For many years the prevailing paradigm for medical decision making for children has been the best interest standard. Recently, some authors have proposed that Mill’s “harm principle” should be used to mediate or to replace the best interest standard. This article critically examines the harm principle movement and identifies serious defects within the project of using Mill’s harm principle for medical decision making for children. While the harm principle proponents successfully highlight some difficulties in present-day use of the best interest (...) standard, the use of the harm principle suffers substantial normative and conceptual problems. A medical decision-making framework for children is suggested, grounded in the four principles. It draws on the best interest standard, incorporates concepts of harm, and provides two questions that can act as guide and limit in medical decision making for children. (shrink)

Defensive medicine has become pervasive. Defensive medicine is often thought of as a systems issue, the inevitable result of an adversarial malpractice environment, with consequent focus on system-responses and tort reform. But defensive medicine also has ethical and professionalism implications that should be considered beyond the need for tort reform. This article examines defensive medicine from an ethics and professionalism perspective, showing how defensive medicine is deeply problematic. First, a definition of defensive medicine is offered that describes the essence of (...) defensive practice: clinical actions with the goal of protecting the clinician against litigation or some adverse outcome. Ethical arguments against defensive medicine are considered: defensive medicine is deceptive and undermines patient autonomy; defensive medicine subjugates patient interests to physician interests and violate fiduciary obligations; defensive medicine exposes patients to harm without benefit; defensive medicine undermines trust in the profession; and defensive medicine violates obligations of justice. Possible arguments in favor of defensive medicine are considered and refuted. Defensive practice is therefore unethical and unprofessional, and should be viewed as a challenge for medical ethics and professionalism. (shrink)

Beneficence is a foundational ethical principle in medicine. To provide benefit to a patient is to promote and protect the patient’s wellbeing, to promote the patient’s interests. But there are different conceptions of wellbeing, emphasizing different values. These conceptions of wellbeing are contrary to one another and give rise to dissimilar ideas of what it means to benefit a patient. This makes the concept of beneficence ambiguous: is a benefit related to the patient’s goals and wishes, or is it a (...) matter of objective criteria that constitute wellbeing? This paper suggests a unified conception of wellbeing for use in medicine to determine what counts as a benefit. Two components of wellbeing are identified: (1) objective functioning/health and (2) the patient’s view of her own good. The paper explores how to apply, balance, and weigh these components in clinical situations to determine what counts as a benefit to a patient. (shrink)

This work clarifies the role of the best interest standard (BIS) as ethical principle in the medical care of children. It relates the BIS to the ethical framework of medical practice. The BIS is shown to be a general principle in medical ethics, providing grounding to prima facie obligations. The foundational BIS of Kopelman and Buchanan and Brock are reviewed and shown to be in agreement with the BIS here defended. Critics describe the BIS as being too demanding, narrow, opaque, (...) not taking the family into account and not suitable as limiting principle. This work responds to these criticisms, showing that they do not stand up to scrutiny. They either do not apply to the BIS, only apply to misuses of the BIS or criticise a BIS that is not seriously defended in the literature. (shrink)

This article examines an argument which may negatively influence measles vaccination uptake. According to the argument, an individual child in a highly vaccinated society may be better off by being non-vaccinated; the child does not risk vaccine adverse effects and is protected against measles through herd immunity. Firstly, the conclusion of the argument is challenged by showing that herd immunity’s protection is unreliable and inferior to vaccination. Secondly, the logic of the argument is challenged by showing that the argument is (...) inherently self-defeating and therefore logically inconsistent. In practice the argument cannot be used to protect children against measles. Measles vaccination is undoubtedly best for children, even in highly vaccinated societies. Only if a medical contraindication to vaccination exists should vaccination be waived in favour of reliance on herd immunity. This places obligations on those who stand in care relationships with the child: parents, healthcare providers, and the state. (shrink)

Pickering, Newton-Howes, and Young argue that a person should be considered incapable of making a specific decision if that decision is judged by onlookers to be seriously harmful to the dec...

The interests of a patient are not only related to objective ideas about health, but are also determined by the patient’s own view of the good. To act in the best interests of a patient requires co...

Carson and Flood (2017) present an interesting argument regarding a duty to vaccinate as a social obligation. Their argument is based on Catholic social teaching, and particularly on the moral prec...

There can be little doubt about the ethical imperative to ensure adequate vaccination uptake against certain infectious diseases. In the face of vaccine refusal, health authorities and providers instinctively appeal to coercive approaches or increased education as methods to ensure adequate vaccine uptake. Recently, some have argued that public fear around Ebola should be used as an opportunity for such approaches, should an Ebola vaccine become available. In this article, the author describes the difficulties associated with coercion and education when (...) addressing vaccine opposition. Both coercion and education can cause opposite effects than intended in certain circumstances. The correct area of focus is to address the breakdown in trust within clinical relationships. The author presents suggestions for an approach towards vaccine refusal that may be more promising. (shrink)

This paper defends four lines of argument that establish an ethical obligation for clinicians to be vaccinated against COVID-19. They are: (1) The obligation to protect patients against COVID-19 spread; (2) The obligation to maintain professional competence and remain available for patients; (3) Clinicians’ role and place in society in relation to COVID-19; (4) The obligation to encourage societal vaccination uptake. These arguments stand up well against potential objections and provide a compelling case to consider acceptance of COVID-19 vaccination a (...) duty for all clinicians. This duty brings with it the implication that vaccine refusal amounts to a dereliction of the professional’s ethical obligations, which means such clinicians should be subject to disciplinary action. Furthermore, this duty provides grounding for mandatory vaccination policies for clinicians. (shrink)

The basic question today is: Can biblical theology do the job of revitalizing the Bible? And in the discussion around the Bible, is the alternative correct: biblical history or biblical kerygmatic theology? Are we, caught in this alternative, not responsible for the rejection of biblical studies today— for avoiding the heart of Bible, namely, the consideration of the validity of biblical religion for us today?

Apparent tensions, even contradictions, within the letters of Paul have led some to abandon the attempt to find coherence in his theology, and others to locate it in his psychological make-up lather than his thought, neither solution represents an adequate response to the apostle's theological reflections.

We discuss games of both perfect and imperfect information at two levels of structural detail: players’ local actions, and their global powers for determining outcomes of the game. We propose matching logical languages for both. In particular, at the ‘action level’, imperfect information games naturally model a combined ‘dynamic-epistemic language’ – and we find correspondences between special axioms and particular modes of playing games with their information dynamics. At the ‘outcome level’, we present suitable notions of game equivalence, plus some (...) simple representation results. (shrink)

Logic is not just about single-agent notions like reasoning, or zero-agent notions like truth, but also about communication between two or more people. What we tell and ask each other can be just as 'logical' as what we infer in Olympic solitude. We show how such interactive phenomena can be studied systematically by merging epistemic and dynamic logic.

Game-theoretic solution concepts describe sets of strategy profiles that are optimal for all players in some plausible sense. Such sets are often found by recursive algorithms like iterated removal of strictly dominated strategies in strategic games, or backward induction in extensive games. Standard logical analyses of solution sets use assumptions about players in fixed epistemic models for a given game, such as mutual knowledge of rationality. In this paper, we propose a different perspective, analyzing solution algorithms as processes of learning (...) which change game models. Thus, strategic equilibrium gets linked to fixed-points of operations of repeated announcement of suitable epistemic statements. This dynamic stance provides a new look at the current interface of games, logic, and computation. (shrink)

According to an increasingly popular view known as non-doxasticism, religious faith need not include belief, but only some cognitively weaker attitude. This view comes with great promises, as it offers a way for the agnostic to partake in religion. My concern is how such a non-doxastic faith might be understood as a rational attitude. I offer three desiderata for any account of rational, non-doxastic faith. These desiderata are based on general considerations regarding epistemic rationality and on major themes from current (...) literature on the closely related notions of trust and hope. The first desideratum states that faith must be able to meet the demands of reason. The second requires, perhaps surprisingly, that faith should not imply trust. The third requires that faith should imply hope while excluding despair. I show how several prominent accounts of non-doxastic faith, by Lara Buchak, Daniel Howard-Snyder and Daniel McKaughan, all fail to meet at least one of these desiderata. I also suggest that the desiderata should make us prefer a reconstructive methodology. (shrink)

European Journal of Philosophy, Volume 29, Issue 4, Page 685-698, December 2021.

In this paper, we criticize the current focus of the bio-based economy (BBE) on efficiency and control and demonstrate the contradictions that this causes. We elucidate these tensions by comparing the BBE to alternative conceptions of economy that emphasise the relevance of both the human condition and unfathomable nature in the macro ecological transition project. From Emmanuel Levinas’s philosophy, we take and extrapolate two major concepts—il y a and enjoyment—that help to re-evaluate the status of both nature and the human (...) subject involved in environmental instability. From this analysis, we evaluate current economic practice in close relation to the deteriorating environment to contribute to a conception of an economy that is truly based on principles of the biosphere. We conclude that humankind and nature are notions that must be always considered in this encompassing and topical effort and explain how they have been fundamentally overlooked in current thought on the bio-based and circular economy. (shrink)

Current dynamic epistemic logics often become cumbersome and opaque when common knowledge is added for groups of agents. Still, postconditions regarding common knowledge express the essence of what communication achieves. We present some methods that yield so-called reduction axioms for common knowledge. We investigate the expressive power of public announcement logic with relativized common knowledge, and present reduction axioms that give a detailed account of the dynamics of common knowledge in some major communication types.

In the last few years, preference logic and in particular, the dynamic logic of preference change, has suddenly become a live topic in my Amsterdam and Stanford environments. At the request of the editors, this article explains how this interest came about, and what is happening. I mainly present a story around some recent dissertations and supporting papers, which are found in the references. There is no pretense at complete coverage of preference logic (for that, see Hanson 2001) or even (...) of preference change (Hanson 1995). (shrink)

_In this paper, we support the adoption of an empirical approach in development ethics research and show that the theoretical insights and methodological guidelines in Sen’s capability approach can offer helpful guidance to development ethicists on designing and execution of such research. To this end, we show how specific insights in the CA guide one to identify and engage with relevant stakeholders in extensive dialogues about the ethical issues underlying their development practices and in gathering empirical data for further ethical (...) reflections. Drawing on an empirical development ethics research project we conducted in the fisheries sector of Ukerewe District in Tanzania, we illustrate how the CA supported us in identifying 310 representatives of various categories of small-scale fishers and stakeholders, and in designing and executing empirical development ethics research in the form of progressive stages of dialogues in stakeholder groups. The participants in these stakeholder groups reflected on and assessed their individual and collective values, capacities, roles and interests in the fisheries sector. In turn, we gathered empirical data on the nature and causes of the poverty of small-scale fishers and ways to overcome it, the __moral roots of the prevalence of institutional and professional apathy, and stakeholders’ motivations and concrete actions to support the redressing of the challenges facing small-scale fishers. Later, we used these empirical data to theorise about moving small-scale fishers from poverty to prosperity, and about the development ethic best suited to guide future initiatives in combatting poverty and generating wealth through the fisheries sector in Ukerewe District._ _Keywords: _Empirical Ethics, Development Ethics, Capability Approach, Small-scale Fisheries, Poverty, Ukerewe District, Tanzania. (shrink)

The significance of being an intellectual when taken prisoner and sent to a concentration camp by the Nazis is rarely discussed – instead, the importance of being either a Jew or a political prisoner is highlighted. By contrast, Jean Amery’s recollections of being tortured and sent to Auschwitz concentrate on his self-understanding as an intellectual. What difference does the identity and outlook as an intellectual make in the extreme circumstances found in Auschwitz? The paper discusses Amery’s views on this question, (...) invoking that of others who have also addressed it, like Primo Levi and Theodor Adorno. (shrink)

. In the philosophy of J. L. Schellenberg, “evolutionary religion” is a religious stance oriented towards the deep future. According to Schellenberg, the best form of evolutionary religion is non-doxastic faith in ultimism. I reject Schellenberg’s arguments for preferring ultimism and suggest that committing non-doxastically to traditional religion makes more sense from an evolutionary perspective. I argue that the alignment argument for traditional religion remains sound even when the deep future is considered. Furthermore, I assess Schellenberg’s claim that humanity is (...) religiously immature. (shrink)

Games, Norms, and Reasons: Logic at the Crossroads provides an overview of modern logic focusing on its relationships with other disciplines, including new interfaces with rational choice theory, epistemology, game theory and informatics. This book continues a series called "Logic at the Crossroads" whose title reflects a view that the deep insights from the classical phase of mathematical logic can form a harmonious mixture with a new, more ambitious research agenda of understanding and enhancing human reasoning and intelligent interaction. The (...) editors have gathered together articles from active authors in this new area that explore dynamic logical aspects of norms, reasons, preferences and beliefs in human agency, human interaction and groups. The book pays a special tribute to Professor Rohit Parikh, a pioneer in this movement. (shrink)