BackgroundPatient autonomy is a fundamental, yet challenging, principle of professional medical ethics. The idea that individual patients should have the freedom to make choices about their lives, including medical matters, has become increasingly prominent in current literature. However, this has not always been the case, especially in communist countries where paternalistic attitudes have been interwoven into all relationships including medical ones. Patients’ expectations and the role of the doctor in the patient-physician relationship are changing. Croatia, as a transitional country, is (...) currently undergoing this particular process.MethodsQualitative research was conducted by means of six focus group discussions held in the years 2012 and 2013 in Croatia. Focus groups were held separately with each of the following: first year and final year medical students, physicians engaged in medical ethics education, physicians practicing in a clinical hospital, family medicine residents and individuals representing patients with chronic disease. This research specifically addresses issues related to patient autonomy, in particular, the principles of truth telling, confidentiality, and informed consent. All focus group discussions were audio taped and then transcribed verbatim and systematized according to acknowledged qualitative analysis methods.Results and discussionPatient autonomy is much more than a simple notion defined as the patient’s right to make treatment decisions independently. It has to be understood in context of the broader socio-cultural setting. At present, both patients and medical doctors in Croatia are increasingly appreciating the importance of promoting the principle of autonomy in medical decision-making. However, the current views of medical students, physicians and patients reveal inconsistencies.Conclusions Knowing how to respect the various facets of patients’ autonomy should be part of physician’s professional duties, and also be reflected in his or her core clinical competencies. For this reason greater importance should be dedicated to patient autonomy issues in medical education in Croatia. (shrink)

Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians is a concise and practical guide to ethical decision-making in medicine. The text is aimed at second- and third-year one-semester ethics courses offered in medical schools, health sciences departments, and nursing programs. By taking an applied approach rather than a theoretical approach, this text serves the needs of medical and nursing students, residents, and practicing physicians by sorting through questions of moral principles relevant to the diverse and growing (...) number of healthcare professionals. The many topics covered include truth telling, refusal of treatment, assisted suicide, managing error, and reproductive choice. (shrink)

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...) ethical vignettes.The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles.This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings. (shrink)

The central view of this dissertation is that a more comprehensive theory of scientific learning must incorporate insights from the disciplines of methodology and sociology. The standards of methodology play an indispensible role in learning by providing some of the principles necessary for theoretical evaluation. But such principles are not sufficient for socially embedded learning and they do not exclude the operation of social interests within science. It is the institutional structure of science that helps make up what abstract standards (...) alone lack: the material means with which to affect the advancement of learning. Institutions add something of their own dynamic to learning by helping to realize the abstract principles of methodology--they are never simply neutral husks. ;The views of a number of methodologists and sociologists are examined to demonstrate that this view of learning has not always been appreciated. Some methodologists have thought that by developing a theory of scientific method they were ensuring science's insulation from society at large. Such projects expect too much of methodology and the best methodology we have--fallibilism--leaves science open to social influence. Some sociologists have seen the role of a social theory as cutting across that of methodology--as if a social account of learning could only be at the expense of methodology. This had led some to deny methodology any explanatory power and others to limit sociology to accounting for merely the external aspects of scientific development. ;I throughout try to suggest how learning may be best accounted for by a fallibilist methodology combined with an institutional social theory. Such a dual view of learning is helpful because the advancement of learning is at times as dependent on its material constraints as on its intellectual ones. Thus, a comprehensive theory of learning can help science be a more critical enterprise and so contribute to its advancement. (shrink)

The continuing spread and development of electronic data interchange in health care settings is fuelling a significant global debate about the practicality, ethics, and legality of such a practice. The uncertainties implicit in this debate are particularly acute in the context of disease or population groups for whom multidisciplinary, multipleagency teamworking has become acknowledged as the “best practice” for providing effective and timely care or support. The greying of the population is a demographic phenomenon that will have a profound impact (...) on the health care system, social care agencies, and caregivers, and will require a greater degree of service coordination in order to meet the complex care needs of both care-receiver and caregiver. (shrink)

The continuing spread and development of electronic data interchange in health care settings is fuelling a significant global debate about the practicality, ethics, and legality of such a practice. The uncertainties implicit in this debate are particularly acute in the context of disease or population groups for whom multidisciplinary, multipleagency teamworking has become acknowledged as the “best practice” for providing effective and timely care or support. The greying of the population is a demographic phenomenon that will have a profound impact (...) on the health care system, social care agencies, and caregivers, and will require a greater degree of service coordination in order to meet the complex care needs of both care-receiver and caregiver. (shrink)

In this chapter, we consider ethical and philosophical aspects of trust in the practice of medicine. We focus on trust within the patient-physician relationship, trust and professionalism, and trust in Western (allopathic) institutions of medicine and medical research. Philosophical approaches to trust contain important insights into medicine as an ethical and social practice. In what follows we explain several philosophical approaches and discuss their strengths and weaknesses in this context. We also highlight some relevant empirical work in the section on (...) trust in the institutions of medicine. It is hoped that the approaches discussed here can be extended to nursing and other topics in the philosophy of medicine. (shrink)

Instead of conceiving ethical commands as divine revelations or as the discoveries of brilliant thinkers, we should see our ethical practices as evolving over tens of thousands of years, as members of our species have worked out how to live together and prosper. Here, Kitcher elaborates his radical vision of this millennia-long ethical project.

A concise and accessible introduction to the evolution of the concept of moral self-cultivation in the Chinese Confucian tradition, this volume begins with an explanation of the pre-philosophical development of ideas central to this concept, followed by an examination of the specific treatment of self cultivation in the philosophy of Kongzi ("Confucius"), Mengzi ("Mencius"), Xunzi, Zhu Xi, Wang Yangming, Yan Yuan and Dai Zhen. In addition to providing a survey of the views of some of the most influential Confucian thinkers (...) on an issue of fundamental importance to the tradition, Ivanhoe also relates their concern with moral self-cultivation to a number of topics in the Western ethical tradition. Bibliography and index are included. (shrink)

This volume introduces readers to emergence theory, outlines the major arguments in its defence, and summarizes the most powerful objections against it. It provides the clearest explication yet of this exciting new theory of science, which challenges the reductionist approach by proposing the continuous emergence of novel phenomena.

Introductory Chapter to the _Cambridge Handbook of Situated Cognition_ (CUP, 2009).

An esteemed philosopher discusses his theory of universal freedom, describing how even those who are members of free societies may find their liberties curtailed and includes tests of freedom including the eyeball test and the tough-luck test.

_Idealist Alternatives to Materialist Philosophies of Science_ (ed. Philip MacEwen) presents some of the major challenges to materialist interpretations of science while also giving materialism a full hearing.

Drawing on the latest work in cognitive neuroscience, a philosopher proposes that delusions are narrative models that accommodate anomalous experiences.

A person presented with adequate but not conclusive evidence for a proposition is in a position voluntarily to acquire a belief in that proposition, or to suspend judgment about it. The availability of doxastic options in such cases grounds a moderate form of doxastic voluntarism not based on practical motives, and therefore distinct from pragmatism. In such cases, belief-acquisition or suspension of judgment meets standard conditions on willing: it can express stable character traits of the agent, it can be responsive (...) to reasons, and it is compatible with a subjective awareness of the available options. (shrink)

In “Scientific Knowledge,” Philip Kitcher challenges arguments that deny the truth of the theoretical claims of science, and he attempts to discover reasons for endorsing the truth of such claims. He suggests that the discovery of such reasons might succeed if we ask why anyone thinks that the theoretical claims we accept are true and then look for answers that reconstruct actual belief‐generating processes. To this end, Kitcher presents the “homely argument” for scientific truth, which claims that when a (...) field of science is continually applied to yield precise predictions, then it is at least approximately true. He defends this approach and offers a supplementary account that gives more attention to detail. This account includes a historical aspect that must answer to skeptical challenges and a social aspect. (shrink)

Research on personality psychology is making important contributions to psychological science and applied psychology. This second edition of The Cambridge Handbook of Personality Psychology offers a one-stop resource for scientific personality psychology. It summarizes cutting-edge personality research in all its forms, including genetics, psychometrics, social-cognitive psychology, and real-world expressions, with informative and lively chapters that also highlight some areas of controversy. The team of renowned international authors, led by two esteemed editors, ensures a wide range of theoretical perspectives. Each research (...) area is discussed in terms of scientific foundations, main theories and findings, and future directions for research. The handbook also features advances in technology, such as molecular genetics and functional neuroimaging, as well as contemporary statistical approaches. An invaluable aid to understanding the central role played by personality in psychology, it will appeal to students, researchers, and practitioners in psychology, behavioral neuroscience, and the social sciences. (shrink)

Este artigo científico procurou investigar o processo de adaptação da Universidade Brasileira aos novos paradigmas impostos pelas políticas neoliberais. A análise se faz a partir de breve histórico do liberalismo e de suas imbricações no ensino. Apontando também a relativização da suposta democratização e modernização do ensino pelas novas perspectivas impostas pelo mercado. São levantadas também questões como autonomia universitária e legitimação da instituição de ensino superior.

This paper explores the role of moral uncertainty in explaining the morally disruptive character of new technologies. We argue that existing accounts of technomoral change do not fully explain its disruptiveness. This explanatory gap can be bridged by examining the epistemic dimensions of technomoral change, focusing on moral uncertainty and inquiry. To develop this account, we examine three historical cases: the introduction of the early pregnancy test, the contraception pill, and brain death. The resulting account highlights what we call “differential (...) disruption” and provides a resource for fields such as technology assessment, ethics of technology, and responsible innovation. (shrink)

Examines what is necessary for a group to constitute an agent that can display akrasia, and what steps such a group might take to establish self‐control. The topic has some interest in itself, and the discussion suggests some lessons about how we should think of akrasia in the individual as well as in the collective case. Under the image that the lessons support, akrasia is a sort of constitutional disorder: a failure to achieve a unity projected in the avowal of (...) agency. This image fits well with the constitutional model of the soul in Plato's Republic. (shrink)

There has recently been a revival of interest in panpsychism as a theory of consciousness. The hope of the contemporary proponents of panpsychism is that the view enables us to integrate consciousness into our overall theory of reality in a way that avoids the deep difficulties that plague the more conventional options of physicalism on the one hand and dualism on the other. However, panpsychism comes in two forms — strong and weak emergentist — and there are arguments that seem (...) to show that weak emergentist panpsychism faces problems analogous to those of physicalism whilst strong emergentist panpsychism faces problems analogous to those of dualism. In this paper, I will develop a new hybrid of the strong and weak emergentist forms of panpsychism, a view according to which subjects of experience are strongly emergent but their phenomenal properties are weakly emergent. I will argue that this hybrid view manages to avoid the challenges facing both physicalism and dualism, and the analogues of those challenges that seem to undermine standard forms of panpsychism. (shrink)

Based on a survey of editors, publishers and staff members of 300 newspapers, this work documents the ethical confusion in the American press in the wake of the Watergate scandal and the Pentagon Papers controversy. It provides an analytical and historical framework to show how the press reached this point and argues for an ethical audit to give publications an independent check on their moral condition.

In 1835, Alexis de Tocqueville famously called for 'a new political science' that could address the problems and possibilities of a 'world itself quite new.' For Tocqueville, the democratic world needed not just a new political science, but also new arts of statesmanship and leadership. In this volume, editors Brian Danoff and L. Joseph Hebert, Jr. have brought together a diverse set of essays which reveal that Tocqueville's understanding of democratic statesmanship remains highly relevant today.

This chapter outlines three programs that aim to use biological insights in support of philosophical positions in ethics: Aristotelian approaches found, for example, in Thomas Hurka and Philippa Foot; Humean approaches found in Simon Blackburn and Allan Gibbard; and biologically grounded approaches found in of Elliott Sober and Brian Skyrms. The first two approaches begin with a philosophical view, and seek support for it in biology. The third approach begins with biology, and uses it to illuminate the status of morality. (...) This chapter pursues a version of the third program. A major accomplishment of evolutionary biology has been the explanation of biological altruism, which opens the door to a similar explanation of psychological altruism, or “fellow-feeling.” The chapter conjectures that humans have evolved a capacity for normative governance by socially shared rules. A process of cultural evolution led to the social rules with which we are familiar. This genealogical story poses a challenge, for the idea of moral truth plays no role in it. The story therefore lends support to non-cognitivism or anti-realist expressivism. The chapter concludes by exploring the implications of the genealogical story for moral knowledge, moral objectivity, and the idea of moral authority. (shrink)

This paper develops a philosophical account of moral disruption. According to Robert Baker (2013), moral disruption is a process in which technological innovations undermine established moral norms without clearly leading to a new set of norms. Here I analyze this process in terms of moral uncertainty, formulating a philosophical account with two variants. On the Harm Account, such uncertainty is always harmful because it blocks our knowledge of our own and others’ moral obligations. On the Qualified Harm Account, there is (...) no harm in cases where moral uncertainty is related to innovation that is “for the best” in historical perspective, or where uncertainty is the expression of a deliberative virtue. The two accounts are compared by applying them to Baker’s historical case of the introduction of mechanical ventilation and organ transplantation technologies, as well as the present-day case of mass data practices in the health domain. (shrink)

Some recent accounts of testimonial warrant base it on trust, and claim that doing so helps explain asymmetries between the intended recipient of testimony and other non-intended hearers, e.g. differences in their entitlement to challenge the speaker or to rebuke the speaker for lying. In this explanation ‘dependence-responsiveness’ is invoked as an essential feature of trust: the trustor believes the trustee to be motivationally responsive to the fact that the trustor is relying on the trustee. I argue that dependence-responsiveness is (...) not essential to trust and that the asymmetries, where genuine, can be better explained without reference to trust. (shrink)

This is a book about the aesthetics of wonder, about wonder as it figures in our relation to the visual world and to rare or new experiences.

Jean Greisch a soixante ans. A l'occasion de cet anniversaire, trente de ses collègues et amis de divers continents ont souhaité unir leurs réflexions à ce que son œuvre, désormais considérable, inspire sur les différentes scènes de la pensée. La thématique générale, qui constitue l'intitulé du présent volume, est emblématique d'une production singulière : passage entre les deux langues de son Luxembourg natal, entre la phénoménologie et la philosophie de la religion, entre la métaphysique et la théologie, entre les sciences (...) humaines et l'herméneutique, entre la poésie et l'éthique. Enseignant, traducteur, conférencier international et auteur, il continue de frayer différents types de passages : dresser des ponts, ouvrir des brèches, risquer des percées, souffrir des traversées, ménager des transitions, inventer des tracés. (shrink)

Technology is a practically indispensible means for satisfying one’s basic interests in all central areas of human life including nutrition, habitation, health care, entertainment, transportation, and social interaction. It is impossible for any one person, even a well-trained scientist or engineer, to know enough about how technology works in these different areas to make a calculated choice about whether to rely on the vast majority of the technologies she/he in fact relies upon. Yet, there are substantial risks, uncertainties, and unforeseen (...) practical consequences associated with the use of technological artifacts and systems. The salience of technological failure (both catastrophic and mundane), as well as technology’s sometimes unforeseeable influence on our behavior, makes it relevant to wonder whether we are really justified as individuals in our practical reliance on technology. Of course, even if we are not justified, we might nonetheless continue in our technological reliance, since the alternatives might not be attractive or feasible. In this chapter I argue that a conception of trust in technological artifacts and systems is plausible and helps us understand what is at stake philosophically in our reliance on technology. Such an account also helps us understand the relationship between trust and technological risk and the ethical obligations of those who design, manufacture, and deploy technological artifacts. (shrink)

Published in 1913, Thomas Mann's _Death in Venic_e is one of the most widely read novellas in any language. In the 1970s, Benjamin Britten adapted it into an opera, and Luchino Visconti turned it into a successful film. Reading these works from a philosophical perspective, Philip Kitcher connects the predicament of the novella's central character to Western thought's most compelling questions. In Mann's story, the author Gustav von Aschenbach becomes captivated by an adolescent boy, first seen on the lido (...) in Venice, the eventual site of Aschenbach's own death. Mann works through central concerns about how to live, explored with equal intensity by his German predecessors, Schopenhauer and Nietzsche. Kitcher considers how Mann's, Britten's, and Visconti's treatments illuminate the tension between social and ethical values and an artist's sensitivity to beauty. Each work asks whether a life devoted to self-sacrifice in the pursuit of lasting achievements can be sustained and whether the breakdown of discipline undercuts its worth. Haunted by the prospect of his death, Aschenbach also helps us reflect on whether it is possible to achieve anything in full awareness of our finitude and in knowing our successes are always incomplete. (shrink)