Volume 24, Issue 12, December 2024, Page 32-34.

In 'Notes on the Theory of Reference' Quine offers a brief argument, based on Tarski's Convention T and semantic definition of truth, that the theory of meaning is 'in a worse state' than is the theory of reference and that the concepts of the theory of meaning are inherently more 'foggy and mysterious' than those of thetheory of reference. A careful reconstruction of Quine's argument, however, is sufficient to show both that he covertly imposes a double standard of clarity on (...) the two theories in question and that in so far as Tarski's contributions clarify or explicate the notion of truth they do likewise for the notion of analyticity. Consequently, the appeal which Quine makes to Tarski's definition of truth cannot be used in the manner he wishes, to draw a clear boundary between the theories of meaning and reference. (shrink)

Care work straddles the divide between activities performed out of love and those performed for pay. The tensions created for workers by this divide raise questions concerning connections between recognition and redistribution. Through an analysis of mobilization among childcare workers, we argue that care workers can address redistribution and recognition simultaneously through vocabularies of both skill and virtue. We conclude with a discussion of strategies to overcome the false dichotomy between recognition and redistribution.

Lvcretivs II. 263 ‘nonne uides etiam patefactos tempore puncto.’ ‘Tempore puncto’ occurs only here in Lucretius and in no other author; but ‘puncto tempore’ is read in II. 456, 1006, IV. 214; ‘puncto in tempore et,’ VI. 230. ‘Temporis puncto’ is found at I. 1109, and ‘temporis in puncto’ at IV. 164, 193. ‘Puncto… diei’ occurs in IV. 201. ‘Punctum’ as a noun corresponds to τομος, for a point has no dimensions; St. August. Ep. 205, 14, ‘atomo temporis, inquit, hoc (...) est in puncto temporis quod diuidi non potest.’ ‘Inquit’ refers to St. Paul I. Ad Corinth. XV. 52, where the N.T. has ν τόμѡ and the present Vulgate ‘in momento.’ And in Ep. 190, 15, St. Austin says ‘summa celeritate atque atomo temporis’; and St. Jerome, Ep. 119, 2, ‘in atomo et in puncto temporis atque momento,’ 5 ‘atomus… punctum temporis est’; J. Cassian, Inst. II. 7, 2, ‘puncto breuissimo’; Lact. Inst. VII. 12 ‘uno temporis puncto.’ ‘Punctum temporis’ or ‘atomus temporis’ means an instant of time that cannot be divided. (shrink)

In 'Notes on the Theory of Reference' Quine offers a brief argument, based on Tarski's Convention T and semantic definition of truth, that the theory of meaning is 'in a worse state' than is the theory of reference and that the concepts of the theory of meaning are inherently more 'foggy and mysterious' than those of thetheory of reference. A careful reconstruction of Quine's argument, however, is sufficient to show both that he covertly imposes a double standard of clarity on (...) the two theories in question and that in so far as Tarski's contributions clarify or explicate the notion of truth they do likewise for the notion of analyticity. Consequently, the appeal which Quine makes to Tarski's definition of truth cannot be used in the manner he wishes, to draw a clear boundary between the theories of meaning and reference. (shrink)

Ontologies are being developed throughout the biomedical sciences to address standardization, integration, classification and reasoning needs against the background of an increasingly data-driven research paradigm. In particular, ontologies facilitate the translation of basic research into benefits for the patient by making research results more discoverable and by facilitating knowledge transfer across disciplinary boundaries. Addressing and adequately treating mental illness is one of our most pressing public health challenges. Primary research across multiple disciplines such as psychology, psychiatry, biology, neuroscience and pharmacology (...) needs to be integrated in order to promote a more comprehensive understanding of underlying processes and mechanisms, and this need for integration only becomes more pressing with our increase in understanding of differences among individuals and populations at the molecular level concerning susceptibility to specific illnesses. Substance addiction is a particularly relevant public health challenge in the developed world, affecting a substantial percentage of the population, often co-morbid with other illnesses such as mood disorders. Currently, however, there is no straightforward automated method to combine data of relevance to the study of substance addiction across multiple disciplines and populations. In this contribution, we describe a framework of interlinked, interoperable bio-ontologies for the annotation of primary research data relating to substance addiction, and discuss how this framework enables easy integration of results across disciplinary boundaries. We describe entities and relationships relevant for the description of addiction within the Mental Functioning Ontology, Chemical Entities of Biological Interest Ontology, Protein Ontology, Gene Ontology and the Neuroscience Information Framework ontologies. (shrink)

This paper introduces a new hypothesis for the rise of the politically correct left via an analysis of Black America. Drawing on Žižekian and psychoanalytical theory, it explores the ideological role of ‘symptom’ within America’s cultural landscape - of that which states that society ‘doesn’t work’ - by way of examining prominent African American figures and how they relate to this ‘symptom’: Will Smith and the ‘hystericization of the symptom’; Barack Obama and the ‘identification with the symptom’; the PC left (...) and the ‘implementation of the symptom as law’; the far right and the ‘fear of loss of the symptom’; Kanye West, Candace Owens and the ‘rejection of clinging to the symptom’. Additionally, the 90s sit-com The Fresh Prince of Bel-Air and the film Black Panther are analyzed and juxtaposed in order to further illustrate the process by which the recent ideological shift in our cultural and political discourse towards political correctness and identity politics has occurred. (shrink)

If you don’t feel it you can’t be taught it. Either you can play Schumann or you can’t. Successful performances of Western classical music exhibit both technical mastery and aesthetic insight. While legacies of music teachers have distilled schools of technique and stylistic performance practices, the aesthetic components of interpretation have not received systematic treatment. This may be due to inherent difficulties with teaching aesthetics: musical meaning is hard to express in words, and even demonstrating for students does not guarantee (...) their understanding. Some teachers, like Theodor Leschetizky in the above quote, believe aesthetics cannot truly be taught because it reflects a musician’s personal.. (shrink)

The Emotion Ontology is an ontology covering all aspects of emotional and affective mental functioning. It is being developed following the principles of the OBO Foundry and Ontological Realism. This means that in compiling the ontology, we emphasize the importance of the nature of the entities in reality that the ontology is describing. One of the ways in which realism-based ontologies are being successfully used within biomedical science is in the annotation of scientific research results in publicly available databases. Such (...) annotation enables several objectives, including searching, browsing and cross-database data integration. A key benefit conferred by realismbased ontology is that suitably annotated research results are able to be aggregated and compared in a fashion that is based on the underlying reality that the science is studying. This has the potential of increasing the power of statistical analysis and meta-analysis in data-driven science. This aspect has been fruitfully exploited in the investigation of the functions of genes in molecular biology. Cognitive neuroscience uses functional neuroimaging to investigate the brain correlates of areas of mental functioning such as memory, planning and emotion. The use of functional neuroimaging to study affective phenomena such as the emotions is called ‘affective neuroscience’. BrainMap is the largest curated database of coordinates and metadata for studies in cognitive neuroscience, including affective neuroscience (Laird et al., 2005). BrainMap data is already classified and indexed using a terminology for classification, called the ‘Cognitive Paradigm Ontology’ (CogPO), that has been developed to facilitate searching and browsing. However, CogPO has been developed specifically for the BrainMap database, and the data are thus far not annotated to a realism-based ontology which would allow the discovery of interrelationships between research results across different databases on the basis of what the research is about. In this contribution, we describe ongoing work that aims to annotate affective neuroscience data, starting with the BrainMap database, using the Emotion Ontology. We describe our objectives and technical approach to the annotation, and mention some of the challenges. (shrink)

Genetic information is widely thought to pose unique risks of reidentifying individuals. Genetic data reveals a great deal about who we are and, the standard view holds, should consequently be treated differently from other types of data. Contrary to this view, we argue that the dangers of reidentification for genetic and nongenetic data—including health, financial, and consumer information—are more similar than has been recognized. Before different requirements are imposed around sharing genetic information, proponents of the standard view must show that (...) they are in fact necessary. We further argue that the similarities between genetic and nongenetic information have important implications for communicating risks during consent for health care and research. While patients and research participants need to be more aware of pervasive data‐sharing practices, consent forms are the wrong place to provide this education. Instead, health systems should engage with patients throughout patient care to educate them about data‐sharing practices. (shrink)

The editors welcome letters from readers, although we cannot guarantee that all will be published. To ensure timeliness, correspondents must respond to an article within seven weeks and not exceed two double‐spaced pages. Letters become the property of the editors and may be edited and shortened at our discretion.

Hastings Center Report, Volume 52, Issue S1, Page S50-S56, March‐April 2022.

Competent patients have considerable legal authority to control life‐and‐death care. They may refuse medical life support, including medically delivered food and fluids. Even when they are not in need of any life‐saving care, they may expedite death by refusing food and water by mouth—voluntarily stopping eating and drinking, or VSED. Neither right is limited to terminal illness. In addition, in four U.S. states, competent patients, if terminally ill, may obtain lethal drugs for aid‐in‐dying.For people who have dementia and are no (...) longer competent, however, control over the end of life is much less extensive. They may have written a clear advance directive for refusing life‐saving care in specified circumstances yet subsequently find themselves living for years in severe dementia with no need for life‐saving care that could be refused. Chronic progressive dementia is not itself life threatening until its very final stage. Even in jurisdictions that permit active aid‐in‐dying, individuals with advanced dementia are not eligible; they lack the required current competence, and they are seldom deemed terminally ill. As for the right to VSED, its very name—voluntarily stopping eating and drinking—is seen as excluding noncompetent persons.One option for ensuring that one does not live years in severe dementia is to use advance directives to withhold food and water by mouth. The driving element behind VSED is that forcing people to ingest food is as objectionable an intrusion on bodily integrity, privacy, and liberty as imposing unwanted medical treatment. Thus, if incompetent people do not lose their rights to refuse life‐saving treatment, and if people when competent have just as strong a right to VSED as they do to refuse life‐saving treatment, then people do not lose their right to VSED when incompetent either. They only have to exercise it by AD. (shrink)

I served as a medical student and resident in the 1960s. Science as a belief system had reached a pinnacle. Yet Not infrequently in those days, I found myself caring, with little available backup, for a hospital ward filled with sick and dying people. It was a lonely and often frightening responsibility. I began to encounter situations that were at odds with our collective certainty that science would provide the answers. Some of these memories I repressed for almost a decade. (...) I was unable to process them until I had personally experienced a more humanistic side of medicine. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Laying Medicine Open: Innovative Interaction Between Medicine and the HumanitiesLaurence B. McCullough and Warren Thomas ReichThe past three decades have witnessed the emergence and remarkable success of the fields of bioethics and medical humanities. The intellectual landscape of medicine and that of the humanities have been remarkably altered in the process. Twenty-five to 30 years ago in the United States there existed but a few courses in what came (...) to be called “bioethics” in departments of philosophy, religious studies, and theology in colleges and universities, a handful of programs of teaching in medical schools such as the University of Texas Medical Branch at Galveston and Pennsylvania State University School of Medicine at Hershey, and but one independent research center (the Hastings Center) and one university-based research center (the Kennedy Institute of Ethics at Georgetown University). Articles on bioethics began to appear in the peer-reviewed medical, nursing, and humanities literature and some books were published. There was only one journal in bioethics, The Hastings Center Report (which consolidated two previously separate journals from the Hastings Center). Graduate programs in bioethics and medical humanities in colleges and universities and fellowship training in bioethics and medical humanities in medical schools did not exist. Very little existed in colleges, universities, and medical schools in other countries. Now, of course, everything is different.Teachers, scholars, and students of bioethics and medical humanities should not take these remarkable changes for granted, for they represent a sustained and innovative interaction between medicine and the humanities. We have chosen the metaphor of “laying medicine open” to characterize the history of bioethics and medical humanities of the past three decades. This surgical metaphor was used in eighteenth-century Britain by a number of writers who wanted to make medical science and practice more accessible to the sick and to the lay public more generally (Lawrence 1975). We use the metaphor to characterize the efforts of teachers and [End Page 1] scholars over the past three decades and more to make the value-laden dimensions of biomedical science and practice and of health care policy more accessible to patients and to the lay public more generally. The result of this laying open of medicine has gone a long way toward bringing closer together the two cultures of science and the humanities that had, as C. P. Snow famously described, become significantly isolated from each otherAlbert Jonsen (1998) has recently contributed the first book-length history of what he calls the “birth” of bioethics, adding to the work of other scholars such as Warren Reich (1994; 1995) and Robert Baker (1993) and, before them, Corrado Viafora (1990) and David Rothman (1991). The articles in this issue of the Kennedy Institute of Ethics Journal make additional contributions to the developing understanding of the history of the past thirty years of interaction between medicine and the humanities.Laurence McCullough provides an historical context for the three accounts of the recent laying open of medicine that follow. McCullough examines two times in the history of medicine when it has been laid open to accountability (in addition to its being laid open to and by bioethics and medical humanities). The first laying open occurred in the work of the eighteenth-century Scottish physician and philosopher John Gregory, who set out to create a profession of medicine in a true moral sense of a fiduciary profession by making medicine accountable for its scientific and moral quality. The second occurred in the late twentieth century in which the managed practice of medicine in general, and managed care in particular, have begun to lay medicine open to accountability for its scientific and moral quality, as well as its cost and, at least in the public sector, its accessibility. McCullough argues that, just as Gregory responded to the ethical challenges of medicine laid open more than two centuries ago, bioethics should respond to the ethical challenges in the current laying open of medicine.Warren Reich provides an account of André Hellegers, whose premature death left an enormous gap in the field that will never be filled. Reich claims that Hellegers was engaged substantially in much more than the laying open of medicine: he... (shrink)

Aid‐in‐dying laws in the United States have two important restrictions. First, only patients who are terminally ill, defined as having a prognosis of six months or less to live, qualify. Second, at the time the patients take the lethal medication, they must be competent to make medical decisions. This means that an advance directive requesting aid in dying for a later time when the patient lacks decision‐making capacity would be invalid. However, many people are more concerned about avoiding living into (...) severe dementia for years—a time when they will lack decision‐making capacity—than they are about preventing suffering or the loss of dignity or autonomy for a few months at the end of life.Gillian Bennett is an example of someone determined not to live into severe dementia. She opted for preemptive suicide in 2014, explaining why in a letter she posted online: “Every day I lose bits of myself, and it’s obvious that I am heading toward the state that all dementia patients eventually get to: not knowing who I am and requiring full‐time care.”A major problem with Bennett’s solution, however, is that the individual is likely thereby to be giving up some “good time.” A legal alternative to preemptive suicide is to create an advance directive stating the circumstances under which one wants not to receive any lifesaving or life‐sustaining treatment, even the most basic and noninvasive. This option is our focus in this paper: how to create effective advance directives to avoid living into severe dementia. To be relevant to progressive dementia, the directive would need to state what kinds of care should be withheld and when. At the same time, advance directives for severe dementia face serious challenges. Before addressing these, we review the normative force of directives themselves. (shrink)

In using quality of life as a guide to rationing health services, Oregon laid itself open to charges of bias against the disabled—charges that cannot be dismissed out of hand.

In False Wisdom, Gary H. Merrill develops criteria for distinguishing genuine from pseudo-philosophy, and then applies his criteria to several case studies, including Ayn Rand, all of whom he finds to be pseudo-philosophers. While offering a mostly helpful overview of better and worse ways of doing philosophy, Merrill fails to motivate adequately his way of distinguishing pseudo-philosophy from mere philosophical vices, errors, or failings. He is inconsistent in his characterization of the criteria for pseudo-philosophy and his application of (...) those criteria, harbors a narrow conception of what counts as philosophy, and displays a lack of interpretive charity toward several thinkers. (shrink)

Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, (...) and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well‐understood in terms of what Bernard Williams calls “agent‐regret.” We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S3-S11, March‐April 2022.

Home care is one of the fastest‐growing industries in the United States, providing valuable opportunities for millions of older adults and people with disabilities to live at home rather than in institutional settings. Home care workers assist clients with essential activities of daily living, but their wages and working conditions generally fail to reflect the importance of their work. Drawing on the work of Eva Feder Kittay and other care ethicists, we argue that good care involves attending to the needs (...) of another out of a concern for their well‐being. Such care should be standard in the home care system. Yet, because of the pervasive racial, gender, and economic inequalities that the home care industry perpetuates, home care workers and their clients cannot reasonably be expected to care about each other. We endorse reforms aimed at enabling home care workers and their clients to form and maintain professional relationships that cultivate care.. (shrink)

Current guidelines treat palliative sedation to unconsciousness as an effective medical treatment for terminally ill patients who need relief from severe symptoms, yet also restrict its use in ways that are extraordinary for medical treatments. A closer look at the kinds of cases in which palliative sedation is used suggests a way of adjusting the guidelines to resolve this seeming contradiction.