After presenting the major objections raised against standard formulations of the H-D method of theory testing, I identify what seems to be an important element of truth underlying the method. I then draw upon this element in an effort to develop a plausible formulation of the H-D method which avoids the various objections.

It is shown that two arguments given by Alvin Plantinga, which he offers to refute the existentialist thesis that propositions, states of affairs, and properties are ontologically dependent upon the objects they are directly about, are unsound. The existentialist position is then defended on the basis of both some intuitive considerations and a rigorous argument that does not presuppose any particular theory of the nature of propositions, states of affairs, and properties.

It is shown that two arguments given by Alvin Plantinga, which he offers to refute the existentialist thesis that propositions, states of affairs, and properties are ontologically dependent upon the objects they are directly about, are unsound. The existentialist position is then defended on the basis of both some intuitive considerations and a rigorous argument that does not presuppose any particular theory of the nature of propositions, states of affairs, and properties.

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un- Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent (...) that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article, we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic. (shrink)

This essay examines whether the Catholic magisterium's use of Aquinas to condemn homosexual acts is actually Thomistic. Rather than being aligned with the magisterium, Aquinas advances a moral epistemology better illuminated by the work of philosopher Judith Butler. Deploying Butler as a means of immanent critique, I show how magisterial attempts to argue against lesbian and gay sex fail on their own terms. Reading Aquinas alongside Butler shows us why we need not choose between fidelity to Thomistic natural law and (...) affirmation of lesbians and gays. (shrink)

Pope Benedict XVI's encyclical Deus Caritas Est continues the magisterium's twentieth-century shift from an act-oriented, procreative approach to sexual ethics to what I will term a heterosexually personalistic one. Situating a heterosexual anthropology within a heterosexual cosmology, Benedict argues that just as God loves humanity with heterosexual eros, so must human beings love each other heterosexually. Although Benedict depends upon the explanatory power of heterosexuality, he perhaps unwittingly ends up depicting God's love not as iconically heterosexual, but as queer. In (...) casting God's love as queer, I do not, even analogously, impute to God a type of homosexuality as Benedict does a heterosexuality. Instead, by drawing attention to the discursive specificity and historical instability of both homosexuality and heterosexuality, I use “queer” to recognize God's love as beyond categorization and as strange; it cannot be corralled into or contained by the historically specific notions of heterosexual and homosexual. But this essay does not merely deconstruct Benedict's heterosexually personalistic cosmology. It uncovers in Benedict's Eucharistic transfiguration of marital love a new and promising way of situating discussions about the ethics of sex. (shrink)

Why flawed logic puts us all at risk, and how critical thinking can save the world. It may seem a big claim, but knowing how to think clearly and critically has literally helped save the world. In September 1983, at the height of the Cold War, the Soviet Union's early warning system showed five US missiles heading towards the country. Stanislaw Petrov knew his duty: he was to inform Moscow that nuclear war had begun, so that they could launch an (...) immediate and devastating response. Instead, he made a call to say the system was faulty. He'd assessed the situation and reasoned that an error was more likely than such a limited attack. We may not have to save the planet from nuclear annihilation, of course, but our ability to think critically has never been more important. In a world where fake news, mistrust of experts, prejudice and ignorance all too often hold sway, we can all too easily be misled. We live in an era where access to all the knowledge in the world is at our fingertips, yet that also means misinformation and falsehoods can spread further and faster than ever before. In The Irrational Ape, David Robert Grimes shows how we can be lured into making critical mistakes or drawing false conclusions, and how to avoid such errors. Given the power of modern science and the way that movements can unite to protest a cause via social media, we are in dangerous times. But fortunately, we can learn from our mistakes, and by critical thinking and scientific method we can discover how to apply these techniques to everything from deciding what insurance to buy to averting global disaster. This book, packed with fascinating case studies and examples, helps ensure we are ready for the modern world. (shrink)

Previously published in The mountain path, quarterly published from Sri Ramanansramam.

On the life and philosophy of Ramana Maharshi and his views on Advaita and epistemology.

In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other.

This volume brings together for the first time a significant number of Reid's manuscript papers on natural history, physiology and materialist metaphysics. An important contribution not only to Reid studies but also to our understanding of eighteenth-century science and its context.

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

The COVID-19 (Coronavirus disease of 2019) pandemic has led to intense conversations about ventilator allocation and reallocation during a crisis standard of care. Multiple voices in the media and multiple state guidelines mention reallocation as a possibility. Drawing upon a range of neuroscientific, phenomenological, ethical, and sociopolitical considerations, the authors argue that taking away someone’s personal ventilator is a direct assault on their bodily and social integrity. They conclude that personal ventilators should not be part of reallocation pools and that (...) triage protocols should be immediately clarified to explicitly state that personal ventilators will be protected in all cases. (shrink)

v. 1. Editorial introduction -- v. 2. The English and Latin texts (i) -- v. 3. The English and Latin texts (ii).

Ableist attitudes and structures regarding disability are increasingly recognized across all sectors of healthcare delivery. After Dobbs, novel questions arose in the USA concerning how to protect reproductive autonomy while avoiding discrimination against and devaluation of disabled persons. As a case study, we examine the Louisiana’s Department of Public Health August 1st Emergency Declaration, “List of Conditions that shall deem an Unborn Child ‘Medically Futile.’” We raise a number of medical, ethical, and public health concerns that lead us to argue (...) the declaration should be rescinded. The ethically objectionable declaration provides valuable lessons concerning how to uphold both reproductive and disability justice in a post-Dobbs landscape. (shrink)

The question of whether a patient has insight is among the first to be considered in psychiatric contexts. There are several competing conceptions of clinical insight, which broadly refers to a patient’s awareness of their mental illness. When a patient is described as lacking insight, there are significant implications for patient care and to what extent the patient is trusted as a knower. Insight is currently viewed as a multidimensional and continuous construct, but competing conceptions of insight still lack consensus (...) on the specifics. Studies also give contradictory evidence regarding the frequency and consequences of poor insight. A number of crucial questions remain unanswered. After outlining some of the key theoretical disagreements about what insight means, I highlight ethical issues that have not received much attention in the literature. Given the conceptual ambiguities and the absence of standardised bedside tools, there are significant ethical concerns about insight assessments. I highlight two main ethical concerns, specifically that these assessments risk: marginalising patients by setting unattainable ideals for self-knowledge and minimising the patient’s own perspective on their mental health. I close with recommendations for documenting and responding to concerns about poor insight, so patients who are vulnerable to losing epistemic trust are better supported in their therapeutic relationships. (shrink)

Robert Veatch’s The Foundations of Justice: Why the Retarded and the Rest of Us Have Claims to Equality delves into deep questions of justice through the case of a child with disabilities. I describe what is basically right about this vision, as well as what is problematic from the standpoint of contemporary disability bioethics. From there, I dive into the notion of vulnerability that is at play in his work. He describes disability as necessarily a condition of weakness, lesser-than existence, (...) and neediness. When disability is viewed in this way as an inherently vulnerable state of being, the essential sociopolitical dimensions of disability receive inadequate attention, which, in turn, makes it impossible to identify injustices correctly. I connect these points to concrete challenges faced by disability communities during the COVID-19 pandemic, which have raised profound questions about the just use of scarce critical care resources. Any case drawn from the pandemic is a very different kind of case than that of the child in Veatch’s book, but a commonality is the question of who should get what limited resources when needs and urgency vary. (shrink)

Thomas Reid was a philosopher who founded the Scottish school of 'common sense'. Much of Reid's work is a critique of his contemporary, David Hume, whose empiricism he rejects. In this work, written after Reid's appointment to a professorship at the university of Glasgow, and published in 1785, he turns his attention to ideas about perception, memory, conception, abstraction, judgement, reasoning and taste. He examines the work of his predecessors and contemporaries, arguing that 'when we find philosophers maintaining that (...) there is no heat in the fire, nor colour in the rainbow … we may be apt to think the whole to be only a dream of fanciful men, who have entangled themselves in cobwebs spun out of their own brain'. Written by one of the Scottish Enlightenment's most important thinkers, this work brings to life the intellectual debates of the time. (shrink)

Although research into the biosemiotic mechanisms underlying the purposeful behavior of brainless living systems is extensive, researchers have not adequately described biosemiosis among neurons. As the conscious use of signs is well-covered by the various fields of semiotics, we focus on subconscious sign action. Subconscious semiotic habits, both functional and dysfunctional, may be created and reinforced in the brain not necessarily in a logical manner and not necessarily through repeated reinforcement. We review literature that suggests hypnosis may be effective in (...) changing subconscious dysfunctional habits, and we offer a biosemiotic framework for understanding these results. If it has been difficult to evaluate any psychological approach, including hypnosis, this may be because contemporary neuroscience lacks a theory of the sign. We argue that understanding the fluid nature of representation in biological organisms is prerequisite to understanding the nature of the subconscious and may lead to more effective of treatments for dysfunctional habits developed through personal experience or culture. (shrink)

In response to Anne L. Dalle Ave and David M. Shaw, we agree with their general argument but emphasize a moral risk of HIV disclosure in deceased donation cases: the risk of relational rupture. Because of the importance that close relationships have to our sense of self and our life plans, this kind of rupture can have long-ranging implications for surviving loved ones. Moreover, the now-deceased individual cannot participate in any relational mending. Our analysis reveals the hefty moral costs that (...) disclosure can bring, which should influence what information is given to wouldbe donors and how organ procurement coordinators approach these conversations. (shrink)

Thomas Aquinas produced a voluminous body of work on moral theory, and much of that work is on virtue, particularly the status and value of the virtues as principles of virtuous acts, and the way in which a moral life can be organized around them schematically. Thomas Osborne presents Aquinas's account of virtue in its historical, philosophical and theological contexts, to show the reader what Aquinas himself wished to teach about virtue. His discussion makes the complexities of Aquinas's (...) moral thought accessible to readers despite the differences between Thomas's texts themselves, and the distance between our background assumptions and his. The book will be valuable for scholars and students in ethics, medieval philosophy, and theology. (shrink)

The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise the (...) variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time. (shrink)

How can social institutions complicate and worsen vulnerabilities of particular individuals or groups? We begin by explicating how certain diagnoses within mental health and medicine operate as interactive kinds of labels and how such labels can create institutional barriers that hinder one's capacity to achieve wellbeing. Interactive-kind modeling is a conceptual tool that elucidates the ways in which labeling can signal to others how the labeled person ought to be treated, how such labeling comes about and is perceived, and how (...) it compounds vulnerabilities. We argue that this shift in standpoint helps us recognize and mitigate compounded vulnerabilities. (shrink)

In this issue of the Hastings Center Report, Jason Wasserman and Mark Navin argue that patients without decisional capacity can still have relatively stable wishes or inclinations toward one treatment option over another and that these preferences are “not devoid of moral weight and might therefore guide or at least influence treatment decisions when they cannot be defeated by other considerations.” This position is not controversial among most bioethicists. The hard work comes in sussing out the details of this position. (...) How much moral weight do these preferences have? When should preferences be defeated by other considerations? How should we identify actual preferences, and how should preferences be differentiated and weighed against one another? (shrink)

Baby A1 was born prematurely with severe encephalopathy, injured brainstem, and a potentially injured spinal cord. He had no response to pain or other external stimuli. The neonatal team unanimousl...