Does respect for autonomy imply respect for precedent autonomy? The principle of respect for autonomy requires us to respect a competent patient’s treatment preference, but not everyone agrees that it requires us to respect preferences formed earlier by a now‐incapacitated patient, such as those expressed in an advance directive. The concept of precedent autonomy, which concerns just such preferences, is problematic because it is not clear that we can still attribute to a now‐incapacitated patient a preference which that patient never (...) disaffirmed but can no longer understand. If we cannot make that attribution, then perhaps we should not respect precedent autonomy – after all, how can you respect patient autonomy by giving patients what they no longer want, even if they never disaffirmed those wants? I argue that whether an earlier preference can still be attributed to a now‐incapacitated patient depends on the reasons behind the preference, for a preference includes (and is not merely supported by) the reasons behind it. When the considerations that served as reasons no longer exist, neither does the preference which included those reasons. In particular, if the considerations that served as reasons for the patient exist only under conditions where the patient retains full mental capacity, then once that capacity is lost, so are those reasons and the preference based upon them. I use this analysis of precedent autonomy to ascertain the merits of various approaches to advance medical decisionmaking, including Nancy Rhoden’s approach, approaches based on a Parfitian personal identity analysis, approaches based on soft paternalism, and approaches based on the stability and longevity of preferences. Despite the apparent absurdity of respecting patient autonomy by giving patients what they no longer prefer but have never disaffirmed, I conclude with some programmatic remarks on when and why respect for (precedent) autonomy nonetheless requires us to respect former preferences. (shrink)

Honoring a living will typically involves treating an incompetent patient in accord with preferences she once had, but whose objects she can no longer understand. How do we respect her precedent autonomy by giving her what she used to want? There is a similar problem with subsequent consent: How can we justify interfering with someone''s autonomy on the grounds that she will later consent to the interference, if she refuses now?Both problems arise on the assumption that, to respect someone''s autonomy, (...) any preferences we respect must be among that person''s current preferences. I argue that this is not always true. Just as we can celebrate an event long after it happens, so can we respect someone''s wishes long before or after she has that wish. In the contexts of precedent autonomy and subsequent consent, the wishes are often preferences about which of two other, conflicting preferences to satisfy. When someone has two conflicting preferences, and a third preference on how to resolve that conflict, to respect his autonomy we must respect that third preference. People with declining competence may have a resolution preference earlier, favoring the earlier conflicting preference (precedent autonomy), whereas those with rising competence may have it later, favoring the later conflicting preference (subsequent consent). To respect autonomy in such cases we must respect not a current, but a former or later preference. (shrink)

Patients sometimes request procedures their doctors find morally objectionable. Do doctors have a right of conscientious refusal? I argue that conscientious refusal is justified only if the doctor's refusal does not make the patient worse off than she would have been had she gone to another doctor in the first place. From this approach I derive conclusions about the duty to refer and facilitate transfer, whether doctors may provide 'moral counseling,' whether doctors are obligated to provide objectionable procedures when no (...) other doctor is available, why the moral consensus among doctors seems relevant even though it does not determine whether something is morally acceptable, and whether doctors should stay out of fields whose standard procedures they find morally unacceptable. (shrink)

Basic issues in the recent ‘death-of-God’ movement can be illuminated by comparison and contrast with the relevant ideas of two American philosophers, John Dewey and William James. Dewey is an earlier spokesman for ideas that are central to the ‘radical theology’ of Thomas J. J. Altizer, William Hamilton, and Paul Van Buren. His reasons for rejecting theism closely resemble propositions maintained by these ‘death-of-God’ theologians. James, on the other hand, points toward a theological alternative. He takes cognizance of ideas (...) similar to those in the ‘radical theology’, but he does not opt for either a metaphorical or real elimination of God. Thus, the contentions of this paper are that there has been a version of the ‘death-of-God’ perspective in American thought before, and that there are resources in the American tradition that suggest a viable option to this perspective. (shrink)

A “post-work world” can mean a couple of things. First, it can mean a world where we attach less importance to work, restructure work so that tasks and authority are distributed more equitably, and otherwise decenter and reform the world of work. Second, it can mean a world where people are no longer working because robots, artificial intelligence, and other forms of automation have replaced humans and there are no longer enough jobs for everyone. This paper is about the second (...) kind of world, and how to support the workers it leaves behind. -/- Automation has always eliminated jobs, but in the past new jobs have appeared to replace them. This may be changing. Thanks to recent advances in automation, machines and software can now do an increasingly large percentage of the tasks that humans do. “Technological unemployment” is what happens when automation can do so many different tasks that new jobs do not appear in sufficient numbers to employ everyone (Keynes 1932). In short, automation may soon leave a very large part of the potential workforce permanently unemployed, leading to a social, political, economic, and humanitarian crisis. For ease of reference, I refer to the technologically unemployed as being displaced from the economy. -/- The displaced need incomes. One obvious source of funds is the money saved through technological unemployment. On the scale of an entire economy, technological unemployment increases the labor savings from automation, for in addition to the usual labor savings from automation, there is less of a need to pay new workers, for there are fewer new jobs. I call this money the displacement gain. This is money that becomes available precisely because technological unemployment has occurred. It is important to understand that the displacement gain is not the same thing as the profit that results from gains in productivity. Automation does not necessarily produce displacement but it does produce gains in productivity, and the profits from gains in productivity occur even when no one is displaced. A productivity gain does not become a displacement gain until technological unemployment occurs. -/- The core of this paper is a set of arguments that the displacement gain is not the private property of businesses or those who have ownership interests in businesses (I refer to both groups as “capitalists”), nor is it the private property of those lucky enough to still have jobs. For these and additional reasons, the displacement gain is collective property in which every person has an equal interest. Moreover, it is a kind of collective property that has been largely overlooked. (Better-known forms of collective property include the natural world and “social capital.” ) As far back as Thomas Paine (1796), many thinkers have argued that, because we all have equal interests in collective property, it should be distributed to everyone, working or not, rich or poor, as equal and unconditional basic incomes. The displacement gain is a new kind of collective property which can fund basic incomes, and those incomes can support the displaced. That’s how to pay for a post-work world. -/- However, I will argue, in order to distribute those funds equally we must pay unequal basic incomes, for those who are technologically unemployed bear a larger share of the burden involved in creating that collective property, and therefore deserve larger basic incomes to offset their larger burdens. My discussion of this leads to a possible solution to a problem that bedevils basic income proposals: how to prevent businesses from, in effect, appropriating basic incomes from their employees by simply paying them less, using basic incomes as a payroll subsidy . (shrink)

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The general problem of visual search can be shown to be computationally intractable in a formal, complexity-theoretic sense, yet visual search is extensively involved in everyday perception, and biological systems manage to perform it remarkably well. Complexity level analysis may resolve this contradiction. Visual search can be reshaped into tractability through approximations and by optimizing the resources devoted to visual processing. Architectural constraints can be derived using the minimum cost principle to rule out a large class of potential solutions. The (...) evidence speaks strongly against bottom-up approaches to vision. In particular, the constraints suggest an attentional mechanism that exploits knowledge of the specific problem being solved. This analysis of visual search performance in terms of attentional influences on visual information processing and complexity satisfaction allows a large body of neurophysiological and psychological evidence to be tied together. (shrink)

"There's nothing available that I know of that comes as close to representing the range of Royce's works.... " -- John H Lavely.

This is the second of a three-volume work constituting a comprehensive, scholarly edition of the correspondence of the English economist, Alfred Marshall, one of the leading figures in the development of economics and the founder of the Cambridge School of Economics. The edition fills a long-standing gap in the history of economic thought with hitherto unpublished material. Students will find it a basic resource for understanding the development of economics and other social sciences in the period since 1870. In particular, (...) it provides much new information about Marshall's views on economic, social and political issues, his struggles to promote the teaching of economics at the University of Cambridge, and his relations with colleagues in Cambridge and elsewhere. Marshall's letters are notable for their frankness and spontaneity. (shrink)

The Failures of Ethics concentrates on the multiple shortfalls and shortcomings of thought, decision, and action that tempt and incite us human beings to inflict incalculable harm. Absent the overriding of moral sensibilities, if not the collapse or collaboration of ethical traditions, the Holocaust, genocide, and other mass atrocities could not have happened. Our senses of moral and religious authority have been fragmented and weakened by the accumulated ruins of history and the depersonalized advances of civilization that have taken us (...) from a bloody twentieth century into an immensely problematic twenty-first. Salvaging the fragmented condition of ethics, this book shows how respect and honor for those who save lives and resist atrocity, deepened attention to the dead and to death itself, and appeals for human rights and renewed spiritual sensitivity confirm that ethics contains and remains an irreplaceable safeguard against its own failures. (shrink)

This is the first of a three-volume work constituting a comprehensive, scholarly edition of the correspondence of the English economist, Alfred Marshall, one of the leading figures in the development of economics and the founder of the Cambridge School of Economics. The edition fills a long-standing gap in the history of economic thought with hitherto unpublished material. Students will find it a basic resource for understanding the development of economics and other social sciences in the period since 1870. In particular, (...) it provides much new information about Marshall's views on economic, social and political issues, his struggles to promote the teaching of economics at the University of Cambridge, and his relations with colleagues in Cambridge and elsewhere. Marshall's letters are notable for their frankness and spontaneity. (shrink)

Contains entries that provide information about some of history's greatest philosophers and philosophical works; arranged alphabetically from Abe-to-Friere.

Moral and legal judgments sometimes depend on personal traits in this sense: the subject offers good reasons for her judgment, but if she had a different social or ideological background, her judgment would be different. If you would judge the constitutionality of restrictions on abortion differently if you were not a secular liberal, is your judgment really based on the arguments you find convincing, or do you find them so only because you are a secular liberal? I argue that a (...) judgment can be based on the considerations the subject claims as justification even when it depends on personal traits. (shrink)

Sometimes the mentally ill have sufficient mental capacity to refuse treatment competently, and others have a moral duty to respect their refusal. However, those with episodic mental disorders may wish to precommit themselves to treatment, using Ulysses contracts known as “mental health advance directives.” How can health care providers justify enforcing such contracts over an agent’s current, competent refusal? I argue that providers respect an agent’s autonomy not retrospectively—by reference to his or her past wishes—and not merely synchronically—so that the (...) agent gets what he or she wants right now—but diachronically and prospectively, acting so that the agent can shape his or her circumstances as the agent wishes over time, for the agent will experience the consequences of providers’ actions over time. Mental health directives accomplish this, so they are a way of respecting the agent’s autonomy even when providers override the agent’s current competent refusal. (shrink)

I note that the logics of the relevant group most closely tied to the research programme in paraconsistency are those without the contraction postulate(A.AB).AB and its close relatives. As a move towards gaining control of the contraction-free systems I show that they are prime (that wheneverA B is a theorem so is eitherA orB). The proof is an extension of the metavaluational techniques standardly used for analogous results about intuitionist logic or the relevant positive logics.

Moral decision procedures such as principlism or casuistry require intuition at certain junctures, as when a principle seems indeterminate, or principles conflict, or we wonder which paradigm case is most relevantly similar to the instant case. However, intuitions are widely thought to lack epistemic justification, and many ethicists urge that such decision procedures dispense with intuition in favor of forms of reasoning that provide discursive justification. I argue that discursive justification does not eliminate or minimize the need for intuition, or (...) constrain our intuitions. However, this is not a problem, for intuitions can be justified in easy or obvious cases, and decision procedures should be understood as heuristic devices for reaching judgments about harder cases that approximate the justified intuitions we would have about cases under ideal conditions, where hard cases become easy. Similarly, the forms of reasoning which provide discursive justification help decision procedures perform this heuristic function not by avoiding intuition, but by making such heuristics more accurate. Nonetheless, it is possible to demand too much justification; many clinical ethicists lack the time and philosophical training to reach the more elaborate levels of discursive justification. We should keep moral decision procedures simple and user-friendly so that they will provide what justification can be achieved under clinical conditions, rather than trying to maximize our epistemic justification out of an overstated concern about intuition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Whisper Before You GoJohn K PettyDavid came with a bang.1A momentary prelude from a dysphonic chorus of pagers announce “Level 1 Pediatric Trauma—MVC ejected” before the abrupt crescendo of the trauma bay doors opening. He is maybe two. Maybe three–years–old. It is hard to tell when a child is strapped in, strapped down, nonverbal, intubated, and alone.The flight team speaks for him, “Four–year–old boy improperly restrained in a single–vehicle (...) crash into a ditch. He was partially ejected. He was unresponsive and pulseless at the scene. He got CPR and code drugs, and they got a pulse back. Emergency medical service (EMS) took him to the nearest hospital where they needled his chest, called for air transport, and scanned him up. He has been shocky for us since we picked him up. Glasgow Coma Scale (GCS) has been three the whole time. They said his head scan showed subarachnoid hemorrhage.”With the words of the flight team as background narrative, we get about doing our thing—hopefully more method and less madness. Bang, bang, bang! Check the tube. Vital signs. IV fluids. Place a chest tube. Hang the blood. Quick X–ray. Neuro exam—nothing. Get him off the board. Warm him up. Place the orogastric (OG) tube. Bang, bang, bang!The neurosurgery resident opens the CT scans from the other hospital. The brain and cervical spine scans show a disaster: some swelling and bleeding in the higher brain, but the worst damage is in the lower brain, brainstem, and top of the spinal cord. I have heard a neurosurgeon describe this pattern before as “internal decapitation.” Such language never makes it into the patient’s chart. For David the last two words of the neurosurgery consult note will eventually read, “Prognosis grim.”He remains unstable in the trauma bay. Inaction is death. We ultrasound his heart, abdomen, and pelvis. He has fluid that shouldn’t be around his heart. He is dying of the neuro injury we cannot control, but the pericardial fluid might be giving him shock, and we can control that. We can’t ignore the fluid. Shouldn’t ignore it. At least, wouldn’t ignore it. So, we bang up to the operating room. Squeezing blood. Spiking fluid. Oxygen tank and crash cart. Up we go.In the operating room, we do much and we do well. We release the fluid around the heart and find it was CPR, not heart injury that put it there. In the pericardial flash we get a view of the cardiac athlete, pounding like the 26th mile of the marathon. We explore the abdomen and find it swollen but innocent of an injury that would take his life. We place our lines and tubes as the neurosurgeons place theirs. If nothing else, we will be able to measure what lies ahead.“Good work, team,” and we bump the door on the way to the pediatric intensive care unit (PICU).The care in the PICU is more Apache brave than Gaelic knight—more bottles, fewer scissors. The curtains and carpets mute the tones. Our efforts continue, but I get a word that David’s father has arrived. He is sitting in a small, private waiting room off of the main PICU waiting room. The PICU staff colloquially refer to this as “the bad news room.” I take a seat next to a solitary man who is having the worst day of his life. His worst day so far.“I am Dr. Petty, and I am one of the doctors who is taking care of your son. I am very sorry about what has happened. Maybe you can tell me a little bit about what you understand is going on, and I’ll tell you what I know.” [End Page 17]He tells me that his wife was driving David back from her sister’s house, just the two of them. He doesn’t know what happened, but he got a call from the other hospital about the crash. His wife was badly hurt. He heard that David had died, but they got him back. Both were transferred up to the... (shrink)

It is shown that there are exactly six normal DeMorgan monoids generated by the identity element alone. The free DeMorgan monoid with no generators but the identity is characterised and shown to have exactly three thousand and eighty-eight elements. This result solves the "Ackerman constant problem" of describing the structure of sentential constants in the logic R.

"Sheriff’s text moves the "guess" to a new level of understanding, while integrating much of Peirce’s philosophy, and provokes many questions." —Society for the Advancement of American Philosophy Newletter "The purpose of Sheriff’s work is to expound Peirce’s unified theory of the universe—from cosmology to semiotic—and to discuss its ramifications for how we should live. He concludes that Peirce has given us a theory we can live with. The book makes an important contribution to philosophy of life and to the (...) humanities in general."—Nathan Houser "In clear and concise prose, Sheriff describes Peirce’s ‘theory of everything,’ a vision of cosmic and human meaning that offers a positive alternative to popular pessimistic and relativistic approaches to life and meaning." —Peirce Project Newsletter. (shrink)

The worst possible way to resolve this issue is to leave it up to individual choice. There is no known social good coming from the conquest of death (Bailey, 1999). - Daniel Callahan Dramatically extending the human lifespan seems increasingly possible. Many bioethicists object that life-extension will have Malthusian consequences as new Methuselahs accumulate, generation by generation. I argue for a Life-Years Response to the Malthusian Objection. If even a minority of each generation chooses life-extension, denying it to them deprives (...) them of many years of extra life, and their total extra life-years are likely to exceed the total life-years of a majority who do not want life-extension. This is a greater harm to those who want extended life than the Malthusian harms to those who refuse extended life, both because losing an extra year of life is worse than enduring a year of Malthusian conditions, and because the would-be Methuselahs have more life-years at stake. Therefore, even if life-extension seems likely to cause severe overcrowding and resource shortages, that threat is not sufficient to justify society in restricting the development or availability of life-extension. (shrink)

CUA Press proudly announces the reissue of 32 titles from this internationally acclaimed series. These long-unavailable titles, which cover all aspects of philosophy, will be published in paperback and ebook formats. Authors include renowned philosophers such as Ralph McInerny, Robert Sokolowski, and John Wippel.