After decades of being met with suspicion or even disdain the epistemic role of intuitions – and specifically the school of ethical intuitionism – has seen a revival. This revival has been undertaken by both leading moral philosophers such as Jonathan Dancy and Robert Audi and moral psychologists like Jonathan Haidt and Joshua Greene.See Jonathan Dancy, Ethics Without Principles (Oxford: Oxford University Press, 2004), Robert Audi, The Good in the Right. A Theory of Intuition and Intrinsic Value (Princeton: Princeton University (...) Press, 2003) and Joshua D. Greene and Jonathan Haidt, “How (and Where) Does Moral Judgment Work?,” Trends in Cognitive Sciences 6 (2002): 517–523.Dancy, for example, has argued that moral principles play no substantive role in moral thought and judgement. Since it has traditionally been assumed that our particular moral judgements are justified on the basis of the more general moral principles from which they are derived, Dancy’s moral epistemology takes a diffe. (shrink)

This is the third volume of Joel Feinberg's highly regarded The Moral Limits of the Criminal Law, a four-volume series in which Feinberg skillfully addresses a complex question: What kinds of conduct may the state make criminal without infringing on the moral autonomy of individual citizens? In Harm to Self, Feinberg offers insightful commentary into various notions attached to self-inflicted harm, covering such topics as legal paternalism, personal sovereignty and its boundaries, voluntariness and assumptions of risk, consent and its (...) counterfeits, coercive force, incapacity, and choice of death. (shrink)

An introduction to the philosophy of mathematics grounded in mathematics and motivated by mathematical inquiry and practice. In this book, Joel David Hamkins offers an introduction to the philosophy of mathematics that is grounded in mathematics and motivated by mathematical inquiry and practice. He treats philosophical issues as they arise organically in mathematics, discussing such topics as platonism, realism, logicism, structuralism, formalism, infinity, and intuitionism in mathematical contexts. He organizes the book by mathematical themes--numbers, rigor, geometry, proof, computability, incompleteness, (...) and set theory--that give rise again and again to philosophical considerations. (shrink)

Since the publication of Wahrheit und Methode in 1960 (Tfibingen), Gadamer's hermeneutics has called forth a varied and fruitful response from the Continent, without receiving anything near the same attention from the English-speaking world. Though E. D. Hirsch thought Gadamer sufficiently important in 1965 to merit an early rebuttal and rehabilitation (Validity in Interpretation [New Haven, Conn., 1967], pp. 245-64), Wahrheit und Methode remained unread in England and America, partly because a translation was not available until 1975 (Truth and Method, (...) ed. Garrett Barden and John Cumming [New York]). Even after that date, Gadamer's influence on Anglo-American debate has been largely secondhand, filtering in through such figures as Paul Ricoeur and Jiurgen Habermas. But a renewed interest in the question of what we are to make of tradition, no doubt spurred in large measure by deconstruction's effort to unmake it, has lent Gadamer a new pertinence. One sign that his stock is on the rise is the publication of Joel Weinsheimer's Gadamer's Hermeneutics, a much needed and admirably written introduction to Truth and Method that should push its value even higher. -- JSTOR (June 12, 2012.). (shrink)

This paper argues that the political adage “Be ye prudent as serpents and guileless as doves” involves three different types of relation between prudence and morality, namely: unification (Vereinigung), subordination (Unterordnung), and association (Beigesellung). I maintain that these relations are set up according to the same principle that determines the relationship between mechanical and teleological causality in the third Critique. Thus, I argue that morality and prudence are much more systematically related within the system of critical philosophy than is normally (...) assumed in the literature and that this is made possible by way of an intimate relationship between prudence and teleological judgment. (shrink)

Background: While the solid organ transplant evaluation process is designed to function equitably, discriminatory practices remain, resulting in disparities in access for persons with disabilities. Physical function and frailty status are often-cited factors in establishing transplant, despite limited consensus on their assessment and impact. Objective: The purpose of this study was to describe how transplant healthcare professionals conceptualize the relationship between physical disability and transplant candidacy. Methods: A convenience sample of multidisciplinary transplant was solicited to respond to an electronic survey (...) between February and March 2024. Results: Of the 126 professionals contacted, 43 participants responded, yielding a response rate of 34 %. The majority of participants (88 %) held contradictory views of physical disability as it relates to transplant candidacy (p = 0.049). Men were more likely to endorse awareness of bias when evaluating transplant candidates (p = 0.008). Professional discipline was significantly associated with perception of transplant process fairness, impact of bias, and interpretation of quality of life. Iterative thematic analysis revealed a propensity to conflate frailty with physical disability. Conclusions: Multidisciplinary transplant professionals rarely endorsed overtly ableist sentiments. However, responses highlighted inconsistent, unclear, and at times contradictory conceptions of physical function and physical disability, which may contribute to disparate access to solid organ transplant for individuals with physical disability. (shrink)

The ethics of long-term Extracorporeal Membrane Oxygenation (ECMO) use, especially when organ recovery appears highly unlikely and the patient does not qualify for organ transplantation, are compli...

In developing their policy on paediatric medical assistance in dying (MAID), DeMichelis, Shaul and Rapoport decide to treat euthanasia and physician-assisted suicide as ethically and practically equivalent to other end-of-life interventions, particularly palliative sedation and withdrawal of care (WOC). We highlight several flaws in the authors’ reasoning. Their argument depends on too cursory a dismissal of intention, which remains fundamental to medical ethics and law. Furthermore, they have not fairly presented the ethical analyses justifying other end-of-life decisions, analyses and decisions (...) that were generally accepted long before MAID was legal or considered ethical. Forgetting or misunderstanding the analyses would naturally lead one to think MAID and other end-of-life decisions are morally equivalent. Yet as we recall these well-developed analyses, it becomes clear that approving of some forms of sedation and WOC does not commit one to MAID. Paediatric patients and their families can rationally and coherently reject MAID while choosing palliative care and WOC. Finally, the authors do not substantiate their claim that MAID is like palliative care in that it alleviates suffering. It is thus unreasonable to use this supposition as a warrant for their proposed policy. (shrink)

... the turn of the fourth/tenth century, in the province of Sijistan, Muhammad b. Tahir b. Bahram was born, known in the fullness of time as Abu Sulayman ...

The raison d’être of the humanities is widely held to reside in its unique ability to generate critical thinking and critical thinkers. But what is “critical thinking?” Is it a generalized mode of...

The clinical research enterprise is changing in fundamental ways. The bright line that separates research and clinical care is beginning to fade, as both “research” and “nonresearch” converge into and are embodied by the concept of the learning health care system. Here, data about care and operations are translated into practice improvement. VA has been a leader in this area, and based on its use of electronic health records and other inputs, has formed large databases and a data‐driven health care (...) system. These changes raise questions about the traditional approach to “research subject” protection. (shrink)

This volume is a comprehensive collection of critical essays on The Taming of the Shrew, and includes extensive discussions of the play's various printed versions and its theatrical productions. Aspinall has included only those essays that offer the most influential and controversial arguments surrounding the play. The issues discussed include gender, authority, female autonomy and unruliness, courtship and marriage, language and speech, and performance and theatricality.

Ethics and Qualities of Life looks at what enters into ethical judgment and choice. Interpretation of a case and of what the options are is always a factor, as is a sense of the possible values at stake. Intuitions also enter in, but often are unreliable. For a long time it seemed only fair that oldest sons inherited, and struck few people as unfair that women were not allowed to attend universities. A moral judgment is putatively part of a moral (...) order in a society that any reasonable person would accept. But what counts as "reasonable" is generally contestable. The unreliability of intuitions leads naturally to ethical theory. Kantian, contractualist, and consequentialist theories all have some important truth in them, but not the whole truth. Contractualism lacks the resources required for a fully determinate account of what counts as "reasonable". Broad general rules are important to Kant and are at the center of everyday morality. But can Kantian ethics explain why they have to have this central role? Our evolving social contract now contains elements that once would have seemed counter-intuitive to most people. But could consequentialists have predicted with entire confidence the consequences of social changes that we now think were desirable? The last part of this book contains a double argument. One is that ethical theory is employed by humans in a state of semi-ignorance of relevant factors, grasping at likely truths and evolved intuitions. The other is that consequentialist considerations have a major role at the fundamental level, but much more in justification or criticism than in ethical discovery. (shrink)

Book reviewed in this article: Public Duties: The Moral Obligations of Government Officials. Edited by Joel L. Fleishman, Lance Liebman, and Mark H. Moore.

Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff seem important, especially (...) where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record. (shrink)

In this paper I defend three different points: first, that the concept of highest good is derived from an a priori but subjective argument, namely a maxim of pure practical reason; secondly, that the theory regarding the highest good has the validity of a practical regulative knowledge; and thirdly, that the practical regulative knowledge can be understood as the same “holding something to be true” as Kant attributes to hope and believe.

Next SectionObjectives To evaluate the adequacy of paediatric informed consent and its augmentation by a supplemental computer-based module in paediatric endoscopy. Methods The Consent-20 instrument was developed and piloted on 47 subjects. Subsequently, parents of 101 children undergoing first-time, diagnostic upper endoscopy performed under moderate IV sedation were prospectively and consecutively, blinded, randomised and enrolled into two groups that received either standard form-based informed consent or standard form-based informed consent plus a commercial (Emmi Solutions, Inc, Chicago, Il), sixth grade level, (...) interactive learning module (electronic assisted consent). Anonymously and electronically, the subjects' anxiety (State Trait Anxiety Inventory), satisfaction (Modified Group Health Association of America), number of questions asked, and attainment of informed consent were assessed (Consent-20). Statistics were calculated using t test, paired t test, and Mann Whitney tests. Results The ability to achieve informed consent, as measured by the new instrument, was 10% in the control form-based consent group and 33% in the electronic assisted consent group (p<0.0001). Electronically assisting form-based informed consent did not alter secondary outcome measures of subject satisfaction, anxiety or number of questions asked in a paediatric endoscopy unit. Conclusions This study demonstrates the limitations of form-based informed consent methods for paediatric endoscopy. It also shows that even when necessary information was repeated electronically in a comprehensive and standardised video, informed consent as measured by our instrument was incompletely achieved. The supplemental information did, however, significantly improve understanding in a manner that did not negatively impact workflow, subject anxiety or subject satisfaction. Additional study of informed consent is required. Clinical trial registration number ClinicalTrials.gov Identifier NCT00899392. (shrink)

Emotions normally include elements of feeling, motivation, and also intentionality; but the argument of this essay is that there can be emotion without feeling, emotion without corresponding motivation, and emotion without an intentional relation to an object such that the emotion is (among other things) a belief about or construal of it. Many recent writers have claimed that some form of intentionality is essential to emotion, and then have created lines of defence for this thesis. Thus, what look like troublesome (...) cases of emotions can be regarded as having a global intentionality or as being “mood-like”. Alternatively surges of non-intentional joy or ecstasy can be regarded as merely feelings rather than as emotions, and what people experience in response to absolute music can be treated similarly. A clear view of how we normally talk about moods, emotions, and feelings however undermines these defences; and in particular we can understand the role of emotions in relation to absolute music once we become clear about the way in which musical content stands in for intentional objects. (shrink)

The essay has two purposes. One is to point out connections and parallels between, On one hand, The debates of metaphysical realists and anti-Realists, And on the other hand, The debates surrounding moral realism. The second is to provide the outlines of a case for a kind of position that would generally be classified as moral realism. One feature of this position is that it emerges as parallel to, And compatible with, A metaphysical position that would generally be classified as (...) anti-Realism. (shrink)

Might there be knowledge of non-instrumental values? Arguments are give for two principal claims. One is that if there is such knowledge, it typically will have features that do not entirely match those of other kinds of knowledge. It will have a closer relation to the kind of person one is or becomes, and in the way it combines features of knowing-how with knowing-that. There also are problems of indeterminacy of non-instrumental value which are not commonly found in other things (...) that we can know about. The second claim is that there is a strong prima-facie case for holding that there is such knowledge, and that the usual arguments against this are all faulty. (shrink)

Joel Spring’s history of school polices imposed on dominated groups in the United States examines the concept of deculturalization—the use of schools to strip away family languages and cultures and replace them with those of the dominant group. The focus is on the education of dominated groups forced to become citizens in territories conquered by the U.S., including Native Americans, Enslaved Africans, Chinese, Mexicans, Puerto Ricans, and Hawaiians. In 7 concise, thought-provoking chapters, this analysis and documentation of how education (...) is used to change or eliminate linguistic and cultural traditions in the U.S. looks at the educational, legal, and social construction of race and racism in the United States, emphasizing the various meanings of "equality" that have existed from colonial America to the present. Providing a broader perspective for understanding the denial of cultural and linguistic rights in the United States, issues of language, culture, and deculturalization are placed in a global context. The major change in the 8 th Edition is a new chapter, "Global Corporate Culture and Separate But Equal," describing how current efforts at deculturalization involve replacing family and personal cultures with a corporate culture to increase worker efficiency. Substantive updates and revisions are made throughout all other chapters. (shrink)

While procurement of organs from donors who are not "brain dead" does not appear to pose insurmountable moral obstacles, the social practice may raise questions of conflict of interest. Non-heart-beating organ donation opens the door for pressure on patients or families to forgo possibly beneficial treatment to provide organs to save others. The combined effects of non-heart-beating donation and organ shortages at major transplant centers brought about by the 1991 United Network for Organ Sharing (UNOS) local-use organ allocation policy created (...) potential conflicts, including the fact that candidates for organs become potential donors far more frequently than previously. Hospitals with a major emphasis on transplantation have economic and academic interests that may have been hurt by the relative organ shortage. Some may view non-heart-beating organ donation as a way to restore weakened programs and thus unconsciously compromise recognition of problems associated with non-heart-beating donation. (shrink)

Rereading Renée C. Fox's “A Sociological Perspective on Organ Transplantation and Hemodialysis,” published in 1970, one is likely to be struck more by continuity than by change. The most pressing of the social, policy, and ethical concerns that Fox raised remain problematic fifty years later. We still struggle with scientific and clinical uncertainty, with the boundary between experimentation and therapy, and with the cost of organ replacement therapies and disparities in how they are allocated. We still have an imperfect understanding (...) of transplant immune responses. We still debate when a potential donor “actually” dies, and we still seem to think better empirical criteria could harmonize the diverse religious, cultural, and socioeconomic values of patients, providers, third‐party payers, and policy‐makers. Organ transplantation was for Fox both a particular case unfolding in time and an entryway for discussing the difficult moral questions presented by many new medical technologies in a context of high demand and limited resources. (shrink)

For the “respectable” part of society there can be a presumption of virtuousness, rather like the presumption of innocence in the law. In both cases, the presumption can be defeated, as we learn more and get into specifics. We still might insist that to be genuinely virtuous is to be able to pass the more familiar sorts of tests of virtue, and to be reliably virtuous also in the ordinary business of life, especially in things that really matter. Something like (...) this is a necessary condition for virtue. Factors of motivation, especially those related to what a person's basic concerns are, can vary enormously. Imagine an extreme case. Someone might be inherently indifferent to what happens to other people, and have no sense of the inherent dignity or worthiness of moral principles, but also be totally convinced that God is watching his or her every move, and that the prospects of heaven or hell depend heavily on one's following accepted morality at every step. (shrink)

There are more than 350,000 health apps available in public app stores. The extolled benefits of health apps are numerous and well documented. However, there are also concerns that poor-quality apps, marketed directly to consumers, threaten the tenets of evidence-based medicine and expose individuals to the risk of harm. This study addresses this issue by assessing the overall quality of evidence publicly available to support the effectiveness claims of health apps marketed directly to consumers. To assess the quality of evidence (...) available to the public to support the effectiveness claims of health apps marketed directly to consumers, an audit was conducted of a purposive sample of apps available on the Apple App Store. We find the quality of evidence available to support the effectiveness claims of health apps marketed directly to consumers to be poor. Less than half of the 220 apps (44%) we audited state that they have evidence to support their claims of effectiveness and, of these allegedly evidence-based apps, more than 70% rely publicly on either very low or low-quality evidence. For the minority of app developers that do publish studies, significant methodological limitations are commonplace. Finally, there is a pronounced tendency for apps—particularly mental health and diagnostic apps—to either borrow evidence generated in other (typically offline) contexts or to rely exclusively on unsubstantiated, unpublished user metrics as evidence to support their effectiveness claims. Health apps represent a significant opportunity for individual consumers and healthcare systems. Nevertheless, this opportunity will be missed if the health apps market continues to be flooded by poor quality, poorly evidenced, and potentially unsafe apps. It must be accepted that a continuing lag in generating high-quality publicly available evidence of app effectiveness and safety is not inevitable: it is a choice. Just because it will be challenging to raise the quality of the evidence base publicly available to support the claims of health apps, this does not mean that the bar for evidence quality should be lowered. Innovation for innovation’s sake must not be prioritized over public health and safety. (shrink)

Neste artigo apresenta-se o significado do conceito de sociabilidade insociável e de sua importância para a filosofia histórico-política de Kant. Defendem-se aqui duas teses importantes: primeira, que esse conceito se insere essencialmente num paradigma biológicoteleológico em vez de físico-mecânico; segunda, que a insociabilidade deve ser compreendida como se referindo a inclinações e não a paixões, o que, por sua vez, permite pensá-la em concordância com um progresso moral também dos indivíduo.

ABSTRACT In this paper, I argue that the idea of a universal history is systematically legitimized in Kant’s transcendental system of philosophy by way of the concept of a need [Bedürfnis] for pure practical reason. In this sense, the idea of a universal history is a fundamental part of the moral image of the world that emerges from Kant’s whole philosophy, and it is crucial for understanding both the possibility of the system of pure reason, as well the full development (...) of Kant’s moral philosophy, especially for political philosophy. RESUMO Nesse artigo eu argumento que a ideia de uma história universal é sistematicamente legitimada no sistema da filosofia transcendental de Kant por meio do conceito de precisão [Bedürfnis] da razão pura prática. Nesse sentido, a ideia de uma história universal é uma parte fundamental da imagem moral do mundo que emerge da totalidade da filosofia de Kant e é crucial para o entendimento tanto da possibilidade de um sistema da razão pura, quanto para um desenvolvimento completo da filosofia moral, particularmente para a filosofia política. (shrink)

We use genomic information to tell us stories of evolutionary origins. But what does it mean when different genomes report wildly different accounts of lineage history? This genomic “discordance” can be a consequence of a fascinating suite of natural history and evolutionary phenomena, from the different inheritance mechanisms of nuclear versus cytoplasmic (mitochondrial and plastid) genomes to hybridization and introgression to horizontal transfer. Here, we explore how we can use these distinct genomic stories to provide new insights into the maintenance (...) of sexual reproduction, one of the most important unanswered questions in biology. We focus on the strikingly distinct nuclear versus mitochondrial versions of the story surrounding the origin and maintenance of asexual lineages in Potamopyrgus antipodarum, a New Zealand freshwater snail. While key questions remain unresolved, these data inspire multiple testable hypotheses that can be powerfully applied across a broad range of taxa toward a deeper understanding of the causes and consequences of mitonuclear discordance, the maintenance of sex, and the origin of new asexual lineages. (shrink)

Doctors in Denial examines the relationship between the Canadian medical profession and the pharmaceutical industry, and explains how doctors have become dependents of the drug companies instead of champions of patients' health. Big Pharma plays a role in every aspect of doctors' work. These giant, wealthy multinationals influence how medical students are trained and receive information, how research is done in hospitals and universities, what is published in leading medical journals, what drugs are approved, and what patients expect when they (...) go into their doctors' offices. But almost all doctors deny the influence and control the drug companies exert. In this book Dr. Lexchin urges the medical profession to make the changes needed to give priority to protecting and promoting patients' health and benefitting society, rather than enabling Big Pharma to dominate health care while raking in billions in profits from citizens and governments. (shrink)

Este artigo apresenta os aspectos liberais e republicanos da filosofia política de Rousseau e defende que eles devem ser interpretados como complementares. Entretanto, essa complementaridade pode ser caracterizada num sentido específico, qual seja, como sendo um liberalismo republicano.

A variety of cases of scientific misconduct have been documented since the 1980s among biological scientists. These cases have focused the attention of the public and scientific community on this behavior and made it the centerpiece of the concern about ethics in the biological sciences. In contrast, the ethics movement in clinical medicine, which arose in the 1960s, was not basically directed at the problems of wrong-doing. Instead it concentrated on the difficult ethical choices that had to be made In (...) the practice of medicine.In this essay, I discuss the two movements. The attention given to misconduct In the biological sciences has become excessive and diverts its ethics movement from exploring and teaching about the difficult ethical decisions scientists must make in weighing obligations to self, science, and society. A more balanced and selective approach to developing an ethical framework in the biological sciences is needed. (shrink)