Evolutionary discussions regarding the relationship between social status and fertility in the contemporary U.S. typically claim that the relationship is either negative or absent entirely. The published data on recent generations of Americans upon which such statements rest, however, are solid with respect to women but sparse and equivocal for men. In the current study, we investigate education and income in relation to age at first child, childlessness, and number of children for men and women in two samples—one of the (...) general American population and one of graduates of an elite American university. We find that increased education is strongly associated with delayed childbearing in both sexes and is also moderately associated with decreased completed or near-completed fertility. Women in the general population with higher adult income have fewer children, but this relationship does not hold within all educational groups, including our sample with elite educations. Higher-income men, however, do not have fewer children in the general population and in fact have lower childlessness rates. Further, higher income in men is positively associated with fertility among our sample with elite educations as well as within the general population among those with college educations. Such findings undermine simple statements on the relationship between status and fertility. (shrink)

Thomas Hobbes's theory of the laws of nature covers only a subset of these rules, namely, those that “concern the doctrine of Civill Society”. There are many interpretations that attribute more ambitious aims to Hobbes, such as reconciling the claims of morality and interest, defending a version of divine command theory, showing that some aims are supremely rational, or using a theory of reciprocity to unite reason and morality. This chapter argues that Hobbes can accomplish his most important goals with (...) the minimalist theory. Hobbes describes the behavior of societies in the state of nature whose members support themselves by raiding other cities. Hobbes's moral theory makes the case for the state because it holds that social life governed by the laws of nature is available only within the state. In addition to supporting Hobbes's political theory, the minimalist theory presents an alternative to Aristotle's theory of justice. (shrink)

What is the value of having medical students engage in creative production as part of their learning? Creating something new requires medical students to take risks and even to fail--something they tend to be neither accustomed to nor comfortable with doing. “Making stuff” can help students prepare for such failures in a controlled environment that doesn’t threaten their professional identities. Furthermore, doing so can facilitate students becoming resilient and creative problem-solvers who strive to find new ways to address vexing questions. (...) Though creating something new can be fun, this is not the main outcome of interest. Rather, the principle reason we recommend devoting precious curricular time to creative endeavors is because it helps medical students become better doctors. (shrink)

This article answers questions about the consistency, coherence, and motivation of Hobbes's account of the right to punish. First, it develops a novel account of authorization that explains how Hobbes could have consistently held both that the subjects do not give the sovereign the right to punish and also that they authorize the sovereign to punish. Second, it shows that, despite appearances, the natural and artificial elements of Hobbes's account form a coherent whole. Finally, it explains why Hobbes thought it (...) was important to establish the sovereign's right to punish apart from the sovereign's power to punish. (shrink)

In the face of mounting criticism against advance directives, we describe how a novel, computer-based decision aid addresses some of these important concerns. This decision aid, Making Your Wishes Known: Planning Your Medical Future , translates an individual's values and goals into a meaningful advance directive that explicitly reflects their healthcare wishes and outlines a plan for how they wish to be treated. It does this by (1) educating users about advance care planning; (2) helping individuals identify, clarify, and prioritize (...) factors that influence their decision-making about future medical conditions; (3) explaining common end-of-life medical conditions and life-sustaining treatment; (4) helping users articulate a coherent set of wishes with regard to advance care planning—in the form of an advance directive readily interpretable by physicians; and (5) helping individuals both choose a spokesperson, and prepare to engage family, friends, and health care providers in discussions about advance care planning. (shrink)

The adage “an ounce of prevention is worth a pound of cure” is widely used in healthcare settings and can be applied to the work of institutional clinical ethics committees. The model of clinical ethics consultation, however, is inherently reactive: a crisis or question emerges, and ethics experts are called to help. In an effort to employ a proactive component to the model of clinical ethics consultation (as well as to standardize our educational interventions), we developed ethics pocket cards. The (...) purpose of this article is to: (1) describe the rationale for using ethics pocket cards, (2) provide examples of our cards, and (3) begin a dialogue about the potential uses of ethics pocket cards. In doing so, we hope to explore how such portable, economical devices can advance the goals of ethics consultation as well as the educational aims of ethics committees. (shrink)

Review of "One For All: The Logic of Group Conflict," by Russell Hardin; "On Nationality," by David Miller; and "Liberal Nationalism," by Yael Tamir.

The American Journal of Bioethics, Volume 12, Issue 5, Page 8-9, May 2012.

Though graphic narratives (or comics) now permeate popular culture, address every conceivable topic including illness and dying, and are used in educational settings from grade school through university, they have not typically been integrated into the medical school curriculum. This paper describes a popular and innovative course on comics and medicine for 4th-year medical students. In this course, students learn to critically read book length comics as well as create their own stories using the comics format. The rationale for the (...) course, its general content and format, and methods for teaching are described. Finally, the author offers some reflections on why this medium resonates so powerfully with medical student learners. (shrink)

The Paleolithic paintings and drawings found on cave walls at sites in France and Spain, such as Lascaux, Altamira and Vallon-Pont-D'Arc, have profound effects on those who see them. In addition to their historical interest, they are prized for their aesthetic and spiritual qualities, which have had an important influence on modern art. But the caves are small and the paintings are fragile. Access to them has been sharply limited: some caves have been closed to protect the paintings from the (...) damage caused by human respiration; access to others is limited to those who negotiate a daunting reservation scheme. Despite being the heritage of humanity as a whole, the cave paintings are, and must be, restricted to a very few. Not everyone who wants to see the paintings can do so if they are to survive. (shrink)

Mr. Galanas, an eighty‐six‐year‐old man, intentionally shot himself in the chest and abdomen. Surprisingly, the bullet damaged only his distal pancreas and part of his colon, requiring a diverting colostomy to prevent leakage of bowel fluids into his abdomen. After being admitted, he lies intubated in the intensive care unit awaiting surgery to repair his colon. He is responsive but does not demonstrate clear decision‐making capacity. He grudgingly accepts pain medications but refuses antibiotics and antidepressants. He has a living will (...) that gives his wife durable power of attorney and also explicitly states a desire to refuse all medical interventions if he is permanently unconscious or in an end‐stage condition. Mrs. Galanas reports frequent conversations in which her husband said he would not want to be sustained on life support. She also says that he often mentioned he would not want an ostomy bag—a likely, albeit temporary, outcome of the proposed surgery. His physicians are nervous about withholding medical interventions when Mr. Galanas's injury is the result of a suicide attempt and his prognosis is good. Should the care team surgically repair his injured colon, regardless of the patient's capacity, his advance directive, and his wife's statement that he would not want surgery or other life‐sustaining treatment? (shrink)

PurposeAdvance directives have been criticized for failing to help physicians make decisions consistent with patients’ wishes. This pilot study sought to determine if an interactive, computer-based decision aid that generates an advance directive can help physicians accurately translate patients’ wishes into treatment decisions.MethodsWe recruited 19 patient-participants who had each previously created an advance directive using a computer-based decision aid, and 14 physicians who had no prior knowledge of the patient-participants. For each advance directive, three physicians were randomly assigned to review (...) the advance directive and make five to six treatment decisions for each of six (potentially) end-of-life clinical scenarios.From the three individual physicians’ responses, a “consensus physician response” was generated for each treatment decision (total decisions = 32). This consensus response was shared with the patient whose advance directive had been reviewed, and she/he was then asked to indicate how well the physician translated his/her wishes into clinical decisions.ResultsPatient-participants agreed with the consensus physician responses 84 percent (508/608) of the time, including 82 percent agreement on whether to provide mechanical ventilation, and 75 percent on decisions about cardiopulmonary resuscitation (CPR).Across the six vignettes, patient-participants’ rating of how well physicians translated their advance directive into medical decisions was 8.4 (range = 6.5-10, where 1 = extremely poorly, and 10 = extremely well). Physicians’ overall rating of their confidence at accurately translating patients’ wishes into clinical decisions was 7.8 (range = 6.1-9.3, 1 = not at all confident, 10 = extremely confident).ConclusionFor simulated cases, a computer-based decision aid for advance care planning can help physicians more confidently make end-of-life decisions that patients will endorse. (shrink)

This paper poses the question, “what are providers’ obligations to patients who lie?” This question is explored through the lens of a specific case: a 26–year–old woman who requests prophylactic bilateral mastectomy with reconstruction reports a significant and dramatic family history, but does not want to undergo genetic testing. Using a conversational–style discussion, the case is explored by a breast surgeon, genetic counselor/medical geneticist, clinical psychologist, chair of a hospital ethics committee and director of a clinical ethics consultation service.

In lieu of an abstract, here is a brief excerpt of the content:141 HUME AND CAUSAL INFERENCE Hume held that any time we reach by inference a belief about the existence or qualities of some object or event that we have not actually perceived, the inference is grounded in beliefs about causal relations holding between the object of belief and some other object or objects that have actually been experienced. I will examine here Hume's account of such causal inferences. There (...) are many places in the Treatise of Human Nature at which Hume seems to claim that causal inferences take place when and only when the percipient has had an extensive previous experience of objects of the respective types as regularly conjoined in relations of contiguity and temporal priority. It seems to me that reliance on these passages alone gives a distorted view of Hume's theory of causal inference. Contrary to appearances, Hume did not hold that extensive previous experiences of objects of the same types as properly conjoined is either necessary or sufficient for causal inference. Hume's view is more subtle and complicated, and there are important considerations of coherence and holism present in it. Getting Hume's view on this matter clear is important because it shows how he can escape some of the objections that have been laid against his theory, and it makes possible a reading of Hume as a causal realist. Hume's theory of inference provides the resources for drawing a distinction between accidental and genuine causal regularities and it is compatible with the view that causal relations (and not mere de facto regularities) hold among events in the world independently of their being perceived. The examination begins by looking at a different, but related, issue. Why does Hume think 142 that of the three types of association, only cause and effect association is capable of producing belief? Hume puts the question in the form of a possible objection to his account. For it may be said, that if all the parts of that hypothesis be true, viz. that these three species of relation are deriv'd from the same principles; that their effects in inforcing and inlivening our ideas are the same; and that belief is nothing but a more forcible and vivid conception of an idea; it shou'd follow, that that action of the mind may not only be deriv'd from the relation of cause and effect, but also from those of contiguity and resemblance. But as we find by experience, that belief arises only from causation, and that we can draw no inference from one object to another, except they be connected by this relation, we may conclude, that there is some error in that reasoning, which leads us into such difficulties. (T 107) It is important to note that Hume is talking here only about beliefs about the existence or situations of objects that have not been intuited or experienced. Beliefs about relations of ideas (e.g., that 2 + 2 = 4) are intuitions (or perhaps memories 2 of intuitions). Beliefs in the existence of things as experienced or in the previous existence of things as previously experienced automatically have the 3 vivacity of impressions or memory ideas. What Hume takes himself to need to explain is why cause and effect association allows for a transfer of this vivacity to an idea of an object or situation that has not itself been intuited or experienced and why 4 resemblance and contiguity association do not. If I see a green ball next to a red sweater, then I will normally subsequently believe that the green ball existed next to the red sweater at that time (at 143 least until my memories begin to lose vivacity). This is purely a matter of sense experience and memory. Now if I subsequently see a different red sweater (or the same sweater in a different location), I may be led to think of a green ball existing next to it purely through contiguity and resemblance association. But presumably I would not believe that a green ball existed next to the currently perceived red sweater unless I currently perceived a green ball or my belief was based on some 5 form of causal inference... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Intention and Wrongdoing: A Defense of the Principle of Double Effect by Joshua StuchlikMichael J. DegnanSTUCHLIK, Joshua. Intention and Wrongdoing: A Defense of the Principle of Double Effect. Cambridge: Cambridge University Press, 2021. xvi + 220 pp. Cloth, $99.99In this book Joshua Stuchlik vigorously defends the principle of double effect (PDE), which states, "There is a strict moral constraint against bringing about serious evil (harm) to an innocent (...) person intentionally, but it is permissible in a wider range of circumstances to act in a way that brings about serious evil incidentally, as a foreseen but non-intended side effect." After defining the terms of the principle and considering an intuitive case-based defense, he supports its truth based on a standard of solidarity. Since the PDE requires the distinction between intended consequences and nonintended side effects, he explains Elizabeth Anscombe's theory of intention, which supports the distinction's moral significance. He uses her theory to treat the closeness problem, the irrelevance of intention critique, and a challenge from Joshua Greene's empirical moral psychology that purports to undermine deontological constraints on causing harm.I present Stuchlik's grounding for the PDE followed by an uncontroversial example of its application. After this I consider two important objections to the PDE that Stuchlik critiques: the closeness problem and James Rachels's argument that intentions are irrelevant to judging the moral permissibility of actions. I conclude by examining Stuchlik's treatment of these challenges.Stuchlik interprets the PDE's very strict constraint against intentional killing or seriously harming the innocent as a near absolute prohibition, for he believes innocent persons are not suitable recipients of intentional harm. He grounds this constraint on the principle of solidarity. Being in solidarity with another is possessing concern for that other's sake. The ground for this concern is a shared human nature that enables members to think of themselves as making a "we." Human nature consists in the structured potentialities for knowing and freely choosing. Evidence of these rational potentialities is the human orientation toward the transcendent values of truth and goodness. Such embodied potentialities have inviolable worth.The scenarios of the precision bomber and the terror bomber illustrate the moral significance of the intended harm versus the nonintended but foreseen harm that Stuchlik adopts from Elizabeth Anscombe's action theory. Each bombers' goal is to help his country win a just war. The precision bomber pursues that goal by targeting a munitions factory. Though he foresees that many noncombatants will be killed or seriously [End Page 367] injured from the bomb, he does not necessarily intend these harms. By contrast, the terror bomber targets a civilian center necessarily intending harm for noncombatants. The PDE rules out his conduct.Anscombe's account of intention can lead to the problem of closeness in which the content of an intention is sufficiently fine-grained that an agent need not intend harm in almost any situation. Stuchlik illustrates the problem with Alexander Pruss's zookeeper scenario.An eccentric literalistic but always truthful magnate tells Sam he will donate to famine relief saving a hundred lives if and only if Sam follows his directions to the iota. Sam is to purchase a gun, sneak at night into a zoo owned by the magnate and kill the first mammal he sees. Sam sneaks into the zoo, sees a mammal in the distance, and forms the intention to shoot it. Then he notices that the mammal is human but shoots nonetheless on utilitarian grounds.In this case applying the PDE shows that Sam is simply intending that a mammal be killed. The fact that the mammal is a human is irrelevant, according to Anscombe's action theory.Stuchlik's response clarifies the scope of intention in the PDE. As stated above, the intention's content includes seriously harming an innocent human. However, if the intention ranges only over an intention to bring about an effect, E, and it turns out that E is a serious harm for an innocent human being, then applying the principle shows that Sam's action is wrong. The intended effect of killing the mammal is, as a matter of fact, an... (shrink)

We argued in Part 1 of this series that because all living systems are extremely far‐from‐equilibrium dynamic confections of matter, they must necessarily be driven to that state by the conversion of chemically specific external disequilibria into specific internal disequilibria. Such conversions require task‐specific macromolecular engines. We here argue that the same is not only true of life at its emergence; it is the enabling cause of that emergence; although here the external driving disequilibria, and the conversion engines needed must (...) have been abiotic. We argue further that the initial step in life's emergence can only create an extremely simple non‐equilibrium “seed” from which all the complexity of life must then develop. We assert that this complexity develops incrementally and progressively, each step tested for value added “in flight.” And we make the case that only the submarine alkaline hydrothermal vent (AHV) model has the potential to satisfy these requirements. (shrink)

Sentences such as “The ship was sunk to collect the insurance” exhibit an unusual form of anaphora, implicit control, where neither anaphor nor antecedent is audible. The non-finite reason clause has an understood subject, PRO, that is anaphoric; here it may be understood as naming the agent of the event of the host clause. Yet since the host is a short passive, this agent is realized by no audible dependent. The putative antecedent to PRO is therefore implicit, which it normally (...) cannot be. What sorts of representations subserve the comprehension of this dependency? Here we present four self-paced reading time studies directed at this question. Previous work showed no processing cost for implicit vs. explicit control, and took this to support the view that PRO is linked syntactically to a silent argument in the passive. We challenge this conclusion by reporting that we also find no processing cost for remote implicit control, as in: “The ship was sunk. The reason was to collect the insurance.” Here the dependency crosses two independent sentences, and so cannot, we argue, be mediated by syntax. Our Experiments 1–4 examined the processing of both implicit (short passive) and explicit (active or long passive) control in both local and remote configurations. Experiments 3 and 4 added either “3 days ago” or “just in order” to the local conditions, to control for the distance between the passive and infinitival verbs, and for the predictability of the reason clause, respectively. We replicate the finding that implicit control does not impose an additional processing cost. But critically we show that remote control does not impose a processing cost either. Reading times at the reason clause were never slower when control was remote. In fact they were always faster. Thus, efficient processing of local implicit control cannot show that implicit control is mediated by syntax; nor, in turn, that there is a silent but grammatically active argument in passives. (shrink)

Before curing was a possibility, medicine was devoted to the relief of suffering. Attention to the relief of suffering often takes a back seat in modern biomedicine. This book seeks to place suffering at the center of biomedical attention, examining suffering in its biological, psychological, clinical, religious, and ethical dimensions.

The comprehension of anaphoric relations may be guided not only by discourse, but also syntactic information. In the literature on online processing, however, the focus has been on audible pronouns and descriptions whose reference is resolved mainly on the former. This paper examines one relation that both lacks overt exponence, and relies almost exclusively on syntax for its resolution: adjunct control, or the dependency between the null subject of a non-finite adjunct and its antecedent in sentences such as Mickey talked (...) to Minnie before ___ eating. Using visual world eyetracking, we compare the time course of interpreting this null subject and overt pronouns (Mickey talked to Minnie before he ate). We show that when control structures are highly frequent, listeners are just as quick to resolve reference in either case. When control structures are less frequent, reference resolution based on structural information still occurs upon hearing the non-finite verb, but more slowly, especially when unaided by structural and referential predictions. This may be due to increased difficulty in recognizing that a referential dependency is necessary. These results indicate that in at least some contexts, referential expressions whose resolution depends on very different sources of information can be resolved approximately equally rapidly, and that the speed of interpretation is largely independent of whether or not the dependency is cued by an overt referring expression. (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

AimThe neurocognitive basis of Developmental Coordination Disorder remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD.MethodsThe review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis.ResultsThe most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent (...) motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions.InterpretationTaken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed.Systematic Review RegistrationPROSPERO, identifier: CRD42020185444. (shrink)

This paper explores relationships between environment and education after the Covid-19 pandemic through the lens of philosophy of education in a new key developed by Michael Peters and the Philosophy of Education Society of Australasia. The paper is collectively written by 15 authors who responded to the question: Who remembers Greta Thunberg? Their answers are classified into four main themes and corresponding sections. The first section, ‘As we bake the earth, let's try and bake it from scratch’, gathers wider (...) philosophical considerations about the intersection between environment, education, and the pandemic. The second section, ‘Bump in the road or a catalyst for structural change?’, looks more closely into issues pertaining to education. The third section, ‘If you choose to fail us, we will never forgive you’, focuses to Greta Thunberg’s messages and their responses. The last section, ‘Towards a new normal’, explores future scenarios and develops recommendations for critical emancipatory action. The concluding part brings these insights together, showing that resulting synergy between the answers offers much more then the sum of articles’ parts. With its ethos of collectivity, interconnectedness, and solidarity, philosophy of education in a new key is a crucial tool for development of post-pandemic education. (shrink)

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This volume is a collection of essays by various contributors in honor of the late Laurence Berns, Richard Hammond Elliot Tutor Emeritus at St. John's College, Annapolis. The essays address the literary, political, theological, and philosophical themes of his life's work as a scholar, teacher, and constant companion of the "great books.".

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

This is the correspondence (1959–1969), on the nature of the evolutionary process, between the biologist Theodosius Dobzhansky and the historian John C. Greene.

The healthcare industry generates significant waste and carbon emissions that negatively impact the environment. Intensive care units are a major contributor to the production of waste, due t...