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)

We describe the educational character and leadership development processes used by the United States Air Force Academy that other educational institutions may find useful. Our processes include an integrated educational curriculum designed to complement and integrate the experiential learning that results in achieving specific organizational outcomes, co-curricular activities in cadet living, and a specific focus on the ethical development of leaders’ respect for human dignity and cultural competency as well as the mechanisms to assess and refine our processes.

In lieu of an abstract, here is a brief excerpt of the content: Canti VI, Bruto Minore GIACOMO LEOPARDI (Translated by Steven J. Willett) To Peter Green After Italian Valor, lying in Thracian dust an immense ruin, had been uprooted, then in the valleys of green Hesperia, on Tiber’s shore, Fate prepares the tramp of barbarian horse, and from naked forests oppressed by the freezing Bear, calls forth the Gothic swords to overthrow Rome’s renowned walls; sitting alone, (...) soaked in brothers’ blood, through black night in a desolate site, Brutus is determined to die, and the implacable gods and Hell itself he accuses with savage cries and strikes the somnambulant air in vain. Fatuous Valor, the empty mists, the fields of unquiet phantoms are your schools, and behind you strides remorse. To you, marmoreal gods, (whether you reside in Phlegethon or the clouds), to you a laughingstock and mockery is the miserable race from whom you extort temples and a fraudulent law insulting to mortals. Is heaven’s wrath, then, so provoked by terrestrial piety? and do you then sit, Jove, impiety’s protector? and when storm clouds exult through the air, and when arion 27.1 spring/summer 2019 you hurl the swift thunderbolt, do you cast the sacred fire on the just and faithful? Invincible destiny and iron necessity crush the sickly slaves of death: and if nothing avails to end their indignities, the common man takes comfort in their necessity. Is the evil without cure less harsh? Does he feel no grief who’s stripped naked of hope? War to the death, eternal, o ignoble fate, the valorous man wages, incapable of surrender; and your tyrannical right hand, victorious as it bears him down, indomitable he shrugs off with a valiant show, when in his noble side the bitter blade runs with blood, and malignly he smiles at the darkening shadows. He displeases the gods who violently breaks into Tartarus. No such courage could be found in their feeble, eternal breasts. Perhaps our torments, perhaps our bitter accidents and wretched passions heaven created as a pleasing spectacle for their idle hours? Not between calamities and crimes, but free in the forests and pure Nature appointed us, once our queen and goddess. But since on earth impious custom has destroyed the blessed realms and subjected our miserable life to other laws; when a virile soul rejects his luckless days does Nature return, and accuse the arrow that’s not hers? 166 CANTI VI, bruto minore Ignorant of guilt and their own misfortunes are the fortunate beasts; serene old age guides them to an unforeseen passage. But if they dash their foreheads on rough tree-trunks or from a mountain cliff cast bodies headlong to the winds, moved by their anguish, against that miserable desire would stand no arcane law or shadowy conception. You alone, among the numerous progeny that heaven created, alone among all, children of Prometheus, regret life. Alone o wretched ones, to you Jove bans, if sluggish fate delays, the shores of death. And you, from the sea stained by our blood, you rise bright moon, and explore the unquiet night and the deadly battlefield of Italian Valor. The victor tramples on kinsmen’s breasts, the hills shudder, from her highest summits ancient Rome collapses— and are you so placid? You saw the birth of Lavinia’s offspring, and their years of happiness, and the memorable victories; and on the mountain peaks you pour your immutable silent light when, in the wreck of the servile Italian name, this solitary place will echo beneath the barbarian tramp. Giacomo Leopardi 167 Here among naked rocks or on green boughs, beast and bird, breasts heavy with their habitual oblivion, ignore the profound ruin and the altered destiny of the world: and as the rooftop of the industrious peasant first glows red, with its morning song the one will wake the valleys, while through high slopes the other will startle the helpless multitude of smaller creatures. Oh destiny! oh insensate race! we are an abject part of things; neither the bloodstained soil nor the howling caves has our calamity ever perturbed, and no human cares stain the stars. Neither to Olympus’ or Cocytus’ deaf kings, or to the unworthy earth, and... (shrink)

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.

In lieu of an abstract, here is a brief excerpt of the content:Open Letter to the Enemy:Jean Genet's Holy WarSteven Miller (bio)J.G. seeks, or is searching for, or would like to discover, never to uncover him, the delicious enemy, quite disarmed, whose equilibrium is unstable, profile uncertain, face inadmissible, the enemy broken by a breath of air, the already humiliated slave, ready to throw himself out the window at the least sign, the defeated enemy: blind, deaf, mute. With no arms, (...) no legs, no stomach, no heart, no sex, no head, all told a complete enemy, already bearing all the marks of my bestiality that now need never be used (too lazy anyway). I want the total enemy, with immeasurable and spontaneous hatred for me, but also the subjugated enemy, defeated by me before he even knows me. Not to be reconciled with me, in any case. No friends. Above all, no friends: a declared enemy, but not a tortured one. Clean, faultless. What are his colors? From a green as tender as a cherry to an effervescent violet. His size? Between the two of us, he presents himself to me man to man. No friends. I seek an inadequate enemy, one who comes to capitulate. I will come at him with all that I can muster: whacks, slaps, kicks, I will feed him to starving foxes, make him eat English food, attend the House of Lords, be received at Buckingham Palace, fuck Prince Phillip, and be fucked by him, live for a month in London, dress like me, sleep in place of me, live in place of me: I seek the declared enemy.This brief text was not published until 1991. It was almost published in 1975 in a book of homages to William Burroughs and Brion Gysin, and was to have been preceded with the following explanation of its origins, written by Gysin:In Tangiers in 1970, Jean Genet asked me what ever happened to the English underground newspaper The International Times. When I responded that the editors were having trouble with the law in England because of the newspaper's ads for "special friendships" [amitiés particulières], he exclaimed: "Why friends? Personally, I am looking for a suitable enemy [un ennemi à ma taille]." He then wrote the following text...[qtd. in Genet, ED 9]Hence the anecdotal reason for the form of the personal advertisement. In 1991 the text was published—according to Genet's wishes—as the first page of the posthumous collection of his political writings and interviews, L'ennemi déclaré.1 Such a placement demands more than an anecdotal explanation. What is a personal ad doing as the preface to a collection of political writings? Albert Dichy, the editor of the collection, notes that this text has the status of an exception: "the text that opens the collection does not belong to the group of writings that make up the book as a whole" [ED 331]. Each of the other texts emerges from Genet's involvement in specific political events (the [End Page 85] 1968 Chicago Democratic National Convention, the Chatila massacre) or with named political figures and groups (the Palestinians, the Black Panthers, the Baader-Meinhof group, George Jackson, Angela Davis), whereas the form of the ad that he wrote for Gysin seems to number it among his literary works. Nonetheless, this eccentric text remains the first in the collection—"en tête de l'ouvrage," is Dichy's phrase—and gives the book its title. Rather than serving as an introduction to the other texts, this text, by virtue of its exceptional form, is a challenge addressed directly to the public. Dichy himself is the first to accept this challenge. His editorial notice passes quickly from anecdote to interpretation:The fact that Genet wished to see the publication of his political articles preceded by this precise text has an unavoidable impact, not only on the identity of the author, now partially assimilable to a fictional character ("J.G. cherche, ou recherche..."), but also on the way in which we read the different texts in the collection, now that we have been given the general tone and the note of secrecy.[ED 331]These suggestions are apt enough... (shrink)

The reality of truth -- The reality of truth in a fallen world -- The reality of truth in the inerrant word -- The reality of truth in the written word -- The reality of truth in the exclusive Gospel -- The rejection of truth -- The rejection of truth by the first couple -- The rejection of truth by an unbelieving age -- The rejection of truth by a worldly church -- The rejection of truth in the Christian's life (...) -- The reign of truth -- The reign of truth in the expository pulpit -- The reign of truth in a believer's walk -- The reign of truth in the highest worship -- The reign of truth in the final judgment. (shrink)

Sensation -- Skepticism -- Internal senses -- The emotions -- Mechanism -- Materialism and dualism -- Hylomorphism -- The problem of universal knowledge -- Reason -- Immortality -- Freedom -- The will -- Free decision -- Purpose.

Behavioral scientists routinely publish broad claims about human psychology and behavior in the world's top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers – often implicitly – assume that either there is little variation across human populations, or that these “standard subjects” are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is (...) substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species – frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior – hence, there are no obviousa priorigrounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions ofhumannature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges. (shrink)

Prof. Steven Klees draws on 45 years of worldwide analysis as an economist and international educator to paint a detailed picture of conservative, liberal, and progressive views on a wide range of social issues.

The leading models of disability struggle to fully encompass all aspects of “disability.” This difficulty arises, the author argues, because the models fundamentally misunderstand the nature of disability. Current theoretical approaches to disability can be understood as “nounal,” in that they understand disability as a thing that is caused or embodied. In contrast, this paper presents an adverbial perspective on disability, which shows that disability is experienced as a personally irremediable impediment to daily-living tasks or goals-like-ours. The picture theory of (...) disability technically constitutes a species of relational approach because its analysis references the interplay between an individual and their environment; it differs from other relational accounts, however, by interpreting disability as a certain kind of negative experience—rather than a function of that relationship. This purely descriptive theory makes no normative claims about disability and operates as both a mechanism for the evaluation of the experience of disability and a heuristic device for the proper interpretation of disability. When disability is reframed in this way, the theory offers a particularist perspective which shows if, when, where, and how disability is experienced. (shrink)

The problem -- The text -- Inclinations -- Good -- Nature -- The will -- Ought -- Obligation -- Principles -- Action.

Ethics and the good life -- Reason and the emotions -- Conscience and choice -- Loving and choosing -- Doing right and desiring right -- Virtue and the emotions -- Justice -- Injustice -- Intrinsically evil actions -- Virtue and truth -- Practical wisdom -- Ethics and knowledge -- Ethics and happiness.

The enigma of an evil will -- The order of actions to the ultimate end -- The satisfaction of desire -- Venial sin -- The first moral act -- The shared good -- Sins of passion -- Weakness of will -- Sins from an evil will -- Sins of ignorance -- Omissions -- The first cause of moral evil -- Compatibilism or libertarianism -- Free decision -- Choose life.

Behavioral scientists routinely publish broad claims about human psychology and behavior in the world's top journals based on samples drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies. Researchers – often implicitly – assume that either there is little variation across human populations, or that these “standard subjects” are as representative of the species as any other population. Are these assumptions justified? Here, our review of the comparative database from across the behavioral sciences suggests both that there is (...) substantial variability in experimental results across populations and that WEIRD subjects are particularly unusual compared with the rest of the species – frequent outliers. The domains reviewed include visual perception, fairness, cooperation, spatial reasoning, categorization and inferential induction, moral reasoning, reasoning styles, self-concepts and related motivations, and the heritability of IQ. The findings suggest that members of WEIRD societies, including young children, are among the least representative populations one could find for generalizing about humans. Many of these findings involve domains that are associated with fundamental aspects of psychology, motivation, and behavior – hence, there are no obviousa priorigrounds for claiming that a particular behavioral phenomenon is universal based on sampling from a single subpopulation. Overall, these empirical patterns suggests that we need to be less cavalier in addressing questions ofhumannature on the basis of data drawn from this particularly thin, and rather unusual, slice of humanity. We close by proposing ways to structurally re-organize the behavioral sciences to best tackle these challenges. (shrink)

Deterrence means threatening to retaliate against an attack in order to deter it in the first place. The central problem with a policy of deterrence is that the threat of retaliation may not be credible if retaliation leads to a worse outcome - perhaps a nuclear holocaust - than a side would suffer from absorbing a limited first strike and not retaliating. - The optimality of deterrence is analyzed by means of a Deterrence Game based on Chicken, in which each (...) player chooses a probability (or level) of preemption, and of retaliation if preempted. The Nash equilibria, or stable outcomes, in this game are compared with those in a Star Wars Game, in which the preemption and retaliation levels are constrained by the defensive capabilities of each side. Unlike threats in the Deterrence Game, which can always stabilize the cooperative outcome, mutual preemption emerges as an equilibrium in the Star Wars Game, underscoring the problem - particularly if defensive capabilities are unbalanced - that deterrence will be subverted by the development of Star Wars. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Elegia i.3 PROPERTIUS Translated by Steven J.Willett Just as she lay when Theseus’ keel was sliding seaward, the Cnossian maid languid on the desolate shore; just as Cepheus’ daughter reclined in her first slumber, Andromeda, now freed from jagged rocks; just as the Thracian bacchant, weary from incessant dancing, slumps on the grassy bank of the Apidanus; even so Cynthia seemed to breathe a soft repose, her head (...) pillowed on open unruly hands, when I came dragging footsteps wobbly with too much wine, the boys waving burnt-out torches in the late night. Against her I tried, not all my senses utterly derelict, to advance gently on the compliant couch; and, though seized by a double ardor—each was commanding me, love here and wine there, both implacable gods— to assault her by slipping my arm lightly beneath her body and with a hand advanced take kisses and arms, yet I lacked the courage to shatter my mistress’ repose, fearing the brawls whose savagery I’d tasted; so I remained standing there motionless with rapt eyes, like Argus at the strange sight of Io’s horns. And now I was untying the garlands from my forehead and placing them, Cynthia, around your temples; and now I was finding it pleasant to smooth your fallen tresses; then I was giving you stolen apples in hollow palms; but I was lavishing all these gifts on ungrateful sleep, gifts that often tumbled from your sloping lap; and every time you heaved a sigh stirring fitfully, arion 28.2 fall 2020 98 elegia 1.3 I froze, foolishly credulous of an empty sign, fearful that some dream was bringing you strange terrors, or some man was forcing you reluctantly to be his: until the moon drifting across the opposite windows, the meddling moon whose eyes incline to linger, drew her closely-lidded eyes open under its delicate beams. Then, her elbow propped on the soft couch, she asked: “Has another’s rejection finally brought you back to my bed, chucked out with the doors slammed in your face? Where have you squandered the long hours of my night, languid, alas for me, as the stars are waning? Oh, I pray that you may endure, you beast, such nights as you are always making poor me to suffer! Just now I was cheating sleep with purple yarn at the loom, and then, exhausted, with song on Orpheus’ lyre; and sometimes, quite desolate, I softly complained to myself of the long waits your outside loves often cost me. Till sleep with gentle wings brushed me down to oblivion. That was the last concern of all my tears.”... (shrink)

*Tackles the Thomistic debate surrounding the inherent good and evil of human actions*.

Naturalism - the thesis that all facts are natural facts, that is the facts that can be recognised and explained by a natural science - plays a central role in contemporary analytical philosophy. Yet many philosophers reject the claims of naturalism. The essays in this anthology explore the difficulties of naturalism by revealing the ambiguities surrounding it, as well as the tensions that exist among its critics.

Cutting a cake, dividing up the property in an estate, determining the borders in an international dispute - such problems of fair division are ubiquitous. Fair Division treats all these problems and many more through a rigorous analysis of a variety of procedures for allocating goods, or deciding who wins on what issues, when there are disputes. Starting with an analysis of the well-known cake-cutting procedure, 'I cut, you choose', the authors show how it has been adapted in a number (...) of fields and then analyze fair-division procedures applicable to situations in which there are more than two parties, or there is more than one good to be divided. In particular they focus on procedures which provide 'envy-free' allocations, in which everybody thinks he or she has received the largest portion and hence does not envy anybody else. They also discuss the fairness of different auction and election procedures. (shrink)

Abstract“Psychological essentialism” refers to our tendency to view the natural world as emerging from the result of deep, hidden, and internal forces called “essences.” People tend to believe that genes underlie a person’s identity. People encounter information about genetics on a regular basis, as through media such as a New York Times piece “Infidelity Lurks in Your Genes” or a 23andMe commercial showing people acquiring new ethnic identities as the result of their genotyping. How do people make sense of new (...) scientific findings that are inherently complex if they don’t have years of specialized training and education at their disposal? Given the substantial overlap between a lay understanding of genetics and lay intuitions about essences, we argue that, when most people are thinking about genes, they are not really thinking about genes in the complex ways that good scientists are. Combating people’s essentialist biases can be a formidable challenge. Although we have identified some promising results of trying to reduce people’s genetic essentialist tendencies, there is still much to learn about how these essentialist biases can be countered. It is important to help people understand genetic information so they are able make well‐informed decisions about their lives. (shrink)

The sexual citizenship of disabled persons is an ethically contentious issue with important and broad-reaching ramifications. Awareness of the issue has risen considerably due to the increasingly public responses from charitable organisations which have recently sought to respond to the needs of disabled persons—yet this important debate still struggles for traction in academia. In response, this paper continues the debate raised in this journal between Appel and Di Nucci, concurring with Appel’s proposals that sexual pleasure is a fundamental human right (...) and that access to sexual citizenship for the severely disabled should be publicly funded. To that endeavour, this paper refutes Di Nucci’s criticism of Appel’s sex rights for the disabled and shows how Di Nucci’s alternative solution is iniquitous. To advance the debate, I argue that a welfare-funded ‘sex doula' programme would be uniquely positioned to respond to the sexual citizenship issues of disabled persons. (shrink)

This report outlines the findings from a Delphi study designed to establish consensus on the definitions of cognitive style and learning style amongst an international style researcher community. The study yields long-needed definitions for each construct that reflect high levels of agreement. In a field that has been criticised for a bewildering array of definitions and a proliferation of terms and concepts, this study represents an important step to address confusion in the meaning of the two terms. New researchers interested (...) in styles are encouraged to draw on these definitions when developing new research agendas aimed at deepening our understanding of style as a core construct in educational psychology. (shrink)

In a study of the kin investment of aunts and uncles we show that the laterality effect expected as a result of paternity uncertainty is statistically reliable but somewhat smaller than the sex effect. Matrilateral aunts invest significantly more than patrilateral aunts, and the same is true for uncles. Regardless of laterality, however, aunts invest significantly more than uncles. Multivariate controls show that the matrilateral bias is fully independent of any age or distance confounds that might result from sex differences (...) in age at marriage or dispersal. We discuss our results in relation to recent findings on the kin investment of grandparents (Euler and Weitzel 1996). In addition, we propose a simple method for estimating the level of paternity uncertainty from kin investment data; application of this method to our data on aunts and uncles suggests that between 13% and 20% of children are not the offspring of their putative father. Our parallel analyses of Euler and Weitzel’s (1996) data on grandparental investment suggest a similar estimate, that paternity uncertainty lies between 9% and 17%. (shrink)

In March 2015, the Dag Hammarskjöld Foundation convened a workshop in Uppsala, Sweden to address questions about antibiotic resistance, in partnership with the Global Strategy Lab, the Journal of Law, Medicine & Ethics, the Norwegian Institute of Public Health, and ReAct – Action on Antibiotic Resistance. Eleven concise articles were commissioned to explore whether ABR depended on global collective action, and if so, what tools could help states and non-state actors to achieve it. This article introduces that collection, which is (...) found in an online-only symposium at aslme.org. (shrink)