Patients living with chronic pain require appropriate access to opioid therapy along with improved access to pain care and additional therapeutic options. It's both medically reasonable and ethical to consider opioid therapy as a treatment option in the management of chronic, non-cancer pain for a subset of patients with severe pain that is unresponsive to other therapies, negatively impacts function or quality of life, and will likely outweigh the potential harms. This paper will examine opioid therapy in the setting of (...) the opioid epidemic, why critics feel that the CDC guideline has resulted in harsh consequences for patients and their physicians, and the rationale for opioid therapy as a means of providing ethical and compassionate pain care. (shrink)

Objective Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians’ attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. Design, Setting, Participants A survey of resident/fellow physicians and internal medicine (...) attendings at an academic medical center, May to August 2013. Measurements We used a 24-item, internet-based survey assessing physician-respondents’ demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. Main Results A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/ fellows. Only 32 percent of the respondents indicated that a surrogate’s consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate’s objection. Those who self-reported as “knowledgeable” about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VAECMO over a surrogate’s objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Conclusions Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/ critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians’ hesitance to cede authority to presumably less knowledgeable patients and surrogates, (2) stem from a stewardship of resources perspective, and/or (3) point to practical efforts to avoid futility and utility disputes. Whether these results indicate a more widespread reversion to paternalism or a more circumscribed usurping of decisional authority occasioned by VA-ECMO necessitates further study. (shrink)

This study examined the historical perspectives of eleven emergent bilingual and bilingual students at two middle schools. Data analysis revealed that the participants’ perspectives on U.S. history reflected three schematic narrative templates focused on nation-building, equality, and discrimination. The participants primarily employed the (in)equality narratives when discussing aspects of U.S. history directly linked to their identities. The findings add to the extant research on student historical perspectives and use of schematic narrative templates. The findings further suggest that engaging (emergent) bilingual (...) students in examining multiple perspectives and conducting critical history inquiry can contribute to notions of culturally and linguistically responsive social studies instruction. (shrink)

Like nature itself, modern economic life is driven by relentless competition and unbridled selfishness. Or is it? Drawing on converging evidence from neuroscience, social science, biology, law, and philosophy, Moral Markets makes the case that modern market exchange works only because most people, most of the time, act virtuously. Competition and greed are certainly part of economics, but Moral Markets shows how the rules of market exchange have evolved to promote moral behavior and how exchange itself may make us more (...) virtuous. Examining the biological basis of economic morality, tracing the connections between morality and markets, and exploring the profound implications of both, Moral Markets provides a surprising and fundamentally new view of economics--one that also reconnects the field to Adam Smith's position that morality has a biological basis. Moral Markets, the result of an extensive collaboration between leading social and natural scientists, includes contributions by neuroeconomist Paul Zak; economists Robert H. Frank, Herbert Gintis, Vernon Smith, and Bart Wilson; law professors Oliver Goodenough, Erin O'Hara, and Lynn Stout; philosophers William Casebeer and Robert Solomon; primatologists Sarah Brosnan and Frans de Waal; biologists Carl Bergstrom, Ben Kerr, and Peter Richerson; anthropologists Robert Boyd and Michael Lachmann; political scientists Elinor Ostrom and David Schwab; management professor Rakesh Khurana; computational science and informatics doctoral candidate Erik Kimbrough; and business writer Charles Handy. (shrink)

The essay examines the impact of thought insertion on typical conceptions of self-consciousness. Stephens and Graham have recently argued that thought insertion is compatible with the inseparability thesis, which maintains that with regard to self-consciousness subjectivity is a proper part of introspection--introspection and subjectivity are inseparable. They argue that thought insertion is an error of agency and not an error of subjectivity. The essay contends that even if they are correct in their interpretation that thought insertion is an error of (...) agency rather than subjectivity, which is unlikely, they are incorrect to maintain that it is not also an error of subjectivity. Evidence is put forth to indicate that thought insertion is, at best, a mistake of agency and subjectivity. It is concluded that thought insertion is incompatible with the inseparability thesis, and a new inseparability thesis is thereby postulated. (shrink)

This collection of papers makes a step towards increased dialogue among philosophical liberals and their theological, sociological and legal critics. The text should be significant for those concerned with the place of religion within a liberal society.

In Religion and the Obligations of Citizenship Paul J. Weithman asks whether citizens in a liberal democracy may base their votes and their public political arguments on their religious beliefs. Drawing on empirical studies of how religion actually functions in politics, he challenges the standard view that citizens who rely on religious reasons must be prepared to make good their arguments by appealing to reasons that are 'accessible' to others. He contends that churches contribute to democracy by enriching political (...) debate and by facilitating political participation, especially among the poor and minorities, and as a consequence, citizens acquire religiously based political views and diverse views of their own citizenship. He concludes that the philosophical view which most defensibly accommodates this diversity is one that allows ordinary citizens to draw on the views their churches have formed when voting and offering public arguments for their political positions. (shrink)

This study examines the effects of demographic characteristics on ethical perceptions. While earlier research has produced conflicting results regarding the predictive power of these variables, significant and definite insights were obtained with proper controls. The following predictors of ethical attitudes are examined: age, gender, marital status, education, dependent children status, region of the country and years in business, while controlling for job status. A nation-wide random sample of employees was used in obtaining a response rate of fifty-three percent (total n (...) of 423). Indices of aspects of business ethical attitudes were constructed using factor analysis. Linear multiple regression analysis indicated the significant predictive variables. Age was found to be a most-significant predictor. Older workers had stricter interpretations of ethical standards. Gender and region predicted attitudes about job-discrimination practices only, with women and persons from the Midwest most strongly opposed to the practice. All the other variables proved to be unreliable ethics predictors. (shrink)

How does personality influence the relationship between appraisals and emotions? Recent research suggests individual differences in appraisal structures: people may differ in an emotion's appraisal pattern. We explored individual differences in interest's appraisal structure, assessed as the within-person covariance of appraisals with interest. People viewed images of abstract visual art and provided ratings of interest and of interest's appraisals (novelty–complexity and coping potential) for each picture. A multilevel mixture model found two between-person classes that reflected distinct within-person appraisal styles. For (...) people in the larger class (68%), the novelty–complexity appraisal had a stronger effect on interest; for people in the smaller class (32%), the coping potential appraisal had a stronger effect. People in the larger class were significantly higher in appetitive traits related to novelty seeking (e.g., sensation seeking, openness to experience, and trait curiosity), suggesting that the appraisal classes have substantive meaning. We conclude by discussing the value of within-person mixture models for the study of personality and appraisal. (shrink)

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The (...) cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students. (shrink)

Millikan's discussion of substance concepts in terms of their information-gathering role ignores the analyses of information-based perception and action developed within the tradition of ecological psychology. Her introduction and use without definition of key Gibsonian terms such as “affordance” and “direct perception” leaves those of us investigating such concepts uncertain of the extent to which she appreciates their theoretical importance. Due recognition of the realist account of categorical perception developed by J. J. Gibson would provide mutual benefit to modern externalist (...) philosophy as well as to experimental psychology and to those investigating the ecological approach to perception–action. (shrink)

Treatments of the moral doctrine of René Descartes found in the Cartesian scholarship do not typically regard the Cartesian philosophy as being devoted to moral instruction. In this essay, it is argued that the moral philosophy of Descartes involves the connection of the method enunciated in the Discourse on the Method with the „morale par provision” articulated in that work. The affinity between morals and method is found in the fact that moral dispositions are to be adapted to the progress (...) achieved in scientific technology. Accordingly, it is the advance of science that determines the good of man. And it is concluded that the Cartesian moral teaching amounts to this: That which man can do is good or moral to do. (shrink)

The book describes Radical Orthodoxy's orientation and highlights those anti-secular strategies and intellectual influences that have shaped its appeal to Aquinas.

In lieu of an abstract, here is a brief excerpt of the content:THOMISTIC PRIDE AND LIBERAL VICE 1 PAUL J. WEITHMAN University of Notre Dame Notre Dame, Indiana L IBERALISM IS often portrayed, and sometimes portrays itself, as a moral and political view that rejects the claims of tradition. Thus liberals characteristically claim that the traditional standing of a social arrangement contributes little or nothing to its political legitimacy. Whether an arrangement is legitimate depends upon whether or not those (...) who currently live under it can understand and accept its rationale. Members of each generation must be able to examine arrangements as if they themselves were signatories of the social contract; the justification of regimes must, as it were, be susceptible of renewal in every age and to every citizen. Jefferson gave this view its most extreme expression when he claimed that each generation has the right to begin its nation's political life anew, and that national constitutions should be rewritten every two decades.2 Liberals often seem no kinder to intellectual than to political traditions. As they think political life can periodically begin anew, so they sometimes seem to think that political and moral philosophy can begin anew. Hobbes famously castigated the obscurities of scholasticism and argued that political philosophy could achieve firm footing only if the rubble of the past were swept away.3 Liberal contract theorists have followed Hobbes's lead, developing political theories that rely not at all upon classi1 Thanks to Alasdair Macintyre, David O'Connor, Michael Pakaluk, David Solomon, Eleonore Stump, and Allen Wood for helpful comments on earlier drafts. This paper is dedicated to the memory of my teacher and friend, Prof. Judith Shklar. 2 See Jefferson's famous letter to Madison of September 6, 1789 (The Portable Jefferson, ed. Merrill D. Peterson [New York: Viking, 1977], 444ff.), as well as his lesser known missive to Samuel Kercheval of July 12, 1816 (ibid., SS2ff.). 3 See Thomas Hobbes, Leviathan, ed. C. B. MacPherson (New York: Penguin Books, 1985), 727, for an especially pungent expression of a view that runs throughout the Leviathan. 241 242 PAUL J. WEITHMAN cal and medieval moral philosophy. To take but one example of this neglect of the past, the ethical writings of scholasticism are dominated by richly detailed analyses of the virtues and vices, yet liberal writers roundly ignore these discussions. Liberals have been quick to defend their suspicions of the thought and politics of the past, but critics of liberalism have been equally quick to seize upon them. Champions of virtue ethics have been among the most vocal critics of liberalism in recent years, arguing that liberals court philosophical peril by neglecting the insights of earlier moral theories. Edmund Burke, the eighteenth-century opponent of liberalism, had an additional complaint. Burke discerned an arrogance in the liberal rejection of intellectual and political tradition. It was mere pride, Burke thought, to suppose that politics and political theory could be made transparent to the reason of every individual in the way that liberals sometimes claim.4 Burke's allegation that the liberal rejection of tradition reflects pride is ironic, for pride is a central element of one of the traditions of moral thought that liberals seem determined to reject. During a lengthy period of philosophy's history, pride was thought to be a motive of all wrong action. The biblical book of Sirach says that pride is the beginning of all evil5 and a long line of medieval moralists labored to explain how this might be so. Yet the tradition of moral thought that accorded pride so central a role now suffers from neglect at the hands of many philosophers. And pride itself is a vice that many philosophers now consider unworthy of attention. Most fail to consider it seriously as a motive for any wrong action at all. I have three aims in this paper. One is to examine pride's neglect more closely. I shall argue that pride suffers this neglect because of its centrality to a religiously based tradition of moral thought that many philosophers no longer accept. The alleged connection between pride and religion is, I shall argue, suggestive. It suggests what an account of pride would have to include 4 See Edmund Burke, Reflections on... (shrink)

Operating as a machine upon the terrain of theoretical truth procedures, philosophy's radical potential describes a militant cartography: interpretation, demarcation, clarification, and demystification.

Examining the philosophical, theological, and political teachings of the Tractatus theologico-politicus, this book proposes that Benedict Spinoza fashions a ...

Individual differences related to emotions are typically represented as emotion traits. Although important, these descriptive models often do not address the psychological dynamics that underlie the trait. Appraisal theories of emotion assume that individual differences in emotions can be traced to differences in patterns of appraisal, but this hypothesis has largely gone untested. The present research explored whether individual differences in the emotion of interest, known as trait curiosity, consist of patterns of appraisal. After completing several measures of trait curiosity, (...) participants read complex poems (Experiment 1) or viewed simple and complex pictures (Experiment 2) and then gave ratings of interest and interest's appraisal components. The effect of trait curiosity on interest was fully mediated by appraisals. Multilevel analyses suggested that curious people differ in the amount of appraisal rather than in the kinds of appraisals relevant to interest. Appraisal theories can offer a process-oriented explanation of emotion traits that bridges state and trait emotional experience. (shrink)

The focus of this article is on the incarnation of Jesus Christ, the Word become flesh, as a way of talking about and understanding mission and addresses at least two concerns in the contemporary debate about the missional church. Many missionary methods and strategies have contradicted both the teaching and actions of Jesus as he trained his disciples to continue his ministry. The message may have been the gospel, but the way the message was made known was often not congruent (...) with the gospel. The attempt to interpret mission in terms of the incarnation of Jesus suggests that the earlier forms of mission strategies should be replaced by a theology and praxis rooted in and defined by the life and ministry of Jesus. Ephesians 4 provides the key to the theology and praxis by giving us a direct link backward into the ministry that infused and led the early church in the life and the ministry of Jesus. (shrink)

Through a detailed re-reading of Saussure's work in the light of contemporary developments in the human, life and physical sciences, Paul Thibault provides us with the means to redefine and refocus our theories of social meaning-making. Saussure's theory of language is generally considered to be a formal theory of abstract sign-types and sign-systems, separate from our individual and social practices of making meaning. In this challenging book, Thibault presents a different view of Saussure. Paying close attention to the original (...) texts, including the Cours de Linguistic Generale, he demonstrates that Saussure was centrally concerned with trying to formulate a theory of how meanings are made. In addition to demonstrating the continuing viability of Saussure's thinking through a range of examples, Re-reading Saussure makes an important intervention in contemporary linguistic and semiotic debate. (shrink)

This book is a detailed comparison of the major political writings of Machiavelli and Xenophon. By elucidating the remarkable scope, depth, and subtlety of the debate between these two great thinkers,Excellence Unleashed offers a fresh perspective on the philosophic and political significance of Machiavelli's proto-modern break from the classical tradition.

Language plays a central role in human life. However, the term 'language' as defined in the language sciences of the 20th century and the traditions these have drawn on, have arguably, limited our thinking about what language is and does. The two inter-linked volumes of Thibault's study articulate crucially important aspects of an emerging new perspective shift on language - the Distributed Language view - that is now receiving more and more attention internationally. Rejecting the classical view that the fundamental (...) architecture of language can be localized as a number of inter-related levels of formal linguistic organization that function as the coded inputs and outputs to each other, the distributed language view argues that languaging behaviour is a bio-cultural organisation of process that is embodied, multimodal, and integrated across multiple space-time scales. Thibault argues that we need to think of human languaging as the distinctively human mode of our becoming and being selves in the extended human ecology and the kinds of experiencing that this makes possible. Paradoxically, this also means thinking about language in non-linguistic ways that break the grip of the conventional meta-languages for thinking about human languaging. Thibault's book grounds languaging in process theory: languaging and the forms of experience it actualizes is always an event, not a thing that we 'use'. In taking a distinctively interdisciplinary approach, the book relates dialogical theories of human sense-making to the distributed view of human cognition, to recent thinking about distributed language, to ecological psychology, and to languaging as inter-individual affective dynamics grounded in the subjective lives of selves. In taking this approach, the book considers the coordination of selves in social encounters, the emergent forms of self-reflexivity that characterise these encounters, and the implications for how we think of and live our human sociality, not as something that is mediated by over-arching codes and systems, but as emerging from the endogenous subjectivities of selves when they seek to coordinate with other selves and with the situations, artefacts, social institutions, and technologies that populate the extended human ecology. The two volumes aim to bring our understanding of human languaging closer to human embodiment, experience, and feeling while also showing how languaging enables humans to transcend local circumstances and thus to dialogue with cultural tradition. Volume 1 focuses on the shorter timescales of bodily dynamics in languaging activity. Volume II integrates the shorter timescales of body dynamics to the longer cultural-historical timescales of the linguistic and cultural norms and patterns to which bodily dynamics are integrated. (shrink)

In Moral Leadership>, Paul J. Olscamp shows how college presidents and trustees can use basic ethical principles to help make moral decisions. Olscamp describes the nature of the college presidency and provides a summary view of western ethical theory, outlining a series of principles relating to morality and obligation.

Bringing together specialists in various fields, this volume shows that the transformation from the scholastic to more empirical approaches to psychology was a gradual process.

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.