Discussions of both personal responsibility and the importance of trust in health-care settings are increasingly prominent in the bioethics literature. In this paper I link the two discussions and argue that health policies that include personal responsibility ought to address climates of social trust. Trust is a social good that is not always fairly distributed. Disadvantaged social groups often face default distrust. I suggest that agent-centered models in which responsibilities are negotiated do a better job of repairing social distrust than (...) authoritative models in which responsibilities are assigned . Attending to climates of trust, distrust, or antitrust is essential for addressing health inequalities. (shrink)

Objective Although patients exercise greater autonomy than in the past, and shared decision making is promoted as the preferred model for doctor-patient engagement, tensions still exist in clinical practice about the primary locus of decision-making authority for complex, scarce, and resource-intensive medical therapies: patients and their surrogates, or physicians. We assessed physicians’ attitudes toward decisional authority for adult venoarterial extracorporeal membrane oxygenation (VA-ECMO), hypothesizing they would favor a medical locus. Design, Setting, Participants A survey of resident/fellow physicians and internal medicine (...) attendings at an academic medical center, May to August 2013. Measurements We used a 24-item, internet-based survey assessing physician-respondents’ demographic characteristics, knowledge, and attitudes regarding decisional authority for adult VA-ECMO. Qualitative narratives were also collected. Main Results A total of 179 physicians completed the survey (15 percent response rate); 48 percent attendings and 52 percent residents/ fellows. Only 32 percent of the respondents indicated that a surrogate’s consent should be required to discontinue VA-ECMO; 56 percent felt that physicians should have the right to discontinue VA-ECMO over a surrogate’s objection. Those who self-reported as “knowledgeable” about VA-ECMO, compared to those who did not, more frequently replied that there should not be presumed consent for VA-ECMO (47.6 percent versus 33.3 percent, p = 0.007), that physicians should have the right to discontinue VAECMO over a surrogate’s objection (76.2 percent versus 50 percent, p = 0.02) and that, given its cost, the use of VA-ECMO should be restricted (81.0 percent versus 54.4 percent, p = 0.005). Conclusions Surveyed physicians, especially those who self-reported as knowledgeable about VA-ECMO and/or were specialists in pulmonary/ critical care, favored a medical locus of decisional authority for VA-ECMO. VA-ECMO is complex, and the data may (1) reflect physicians’ hesitance to cede authority to presumably less knowledgeable patients and surrogates, (2) stem from a stewardship of resources perspective, and/or (3) point to practical efforts to avoid futility and utility disputes. Whether these results indicate a more widespread reversion to paternalism or a more circumscribed usurping of decisional authority occasioned by VA-ECMO necessitates further study. (shrink)

This collection of essays is a sequel to the editors' 1976 volume Studies in Nietzsche and the Classical Tradition. Philosophers, theologians, and literary historians discuss important aspects of Nietzsche's attack on Judaism and Christianity. The book contains studies of his view of biblical figures, Luther and Pascal as well as comparisons of his thought with that of Spinoza, Lessing, Heine, and Kierkegaard. Nietzsche's critique of the Old Testament, the Jewish religion of the diaspora, and historical Christianity are also investigated. Of (...) the eighteen articles included here, thirteen were prepared expressly for this volume--five were translated from German, one from French, and one from Hebrew. Contributors to this volume are: Eugen Biser, Harry Neumann, Israel Eldad, Charles Lewis, Jorg Salaquarda, Joan Stambaugh, Max L. Baeumer, Brendan Donellan, Diana Behler, Sander L. Gilman, Gerd-Gunther Grau, Josef Simon, James C. O'Flaherty, Bernd Magnus, Georges Goedert, Hans Lung, and Karl Barth. (shrink)

These fifteen essays on Nietzsche's indebtedness to the Classical Tradition were composed by scholars in the fields of philosophy, theology, German and Classics. The essays roughly cover the following epochs: the age of the Fathers of the Western Church, medieval scholasticism, the Renaissance, the Enlightenment, Weimar Classicism, Romanticism and the several other intellectual trends and movements in the nineteenth century. Collection includes three essays comparing Nietzsche's perceptions of Plato, Aristotle, and Socrates with those (respectively) of Augustine, Aquinas, and Hamann. Three (...) essays treat Nietzsche's relationship to Goethe, Schiller, and Heine. Three deal with Nietzsche and French literature or thought, one explores possible parallels between Nietzsche and Dante, another the extent of his debt to Byron. Four contributions center on Nietzsche's view of tragedy, and an older study has been expanded to show the underlying harmony of Nietzsche's conception with that of the French classical tragedians. This book affirms and fulfills the need for serious scholarship by the student of Nietzsche unable to work in German, while presenting a readable cross-section of the work being done relating Nietzsche to the intellectual tradition from which he sprang. (shrink)

This paper reports on an ongoing ARC Discovery Project that is conducting design research into learning in collaborative virtual worlds (CVW).The paper will describe three design components of the project: (a) pedagogical design, (b)technical and graphics design, and (c) learning research design. The perspectives of each design team will be discussed and how the three teams worked together to produce the CVW. The development of productive failure learning activities for the CVW will be discussed and there will be an interactive (...) demonstration of the project's CVW. (shrink)

The question I wish to explore is this: Does idealism conflict with common sense? Unfortunately, the answer I give may seem like a rather banal one: It depends. What do we mean by ‘idealism’ and ‘common sense?’ I distinguish three main varieties of idealism: absolute idealism, Berkeleyan idealism, and dualistic idealism. After clarifying what is meant by common sense, I consider whether our three idealisms run afoul of it. The first does, but the latter two don’t. I conclude that while (...) Moore’s famous common sense critique is sound against external world skepticism, against Berkeleyan idealism and dualist idealism it is unavailing. (shrink)

Nearly all Disney movies represent to people mere possibilities. One can conceive of scenarios with genies, wooden puppets coming to life, flying elephants, and mermaids. And there certainly seems to be no special problem in conceiving of a scenario where all the author's experiences are a mere dream induced by a Maleficent‐like evil genius. The problem in the present context is that the possibility of a dream‐inducing Maleficent‐like evil genius guarantees that how things appear would be no different, whether she (...) is dreaming or not. But maybe there is a difference: does it not appear to her that there is a difference between dreaming and wakefulness? The very fact that she is aware of such a distinction at all suggests the distinction is real. People prefer a real life over an experientially identical dream life, or even a more pleasurable dream life, because there is more to life than just experience. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This volume contains the selected discourses of four seventeenth-century philosophers, carefully chosen to illustrate the tenets characteristic of the influential movement known as Cambridge Platonism. Fundamental to their beliefs is the statement most clearly voiced by Benjamin Whichcote, their leader by common consent, that the spiritual is not opposed to the rational, nor Grace to nature. Religion is based on reason, even in the presence of 'mystery'. Free will and Grace are not mutually exclusive. The editor's comprehensive introduction delineates the (...) main principles of the Cambridge Platonists, in the light of their heritage. It compares their attitude to contemporary thought, stressing their mistrust both of institutionalised religion and of the rising tide of materialism. The sermons are reprinted from the original texts and fully annotated with comparisons and references to a wide range of works. The editor also includes a useful list for further reading, biographical notes and a comprehensive index. (shrink)

Our trust in the word of others is often dismissed as unworthy, because the illusory ideal of "autonomous knowledge" has prevailed in the debate about the nature of knowledge. Yet we are profoundly dependent on others for a vast amount of what any of us claim to know. Coady explores the nature of testimony in order to show how it might be justified as a source of knowledge, and uses the insights that he has developed to challenge certain widespread assumptions (...) in the areas of history, law, mathematics, and psychology. (shrink)

Coady explores the challenges that morality poses to politics. He confronts the complex intellectual tradition known as realism, which seems to deny any relevance of morality to politics, especially international politics. He argues that, although realism has many serious faults, it has lessons to teach us: in particular, it cautions us against the dangers of moralism in thinking about politics and particularly foreign affairs. Morality must not be confused with moralism: Coady characterizes various forms of moralism and sketches their distorting (...) influence on a realistic political morality. He seeks to restore the concept of ideals to an important place in philosophical discussion, and to give it a particular pertinence in the discussion of politics. He deals with the fashionable idea of "dirty hands," according to which good politics will necessarily involve some degree of moral taint or corruption. Finally, he examines the controversial issue of the role of lying and deception in politics. Along the way Coady offers illuminating discussion of historical and current political controversies. This lucid book will provoke and stimulate anyone interested in the interface of morality and politics. (shrink)

Many philosophers have appealed to the PSR in arguments for a being that exists a se, a being whose explanation is in itself. But what does it mean, exactly, for something to have its explanation ‘in itself’? Contemporary philosophers have said next to nothing about this, relying instead on phrases plucked from the accounts of various historical figures. In this article, I analyse five such accounts – those of Anselm, Aquinas, Descartes, Spinoza, and Leibniz – and argue that none are (...) satisfactory. Should we abandon or restrict the PSR, then? I think that would be hasty, for many reasons. I therefore consider the prospects of explaining everything, including God, given the constraints of certain features of good explanations, and conclude with several observations about future approaches. (shrink)

Containing selected papers on the fundamentals and applications of Complexity Science, this multi-disciplinary book presents new approaches for resolving complex issues that cannot be resolved using conventional mathematical or software models. Complex Systems problems can occur in a variety of areas such as physical sciences and engineering, the economy, the environment, humanities and social and political sciences. Complexity Science problems, the science of open systems consisting of large numbers of diverse components engaged in rich interaction, can occur in a variety (...) of areas such as physical sciences and engineering, the economy, the environment, humanities and social and political sciences. The global behaviour of these systems emerges from the interaction of constituent components and is unpredictable but not random. The key attribute of Complex Systems is the ability to self-organise and adapt to unpredictable changes in their environment. (shrink)

The Three Papers comprising this series, together with my earlier [34] also published in this journal, constitute an attempt to set out the major issues in the theoretical domain of reduction and to develop a general theory of theory reduction. The fourth paper, [34], though published separately from this trio, is integral to the presentation and should be read in conjunction with these papers. Even so, the presentation is limited in scope – roughly, to intertheoretic reduction among empirical theories – (...) and informal in presentation – not least because a satisfying formal account of theories has yet to be offered. And despite the length, the treatment is still condensed; often corroborating and/or intuitively helpful detail has had to be consigned to footnotes or omitted. I approach the problem from within my own naturalistic realist philosophy of science and formal analysis of abstract hierarchy in theory. The sources for the former are [25], [29], [31], and [32] and those for the latter essentially [27] and [30]. Hierarchical notions played a significant role in the already published [34]. (shrink)