McCullough and colleagues draw an historical line from the writings of Percival, who found himself resolving arguments (sometimes violent) between physicians, surgeons and apothecaries, to the concept of civility as a professional virtue and duty. The authors show that civility is a prerequisite to effective cooperation, which itself underpins patient safety and positive clinical outcomes—desirable endpoints of any discussion about healthcare. They exhort academic leaders to teach, role model and reward correct behaviours.1 Why then, as a clinician manager with a (...) deep interest in fostering civility and psychological safety, am I not satisfied? Three reasons: the paper does not adequately explore the reasons why, its focus is largely restricted to academic institutions, and it does not encompass the non-clinical workforce; as a result, its proposed solutions appear ungrounded. Why are ‘good people’, who were attracted to careers that demand altruism and empathy, uncivil in the workplace? What are the competing goals that result in curt, disrespectful or downright rude exchanges? This has been studied. Leape et al concluded that endogenous factors such as personality, insecurity, anxiety, depression, narcissism and responses to prior …. (shrink)

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

In cases of sudden, life-threatening illness where the chance of survival appears negligible to the admitting physician, this opinion is not always revealed during the initial meeting with the patient's relatives. Reasons as to why this withholding of the truth may be acceptable are explored through review of available evidence and personal reflection. Factors identified include: the importance of hope in families' coping mechanisms, and the instinct to preserve it; the fallibility of physicians' perception of poor prognosis in the early (...) phase of illness; the need to avoid large swings in relatives' expectations that occur when patients appear to rally during initial resuscitation; and the adverse effect that an atmosphere of hopelessness can have on the provision of medical care. A strategy for the staged disclosure of information and the confirmation of hopelessness is then described, the aim being to find a compromise between providing a true opinion about a patient's prognosis, and regard for the opposing factors described. (shrink)

Philip Berry examines the case of euthanasia from very close emotional range.

Patient autonomy and distributive justice are fundamental ethical principles that may be at risk in liver transplant units where decisions are dictated by the need to maximise the utility of scarce donor organs. The processes of patient selection, organ allocation and prioritisation on the wait list have evolved in a constrained environment, leading to high levels of complexity and low transparency. Regarding paternalism, opaque listing and allocation criteria, patient factors such as passivity, guilt, chronic illness and sub-clinical encephalopathy are cited (...) as factors that may inhibit patient engagement. Regarding justice, established regional, gender and race based inequities are described. The paradox whereby hepatologists both advocate for individual patients and discharge their duty of stewardship to apportion organs according to larger utilitarian principles is explored. Competing subjective factors such as physicians’ perception of moral responsibility, the qualitative nature of expert medical assessment and institutional or personal loyalty to re-transplantation candidates are described. Realistic limits of self-determination and justice are discussed, and possible future directions in terms of patient involvement proposed. (shrink)

Assisted dying (AD) has not been legalized despite a number of presentations to parliament. It is necessary for doctors who support AD to justify themselves in the context of repeated legislative failure. This article describes the author's personal approach to the problem, one that prioritizes respect for autonomy above legal or societal objections. It is argued that for debilitated patients, the preservation of autonomy depends on a doctor's empathy and willingness to advocate. This sequence can be interrupted by externally and (...) internally imposed barriers. External factors include indiscriminate respect for the law and society's institutions, an inaccurate perception of the balance of risks to society and insufficient compensation for the dying person's inability to mount a sustained challenge. Internal brakes to advocacy such as elevation of personal morality above the needs of patients, attenuation of the therapeutic relationship in cases of moral complexity and the temptation to abdicate the role of physician are also explored. It is concluded that if AD could in theory be of benefit to a patient, but cannot be achieved due to its illegality, doctors have a duty to actively represent their demands as they would for other forms of treatment. (shrink)

Cardiopulmonary resuscitation is frequently performed on patients who, in retrospect, had a very low chance of survival. This is because all patients are ‘For cardiopulmonary resuscitation’ on admission to hospital by default, and delays occur before cardiopulmonary resuscitation can be ‘de-prescribed’. This article reviews the nature of potential harms caused by futile cardiopulmonary resuscitation, the reasons why de-prescription may be delayed, recent legal judgements relevant to timely do not attempt cardiopulmonary resuscitation decision making, and the possible detrimental effects of do (...) not attempt cardiopulmonary resuscitation discussions on end of life care. The moral and operational feasibility of a model in which informed consent must be obtained before cardiopulmonary resuscitation is attempted in some patient groups is then explored. (shrink)

Due to the ethical breaches of tobacco companies over a 50-year period, a U.S. Court ruled in United States v. Philip Morris USA, Inc. that major U.S. tobacco companies had misled consumers and the government about tobacco’s addictiveness, effects of environmental smoke, marketing targeted at adolescents, and deceptive practices related to harmfulness of smoking. We address the actions of the tobacco companies based on the consumer’s right to be informed and values for ethical corporate behavior, and we draw from (...) psychological theories and the smoking literature to develop our conceptual framework and test the effectiveness of the ensuing corrective advertising campaign mandated in the Court decision. We use a quota sample of 470 smokers and non-smoker participants in a longitudinal study to test the impact of the corrective advertising campaign on key antismoking beliefs from the campaign. Results reveal that the corrective ad campaign has not been successful in affecting smokers’ or non-smokers’ antismoking beliefs. However, differences are found between smokers’ and non-smokers’ beliefs about the adverse health effects of smoking, effects of secondhand smoke, and tobacco company deceptiveness, with these beliefs being stronger for non-smokers. Smokers’ weaker beliefs about the effects of secondhand smoke are viewed as particularly problematic, given the established health risks. We address the implications of the ethical breaches and the corrective advertising attempt to address the deception identified by the Court. (shrink)

In many ways set theory lies at the heart of modern mathematics, and it does powerful work both philosophical and mathematical – as a foundation for the subject. However, certain philosophical problems raise serious doubts about our acceptance of the axioms of set theory. In a detailed and original reassessment of these axioms, Sharon Berry uses a potentialist approach to develop a unified determinate conception of set-theoretic truth that vindicates many of our intuitive expectations regarding set theory. Berry (...) further defends her approach against a number of possible objections, and she shows how a notion of logical possibility that is useful in formulating Potentialist set theory connects in important ways with philosophy of language, metametaphysics and philosophy of science. Her book will appeal to readers with interests in the philosophy of set theory, modal logic, and the role of mathematics in the sciences. (shrink)

In management research, theory testing confronts a paradox described by Meehl in which designing studies with greater methodological rigor puts theories at less risk of falsification. This paradox exists because most management theories make predictions that are merely directional, such as stating that two variables will be positively or negatively related. As methodological rigor increases, the probability that an estimated effect will differ from zero likewise increases, and the likelihood of finding support for a directional prediction boils down to a (...) coin toss. This paradox can be resolved by developing theories with greater precision, such that their propositions predict something more meaningful than deviations from zero. This article evaluates the precision of theories in management research, offers guidelines for making theories more precise, and discusses ways to overcome barriers to the pursuit of theoretical precision. (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)

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.

The intellectual history of Germany in the late eighteenth and nineteenth centuries is sometimes compared to the philosophical achievement of Athens at the very height of the classical age. Both were tremendously fruitful periods, which saw the birth of revolutionary philosophical systems that inspired a fantastic intellectual commerce among new and rival schools of thought. The plenitude of references to Greek mythology in literary works from Goethe and Lessing to Schiller, Novalis, and Hölderlin; the burgeoning interest in classical philology and (...) the translation and transmission of works of antiquity; and the growing interest in the history of skepticism in ancient Greece; all are instances of a widespread preoccupation with Hellenic thought and culture that persisted throughout the nineteenth and into the twentieth century. The intellectual associations between many seminal thinkers during this time make it easy to trace the transmission of this enthusiasm from one figure or group to another. (shrink)

By illuminating the striking affinity between the most innovative aspects of postmodern thought and religious mystical discourse, Shadow of Spirit challenges the long established assumption that western thought is committed to nihilism. This collection of essays by internationally recognized scholars explores the implications of the fascination with the "sacred," "divine" or "infinite" which characterizes much contemporary thought. It shows how these concerns have surfaced in the work of Derrida, Baudrillard, Lyotard, Kristeva, Irigaray and others. Examining the connection between this postmodern (...) "turn" and the current search for a new discourse of ethics and politics, it also stresses the contribution made by feminist thought to this unexpected intellectual direction. (shrink)

Advocates of “Mendelism” early on stressed the usefulness of Mendelian principles for breeders. Ever since, that usefulness—and the favourable opinion of Mendelism it supposedly engendered among breeders—has featured in explanations of the rapid rise of Mendelian genetics. An important counter-tradition of commentary, however, has emphasized the ways in which early Mendelian theory in fact fell short of breeders’ needs. Attention to intellectual property, narrowly and broadly construed, makes possible an approach that takes both the tradition and the counter-tradition seriously, by (...) enabling a more complete description of the theory-reality shortfall and a better understanding of how changing practices, on and off the Mendelians’ experimental farms, functioned to render that shortfall unproblematic. In the case of plant breeding in Britain, a perennial source of lost profits and disputes over ownership was the appearance of individual plants departing from their varietal types—so-called “rogues.” Mendelian plant varieties acquired a reputation for being rogue-free, and so for demonstrating the correctness of Mendelian principles , at a time when Mendelians were gradually taking control of the means for distributing their varieties. Mendelian breeders protected their products physically from rogue-inducing contamination in such a way that when rogues did appear, the default explanation—that contamination had somehow occurred—ensured that there was no threat to Mendelian principles. (shrink)

Presents general information about meteorology, weather, and climate and includes more than thirty activities to help study these topics, including making a ...

The impact of Nietzsche's engagement with the Greek skeptics has never before been systematically explored in a book-length work - an inattention that belies the interpretive weight scholars otherwise attribute to his early career as a professor of classical philology and to the fascination with Greek literature and culture that persisted throughout his productive academic life. Jessica N. Berry fills this gap in the literature on Nietzsche by demonstrating how an understanding of the Pyrrhonian skeptical tradition illuminates Nietzsche's own (...) reflections on truth, knowledge, and ultimately, the nature and value of philosophic inquiry. This entirely new reading of Nietzsche's epistemological and ethical views promises to make clear and render coherent his provocative but often opaque remarks on the topics of truth and knowledge and to grant us further insight into his ethics-since the Greek skeptics, like Nietzsche, take up the position they do as a means of promoting well-being and psychological health. In addition, it allows us to recover a portrait of Nietzsche as a philologist and philosophical psychologist that has been too often obscured by commentaries on his thought. "The book addresses a number of central issues in Nietzsche's philosophy, including perspectivism and his conception of truth. The idea that his views in these areas owe much to the ancient Pyrrhonists casts them in an important new light, and is well supported by the texts. A lot of people from a lot of different areas in philosophy will have good reason to take notice." - Richard Bett, Johns Hopkins University. (shrink)

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.

Analysis of sites of newly integrated DNA in cellular genomes is important to several fields, but methods for analyzing and visualizing these datasets are still under development. Here, we describe tools for data analysis and visualization that take as input integration site data from our INSPIIRED pipeline. Paired-end sequencing allows inference of the numbers of transduced cells as well as the distributions of integration sites in target genomes. We present interactive heatmaps that allow comparison of distributions of integration sites to (...) genomic features and that support numerous user-defined statistical tests. To summarize integration site data from human gene therapy samples, we developed a reproducible report format that catalogs sample population structure, longitudinal dynamics, and integration frequency near cancer-associated genes. We also introduce a novel summary statistic, the UC50, which provides a single number summarizing possible clonal expansion. Using these tools, we characterize ongoing longitudinal characterization of a patient from the first trial to treat severe combined immunodeficiency-X1, showing successful reconstitution for 15 years accompanied by persistence of a cell clone with an integration site near the cancer-associated gene CCND2. Software is available at https://github.com/BushmanLab/INSPIIRED. (shrink)

There are many touch points between the work of Jacques Derrida and René Girard. To me, as a student of literature, these two writers particularly stand out as great readers or great exegetes.1 The way they handle and combine texts, the way they dare to break with reading conventions, has proved to be really fruitful.Some time ago I watched a documentary about Derrida, made by Kirby Dick and Amy Ziering Kofman, published in 2002, carrying the simple title Derrida.2 I found (...) that this experimental documentary at the same time reflected Derrida’s many reservations, not to say his skepticism, as to the possibility of making portraits—and—proved to be far more revealing, even intimate, than a conventional documentary... (shrink)

Next SectionAn attempt to resolve the controversy regarding the solution of the Sleeping Beauty Problem in the framework of the Many-Worlds Interpretation led to a new controversy regarding the Quantum Sleeping Beauty Problem. We apply the concept of a measure of existence of a world and reach the solution known as ‘thirder’ solution which differs from Peter Lewis’s ‘halfer’ assertion. We argue that this method provides a simple and powerful tool for analysing rational decision theory problems.

_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.

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)

The way a rational agent changes her belief in certain propositions/hypotheses in the light of new evidence lies at the heart of Bayesian inference. The basic natural assumption, as summarized in van Fraassen's Reflection Principle, would be that in the absence of new evidence the belief should not change. Yet, there are examples that are claimed to violate this assumption. The apparent paradox presented by such examples, if not settled, would demonstrate the inconsistency and/or incompleteness of the Bayesian approach, and (...) without eliminating this inconsistency, the approach cannot be regarded as scientific. The Sleeping Beauty Problem is just such an example. The existing attempts to solve the problem fall into three categories. The first two share the view that new evidence is absent, but differ about the conclusion of whether Sleeping Beauty should change her belief or not, and why. The third category is characterized by the view that, after all, new evidence is involved. My solution is radically different and does not fall into either of these categories. I deflate the paradox by arguing that the two different degrees of belief presented in the Sleeping Beauty Problem are in fact beliefs in two different propositions, i.e., there is no need to explain the change of belief. The Sleeping Beauty Problem The Problem Deflated 2.1 From contradiction to consistency 2.2 The inanimate version 2.3 Back to SB Summary CiteULike Connotea Del.icio.us What's this? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Pyrrhonian Revival in Montaigne and NietzscheJessica N. BerryMichel de Montaigne occupies a unique place in Nietzsche's history of ideas. He is one of a very few figures for whom Nietzsche expresses deep admiration and about whom he has virtually nothing critical to say. This is a rare enough mark of distinction; but contrary to what it might lead us to expect, the relationship between Montaigne and Nietzsche has (...) seldom been carefully examined. There has yet to be a book-length study devoted solely to Montaigne and Nietzsche,1 and article-length treatments of the relationship between their works and thought have been surprisingly scarce. What discussions there have been tend to locate the connections between Nietzsche and Montaigne mainly in matters of either literary or personal style,2 but studies that examine Montaigne's influence on Nietzsche with an eye toward philosophical rather than literary or stylistic issues have been almost non-existent.3 This dearth of treatments can be explained, at least in part, by the fact that, while Montaigne is rightly recognized for the literary merits of his work and for its subsequent influence on later prose stylists (and not only in French), his work on the whole has seldom been appreciated as having any philosophical value in its own right. Small wonder, then, that the connection between Montaigne and Nietzsche has [End Page 497] appeared more significant to commentators on Montaigne who are interested in tracing his influence on later thinkers than to scholars of Nietzsche—even those Nietzsche scholars who take an acute interest in his intellectual heritage. What I will argue here is that Montaigne makes a more concrete and philosophically more substantive contribution to Nietzsche's thought than has generally been appreciated; specifically, by giving impetus to the naturalism that develops in Human, All Too Human as an antidote to Schopenhauer's pessimistic metaphysics of will.In this essay, I present a two-fold thesis about Montaigne's influence on Nietzsche's early work. First, I will argue that the "naturalistic turn" in Human, All Too Human reflects Nietzsche's engagement with Montaigne during a crucial moment in the development of his thought. Second, I will demonstrate that the naturalism Nietzsche adopts from Montaigne has roots in the tradition of Pyrrhonian skepticism that Montaigne carries forward into the Renaissance. In the end, a better understanding of the skeptical ancestry of Nietzsche's naturalism should help us make better sense of Human, All Too Human and its immediate successors in Nietzsche's oeuvre, which cultivate what otherwise seems to be an uneasy partnership between naturalism and skepticism.I. It is by now widely accepted that Nietzsche's estimation of the value of the techniques and methods of the natural sciences undergoes radical revision in the period culminating in the first volume of Human, All Too Human (HAH),4 a book sometimes described as inaugurating a "positivist" phase in Nietzsche's work. From the first of its nine major sections, "Of First and Last Things," HAH narrates a struggle between science on the one hand and philosophy on the other. It is important to note the breadth of the extension of the term "science" (Wissenschaft), which includes not only what we think of as the "hard" or physical sciences (physics, chemistry, and the like) but also areas of inquiry we now consider "behavioral sciences" such as psychology and sociology—and, Nietzsche would say, philology as well. "Philosophy," by contrast is specified more narrowly. As Nietzsche uses the term throughout HAH, "philosophy" is usually shorthand for "metaphysical philosophy" and singles out for criticism the discourse of metaphysics that has dominated the philosophical landscape at least since Plato.In the sense in which Nietzsche worries about it "metaphysical philosophy" promotes speculation about such supra-sensible entities as Platonic forms, Descartes's "immaterial substances," and Kantian things-in-themselves. That its contributions include, for instance, theories about the existence and immortality of the soul accounts for Nietzsche's grouping "metaphysical philosophy" [End Page 498] together with religion and art as "arts of narcosis."5 Consciously or not they endeavor to comfort us by assuaging our fear of death, our existential anxieties about the purposelessness of... (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)

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)

Can groups be rational agents over and above their individual members? We argue that group agents are distinguished by their capacity to mimic the way in which individual agents act and that this capacity must “supervene” on the group members' contributions. But what is the nature of this supervenience relation? Focusing on group judgments, we argue that, for a group to be rational, its judgment on a particular proposition cannot generally be a function of the members' individual judgments on that (...) proposition. Rather, it must be a function of their individual sets of judgments across many propositions. So knowing what the group members individually think about some proposition does not generally tell us how the group collectively adjudicates that proposition: the supervenience relation must be “setwise,” not “proposition‐wise.” Our account preserves the individualistic view that group agency is nothing mysterious but also suggests that a group agent may hold judgments that are not directly continuous with its members' corresponding individual judgments. (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.