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)

The author introduces and critically analyzes two recent, curious findings and their accompanying explanations regarding how the folk intuits the capabilities of the dead and those in a persistent vegetative state. The dead are intuited to survive death, whereas PVS patients are intuited as more dead than the dead. Current explanations of these curious findings rely on how the folk is said to conceive of death and the dead: either as the annihilation of the person, or that person’s continuation as (...) a disembodied being. The author argues that these two conceptions are incompatible and inconsistent with each other and the evidence. Contrariwise, the author argues that the folk intuition about dead-survivors and the living dead are more easily explained by appealing to cross-culturally established concepts: the folk biological concept of death the existential concept of death, and the concept of social death. (shrink)

I argue that comparisons of Stoic virtue to stochastic skills — now standard in the secondary literature on Stoicism — are based on a misreading of the sources and distort the Stoic position in two respects. In paradigmatic stochastic skills such as archery, medicine, or navigation the value of the skill’s external end justifies the existence and practice of the skill and constitutes an appropriate focus of rational motivation. Neither claim applies to virtue as the Stoics understand it. The stochastic (...) model of virtue almost certainly originated with Carneades and should be distinguished clearly from the Stoic account. Doing so clarifies the Stoic position and shows that it anticipates what Thomas Hurka calls a modern view of value. (shrink)

This volume is a study of the relationship between philosophy and faith in Søren Kierkegaard's Philosophical Fragments. It is also the first book to examine the role of Socrates in this body of writings, illuminating the significance of Socrates for Kierkegaard's thought. Jacob Howland argues that in the Fragments, philosophy and faith are closely related passions. A careful examination of the role of Socrates demonstrates that Socratic, philosophical eros opens up a path to faith. At the same time, the (...) work of faith - which holds the self together with that which transcends it - is essentially erotic in the Socratic sense of the term. Chapters on Kierkegaard's Johannes Climacus and on Plato's Apology shed light on the Socratic character of the pseudonymous author of the Fragments and the role of 'the god' in Socrates' pursuit of wisdom. Howland also analyzes the Concluding Unscientific Postscript and Kierkegaard's reflections on Socrates and Christ. (shrink)

Various claims have been made, recently, that Darwin's argumentation in the Origin instantiates and so supports some general philosophical proposal about scientific theorizing, for example, the "semantic view". But these claims are grounded in various incorrect analyses of that argumentation. A summary is given here of an analysis defended at greater length in several papers by the present author. The historical and philosophical advantages of this analysis are explained briefly. Darwin's argument comprises three distinct evidential cases on behalf of natural (...) selection, cases, that is, for its existence, its adequacy and its responsibility. Theorizing, today, about evolution by natural selection involves a similar structure of evidential and explanatory concerns. (shrink)

The naturalist and geologist Charles Darwin ranks as one of the most influential scientific thinkers of all time. In the nineteenth century his ideas about the history and diversity of life - including the evolutionary origin of humankind - contributed to major changes in the sciences, philosophy, social thought and religious belief. This volume provides the reader with clear, lively and balanced introductions to the most recent scholarship on Darwin and his intellectual legacies. A distinguished team of contributors examines Darwin's (...) main scientific ideas and their development; Darwin's science in the context of its times; the influence of Darwinian thought in recent philosophical, social and religious debate; and the importance of Darwinian thought for the future of naturalist philosophy. New readers will find this a most convenient and accessible guide to Darwin. Advanced students and specialists will find a conspectus of recent developments in the interpretation of Darwin. (shrink)

Those standard historiographic themes of "evolution" and "revolution" need replacing. They perpetuate mid-Victorian scientists' history of science. Historians' history of science does well to take in the long run from the Greek and Hebrew heritages on, and to work at avoiding misleading anachronism and teleology. As an alternative to the usual "evo-revo" themes, a historiography of origins and species, of cosmologies and ontologies, is developed here. The advantages of such a historiography are illustrated by looking briefly at a number of (...) transitions: the transition from Greek and Hebrew doctrines to their integrations by medieval authors; the transition from the Platonist, Aristotelian, Christian Aquinas to the Newtonian Buffon and to the no less Newtonian Lamarck; the departures the early Darwin made away from Lamarck's and from Lyell's views. Issues concerning historical thinking about nature, concerning essentialism and concerning classification are addressed in an attempt to challenge customary stereotypes. Questions about originality and influence are raised, especially concerning Darwin's "tree of life" scheme. The broader historiography of Darwinian science as a social ideology, and as a "worldview," is examined and the scope for revisions emphasised. Throughout, graduate students are encouraged to see this topic area not as worked out, but as full of opportunities for fresh contributions. (shrink)

On April 16, 2007, Cho Seung-Hui used two semiautomatic handguns to kill 32 persons and then himself at Virginia Tech University in the largest campus shooting in U.S. history. Mr. Cho purchased his handguns from a pawnshop and a gun store in Virginia, where under state law a background check was conducted to determine whether he had any disqualifying criminal or mental health history. The paperwork for the background check was completed at the gun store, and the check itself was (...) conducted through an “instant” system facilitated by a toll-free telephone number. The entire transaction took approximately 20 minutes. At no point was Mr. Cho asked why he wished to purchase the guns. And although he had been deemed a potential danger to himself by a state magistrate in 2005 – which should have disqualified his purchase of a gun under federal law – this information never reached those conducting the background check. (shrink)

The author argues for three interconnected theses which provide a cognitive account for why humans intuitively believe that others survive death. The first thesis, from which the second and third theses follow, is that the acceptance of afterlife beliefs is predisposed by a specific, and already well-documented, imaginative process - the offline social reasoning process. The second thesis is that afterlife beliefs are social in nature. The third thesis is that the living imagine the deceased as socially embodied in such (...) a way as to continue to fulfill on-going social obligations with others. The author further suggests six reasons why the fantasy/reality distinction breaks down for the imaginer such that the continued existence of the decedent in the afterlife is believed to be real. Finally, the author suggests avenues for further research which would support this cognitive account. (shrink)

In engaging five of Plato's dialogues—Theaetetus, Euthyphro, Cratylus, Sophist, and Statesman—and by paying particular attention to Socrates' intellectual defense in the "philosophic trial" by the Stranger from Elea, Jacob Howland illuminates Plato's understanding of the proper relationship between philosophy and politics. This insightful and innovative study illustrates the Plato's understanding of the difference between sophistry and philosophy, and it identifies the innate contradictions of political philosophy that Plato observed and remain entrenched within the field to this day. This is (...) essential reading for anyone interested in the past, present, and future of political philosophy. (shrink)

ABSTRACTPrevious research has found that individuals vary greatly in emotion differentiation, that is, the extent to which they distinguish between different emotions when reporting on their own fe...

In referendum elections, voters are often required to register simultaneous votes on multiple proposals. The separability problem occurs when a voter’s preferred outcome on one proposal depends on the outcomes of other proposals. This type of interdependence can lead to unsatisfactory or even paradoxical election outcomes, such as a winning outcome that is the last choice of every voter. Here we propose an iterative voting scheme that allows voters to revise their voting strategies based on the outcomes of previous iterations. (...) Using a robust computer simulation, we investigate the potential of this approach to solve the separability problem. (shrink)

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)

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)

Several hypotheses on the form and function of sex differences in social behaviors were tested. The results suggest that friendship preferences in both sexes can be understood in terms of perceived reciprocity potential—capacity and willingness to engage in a mutually beneficial relationship. Divergent social styles may in turn reflect trade-offs between behaviors selected to maintain large, functional coalitions in men and intimate, secure relationships in women. The findings are interpreted from a broad socio-relational framework of the types of behaviors that (...) facilitate selective advertisement and investment of reciprocity potential across individuals and within groups of men and women. (shrink)

Historians of science have long been agreeing: what many textbooks of evolutionary biology say, about the histories of Darwinism and the New Synthesis, is just too simple to do justice to the complexities revealed to critical scholarship and historiography. There is no current consensus, however, on what grand narratives should replace those textbook histories. The present paper does not offer to contribute directly to any grand, consensual, narrational goals; but it does seek to do so indirectly by showing how, in (...) just one individual case, details of intellectual biography connect with big picture issues. To this end, I examine here how very diverse scientific and metaphysical commitments were integrated in Sewall Wright’s own personal synthesis of biology and philosophy. Taking as the decisive text the short final section of Wright’s long 1931 paper on ‘Evolution in Mendelian populations,’ I examine how his shifting balance theory related to his optimum breeding strategy research, his physiological genetics, his general theory of homogenising and heterogenesing causation and his panpsychist view of mind and matter; and I discuss how understanding these relations can clarify Wright’s place in the longue durée of evolutionary thought. (shrink)

There is perhaps no duty more fundamental to American government than the protection of the public's health, safety, and welfare. On September 11, 2001, this governmental duty was severely tested through a series of terrorist acts. The destruction of the World Trade Towers in New York City and a portion of the Pentagon in Washington, D.C., presented many Americans with a new, visible reality of the potential harms that terrorists can cause. The staggering loss of lives damaged the national psyche (...) in ways far exceeding the physical scars to American institutions.As horrific as the images of destruction and loss of human lives may be, events that unfolded after September 11 revealed another dreaded, and potentially more catastrophic, threat to Americans sense of security and public health: bioterrorism. Unlike terrorists that use bombs, explosives, or other tools for mass destruction, a bioterrorist's weapon is an infectious agent. (shrink)

The essential nature of science is revealed in an amplification of the relation between the arts and science.

In September 2010 at the Johns Hopkins Hospital, one of the nation's elite academic hospitals located in East Baltimore, Maryland, Paul Warren Pardus entered the facility to visit his mother, a patient. During a discussion with her doctor in a hospital hallway, Pardus became “overwhelmed” about the care and condition of his mother, pulled a handgun from his waistband, and shot the doctor in the chest. Pardus then locked himself and his mother in her room, shot and killed her, and (...) committed suicide.Dr. Gabe Kelen, a national expert on emergency preparedness and director of the Johns Hopkins emergency department, admitted several years later that this tragic event “really got us thinking in a very serious way.” Together with colleagues at the Johns Hopkins Office of Critical Event Preparedness and Response, Kelen conducted research on the threat and impact of “active shooters” in health care settings. (shrink)

The Kohl government sought a policy on the Balkan crisis that would both appeal to the self-conscious pacifist-internationalist strain in German public opinion and avoid direct German and European responsibility for the largely unknown consequences of that policy.

This book is Stanley Cavell’s definitive expression on Emerson. Over the past thirty years, Cavell has demonstrated that he is the most emphatic and provocative philosophical critic of Emerson that America has yet known. The sustained effort of that labor is drawn together here for the first time into a single volume, which also contains two previously unpublished essays and an introduction by Cavell that reflects on this book and the history of its emergence. Students and scholars working in philosophy, (...) literature, American studies, history, film studies, and political theory can now more easily access Cavell’s luminous and enduring work on Emerson. Such engagement should be further complemented by extensive indices and annotations. If we are still in doubt whether America has expressed itself philosophically, there is perhaps no better space for inquiry than reading Cavell reading Emerson. (shrink)

Government’s responsibility to safeguard the public’s health through law has been part of the social contract since ancient times. Cicero declared salus populi suprema lex esto - “the safety of the people is the supreme law”. Disraeli proclaimed that protecting the public’s health is the first duty of the statesman. Of the ten most important public health achievements of the 20th century in the US., seven are directly related to legal interventions, including legislative interventions. As new and existing risks to (...) health risks emerge internationally, governments have consistently used the law as a tool to define the goals of public health, direct public health authorities to accomplish these goals, and equip them with the power and resources to do so.Tobacco control represents a salient example of how law can be used to ensure health. Like other public health laws, tobacco control laws have historic grounds. Government and other policymakers have enacted laws to control tobacco use for hundreds of years. The Russian church forbade tobacco use as an “abomination.”. (shrink)

Rarely in the short history of liberal-democratic government has a primer on basic liberal-democratic values and institutions been more needed than now. Popular discontent, even anger, with democratic governments has grown steadily over the past twenty years. And not since the 1930s have citizens and their elected officials been so baffled about their respective roles in the maintenance of both democratic governments and liberal economies. This book attempts to address this growing need. Especially written as a primer for courses in (...) Philosophy, Politics and Economics (PPE), it has introductory chapters on all three main disciplines. It also has chapters on the rule of law and on three important public-policy areas: Corruption, Climate, and Civil Society. Individual topics discussed include free and fair elections, populism, responsible government, republican and Westminster systems of government, regulated free markets, the Great Recession of 2008, globalization, greenwashing, identity politics, academic freedom, utilitarianism, social contract theory, positive and negative liberty, and the good life. Historically informed, The Ethics and Economics of Liberal Democracies: Foundations for PPE is sure to be of interest to students who are interested in public-policy work, as well as those who are interested in both the theory and practice of democratic government. (shrink)

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)

In his ‘On a Supposed Right to Lie from Philanthropy’ Kant makes the astonishing claim that one is not entitled to lie even to save a friend from a murderer. This claim has been an embarrassment for Kant's defenders and an indication of Kant's excessive rigour for his detractors. Responses to SRL fall into three main groups. The first of these groups, that of Kant's critics, claim that SRL demonstrates that Kant's ethical views are so rigorous that they become abhorrent (...) in practice. The second group, Kant's defenders, argues that Kant's conclusions in SRL do not follow from his own ethical principles. The third group, made up of scholars who are generally sympathetic to Kant's position, attempts to explain why a liar is responsible for all the bad consequences that follow from his act by providing an account of Kant's theory of imputation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics and Time:Lévinas Between Kant and HusserlJoanna Hodge (bio)This article stems from the conviction that the source of the bloody barbarism of National Socialism lies not in some contingent anomaly within human reasoning, nor in some accidental ideological misunderstanding. This article expresses the conviction that this source stems from the essential possibility of elemental evil into which we can be led by logic and against which Western philosophy (...) had not sufficiently insured itself. This possibility is inscribed within the ontology of a being concerned with being—a being, to use the Heideggerian expression, "which in its own being is concerned with that being." Such a possibility still threatens the subject correlative with being as gathering together and as dominating, that famous subject of transcendental idealism that before all else wishes to be free and thinks itself free. We must ask ourselves if liberalism is all we need to achieve the authentic dignity for the human subject. Does the subject ever arrive at the human condition prior to assuming responsibility for the other in the act of election that raises him up to this height? This election comes from a god—or God—who beholds him in the face of the other, the neighbour, the original "site" of the Revelation.—Emmanuel Lévinas, 28 March 1990, introduction to "Reflections on the Philosophy of Hitlerism" (1934)1IntroductionThe intent of this essay is to establish the relevance of various divergent workings of time for an understanding of the difficulties distinctive of moral dilemmas and ethical doubt. It will introduce the thinking of Lévinas (1905-96) to bring into focus the differences entailed in addressing ethical contexts from various perspectives of time, whether in terms of past experience, present contingencies, or considerations of the future. It turns out to be necessary to distinguish between various conceptions of the future as well, in order to grasp the different construals of constraints on moral deliberation. A contrast may be drawn between the individualism and the collectivism, [End Page 107] respectively, of Nietzsche's and Heidegger's visions of the future;1 and between the religious determinacies of Lévinas's invocation of futurity and Derrida's more ascetic, formally indicative recasting of Lévinas's à-dieu.2 It is also the case that distinct conceptions of the past impose significant constraints on what human beings can hope to achieve in their moral efficacy. There is an important difference between the Greco-pagan past, invoked by Nietzsche and Heidegger, and the divine time of creation invoked in the opening pages of Genesis, which is the source of Lévinas's notion of an immemorial time, and which is subjected to deconstructive reading by Jacques Derrida in "The Animal Which Therefore I Am, to Be Continued" [see Derrida, "L'animal autobiographique"].I shall introduce a reading of the second part of Kant's treatise The Conflict of the Faculties (1798) [139-71], on the contest between philosophy and law, to suggest that for ethics, by contrast to concerns with aesthetics, metaphysics, and epistemology, a consideration of conceptions of futurity is especially pressing. This provides a context for responding to Lévinas's early article "Reflections on the Philosophy of Hitlerism" (1934), to which Lévinas wrote an introduction, including my opening citation, some sixty years later.3 Lévinas is not simply engaging with the problem of evil, in relation to the now well-known moral deficiencies of Heidegger's fundamental ontology.4 He is also warning, more generally, against delusions arising from theoretical abstraction, in both absolute idealism and, indeed, in a Nietzschean ethics. His own writings, from Time and the Other (1947) on, suggest that the deficiency arises from oversimplifications [End Page 108] in the thinking of time. Taking this as a clue, the main tasks of this essay are to show that the broadly historical notion of time, which appears oriented toward the past, requires a complementary reflection on futurity, if the ethical significance of different ways of relating to the past is to emerge; and, in relation to that futurity, to show that the broadly teleological, future-directed notions of self-formation, deliberation, and genesis require supplementation... (shrink)

What are the Differences between Public Health Practice and Research? This perplexing question constantly arises in the planning and performance of public health activities involving the acquisition and use of identifiable health information. Public health agencies collect and analyze significant identifiable health data from health care providers, insurers, other agencies, or individuals to perform an array of public health activities. These activities include surveillance, epidemiological investigations, and evaluation and monitoring. Few debate that these essential public health activities, often specifically authorized (...) by law, are classifiable as public health practice.Other public health activities in which identifiable health data are acquired or used, however, can resemble, include, or constitute human subjects research. “Human subjects research” is legally defined as “a systematic investigation, including research development, testing, and evaluation, designed to develop or contribute to generalizable knowledge” that involves living human subjects. (shrink)

Protecting the privacy of individually-identifiable health data and promoting the public’s health often seem at odds. Privacy advocates consistently seek to limit the acquisition, use, and disclosure of identifiable health information in governmental and private sector settings. Their concerns relate to misuses or wrongful disclosures of sensitive health data that can lead to discrimination and stigmatization against individuals. Public health practitioners, on the other hand, seek regular, ongoing access to and use of identifiable health information to accomplish important public health (...) objectives. The collection and use of identifiable health data by federal, tribal, state, and local health authorities support nearly all public health functions and goals.Identifiable health data are the lifeblood of public health practice. When aggregated, these data help authorities monitor the incidence, patterns, and trends of injury and disease in populations. Health data are acquired by public health authorities through testing, screening, and treatment programs. (shrink)

Este trabajo se propone recuperar las tesis antropológicas centrales del De natura hominis de Nemesio de Emesa, autor cristiano del siglo V. La perspectiva desde la cual se aborda dicha obra es la filosofía moral, como ha sugerido Telfer. Siguiendo dicha horma, el autor busca poner de realce cómo las características centrales del ser humano que plantea Nemesio se relacionan con las virtudes morales.

Scientists, more than ever before, are interested in the logic of science, which has been stimulated by various interrelated circumstances including the development of the postulation method in mathematics, the unprecedented expansion of modern technology, and recent advances in the biological, psychological, and anthropological sciences that have created a demand for more effective theory and system construction. In this book, an attempt is made to free the logic of science from the historical epistemologies and ontologies. The elimination of spiritistic entities (...) enables the logician to study the evolution of scientific constructs from the actual behavior of persons with objects and events. The naturalistic study of scientific work and its systemic products is based upon Interbehavioral Psychology, which demands that the scientist be studied in his various contacts with objects and processes, both in the field and laboratory. (shrink)

Although there has been consistent interest in Marx and Marxism there has been little sustained interest in the origins of Marx’s ethical thought and his relation to the German philosophical tradition as a whole. Work has been done linking Marx to Fichte, and a great deal more linking him to Hegel. However, the fundamental concept joining them all is recognition, or interpersonal relations in general. In this regard, none of the German thinkers can be understood withoutfirst grasping their understanding of (...) the human person as one among many. This article begins this process for Marx. Although some literature has been devotedto the explication of Marx’s notion of species-being it is sparse and dated. In this article I proceed to reiterate how important species-being is as the foundationto Marx’s ethical philosophy. However, my main focus is on simply how to understand the concept itself. I, therefore, devote the majority of the article to ananalysis of Marx’s use of the concept in his early work as well as his critique of Ludwig Feuerbach’s use of it. This account provides the basis for understandingMarx’s concept of human essence and is the beginning of a project of rephrasing Marxian ethics around the concept of recognition thus reconnecting him to theGerman philosophical tradition. (shrink)