Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

Shared decision-making has become a new focus of health policy. Though its core elements are largely agreed upon, there is little consensus regarding which outcomes to prioritize for policy-mandated shared decision-making.

Successful interactions between people are dependent on rapid recognition of social cues. We investigated whether head direction – a powerful social signal – is processed in the absence of conscious awareness. We used continuous flash interocular suppression to render stimuli invisible and compared the reaction time for face detection when faces were turned towards the viewer and turned slightly away. We found that faces turned towards the viewer break through suppression faster than faces that are turned away, regardless of eye (...) direction. Our results suggest that detection of a face with attention directed at the viewer occurs even in the absence of awareness of that face. While previous work has demonstrated that stimuli that signal threat are processed without awareness, our data suggest that the social relevance of a face, defined more broadly, is evaluated in the absence of awareness. (shrink)

For William James, work was the problem. Ultimately, going to work was the resolution, and James's quest for meaningful work remains as relevant at the end of the twentieth century as it was in the nineteenth. Weaving letters, diaries, drawings, and published texts, Becoming William James provides a convincing biographical analysis rich in detail and tone. In his new introduction, Howard M. Feinstein adds biological psychiatry to psychoanalytic and family systems theories to inform our understanding of a complex man. (...) In addition, he discusses whether James's mental illness might have been treated with drugs. (shrink)

We investigate the connection between interference and computational power within the operationally defined framework of generalised probabilistic theories. To compare the computational abilities of different theories within this framework we show that any theory satisfying four natural physical principles possess a well-defined oracle model. Indeed, we prove a subroutine theorem for oracles in such theories which is a necessary condition for the oracle model to be well-defined. The four principles are: causality, purification, strong symmetry, and informationally consistent composition. Sorkin has (...) defined a hierarchy of conceivable interference behaviours, where the order in the hierarchy corresponds to the number of paths that have an irreducible interaction in a multi-slit experiment. Given our oracle model, we show that if a classical computer requires at least n queries to solve a learning problem, because fewer queries provide no information about the solution, then the corresponding “no-information” lower bound in theories lying at the kth level of Sorkin’s hierarchy is \. This lower bound leaves open the possibility that quantum oracles are less powerful than general probabilistic oracles, although it is not known whether the lower bound is achievable in general. Hence searches for higher-order interference are not only foundationally motivated, but constitute a search for a computational resource that might have power beyond that offered by quantum computation. (shrink)

I claim that there are four major strands of argument for externalism and set out to discuss three of them. The four are: (A) That referential thoughts are object-dependent. This I do not discuss. (B) That the semantics of natural kind terms is externalist. (C) That all semantic content, even of descriptive terms, stems from the causal relations of representations to the things or properties they designate in the external world. (D) That, because meaning is a social product and no (...) individual can capture the whole social practice that defines a concept, what the speaker means always outruns what he can know.I briefiy discuss (C) and (D) and conclude that they cannot be correct, because, if they were, the content of every thought would permanently transcend the refiective grasp of all thinkers. Then I discuss (B) and conclude that, though Putnam shows something interesting about natural kind terms -- namely that a real verbal definition requires science -- this has none of the consequences for philosophy of mind that it is normally supposed to have. (shrink)

Until recently, psychologists have conceptualised and studied trust in God (TIG) largely in isolation from contemporary work in theology, philosophy, history, and biblical studies that has examined the topic with increasing clarity. In this article, we first review the primary ways that psychologists have conceptualised and measured TIG. Then, we draw on conceptualizations of TIG outside the psychology of religion to provide a conceptual map for how TIG might be related to theorised predictors and outcomes. Finally, we provide a research (...) agenda for future empirical work in this area, as well as practical applications for counsellors and religious leaders. (shrink)

Ulf Schmidt, writing on “Medical Ethics and Nazism” in the recently published Cambridge World History of Medical Ethics, states:In 1920, the lawyer Karl Binding and the psychiatrist Alfred Hoche published their tract Permission for the Destruction of Life Unworthy of Life. … Their positivistic theory was a combination of legal norms and medical arguments that granted the state fundamental rights while overriding the rights of individuals. The traditional moral belief system that advocated care and compassion for the weak and unproductive (...) was radically called into question. The book was written in the wake of World War I; readers were asked to compare the “battlefields littered with.. (shrink)

An introduction to informal logic, critical thinking and rhetoric utilizing actual public discourse .

This symposium contributes to the broader discussion about humanism in management and organizational well-being. Dignity plays a crucial role as both a fundamental value and as an end state in the process of humanizing organizational cultures, workplaces and relationships. However, despite its significance, it has yet to be addressed properly in the growing discourse on humanistic capitalism and management, and indeed in business ethics as a whole. This symposium seeks to inform and inspire emerging research and approaches towards human dignity (...) through the lens of artistic expression and explores how arts may promote human dignity in organizational life. (shrink)

The Vatican’s position on in vitro fertilization (IVG), found in the ’Instruction on Bioethics’ (1987), is that all IVF is immoral, for it violates the normative procreative act of married spouses. The dilemma created is, if all instances of IVF are immoral, then God’s act in the Incarnation (granting the traditional doctrine) must also have been immoral. Conversely, if God’s act in the Incarnation was not immoral, then at least some cases of human IVF are not immoral either. A resolution (...) is offered. Two diagrams are employed. (shrink)

Responding to a major pandemic and planning for allocation of scarce resources under crisis standards of care requires coordination and cooperation across federal, state and local governments in tandem with the larger societal infrastructure. Maryland remains one of the few states with no state-endorsed ASR plan, despite having a plan published in 2017 that was informed by public forums across the state. In this article, we review strengths and weaknesses of Maryland’s response to COVID-19 and the role of the Maryland (...) Healthcare Ethics Committee Network in bridging gaps in the state’s response to prepare health care facilities for potential implementation of ASR plans. Identified “lessons learned” include: Deliberative Democracy Provided a Strong Foundation for Maryland’s ASR Framework; Community Consensus is Informative, Not Normative; Hearing Community Voices Has Inherent Value; Lack of Transparency & Political Leadership Gaps Generate a Fragmented Response; Pandemic Politics Requires Diplomacy & Persistence; Strong Leadership is Needed to Avoid Implementing ASR … And to Plan for ASR; An Effective Pandemic Response Requires Coordination and Information-Sharing Beyond the Acute Care Hospital; and The Ability to Correct Course is Crucial: Reconsidering No-visitor Policies. (shrink)