Evidence based medicine has been a topic of considerable controversy in medical and health care circles over its short lifetime, because of the claims made by its exponents about the criteria used to assess the evidence for or against the effectiveness of medical interventions. The central epistemological debates underpinning the debates about evidence based medicine are reviewed by this paper, and some areas are suggested where further work remains to be done. In particular, further work is needed on the theory (...) of evidence and inference; causation and correlation; clinical judgment and collective knowledge; the structure of medical theory; and the nature of clinical effectiveness. (shrink)

The purpose of the present article is to examine the use of Logos as an ontological term in the Plotinian system and to seek to trace its connexion with Stoicism. Although at first the fact that the fundamental meaning metaphysically of Logos for Plotinus is a spiritual activity due, both as created and as creator, to the desire for contemplation may appear to be an obstacle to a close resemblance with the Spermatic Logos of Stoicism, the creative aspect of the (...) elemental Fire, nevertheless abundant and striking similarities in other respects seem to furnish conclusive evidence that the title which I have selected is not mistaken. The full importance of the Plotinian Logos cannot indeed be grasped until the development of the term has been studied not merely in Stoicism but in Philo and early Patristic Literature; for then the common function of Logos in every system, the reconciliation of the transcendent and the immanent views of God, is clearly manifested. But here only a brief indication of the evolution of the Logos doctrine between the diffusion of Stoic thought and the emergence of Neoplatonism is possible. Chief interest will be directed to the use by Plotinus of the spermatic conception, fundamentally Stoic, of a creative Nature which informs and pervades the Cosmos as its immanent Logos. (shrink)

What concerns me in this paper is a connection between motivation and various duties, especially duties that arise in the context of an institution such as a police force. I shall want to spread my net wider than that and discuss such issues as the role of loyalty in human life, but the focus will come back to the professional loyalties of police officers and, particularly, the discussion of the police culture in the Fitzgerald Report. What is it that motivates (...) people to perform their duties? Perhaps what matters, in the end, is that the duty is done more than why it is done, but motivation will have a lot to do with whether duty is done at all and with how well it is done. Motivation affects efficiency as well as morality and must, therefore, be given considerable thought by anybody concerned with an organization in which people are to perform their duties. (shrink)

This distinction has sometimes been read as purely epistemic, resting not on things, but on our knowledge of them: there is one world, not two, though it may be apprehended in two ways. But this view is patently at odds with the text. Knowledge and opinion are δυνάμεις, "faculties," to be distinguished and defined by their objects, no less than by the state of mind they produce, and Plato clearly states that the fallibility and unclearness of opinion is rooted in (...) the relative unreality of opinables. (shrink)

Background: Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors’ decisions. Associations between physicians’ religious characteristics and their weighting of the criteria were also examined. Methods: Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association masterfile. (...) Physicians were asked how much weight should be given to the following: (1) the patient’s expressed wishes and values, (2) the physician’s own judgment about what is in the patient’s best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. Results: Response rate 51% (446/879). Half of physicians (55%) gave the patient’s expressed wishes and values “the highest possible weight”. In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient’s expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the “highest possible weight”, versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). Conclusions: Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians’ decisions as much as is often recommended in the ethics literature. (shrink)

Kaukua's book will appeal to two audiences: historians of Islamic philosophy and philosophers concerned with postmodern theories of the self.It begins with Avicenna's Gedankenexperiment, the flying man, "imagined created all at once and perfect … as though floating in air or a void," completely bereft of sensations. This image is the capstone of Avicenna's two-stage argument for the existence and nature of the soul. Considering the soul in relation to other things, we see it is not a body, but a (...) form, first actuality of the body, its perfection and power, as Aristotle said. Then comes the flying man, acting as an ishârat directing us to the mâhîyya of the soul. Avicenna "will not hesitate in... (shrink)

Public health ethics is a relatively new academic field. Crucially, it is distinguished from traditional medical ethics by its focus on populations rather than individuals. Still, the ethics of public health cannot be perceived completely detached from the ethics of individuals, as populations are made up of individuals. One issue that clearly falls within the intersection of a population- and an individual based perspective on ethics is resource allocation. Resource allocation takes place at various stages within the organisation of healthcare, (...) i.e. at the micro-, meso- and macro level [3]. Resources are almost always limited, with the consequence that some healthcare is prioritised while other care is rationed. In this manner, resource allocation creates winners and losers; those who get the best care available, those who do not receive the best care and those who do not receive care at all. It seems prudent to assume that any adequate public health ethics involved in population-based decision-making will have to address all ethical aspects of resource allocation, all the way from the macrolevel policy-making process to the micro-level implementation where it affects specific and identifiable individuals. More specifically, such an ethics must be able to deal with the ethical tensions arising between population-based concerns framing the policy design process, and individual concerns in the realisation of the resource allocations. In the following, I will identify an inherent ethical tension involved in ‘legitimate resource allocation’, which is related to the challenge of meeting the ethical requirements from a population- and an individual based perspective at the same time. (shrink)

Agathon, in his panegyric of Eros, had maintained that it is good, beautiful, and divine. Socrates begins his elenchus of this claim by pointing out that Eros is relational in character: love is always love of something, desire desire for something. Eros falls in that class of terms later described as ta pros ti, terms which have their meaning ‘toward’ something else. Furthermore, Eros lacks what it loves and desires to possess it: “everyone … who desires something desires what has (...) not been obtained and is not present; his love and desire are set on things he lacks, things he does not possess.” Desire implies privation. Agathon and Plato also agree that Eros is always in love with the beautiful ; as Agathon had earlier said, “the world was fashioned by the gods through love of beautiful things; for there is no love of the ugly.” It then follows that, since Eros is love of what it lacks, it cannot be beautiful or good, and since the gods possess both attributes, it cannot be divine. It is not, however, bad or ugly or mortal, but ‘intermediate’ between those attributes. (shrink)

J. Krishnamurti (1895-1986) was thought by many to be a modern-day equivalent of the Buddha. In fact, he was once even considered to be the second coming of Christ. While many think it wonderful to live and work in close proximity with such a person, it's difficult to understand the depth of what this means and how challenging this might be. In Knocking at the Open Door, author R.E. Mark Lee provides an ordinary person view of what being close-up and (...) working together with such a man means, how it challenges one at every turn, and how it causes one to question ceaselessly, even more deeply than one ordinarily would. Lee offers an insightful, candid, and heartfelt narrative that reveals various unknown facets of the eminent world teacher J. Krishnamurti and highlights his distinctive vision for education worldwide. This comprehensive volume brings alive the practical and everyday interactions Lee had with Krishnamurti during a twenty-year period in India and the United Sates. Knocking at the Open Door shares a clear and honest account that demonstrates the challenges of working with Krishnamurti in running a school that is true to the teaching and yet able to function in the reality of modern parental, student, and educational establishment expectations. (shrink)

Probably no philosopher of antiquity has occasioned more daring speculations and the expression of graver doubts than Posidonius. On the one hand it has been argued that he was purely a man of science and hardly a Stoic philosopher at all. On the other hand he has been called the first and greatest Stoic mystic who under Oriental influence spurned the body as vile and earthly. Reinhardt has of late years resolutely maintained that the importance of Posidonius in the history (...) of thought lies in his having originated a completely new Vitalism, and that his conception of the world is one in which ‘Subjekt und Objekt, Geist und Wissen, Mensch und Gott, νος und ζω durch eine im Bewusstsein neu erwachte Kraft sich einen und durchdringen: durch die “Sympathie.”’ Among other German scholars Geffcken holds that Plotinus borrowed much from Posidonius, and Jaeger roundly declares that if Posidonius had but found a place for the Platonic Ideas, there would have been nothing left for Plotinus to find. Schmekel and Bréhier have both stated that modifying the Platonic Theory of Ideas Posidonius established an identification between the Ideas and the Spermatic Logoi of Stoicism. (shrink)

Robert Solomon has presented a version of business ethics in terms of virtues theory. It is a good thing that business ethics should be understood in terms of virtues theory, but the account that Solomon gives is seriously misleading in important respects. "A virtue is a pervasive trait of character that allows one to 'fit into' a particular society and to excel in it," he says. This is something that we might query: what a society will recognize as a virtue (...) might well be what fits that formula, but sometimes we shall want to recognize as a virtue what enabled somebody to stand out against his or her society and change it, and shall want to say that those traits that enable somebody to fit happily into (say) a slave society are vices rather than virtues. That is to say, a society's recognition of virtues, its application of virtues theory in picking out various character traits as valuable, will depend on other judgments common in that society, and we might well differ from that society in those judgments. (shrink)

Hume's is/ought distinction has long limited the role of empirical research in ethics, saying that data about what something is cannot yield conclusions about the way things ought to be. However, interest in empirical research in ethics has been growing despite this countervailing principle. We attribute some of this increased interest to a conceptual breakdown of the is/ought distinction. MacIntyre, in reviewing the history of the is/ought distinction, argues that is and ought are not strictly separate realms but exist in (...) a close relationship that is clarified by adopting a teleological orientation. We propose that, instead of recovering a teleological orientation, society tends to generate its own goals via democratic methods like those described by Rousseau or adopt agnosticism about teleology such as described by Richard Rorty. In both latter scenarios, the distinction between is and ought is obscured, and the role for empirical research grows, but for controversial reasons. MacIntyre warns that the is/ought distinction should remain, but reminds ethicists to make careful arguments about when and why it is legitimate to move from is to ought. (shrink)

Open peer commentary on the article “The Circular Conditions of Second-order Science Sporadically Illustrated with Agent-based Experiments at the Roots of Observation” by Manfred Füllsack. Upshot: I follow the general tenor of Füllsack’s target article but I have some basic reservations as to the utilization of the thermodynamics involved.

“To whom is the Consecration of Medal, Stature or even Pyramid more jusly due, than to … the late Illustraious Boyle? … for the happy Improvement of Otto Guericks Magdeburg Exhausterm and for his Profound and Noble Researches into all the abstruser Parts and Recesses of the most useful Philosophy … I have named the Illustrious Boyle, and fix his Trophy here.”John Evelyn, Numismata, 1697.

Loyalty, by making us identify with others, takes us beyond the very limited self (roughly the self of the Hobbesian natural condition) that is involved in selfishness and that is usually involved when people consider that self-concern, that aspect of human nature that must be limited if we are to live peaceably, is the main stumbling block to morality. Loyalty can thus be thought of as a version of altruism, as an inclination to identify with others and to share their (...) good. That is to say, loyalty seems opposed to the troublesome aspects of self-concern. We would, nevertheless, be mistaken to conclude that it must simply be a good in people, something to be encouraged. The primary issue is: Which loyalties should be encouraged? There is no general truth about the value of loyalty as such. (shrink)

Francis Fukuyama, in his Our Posthuman Future, and Gregory Stock, in his Redesigning Humans, present competing versions of the biomedical future of human beings, and debate the merits of more or less stringent regimes of regulation for biomedical innovation. In this article, these positions are shown to depend on a shared discourse of market liberalism, which limits both the range of ends for such innovation discussed by the authors, and the scope of their policy analyses and proposals. A proper evaluation (...) of the human significance and policy imperatives for biomedical innovation needs to be both more utopian in its imagination, and more sophisticated in its political economy. In essence, the Fukuyama/Stock debate tells us more about current US political ideology than it does about the morality of human genetic and biopsychological engineering. (shrink)

R. E. Heinaman; XI*—Communion of Forms, Proceedings of the Aristotelian Society, Volume 83, Issue 1, 1 June 1983, Pages 175–190, https://doi.org/10.1093/aristot.

This paper has two goals: 1) to understand justice as a cardinal virtue, according to Aquinas; and 2) to use his conception of justice as a cardinal virtue to understand how one engages in acts of “general” justice. The argument proceeds in four stages: 1) how Aquinas understands the virtues by looking to their “objects”; 2) the two distinct “modes” of the four cardinal virtues, as “general” and “specific” virtues; 3) the triangle of three kinds of justice, seen in terms (...) of their “objects”; 4) Aquinas’s doctrine of justice as a “general” virtue (ST 2-2.58.5–6) shows that we can perform operations of “general” justice in two ways, as do the ruler and his minsters, and as ordinary folk do. Surprisingly, it is the latter mode of acting for “general” justice that is primary, not the former. (shrink)