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)

Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

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)

This paper examines the connection between model-theoretic truth and necessary truth. It is argued that though the model-theoretic truths of some standard languages are demonstrably ''''necessary'''' (in a precise sense), the widespread view of model-theoretic truth as providing a general guarantee of necessity is mistaken. Several arguments to the contrary are criticized.

This paper defends the view that Frege’s reduction of arithmetic to logic would, if successful, have shown that arithmetical knowledge is analytic in essentially Kant’s sense. It is argued, as against Paul Benacerraf, that Frege’s apparent acceptance of multiple reductions is compatible with this epistemological thesis. The importance of this defense is that (a) it clarifies the role of proof, definition, and analysis in Frege’s logicist works; and (b) it demonstrates that the Fregean style of reduction is a valuable tool (...) for those who would investigate the nature of arithmetical knowledge. (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)

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)

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)

Clinical next generation sequencing is a term that refers to a variety of technologies that permit rapid sequencing of large numbers of DNA segments, up to and including entire genomes. As an approach that is playing an increasingly important role in obtaining genetic information from patients, it may be viewed by public and private payers either positively, as an enabler of the promised benefits of personalized medicine, or as “the perfect storm” resulting from the confluence of high market demand, an (...) uproven technology, and an unprepared delivery system. A number of recent studies have noted that coverage and reimbursement will be critical for clinical integration of NGS, yet the evidentiary pathway for payer decision-making is unclear. Although there are multiple reasons for this uncertain reimbursement environment, the situation stems in large part from a long-standing lack of alignment between the information needs of regulators and post-regulatory decision-makers such as payers. (shrink)

The theologies of the saints of Hans Urs Von Balthasar and Karl Rahner are grounded in the theologians' distinct articulations of the relationship between nature and grace, Rahner's shaped by his response to the Nouvelle Théologie and Von Balthasar's influenced by his engagement with Henri De Lubac and Karl Barth. It is a generalization, but one useful for drawing contrasts, that for Rahner the saints are mediators of the Mediator and that for Von Balthasar they are revealers of the Revealer. (...) While the theologies can be reconciled, a richer understanding of the function of saints can emerge by maintaining the contrasts. The symbolic capacity of saints in Rahner's thought and the saints' exemplary abandonment to personal mission in Von Balthasar's thought are each an emphasis valuable in communicating saints' instructional and efficacious presence for others in the ecclesial Body. (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)

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.

This paper argues that the creation narrative of the Fall in Genesis 2:4b–3:24 is not history and does not contain a doctrine of original sin. The doctrine of original sin as a theory of human nature needs a new foundation. The contemporary science of sociobiology has a theory of human nature that is remarkably similar to major versions of the Christian doctrines of original sin. To incorporate sociobiology's theory of human nature into Christianity is to lay the foundation for a (...) new, ecumenical understanding of original sin. (shrink)

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical and (...) moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (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 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)

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)

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)

Designing for culture through intelligent tutoring systems is on the rise. The needs of military personnel to communicate and understand cultures other than their own in deployments, missions, and work-related assignments have strongly encouraged the creation of culturally aware tutoring systems (CATS) that teach about other cultures. This paper critically analyzes three systems (i.e., ELECT-BiLAT, Tactical Iraqi, and VECTOR) and the frameworks that guided the design and development process. The examination reveals that there is a need for comprehensive guidelines to (...) build CATS. Therefore, the Culture Based Model is offered as a framework to guide the design of culture-based information and communication technologies. (shrink)

This thesis is an examination of Frege's logicism, and of a number of objections which are widely viewed as refutations of the logicist thesis. In the view offered here, logicism is designed to provide answers to two questions: that of the nature of arithmetical truth, and that of the source of arithmetical knowledge. ;The first objection dealt with here is the view that logicism is not an epistemologically significant thesis, due to the fact that the epistemological status of logic itself (...) is not well understood. I argue to the contrary that on Frege's conception of logic, logicism is of clear epistemological importance. ;The second objection examined is the claim that Godel's first incompleteness theorem falsifies logicism. I argue that the incompleteness theorem has no impact on logicism unless the logicist is compelled to hold that logic is recursively enumerable. I argue, further, that there is no reason to impose this requirement on logicism. ;The third objection concerns Russell's paradox. I argue that the paradox is devastating to Frege's conception of numbers, but not to his logicist project. I suggest that the appropriate course for a post-Fregean logicist to follow is one which divorces itself from Frege's platonism. ;The conclusion of this thesis is that logicism has of late been too easily dismissed. Though several critical aspects of Frege's logicism must be altered in light of recent results, the central Fregean thesis is still an important and promising view about the nature of arithmetic and arithmetical knowledge. (shrink)

While ethical conflicts in the provision of healthcare are common, the current third-party mediator model is limited by a lack of expert ethical mediators, who are often not on site when conflict escalates. In order to improve clinical outcomes in situations such as conflicts at the end of life, we suggest that clinicians—physicians, nurses and social workers—be trained to prevent and deescalate emerging conflicts. This can be achieved using a mediation model framed by a communication-training approach. A case example is (...) presented and the model is discussed. The implication of this preventative/early intervention model for improving clinical outcomes, in particular end-of life conflict, is considered. (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)

A proof of pragmatism is proposed in Peirce's 1903 lecture series on Pragmatism as a Principle and Method of Right Thinking. It is necessary first to define what pragmatism is, a task for which a practitioner of the pragmatic maxim would be fitted, but which, however, must be highly problematic to a potential practitioner who does not yet know its full meaning. In order to clarify its meaning, Peirce uses a method he recommends for such conundrums in his 1891 article, (...) “The Architecture of Theories,” that is, “to make a systematic study of the conceptions out of which a philosophical theory may be built, in order to ascertain what place each conception may fitly occupy in such a theory and to what uses it is adapted”. Peirce's systematic study of the basis of logic and pragmatism in relation to it begins to appear around 1898 and peaks in 1903 when pragmatism's definition and role within the sciences is established in these lectures. (shrink)

In Phylogenetic Systematics (1966), Willi Hennig conflates the Linnaean hierarchy with what Hennig refers to as the divisional hierarchy. In doing so, he lays the foundations of that school of biological taxonomy known as cladism on a philosophically ambiguous basis. This paper compares and contrasts the two hierarchies and demonstrates that Hennig conflates them. It shows that Hennig's followers also conflate them. Finally, it illuminates five persistent problems in cladism by suggesting that they arise from Hennig's original confusion.

This chapter contains section titled: Life and Works Desgabets's Philosophical System Cartesianism or Robertism?

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)

Many models of motivation suggest that goals can be arranged in a hierarchy, ranging from higher-level goals that represent desired end-states to lower-level means that operate in the service of those goals. We present a hierarchical model that distinguishes between three levels—goals, strategies, and tactics—and between approach/avoidance and regulatory focus motivations at different levels. We focus our discussion on how this hierarchical framework sheds light on the different ways that success and failure are defined within the promotion and prevention systems (...) outlined in regulatory focus theory. Specifically, we review research that demonstrates that differences in what “counts” as success versus failure in these systems have important implications for motivational strength, emotional responses, and risky behavior. (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)