Discussions surrounding patient engagement and empowerment often use the terms “patient” and “consumer” interchangeably. But do the two terms hold the same meaning, or is a “patient” a passive actor in the health care arena and a “consumer” an informed, rational decision-maker? Has there been a shift in our usage of the two terms that aligns with the increasing commercialization of health care in the U.S. or has the patient/consumer dynamic always been a part of the buying and selling of (...) health care in the American system? Recent discussions of the issue exist in the popular press and in social media forums such as TEDMED, but few direct analyses of the ethical, legal, and policy ramifications of this possible shift in terminology are available in the academic literature. This paper analyzes our usage of the terms and any recent changes in the dynamic and discusses the ethical, legal, and policy implications of this simple terminology for the physicianpatient relationship. (shrink)

During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent's proper role in a health care environment in which electronic information sharing holds primary importance. This article discusses current implementation of the doctrine within health information exchange networks; the relationship between informed consent and privacy; the variety of ways that the concept is referenced in discussions of information sharing; and challenges that surround incorporation of the doctrine into the evolving HIT environment. The (...) article concludes by reviewing the purpose behind the traditional obligation to obtain informed consent and the possibility of maintaining its relevance in the new environment. (shrink)

As policy makers place great hope in health information technology as a means to lower costs and achieve improvements in health care quality, safety, and efficiency, organizations at the forefront of building health information exchange networks attempt to weave the concept and function of informed consent into an evolving information-driven health care system. The vast amount of information that will become available to both health professionals and patients in the new HIT-driven environment can reasonably be expected to affect the relationship (...) between them in many ways, particularly in the area of informed consent. During this early stage of HIT adoption, it is critical that we engage in discussions regarding informed consent’s proper role in a heretofore unknown health care environment — one in which electronic information sharing holds primary importance. The central and largely unexamined question of whether and how the legal and ethical underpinnings of informed consent will fit into the context of HITenabled treatment is critical to both public policy and clinical practice. (shrink)

The widespread adoption of health information technology has been recognized as both a necessary element of health reform and a required building block of a modern, high performing health care system.

Information technology is considered a potentially transformative element in the field of health care by payers, providers, vendors, and consumers alike. Because of this transformative potential, health information technology adoption is viewed by many as a key component of health system reform. HIT is in its earliest stages, with diffusion of the technology still relatively limited; at the same time, there is growing awareness of its potential to affect the operation of the entire health care system as a result of (...) the vast amount of information that will become available to both health professionals and patients. (shrink)

As we move toward the creation of a networked health information environment, the potential of privacy intrusions increases, with potentially devastating impact on quality and access to healthcare. This paper describes the risks we face and proposes a framework to minimize those risks. In particular, it proposes nine principles to protect privacy in an information age.

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

Patients and family members (N = 671) were surveyed in five Mid-Atlantic U.S. hospitals to ascertain the number and kinds of ethical concerns they are presently experiencing or have previously experienced while being sick or receiving medical care. Seventy percent of participants had at least one (range 0–14) type of ethical concern or question. The most commonly experienced concerns pertained to being unsure how to plan ahead or complete an advance directive (29.4%), being unsure whether someone in the family was (...) able to make their own decisions (29.2%), deciding about limiting life-sustaining treatments (28.6%), wondering about disclosing personal medical information to others in the family (26.4%) and not being sure whether to undergo treatment because of cost (26.2%). Most were interested to some degree in getting help from ethics consultants in the future (76.6%). Given this prevalence, common concerns might usefully be addressed systematically, rather than exclusively on a case-by-case basis. (shrink)

Recent literature on Stalnaker's Thesis, which seeks to vindicate it from Lewis (1976)'s triviality results, has featured linguistic data that is prima facie incompatible with Conditionalization in iterated cases (McGee 1989, 2000; Kaufmann 2015; Khoo & Santorio, 2018). In a recent paper (2021), Goldstein & Santorio make a bold claim: they hold that these departures light the way to a new, non‐conditionalizing theory of rational update.Here, I consider whether this new form of update is subject to a Dutch book. (...) On the official, invariantist version of the theory, I show that the answer is “yes”. On a competing, contextualist theory of indicative conditionals (Bacon, 2015), the answer is “no”, for reasons that have familiar connections to the limits of textbook Bayesianism. After presenting a concrete case, I explore the dialectical ramifications. The upshot is some hard choices for theories that seek to save the linguistic phenomena. (shrink)

A crucial feature of Kant's critical-period writing on the sublime is its grounding in moral psychology. Whereas in the pre-critical writings, the sublime is viewed as an inherently exhausting state of mind, in the critical-period writings it is presented as one that gains strength the more it is sustained. I account for this in terms of Kantian moral psychology, and explain that, for Kant, sound moral disposition is conceived as a sublime state of mind.

New natural lawyers--notably Grisez, Finnis, and George--have written much on civil marriage's moral boundaries and grounds, but with slight influence. The peripheral place of the new natural law theory (NNLT) results from the marital grounds they suggest and the exclusionary moral conclusions they draw from them. However, I argue a more authentic and attractive NNLT account of marriage is recoverable through overlooked resources within the theory itself: friendship and moral self-constitution. This reconstructed account allows us to identify the relation between (...) marriage and human flourishing and the morality of same-sex marriage without making marriage infinitely plastic. (shrink)

A person skeptical about other minds supposes it is possible in principle that there are no minds other than his. A person skeptical about an external world thinks it is possible there is no world external to him. Some philosophers think a person can refute the skeptic and prove that his world is not the solitary scenario the skeptic supposes might be realized. In this paper I examine one argument that some people think refutes solipsism. The argument, from Wittgenstein, is (...) grounded in a thesis about language. Some people believe that in using language a person necessarily is linked to persons other than himself. Some people think a person can use the ‘communalist’ principle to refute forms of solipsism. I show that people do not refute solipsism with the Wittgensteinian, language-necessarily-is-shared principle. (shrink)

It has been insufficiently remarked that Murdoch deems “Kant’s ethical theory” to be “one of the most beautiful and exciting things in the whole of philosophy” in her 1959 essay “The Sublime and the Good”. Murdoch specifically has in mind the connection between Kant’s ethics and his theory of the sublime, which runs via the moral feeling of respect (Achtung). The chapter examines Murdoch’s interest in Kant on this point as a way to tease out the range of issues that (...) complicate Kant’s significance for the development of Murdoch’s distinctive conception of ethics as it is articulated in _The Sovereignty of Good_ and earlier essays. It focuses on her particular concerns about the moral dangers of consolation, and why this led her to propose reworking the Kantian theory of the sublime as a theory of art, and specifically of tragedy. (shrink)

This book is about the mind and its connection to the brain. The first two chapters discuss the basic characteristics of the mind, and places it in historical context by noting trends in popular culture, and various people's ideas about the mind. This discussion ends by concluding that the most fruitful approach to studying the mind is a scientific approach that looks for connections between the mind and the brain. The last four chapters focus on the following specific principles: The (...) operation of the mind is hidden; Prediction is an important function of the mind; and Connectivity and communication between different areas of the mind are crucial for the mind's operation. An important feature of this discussion is that it is supported by empirical research, by briefly describing experiments. This book therefore goes beyond simply presenting conclusions, by elucidating the procedures and reasoning that led to those conclusions. The intent of the book is to give readers a feel for the latest scientific thinking about the mind, by focusing on basic principles that hold across many different functions of the mind. One key to marketing the book is to emphasize the fact that the writing makes a fascinating, but complex, subject accessible to the general reader. (shrink)

This Element considers Kant's account of the sublime in the context of his predecessors both in the Anglophone and German rationalist traditions. Since Kant says with evident endorsement that 'we call sublime that which is absolutely great' and nothing in nature can in fact be absolutely great, Kant concludes that strictly speaking what is sublime can only be the human calling to perfect our rational capacity according to the standard of virtue that is thought through the moral law. The Element (...) takes account of the difference between respect and admiration as the two main varieties of sublime feeling, and concludes by considering the role of Stoicism in Kant's account of the sublime, particularly through the channel of Seneca. (shrink)

On a version of consent theory that tempts many, predatory sexual relations involving significant power imbalances (e.g. between professors and students, adults and teenagers, or employers and employees) are wrong because they violate consent-centric norms. In particular, the wronged party is said to have been _incapable_ of consenting to the predation, and the sexual wrong is located in the encounter’s nonconsensuality. Although we agree that these are sexual wrongs, we resist the idea that they are always nonconsensual. We argue instead (...) that it is possible for students, teenagers, employees, etc. to fully consent to sexually predatory encounters; denying as much renders survivors of predation vulnerable to compounding harms. Survivors face a dilemma: give up either their understanding of their experience as wrong, or their self-conception as an agent capable of consenting. We call the latter phenomenon _agential demotion_. (shrink)

A new reading of Plato’s political thought Plato famously defends the rule of knowledge. Knowledge, for him, is of the good. But what is rule? In this study, Melissa Lane reveals how political office and rule were woven together in Greek vocabulary and practices that both connected and distinguished between rule in general and office as a constitutionally limited kind of rule in particular. In doing so, Lane shows Plato to have been deeply concerned with the roles and relationships (...) between rulers and ruled. Adopting a longstanding Greek expectation that a ruler should serve the good of the ruled, Plato’s major political dialogues—the Republic, the Statesman, and Laws—explore how different kinds of rule might best serve that good. With this book, Lane offers the first account of the clearly marked vocabulary of offices at the heart of all three of these dialogues, explaining how such offices fit within the broader organization and theorizing of rule. Lane argues that taking Plato’s interest in rule and office seriously reveals tyranny as ultimately a kind of anarchy, lacking the order as well as the purpose of rule. When we think of tyranny in this way, we see how Plato invokes rule and office as underpinning freedom and friendship as political values, and how Greek slavery shaped Plato’s account of freedom. Reading Plato both in the Greek context and in dialogue with contemporary thinkers, Lane argues that rule and office belong at the center of Platonic, Greek, and contemporary political thought. (shrink)

The idea of 'holiness' is central to religion, but it is also one of the hardest concepts to define. Is 'holiness' a synonym for Godliness, one of God's attributes, or does it have independent existence? What does it mean to say that both God and man are holy? What is the proper understanding of 'Be holy, because I the Lord your God am holy'? A Theology of Holiness analyzes the meaning of the Hebrew root k-d-sh from ancient sources, throughout Tanakh, (...) the Talmud, Rashi, Maimonides, Nachmanides, Rabbi Samson Raphael Hirsch, and Rabbi Joseph B. Soloveitchik. Ultimately, it is a work of theology, and helps the reader achieve a deeper understanding of holiness"--Page 4 of cover. (shrink)

Numerous functions, cognitive skills, and behaviors are associated with intelligence, yet decades of research has yielded little consensus on its definition. Emerging from often conflicting studies is the provocative idea that intelligence evolved as an adaptation humans needed to keep up with - and survive in - challenging new environments. The Handbook of Intelligence addresses a broad range of issues relating to our cognitive and linguistic past. It is the first full-length volume to place intelligence in an evolutionary/cultural framework, tracing (...) the development of the human mind, exploring differences between humans and other primates, and addressing human thinking and reasoning about its own intelligence and its uses. The works of pioneering thinkers - from Plato to Darwin, Binet to Piaget, Luria to Wechsler - are referenced to illustrate major events in the evolution of theories of intelligence, leading to the current era of multiple intelligences and special education programs. In addition, it examines evolutionary concepts in areas as diverse as creativity, culture, neurocognition, emotional intelligence, and assessment. Featured topics include: The evolution of the human brain from matter to mind Social competition and the evolution of fluid intelligence Multiple intelligences in the new age of thinking Intelligence as a malleable construct From traditional IQ to second-generation intelligence tests The evolution of intelligence, including implications for educational programming and policy. The Handbook of Intelligence is an essential resource for researchers, graduate students, clinicians, and professionals in developmental psychology; assessment, testing and evaluation; language philosophy; personality and social psychology; sociology; and developmental biology. (shrink)

Chapter One The Karaite Community of Jerusalem in the Tenth and Eleventh Centuries: Background and Development A time of intellectual change The eighth and ninth centuries were a time of great political and intellectual change for Jews ...

The Great Divide in metaphysical debates about laws of nature is between Humeans, who think that laws merely describe the distribution of matter, and non-Humeans, who think that laws govern it. The metaphysics can place demands on the proper formulations of physical theories. It is sometimes assumed that the governing view requires a fundamental / intrinsic direction of time: to govern, laws must be dynamical, producing later states of the world from earlier ones, in accord with the fundamental direction of (...) time in the universe. In this paper, we propose a minimal primitivism about laws of nature (MinP) according to which there is no such requirement. On our view, laws govern by constraining the physical possibilities. Our view captures the essence of the governing view without taking on extraneous commitments about the direction of time or dynamic production. Moreover, as a version of primitivism, our view requires no reduction / analysis of laws in terms of universals, powers, or dispositions. Our view accommodates several potential candidates for fundamental laws, including the principle of least action, the Past Hypothesis, the Einstein equation of general relativity, and even controversial examples found in the Wheeler-Feynman theory of electrodynamics and retrocausal theories of quantum mechanics. By understanding governing as constraining, non-Humeans who accept MinP have the same freedom to contemplate a wide variety of candidate fundamental laws as Humeans do. (shrink)

The paper argues that existing interpretations of Kant's Critique of Pure Reason as an "analysis of experience" (e.g., those of Kitcher and Strawson) fail because they do not properly appreciate the method of the work. The author argues that the Critique provides an analysis of the faculty of reason, and counts as an analysis of experience only in a derivative sense.

‘War is definitely hell on earth’. All too often, we hope the hell will be short-lived, over in a few days, and yet, as we know from experience, hell can go on and on and on. For healthcare workers who provide care to victims of conflict, the work raises many ethical dilemmas. The stories showcased in this edition of NIB share the experiences of a handful of brave individuals and how they navigated their professional ethical obligations as well as their (...) personal convictions during times of conflict. Adeptly portrayed are various approaches to ethical dilemmas, such as adhering to the ethical imperative of medical impartiality, the limits of professional and personal responsibility, coping with moral distress, and the power of humanity, evident through the collective efforts of strangers to help others. This commentary reflects on the ethical grey zones of being a healthcare provider in conflict, as there is no single right way of fulfilling professional obligations, each context being different. As several stories highlight, whilst stressful, the solidarity and comradery of working in a healthcare team can provide great support, purpose, and motivation. (shrink)

One of the achievements of Hans Blumenberg’s historical anthropology is to have reflected on the way individuals can preserve themselves when they come up against points of significance (Bedeutsamkeiten). Goethe’s encounter with Napoleon, in which the poet succeeded in standing up to the emperor at eye level, was of such self-preserving significance. For Blumenberg himself, his sole encounter with Thomas Mann was of comparable significance, since the Nobel prize-winner asserted himself in the face of the ascendant Nazis as the representative (...) of Goethe and the defender of a humane world. Blumenberg likewise sought contact with Carl Schmitt in order to claim his own interpretative sovereignty over Goethe and thereby — following the model of Goethe and Thomas Mann — assert himself against a representative of the Third Reich. (shrink)

The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

This book explores the role and implications of responsibility for anthropology, asking how responsibility is recognised and invoked in the world, what relations it draws upon, and how it comes to define notions of the person, institutional practices, ways of knowing and modes of evaluation. The category of responsibility has a long genealogy within the discipline of anthropology and it surfaces in contemporary debates as well as in anthropologists' collaboration with other disciplines, including when anthropology is applied in fields such (...) as development, medicine, and humanitarian response. As a category that unsettles, challenges and critically engages with political, ethical and epistemological questions, responsibility is central to anthropological theory, ethnographic practice, collaborative research, and applied engagement. With chapters focused on a variety of cultural contexts, this volume considers how anthropology can contribute to a better understanding of responsibility, including the 'responsibility of anthropology' and the responsibility of anthropologists to specific others. (shrink)

This revolutionary book empowers its readers intellectually by providing a snapshot of perennial and timely philosophical topics. Written by twenty expert women in philosophy and representing a diverse and pluralistic approach to philosophy as a discipline, this book appeals to a wide audience. Individual readers, especially girls and women ages 16-24, as well as university and high school educators and students who want a change from standard anthologies that include few or no women will find value in these pages. This (...) volume contains several notable features: the book is divided into four sections that correspond to major fields in Philosophy-metaphysics, epistemology, social and political philosophy, and ethics-but the chapters within those sections provide fresh ways of understanding those fields. " Every chapter begins with a lively anecdote about a girl or woman in literature, myth, history, science, or art to introduce the chapter's specific topic." Chapters are dominated by women's voices, with nearly all primary and secondary sources used coming from women in the history of philosophy and a diverse set of contemporary women philosophers. "All chapters offer the authors' distinct philosophical perspectives written in their own voices and styles, representing diverse training, backgrounds, and interests." The Introduction and Prologue explicitly invite the book's readers to engage in philosophical conversation and reflection, thus setting the stage for continued contemplation and dialogue beyond the book itself. The result is a rigorous yet accessible entry-point into serious philosophical contemplation designed to embolden and strengthen its readers' own senses of philosophical inquiry and competence. The book's readers will feel confident in knowing that expert women affirm an equitable and just intellectual landscape for all and thus have lovingly collaborated to write this book. (shrink)