Whether we're buying a pair of jeans, ordering a cup of coffee, selecting a long-distance carrier, applying to college, choosing a doctor, or setting up a 401(k), everyday decisions ; both big and small ; have become increasingly complex due to the overwhelming abundance of choice with which we are presented. As Americans, we assume that more choice means better options and greater satisfaction. But beware of excessive choice: choice overload can make you question the decisions you make before you (...) even make them, it can set you up for unrealistically high expectations, and it can make you blame yourself for any and all failures. In the long run, this can lead to decision-making paralysis, anxiety, and perpetual stress. And, in a culture that tells us that there is no excuse for falling short of perfection when your options are limitless, too much choice can lead to clinical depression. In The Paradox of Choice, Barry Schwartz explains at what point choice ; the hallmark of individual freedom and self-determination that we so cherish ; becomes detrimental to our psychological and emotional well-being. In accessible, engaging, and anecdotal prose, Schwartz shows how the dramatic explosion in choice ; from the mundane to the profound challenges of balancing career, family, and individual needs ; has paradoxically become a problem instead of a solution. Schwartz also shows how our obsession with choice encourages us to seek that which makes us feel worse. By synthesizing current research in the social sciences, Schwartz makes the counter intuitive case that eliminating choices can greatly reduce the stress, anxiety, and busyness of our lives. He offers eleven practical steps on how to limit choices to a manageable number, have the discipline to focus on those that are important and ignore the rest, and ultimately derive greater satisfaction from the choices you have to make."--provided by publisher. (shrink)

The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...) the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions. (shrink)

Accounts of the concepts of function and dysfunction have not adequately explained what factors determine the line between low‐normal function and dysfunction. I call the challenge of doing so the line‐drawing problem. Previous approaches emphasize facts involving the action of natural selection (Wakefield 1992a, 1999a, 1999b) or the statistical distribution of levels of functioning in the current population (Boorse 1977, 1997). I point out limitations of these two approaches and present a solution to the line‐drawing problem that builds on the (...) second one. (shrink)

Abstract:Extrapolating from Carroll’s four domains of corporate social responsibility (1979) and Pyramid of CSR (1991), an alternative approach to conceptualizing corporate social responsibility (CSR) is proposed. A three-domain approach is presented in which the three core domains of economic, legal, and ethical responsibilities are depicted in a Venn model framework. The Venn framework yields seven CSR categories resulting from the overlap of the three core domains. Corporate examples are suggested and classified according to the new model, followed by a discussion (...) of limitations and teaching and research implications. (shrink)

This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations. In the narratives, not treating the patient(s) was sometimes understood as the right thing to do, and sometimes as wrong. In analyzing participants’ narratives we draw attention to how medications and equipment are represented. In one type of narrative, medications and equipment are represented primarily as scarce resources; in another, they are (...) represented as patient care. In the contexts respondents were working, medications and equipment were often both patient care interventions and scarce resources. The analytic point is that health professionals tend to emphasize one conceptualization over the other in coming to assert that not treating is right, or wrong. Rendering tacit ethical frameworks more explicit makes them available for reflection and debate. (shrink)

In November, 1991, the U.S. Congress enacted the U.S. Federal Sentencing Guidelines legislation which had a dramatic impact on corporate America. Can the Guidelines be used as a model or framework by other countries? Could other countries in the world benefit from adopting a similar piece of legislation? Are there any limitations to consider? In addressing these issues, the authors make the argument that the time has arrived for other countries to consider the development of legislation similar to the Guidelines (...) in order to improve organizational ethics. (shrink)

The problem of the unity of the proposition asks what binds together the constituents of a proposition into a fully formed proposition that provides truth conditions for the assertoric sentence that expresses it, rather than merely a set of objects. Hanks’ solution is to reject the traditional distinction between content and force. If his theory is successful, then there is a plausible extension of it that readily solves the Frege–Geach problem for normative propositions. Unfortunately Hanks’ theory isn’t successful, but it (...) does point to significant connections between expressivism, unity, and embedding. (shrink)

Countless contracts have been undermined by the COVID-19 pandemic of 2020 as well as government orders to contain it. Flights have been canceled, concerts have been called off, and dorms have been closed, just to name a few. Do these all count as breaches of contract—or are the parties excused due to the extraordinary circumstances? And how should the losses be allocated between the parties? The law provides one set of answers to these questions; ethics offers another. With a focus (...) on American law and Jewish ethics, this paper shows that the two systems are in accord with some respects and differ in others: Both law and Jewish ethics would excuse a party who cannot complete his contract due to a force beyond his control, like the COVID-19 pandemic. Yet Jewish ethics would require that the excused party still be paid, while American law would not. (shrink)

The most common solutions to the problem of high pharmaceutical prices have taken the form of regulations, price negotiations, or changes in drug coverage by insurers. These measures for the most part transfer the burden of drug expenditures between pharmaceutical companies and payers or between payers. The aim of this study is to propose an alternative model for the relationship between the main stakeholders involved in the price setting and purchasing of pharmaceuticals, one that encourages a more cooperative approach. We (...) draw from principles of ethics and health economics and apply them to the context of the pharmaceutical industry. The model prioritises two objectives, to make drugs financially accessible to the patients who need them, and to keep pharmaceutical companies viable and profitable. It is centered around the sharing of financial risk between the main stakeholders, which we describe as ‘enlightened risk sharing’. After establishing the foundations of this model, we expand on the type of policies that can follow these principles with current day examples. (shrink)

_A Brief History of Analytic Philosophy: From Russell to Rawls_ presents a comprehensive overview of the historical development of all major aspects of analytic philosophy, the dominant Anglo-American philosophical tradition in the twentieth century. Features coverage of all the major subject areas and figures in analytic philosophy - including Wittgenstein, Bertrand Russell, G.E. Moore, Gottlob Frege, Carnap, Quine, Davidson, Kripke, Putnam, and many others Contains explanatory background material to help make clear technical philosophical concepts Includes listings of suggested further readings (...) Written in a clear, direct style that presupposes little previous knowledge of philosophy. (shrink)

Since our moral and legal judgments are focused on our decisions and actions, one would expect information about the neural underpinnings of human decision-making and action-production to have a significant bearing on those judgments. However, despite the wealth of empirical data, and the public attention it has attracted in the past few decades, the results of neuroscientific research have had relatively little influence on legal practice. It is here argued that this is due, at least partly, to the discussion on (...) the relationship of the neurosciences and law mixing up a number of separate issues that have different relevance on our moral and legal judgments. The approach here is hierarchical; more and less feasible ways in which neuroscientific data could inform such judgments are separated from each other. The neurosciences and other physical views on human behavior and decision-making do have the potential to have an impact on our legal reasoning. However, this happens in various different ways, and too often appeal to any neural data is assumed to be automatically relevant to shaping our moral and legal judgments. Our physicalist intuitions easily favor neural-level explanations to mental-level ones. But even if you were to subscribe to some reductionist variant of physicalism, it would not follow that all neural data should be automatically relevant to our moral and legal reasoning. However, the neurosciences can give us indirect evidence for reductive physicalism, which can then lead us to challenge the very idea of free will. Such a development can, ultimately, also have repercussions on law and legal practice. (shrink)

Most empirical research examining physician views on physician-assisted suicide has used quantitative methods to characterize positions and identify predictors of individual attitudes. This approach has generated limited information about the nature and depth of sentiments among physicians most impassioned about PAS. This study reports qualitative data provided by 909 physicians as part of a larger survey regarding attitudes toward and experiences with PAS and palliative care. Emergent themes illustrate important clinical, social, and ethical considerations in this area. The data illustrate (...) the diverse and ardent responses that PAS evokes among certain physicians. The role of physicians' personal values is central to discussions about legalization of PAS. Polarized views such as those expressed by physicians in this study are not likely to be reconciled, thereby constraining the development of public policy regarding PAS. (shrink)

In this paper we discuss the two-system framework, examine its strengths, point out a fundamental weakness concerning the unity of conscious experience, and then propose a new hypothesis that avoids that weakness and other related concerns. According to our strong emergence hypothesis, what emerges are not merely mental properties in specialized, distributed neural areas, but also a new, irreducibly singular entity that functions in a recurrent manner to integrate its mental properties and to rewire its brain. We argue that the (...) former function is suggested, in part, by the effects of anesthetics on sensory integration, and that the latter function is suggested by evidence garnered from the neuroscience of mindfulness, constraint-induced movement therapy for stroke, and neuroimaging data surrounding mental illness. We then discuss how our strong emergence hypothesis relates to the description and treatment of neuropsychiatric disorders. Finally, potential objections are addressed. (shrink)

Daniel Schwartz examines the views on friendship of the great medievalphilosopher Thomas Aquinas.

Background: The use of race as a category in medical research is the focus of an intense debate, complicated by the inconsistency of presumed independent variables, race and ethnicity, on which analysis depends. Interpretation is made difficult by inconsistent methods for determining the race or ethnicity of a participant. The failure to specify how race or ethnicity was determined is common in the published literature.Hypothesis: Criteria by which they assign a research participant to racial or ethnic categories are not reported (...) by published articles.Methods: Methods were reviewed for assigning race and ethnicity of research participants in 268 published reports reporting associations among race , health outcome and genotype.Results: Of the 268 published reports reviewed, it was found that 192 did not explain their methods for assigning race or ethnicity as an independent variable. This was despite the fact that 180 of those reports reached conclusions about associations among genetics, health outcome and race or ethnicity.Conclusions: More attention needs to be given to the definition of race and ethnicity in genetic studies, especially in those diseases where health disparities are known to exist. (shrink)

This paper examines the practice of using predictive systems to lengthen the prison sentences of convicted persons when the systems forecast a higher likelihood of re-offense or re-arrest. There has been much critical discussion of technologies used for sentencing, including questions of bias and opacity. However, there hasn’t been a discussion of whether this use of predictive systems makes sense in the first place. We argue that it does not by showing that there is no plausible theory of punishment that (...) supports it. (shrink)

How and why did comparative political economy lose sight of the sources of growing macroeconomic and political instability, a problem that encompassed a growing financial bubble and then a crash in the housing market, a period of sluggish growth that plausibly constitutes secular stagnation, and a crisis of political legitimacy manifesting itself in the rise of antisystem “populist” parties? A gradual shift in CPE’s research agenda from macroeconomic to microeconomic concerns, and from demand-side to supply-side explanations, diminished its ability to (...) analyze adequately the central economic and political problems of the past twenty years. This article traces CPE’s evolution through successive “supermodels” that constituted its core research foci. To understand the current crisis, CPE needs to revisit and update its original roots in Keynes, macroeconomics, and the demand side. This shift is already happening at the margins, as CPE scholars struggle to understand the current crisis. (shrink)

This paper concerns the growing political polarization in the U.S. and the challenges faced by political activists in their effort to mobilize around struggles and demands for policy changes. We argue that basic income can serve as a key policy around which social movements and political activists of different beliefs systems – feminist activists, racial justice activists, liberal egalitarians, Marxists-socialists, and libertarians – could form an overlapping consensus. This would allow them to have a common political goal without having to (...) reach agreement over fundamental values, thus gaining more political visibility and increasing their ability to promote socio-political change. (shrink)

For over four decades, Richard Schwartz has engaged with two ethically rich ways of living that, as he charts in this book, he came to appreciate in middle age: Judaism and veganism. Having been born into a secular Jewish family, it was his marriage and an increasing commitment to social justice that propelled him to study and rediscover the essence of his Jewish faith. That sense of social justice further raised his awareness of the environmental movement, and, ultimately, to (...) animal rights and veganism. In Vegan Revolution: Saving Our World, Revitalizing Judaism, Schwartz shows how, now perhaps more than ever, veganism offers a pathway for all of us of whatever faith (or no faith) to reduce hunger, conserve the environment, save water, reinstitute justice, and care for animals and the Earth. It is no coincidence, as Schwartz demonstrates, that many of these ideas are mandates in Jewish scripture, and that reincorporating a care for the world (tikkun olam) can itself reinvigorate the spirit of a faith and galvanize its practitioners to act. (shrink)

The clinical ethics propounded by Richard Zaner is unique. Partly because of his phenomenological orientation and partly because of his own daily practice as a clinical ethicist in a large university hospital, Zaner focuses on the particular concrete situations in which patients and their families confront illness and injury and struggle toward workable ways for dealing with them. He locates ethical reality in the clinical encounter. This encounter encompasses not only patient and physician but also the patients family and friends (...) and indeed the entire lifeworld in which the patient is still striving to live. In order to illuminate the central moral constituents of such human predicaments, Zaner discusses the often-overlooked features of disruption and crisis, the changed self, the patients dependence and the physicians power, the violation of personal boundaries and their necessary reconfiguring, and the art of listening. (shrink)

A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to.

Psychologists are paying increasing attention to a distinction between two ways of thinking. Cognitive psychologists discern between non-reflective “intuitive” and critical reflective “analytic” thinking. Cultural psychologists discern between context-focused “holistic” and object-focused “analytic” thinking. Both find the former strongly correlated with religious beliefs and Asian cultures, the latter with secular beliefs and Euro-American cultures. Yet, recent studies convincingly suggest: first, that analytic thinking does not just relate to secular beliefs but also to alternative beliefs that straddle the boundaries between secular (...) and religious worldviews; second, that critical reflective thinking includes both the holistic context-focus of Asian religions and the analytic object-focus of European philosophies and sciences. This article supports these recent studies in the psychology of religion based on recent studies from the history and sociology of religion and a discourse analysis of interviews with members of a small-scale twenty-first-century spiritual group, as an example. We show that people who identify as spiritual in a metamodern context use both holistic and analytic thinking in creating alternative worldviews, which dialectically reconcile beliefs that many within modern western cultures would consider contradictory. We conclude that this both/and logic challenges theories and stereotypes about “secular versus religious” and “eastern versus western” thinking. (shrink)

ABSTRACT The emergence of the coronavirus disease 2019 pandemic has wide-ranging implications for the field of professional psychology. As clinical practice has rapidly adapted to ensure continuity of care, doctoral students have encountered unique opportunities for ethics-related competency development across practicum training settings. This article discusses the relevant American Psychological Association Ethics Code standards and additional ethical considerations facing trainees as they navigate their foundational clinical experiences and develop as professional psychologists in light of a pandemic.

Excellence in the care of hospital patients, particularly those in an intensive care unit, reflects esprit de corps among the care team. Esprit de corps depends on a delicate balance; each clinician must preserve a sense of personal responsibility for “my” patient and yet participate in the collaborative work essential to the care of “our” patient. A harmful imbalance occurs when a physician demands total control of the decision-making process, especially concerning end-of-life treatment options. Although emotional factors may push a (...) physician to claim decision-making exclusivity, compounded by a legal framework that overemphasizes individual responsibility, esprit de corps can be preserved through timely communication among clinicians and a recognition that optimal care for “my” patient requires effective team practice. (shrink)

Page's target article makes a good case for the strength of localist models. This can be characterized as an issue of where new information is integrated with respect to existing knowledge structures. We extend the analysis by discussing the dimension of when this integration takes place, the implications, and how they guide us in the creation of cognitive models.

Given the technological constraints of long-duration space travel and planetary settlement, off-Earth humans will likely need to employ food systems very different from their terrestrial counterparts, and newly emerging food technologies are being developed that will shape novel food systems in these off-Earth contexts. Projected off-Earth food systems may therefore potentially “alienate” their users in new ways compared to Earth-based food systems. They will be susceptible to alienation in ways that are similar to such potential on Earth, where there are (...) points of overlap between off-Earth food systems and any of the multitudes of ways in which food systems on Earth are structured. They will also be susceptible to new forms of alienation, as we encounter scenarios that are genuinely structurally novel to humanity. These are especially important to consider since there are comparatively fewer analyses of these food systems where they differ from existing ones. We propose five non-exhaustive sources of value beyond nutrition our individual relationships with a food may possess: gustatory, social, cultural, epistemic, and authorial value. Using these, we offer examples of ways in which an off-Earth food system may exacerbate or alleviate alienation for humans in long-term off-Earth food systems. (shrink)

a Mathematicians, like Proust and everyone else, are at their best when writing about their first lovea (TM) a ] They are among the very best we have; and their best is very good indeed. a ] One approaches this book with high hopes. Happily, one is not disappointed. a ]In paperback it might well have become a best seller. a ]read it. From The Mathematical Intelligencer Mathematics is shaped by the consistent concerns and styles of powerful minds a three (...) of which are represented here. Kaca (TM)s work is marked by deep commitment and breadth of inquiry. Rota is the easiest of these authors to reada ]a delight: witty and urbane, with a clear and interesting agenda and an astonishing intellectual range. To read him is to be a part of a pleasant and rewarding conversation. Jacob T. Schwartz attacks problems ina ]computer science, mathematical economics, computer and instructional a ] No matter how slippery the problem, Schwartz manages to capture a substantial chunk of it in his mathematical net. a Mathematics Magazine This is a volume of essays and reviews that delightfully explore mathematics in all its moods a from the light and the witty, and humorous to serious, rational, and cerebral. Topics include: logic, combinatorics, statistics, economics, artificial intelligence, computer science, and applications of mathematics broadly. You will also find history and philosophy covered, including discussion of the work of Ulam, Kant, Heidegger among others. (shrink)

Some experts have argued that patients facing certain types of choices should not be told whether their risk is above or below average, because this information may trigger a bias (Fagerlin et al. 2007). But careful consideration shows that the comparative risk heuristic can usefully guide decisions and improve their quality or rationality. Building on an earlier paper of mine (Schwartz 2009), I will argue here that doctors and decision aids should provide comparative risk information to patients, even while (...) further research is conducted. (shrink)

Most of us find the surgeon's surprise at this patient' request understandable, and it is hard to imagine any surgeon acceding to this patient's demand. On the other hand, the patient is right—the surgeon is denying his technical skill because his values are different from those of the patient, whose values the surgeon does not respect. The autonomy of the patient is being limited by the values of the doctor whose own interests, other than his interest in practicing medicine according (...) to his own ethical values, would remain unaffected by his decision to provide the service. (shrink)

Three decades ago, interactions between evolutionary biology and physiology gave rise to evolutionary physiology. This caused comparative physiologists to improve their research methods by incorporating evolutionary thinking. Simultaneously, evolutionary biologists began focusing more on physiological mechanisms that may help to explain constraints on and trade‐offs during microevolutionary processes, as well as macroevolutionary patterns in physiological diversity. Here we argue that evolutionary physiology has yet to reach its full potential, and propose new avenues that may lead to unexpected advances. Viewing physiological (...) adaptations in wild animals as potential solutions to human diseases offers enormous possibilities for biomedicine. New evidence of epigenetic modifications as mechanisms of phenotypic plasticity that regulate physiological traits may also arise in coming years, which may also represent an overlooked enhancer of adaptation via natural selection to explain physiological evolution. Synergistic interactions at these intersections and other areas will lead to a novel understanding of organismal biology. (shrink)