Abstract Context: Established in 1997, Summa Health System’s Medical Ethics Committee (EC) serves as an educational, supportive, and consultative resource to patients/families and providers, and serves to analyze, clarify, and ameliorate dilemmas in clinical care. In 2009 the EC conducted its 100th consult. In 2002 a Palliative Care Consult Service (PCCS) was established to provide supportive services for patients/families facing advanced illness; enhance clinical decision-making during crisis; and improve pain/symptom management. How these services affect one another has thus far been (...) unclear. Objectives: This study describes EC consults: types, reasons, recommendations and utilization, and investigates the impact the PCCS may have on EC consult requests or recommendations. Methods: Retrospective reviews of 100 EC records explored trends and changes in types of consults, reasons for consults, and EC recommendations and utilization. Results: There were 50 EC consults each in the 6 years pre- and post-PCCS. Differences found include: (1) a decrease in number of reasons for consult requests (133–62); (2) changes in top two reasons for EC consult requests from ‘Family opposed to withdrawing life-sustaining treatment (LST)’ and ‘Patient capacity in question’ to ‘Futility’ and ‘Physician opposed to providing LST’; (3) changes in top two recommendations given by the EC from ‘Emotional Support for Patient/Family’ and ‘Initiate DNR Order’ to ‘Comfort Care’ and ‘Withdraw Treatment.’ Overall, 88% of recommendations were followed. Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. Content Type Journal Article Pages 1-16 DOI 10.1007/s10730-011-9170-9 Authors Jessica Richmond Moeller, Department of Psychiatry and Behavioral Sciences, Akron General Medical Center, 400 Wabash Ave, Akron, OH 44307, USA Teresa H. Albanese, Health Services Research and Education Institute, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Kimberly Garchar, Kent State University, 6000 Frank Ave., N.W, North Canton, OH 44720, USA Julie M. Aultman, Department of Family and Community Medicine, Northeast Ohio Medical University, P.O. Box 95, Rootstown, OH 44272, USA Steven Radwany, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Dean Frate, Internal Medicine, Palliative Care and Hospice Services, Summa Health System and Northeast Ohio Medical University, 55 Arch St., Suite 1A, Akron, OH 44304, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

What are the forces shaping the future of international green politics? This book provides an objective account of the basis of green arguments and their social and political implications. It offers a clear overview of the most pressing environmental threats.

What role have experiments played, and should they play, in physics? How does one come to believe rationally in experimental results? The Neglect of Experiment attempts to provide answers to both of these questions. Professor Franklin's approach combines the detailed study of four episodes in the history of twentieth century physics with an examination of some of the philosophical issues involved. The episodes are the discovery of parity nonconservation in the 1950s; the nondiscovery of parity nonconservation in the 1930s, when (...) the results of experiments indicated, at least in retrospect, the symmetry violation, but the significance of those results was not realized; the discovery and acceptance of CP symmetry; and Millikan's oil-drop experiment. Franklin examines the various roles that experiment plays, including its role in deciding between competing theories, confirming theories, and calling fo new theories. The author argues that one can provide a philosophical justification for these roles. He contends that if experiment plays such important roles, then one must have good reason to believe in experimental results. He then deals with deveral problems concerning such reslults, including the epistemology of experiment, how one comes to believe rationally in experimental results, the question of the influence of theoretical presuppositions on results, and the problem of scientific fruad. This original and important contribution to the study of the philosophy of experimental science is an outgrowth of many years of research. Franklin brings to this work more than a decade of experience as an experimental high-energy physicist, along with his significant contributions to the history and philosophy of science. (shrink)

In an unusual instance of lay participation in biomedical research, U.S. AIDS treatment activists have constituted themselves as credible participants in the process of knowledge construction, thereby bringing about changes in the epistemic practices of biomedical research. This article examines the mechanisms or tactics by which these lay activists have constructed their credibility in the eyes of AIDS researchers and government officials. It considers the inwlications of such interventions for the conduct of medical research; examines some of the ironies, tensions, (...) and limitations in the process; and argues for the importance of studying social movements that engage with expert knowledge. (shrink)

Wigner famously referred to the `unreasonable effectiveness' of mathematics in its application to science. Using Wigner's own application of group theory to nuclear physics, I hope to indicate that this effectiveness can be seen to be not so unreasonable if attention is paid to the various idealising moves undertaken. The overall framework for analysing this relationship between mathematics and physics is that of da Costa's partial structures programme.

This book is a fresh examination of Thucydides' treatment of Alcibiades in his History of the Peloponnesian War, Alcibiades' significance in the History, and his relation to Thucydides' political themes.

When do descriptive regularities become prescriptive norms? We examined children's and adults' use of group regularities to make prescriptive judgments, employing novel groups that engaged in morally neutral behaviors. Participants were introduced to conforming or non-conforming individuals. Children negatively evaluated non-conformity, with negative evaluations declining with age. These effects were replicable across competitive and cooperative intergroup contexts and stemmed from reasoning about group regularities rather than reasoning about individual regularities. These data provide new insights into children's group concepts and have (...) important implications for understanding the development of stereotyping and norm enforcement. (shrink)

This paper explores, from a phenomenological perspective, the conditions necessary for the possession of intentional content, i.e., for being intentionally directed toward the world. It argues that Levinas's concept of ethics as first philosophy makes an important contribution to this task. Intentional directedness, as understood here, is normatively structured. Levinas's ‘ethics’ can be understood as a phenomenological account of how our experience of the other subject as another subject takes place in the recognition of the normative force of a command. (...) This supplies a condition that—as the paper shows by examining Husserl and Sartre on how our experience of the Other constitutes an ‘objective’ world—earlier phenomenologists have misunderstood, because they have treated ethical experience as ‘founded’ on a prior theory of representation (‘ontology’ in Levinas's language). Ethics is first philosophy because it is only by acknowledging the command in the ‘face’ of the Other that we can account for the sensitivity to the normative distinctions that structure intentional content. Throughout, the paper shows how Levinas's analyses, in Totality and Infinity, draw upon and develop the analyses of Husserl and Sartre. (shrink)

Bovine tuberculosis is an important animal health policy issue in Britain, which impacts farmers, the public, domestic farmed cattle and the wild badger population. The Westminster government’s badger culling policy in England, which began in 2013, has caused considerable controversy. This is in part because the Independent Scientific Group advised against culling, based on the Randomised Badger Culling Trial. Those opposed to badger culling support more stringent cattle-based measures and the vaccination of badgers. This paper argues for ethical analysis of (...) public policy options which impact sentient species. It provides a summary Animal Welfare Impact Assessment of a do-nothing approach, badger culling, and badger vaccination. A utilitarian analysis is then applied to these policy options considering human wellbeing and animal welfare. The analysis compares a badger culling policy that achieves a 19% reduction in bovine TB incidence, a badger vaccination model achieving a 12.5% reduction, and a do-nothing approach. Policy options are assessed over 9 years and a longer timeframe, and uncertainty is considered. The analysis finds that non-culling approaches, particularly badger vaccination, result in greater total utility, compared to badger culling. Badger culling causes 30% reduction in the badger population in England as well as substantial harms due to the culling process. Culling is opposed by public opinion and is associated with considerable risks and uncertainty. In contrast, non-culling approaches, such as cattle-based measures and badger vaccination, are supported by public opinion and are not associated with such risks. (shrink)

Stein once urged us not to confuse the means of representation with that which is being represented. Yet that is precisely what philosophers of science appear to have done at the meta-level when it comes to representing the practice of science. Proponents of the so-called ‘syntactic’ view identify theories as logically closed sets of sentences or propositions and models as idealised interpretations, or ‘theoruncula, as Braithwaite called them. Adherents of the ‘semantic’ approach, on the other hand, are typically characterised as (...) taking them to be families of models that are set-theoretic, according to Suppes and others, or abstract, as Giere has argued. da Costa and French (Science and Partial Truth. OUP, Oxford, 2003) suggested that we should refrain from ontological speculation as to the nature of scientific theories and models and focus on their appropriate representation for various purposes within the philosophy of science. Such an approach allows both linguistic and non-linguistic resources to play their appropriate role (see also French and Saatsi, Philosophy of Science, Proceedings of the 2004 PSA Meeting, 78:548–559, 2006) and can be supported by recent case studies illustrating the heterogeneity of scientific practice. My aim in this paper is to further develop this ‘quietist’ view, and to indicate how it offers a fruitful way forward for the philosophy of science. (shrink)

The literature on the politics of science and on science policy is dominated by information about large and highly industrialized countries. For example, models of the different forms of science policy administration and management tend to derive from French, U.S., and British exemplars. Yet in the mid-1990s there is a growing number of small nations, all of which are seeking to harness research communities to the cause of socioeconomic development, while still extracting "value for money" from science budgets. This article (...) uses the case study approach—focusing on the political economy of the politics of science in the Irish Republic, chiefly since the 1950s-to analyze the problems faced by science policy agencies and the scientific community in small nations. The study offers analogies and possible insights into the politics of research policy in other small nations ; it also aims to throw light on emerging research policy trends even in bigger countries as the "bargain" between the funders and the performers of research becomes more and more explicit and increasingly subject to economic justifications. (shrink)

Howard argues that the existence of unitarily inequivalent representations in Quantum Field Theory presents a problem for structural realism in this context. I consider two potential ways round this problem: 1), follow Wallace in adopting the 'naive' Lagrangian form of QFT with cut-offs; 2), adapt Ruetsche's 'Swiss Army Knife' approach. The first takes us into the current debate between Wallace and Fraser on conventional vs. algebraic QFT. The second involves consideration of the role of inequivalent representations in understanding spontaneous symmetry (...) breaking and quantum statistics. In both cases, I suggest, the structural realist has sufficient room to manoeuvre. (shrink)

The idea of nirvana is alluring but elusive for non-specialists and specialists alike. Offering his own interpretation of key texts, Steven Collins explains the idea in a new, accessible way - as a concept, as an image, and as an element in the process of narrating both linear and cyclical time. Exploring nirvana from literary and philosophical perspectives, he argues that it has a specific role: to provide 'the sense of an ending' in both the systematic and the narrative (...) thought of the Pali imaginaire. Translations from a number of texts, including some dealing with past and future Buddhas, enable the reader to access source material directly. This book will be essential reading for students of Buddhism, but will also have much to teach anyone concerned with Asia and its religions, or indeed anyone with an interest in the ideas of eternal life or timelessness. (shrink)

ABSTRACT We must, Isaiah Berlin argues, make tragic tradeoffs as we navigate the clash of incommensurable and irreconcilable values and ends of modernity. To deny this is to succumb to a politics of immaturity, and to the totalitarian temptation. The twentieth century taught that to resist final-solution fantasies, we must resist the allure, if not reject the value, of positive liberty, the liberty of self-mastery and self-rule. Two decades in, has the twenty-first century taught a different lesson? Have we learned (...) that negative liberty, liberty from rule, with its antipaternalistic ethic of ultra-individualism, harbors its own politics of immaturity, and a demagogic temptation? I argue that this is the more frequent, if less fatal, threat to human dignity and decency today, and that we therefore ought to rebalance the scales in the tragic tradeoff of positive for negative liberty. (shrink)

The self-interest paradigm predicts that unethical behavior occurs when such behavior benefits the actor. A recent model of lying behavior, however, predicts that lying behavior results from an individual''s inability to meet conflicting role demands. The need to reconcile the self-interest and role conflict theories prompted the present study, which orthogonally manipulated the benefit from lying and the conflicting role demands. A model integrating the two theories predicts the results, which showed that both elements — self benefit and role conflict (...) — influenced lying, separately and interactively. Additionally, the relative strength of the roles in conflict affected their level of influence. Theoretical and practical implications are discussed. (shrink)

Most proposals for new international agreements aim to address important global challenges. If the goal is to solve problems, then the value of these agreements depends on their ability to influence the world — to shape norms, constrain behavior, facilitate cooperation, and mobilize action. A recent review of empirical studies has suggested that many international agreements fail to achieve their aspirations. The review indicates that the form in which states make commitments to each other — through an international legal agreement (...) or through other means — may not be as important as commonly thought. It is the content of the commitments and how these are supported by mechanisms to encourage implementation that matter the most. When developing proposals for new international agreements, like the one that has recently been proposed to address antibiotic resistance, attention to implementation mechanisms should therefore be equal to if not greater than the attention paid to its form. (shrink)

In the not too distant past, it was common to treat Hume's skeptical doubts regarding the justification of our beliefs in causal connections—understood as necessary connections between objects or events—as having appeared per conceptionem immaculatam in his post-Cartesian mind. Thanks to recent efforts by scholars in early modern philosophy, however, we are now more informed about the roots of Hume's conclusions in Cartesian thought itself, especially the influence of Malebranche and his arguments for occasionalism. And by the research of historians (...) of Medieval philosophy we are reminded that many aspects of seventeenth-century occasionalism, in turn, have their ancestry in Latin and Arabic thought of the Middle Ages. In this paper I offer a small contribution to the overall project of illuminating the precedents in Medieval philosophy for the theses and arguments in Malebranche that so clearly influenced the most important and influential philosophical analysis of causation ever. There is a tradition here, where the goal is to undermine claims to discover real causal relations or powers in nature. I will concentrate on one particular aspect or tool of that tradition: the negative argument that we can never perceive a sufficiently necessary connection between any two natural objects or events. (shrink)

ABSTRACTEmotional distractors can impair perception of subsequently presented targets, a phenomenon called emotion-induced blindness. Do emotional distractors lose their power to disrupt perception when appearing with increased frequency, perhaps due to desensitisation or enhanced recruitment of proactive control? Non-emotional tasks, such as the Stroop, have revealed that high frequency distractors or conflict lead to reduced interference, and distractor frequency appears to modulate attentional capture by emotional distractors in spatial attention tasks. But emotion-induced blindness is thought to reflect perceptual competition between (...) targets and emotional distractors, and it is unclear whether high frequency emotional stimuli cause less disruption at this relatively early stage of processing. In four experiments, participants searched streams of images for a rotated target image. A negative or neutral distractor appeared before the target, and their relative frequency was manipulated. Across all exper... (shrink)

This article examines the presuppositions underlying Derrida's criticisms of Husserl's theory of expression, and philosophy of language generally. I argue that Derrida's claim that indication (and so the sign-function) is present at the heart of phenomenological "expression" is based on an unwarranted substitution of a Hegelian structure of reflection for Husserl's own phenomenological concept of reflection and evidence. I then criticize a different sort of unclarity in Husserl's analysis of the noetic and noematic relations between "expressive" (linguistic) and "preexpressive" sense. (...) The positions of John Caputo, Claude Evans, and Robert Sokolowski on these issues are discussed and evaluated. (shrink)

In 1928 Heidegger argued that the transcendental philosophy he had pursued in Being and Time needed to be completed by what he called “metontology.” This paper analyzes what this notion amounts to. Far from being merely a curiosity of Heidegger scholarship, the place occupied by “metontology” opens onto a general issue concerning the relation between transcendental philosophy and metaphysics, and also between both of these and naturalistic empiricism. I pursue these issues in terms of an ambiguity in the notion of (...) “grounding” in Being and Time and in the works of what I call Heidegger’s “metaphysical decade” , defending a phenomenological conception against what proves to be the illusory idea that metaphysical grounds are presupposed in such transcendental philosophy. (shrink)

According to the substantialist, substances should be regarded as the fundamental ontological category. It is substances that are the bearer of properties, that are causally efficacious and that compose the things we see and touch around us. Cumpa has argued that this metaphysics fits poorly with classical physics and Buonomo has extended this argument into the quantum realm. After reviewing their claims, I shall argue that simple reflection on the form of the Standard Model also undermines substantialism. I will then (...) explore Dasgupta’s qualitative factualism in this context before suggesting that modern physics does not compel us to adopt such a stance. The alternative is to adopt a form of structuralism which, although it may be rendered compatible with factualism, can also stand as a ‘third way’ between these stances. (shrink)

Richard Rorty’s writings have long frustrated scholars of classical American philosophy. Robert Brandom’s recent engagements with the history of pragmatism have been met with similar disdain. This essay draws on Larry A. Hickman’s theory of technology and tool-use to find a productive framework for thinking through these interpretations. Foregrounding the purposes that guide their readings, we may find value where many readers have seen only ignorance. This strategy does not embrace interpretive relativism, nor does it preclude all scholarly criticism, but (...) it instead promises a living and engaged approach to working with the history of philosophy. (shrink)

Somatic mutation plays a key role in transforming normal cells into cancerous cells. The analysis of cancer progression therefore requires the study of how point mutations and chromosomal mutations accumulate in cellular lineages. The spread of somatic mutations depends on the mutation rate, the number of cell divisions in the history of a cellular lineage, and the nature of competition between different cellular lineages. We consider how various aspects of tissue architecture and cellular competition affect the pace of mutation accumulation. (...) We also discuss the rise and fall of somatic mutation rates during cancer progression. BioEssays 26:291–299, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

Antimicrobial resistance is one of the greatest public health crises of our time. The natural biological process that causes microbes to become resistant to antimicrobial drugs presents a complex social challenge requiring more effective and sustainable management of the global antimicrobial commons—the common pool of effective antimicrobials. This special issue of Health Care Analysis explores the potential of two legal approaches—one long-term and one short-term—for managing the antimicrobial commons. The first article explores the lessons for antimicrobial resistance that can be (...) learned from recent climate change agreements, and the second article explores how existing international laws can be adapted to better support global action in the short-term. (shrink)

According to Michael Barnwell, Aquinas’s explanation of the first cause of moral evil is inadequate. Against Barnwell’s criticisms, this article defends Aquinas, according to whom the first cause of moral evil is the failure to consider the moral rule. According to Barnwell, the ignorance found within Aquinas’s explanation must remove moral responsibility; Barnwell also points out that the failure to consider the moral rule does not explain the sinfulness of the action. Underlying Barnwell’s criticisms are certain presuppositions and oversights. First, (...) he fails to distinguish between explaining how a sinful choice is possible (Aquinas’s concern) and what makes the choice to be sinful (part of Barnwell’s concern). Second, he supposes that an awareness of one’s own ignorance must include detailed awareness of the content of that ignorance. Finally, he supposes that an initial causal defect can be voluntary only when there is full knowledge concerning it. (shrink)

I examine Robert Brandom's reading of the classical pragmatists, as given in his new book Perspectives on Pragmatism: Classical, Recent, and Contemporary. I argue that his reading is deficient in certain fundamental respects, and that this deficiency illuminates important blind spots in Brandom's overall theoretical project. Specifically, I focus on Brandom's rationalist pragmatism and its rejection of the classical pragmatic conception of experience. I argue that this rejection is based on an overly instrumental reading of the classical figures, as well (...) as on an incorrect interpretation of them as succumbing to the Myth of the Given. My overall goal is to demonstrate that Brandom is lead astray in his encounter with the classical pragmatists because of his unwillingness to integrate into his theoretical picture the essentially embodied nature of human cognitive and practical activity. (shrink)

How should we evaluate the success of each person's life? Countering the prevalent philosophical perspective on the subject, Steven M. Cahn and Christine Vitrano defend the view that our well-being is dependent not on particular activities, accomplishments, or awards but on finding personal satisfaction while treating others with due concern. The authors suggest that moral behavior is not necessary for happiness and does not ensure it. Yet they also argue that morality and happiness are needed for living well, and (...) together suffice to achieve that goal. Cahn and Vitrano link their position to elements within both the Hellenistic and Hebraic traditions, in particular the views of Epicurus and lessons found in the Book of Ecclesiastes. Written in an accessible style and illustrated with incisive vignettes drawn from history, literature, films, and everyday life, _Happiness and Goodness_ is a compelling work of philosophy for anyone who seeks to understand the nature of a good life. (shrink)

This chapter contains sections titled: Modern Theory and Kierkegaard's Assault on Reason Nietzsche and the Postmodern Nietzsche's Progeny and the Postmodern Turn: From Heidegger through Derrida Foucault's Critique of Rationality and Modernity Lyotard's “Postmodern Condition”: Polemics and Aporia Richard Rorty, the Attack on Theory, and Renunciation of Radical Politics For Theory and Politics.

Crucifixion and Death as Spectacle: Umayyad Crucifixion in Its Late Antique Context. By Sean W. Anthony. American Oriental Series, vol. 96. New Haven: American Oriental Society, 2014. Pp. x + 99. $39.50.