Knowledge about ethical judgments has not advanced appreciably after decades of research. Such research, however, has rarely addressed the possible importance of the content of such judgments; that is, the material appearing in the brief vignettes or scenarios on which survey respondents base their evaluations. Indeed, this content has seemed an afterthought in most investigations. This paper closely examined the vast array of vignettes that have appeared in relevant research in an effort to reduce this proliferation to a more concise (...) set of overarching vignette themes. Six generic themes emerged from this process, labeled here as Dilemma, Classic, Conspiracy, Sophie’s Choice, Runaway Trolley, and Whistle Blowing. Each of these themes is characterized by a unique combination of four key factors that include the extent of protagonist personal benefit from relevant vignette activities and victim salience in vignette descriptions. Theme identification enabled inherent ambiguities in vignettes that threaten construct validity to come into sharp focus, provided clues regarding appropriate vignette construction, and may help to make sense of patterns of empirical findings that heretofore have seemed difficult to explain. (shrink)

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving POLST (physician orders for lifesustaining treatment.) POLST has been the subject of recent articles in JCE. It has been the subject of major policy reports and a recent New York Times editorial. And POLST has been the subject of significant legislative, regulatory, and policy attention over the past several months. These developments and a survey of the current landscape are usefully grouped into the following 14 categories: 1. Terminology2. Purpose, function, (...) and success3. Status in the states4. Four legal routes of implementation5. Which professionals can authorize POLST?6. Is the patient’s signature required?7. Can surrogates consent to for incapacitated patients?8. If a POLST conflicts with an advance directive, which prevails?9. Is offering POLST mandatory?10. What are the duties of healthcare providers?11. What is the role of electronic registries?12. What is the role of the federal government?13. International adoption14. Court cases. (shrink)

In their recent article, Brummett and Muaygil reject Bishop et al.’s framing of the debate over standardization in clinical ethics consultation (CEC) “as one between pro-credentialing procedural and anti-credentialing phenomenological,” claiming that this framing “amounts to a false dichotomy between two extreme approaches to CEC.” Instead of accepting proceduralism and phenomenology as a binary, Brummett and Muaygil propose that these two views should be seen as the extreme ends of a spectrum upon which CEC should be done. However, as evidenced (...) by several inconsistencies within their article, they have failed to fully appreciate the concern animating Bishop et al.’s proposal. Additionally, because of this failure, they do not seem to realize that credentialing ethicists for CEC will only create different problems in Saudi Arabia even as it possibly solves some of the current problems they identify. In this commentary, we highlight and clarify Brummet and Muaygil’s five misunderstandings of Bishop et al. This leads us to conclude that while they claim to be advocating a middle way between proceduralism and phenomenology, in fact they would like for us to standardize another proceduralism, albeit one that incorporates some of the “qualitative” values of American bioethics. (shrink)

What is moral reasoning? For that matter, what is any sort of reasoning? Let me begin by making a few distinctions. First, there is a distinction between reasoning as something that that people do and the abstract structures of proof or “argument” that are the subject matter of formal logic. I will be mainly concerned with reasoning in the first sense, reasoning that people do. Second, there is a distinction between moral reasoning with other people and moral reasoning by and (...) for yourself . Moral reasoning with others may involve discussion with them, bargaining with them, and possibly arguing with them. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page 43-45, October 2012.

In recent years, increasingly advanced artificial intelligence (AI), and in particular machine learning, has shown great promise as a tool in various healthcare contexts. Yet as machine learning in medicine has become more useful and more widely adopted, concerns have arisen about the “black-box” nature of some of these AI models, or the inability to understand—and explain—the inner workings of the technology. Some critics argue that AI algorithms must be explainable to be responsibly used in the clinical encounter, while supporters (...) of AI dismiss the importance of explainability and instead highlight the many benefits the application of this technology could have for medicine. However, this dichotomy fails to consider the particular ways in which machine learning technologies mediate relations in the clinical encounter, and in doing so, makes explainability more of a problem than it actually is. We argue that postphenomenology is a highly useful theoretical lens through which to examine black-box AI, because it helps us better understand the particular mediating effects this type of technology brings to clinical encounters and moves beyond the explainability stalemate. Using a postphenomenological approach, we argue that explainability is more of a concern for physicians than it is for patients, and that a lack of explainability does not introduce a novel concern to the physician–patient encounter. Explainability is just one feature of technological mediation and need not be the central concern on which the use of black-box AI hinges. (shrink)

Gratitude, a significant Christian value, is regarded as a duty among Indians. The present study examines the role played by spiritual development in gratitude among the Indian population. The participants were emerging Indian male adults, aged between 18 and 30 years. The first sample is from 495 Catholic Indian seminarians with intensive spiritual training, and the second is from 504 Catholic Indian nonseminarians. We use the Gratitude Questionnaire-6 and the Spiritual Assessment Inventory in the study. The results show that the (...) factors of SAI, Awareness and Realistic Experience, had medium-size correlations with gratitude in both samples. Awareness predicted gratitude in both samples and Realistic Acceptance predicted gratitude only in seminarians. The study shows that individuals with an awareness of God's presence tend to be highly grateful. Spiritually mature individuals who undergo spiritual training were also more grateful. (shrink)

The blind bandit -- Zuko alone -- The chase -- Bitter work -- The library.

Investigations into ethical judgments generally seem fuzzy as to the relevant research domain. We first attempted to clarify the construct and determine domain parameters. This attempt required addressing difficulties associated with pinpointing relevant literature, most notably the varied nomenclature used to refer to ethical judgments (individual evaluations of actions’ ethicality). Given this variation in construct nomenclature and the difficulties it presented in identifying pertinent focal studies, we elected to focus on research that cited papers featuring prominent and often-used measures of (...) ethical judgments (primarily, but not exclusively, the Multidimensional Ethics Scale). Our review of these studies indicated a preponderance of inferences and conclusions unwarranted by empirical evidence (likely attributable at least partly to inconsistent nomenclature). Moreover, ethical judgments related consistently to few respondent characteristics or any other variables, emergent relationships may not always be especially meaningful, and much research seems inclined to repetition of already verified findings. Although we concluded that knowledge about ethical judgments seems not to have advanced appreciably after decades of investigation, we suggested a possible path forward that focuses on the content of what is actually being judged as reflected in the myriad of vignettes used in the literature to elicit judgments. (shrink)

Debate about the nature of time has been dominated by discussion of two issues: the reality of absolute time and the reality of A-series. We argue that Aristotle adopts a form of the A-theory entailing a denial of the reality of absolute time. Furthermore, Aristotle's denial of absolute time is linked to a denial of the reality of pure temporal becoming, namely, the idea that the now moves through a fixed continuum along which events are arranged in chronological order. We (...) show that the puzzles discussed by Aristotle in IV:10 of the Physics are generated by this view of time and that Aristotle's own theory of time, according to which changes are used to measure one another, avoids these problems. (shrink)

Cook and Hoas (2008) have identified and illustrated serious shortcomings in rural bioethics and healthcare decision-making. Some of the problems that the authors discuss are unique to the rural co...

Hume after arguing for the compatibility of liberty and necessity, a view now known as soft determinism or compatibilism , noted that it is not ‘possible to explain distinctly, how the Deity can be the mediate cause of the actions of sin and moral turpitude’. It seems that Hume is correct if the explanation must show specifically why an omnipotent and omnibenevolent deity must permit certain actions that to human reason seem to be unnecessary evils. On the other hand if (...) such specifity is not required, the soft determinist who also happens to be a theist can argue that it is possible that the actual world is the best of all possible worlds even though the reason for any specific apparent evil cannot be known. If seemingly evil choices are free in the soft determinist's sense but determined by an omnipotent and omniscient deity, then either that deity is not omnibenevolent or that deity has determined the world to have the maximum possible goodness through including seemingly evil choices in the scheme of things. Consequently if, as the traditional theist believes, the creator is omnibenevolent as well as omnipotent and omniscient, the occurrence of seemingly evil choices are necessary for maximizing the goodness of the whole. (shrink)

Smartphone acceptance could improve instruction, increase accessibility, and foster student involvement, which is a fundamental element in the development and application of m-learning in the classroom. This process reflects continuing advancements and versions in educational methods. The effect of mobile technology adoption in classrooms is examined in this study, focusing on its effects on student engagement, educational outcomes, and the associated infrastructure and support. The study comprised qualitative and quantitative data collected from 300 students using a mixed-method approach. Five key (...) variables related to mobile technology use were integrated, and SPSS software was employed for analysis. Descriptive statistics were used to compute an adoption index, highlighting positive student feedback and assessing technological integration, despite, to assess variations in student satisfaction and academic achievement; a one-sample t-test was used. Results revealed significant positive impacts on engagement and outcomes, though challenges in infrastructure and cost price. The findings highlight how mobile technology could transform education, but they also highlight how much additional resources and encouragement are required to ensure that it is as sustainable and effective as possible. (shrink)

Deemed consent legislation for deceased organ donation was introduced in England in 2020, and is considered a vital part of the new UK NHS Blood and Transplant’s 10-year strategy to increase consent for organ donation. Despite the legislation containing safeguards to protect the public, the introduction of deemed consent creates ethical, psychological and social un/certainties for healthcare professionals in their practice. In this paper, we offer insights into healthcare professionals’ perspectives on deemed consent, drawn from interview data with 24 healthcare (...) professionals in an NHS Trust in England, prior to the introduction of the legislation. Whilst participants supported deemed consent in principle, they were concerned that it would present a threat to the nature of donation as a ‘gift’; the notion of informed consent (or non-consent); and the autonomy of donors, their relatives, and their own roles as health professionals, posing dilemmas for practice. We argue that healthcare professionals present themselves as guardians of potential (non)donors and thus as having ethics and integrity in their own practice. We draw conclusions around the values and principles that matter to healthcare professionals when contemplating consent in deceased donation which will be useful for organ donation committees and ethics forums. (shrink)

People are treated differently as a result of their looks. But when is appearance discrimination, or "lookism" as it is often called, morally objectionable? This issue is important for at least two reasons. First, the benefits that flow to people who are regarded as visually attractive are sizeable and are enjoyed in a number of contexts, including employment, personal relationships, education, politics, and the criminal justice system. Second, appearance discrimination is of moral interest not only in its own right, but (...) also in terms of its connection to other forms of discrimination. Appearance norms, that is, norms concerning how we should look, often place greater burdens on disadvantaged groups. As a result, discrimination on the basis of appearance, when it rewards people who conform to these norms, may involve, or interact with, the effects of, wrongful discrimination on the basis of features other than appearance, in a way that aggravates existing injustices. What's Wrong with Lookism? examines the morality of appearance discrimination in three contexts: employment decisions; the choice of friends or romantic partners; and the everyday practice of judging and commenting upon people's looks. Andrew Mason develops a pluralist theory of what makes discrimination wrong that identifies three wrong-making features, namely, disrespect, deliberative unfairness, and contributing to unjust consequences, and demonstrates how the presence of one or more of these features in each of these contexts problematises the lookism that takes place in it. (shrink)

We commonly evaluate search engines and the results they return, but what grounds those evaluations? One straightforward way of evaluating search engines appeals to their ability to satisfy the goals of the user. Are there, in addition, user-independent norms, that allow us to evaluate search engines in ways that may come apart from their ability to satisfy the individuals who use them? One way of grounding such norms appeals to moral or political considerations. I argue that in addition to those (...) norms, there are also distinct user-independent epistemic norms that apply to search engines. Evaluating search engines relative to them, however, requires us to appreciate the impact search engines have on our practices and norms of inquiry more broadly: by systematically altering the accessibility of information, search engines don’t just give us information but shape our collective imagination, and the categories it operates over. (shrink)

Mason and McCall Smith's classic textbook discusses the relationship of medical practice and ethics with the operation of the law. The subjects covered include natural and assisted reproduction, the impact of modern genetics on medicine, medical confidentiality, consent to medical treatment, the use of resources and problems surrounding death in the new medical era. It is of significance to anyone with an interest in the ethical and legal practice of medicine.

From Chaos to Creativity is a book that teaches readers how to build a productivity system that works with their art and with their lifestyle. Author Jessie Kwak helps readers tame the chaos that often surrounds a creative career and further enhance readers' creative output.

What does it take to be prejudiced against a particular group? And is prejudice always epistemically problematic, or are there epistemically innocent forms of prejudice? In this paper, I argue that certain important forms of prejudice can be wholly constituted by the differential accessibility of certain pieces of information. These accessibility relations constitute a salience structure. A subject is prejudiced against a particular group when their salience structure is unduly organised around that category. This is significant because it reveals that (...) prejudice does not require the presence of any explicit cognitive or emotive attitude, nor need it manifest in behaviour: it can be solely constituted by the organisation of information, where that information may be accurate and well-founded. Nonetheless, by giving an account of ‘undue organisation’ in epistemic terms, I show that this account is compatible with an understanding of prejudice as a negatively valenced epistemic category. (shrink)

It is an apparent truism about visual perception that we can see only what is visible to us. It is also frequently accepted that visual perception is dynamic: our visual experiences are extended through, and can evolve over time. I argue that taking the dynamism of visual experience seriously renders certain simplistic interpretations of the first claim, that a subject at a given time can see only what is visible to her at that time, false: we can be meaningfully said (...) to see invisible objects. This counterintuitive result in turn focuses our attention on the relationship between perception and memory. I show that it is difficult to draw a clear or simple distinction between the two. Memory and perception rely on, and blend with, one another. Together, these claims point us away from understanding visual perception as a simple reflection of the environment, and instead as closer to a process of dynamic modelling that draws together occurrent stimulation and stored information. (shrink)

Visual perception relies on stored information and environmental associations to arrive at a determinate representation of the world. This opens up the disturbing possibility that our visual experiences could themselves be subject to a kind of racial bias, simply in virtue of accurately encoding previously encountered environmental regularities. This possibility raises the following question: what, if anything, is wrong with beliefs grounded upon these prejudicial experiences? They are consistent with a range of epistemic norms, including evidentialist and reliabilist standards for (...) justification. I argue that we will struggle to locate a flaw with these sorts of perceptual beliefs so long as we focus our analysis at the level of the individual and her response to information. We should instead broaden our analysis to include the social structure within which the individual is located. Doing so lets us identify a problem with the way in which unjust social structures in particular “gerrymander” the regularities an individual is exposed to, and by extension the priors their visual system draws on. I argue that in this way, social structures can cap perceptual skill. (shrink)

I identify three aspects to the puzzle of the speckled hen: A general puzzle, an epistemic puzzle, and a puzzle for the representationalist. These puzzles rely on an underlying “pictorialist” assumption, that we visually perceive general, determinable properties only in virtue of determinate properties or more specific, local features of our visual experience. This assumption is mistaken: Visual perception frequently starts from a position of uncertainty, and is routinely able to acquire information about general properties in the absence of more (...) specific information. Acknowledging that visual indeterminacy is structured this way resolves all three puzzles of the speckled hen. (shrink)

Jessy Giroux | : J’aborde dans cet article un problème que je nomme le « spectre épistocratique ». Le problème se présente ainsi : s’il existe des vérités politiques, c’est-à-dire des positions politiques qui soient véritablement bonnes, ne devrait-on pas faire de l’atteinte de ces vérités politiques l’objectif central de notre système politique, ce qui pourrait nous conduire à limiter le pouvoir populaire afin de laisser les individus « éclairés » prendre toutes les décisions politiques ? J’explore différentes stratégies possibles (...) afin de défendre la démocratie contre l’attrait d’une telle épistocratie, et je conclus que la meilleure stratégie consiste à souligner qu’une démocratie délibérative bien organisée démontre un potentiel épistémique supérieur à tout autre système politique. Je termine en montrant comment une telle conclusion parvient à nous informer sur le phénomène de la contestation politique. | : In this paper, I consider a problem that I call the “epistocratic specter”. The problem goes as follows : if there are political truths, by which I mean political positions that are truly good, shouldn’t we make the attainment of such truths the central goal of our political system, which could lead us to restrict popular power and let only truly “enlightened” individuals make every political decision ? I explore various possible strategies in order to defend democracy against the appeal of such an epistrocratic system, and I conclude that the best available strategy is one that emphasizes that a well-organized deliberative democracy possesses an epistemic potential that is superior to that of any other political system. I conclude by showing how this fact can inform our understanding of the phenomenon of political dissent. (shrink)

What kind of content must visual states have if they are to offer direct (noninferential) justification for our external world beliefs? How must they present that content if the degree of justification they provide is to reflect the nuance of our changing visual experiences? This paper offers an argument for the view that visual states comprise not only a content, but a confidence relation to that content. This confidence relation lets us explain how visual states can offer noninferential perceptual justification (...) of differing degrees for external world beliefs. These confidence relations let visual states justify beliefs in a way that is sensitive to subtle differences in the character of our visual experiences, while still allowing that visual states give us direct access to the external world in virtue of their content. (shrink)

Elinor Mason draws on ethics and responsibility theory to present a pluralistic view of both wrongness and blameworthiness. Mason argues that our moral concepts, rightness and wrongness, must be connected to our responsibility concepts. But the connection is not simple. She identifies three different ways to be blameworthy, corresponding to different ways of acting wrongly. The paradigmatic way to be blameworthy is to act subjectively wrongly. Mason argues for an account of subjective obligation that is connected to (...) the notion of trying - to act rightly is try to do well by morality, to act wrongly (and to be blameworthy) is to fail to try hard enough. Trying involves understanding morality, those who do not grasp morality are in a different category. So agents might also be blameworthy for being oriented away from what really matters. In that case, agents are blameworthy in a different sense, the detached sense. Finally, we can become blameworthy by taking responsibility in cases where our agency is ambiguous. In the final section, Mason gives us an account of taking responsibility and agues that that is an important art of our responsibility practices. (shrink)

What, if anything, is epistemically wrong with beliefs involving accurate statistical generalizations about demographic groups? This paper argues that there is a perfectly general, underappreciated epistemic flaw which affects both ethically charged and uncharged statistical generalizations. Though common to both, this flaw can also explain why demographic statistical generalizations give rise to the concerns they do. To identify this flaw, we need to distinguish between the accuracy and the projectability of statistical beliefs. Statistical beliefs are accompanied by an implicit representation (...) of the statistic's modal profile. Their modal profile determines the circumstances in which they can legitimately be projected to unobserved instances. Errors in that implicit content can be compatible with the accuracy of the “bare” statistic, whilst systematically leading to downstream errors in reasoning, in a manner which reveals an epistemic flaw with an important aspect of the belief state itself. (shrink)

Are there ever good epistemic reasons to neglect base rates? Assuming an empiricist modal epistemology, I argue that we face an interesting tension between some very plausible epistemic norms: a norm requiring us to proportion our beliefs to the evidence may facilitate knowledge of the actual world, whilst inhibiting our acquisition of modal knowledge—knowledge of how things could be, but are not. The potential for this tension in our epistemic norms is a significant result in its own right. It can (...) also rationalize certain forms of demographic base-rate neglect. (shrink)

Although thick ethical concepts have been neglected in Murdochian scholarship, this article argues that they were central to the thought of Iris Murdoch. In the first section, the article provides a sustained account of thick ethical concepts in Murdoch's philosophy, demonstrating how these concepts align with and illuminate familiar aspects of her philosophical essays. The first section also explores the ways in which Murdoch's alternative account of moral concepts was at the heart of her overall attack on the noncognitivism of (...) her day. In the second section, the article provides a reading of The Black Prince and considers the ways that thick ethical concepts offer new insight into Murdoch's literary activity. It concludes by suggesting that studying Murdoch's philosophy and literature in light of thick ethical concepts reveals a deep unity between her two intellectual projects. (shrink)