Extracorporeal membrane oxygenation (ECMO) is a form of life support for cardiac and/or pulmonary failure with unique ethical challenges compared to other forms of life support. Ethical challenges with ECMO exist when conventional standards of care apply, and are exacerbated during periods of absolute ECMO scarcity when “crisis standards of care” are instituted. When conventional standards of care apply, we propose that it is ethically permissible to withhold placing patients on ECMO for reasons of technical futility or when patients have (...) terminal, short-term prognoses that are untreatable by ECMO. Under crisis standards of care, it is ethically permissible to broaden exclusionary criteria to also withhold ECMO from patients who have a low likelihood of recovery, to maximize the overall number of lives saved. Unilateral withdrawal of ECMO against a patient’s preferences is unethical under conventional standards of care, but is ethical under crisis standards of care to increase access to ECMO to others in society. ECMO should only be rationed when true scarcity exists, and allocation protocols should be transparent to the public. When rationing must occur under crisis standards of care, it is imperative that oversight bodies assess for inequities in the allocation of ECMO and make frequent changes to improve any inequities. (shrink)

For much of 2021, allocating the scarce supply of Covid‐19 vaccines was the world's most pressing bioethical challenge, and similar challenges may recur for novel therapies and future vaccines. In the United States, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) identified three fundamental ethical principles to guide the process: maximize benefits, promote justice, and mitigate health inequities. We argue that critical components of the recommended protocol were internally inconsistent with these principles. Specifically, the ACIP (...) violated its principles by recommending overly broad health care worker priority in phase 1a, using being at least seventy‐five years of age as the only criterion to identify individuals at high risk of death from Covid‐19 during phase 1b, failing to recommend place‐based vaccine distribution, and implicitly endorsing first‐come, first‐served allocation. More rigorous empirical work and the development of a complete ethical framework that recognizes trade‐offs between principles may have prevented these mistakes and saved lives. (shrink)

We propose 4 equity-advancing operational improvements to eligibility and sign-up processes at mass vaccination sites: (1) preregistration using existing information, (2) eligibility rules that recognize the greater burden of COVID-19 in underserved neighborhoods, (3) appointment assignment that prioritizes those with disadvantage, and (4) socioculturally informed outreach to lottery selectees.

Objective: A deep understanding of the relationship between a scarce drug's dose and clinical response is necessary to appropriately distribute a supply-constrained drug along these lines. Summary of key data: The vast majority of drug development and repurposing during the COVID-19 pandemic – an event that has made clear the ever-present scarcity in healthcare systems –has been ignorant of scarcity and dose optimisation's ability to help address it. Conclusions: Future pandemic clinical trials systems should obtain dose optimisation data, as these (...) appear necessary to enable appropriate scarce resource allocation according to societal values. (shrink)

Scarce resource allocation policies vary across the United States. Little is known about regional variation in resource allocation protocols and variation in their application. We sought to evaluat...

Josiah Royce (1855-1916) was the leading American proponent of absolute idealism, the metaphysical view (also maintained by G. W. F. Hegel and F. H. Bradley) that all aspects of reality, including those we experience as disconnected or contradictory, are ultimately unified in the thought of a single all-encompassing consciousness. Royce also made original contributions in ethics, philosophy of community, philosophy of religion and logic. His major works include The Religious Aspect of Philosophy (1885), The World and the Individual (1899-1901), The (...) Philosophy of Loyalty (1908), and The Problem of Christianity (1913). Royce's friendly but longstanding dispute with William James, known as "The Battle of the Absolute," deeply influenced both philosophers' thought. In his later works, Royce reconceived his metaphysics as an "absolute pragmatism" grounded in semiotics. This view dispenses with the Absolute Mind of previous idealism and instead characterizes reality as a universe of ideas or signs which occur in a process of being interpreted by an infinite community of minds. These minds, and the community they constitute, may themselves be understood as signs. Royce's ethics, philosophy of community, philosophy of religion, and logic reflect this metaphysical position. (shrink)

Of the philosophers in recent times who have striven to heal this rupture between head and heart perhaps none has caught the fancy or stirred the hopes of the American philosophical community as Alfred North Whitehead has. But since the master started this task too late in life, it was left to his disciples to complete his work. And of those disciples who have continued the master's healing in theology, perhaps none has been so energetic or resourceful as Professor Charles (...) Hartshorne. While Professor Hartshorne has usually practised this therapy alone and unaided, he has on one notable occasion enlisted the aid both of another contemporary theological therapist, Professor William L. Reese, and also of most of the great philosophers in history. The fruit of this collaboration, Philosophers Speak of God, while not adding anything essentially novel to Professor Hartshorne's earlier work, presents the physician not only as an isolated laboratory researcher but also, with Professor Reese's help, in the process of actually confronting and healing his patients. Hence this book is an especially interesting and valuable case study of one type of contemporary attempt to cure theological schizophrenia. Theological therapists are to be found among scientists as well as among philosophers, moreover, for even in science the intellect does not- succeed in quieting the restless heart until it finds the God for which that restless heart seeks. Going "through the world with a reverent attitude yet an almost total absence of doctrine or belief--with a religious heart and a skeptical head... is," as we are told in a recent book representing this theological therapy from the point of view of a scientist--a biologist and natural historian--Alexander F. Skutch's The Quest of the Divine, "a most unsatisfactory way to live.". (shrink)

Autobiography and Teacher Development in China investigates the roles of autobiography in teacher education, as several scholars in China recontextualize Western conceptions of teacher development, combining them with uniquely Chinese cultural conceptions to articulate a reconceptualization of teacher development that holds worldwide significance. Framed by the work of Zhang Hua and William F. Pinar, these theoretical and practical essays point to an internationally inflected reconceptualization of teachers' professional development, pre-service and in-service. This volume addresses multiple movements of teacher education (...) reform worldwide, focused on crafting a nationally distinctive course not only internationally, but also culturally, historically, and locally. (shrink)

A discussion of Christian ethics focuses on the physician's image as a parent, warrior against death, expert, and teacher, and the oath that guides his or her practice.

Modern professionals wield considerable power by virtue of their knowledge. However, they also feel beleaguered by the constraints they face and the public disapproval they often experience. These pressures combine to diminish the professional's sense of public responsibility and convert him or her in self-perception to a careerist.

The goal of this chapter is to describe recollective memory and give an account of some of the characteristics of this form of human memory. I take recollective memory to be the type of memory that occurs when an individual recalls a specific episode from their past experience. I start with this very loose definition because a large part of this chapter consists of an attempt to work out a more detailed and analytic description of this form of memory.

We use evidence from cognitive psychology and the history of science to examine the issue of the theory-ladenness of perceptual observation. This evidence shows that perception is theory-laden, but that it is only strongly theory-laden when the perceptual evidence is ambiguous or degraded, or when it requires a difficult perceptual judgment. We argue that debates about the theory-ladenness issue have focused too narrowly on the issue of perceptual experience, and that a full account of the scientific process requires an examination (...) of theory-ladenness in attention, perception, data interpretation, data production, memory, and scientific communication. We conclude that the evidence for theory-ladenness does not lead to a relativist account of scientific knowledge. (shrink)

Hegel's objection -- Is Kant's idealism subjective? -- An ambiguity in 'subjectivism' -- The epistemological problem -- The transcendental deduction of the categories and subjectivism -- Are Kant's categories subjective? -- Hegel's suspicion : Kantian critique and subjectivism -- What is kantian philosophical criticism? -- Hegel's suspicion : initial formulation -- A shallow suspicion? -- Deepening the suspicion : criticism, autonomy, and subjectivism -- Directions of response -- Critique and suspicion : unmasking the critical philosophy -- Hegel's transformation of critique (...) -- The rejection of Kantian critique : philosophy, skepticism, and the recovery of the ancient idea -- Hegel's epistemology in the shadow of Schelling -- Schulze's skepticism contra the critical philosophy -- Ancient versus modern skepticism : Hegel's difference -- Against the modern conception of rational cognition -- Against modern self-certainty -- The history of skepticism: decline into dogmatism -- Philosophy counter culture and time -- The return to Kantian critique : recognizing the rights of ordinary consciousness -- Two conceptions of philosophical critique -- The return to critique and the relation of philosophy to its history -- The rights of ordinary consciousness and the need for critique -- Critique as the realization of the science of metaphysics -- Hegel's self-transformational criticism -- Presuppositionless philosophy -- The problem of the criterion -- Self-transformational criticism -- The problem of the we' -- Our transformation -- Hegel's alternative model : critical transformation as self-realization. (shrink)

This article examines one of the sources of David Benatar’s anti-natalism. This is the view that ‘all procreation is [morally] wrong.’ (Benatar and Wasserman, 2015:12) One of its sources is the claim that each of our lives is objectively bad, hence bad whether we think so or not. The question I will pose is whether the constraints of metaphysical naturalism allow for an objective devaluation of human life sufficiently negative to justify anti-natalism. My thesis is that metaphysical naturalism does not (...) have the resources to support such a negative evaluation. Metaphysical naturalism is the view that causal reality is exhausted by nature, the space-time system and its contents. The gist of my argument is that the ideal standards relative to which our lives are supposed to be axiologically substandard cannot be merely subjective expressions of our desires and aversions; they must be (i) objectively binding standards that are (ii) objectively possible in the sense of concretely realizable. The realizability condition, however, cannot be satisfied on metaphysical naturalism; ergo, failure to meet these ideal standards cannot show that our lives are objectively bad. (shrink)

This book is intended to help transform epistemology - the traditional study of knowledge - into a rigorous discipline by removing conceptual roadblocks and developing formal tools required for a fully naturalized epistemology. The evolutionary approach which Harms favours begins with the common observation that if our senses and reasoning were not reliable, then natural selection would have eliminated them long ago. The challenge for some time has been how to transform these informal musings about evolutionary epistemology into a rigorous (...) theoretical discipline capable of complementing current scientific studies of the evolution of cognition with a philosophically defensible account of meaning and justification. (shrink)

The realization that prokaryotes naturally and frequently disperse genes across steep taxonomic boundaries via lateral gene transfer gave wings to the idea that eukaryotes might do the same. Eukaryotes do acquire genes from mitochondria and plastids and they do transfer genes during the process of secondary endosymbiosis, the spread of plastids via eukaryotic algal endosymbionts. From those observations it, however, does not follow that eukaryotes transfer genes either in the same ways as prokaryotes do, or to a quantitatively similar degree. (...) An important illustration of the difference is that eukaryotes do not exhibit pangenomes, though prokaryotes do. Eukaryotes reveal no detectable cumulative effects of LGT, though prokaryotes do. A critical analysis suggests that something is deeply amiss with eukaryote LGT theories. In prokaryotes, genes from the environment can enter the genome via lateral gene transfer. In eukaryote genetics, natural variation comes from within the genome, not from the environment. Yet many reports claim that eukaryotes undergo LGT just like prokaryotes. Such claims do not withstand scrutiny and are probably untrue. (shrink)

Analytic philosophy of existence in the 20th century and beyond has been dominated by two central claims. One is that existence is instantiation. The other is that there are no modes of existence. This article attempts to refute both claims.

The doctrine of divine simplicity, according to which God is devoid of physical or metaphysical complexity, is widely believed to be incoherent. I argue that although two prominent recent attempts to defend it fail, it can be defended against the charge of obvious incoherence. The defense rests on the isolation and rejection of a crucial assumption, namely, that no property is an individual. I argue that there is nothing in our ordinary concepts of property and individual to warrant the assumption, (...) and that once the assumption is rejected, the way is clear to viewing the divine attributes as self-exemplifying properties whose self-exemplification entails their identity with an individual. (shrink)

This article articulates and defends F. H. Bradley's regress argument against external relations using contemporary analytic techniques and conceptuality. Bradley's argument is usually quickly dismissed as if it were beneath serious consideration. But I shall maintain that Bradley's argument, suitably reconstructed, is a powerful argument, plausibly premised, and free of such obvious fallacies as petitio principii. Thus it does not rest on the question‐begging assumption that all relations are internal, as Russell, and more recently van Inwagen, maintain. Bradley does not (...) attack external relations in order to affirm a doctrine of internal relations, and his monism is not derived from the internality of all relations, but from the self‐contradictory nature of all relations. For Bradley, it is the “relational situation”as such that is ontologically defective. (shrink)

Various laws and theories in the natural and social sciences are presented with a view to discerning the syntactic and semantic characteristics of many idealizations in science. Three different kinds of idealizations are discussed: ideal conditions, ideal cases, and idealized theories. An ideal condition is a formula in which state variables occur, whose existential closure is false, and for which there is another formula that can be constructed out of the original formula such that the existential closure of the new (...) formula is true. An ideal case is a statement which is logically equivalent to a universal conditional which has an ideal condition as its antecedent. And an idealized theory is a set of false universal conditional statements. Alternative syntactic and semantic analyses are viewed and criticized. (shrink)

William F. Doverspike, PhD, is a licensed psychologist who holds a Diplomate in Clinical Psychology (ABPP) and he is also board certified in Neuropsychology (ABPN). He is an Associate Faculty member of the Georgia School of Professional Psychology, where he teaches graduate courses in professional ethics. As an independent practitioner, he maintains privileges at several local hospitals. He is a member of the Ethics Committee of the Georgia Psychological Association. Dr. Doverspike is Editor of the Georgia Psychologist magazine and (...) has authored over 50 articles and chapters. He conducts seminars on ethics, risk management, and diagnostic consultation. (shrink)

In Divine Providence, Swedish visionary Emanuel Swedenborg describes how God works in our lives to turn us away from evil and toward him while still allow us to make our own choices. Swedenborg addresses a number of questions that challenge people of faith, such as why accidents and disasters happen, and why evil people seem to prosper while others suffer. This edition is a reprint of a 1963 translation by William F. Wunsch.

The question concerning the meaning of life is important, but it immediately confronts the present authors with insurmountable obstacles from a philosophical standpoint, as it would require us to define not only what we hold to be life, but what we hold to be meaning in addition, requiring us to do both in a properly researched context. We unconditionally surrender to that challenge. Instead, we offer a vernacular, armchair approach to life’s origin and meaning, with some layman’s thoughts on the (...) meaning of origins as viewed from the biologist’s standpoint. One can observe that biologists generally approach the concept of biological meaning in the context of evolution. This is the basis for the broad resonance behind Dobzhansky’s appraisal that “Nothing in biology makes sense except in the light of evolution”. Biologists try to understand living things in the historical context of how they arose, without giving much thought to the definition of what life or living things are, which for a biologist is usually not an interesting question in the practical context of daily dealings with organisms. Do humans generally understand life’s meaning in the context of history? If we consider the problem of life’s origin, the question of what constitutes a living thing becomes somewhat more acute for the biologist, though not more answerable, because it is inescapable that there was a time when there were no organisms on Earth, followed by a time when there were, the latter time having persisted in continuity to the present. This raises the question of where, in that transition, chemicals on Earth became alive, requiring, in turn, a set of premises for how life arose in order to conceptualize the problem in relation to organisms we know today, including ourselves, which brings us to the point of this paper: In the same way that cultural narratives for origins always start with a setting, scientific narratives for origins also always start with a setting, a place on Earth or elsewhere where we can imagine what happened for the sake of structuring both the problem and the narrative for its solution. This raises the question of whether scientific origins settings convey meaning to humans in that they suggest to us from what kind of place and what kinds of chemicals we are descended, that is, to which inanimate things we are most closely related. (shrink)

A growing body of literature places blame for accounting frauds on the failure of educators to implement ethics training in accounting curriculums in higher educational institutions. Although, the professional accountancy bodies in the UK espouse high ethical standards, others suggest that these bodies are failing to cover ethics in any meaningful way. This study surveys faculty about what is being taught and how much time is dedicated to ethics training. This is the first study to examine whether content suggested by (...) the Ethics Education Framework has been implemented in curriculums in the UK. In addition, we look to determine if there is a notable difference between what is covered in both pre-1992 and post-1992 UK universities. Although we find that post-1992 institutions have implemented the EEF suggestions more than pre-1992 UK universities, current ethics training is insufficient and has not changed much over the last two decades. (shrink)

Mercy is often thought to be a praiseworthy moral virtue. However, the quality of mercy has been thrown into doubt. Since to be merciful is to be lenient to a wrongdoer beyond the dictates of justice, it seems as if mercy cannot be a praiseworthy virtue. I argue that several recent attempts to reconcile mercy with justice fail, and that the subsequent endeavour to resurrect mercy as a praiseworthy moral virtue is doubtful. However, I also show how the praiseworthy quality (...) of mercy can be retrieved, if we carefully reconstruct the moral case in its favour outside the law. /// La clemencia se suele considerar como una virtud moral loable. Sin embargo, se ha puesto en duda la cualidad de la clemencia. Puesto que ser clemente implica ser indulgente con un malhechor más allá de los dictados de la justicia, parece que la clemencia no puede ser una virtud loable. Sostengo que varios intentos recientes por reconciliar la clemencia con la justicia fracasan, y que la tentativa subsiguiente por resucitar la clemencia como virtud moral loable es dudosa. Sin embargo, también demuestro cómo se puede recuperar la calidad loable de la clemencia si reconstruimos cuidadosamente su defensa moral fuera de la ley. (shrink)

Chernyshevskii (1828-1889), a pivotal figure in the Russian protest movement after the Crimean War, was esteemed by Marx and Lenin. This first thorough treatment of Chernyshevskii in English is a biography and a presentation of his views on philosophy, aesthetics and literary criticism, economics and social relations, politics and revolution.

Conventional wisdom has it that evolution makes a sham of morality, even if morality is an adaptation. I disagree. I argue that our best current adaptationist theory of meaning offers objective truth conditionsfor signaling systems of all sorts. The objectivity is, however, relative to species – specifically to the adaptive history of the signaling system in question. While evolution may not provide the kind of species independent objective standards that (e.g.) Kantians desire, this should be enough for the practical work (...) of justifying our confidence in the objectivity of moral standards. If you believe morality is an adaptation, you should be a moral realist. (shrink)