School psychologists often break confidentiality if confronted with risky adolescent behavior. Members of the National Association of School Psychologists ( N = 78) responded to a survey containing a vignette describing an adolescent engaging in risky behaviors and rated the degree to which it is ethical to break confidentiality for behaviors of varying frequency, intensity, and duration. Respondents generally found it ethical to break confidentiality when risky adolescent behaviors became more dangerous or potentially harmful, although there was considerable variability between (...) respondents. Significant gender effects were found between male and female respondents for alcohol use, and a significant Form Type (i.e., male or female vignette) Frequency/Duration interaction was observed for antisocial behaviors. School psychologists could benefit from further training in ethical decision making because these ethical dilemmas are not always clear-cut. (shrink)

The claims of randomized controlled trials to be the gold standard rest on the fact that the ideal RCT is a deductive method: if the assumptions of the test are met, a positive result implies the appropriate causal conclusion. This is a feature that RCTs share with a variety of other methods, which thus have equal claim to being a gold standard. This article describes some of these other deductive methods and also some useful non-deductive methods, including the hypothetico-deductive method. (...) It argues that with all deductive methods, the benefit that the conclusions follow deductively in the ideal case comes with a great cost: narrowness of scope. This is an instance of the familiar trade-off between internal and external validity. RCTs have high internal validity but the formal methodology puts severe constraints on the assumptions a target population must meet to justify exporting a conclusion from the test population to the target. The article reviews one such set of assumptions to show the kind of knowledge required. The overall conclusion is that to draw causal inferences about a target population, which method is best depends case-by-case on what background knowledge we have or can come to obtain. There is no gold standard. (shrink)

What kinds of evidence reliably support predictions of effectiveness for health and social care interventions? There is increasing reliance, not only for health care policy and practice but also for more general social and economic policy deliberation, on evidence that comes from studies whose basic logic is that of JS Mill's method of difference. These include randomized controlled trials, case–control studies, cohort studies, and some uses of causal Bayes nets and counterfactual-licensing models like ones commonly developed in econometrics. The topic (...) of this paper is the 'external validity' of causal conclusions from these kinds of studies. We shall argue two claims. Claim, negative: external validity is the wrong idea; claim, positive: 'capacities' are almost always the right idea, if there is a right idea to be had. If we are right about these claims, it makes big problems for policy decisions. Many advice guides for grading policy predictions give top grades to a proposed policy if it has two good Mill's-method-of difference studies that support it. But if capacities are to serve as the conduit for support from a method-of-difference study to an effectiveness prediction, much more evidence, and much different in kind, is required. We will illustrate the complexities involved with the case of multisystemic therapy, an internationally adopted intervention to try to diminish antisocial behaviour in young people. (shrink)

Calls are increasing for American health care to be organized as a learning health care system, defined by the Institute of Medicine as a health care system “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care.” We applaud this conception, and in this paper, we put forward a new ethics framework for it. No such (...) framework has previously been articulated. The goals of our framework are twofold: to support the transformation to a learning health care system and to help ensure that learning activities carried out within such a system are conducted in an ethically acceptable fashion. (shrink)

Should you wash your hands? -- Are workarounds ethical? -- Turfing, bending, and gaming -- Dirty hands and the semiclear conscience -- Problems of humanity -- Ethics without heroics : foreseeing moral problems in complex systems.

This article agrees with Philip Kitcher that we should aim for a well-ordered science, one that answers the right questions in the right ways. Crucial to this is to address questions of use: Which scientific account is right for which system in which circumstances? This is a difficult question: evidence that may support a scientific claim in one context may not support it in another. Drawing on examples in physics and other sciences, this article argues that work on the warrant (...) of theories in philosophy of science needs to change. Emphasis should move from the warrant of theories in the abstract to questions of evidence for use. (shrink)

Significantly, Berkeley, in his Essay Towards a New Theory of Vision, leveled a sustained attack on just this geometrical theory of distance perception. At first glance it may seem, as it did to Berkeley, that Descartes’ geometrical theory is produced by a simple error: namely, by the idea that a physiological optics provides an adequate description of the psychological processes of judging distances. In truth, this is the weakest of Berkeley’s objections to Descartes’ theory. Obviously we do not see the (...) angles and lines of convergence when we focus on a distant object, nor are we aware of having used any geometrical rules in judging distance. And Descartes never claimed this. (shrink)

Do neurosurgical procedures ever result in the patient prior to the procedure not being identical with the individual who wakes up postsurgery in the hospital bed? We address this question by offering an analysis of the persistence of persons that emphasizes narrative, rather than numerical, identity. We argue that a narrative analysis carries the advantage of highlighting what matters to patients in their ordinary lives, explaining the varying degrees of persistence of personal identity, and enhancing our understanding of patients' experiences. (...) We illustrate these points in cases involving temporal lobectomy for treatment of refractory epilepsy and deep brain stimulation for refractory Parkinson's disease. (shrink)

While few soldiers may have read the works of Epictetus or Marcus Aurelius, it is undoubtedly true that the ancient philosophy known as Stoicism guides the actions of many in the military. Soldiers and seamen learn early in their training “to suck it up,” to endure, to put aside their feelings and to get on with the mission. This book explores what the Stoic philosophy actually is, the role it plays in the character of the military (both ancient and modern), (...) and its powerful value as a philosophy of life. Marshalling anecdotes from military history—ranging from ancient Greek wars to World War II, Vietnam, and Iraq—the book illuminates the military mind and uses it as a window on the virtues of the Stoic philosophy, which are far richer and more interesting than our popularized notions. The book explores the deep, lasting value that Stoicism can yield, in issues of military leadership and character; in the Stoic conception of anger and its control (does a warrior need anger to go to battle?); and in Stoic thinking about fear and resilience, grief and mourning, and the value of camaraderie and brotherhood. The book concludes by recommending a moderate Stoicism, where the task for the individual, both civilian and military, youth and adult, is to temper control with forgiveness, and warrior drive and achievement with humility and humor. (shrink)

This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group (...) justice and illustrates them using a principle of respect for human dignity, understood in terms of reasonable support for floor level central human capabilities at each stage of life. I argue that different frames are suitable for different kinds of decisions, and each provides a true, but partial, picture of aging and age group justice. (shrink)

Is age discrimination ethically objectionable? One puzzle is that we sometimes assume that the target of both age discrimination and ageism must be older people, yet in poorer nations, older people are generally shown more respect. This article explores the ethical question. It looks first at ethical arguments favoring age discrimination toward younger people in low‐income, less industrialized countries of the global South, using sub‐Saharan Africa as an illustration. It contrasts these with arguments favoring age discrimination toward older people in (...) high‐income, more industrialized countries of the global North, particularly the United States and United Kingdom. Finally, it considers what role, if any, differences in life expectancy, infant and child mortality, and prospects for healthy lives should play in the moral embrace of a particular view by a community. It argues that there can be reasons to favor different types of discrimination in different parts of the world. (shrink)

Causation is in trouble—at least as it is pictured in current theories in philosophy and in economics as well, where causation is also once again in fashion. In both disciplines the accounts of causality on offer are either modelled too closely on one or another favoured method for hunting causes or on assumptions about the uses to which causal knowledge can be put—generally for predicting the results of our efforts to change the world. The first kind of account supplies no (...) reason to think that causal knowledge, as it is pictured, is of any use; the second supplies no reason to think our best methods will be reliable for establishing causal knowledge. So, if these accounts are all there is to be had, how do we get from method to use? Of what use is knowledge of causal laws that we work so hard to obtain? (shrink)

An advertising firm''s ethical culture (as defined by the firm''s managerial and peer ethical behaviors) may affect the employees'' comfort levels and ethical behaviors. In this research, scenarios were used to describe advertising firms with various ethical cultures. Respondents'' perceived comfort levels in working for the firms described in the scenarios and the respondents'' behavioral intentions when faced with various advertising situations were assessed. Results of the study indicate that peer ethical behavior exerts a strong influence on the comfort or (...) discomfort level and the ethical behavioral intentions of potential advertising employees. Further, the strong influence exerted by peers seems to transcend the ethical behavior of the manager and carry over to the attitude toward the entire corporate advertising environment. This study provides insights for firms and researchers interested in assessing the impact of an advertising firm''s ethical culture on potential employees. (shrink)

People who lack decision‐making capacity may be able to communicate preferences, which can and should inform surrogate decision‐making on their behalf. It is unclear whether making a further distinction about “capacity for preferences,” as Jason Wasserman and Mark Navin propose in this issue of the Hastings Center Report, would improve the process of surrogate decision‐making. Anyone who is regularly involved in surrogate decision‐making or who has worked to articulate decision‐making standards and processes can think of cases in which a patient's (...) voice was ignored or his or her preferences and ability to communicate them overlooked. However, we can also think of cases in which it was unclear whether information provided by a patient, recently or in the past, should have been characterized as a preference relevant to a medical decision that the patient lacked the capacity to make. We should also recognize that clear preferences of a patient who lacks decision‐making capacity may conflict with the limits of another person or of a family's resources such that these preferences cannot guide a surrogate's decision. This patient will not get what he wants. A situation in which preferences are known and make sense but cannot be applied in a feasible way demonstrates the limits of the medical decision‐making framework concerning care that is not covered by medical insurance. (shrink)

Character structures underlie everyone’s personality. When rigidly defended, they limit us; yet as they become more flexible, they can reveal sources of animation, renewal and authenticity. _The Matrix and Meaning of Character_ guides the reader into an awareness of the archetypal depths that underlie character structures, presenting an original developmental model in which current analytic theories are synthesised. The authors examine nine character structures, animating them with fairy tales, mythic images and case material, creating a bridge between the traditional language (...) of psychopathology and the universal realm of image and symbol. This book will appeal to all analytical psychologists, psychoanalysts and psychotherapists who want to strengthen their clinical expertise. It will help clinicians to extend their clinical insights beyond a strictly behavioural, medical or cognitive approach, revealing the potential of the human spirit. (shrink)

In this paper I argue that a narrow view of justice dominates the bioethics literature. I urge a broader view. As bioethicists, we often conceive of justice using a medical model. This model focuses attention at a particular point in time, namely, when someone who is already sick seeks access to scarce or expensive services. A medical model asks how we can fairly distribute those services. The broader view I endorse requires looking upstream, and asking how disease and suffering came (...) about. In contrast to a medical model, a social model of justice considers how social determinants affect the health of a population. For example, social factors such as access to clean drinking water, education, safe workplaces, and police protection, profoundly affect risk for disease and early death. I examine one important social determinant of health, health care coverage, to show the limits of a medical model and the merits of a broader view. (shrink)

What is commonly called Reichenbach’s “Principle of the Common Cause” is not a general criterion for a common cause, as many philosophers nowadays suppose. Examples include W. Salmon in his accounts of causal processes and Bas van Fraassen in his new book on quantum mechanics, in which he argues that the quantum world has no causal structure. This does not matter for Reichenbach’s purposes. Indeed it should not be surprising from his point of view that in different situations we need (...) different criteria or different methods for testing for the same phenomenon. The third thesis begins from a question: Where do probabilistic criteria for causality come from? (shrink)

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.

This paper is a personal account of the events associated with the author’s work at the University of Toronto’s Hospital for Sick Children on a drug, deferiprone, for the treatment of thalassaemia. Trials of the drug were sponsored by the Canadian Medical Research Council and a drug company which would have been able, had the trials been successful, to seek regulatory approval to market the drug. When evidence emerged that deferiprone might be inadequately effective in a substantial proportion of patients, (...) the drug company issued legal threats when the author proposed informing her patients and the scientific community. Until protests were made by international authorities in her field of research, the hospital and university did not adequately support the author’s academic freedom and responsibilities as a medical practitioner. It is argued that underlying cause of this, and of other similar cases, is the political philosophy which is driving the commercialisation of universities and bringing about the deregulation of drug approval procedures. Together these changes constitute a serious threat to the public good. (shrink)

Carpendale & Lewis (C&L) emphasize the importance of viewing language as activity. In this commentary I push further their claim by highlighting how constructions, rather than words, are the appropriate unit of analysis. In addition, I suggest how a discussion of indexicality paves the way for a better understanding of how language provides a powerful tool for children's construction of mind.

Stigmatization and sharming of healthcare workers in Japan during the coronavirus 2019 pandemic reveal uniquely Japanese features. Seken, usually translated as ‘social appearance or appearance in the eyes of others,’ is a deep undercurrent woven into the fabric of Japanese life. It has led to providers who become ill with the SARS-CoV-2 virus feeling ashamed, while concealing their conditions from coworkers and public health officials. It also has led to healthcare providers being perceived as polluted and their children being told (...) they were not welcome in schools. Although such experiences are not isolated to Japan and have appeared in other parts of the world, the cultural forces driving them in Japan are unique. Overcoming stigmatization and shaming of Japanese healthcare providers will require concerted efforts to understand cultural barriers and to view such practices as raising human rights issues affecting the safety and well-being of all. (shrink)

Charlemagne's monogram -- Introduction -- The problem of consciousness -- The earliest vision -- Truth, being, and mind -- The Kehre -- The essence of truth -- The later Heidegger -- Reading Heidegger after Heidegger -- Being not a soul but the unmediated discovery of being.

Adoration is the second volume of the Deconstruction of Christianity, following Dis-Enclosure. The first volume attempted to demonstrate why it is necessary to open reason up not to a religious dimension but to one transcending reason as we have been accustomed to understanding it; the term "adoration" attempts to name the gesture of this dis-enclosed reason. -/- Adoration causes us to receive ignorance as truth: not a feigned ignorance, perhaps not even a "nonknowledge," nothing that would attempt to justify the (...) negative again, but the simple, naked truth that there is nothing in the place of God, because there is no place for God. The outside of the world opens us in the midst of the world, and there is no first or final place. Each one of us is at once the first and the last. Each one, each name. And our ignorance is made worse by the fact that we do not know whether we ought to name this common and singular property of all names. We must remain in this suspense, hesitating between and stammering in various possible languages, ultimately learning to speak anew. -/- In this book, Jean-Luc Nancy goes beyond his earlier historical and philosophical thought and tries to think-or at least crack open a little to thinking-a stance or bearing that might be suitable to the retreat of God that results from the self-deconstruction of Christianity. Adoration may be a manner, a style of spirit for our time, a time when the "spiritual" seems to have become so absent, so dry, so adulterated. -/- The book is a major contribution to the important strand of attempts to think a "post-secular" situation of religion. (shrink)

This paper defends the need for evidential diversity and the mix of methods that that can in train require. The focus is on causal claims, especially ‘singular’ claims about the effects of causes in a specific setting—either what will happen or what has happened. I do so by offering a template that categorises kinds of evidence that can support these claims. The catalogue is generated by considering what needs to happen for a causal process to carry through from putative cause (...) at the start to the targeted effect at the end. The usual call for mixed methods focusses on a single overall claim and argues that we increase certainty by the use of different methods with compensating strengths and weaknesses. My proposals instead focus on the evidence that supports the great many subsidiary claims that must hold if the overall one is to be true. As is typical for singular causal claims, the mix of methods that will generally be required to collect the kinds of evidence I urge will usually have little claim to the kind of rigour that is now widely demanded in evidencing causal claims, especially those for policy/treatment effectiveness. So I begin with an exploration of what seems to be intended by ‘rigour’ in such discussions, since it is seldom made clear just what makes the favoured methods especially rigorous. I then argue that the emphasis on rigour can be counterproductive. Rigour is often the enemy of evidential diversity, and evidential diversity—lots of it—can make for big improvements in the reliability of singular causal predictions and post hoc evaluations. I illustrate with the paragon of rigour for causal claims, randomised controlled trials (RCTs), rehearsing at some length what they can and cannot do to make it easier to assess the importance of rigour in warranting singular causal claims. (shrink)

La vuelta de los comunes ha sido la respuesta contrahegemónica más clara del siglo pasado frente al modelo neoliberal de cercamiento y extracción en los sures geográficos y políticos del mundo, específicamente en América Latina. Esto ha probado que los comunes no son solo un hecho existente en la realidad social rural y urbana, sino que, pueden ser vistos desde la óptica institucional y, sobre todo, como un proceso cultural cuyo alcance transformador viene a dar un nuevo valor a estructuras (...) jurídicas y políticas. En el contexto de la pandemia, los comunes han demostrado ser necesarios para responder a las crisis colectivas que afrontamos. Son una resistencia fundamental que busca comunizar los derechos a través de la reapropiación de los espacios que permiten la reproducción de la vida. (shrink)

Furman and Tuminello raise a central question about people living with mental illness: What kind of life is possible for them? Can one live a flourishing life even when struggling with a mental disorder? The authors draw on research studies to argue that a technique called Applied Behavioral Analysis can improve the lives of children with autism. One study, from 1987, found that 47% of children exposed to ABA attained normal IQ levels, adaptive skills, and social skills, and other studies (...) replicated these results. This is a promising avenue for those living with autism.Furman and Tuminello focus on autism, but their claims, if true, might be extended to other disorders as well; as they note, people... (shrink)

I discuss pedagogical issues that concern incest survivors. As teachers, we need to understand the ways in which the legacy of incest variously affects survivors' educational experiences and to be aware that the interplay of trust, knowledge, and power may be particularly complex for survivors. I emphasize the responsibility teachers have to create classrooms that are inclusive of survivors, while raising concerns about the practice of personal disclosure and assumptions about trust and safety in the classroom.

The essays in this volume provide rich fodder for reflection on topics that are of urgent interest to all thinking people. Each one suggests new ways to contemplate our own role(s) in the production and promotion of evil.

Evidence abounds of a close relation between ingestive and affective processes in rats and in humans. Emotional distress alters food intake and body weight; conversely, alterations in eating and weight influence emotional health. Thorough experimental analysis of the ingestion-affect relation may clarify the mechanisms of anxiety and depression. A strategy is proposed for examination of environmental and dispositional determinants of ingestive processes, emotionality, and responses to stress.

People are living, breathing creatures. Dominant feminist discourses are situated within hegemonic human exceptionalism which, by framing the body in terms of human forms of meaning-making and social life, eschews first-order embodiment as worthy of inquiry. Here, well-known reasons for avoidance of “the biological” are briefly summarized and an argument is advanced for meta-theoretical centering of creatureliness. A three-pronged agenda is proposed that embraces the creaturely body without the “-isms” and “-izings” that subvert feminist commitments. By unsettling HHE, executing the (...) agenda would promote broader feminist coalitions and new scholarly collaborations aimed at fleshing out gender. (shrink)

In “Surmounting Elusive Barriers: The Case for Bioethics Mediation,” Bergman argues that professionals trained in bioethics, reluctant to acquire the skills of mediation, would better be replaced by a cadre of mediators with some bioethics knowledge, to which I respond, “yes … but.”.