state of consciousness whereby an invidual may be conscious of an object or property without thereby being conscious of being in such a state.