This article explores emerging ethical questions that result from knowledge development in a complex, technological age. Nursing practice is at a critical ideological and ethical precipice where decision-making is enhanced and burdened by new ways of knowing that include artificial intelligence, algorithms, Big Data, genetics and genomics, neuroscience, and technological innovation. On the positive side is the new understanding provided by large data sets; the quick and efficient reduction of data into useable pieces; the replacement of redundant human tasks by (...) machines, error reduction, pattern recognition, and so forth. However, these innovations require skepticism and critique from a profession whose mission is to care for and protect patients. The promise of technology and the new biological sciences to radically and positively transform healthcare may seem compelling when couched in terms of safety, efficiency, and effectiveness but their role in the provision of ethical nursing care remains uncertain. Given the profound moral and clinical implications of how today’s knowledge is developed and utilized, it is time to reconsider the relationship between ethics and knowledge development in this new uncharted area. (shrink)

Comment by Aaron L. Mackler on “‘Through Her I Too Shall Bear a Child’: Birth Surrogates in Jewish Law” by Elie Spitz Reply by Elie Kaplan Spitz Research Note by G. Scott Davis.

Structural Realism (SSR), as embodied in the Ramsey-sentence H of a theory H, is defended against the view that H reduces to a trivial statement about the cardinally of the domain of H, a view which arises from ignoring the central role of observation within science. Putnam's theses are examined and shown to support rather than undermine SSR. Finally: in view of its synthetic character, applied mathematics must enter into the formulation of H and hence to be shown axiomatisable; this (...) is done in the Appendix, which is the most important part of the paper. (shrink)

Rather than a return to Bergson, the ‘Kyoto manifesto’ argues for a renewed, expanded Bergsonism: a philosophical inquiry that lives up to the methodological standards set by Bergson, even if this implies prolonging some of his intuitions in different directions—possibly against himself. Several aspects of this endeavour are examined in turn: the meaning of ‘intuition’ and the prospects of speculative empiricism, the ontological scope of scientific theories, emergentism and the virtual, the relevance of space-time for duration, the place of metaphysical (...) imagination and its capacity to probe the utopian potential of a truly open science. (shrink)

Este manifesto, escrito a quatro mãos no contexto de um colóquio sobre Bergson organizado no Japão, visa inicialmente responder a uma simples questão: que significa, hoje, trabalhar à maneira de Bergson? Não se trata de uma pergunta sobre a dedicação para com o corpus bergsoniano ou quanto a certos temas que o seu pensamento permite renovar a compreensão, mas sim sobre o método que ele próprio recomenda. Este método foi aplicado diligentemente por Bergson no curso de suas investigações, particularmente quanto (...) ao seu trato com as ciências positivas, tanto as da vida quanto às do universo material em sentido amplo. No que diz respeito à função da imaginação metafísica, este manifesto refaz os passos de Bergson quanto a um empirismo não especulativo e verdadeiramente contemporâneo à inteligência científica. (shrink)

Do individuals have a positive right of self-defence? And if so, what are the limits of this right? Under what conditions does this use of force extend to the defence of others? These are some of the issues explored by Dr Uniacke in this comprehensive 1994 philosophical discussion of the principles relevant to self-defence as a moral and legal justification of homicide. She establishes a unitary right of self-defence and the defence of others, one which grounds the permissibility of the (...) use of necessary and proportionate defensive force against culpable and non-culpable, active and passive, unjust threats. Particular topics discussed include: the nature of moral and legal justification and excuse; natural law justifications of homicide in self-defence; the Principle of Double Effect and the claim that homicide in self-defence is justified as unintended killing; and the question of self-preferential killing. This is a lucid and sophisticated account of the complex notion of justification, revolving around a critical discussion of trends in the law of self-defence. (shrink)

BackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of Practice throughout the (...) study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process. Phase one, Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps. Phase two, Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation. Phase three, Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments. (shrink)

Anyone familiar with contemporary French culture could not fail to notice that, in the field of ideas, history and the philosophy of history occupy in France a more central place than in England or North America. The work and concerns—including the methodological concerns—of historians like Marc Bloch, Fernand Braudel and the Annalistes, Georges Lefebvre, Emmanuel Le Roy Ladurie, Michel de Certeau, Jacques Le Goff and Francois Furet, are known, discussed and taken on board by most French intellectuals and academics.

The causal compatibility question asks whether a given causal structure graph — possibly involving latent variables — constitutes a genuinely plausible causal explanation for a given probability distribution over the graph’s observed categorical variables. Algorithms predicated on merely necessary constraints for causal compatibility typically suffer from false negatives, i.e. they admit incompatible distributions as apparently compatible with the given graph. In 10.1515/jci-2017-0020, one of us introduced the inflation technique for formulating useful relaxations of the causal compatibility problem in terms of (...) linear programming. In this work, we develop a formal hierarchy of such causal compatibility relaxations. We prove that inflation is asymptotically tight, i.e., that the hierarchy converges to a zero-error test for causal compatibility. In this sense, the inflation technique fulfills a longstanding desideratum in the field of causal inference. We quantify the rate of convergence by showing that any distribution which passes the nth-order inflation test must be On−1/2$\begin{array}{} \displaystyle {O}{\left(n^{{{-}{1}}/{2}}\right)} \end{array}$-close in Euclidean norm to some distribution genuinely compatible with the given causal structure. Furthermore, we show that for many causal structures, the (unrelaxed) causal compatibility problem is faithfully formulated already by either the first or second order inflation test. (shrink)

Les sciences de la nature construisent des symboles spécifiques pour saisir adéquatement la réalité de la nature. La puissance de leurs symboles est telle que la pensée scientifique déborde ce réel, l’anticipe, le reconstruit et finalement le réalise et le prolonge sur le plan technique. Mais quel est le point de départ de la symbolisation scientifique? Comment peut-elle, couplée à la technique, réaliser la réalité même de la nature? Enfin, le langage spécifique des sciences de la nature peut-il s’autonomiser par (...) rapport aux langues « naturelles », relatives à des groupes humains et parlées spontanément? L’enjeu consiste à montrer, tout à la fois, les limites et la puissance des symboles des sciences de la nature que sont la physique et la chimie. (shrink)

Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...) such an intervention. In this paper, we add to this proposition by discussing Moral Case Deliberation (MCD) as a specific form of clinical ethics support that promotes moral resilience. We argue that MCD in general may contribute to the moral resilience of healthcare professionals as it promotes moral agency. In addition, we focus on three specific MCD reflection methods: the Dilemma Method, the Aristotelian moral inquiry into emotions, and CURA, a method consisting of four main steps: Concentrate, Unrush, Reflect, and Act. In practice, all three methods are used by nurse ethicists or by nurses who received training to facilitate reflection sessions with these methods. We maintain that these methods also have specific elements that promote moral resilience. However, the Dilemma Method fosters dealing well with tragedy, the latter two promote moral resilience by including attention to emotions as part of the reflection process. We will end with discussing the importance of future empirical research on the impact of MCD on moral resilience, and of comparing MCD with other interventions that seek to mitigate moral distress and promote moral resilience. (shrink)

This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case (...) was discussed with CURA at a psychogeriatric ward of an elderly care home. Furthermore, we go into some considerations regarding the use of the instrument in clinical practice. Finally, we focus on the need for further research on the effectiveness and implementation of CURA. (shrink)

There is a concern that physicians/researchers are inappropriately profiting from information derived from advance copies of high-impact clinical trial data distributed by medical conferences or journals. Despite these concerns, it has never been systematically evaluated, and little is known about the degree to which it exists. This is largely due to difficulties associated with directly verifying whether or not such activities have taken place and, furthermore, many medical conferences/journals today have taken the necessary actions to guard against this. One medical (...) association in particular, the American Society of Clinical Oncology, only began responding to such concerns several years ago. Their actions during that time serve as a compelling case study, with wide-ranging ramifications, and provide the unique opportunity to delve into this phenomenon.Up until 2008, ASCO selectively and discreetly distributed abstracts from all forthcoming presentations to ASCO members two weeks prior to it becoming publicly accessible during the conference. (shrink)

Résumé Dans les débats métaphysiques contemporains, « endurer » et « perdurer » désignent deux manières irréductibles de persister dans le temps et de subir le changement. Parce qu’ils mobilisent différemment la forme de représentation « espace-temps », ces schèmes conceptuels révèlent peut-être deux figures ou deux aspects du temps lui-même.

In this paper I try to explain why Lakatos’s conventionalist view must be replaced by a phenomenological conception of the empirical basis; for only in this way can one make sense of the theses that the hard core of an RP can be shielded against refutations; that this metaphysical hard core can be turned into a set of guidelines or, alternatively, into a set of heuristic metaprinciples governing the development of an RP; and that a distinction can legitimately be made (...) between novel predictions and facts to which a theory might have been adjusted post hoc. Two basic metaprinciples are finally examined: the Correspondence Principle and various symmetry requirements; both of these heuristic devices illustrate the fundamental role which, according to Lakatos, mathematics plays in the progress of empirical science. (shrink)

What does it mean to be an individual and how can an individual exist within society? Serious Leisure and Individuality examines the circumstances in the modern world that make for individual distinctiveness, and the role of these conditions in personal and social life. "The individual," said Friedrich Nietzsche, "has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. But no price is too high to pay (...) for the privilege of owning yourself." Elie Cohen-Gewerc and Robert Stebbins explore the road to finding that privilege. They approach individuality by examining its relationship to freedom and being free, and by defining and elaborating on the concept of leisure space. They also look at individuality's place in community, citizenship, and globalization. The complex relationship between individuality and alienation is put under the microscope to highlight the negative side of being distinctive, which has adverse consequences for the individual and society. There are many studies on the modern individual that centre almost entirely on the person facing his local community and broader society. What is missing in the literature - and what Serious Leisure and Individuality provides - is a broad, comprehensive examination of individuality, particularly as it is rooted in leisure and the leisure-like areas of work. (shrink)

In this paper, I offer a new interpretation of Aristophanes’ speech in Plato’s Symposium. Though Plato deliberately draws attention to the significance of Aristophanes’ speech in relation to Diotima’s (205d-206a, 211d), it has received relatively little philosophical attention. Critics who discuss it typically treat it as a comic fable, of little philosophical merit (e.g. Guthrie 1975, Rowe 1998), or uncover in it an appealing and even romantic treatment of love that emphasizes the significance of human individuals as love-objects to be (...) valued for their own sakes (e.g. Dover 1966, Nussbaum 1986). Against the first set of interpreters, I maintain that Aristophanes’ speech is of the utmost philosophical significance to the dialogue; in it, he sets forth a view of eros as a state of lack and a corresponding desire for completion, which is the starting-point for Diotima’s subsequent analysis. Against the second, I argue that Aristophanes’ speech contains a profoundly pessimistic account of eros. Far from being an appreciative response to the individuality of the beloved, eros, for Aristophanes, is an irrational urge, incapable of satisfaction. It is this irrationality that precludes Aristophanes’ lovers from achieving the partial satisfaction of erotic desire that is open to their Socratic counterparts through their relationship to the forms. (shrink)

Nous présupposons le critère de démarcation de Popper d’après lequel un énoncé M est dit métaphysique s’il est empiriquement irréfutable. M sera qualifié de synthétique a priori si, de surcroît, il ne peut pas être expérimentalement vérifié. Nous démontrerons que le principe d’induction physique J* est synthétique a priori, J* étant défini — en gros — comme le principe suivant : toute théorie H qui est à la fois non-adhoc et empiriquement corroborée dans un domaine Δ courra, à l’avenir, moins (...) de risques d’être mise en défaut — dans Δ — qu’une hypothèse rivale infirmée par l’expérience. Bien qu’étant invérifiable tout autant qu’incritiquable, J* s’avère indispensable à la technologie ; ce que Popper avait d’ailleurs admis à plusieurs reprises. Nous critiquons ensuite le point de vue de David Miller selon lequel il n’est besoin d’aucune thèse métaphysique telle que J*, le critère de démarcation étant le seul principe requis par la science comme par la technologie. Dans ce même contexte, nous soutenons, contre Miller, que la science entretient un rapport positif, plutôt que purement critique ou négatif, avec la technologie. (shrink)

Es wird die Frage nach dem Ursprung des Konventionalismus aufgeworfen und ein Versuch ihrer Beantwortung unternommen. Die Entstehung des Konventionalismus wird auf das Versagen der philosophischen Grundlegung befremdender, aber auch empirisch erfolgreicher wissenschaftlicher Hypothesen zurückgeführt. Auch verdankt der moderne Positivismus seinen Aufschwung zum Teil der Unvereinbarkeit solcher Hypothesen mit herrschenden metaphysischen, bzw. religiösen, Weltanschauungen. Dies führt zum Versuch, die ontologischen Voraussetzungen wissenschaftlicher Theorien auszuklammern, ohne dadurch ihren empirischen Gehalt zu verringern. Im letzten Abschnitt wird dargetan, daß sowohl der moderne Positivismus (...) wie auch der Realismus in verschiedenen Aspekten der Kantschen Transzendentalphilosophie wurzeln. (shrink)

This article discusses an approach to translational bioethics (TB) that is concerned with the adaptation—or ‘translation’—of concepts, theories and methods from bioethics to practical contexts, in order to support ‘non-bioethicists’, such as researchers and healthcare practitioners, in dealing with their ethical issues themselves. Specifically, it goes into the participatory development of clinical ethics support (CES) instruments that respond to the needs and wishes of healthcare practitioners and that are tailored to the specific care contexts in which they are to be (...) used. The theoretical underpinnings of this participatory approach to TB are found in hermeneutic ethics and pragmatism. As an example, the development of CURA, a low-threshold CES instrument for healthcare professionals in palliative care, is discussed. From this example, it becomes clear that TB is a two-way street. Practice may be improved by means of CES that is effectively tailored to specific end users and care contexts. The other way around, ethical theory may be enriched by means of the insights gained from engaging with practice in developing CES in a process of co-creation. TB is also a two-way street in the sense that it requires collaboration and commitment of both bioethicists and practitioners, who engage in a process of mutual learning. However, substantial challenges remain. For instance, is there a limit to the extent to which a method of moral reasoning can be adapted in order to meet the constraints of a given healthcare setting? Who is to decide, the bioethicist or the practitioners? (shrink)

This essay concerns the dignity of nonhuman animals. It is composed of three sections. The first recounts my experience of a Moscow Circus performance and records some of my thoughts, feelings, and observations of this circus' famous bears. As is obvious from that account, the performance and presentation of the bears seemed to me to be undignified in a nontrivial, that is, morally objectionable sense of the word. The second section of the essay tries to specify that sense, to identify (...) the wrong(s) with these sorts of undignified performances, by developing a moral sense of dignity that might extend, generally, to nonhuman animals. I believe that the setting of this performance and my own frame of mind—the fact that it took place in Moscow and in the midst of my exposure to sites and stories of communist oppression—helped me to see the oppression of human and nonhuman animals as linked and the performance as a performance of power relations. The third section of the essay explores these power relations from an ecofeminist perspective through the circus' depiction of the 'momma bear.'. (shrink)

Contemporary Greeks and Arabs are heirs of a common empire which ruled the lives of their ancestors for long centuries before it ended at the beginning of the twentieth century. These heirs imagined, constructed and experienced their post-Ottoman nations in connection with the existential crises of the empire. Their national selves emerged from political and military struggles, and were fashioned by ideas about enlightenment, modernization, selfhood and emancipation. Their journeys to national statehood were shaped by the different positions they held (...) in the empire; they were marked by different givens and different circumstances. Their post-independence eras witnessed numerous challenges and faced dramatic crises. They were often internally disenchanting and externally checked by geo-political pressures. But they were experienced in total isolation from each other’s situations. Today these journeys are critically reflected upon by the intellectuals of these nation-states but almost never in conjunction with the other’s experiences, despite their geographical contiguity, significant common historical past, and many shared social mores. This study looks at how these two estranged neighbors fared after they parted ways on their independence journeys in their definitions of cultural identity and practices of cultural critique, and compares these journeys, by establishing links that were rarely, if ever, made hitherto. It focuses on the respective contemporary debates on enlightenment and emancipation that look at the early ideas of independence and progress and assess their fate in the post-independence era to our present day. The study aims at revealing the commonalities and specificities of the struggles of these nation-states for enlightenment, emancipation, progress and modernization. It helps us raise a number of questions about the meaning of enlightenment in these post-Ottoman contexts. (shrink)

This research aims to explore the relationship between corporate governance and CSR: What are the major factors that play a direct role in the establishment of this relationship? How does context and institutional background impact upon the relationship between CSR and Governance? Using in-depth semi-structured interviews from two types of governance systems in three countries over three years, this study has demonstrated that in practice, within different settings, CSR is being used both as a strategy as well as a reaction (...) to different drivers. We call this adaptive governance where governance can be defined as a flexible system of action incorporating strategic and monitoring activities that determines the way a company enacts its responsibilities to its shareholders and stakeholders and which is determined at any given time by the interrelationship of institutional drivers and behavioural norms. Governance systems and their interrelationships with CSR are demonstrated as fluid according to the national and institutional context, economic situation and industry impact. In the eyes of practitioners corporate governance includes both structural and behavioural factors as well as responsibilities and actions towards shareholders and stakeholders. Contextual factors that this research highlights to be important to the incorporation of CSR into governance include the economic environment, national governance system, regulation and soft law, shareholders, national culture, behavioural norms and industry impacts. Hypotheses on the impact of institutional contexts, industry impacts and economic situations on different types of CSR actions are proposed for further research. (shrink)