The work of Tversky, Kahneman and others suggests that people often make use of cognitive heuristics such as availability, salience and representativeness in their reasoning and decision making. Through use of a historical example--the recent plate tectonics revolution in geology--I argue that such heuristics play a crucial role in scientific decision making also. I suggest how these heuristics are to be considered, along with noncognitive factors (such as motivation and social structures) when drawing historical and epistemological conclusions. The normative perspective (...) is community-wide, contextual, and instrumental. (shrink)

_The_ _Routledge Companion to Philosophy of Medicine _is a comprehensive guide to topics in the fields of epistemology and metaphysics of medicine. It examines traditional topics such as the concept of disease, causality in medicine, the epistemology of the randomized controlled trial, the biopsychosocial model, explanation, clinical judgment and phenomenology of medicine and emerging topics, such as philosophy of epidemiology, measuring harms, the concept of disability, nursing perspectives, race and gender, the metaphysics of Chinese medicine, and narrative medicine. Each of (...) the 48 chapters is written especially for this volume and with a student audience in mind. For pedagogy and clarity, each chapter contains an extended example illustrating the ideas discussed. This text is intended for use as a reference for students in courses in philosophy of medicine and philosophy of science, and pairs well with _The_ _Routledge Companion to Bioethics_ for use in medical humanities and social science courses. (shrink)

Bioethics in the twenty‐first century is confronting what one might call “collective‐impact problems.” The ethics guidance and policies that are developed to address these kinds of problems will affect not only individuals but everyone living and future generations too. With many collective‐impact problems, all parties will eventually be worse off if there is a failure to develop solutions to head off damage to the shared environment. However, the effects are not felt equally throughout and across societies; some groups are hit (...) far worse. To address collective‐impact problems, bioethics needs to recalibrate. Our field, and especially American bioethics, should find a better balance between individual rights and the best interests of the group, develop more robust tools for examining structural inequities that damage people's health and well‐being, and study how to engage the public in learning about and shaping ethics guidance for these complex problems. (shrink)

General science literacy contributes to good public decision‐making about technology and medicine. This essay explores the kinds of science literacy currently developed by public education in the United States of America. It argues that current curricula on “science as inquiry” (formerly the “nature of science”) need to be brought up to date with the inclusion of discussion of social epistemological concepts such as trust and scientific authority, scientific disagreement versus science denialism, the role of ideology and bias in scientific research, (...) and the importance of peer review and responsiveness to criticism. (shrink)

This chapter explains why virtue ethics in the latter twentieth century has taken the following two forms: the first form orders evaluative concepts and then argues that the concept of a virtue is more basic than the concepts of a right act and a good state of affairs; the second form focuses on deeper questions about the nature and ambition of modern ethics and its ability to satisfy our need for reflective guidance. The former is a common approach given its (...) focus on arguments for theory construction. The latter is more radical given that its themes are suspicious of rules and principles and, sometimes, moral theory itself. Because so many debates over virtue ethics reduce to debates over the kind of criteria needed to judge ethical theories, they will remain unresolved. Epistemologists must learn from moral philosophers about the myriad usages of virtue in language, as well as the different models each usage is working within. (shrink)

Draws together important selections from classical and contemporary theories and debates about emotion from a variety of subject areas.

The ethical dimensions of an aging society are larger than the experience of chronic illness, the moral concerns of health care professionals, or the allocation of health care resources. What, then, is the role of bioethics in an aging society, beyond calling attention to these problems? Once we’ve agreed that aging is morally important and that population‐level aging across wealthy nations raises ethical concerns that cannot be fixed through transhumanism or other appeals to transcend aging and mortality through technology, what (...) is our field’s contribution? We argue that it is time for bioethics to turn toward social justice and problems of injustice and that part of doing so is articulating a concept of good citizenship in an aging society that goes beyond health care relationships. (shrink)

TWENTY QUESTIONS, one of the best selling introduction to philosophy anthologies available today, presents a proven, well-acclaimed forum for introducing students to the rich variety of philosophical reflection. Animated by some of philosophy's more concrete questions--questions that students are likely to have pondered long before signing up for their first philosophy classes--TWENTY QUESTIONS fosters the creative exploration of many renowned classical and contemporary thinkers' responses to the very same questions.

Michael Friedman has recently argued that Carnap'sLogical Syntax of Language is fundamentally flawed in a way that reveals the ultimate failure of logical positivism. Friedman's argument depends crucially on two claims: (1) that Carnap was committed to the view that there is a universal metalanguage and (2) that given what Carnap wanted from a metalanguage, in particular given that he wanted a definition of analytic for an object language, he was in fact committed to a hierarchy of stronger and stronger (...) metalanguages. We argue that neither of these claims need be accepted. We show that there is no textual evidence for (1) and that if metalanguages are to be used for merely descriptive and not also justificatory purposes, Carnap does not need to define analyticity sufficiently for proving consistency, and so could have given a definition that does not entail a hierarchy of metalanguages. (shrink)

This paper advances a new paradigm in clinical ethics education that not only emphasizes development of individual cli but also focuses on the institutional context within which health care professionals work. This approach has been applied to the goal of improving the care provided to critically and terminally ill adults. The model has been adopted by about thirty hospitals and nursing homes; additional institutions will soon join the program, entitled Decisions Near the End of Life. Here, we describe the history (...) and rationale for this approach, its goals, pedagogical assumptions, and design. (shrink)

This is a collection of essays on the work of the German philosopher Friederich Wilhelm Nietzsche. Each essay concentrates on a single work, and the volume is organized on a chronological principle, considering the works in the order in which Nietzsche wrote them. Among the contributors are many Nietzsche scholars, including Ivan Soll, Alexander Nehemas, Frithjof Bergmann, and Arthur Danto. Most of the essays are previously unpublished, and none has been anthologized before.

“What is an emotion?” William James asked that question in the title of an essay he wrote in 1884, and his answer was that an emotion is a sensation brought about by bodily disturbance. Writing as a psychologist, he was concerned to help turn his discipline into a science. But as a philosopher writing about religious faith, by contrast, James argued that emotions must be understood in terms of such large and fuzzy issues as “the meaning of life.” The philosophy (...) of emotions and emotions research has since gone off in two quite different directions, one a broad-based perennial philosophical concern with the proper place of the emotions in ethics and living well, the other an increasingly sophisticated pursuit of the latest ammunition and theoretical weaponry in the biological and neurological sciences. (shrink)

Is grief a “negative” emotion? Is it an emotion at all? We often tend to conflate what causes an emotion with the value of the emotion itself. I argue that grief plays an unappreciated positive role in our experience. I also suggest that we too often tend to think of emotions as distinctive feelings and not as processes, but grief is a clear case of an emotional process. I similarly suggest that gratitude is an unappreciated emotion in ethics. But, on (...) a cosmic level, there is some question who the grateful person is grateful to. (shrink)

Two papers in this issue address the limits of surrogates’ authority when making life-and-death decisions for dying family members or friends. Using palliative sedation as an example, Jeffrey Berger offers a conceptual argument for bounding surrogate authority. Since freedom from pain is an essential interest, when imminently dying, cognitively incapacitated patients are in duress and their symptoms are not manageable in any other way, clinicians should be free to offer palliative sedation without surrogate consent, although assent should be sought and (...) every effort made to work with surrogates as harmoniously as possible. Ellen Robinson and her colleagues report on the implementation of a policy at Massachusetts General Hospital that supports do-not-resuscitate orders when cardiopulmonary resuscitation is likely to be ineffective or harmful, even if surrogates disagree. The “Doing No Harm” policy at MGH allows for what MGH calls a “medically indicated DNR” and what in some other places is called “a unilateral DNR”—the writing of an order not to provide cardiopulmonary resuscitation, regardless of surrogate disapproval. These kinds of DNR policies have emerged in some hospitals across the country and for much the same reason that Berger provides in his argument regarding palliative sedation. I support the reasoning and the policies in both the Berger and Robinson papers. However, as the authors would most likely agree, the problems they aim to remedy are not simply about the scope of surrogate and professional authority. They are also symptoms of inattention to professional obligations and system failures. (shrink)

An existential psychodynamic theory is presented based on Ernest Becker's claim that self‐esteem and cultural worldviews function to ameliorate the anxiety associated with the uniquely human awareness of vulnerability and mortality. Psychological equanimity is hypothesized to require (1) a shared set of beliefs about reality that imbues the universe with stability, meaning, and permanence; (2) standards by which individuals can judge themselves to be of value; and (3) promises of safety and the transcendence of death to those who meet the (...) standards of value. An empirical research program in support of this theory is then described, and the personal and interpersonal implications of these ideas are briefly considered. (shrink)

This chapter introduces many of the themes that are developed in more detail in later contributions: the notion that deception and self-deception are essential to self-maintenance; the suspicion that philosophers place too high a price on the truth, and naively fail to recognize the importance of false beliefs and even lies for human flourishing; the complex nature of both deception and self-deception, and their importance to communication; the observation that lies and self-deceptions are crucial to social interaction; the difficulties of (...) defining lie and deception; and the suggestion that it may be the motives behind a deception and not the deception itself that people find morally blameworthy. Nevertheless, it stresses that the truth is to be prized, and deceptions are to be viewed as a kind of necessary evil. (shrink)

H. Tristram Engelhardt, Jr., Joseph Boyle, John Peppin, David Solomon; Christian Bioethics, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Vol.

Background Shared decision-making in healthcare is a collaborative process where patients are supported to make informed decisions according to their preferences. Healthcare decisions affect patients' lives which necessitates patients to participate in decisions concerning their health. This study explored experiences and ethical issues related to shared decision-making in a rural healthcare setting. Methods An exploratory qualitative study was conducted at Budumba Health Centre III and Butaleja Health Centre III in rural Eastern Uganda. In this study, 23 in-depth interviews were conducted (...) among 12 healthcare providers and 11 patients. Data was analyzed thematically using NVivo-12 plus software. Results Four themes emerged which included: Paternalistic cultures of care, challenges, strategies for improvement, and ethical issues. Patients at both facilities expressed the need to be involved in decision-making processes. However, many stressed that they are not engaged in decision-making about their health. Many healthcare providers noted that shared decision-making could improve patient prognosis but are faced with challenges related to low male involvement and the influence of cultural and religious practices, including myths and patriarchal attitudes which impact effective patient engagement. Ethical issues identified include concerns about informed consent, privacy and confidentiality, deception, and harm. Conclusions This study highlighted the need for better sensitization of patients and comprehensive training for healthcare providers to minimize and resolve ethical issues that emerge during shared decision-making processes. Therefore, targeted interventions are needed to enhance decision-making processes in rural healthcare including but not limited to developing shared decision-making manual and continuous training of healthcare providers to ethically engage patients. Further research is needed to explore larger facilities with a bigger scope including patients under 18 years of age and and their surrogates. (shrink)

Divorce amongst married couples is a disturbing phenomenon amongst the Yoruba people of southern Nigeria. Unfortunately, the church in Yoruba land, which has focused much of its teachings on financial prosperity, has started facing the consequences of these lopsided teachings. Using a phenomenological approach, this study argues that the lack of sexual satisfaction, poverty, activities of fake pastors, infidelity and lies from any of the partners are the major causes of increasing divorce rates amongst Yoruba Christians. Existing literature has not (...) adequately addressed the issue of divorce amongst Yoruba Christians. This study explores the growing divorce rates from the lens of Yoruba Christians and how it impacts on the family, children and the church at large. As part of this recommendation, church leadership should start organising marriage seminars for married couples where they are taught a nonviolent approach to conflict resolution in the family.Contribution: This study indicates that the activities of some churches and their leaders indirectly support divorce, and the consequence is mostly felt by the children. This study argues that divorce is not supported by the church in Yoruba land. The study implicated practical theology. (shrink)

Scholars and policymakers continue to struggle over the meaning of the word “vulnerable” in the context of research ethics. One major reason for the stymied discussions regarding vulnerable populations is that there is no clear distinction between accounts of research vulnerabilities that exist for certain populations and discussions of research vulnerabilities that require special regulations in the context of research ethics policies. I suggest an analytic process by which to ascertain whether particular vulnerable populations should be contenders for additional regulatory (...) protections. I apply this process to two vulnerable populations: the cognitively vulnerable and the economically vulnerable. I conclude that a subset of the cognitively vulnerable require extra protections while the economically vulnerable should be protected by implementing existing regulations more appropriately and rigorously. Unless or until the informed consent process is more adequately implemented and the distributive justice requirement of the Belmont Report is emphasized and operationalized, the economically disadvantaged will remain particularly vulnerable to the harm of exploitation in research. (shrink)

Historical myths are appealing primarily because they provide people with views of life and their role in it as significant and enduring. These worldviews help people manage death anxiety by enabling them to view themselves as part of something great that stretches far into the past and endures indefinitely into the future. We review empirical evidence supporting this analysis.

We examine the impact of corporate culture on environmental performance using a sample of 7199 firm-year observations over the period of 2002–2018. We find that stronger corporate culture improves environmental performance, measured by the amount of toxic chemical release (TCR). Our result is both statistically and economically significant. We also show that cultural norms of innovation, quality and teamwork as well as a technology-oriented corporate culture have a greater impact on enhancing environmental performance. Further analyses show that managerial competence and (...) strong institutional ownership moderate the relationship between corporate culture and environmental performance. We introduce the decomposition of expected and unexpected components of TCR and document that firms with a strong corporate culture implement strategies to reduce the unexpected component of TCR in addition to the expected component of TCR. Finally, we document that strong corporate culture and environmental performance improve firms’ financial performance. Our results are robust to several sensitivity tests and procedures to mitigate endogeneity and self-selection problems. From a practical point of view, our findings suggest that a firm’s culture can determine its environmental sustainability and ethical practices. (shrink)

In the vertex pursuit game of cops and robbers on finite graphs, the cop has a winning strategy if and only if the graph admits a dominating order. Such graphs are called constructible in the graph theory literature. This equivalence breaks down for infinite graphs, and variants of the game have been proposed to reestablish partial connections between constructibility and being cop-win. We answer an open question of Lehner about one of these variants by giving examples of weak cop-win graphs (...) which are not constructible. We show that the index set of computable constructible graphs is Π11 hard and the index set of computable constructible locally finite graphs is Π40 hard. Finally, we give an example of a computable constructible graph for which every dominating order computes 0″. (shrink)

This chapter introduces many of the themes that are developed in more detail in later contributions: the notion that deception and self-deception are essential to self-maintenance; the suspicion that philosophers place too high a price on the truth, and naively fail to recognize the importance of false beliefs and even lies for human flourishing; the complex nature of both deception and self-deception, and their importance to communication; the observation that lies and self-deceptions are crucial to social interaction; the difficulties of (...) defining lie and deception; and the suggestion that it may be the motives behind a deception and not the deception itself that people find morally blameworthy. Nevertheless, it stresses that the truth is to be prized, and deceptions are to be viewed as a kind of necessary evil. (shrink)

A belief that high school students have the cognitive ability to analyze and assess moral choices and should be encouraged to do so but have rarely been helped to do so was the motivation for developing Exploring Bioethics, a six-module curriculum and teacher guide for grades nine through twelve on ethical issues in the life sciences. A multidisciplinary team of bioethicists, science educators, curriculum designers, scientists, and high school biology teachers worked together on the curriculum under a contract between the (...) National Institutes of Health and Education Development Center, a nonprofit research and development organization with a long history of innovation in science education. At the NIH, the Department of Bioethics within the Clinical Center and the Office of Science Education within the Office of the Director guided the project.Our overarching goal for Exploring Bioethics was to introduce students to bioethics as a field of inquiry and to enable them to develop ethical reasoning skills so they could move beyond “gut reactions” to more nuanced positions. (shrink)

We discuss in this paper the question of the scope of the principle of tolerance about languages promoted in Carnap's The Logical Syntax of Language and the nature of the analogy between it and the rudimentary conventionalism purportedly exhibited in the work of Poincaré and Hilbert. We take it more or less for granted that Poincaré and Hilbert do argue for conventionalism. We begin by sketching Coffa's historical account, which suggests that tolerance be interpreted as a conventionalism that allows us (...) complete freedom to select whatever language we wish—an interpretation that generalizes the conventionalism promoted by Poincaré and Hilbert which allows us complete freedom to select whatever axiom system we wish for geometry. We argue that such an interpretation saddles Carnap with a theory of meaning that has unhappy consequences, a theory we believe he did not hold. We suggest that the principle of linguistic tolerance in fact has a more limited scope; but within that scope the analogy between tolerance and geometric conventionalism is quite tight. (shrink)

It is by way of clue but not argument that we remind ourselves that the etymology of "truth" and "true" takes us back to an old Anglo-Saxon word, "treowth" and the Old English "treowe" and "trywe" which mean "faithful" as well as "true," applying to friends and servants as well as to statements. Similarly, the Latin "veritas" and its modern Romantic language derivatives and the German root "Wahr" carry the meaning of "fidelity" as well as epistemic "correctness.".

About ten years ago, I participated in a consensus process on migraine nomenclature. Participants used a modified Delphi technique to explore their views about what migraine is. Candidate concepts included an illness, disease, syndrome, condition, disorder, or susceptibility. Initially, there was a wide range of views about which concept best fits our concept of migraine. Migraine—in common with many psychiatric disorders—is poorly understood by neuroscience. On scientific grounds, participants thought that "susceptibility" and "syndrome" describes our current knowledge well. However, participants (...) were concerned that terms like "susceptibility" and "syndrome" could lead to migraine not... (shrink)