In June 2001, the American Medical Association (AMA) issued a revised and expanded version of the Principles of Medical Ethics (last published in 1980). In light of the new and more comprehensive document, the present essay is geared to consideration of a longstanding tension between physician's autonomy rights and societal obligations in the AMA Code. In particular, it will be argued that a duty to treat overrides AMA autonomy rights in social emergencies, even in cases that involve personal risk to (...) physicians (e.g., bioterrorist attack, HIV infection, SARS). The argument will be made by way of the logic and language of the AMA Code through its history, commentaries, and precedents. It also will be shown that there are substantial reasons to believe that the logic of the Code is sound in morally relevant ways. The essay will conclude with some philosophical proposals suggesting a framework for the duty to render aid and the extension of those duties to physicians facing personal risks. (shrink)

Trust relations in medicine are argued to be a requisite response to the special vulnerability of persons as patients. Even so, the problem of motivating trust remains a vital concern. On this score, it is argued that a strong motivation can be found in recognizing that professional self-interest actually entails cultivation of patient trust as a means to maintain professional self-governance. And while the initial move to restore trust must be provoked from such narrow concerns, the process of sustaining trust (...) will require educational initiatives aimed at restoring attitudes and skills suggestive of Percival's concept of empathic care. By including such initiatives, future waves of medical professionals are apt to sustain trust with deepened commitments to character, care, and trust as constitutive properties of their professional mission. (shrink)

As the issue of assisted dying continues toward more expanded legal standing, we shift our primary focus from questions of patients' rights to the largely overlooked challenges that face physicians who elect to assist patients in ending their lives. Dr. Howard Grossman, a Manhattan internist and plaintiff in the unsuccessful New York lawsuit to the Supreme Court, came forward to say, “Anybody who has done it knows that it is a tremendous decision that you carry with you forever.”1 We focus (...) our attention on the psychological experience and philosophical conflicts faced by physicians engaged in physician-assisted dying. Based on those potential conflicts, we argue for a new model of the physician and patient relationship in assisted dying: a medical friendship. a. (shrink)

In this paper I will argue that in emergency cases, physician autonomy is soci-etally constrained under Principle VI of the American Medical Association's “Principles of Medical Ethics”1 The issue will be seen to turn on whether the contextual use of “emergency” should be construed narrowly or broadly; I argue for a broadened rendering. Although a societal emergency is not defined here, I recommend that the condition of inner city healthcare presents a paradigm “patient” for such emergency care. I further urge (...) that because societal constraints on physician autonomy are ambiguous and only derived indirectly in the AMA document, further AMA comment on physician autonomy and societal responsibility would advance clarity on the profession's commitment to the public trust. (shrink)

In this essay it is shown that the imaginative art of scientific theorizing – at its technical best – animates Quine's philosophy as importantly as the more Spartan norms honored in his present pantheon of virtues. By drawing a contrast between the standing of theories in philosophy and theories in science, it will be shown that the speculative reaches of philosophy, along with developments in semantic theory, now oblige an internal revision of Quine's stance against meaning as it was announced (...) in “Two Dogmas of Empiricism.” So, corollary to this proposed revision, I argue that in natural philosophy, the muse of the “art of science” deserves an address along with the more Spartan norms in Quine's present philosophical pantheon. As semantic theory and analyticity thus gain a measure of philosophical tenability, Quine's holism emerges as the more central doctrine of his mature vision. (shrink)

In this essay it is shown that the imaginative art of scientific theorizing – at its technical best – animates Quine's philosophy as importantly as the more Spartan norms honored in his present pantheon of virtues. By drawing a contrast between the standing of theories in philosophy and theories in science, it will be shown that the speculative reaches of philosophy, along with developments in semantic theory, now oblige an internal revision of Quine's stance against meaning as it was announced (...) in “Two Dogmas of Empiricism.” So, corollary to this proposed revision, I argue that in natural philosophy, the muse of the “art of science” deserves an address along with the more Spartan norms in Quine's present philosophical pantheon. As semantic theory and analyticity thus gain a measure of philosophical tenability, Quine's holism emerges as the more central doctrine of his mature vision. (shrink)

It is true that Hegelian historicism has indeed led to a dominant ethos of moral relativism bound up with the belief that individual self-actualization is the highest value, thus creating a society that is, in the phrase of H. Tristram Engelhardt, Jr. “after God.” Nevertheless, this egocentric and nihilistic relativism exists alongside a robust and militant moral totalitarianism enforced by the modern clerisy of the media, multi-national corporations, and government bureaucrats, that is, a “managerial elite.” This article argues that the (...) transcendental idealism of Kant and the subsequent historicization of Kant’s dialectic by Hegel has served to reconceptualize the older, Baconian view of science, creating the idea that scientific progress is moving toward the goal of a future perfection of absolute rational unity. The a priori rational structure of reality that makes science possible is not a Platonic Ideal, but something that unfolds within history. This is what allowed Marx to conceive of dialectical materialism as a science, and this is what allows the managerial elite of the present to claim a scientific and objective basis for their programs while at the same time using the tools of historical and cultural criticism to relativize and historicize the claims of all competing moral and social “constructs.”. (shrink)

This article argues that Dr. Kornu has failed to demonstrate how Jonathan Edward’s theology of beauty can substantively contribute to a contemporary Christian theology of medicine. Edward’s appropriation of Neo-Platonic language is contrasted with the use of the same language by the Orthodox Church Fathers. It is argued that the absence of a mystical understanding of theology, sacramental church structure, and ascetical discipline within the Reformed Tradition renders any attempt to appropriate a Neo-Platonic understanding of beauty ineffectual.

Betrifft die Handschrift Cod. 136 der Burgerbibliothek Bern.

The paper discusses the extended mind thesis with a view to the notions of “agent” and of “mind”, while helping to clarify the relation between “embodiment” and the “extended mind”. I will suggest that the extended mind thesis constitutes a reductio ad absurdum of the notion of ‘mind’; the consequence of the extended mind debate should be to drop the notion of the mind altogether – rather than entering the discussion how extended it is.

In their influential paper “The extended mind”, Andy Clark and David Chalmers argue for the possibility of the extended mind. Based on Clark and Chalmers’s views, Stephen Hetherington argues in his paper “The extended knower” that there are extended knowers, provided epistemic externalism holds. He also uses the argument and its conclusion to criticize Baron Reed’s scepticism in the paper “The long road to skepticism” : 236–262, 2007). In this chapter, I argue that both Hetherington’s notion (...) of the extended knower and his argument are problematic. This is because the conceptual intelligibility of his notion of the extended knower entails the highly counterintuitive consequence that, in some cases, some negative entities would have to be constitutive of the extended knower. I also show that Hetherington’s criticism of Reed’s scepticism is not successful, and that there is no reason to believe that Clark and Chalmers would hold that there is the extended knower in Hetherington’s sense. (shrink)

Recent work in the philosophy of mind and cognitive science (e.g., Clark and Chalmers 1998; Clark 2010a; Clark 2010b; Palermos 2014) can help to explain why certain kinds of assertions—made on the basis of information stored in our gadgets rather than in biological memory—are properly criticisable in light of misleading implicatures, while others are not.

Discussions of the importance of including physics as part of a liberal education.

We conduct an experiment with 459 nonprofessional investors to examine whether they evaluate companies differently based on management’s stated purpose for undertaking corporate social responsibility activities in the presence versus absence of a company-specific negative event. Specifically, we vary whether or not management intends to achieve financial returns from CSR activities in addition to promoting social good. We address investors’ decision processes by investigating whether their judgments are mediated by perceptions of future cash flows and/or the underlying ethical culture of (...) the company. Results show that absent a negative event, investment judgments are stronger when CSR activities are intended to achieve financial returns, through expectations of higher future cash flows. However, when a negative event occurs, we find a moderating effect of independent assurance of CSR disclosures. When disclosures are not assured, investors prefer CSR undertaken only for societal benefit, mediated by perceptions of a stronger ethical culture. However, when disclosures are assured, ethical culture is viewed similarly regardless of management’s intention to achieve financial returns from CSR activities. This suggests that management’s willingness to obtain independent assurance on disclosures is viewed as a positive ethical signal. Thus, assurance complements disclosure of CSR activities by contributing to protection against the impact of negative events. (shrink)

Where does the mind stop and the rest of the world begin? The question invites two standard replies. Some accept the demarcations of skin and skull, and say that what is outside the body is outside the mind. Others are impressed by arguments suggesting that the meaning of our words "just ain't in the head", and hold that this externalism about meaning carries over into an externalism about mind. We propose to pursue a third position. We advocate a very different (...) sort of externalism: an _active externalism_, based on the active role of the environment in driving cognitive processes. (shrink)

Galvanic vestibular stimulation is a non-invasive method of electrically stimulating the vestibular system. We investigated whether the application of GVS can alter the learning of new functional mobility and manual control tasks and whether learning can be retained following GVS application. In a between-subjects experiment design, 36 healthy subjects performed repeated trials, capturing the learning of either a functional mobility task, navigating an obstacle course on a compliant surface with degraded visual cues or a manual control task, using a joystick (...) to null self-roll tilt against a pseudo-random disturbance while seated in the dark. In the “learning” phase of trials, bilateral, bipolar GVS was applied continuously. The GVS waveform also differed between subjects in each task group: white noisy galvanic vestibular stimulation at 0.3 mA high-level random GVS at 0.7 mA, or with the absence of stimulation. Following the “learning” trials, all subjects were blindly transitioned to sham GVS, upon which they immediately completed another series of trials to assess any aftereffects. In the functional mobility task, we found nGVS significantly improved task learning. Further, improvements in learning the functional mobility task with nGVS were retained, even once the GVS application was stopped. The benefits in learning with nGVS were not observed in the manual control task. High level GVS tended to inhibit learning in both tasks, but not significantly so. Even once the high-level stimulation was stopped, the impaired performance remained. Improvements in learning with nGVS may be due to increased information throughput resulting from stochastic resonance. The benefit of nGVS for functional mobility, but not manual control nulling, may be due to the multisensory, strategic, motor coordination, or spatial awareness aspects of the former task. Learning improvements with nGVS have the potential to benefit individuals who perform functional mobility tasks, such as astronauts, firefighters, high performance athletes, and soldiers. (shrink)

The multifaceted work of the late Susan Leigh Star is explored through a selection of her writings and essays by friends and colleagues. Susan Leigh Star (1954–2010) was one of the most influential science studies scholars of the last several decades. In her work, Star highlighted the messy practices of discovering science, asking hard questions about the marginalizing as well as the liberating powers of science and technology. In the landmark work Sorting Things Out, Star and Geoffrey Bowker revealed the (...) social and ethical histories that are deeply embedded in classification systems. Star's most celebrated concept was the notion of boundary objects: representational forms—things or theories—that can be shared between different communities, with each holding its own understanding of the representation. Unfortunately, Leigh was unable to complete a work on the poetics of infrastructure that further developed the full range of her work. This volume collects articles by Star that set out some of her thinking on boundary objects, marginality, and infrastructure, together with essays by friends and colleagues from a range of disciplines—from philosophy of science to organization science—that testify to the wide-ranging influence of Star's work. Contributors Ellen Balka, Eevi E. Beck, Dick Boland, Geoffrey C. Bowker, Janet Ceja Alcalá, Adele E. Clarke, Les Gasser, James R. Griesemer, Gail Hornstein, John Leslie King, Cheris Kramarae, Maria Puig de la Bellacasa, Karen Ruhleder, Kjeld Schmidt, Brian Cantwell Smith, Susan Leigh Star, Anselm L. Strauss, Jane Summerton, Stefan Timmermans, Helen Verran, Nina Wakeford, Jutta Weber. (shrink)

BackgroundWe conducted a survey to identify what types of health/medical research could be exempt from research ethics reviews in Australia.MethodsWe surveyed Australian health/medical researchers and Human Research Ethics Committee members. The survey asked whether respondents had previously changed or abandoned a project anticipating difficulties obtaining ethics approval, and presented eight research scenarios, asking whether these scenarios should or should not be exempt from ethics review, and to provide comments. Qualitative data were analysed thematically; quantitative data in R.ResultsWe received 514 responses. (...) Forty-three per cent of respondents to whom the question applied, reported changing projects in anticipation of obstacles from the ethics review process; 25% reported abandoning projects for this reason. Research scenarios asking professional staff to provide views in their area of expertise were most commonly exempted from ethics review ; scenarios involving surplus samples and N-of-1 studies were most commonly required to undergo ethics review. HREC members were 26% more likely than researchers to require ethics review. Need for independent oversight, and low risk, were most frequently cited in support of decisions to require or exempt from ethics review, respectively.ConclusionsConsiderable differences exist between researchers and HREC members, about when to exempt from review the research that ultimately serves the interests of patients and the public. It is widely accepted that evaluative research should be used to reduce clinical uncertainties—the same principle should apply to ethics reviews. (shrink)

On the text and translation of the De mysteriis -- Iamblichus the man -- The De mysteriis : a defence of theurgy, and an answer to Porphyry's letter to Anebo -- Iamblichus's knowledge of Egyptian religion and mythology -- The nature and contents of De mysteriis -- Iamblichus, De mysteriis : text and translation.

As the issue of assisted dying continues toward more expanded legal standing, we shift our primary focus from questions of patients' rights to the largely overlooked challenges that face physicians who elect to assist patients in ending their lives. Dr. Howard Grossman, a Manhattan internist and plaintiff in the unsuccessful New York lawsuit to the Supreme Court, came forward to say, “Anybody who has done it knows that it is a tremendous decision that you carry with you forever.”1 We focus (...) our attention on the psychological experience and philosophical conflicts faced by physicians engaged in physician-assisted dying. Based on those potential conflicts, we argue for a new model of the physician and patient relationship in assisted dying: a medical friendship. a. (shrink)