Abraham Flexner delivered his eponymous report 100 years ago. The Report had an immediate and profound impact on medical education in North America that resonated for several decades afterwards. Its impact was less immediate in the United Kingdom, but over time the major principles have been assimilated (GMC 1993). However, which—if any—of these principles are still relevant today? No doubt there will be debate about this, but in my view, Flexner's principle of academic and scientific excellence as one of the (...) most fundamental underpinnings of medical education is even more relevant today than it was in 1910. To illustrate this, I shall highlight two aspects of current medical education in the United Kingdom: the .. (shrink)

The argument in this paper is that the exclusion of empirical research has led to a deficiency in the Positivist model; the neglect of conflict in the form of the trouble-case. In the attempt to define law in a relatively narrow way Positivists have avoided important knowledge about social behavior. In addition the analytical method of Positivism has been connected with a value-position which tends to exaggerate the extent to which law functions within social structures as an orderly system. One (...) consequence of this perspective is that the role of conflict in the law process is hardly appreciated. Studies of law in some primitive societies suggest that although social behavior generally is not regulated in rule-terms, conflict often is institutionalized in a manner capable of providing norms appropriate to new situations. It is suggested that the focus upon the trouble-case is more likely to develop our understanding of conflict as a dynamic element in the law process. (shrink)

A meta-analytic review of studies that experimentally elicited awe and compared the emotion to other conditions (84; 487 effects; 17,801 participants) examined the degree to which experimentally elicited awe (1) affects outcomes relative to other positive emotions (2) affects experience, judgment, behaviour, and physiology, and (3) differs in its effects if the awe state was elicited through positive or threatening contexts. The efficacy of methods that have been used to experimentally elicit awe and the possibility of assessing changes in the (...) state of the self with experimental awe elicitations were also examined. Meta-analyses with robust variance estimation revealed that awe affected outcomes compared to other positive emotions and control conditions; affected experience, judgment, and behaviour; and had similar effects if elicited through positive or threatening contexts. The ability to compare awe to negative emotion states and its effects on physiology was limited by a small number of available effects. Images, videos, autobiographical recall, and naturalistic exposure were effective in eliciting awe. Exploratory analyses suggested that some processes involved in changes in the self can be related to experimental awe elicitations. These findings suggest awe is a discrete emotion and identifies areas for future investigation. (shrink)

“Imagination may be thought of as a ‘work-around.’ It is a resourceful tactic to ‘undo’ a rule by creating a path around it without necessarily defying it.... Transgression, on the other hand, is rule breaking. There is no pretense of reinterpretation; it is defiance pure and simple. Whether imagination or disobedience is the source, constraints need not constrain, ties need not bind.” So writes Kenneth A. Shepsle in his introduction to Rule Breaking and Political Imagination. Institutions are thought to (...) channel the choices of individual actors. But what about when they do not? Throughout history, leaders and politicians have used imagination and transgression to break with constraints upon their agency. Shepsle ranges from ancient Rome to the United States Senate, and from Lyndon B. Johnson to the British House of Commons. He also explores rule breaking in less formal contexts, such as vigilantism in the Old West and the CIA’s actions in the wake of 9/11. Entertaining and thought-provoking, Rule Breaking and Political Imagination will prompt a reassessment of the nature of institutions and remind us of the critical role of political mavericks. (shrink)

In the ‘Justice Cascade’, Kathryn Sikkink argues that “foreign prosecutions and international tribunals can be cost-effective alternatives to military intervention.” Yet, the successes of the Special Court for Sierra Leone—in prosecuting former Liberian President Charles Taylor and in imposing accountability on the leaders of all armed groups regardless of political alignment—were dependent on a commitment by Western powers and international and regional organizations to a military victory against the rebels in Sierra Leone and coercive regime change in Liberia. The lesson (...) that should be drawn from this case—which parallels that of other international tribunals set up during ongoing violence—is that the prospects for international criminal justice during civil wars are dependent on the political strategies adopted by outsiders to address the conflict and that taking criminal accountability seriously requires an interventionist rather than a consent-based approach to conflict resolution. (shrink)

The Ethics Consultation Quality Assessment Tool (ECQAT) establishes standards by which the quality of ethics consultation records (ECRs) can be assessed. These standards relate to the ethics question, consultation-specific information, ethical analysis, and recommendations and/or conclusions, and result in a score associated with one of four levels of ethics consultation quality. For the ECQAT to be useful in assessing and improving the quality of healthcare ethics consultations, individuals who rate the quality of ECRs need to be able to reliably use (...) the tool.We developed a short course to train ethics consultants in using the ECQAT, and evaluated whether the participants (1) achieved an acceptable level of calibration in matching expert-established quality scores for a set of ethics consultations, and (2) were satisfied with the course. We recruited 28 ethics consultants to participate in a virtual, six-session course. At each session participants and faculty reviewed, rated, and discussed one to two ECRs. The participants’ calibration in matching expert-established quality scores improved with repeated exposure at all levels of ethics consultation quality. Participants were generally more accurate when assessing consultation quality at the dichotomous level of “acceptable” (scores of three or four) versus “unacceptable” (scores of one or two) than they were with a more specific score. Participants had higher rates of accuracy with the extreme ratings of “strong” (level four) or “poor” (level one). Although participants were highly satisfied with the course, only a minority of participants achieved the prespecified acceptable level of calibration (that is, 80 percent or greater accuracy between their score and expert-established scores). These results suggest that ECQAT training may require more sessions or need modification in the protocol to achieve higher reliability in scoring. Such trainings are an important next step in ensuring that the ECQAT is a tool that can be used to promote improvement in ethics consultation quality. (shrink)

By appealing to Paul Ricoeur’s view of interpretation as the dialectical process of understanding through explanation, Kenneth A. Reynhout contributes to the growing field of religion and science by developing an alternative understanding of interdisciplinary theology that is fundamentally hermeneutical.

Recent research on genetic and biological diversity suggests that they underlie, and are the source of renewable resources--which are themselves more fundamental than non-renewable resources. If this is the case, then our understandings of the "limits to growth" debate will need modification and current approaches to development--in both the industrial countries and in the Third World--will need reconceptualization. A major part of this will involve a reversal of roles and priorities for agricultural and industrial development. Also, more sustainable/regenerative types of (...) agriculture and food systems will need to be developed. Current explorations along these lines are briefly reviewed. Finally, the links between this and the wider need to develop more sustainable societies are examined. (shrink)

A translation of Aristotle’s Nicomachean Ethics.

This essay defends three interlocking claims about singular beliefs and their ascriptions. The first is a claim about the nature of such beliefs; the second is a claim about the semantic contents of ascriptions of such beliefs; the third is a claim about the pragmatic significance of such ascriptions. With respect to the nature of singular belief, I claim that the contents of our singular beliefs are a joint product of mind and world, with neither mind nor world enjoying any (...) peculiar priority over the other in the constitution of content. This view amounts to a rejection of the priority of so-called narrow or notional content over wide or referential content for singular beliefs. About the semantics of ascriptions of singular belief, I claim that such ascriptions ascribe what I call predicative doxastic commitments and nothing more. In particular, I will argue that to ascribe a predicative commitment is merely to say what property is being predicated by she who undertakes the relevant commitment to what object. My view has the consequence that ascriptions of singular beliefs typically do not either semantically specify or pragmatically implicate the modes of presentations, notions, or conceptions via which the ascribee cognizes the objects and properties relative to which she undertakes predicative commitments. To be sure, many maintain that at least one class of belief ascriptions -- so called de dicto ascriptions. (shrink)

Drawing on broad definitions of technology and engineering as well as precedents in the philosophical literature, this paper makes the novel argument that the purposeful design of one’s unique good life using existing philosophical concepts is an engineering activity. Whether as a metaphor or as an engineering activity in its own right, a sampling of important benefits and perspectives provided for well-being by the presented “life engineering” framework are highlighted. A key strength of the framework is the conceptual simplicity, with (...) minimal sacrifices in completeness or consistency. This necessitates a tradeoff of limited precision for any one practical implementation. Consistent conceptual definitions for wisdom, virtue and the good life are presented within an informative ethics. Only a descriptive evaluation to aid in conceptual understanding is discussed, no prescriptive normative evaluations are made. The good life is defined to be one in which the minimum requirements are met and then performance is good, but no attempt is made to define what is good. A fundamental limitation of the framework stems from the inherent focus of technology on human utility. Although no novel fundamental conclusions are drawn in this paper, the presented framework is demonstrated to correspond with numerous ethical precepts of many existing philosophical traditions. (shrink)

The primary psychological process leading aggressive children to grow into dysfunctional adults is a defensive mindset, which encompasses a pattern of deviant social information processing steps, including hypervigilance to threat; hostile attributional biases; psychophysiological reactivity, experience of rage and testosterone release (in males); aggressive problem-solving styles; aggressogenic decision-making biases; and deficient behavioral skills. These processes are acquired in childhood and predict adult maladjustment outcomes, including incarceration and premature death. The antecedents of defensive mindset lie in early childhood experiences of trauma (...) and threat. The Fast Track (FT) intervention was designed to improve social competence in aggressive children. A randomized controlled trial demonstrated that FT is effective in preventing externalizing psychopathology; the primary mediating factor is the reduction of defensive mindset processes. This Element concludes with insights that defensive mindset might also explain dysfunction in other realms, including school culture, parenting, marriage, the workplace, intergroup relationships, politics, and international relations. (shrink)

Aristotle’s Categories and Concerning Interpretation, translated and with commentary.

"This book casts the argument for personal immortality into new light as the outcome of systems processes rather than human nature. Personal immortality is the output of becoming human rather than of being human. If this is the case, then God must be seen to enter into personal relationships with us: a view that current science supports."--Jacket.