Volume 25, Issue 2, February 2025, Page 157-159.

Long term care (LTC) facilities are fraught with unique ethical challenges. Unlike in the acute care setting, where patients are admitted for a temporary period and then discharged to the next leve...

Volume 20, Issue 7, July 2020, Page 193-195.

In recent years, US policy makers have faced persistent calls for the price of flood and hurricane insurance cover to reflect the true or real risk. The appeal to a true or real measure of risk is rooted in two assumptions. First, scientific research can provide an accurate measure of risk. Second, this information can and should dictate decision-making about the cost of insurance. As a result, contemporary disputes over the cost of catastrophe insurance coverage, hurricane risk being a prime (...) example, become technical battles over estimating risk. Using examples from the Florida hurricane rate-making decision context, we provide a quantitative investigation of the integrity of these two assumptions. We argue that catastrophe models are politically stylized views of the intractable scientific problem of precise characterization of hurricane risk. Faced with many conflicting scientific theories, model theorists use choice and preference for outcomes to develop a model. Models therefore come to include political positions on relevant knowledge and the risk that society ought to manage. Earnest consideration of model capabilities and inherent uncertainties may help evolve public debate from one focused on “true” or “real” measures of risk, of which there are many, toward one of improved understanding and management of insurance regimes. (shrink)

Achieving valid informed consent from a human research participant involves an ongoing process designed to protect the participant and ensure their rights, safety, and well-being are not compromise...

Volume 20, Issue 4, May 2020, Page 108-110.

Smartphone use changes the landscape of social interactions, including introducing new social dilemmas to daily life. The challenge of putting down one's smartphone is an example of a classic coordination problem from game theory: the stag hunt game. In a stag hunt game, there are two possible coordination points, one that involves big payoffs for both partners (e.g., working together to hunt large game like stag) and one that involves smaller payoffs for both partners (e.g., individually hunting small game like (...) rabbits) but is safer because it does not require that your partner choose that option as well. This is similar to the challenges of putting down smartphones to have a face‐to‐face interaction: you and your interaction partner might both prefer the higher payoff option of having a face‐to‐face interaction, but neither of you wants to put down your phone and risk not having anything to do in the meantime. It is also discussed how new technological innovations are changing the payoffs of face‐to‐face conversation versus side‐by‐side smartphone scrolling. Insights that come from applying game theory to this “social media dilemma” are discussed here and potential solutions that come out of a game theoretic analysis are offered. Also see the video abstract here https://youtu.be/9esL578zM‐E. (shrink)

This volume is a tribute to Roger Schwarzschild's immense contributions in the formal semantics of nouns, focus, degrees and space, and tense and aspect. Collectively, the papers in the volume reveal parallels across ontological domains, in particular in the context of elements with internal structure, like plural sets, alternative sets, degree intervals, temporal intervals, and vectors. This research suggests that the structure of an entity could inform the semantic behavior of that entity just as much than its semantic type or (...) lexical category. And because these structures dictate the formation of semantic alternatives, it can help inform focus semantics and scalar implicature as well. Old questions on plurals, focus and degree expressions get new answers in this collection of papers in honor of Roger Schwarzchild. Roger Schwarzschild is one of the leading scholars in semantics, and the editors have been highly successful in requesting contributions by his teachers, peers and former students. Some papers have circulated in draft form for many years, and find their final home in this edited volume, which well reflects the state of the art in the field. Prof. dr. Henriëtte de Swart, Utrecht University, The Netherlands. (shrink)

In this preface, we introduce Roger Schwarzschild’s body of work, as well as the papers in this volume. Because Roger’s work is so diverse and comprehensive, the book is divided into four categories: papers that address the semantics of nouns and plurals; papers on focus semantics; papers on degree semantics; and papers addressing the semantics of tense and aspect. We end with compelling arguments that Roger is the best.

The number of children with chronic critical illness (CCI) is a growing population in the United States. A defining characteristic of this population is a prolonged hospital stay. Our study assessed the proportion of pediatric patients with chronic critical illness in U.S. hospitals at a specific point in time, and identified a subset of children whose hospital stay lasted for months to years. The potential harms of a prolonged hospitalization for children with CCI, which include over treatment, infection, disruption of (...) family life, and the intensive utilization of resources—combined with the moral distress experienced by the clinicians who care for the children, suggest the need for ethical analysis of this growing issue to identify actions that could be taken at the clinical and health systems levels to reduce the harms associated with prolonged hospital stay.In this article we present three real cases from our study that involved a very long hospital stay. We applied a framework developed by Mackenzie, Rogers, and Dodds to analyze inherent, situational, and pathogenic vulnerabilities to examine the ways that interventions intended to remedy one source of harm for the children in our cohort inadvertently created other harms. We examined the complex ways that children with protracted hospitalization are vulnerable to the choices made by their family and clinicians, as well as by healthcare systems and communities. Finally, we used this analysis to summarize actions and ethical responses to this growing patient population. Such an understanding is essential to making clinical and ethical decisions that arise for children who are at risk for a very long stay in the hospital. (shrink)

Bringing together 20 foundational texts in contemporary modernist criticism in one accessible volume, this book explores the debates that have transformed the field of modernist studies at the turn of the millennium and into the 21st century. The New Modernist Studies Reader features chapters covering the major topics central to the study of modernism today, including: Feminism, gender and sexuality; Empire and race; Print and media cultures; Historical and geographical debates. Each text includes an introductory summary of its historical and (...) intellectual contexts, as well as guides to further reading to help students and teachers explore the ideas further. Includes essential texts by leading critics such as: Pascale Casanova, Anne Anlin Cheng, Brent Hayes Edwards, Rita Felski, Susan Stanford Friedman, Mark Goble, Miriam Hansen, Andreas Huyssen, David James, Fredric Jameson, Heather K. Love, Douglas Mao, Mark S. Morrisson, Michael North, Jessica Pressman, Lawrence Rainey, Paul K. Saint-Amour, Bonnie Kime Scott, Urmila Seshagiri, Robert Spoo, and Rebecca Walkowitz. (shrink)

Self-Interest discusses the reconciliation of inevitable self-concern with its manifest potential for harm. This anthology brings together the efforts of twenty three renown philosophers to address the matter of how to bring about such a reconciliation. The drive for self-preservation, as observed by Aquinas, is the first law of nature. With this self-love, however, comes the threat of "the excessive love of self". Self-Interest brings into discussion the reconciliation of necessary self-concern with its manifest potential for harm. This anthology brings (...) together the work of twenty-three important philosophers to address the question of how to bring about such a reconciliation. Contributors include: Democritus, Plato, Aristotle, Augustine of Hippo, Aquinas,Hobbes, Nicole, Mandeville, Butler, Hutchenson, Hume, Smith, Kant, Bentham, Mill, James, Nietzsche, Dewey, Rand, and Gauthier. (shrink)

Political philosophy was once dominated by discussion of the virtues of character and their importance to the good life and the good society. Contemporary political philosophers, however, following the towering influence of John Rawls, have primarily focused on a single virtue of institutions: justice, while largely avoiding controversial claims about the good life. As a result, political philosophy lacks a unified account of the virtues of institutions and the virtues of character. More importantly, we lack an understanding of the connection (...) between the just society and the good life. This book begins to mend this broken seam, which, on reflection, lies at the heart of our deepest political problems. The book’s central argument is that the virtues of character require institutions, while good institutions enable persons to live together virtuously. Political institutions are a necessary precondition for the moral agency exhibited by the virtues. But good institutions enable virtue to grow, while helping to constrain the excesses of vice. On this view, justice emerges primarily as a virtue of character, not institutions. The just person balances conformity to existing institutional norms with practically wise reforms. Ultimately, this book concludes that the just society and the good life are linked through the common good of virtuous activity within the shared institutions of a political community. (shrink)

This article explores the affective dimension of resilient epistemological systems. Specifically, I argue that responsible epistemic practice requires affective engagement with nondominant experiences. To begin, I outline Kristie Dotson's account of epistemological resilience whereby an epistemological system remains stable despite counterevidence or attempts to alter it. Then, I develop an account of affective numbness. As I argue, affective numbness can promote epistemological resilience in at least two ways. First, it can reinforce harmful stereotypes even after these stereotypes have been rationally (...) demystified. To illustrate, I examine the stereotype of Black criminality as it relates to false confessions. Second, it can encourage “epistemic appropriation”, which I demonstrate by examining the appropriation of “intersectionality” and #MeToo by white culture. Finally, I conclude that resisting harmful resilience requires affective resistance, or efforts that target numbness via different kinds of affective engagement. I consider Kantian “disinterestedness” as a candidate. (shrink)

Americans have always been divided over whether to welcome or to discourage immigration. But virtually all American leaders have rested their views on notions that the United States has unique providential or world-historical significance-as an asylum for the world's oppressed, as a model to the world, or even as the world's leader. Today, it is normatively desirable for the U.S. to view itself not as the world's "city on a hill" but simply as one worthy political society among many others. (...) Whether such a view can be made politically appealing to most Americans, however, remains in doubt. (shrink)

Bioethics is a practically oriented discipline that developed to address pressing ethical issues arising from developments in the life sciences. Given this inherent practical bent, some form of advocacy or activism seems inherent to the nature of bioethics. However, there are potential tensions between being a bioethics activist, and academic ideals. In academic bioethics, scholarship involves reflection, rigour and the embrace of complexity and uncertainty. These values of scholarship seem to be in tension with being an activist, which requires pragmatism, (...) simplicity, certainty and, above all, action. In this paper I explore this apparent dichotomy, using the case example of my own involvement in international efforts to end forced organ harvesting from prisoners of conscience in China. I conclude that these tensions can be managed and that academic bioethics requires a willingness to be activist. (shrink)

A collection of material on Husserl's Logical Investigations, and specifically on Husserl's formal theory of parts, wholes and dependence and its influence in ontology, logic and psychology. Includes translations of classic works by Adolf Reinach and Eugenie Ginsberg, as well as original contributions by Wolfgang Künne, Kevin Mulligan, Gilbert Null, Barry Smith, Peter M. Simons, Roger A. Simons and Dallas Willard. Documents work on Husserl's ontology arising out of early meetings of the Seminar for Austro-German Philosophy.

Human beings naturally care a great deal for themselves--and couldn't survive otherwise. As Aquinas observed, the drive for self-preservation is the first law of nature. Yet in the imperative of self-love, philosophers have also perceived a tacit threat. Plato reminds us that 'the excessive love of self is in reality the source to each man of all offences.' And so the inevitability of self- concern must be balanced with its manifest potential for harm. But how is such a reconciliation possible? (...) This collection brings tohether the efforts of twenty- three great thinkers addressing such themes as the nature of self-interest, its connection to benevolence and morality, and its implications for political theory. The philosophical results are rich and varied. Self-Interest is intended for philosophers, students, and anyone inclined to reflect upon a subject of such enduring importance and perplexity as the love of self. (shrink)

Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and (...) several strategies for achieving these goals using existing “legal hooks” that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR. (shrink)

Surgery is an increasingly common and expensive mode of medical intervention. The ethical dimensions of the surgeon-patient relationship, including respect for personal autonomy and informed consent, are much discussed; but broader equity issues have not received the same attention. This paper extends the understanding of surgical ethics by considering the nature of evidence in surgery and its relationship to a just provision of healthcare for individuals and their populations.

Recent calls for retraction of a large body of Chinese transplant research and of Dr Jiankui He’s gene editing research has led to renewed interest in the question of publication, retraction and use of unethical biomedical research. In Part 1 of this paper, we briefly review the now well-established consequentialist and deontological arguments for and against the use of unethical research. We argue that, while there are potentially compelling justifications for use under some circumstances, these justifications fail when unethical practices (...) are ongoing—as in the case of research involving transplantations in which organs have been procured unethically from executed prisoners. Use of such research displays a lack of respect and concern for the victims and undermines efforts to deter unethical practices. Such use also creates moral taint and renders those who use the research complicit in continuing harm. In Part 2, we distinguish three dimensions of ‘non-use’ of unethical research: non-use of published unethical research, non-publication, and retraction and argue that all three types of non-use should be upheld in the case of Chinese transplant research. Publishers have responsibilities to not publish contemporary unethical biomedical research, and where this has occurred, to retract publications. Failure to retract the papers implicitly condones the research, while uptake of the research through citations rewards researchers and ongoing circulation of the data in the literature facilitates subsequent use by researchers, policymakers and clinicians. (shrink)

Overdiagnosis refers to diagnosis that does not benefit patients because the diagnosed condition is not a harmful disease in those individuals. Overdiagnosis has been identified as a problem in cancer screening, diseases such as chronic kidney disease and diabetes, and a range of mental illnesses including depression and attention deficit hyperactivity disorder. In this paper, we describe overdiagnosis, investigate reasons why it occurs, and propose two different types. Misclassification overdiagnosis arises because the diagnostic threshold for the disease in question has (...) been set at a level where many people without harmful disease are nonetheless diagnosed. We illustrate misclassification overdiagnosis using the example of chronic kidney disease. Misclassification occurs in diseases diagnosed using biomarkers or based on patient reported phenomena. Maldetection overdiagnosis arises because, at the time the diagnosis is made and despite the presence of a 'gold standard' diagnostic test, it is not possible to discriminate between harmful and non-harmful cases of the index disease. We illustrate maldetection overdiagnosis using the example of thyroid cancer. While there is some overlap between misclassification and maldetection overdiagnosis, this conceptual analysis helps to clarify the phenomenon of overdiagnosis and is a necessary first step in developing strategies to address the problem. (shrink)

In this paper I argue that it is morally important for doctors to trust patients. Doctors' trust of patients lays the foundation for medical relationships which support the exercise of patient autonomy, and which lead to an enriched understanding of patients' interests. Despite the moral and practical desirability of trust, distrust may occur for reasons relating to the nature of medicine, and the social and cultural context within which medical care is provided. Whilst it may not be possible to trust (...) at will, the conscious adoption of a trusting stance is both possible and warranted as the burdens of misplaced trust fall more heavily upon patients than doctors. (shrink)

Breast cancer screening aims to help women by early identification and treatment of cancers that might otherwise be life-threatening. However, breast cancer screening also leads to the detection of some cancers that, if left undetected and untreated, would not have damaged the health of the women concerned. At the time of diagnosis, harmless cancers cannot be identified as non-threatening, therefore women are offered invasive breast cancer treatment. This phenomenon of identifying non-harmful cancers is called overdiagnosis. Overdiagnosis is morally problematic as (...) it leads to overall patient harm rather than benefit. Further, breast cancer screening is offered in a context that exaggerates cancer risk and screening benefit, minimises risk of harm and impedes informed choice. These factors combine to create pathogenic vulnerability. That is, breast cancer screening exacerbates rather than reduces women’s vulnerability and undermines women’s agency. This paper provides an original way of conceptualising agency-supporting responses to the harms of breast cancer overdiagnosis through application of the concept of pathogenic vulnerability. (shrink)

Synthetic biology (synbio) involves designing and creating new living systems to serve human ends, using techniques including molecular biology, genomics, and engineering. Existing bioethical analyses of synbio focus largely on balancing benefits against harms, the dual-use dilemma, and metaphysical questions about creating and commercializing synthetic organisms. We argue that these approaches fail to consider key feminist concerns. We ground our normative claims in two case studies, focusing on the public good, who holds and wields power, and synbio research projects’ particularity (...) and context. Attention to feminist concerns is essential for synbio to realize its potential in ethically justifiable ways. (shrink)

In this prcis we focus on phenomena central to the reaction against similarity-based theories that arose in the 1980s and that subsequently motivated the approach to semantic knowledge. Specifically, we consider (1) how concepts differentiate in early development, (2) why some groupings of items seem to form or coherent categories while others do not, (3) why different properties seem central or important to different concepts, (4) why children and adults sometimes attest to beliefs that seem to contradict their direct experience, (...) (5) how concepts reorganize between the ages of 4 and 10, and (6) the relationship between causal knowledge and semantic knowledge. The explanations our theory offers for these phenomena are illustrated with reference to a simple feed-forward connectionist model. The relationships between this simple model, the broader theory, and more general issues in cognitive science are discussed. (shrink)

Rogers takes up each of the manual's topics in turn, providing explanation and commentary, and investigates the role of reasoning in the Ge-luk-pa system of ...

In theTractatus, Wittgenstein advocates two major notational innovations in logic. First, identity is to be expressed by identity of the sign only, not by a sign for identity. Secondly, only one logical operator, called “N” by Wittgenstein, should be employed in the construction of compound formulas. We show that, despite claims to the contrary in the literature, both of these proposals can be realized, severally and jointly, in expressively complete systems of first-order logic. Building on early work of Hintikka’s, we (...) identify three ways in which the first notational convention can be implemented, show that two of these are compatible with the text of theTractatus, and argue on systematic and historical grounds, adducing posthumous work of Ramsey’s, for one of these as Wittgenstein’s envisaged method. With respect to the second Tractarian proposal, we discuss how Wittgenstein distinguished between general and non-general propositions and argue that, claims to the contrary notwithstanding, an expressively adequate N-operator notation is implicit in theTractatuswhen taken in its intellectual environment. We finally introduce a variety of sound and complete tableau calculi for first-order logics formulated in a Wittgensteinian notation. The first of these is based on the contemporary notion of logical truth as truth in all structures. The others take into account the Tractarian notion of logical truth as truth in all structures over one fixed universe of objects. Here the appropriate tableau rules depend on whether this universe is infinite or finite in size, and in the latter case on its exact finite cardinality.As it is obviously easy to express how propositions can be constructed by means of this operation and how propositions are not to be constructed by means of it, this must be capable of exact expression.5.503. (shrink)

Digital hyperconnectivity is a defining fact of our time. In addition to recasting social interaction, culture, economics, and politics, it has profoundly transformed the self. It has created new ways of being and constructing a self, but also new ways of being constructed as a self from the outside, new ways of being configured, represented, and governed as a self by sociotechnical systems. Rather than analyze theories of the self, I focus on practices of the self, using this expression in (...) a looser, more general sense than that used by Foucault. I begin by considering and reformulating two early lines of argument about the web as a medium for exploring and emancipating the self. Subsequent sections show how digital hyperconnectivity has engendered new ways of objectifying, quantifying, producing, and regulating the self—considered both as active, reflexive practices and as systemic, data- and algorithm-driven processes. I conclude by reflecting on the broader implications of contemporary modes of governing the self and by underscoring the ways in which hyperconnectivity has colonized the territories of the self, conscripting the self into the service of techno-social systems. (shrink)

Rogers suggests that human spirituality comprises the interplay of three foundational human dynamics: suffering, interconnecting, and valuing. The spiritual orientations that result from these clusters of dynamics are primarily integrating or disintegrating. The dominant spiritual orientation in this country has been disintegrating; and this orientation has characterized the attitude of the majority population toward African Americans since the beginning of slavery, fostering radical separation, displacing the suffering of the majority onto a minority, and defining the experience and perspectives of (...) the majority as normative without regard for the minority. Rogers explores the effects of this disintegrating spiritual orientation in terms of the dynamics of oppression using the ideas of 'being' and 'non-being'. The key to ameliorating oppression is to recognize the liberating capacity of suffering as potentially subversive within ever-enlarging contexts addicted to increasing material consumption and sensual gratification. ;Chapter 1 is a general introduction to the dissertation. ;Chapter 2 provides an overview of the primary methodology for research in 'formation theory' as developed by Adrian van Kaam. Using issues from the philosophy of science, the chapter also discusses the basis for divergence from the standard methodology based in the anomalous character of the researcher's 'formative event' and perspective relative to concerns that have been researched using formation theory. ;Chapter 3 considers a conceptualization of spirit as questing for meaningfulness, which provides the experiential ground for relating spirituality and liberation: Since oppression precipitates meaninglessness through disintegration, the reaffirmation of an integrative spirituality provides the ground for meaningfulness, which in turn grounds liberation, or transcendence. ;Chapter 4 presents the construct of human spirituality using the three foundational foci of spiritual formation: suffering, relating, and valuing. ;Chapter 5 concludes the dissertation using the two principle laws of thermodynamics to develop an analogous understanding for the necessity of suffering in maintaining an integrative and liberating spirituality. It also considers implications of the dissertation for liberation of oppressed peoples, the development of science and social policy, and formation theory. (shrink)