State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public. However, there is noteworthy variability in the extent to which SMBs impose severe disciplinary action. In this manuscript, we present and synthesize a subset of 11 recommendations based on findings from our team’s larger consensus-building project that identified a list of 56 policies and legal provisions SMBs can use to better protect patients from egregious (...) wrongdoing by physicians. (shrink)

This paper explores the intellectual relationship between three eighteenth century women thinkers: Catharine Trotter Cockburn, and the Bluestockings Elizabeth Carter and Catherine Talbot. All three share a virtue-ethical approach according to which human happiness depends on the harmonization of our essentially rational and sociable natures. The affinity between the Bluestockings and Cockburn, I show, illuminates important new avenues for thinking about the Bluestockings as philosophers in their own right and for thinking about the feminist dimensions of Cockburn's morality. Further, (...) their shared moral outlook sheds interesting light on the burgeoning feminism of the eighteenth century and the contributions of Cockburn and the Bluestockings to a new and growing discourse about women and their social and political role. (shrink)

In 1785, George Washington described a “knowing farmer” as “one who can convert every thing he touches into manure, as the first transmutation towards Gold.” With these words, Washington linked the “knowing farmer” to the alchemist who endeavored to transform base metals into gold with the aid of a philosopher's stone. In each instance, the challenge was to convert raw materials into something new and precious.Today, the “knowing bioethicist” is in a similar position. American bioethics harbors a variety of ethical (...) methods that emphasize different ethical factors, including principles, circumstances, character, interpersonal needs, and personal meaning. Each method reflects an important aspect of ethical experience, adds to the others, and enriches the ethical imagination. (shrink)

A comprehensive look at fictive letters in Greek literature from Homer to Philostratus, first published in 2001. It includes both embedded epistolary narratives in a variety of genres, and works consisting solely of letters, such as the pseudonymous letter collections and the invented letters of the Second Sophistic. The book challenges the notion that Ovid 'invented' the fictional letter form in his Heroides and considers a wealth of Greek antecedents for the later European epistolary novel tradition. Epistolary technique always problematizes (...) the boundaries between fictionality and reality. Based on a process of selection and self-censorship, the letter is a construction, not a reflection, of reality. The author bypasses the question of sincerity for a close look at epistolary self-representation, the function of the letter form and the nature of the relationship between writer and reader in a wide range of ancient Greek texts. (shrink)

Abstract:This essay suggests that the word decolonial offers analytic power for feminist historians of women. As a category, it creates interpretive space for female experience beyond the elite/subaltern binary, where arguably most women live and work in the modern period. As a reading practice, the decolonial fosters intellectual awareness of social and intellectual practices that neither address the state, as in “anti-imperialism,” nor proffer counter nationalism or counter racialization as responses to coloniality. Offering examples from the archive, the media, and (...) teaching, this essay describes the decolonial as a productive site of women's agency in domains all too easily overlooked when historians focus on the conventional categories of state and nation. (shrink)

In this essay, I attempt to solve the problem of the existence of evil in a world created by an omniscient, omnibenevolent, omnipotent God. I conclude that evil exists because God wanted to create moral creatures. Because choice is necessary for morality, God created creatures with enormous capacities for choice—and therefore enormous capacities for evil. Material creatures are subject to pain and death because, for such creatures, moral choices are deeply serious. The laws that underlie the material world and from (...) which material life arises are such that, from their workings out on a planet that can support life, natural evils happen. (shrink)

A medical information commons is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S., we engaged 75 adults in two-day facilitated discussions on the ethical and social issues inherent to sharing data with an MIC. Deliberants made recommendations regarding opt-in consent, transparent data policies, public representation on MIC governing boards, and strict data security and privacy protection. Community engagement is critical to earning the public's trust.

In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. (...) I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry. (shrink)

Callimachus' Victoria Berenices has received a good deal of scholarly attention since its first publication in 1976, both from textual critics, attempting to clarify uncertain readings, and from specialists in Latin poetry, eager to trace allusions to Callimachus in Vergil, Statius, or Ovid. While the search for Callimachean influence on the later texts has proved quite fruitful, it opens up the possibility of reading certain issues inappropriately backwards into the Hellenistic material. The discovery of parallels may lead to an assumption (...) of complete agreement that misrepresents the earlier, more fragmentary text. I would like to consider one particular incident in the Victoria Berenices that has fallen prey to this fate, namely the reception of Heracles by the farmer Molorcus. (shrink)

While sympathetic to Tilley’s call for a practical philosophy of religion, I raise three questions: Does Tilley think that one can do philosophy of religion from a position other than that of a committed believer? Does Tilley’s description of the ordinary believer disburden most people from doubt and answerability? Does Tilley’s description of the role of the theologian place too much trust in the theologian? I suggest that some insights from contemporary phenomenology and hermeneutics would lead to a clearer understanding (...) of the role that philosophy of religion can play in the development of a practical philosophy of religion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Credibility, Persuasiveness, and EffectivenessPatricia A. King (bio)Since the early 1970s, complex ethical, social, legal, and scientific controversies generated by biomedicine have been referred to governmentally created commissions, committees, boards, and panels that are commonly referred to as “ethics” committees. The Advisory Committee on Human Radiation Experiments is the most recent example of such a group. Although it is too early to know the full impact of the Committee’s work, (...) it is important to reflect on aspects of its deliberations that shed light on the public policy role of ethics bodies. Specifically, I will reflect on matters that go to the credibility, persuasiveness, and effectiveness of these committees.The point should be made at the outset that these ethics committees are, first and foremost, public policy groups. Governmentally created bodies of all types, including ethics committees, are established to provide pragmatic advice to governments about specific problems and controversies or to complete specified tasks on behalf of governments. What distinguishes ethics committees from other advisory groups is that the issues assigned to them are presumed to be primarily ethical, as opposed to, say, economic, in nature. It is expected that ethical analyses and premises will play a significant, albeit not exclusive, role in the committee’s deliberations. 1 As with other advisory groups, the primary responsibility of ethics committees is to respond to the branches of government that were instrumental in their creation as well as to the public at large. Since political concerns undoubtedly play a role in the creation of these groups, it is understandable that political concerns have some impact on the committee’s work. Thus, ethics committees are generally cognizant of the need to ensure that their processes and substantive conclusions are credible, persuasive, and effective.In my experience, members of ethics commissions understand the need to offer principled arguments that are factually accurate to justify their recommendations and conclusions. They also appreciate the need for consensus and rightly worry about disagreement among members. I believe, however, that committee members are less attentive than they should be to the social and political contexts in which they operate. This is not surprising. Members of these committees, and often their staffs as well, are typically experts drawn from the academy. [End Page 313] Scholars traditionally offer advice or influence policy through articles and scholarly work undertaken individually or in cooperation with like-minded individuals who do not need to be persuaded about the merits of a specific position. Moreover, scholarly articles are often pitched at a level of abstraction that may be of limited utility in the context of concrete decision making.Scholarly efforts are important. Particularly in bioethics, these scholarly efforts often have furnished the conceptual frameworks that are critical to the efforts of those who grapple with complex matters, the appropriate resolution of which pose moral disagreement and genuine perplexity. Policy formulation by its very nature, however, requires more. Attention must be paid to competing moral and social frameworks. Logical, rational arguments and risk/benefit assessments are important, but emotion, passion and values grounded in experience also demand consideration. Policy formulation as a result can be a quite messy process.Members of the academy are often uncomfortable in this environment. Pursuing the messy details can be threatening and at times at odds with values that academics prize highly. I believe this discomfort was evident in the reluctance of several Advisory Committee members to obtain security clearances that were required in order to see classified material related to the Committee’s work. Secrecy may have seemed at odds with cherished values of openness. As a result the perusal of classified materials was left to those with clearances. Fortunately, the Committee was successful in having relevant information declassified so all committee members read and deliberated about the same information. Committees needing to see more contemporaneous classified information might not be so fortunate.Ethics commission members correctly worry about disagreement. The ability to reach consensus helps to give recommendations a compelling quality. Morris Abram, chairman of the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, makes this point powerfully. He states that “a commission requires agreement that is as... (shrink)

. Current debates concerning the concept of mental disorder involve many different philosophical issues. However, it is not always clear from these discussions how, or whether, these issues relate to one another, or in exactly what way they are important for the definition of disorder. This article aims to sort through some of the philosophical issues that arise in the current literature and provide a clarification of how these issues are related to one another and whether they are necessary for (...) defining disorder. I argue that the main concern in defining disorder, namely demarcation, is obscured by a number of these other philosophical issues and that a focus on demarcation gives us a means of placing these other issues in a clarifying context. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Truth Will Set You Free, or How a Troubled Philosophical Theory May Help to Understand How People Talk About Their AddictionPatricia A. Ross (bio)Keywordsveridicality of narrative, contingency of theories, belief-behavior, causal connectionConsider the following proposition: If one were to recognize the unsatisfactory implications of maintaining a certain theoretical position, one would thereby be motivated to accept a more adequate theory, which would alter one's beliefs and, in turn, (...) alter the behaviors that are based upon those beliefs. Faith in this proposition is what motivates many of us to teach. But, alas...Allison Mitchell's argument for rethinking addiction intervention—in particular, rethinking twelve-step programs—is premised on this proposition. According to her argument, addicts function with an impoverished sense of self that is reflective of a grossly simplified form of philosophical materialism. By recognizing the limitations of this philosophically unconvincing view, and by, in effect, accepting a better, more complete materialism, addicts can come to modify their self-conception. This modification is instrumental to recovery.A careful consideration of the chain of events being proposed, and the problems with it, is helpful for understanding the limitations of her argument. There are four points that I consider in turn: (1) considering narratives can tell us something about the self-conception of addicts, (2) philosophical materialism can help us to understand and explain something about an addict's self-conception and how it is inadequate, (3) this sense of self is distinct from nonusers and the way in which it is distinct helps to understand the problem of addiction, and (4) a change in self-conception with respect to materialism helps recovery and, thus, our best intervention is one based on having addicts accept a full materialist theory of the self and not a pretheoretic one. [End Page 227]With respect to the first point, it should be noted that Mitchell's overall argument does not depend on whether or not it is true that narratives of addiction tell us something veridical about the self-conception of addicts. Such narratives may simply provide us with a potential theory—a possible worlds scenario—of how addicts conceive of themselves. Mitchell points this out herself. The narratives and the interpretation that she provides of these narrative, "are meant only to highlight a certain pattern of self-expression and conception that may in fact be common in persons who use mind-altering substances; the readings do not establish any empirical matters of fact or philosophical truths, nor do they prove any conclusions about how such persons (must) express themselves or conceive their nature" (Mitchell 2006, 214).Thus, what the argument is actually concerned with are the theoretical claims about the self-conception of addicts that are garnered from these narratives. Nevertheless, because the narratives provide the starting point for Mitchell's argument, it is worth thinking carefully about the epistemic status of this body of literature. In particular, could a consideration of such literature lead us astray in our endeavors to understand how addicts might misconceive of themselves and, if so, in what way? What sort of epistemic status does this information hold?Mitchell is motivated by Wittgensteinian analyses of the relationship between thought and language. The particular idea that she employs from Wittgenstein is that every act of self-expression, whether it is verbal or written narrative, reveals something about the conceptual framework with which the author is working. Thus, one can learn about the author of a narrative—one can acquire a sense of how that individual conceives of him- or herself—by looking at the language that is employed to talk about and describe him- or herself.Mitchell enumerates some problems with this approach. She mentions that the author may fail to make his or her intended sense clear to readers; that the reader's narrative expectations determine the interpretation given to the narrative; that literary narrative may be less direct, less ordinary than everyday uses of language; and that interpreting such narrative via philosophical framework may ascribe to people positions that are more precise and sophisticated than they actually intend (p. 213).Aside from these quite serious problems, it is necessary to recognize... (shrink)

Gottlob Frege famously rejects the methodology for consistency and independence proofs offered by David Hilbert in the latter's Foundations of Geometry. The present essay defends against recent criticism the view that this rejection turns on Frege's understanding of logical entailment, on which the entailment relation is sensitive to the contents of non-logical terminology. The goals are (a) to clarify further Frege's understanding of logic and of the role of conceptual analysis in logical investigation, and (b) to point out the extent (...) to which his understanding of logic differs importantly from that of the model-theoretic tradition that grows out of Hilbert's work. (shrink)

The primary purpose behind effectiveness research is to determine whether a treatment with demonstrated efficacy has utility when administered to the general population. The main questions these studies are meant to answer are these: Can the typical patient respond to treatment? Is the treatment acceptable to the typical patient? Can the treatment be administered safely and in its entirety in the typical treatment setting? Is the treatment under study significantly better than the community standard of care both from a cost (...) and outcome perspective? Answering these questions is meant to provide sufficient information to providers and policymakers so that effective interventions can be adopted and become the new community standard. For this research to make a meaningful impact on a provider and policymaker's decision to change the status quo, study interventions should be compared to the existing community standard of treatment, often referred to as treatment as usual (TAU). From an ethical perspective, this decision may not always be the safest choice. In some populations, TAU may mean no treatment at all, and in others TAU may be worse than withholding treatment. The effectiveness researcher is then caught between the pull to do no harm and the need for research to have an impact on change. The purpose of this article is to highlight certain conditions when TAU is ethically acceptable and to discuss alternatives when TAU may be an unethical treatment condition. For purposes of precision, we focus exclusively on psychotherapy effectiveness research rather than system-intervention research or medication-intervention research. (shrink)

Much of the fascination that Petronius' Satyricon holds for its readers originates in the work's gleeful violation of traditional categories of classical genres. Critical terminology makes explicit the issue of unconventionality, as it is reduced to the neutral word ‘work’ in describing the Satyricon, which, as far as we can tell, belongs to no single category , but appropriates elements from many sources in both poetry and prose. Perhaps if we had more evidence with which to compare the work, such (...) as a greater selection of Menippean satire or proto-novels from antiquity, we might be able to identify it more accurately. But the suspicion remains that the intense variety of its evocations, allusions, and parodic passages differentiates it clearly from its component genres without allowing it to settle firmly in any one established genre. A certain amount of ‘Kreuzung der Gattungen’ is, of course, typical of both Alexandrian and consequently Roman texts. But the Satyricon seems to revel in its generic instability; it plays with the notion of ‘literariness’ by revealing impulses from non-literary forms such as mime and subliterary prose fiction, raising this material to an unfamiliar level of literary sophistication even as it debases other traditional genres through parodic techniques. One of the results of this open experimentation with style and decorum is an extremely dense fabric of literary allusion which some would label ‘literary opportunism’. The reader quickly learns to expect intertextual pyrotechnics, swift changes from the sublime to the ridiculous, and humorous incongruities in plot and form, as the stylistic disorder of the text reflects the topsyturvy Petronian world. The modern reader's response to this profusion of referents is to explore the recognizable categories and sources embedded in the work, to tease out the familiar elements in the hope of gaining a better understanding of the whole. Since a great deal of the allusion in the Satyricon functions parodically, there is yet another step necessary in the interpretation, namely taking into account the effect of the decontextualization of language and events from the source material and their recombination and transformation into the new text. (shrink)

This paper attempts to determine what the.Characteristics of post-modernity, found within the work process, are, based on reflections on Latin America. In order to do this we look at post-modernity not as a context in and of itself, but as characteristics superimposed on these new forms of l..

Richard C. Atkinson’s eight-year tenure as president of the University of California reflected the major issues facing California itself: the state’s emergence as the world’s leading knowledge-based economy and the rapidly expanding size and diversity of its population. As this selection of President Atkinson’s speeches and papers reveals, his administration was marked by innovative approaches that deliberately shaped U.C.’s role in this changing California. These writings tell the story of the national controversy over the SAT and Atkinson’s successful challenge to (...) the dominance of the seventy-five-year-old college entrance examination. They also highlight other issues with national significance: U.C.’s experiments with race-neutral admissions programs; the challenges facing academic libraries and the University’s pioneering activities with the California Digital Library; and the University’s involvement in new paradigms of industry-university research. Together, these speeches and papers open a window on an eventful period in the history of the nation’s leading public research university and the history of American higher education. (shrink)

We examined differences in the knowledge and beliefs that exist among nurse researchers in the USA (n = 119) regarding informed consent and the use of data from patients’ medical records. Using a mail survey, two domains of ethical knowledge and beliefs were assessed: the legal right to privacy and the moral right to privacy. More than half of the participants were very confident in their knowledge of institutional review board procedures, research ethics, informed consent, the legal right to privacy, (...) and the moral right to privacy. In contrast, most rated themselves as uncertain about US federal research regulations and there was wide variation in knowledge about current federal guidelines. Those who were more confident in their knowledge of or had more practical experience with research ethics, were no more likely to answer correctly a question about current federal guidelines regulating the use of patient data from medical records than those who reported less confidence or experience. (shrink)

This essay addresses the question of the effect of Russell's paradox on Frege's distinctive brand of arithmetical realism. It is argued that the effect is not just to undermine Frege's specific account of numbers as extensions (courses of value) but more importantly to undermine his general means of explaining the object-directedness of arithmetical discourse. It is argued that contemporary neo-Fregean attempts to revive that explanation do not successfully avoid the central problem brought to light by the paradox. Along the way, (...) it is argued that the need to fend off an eliminative construal of arithmetic can help explain the so-called Caesar problem in the Grundlagen, and that the "syntactic priority thesis" is insufficient to establish the claim that numbers are objects. (shrink)

This paper explores the complex meanings of paizein and its compound sumpaizein used in connection with young girls and/or Eros in archaic Greek poetry. My basic question is whether the verb necessarily implies a knowing eroticism on the part of the character whom it describes, or whether it is the poet's way of inviting the audience to share his knowledge at the expense of the character, a kind of "wink" of complicity. I argue that there are fundamental ambiguities in this (...) particular use of paizein and that the instability of its semantic field is linked to the liminality of the stage of life to which it commonly refers. When Eros "plays," we know we should be on guard, but a young girl's "play" is somewhat more difficult to interpret. In this context, I suggest that Greek poetry can represent the liminality of a girl's sexual status through the physical setting in which the action takes place: the "players" are placed in a natural environment that reflects their stage in life, namely, the moments just before the loss of innocence, and that locus itself is open to divergent interpretations dependent on the sexual "knowledge" of the viewer. The notion "girls at play" thus resists any single interpretation, as the girls' sexual status always contains within it the potential for rapid and drastic change. (shrink)