Institutions have ethical lives and characters just as their individual members do. Health care organizations must look critically at how professed institutional values can best be realized in day‐to‐day interactions within the institution and with the wider community.

Advances in medicine have brought us the stethoscope, artificial kidneys, and computerized health records. They have also changed the doctor-patient relationship. This book explores how the technologies of medicine are created and how we respond to the problems and successes of their use. Stanley Joel Reiser, MD, walks us through the ways medical innovations exert their influence by discussing a number of selected technologies, including the X-ray, ultrasound, and respirator. Reiser creates a new understanding of thinking (...) about how health care is practiced in the United States and thereby suggests new methods to effectively meet the challenges of living with technological medicine. As healthcare reform continues to be an intensely debated topic in America, Technological Medicine shows us the pros and cons of applying technological solutions health and illness. (shrink)

A variety of cases of scientific misconduct have been documented since the 1980s among biological scientists. These cases have focused the attention of the public and scientific community on this behavior and made it the centerpiece of the concern about ethics in the biological sciences. In contrast, the ethics movement in clinical medicine, which arose in the 1960s, was not basically directed at the problems of wrong-doing. Instead it concentrated on the difficult ethical choices that had to be made In (...) the practice of medicine.In this essay, I discuss the two movements. The attention given to misconduct In the biological sciences has become excessive and diverts its ethics movement from exploring and teaching about the difficult ethical decisions scientists must make in weighing obligations to self, science, and society. A more balanced and selective approach to developing an ethical framework in the biological sciences is needed. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Divided Staffs, Divided Selves offers a case-centered approach to the teaching of health care ethics to a wide range of students and clinicians. The book provides both clinical case material and a method for engaging in a dialogue regarding difficult decisions in the mental health care field that have potentially tragic choices. The essays that introduce the volume place the ethical problems of treating mentally ill people in the context of the health care ethics movement and traditions of ethical decision (...) making. The individual cases are real, derived from actual clinical and consultative experiences. (shrink)

Throughout the world, research ethics committees are relied on to prevent unethical research and protect research subjects. Given that reliance, the composition of committees and the manner in which decisions are arrived at by committee members is of critical importance. There have been Instances in which an inadequate review process has resulted in serious harm to research subjects. Deficient committee review was identified as one of the factors In a study in New Zealand which resulted in the suffering and death (...) of many women diagnosed with carcinoma in situ. (shrink)

Biological scientists, like scientists in other disciplines, are uncertain about whether or how to use their knowledge and time to provide society with insight and guidance in handling the effects of inventions and discoveries. This article addresses this issue. It presents a typography of structures in which scientists may contribute to social understanding and decisions. It describes the different ways in which these contributions can be made. Finally it develops the ethical arguments that justify the view that biological scientists have (...) social responsibilities. (shrink)

Book reviewed in this article: Enemies of Patients. By Ruth Macklin.

This is the second edition of a highly successful and well-received textbook on the responsible conduct of biomedical and health science research. It is aimed at faculty and graduate students in health science and biomedical science programs. In addition those on National Institute of Health research grants, administrators at universities, academic health centers, and medical and graduate schools will find the book a useful resource. The structure of the book remains the same as the first edition. Each chapter offers an (...) overview together with important primary documents and case studies concerned with core ethical issues underlying responsible research. The major changes from the first edition include new chapters providing overviews of each topic, several new published articles added to the readings, revised case studies along with an essay on how they can be used, as well as further readings and web addresses that will serve as invaluable sources of reference. (shrink)

This is the first systematically organized anthology on responsible conduct in scientific research aimed at students and practicing researchers in the biological sciences. It has been designed in response to the increasing concern to teach graduate students about ethical issues in the biological sciences. The book contains classic essays and other published material and is carefully structured to explore a range of subjects: the qualifications for authorship; plagiarism; the use of human beings and animals in research; the norms of ethical (...) conduct in science; scientific honesty and its relationship to gullibility and self-deception; ethical issues in laboratory work; the relation between science and society; the ethics of teaching and learning. The volume also provides insights into issues often not formally considered in graduate science education such as methods of scientific investigation, scientific paradigms, and the creative process. (shrink)

Reflections about the role of human choice in determining personal health occur in the writings of practitioners and laymen throughout history. The Greek and Roman writers emphasized the effect of life's activities. During the Middle Ages and Renaisance, disease continued to be seen as a consequence of disorder of the bodily humors, which were under the individual's control. The rise of the paternalistic national regimes in Europe produced the view that society had the responsibility to maintain health. Jacksonian egalitarianism led (...) to a reaction against the agressive therapies of established professional experts, a view furthered by the Thomsonian belief that people should wrest control of their health away from orthodox physicians. Among the twentieth century reactions was the movement to urge people to have doctors evaluate laypersons' health. By the 1970s a movement emerged emphasizing again personal responsibility, which, in turn, produced a concern that this was merely "victim-blaming". Views on the role of lay people in determining personal health are heavily influenced by prevailing social, political, and moral climates. Keywords: "responsibility for health: social, personal, or professional?", "causes of illness", "self-reliant health care", historical influences, responsibility for health, "victim-blaming" CiteULike Connotea Del.icio.us What's this? (shrink)

Biological evolution provides a creative fount of complex and subtle adaptations, often surprising the scientists who discover them. However, because evolution is an algorithmic process that transcends the substrate in which it occurs, evolution’s creativity is not limited to nature. Indeed, many researchers in the field of digital evolution have observed their evolving algorithms and organisms subverting their intentions, exposing unrecognized bugs in their code, producing unexpected adaptations, or exhibiting outcomes uncannily convergent with ones in nature. Such stories routinely reveal (...) creativity by evolution in these digital worlds, but they rarely fit into the standard scientific narrative. Instead they are often treated as mere obstacles to be overcome, rather than results that warrant study in their own right. The stories themselves are traded among researchers through oral tradition, but that mode of information transmission is inefficient and prone to error and outright loss. Moreover, the fact that these stories tend to be shared only among practitioners means that many natural scientists do not realize how interesting and lifelike digital organisms are and how natural their evolution can be. To our knowledge, no collection of such anecdotes has been published before. This paper is the crowd-sourced product of researchers in the fields of artificial life and evolutionary computation who have provided first-hand accounts of such cases. It thus serves as a written, fact-checked collection of scientifically important and even entertaining stories. In doing so we also present here substantial evidence that the existence and importance of evolutionary surprises extends beyond the natural world, and may indeed be a universal property of all complex evolving systems. (shrink)

Numerous writers on photography and motion pictures have claimed that photographically originated pictures are essentially different from handmade pictures. Arguments made on behalf of the essential difference of photographs from other kinds of pictures generally depend upon one or another of two models of the photographic process: the visual model claims that photographs are closely allied to vision and show what we would have seen from the standpoint of the camera at the time of exposure; the mechanical or automatic model (...) claims that irrespective of what a photograph looks like, it is a reliable index of what was the case at the moment of exposure. Each of these models is examined and shown to be faulty on either or both factual and/or conceptual grounds. Stanley Cavell's assertions about the "automatic" nature of photography are examined in some detail and shown to be either equivocal or false. It is suggested, in closing, that sharp, categorial differences between photographs and handmade pictures do not exist and that questions about the differences between photographs and, say, paintings, can be solved only within the context of viewing particular photographs and particular paintings. In sum, claims about the ontological distinctions between photographs and handmade pictures cannot be warranted. (shrink)

Numerous writers on photography and motion pictures have claimed that photographically originated pictures are essentially different from handmade pictures. Arguments made on behalf of the essential difference of photographs from other kinds of pictures generally depend upon one or another of two models of the photographic process: the visual model claims that photographs are closely allied to vision and show what we would have seen from the standpoint of the camera at the time of exposure; the mechanical or automatic model (...) claims that irrespective of what a photograph looks like, it is a reliable index of what was the case at the moment of exposure. Each of these models is examined and shown to be faulty on either or both factual and/or conceptual grounds. Stanley Cavell's assertions about the "automatic" nature of photography are examined in some detail and shown to be either equivocal or false. It is suggested, in closing, that sharp, categorial differences between photographs and handmade pictures do not exist and that questions about the differences between photographs and, say, paintings, can be solved only within the context of viewing particular photographs and particular paintings. In sum, claims about the ontological distinctions between photographs and handmade pictures cannot be warranted. (shrink)

This paper presents and defends a reappraisal of J.L. Austin’s infamous analogy between saying ‘I know’ and ‘I promise’ in ‘Other Minds.’ The paper has four sections. In §1, I contend that the standard reading of Austin’s analogy is a strawman that distorts the terms of the analogy and superimposes philosophical commitments that Austin was precisely trying to combat. In §§2 and 3, I argue that to understand the point of the analogy we must contextualize ‘Other Minds’ as a response (...) to logical positivism. I recap A.J. Ayer’s influential account of positivism, before arguing that ‘Other Minds’ and its centrepiece analogy should be read as an attack on Austin’s colleague’s organizing positivist assumptions – specifically, descriptivism and the fact/value dichotomy that it props up. My main thesis is that Austin sought to show that epistemic discourse is imbricated with ethical commitments. This reading is anticipated by Cavell, to whom I turn in §4. I bring together insights from across Cavell’s oeuvre to develop this reading of Austin’s analogy and finally to critique certain aspects of it. This paper adds to the recent resurgence in Austin scholarship and aims to get clear the philosophical and historical stakes of his historically maligned analogy. (shrink)

Introduction -- Media and representation. On the one medium / Eric Gans -- The scapegoat mechanism and the media: beyond the folk devil paradigm / John O'Carroll -- The apocalypse will not be televised / Chris Fleming -- Film. Mirrors of nature: artificial agents in real life and virtual worlds / Paul Dumouchel -- Superheroes, scapegoats, and saviors: the problem of evil and the need for redemption / Joel Hodge -- Sanctified victimage on page and screen: The hunger games (...) as prophetic media / Debra E. Macdonald -- The mimetic e-motion: from The matrix to Avatar / Nidesh Lawtoo -- Apocalypse of the therapeutic: The cabin in the woods and the death of mimetic desire / Peter Y. Paik -- Eyes wide shut: mimesis and historical memory in Stanley Kubrick's The shining / David Humbert -- Against romantic love: mimeticism and satire in Woody Allen's Vicky, Cristina, Barcelona; you will meet a tall dark stranger; and To Rome with love / Scott Cowdell -- A beautiful crisis: Ang Lee's film adaptation of The ice storm / Carly Osborn -- Cowboy metaphysics, the virtuous-enough cowboy, and mimetic desire in Stephen Fears' The hi-lo country / Thomas Ryba -- Television. The self in crisis: watching Mad men and Homeland with Girard and Hegel / Paolo Diego Bubbio -- Media, murder, and memoir: Girardian baroque in Robert Drewe's The shark net / Rosamund Dalziell -- Conversion in Dexter / Matthew John Paul Tan and Joel Hodge. (shrink)

Katzav and Vaesen have argued that control by analytic philosophers of key journals, philosophy departments and at least one funding body plays a substantial role in explaining the emergence of analytic philosophy into dominance in the Anglophone world and the corresponding decline of speculative philosophy. They also argued that this use of control suggests a characterisation of analytic philosophy as, at the institutional level, a sectarian form of critical philosophy. I test these hypotheses against data about philosophy job hires at (...) key philosophy departments in the USA during the period 1930-1979, and against data about PhD completions during the period 1956-1965. I argue, further, that Katzav and Vaesen’s hypotheses can fully explain the data and are more fully able to do so than are some other key accounts of the emergence of analytic philosophy in the USA. (shrink)

Fictionalist approaches to ontology have been an accepted part of philosophical methodology for some time now. On a fictionalist view, engaging in discourse that involves apparent reference to a realm of problematic entities is best viewed as engaging in a pretense. Although in reality, the problematic entities do not exist, according to the pretense we engage in when using the discourse, they do exist. In the vocabulary of Burgess and Rosen (1997, p. 6), a nominalist construal of a given discourse (...) is revolutionary just in case it involves a “reconstruction or revision” of the original discourse. Revolutionary approaches are therefore prescriptive. In contrast, a nominalist construal of a given discourse is hermeneutic just in case it is a nominalist construal of a discourse that is put forth as a hypothesis about how the discourse is in fact used; that is, hermeneutic approaches are descriptive. I will adopt Burgess and Rosen’s terminology to describe the two different spirits in which a fictionalist hypothesis in ontology might be advanced. Revolutionary fictionalism would involve admitting that while the problematic discourse does in fact involve literal reference to nonexistent entities, we ought to use the discourse in such a way that the reference is simply within the pretense. The hermeneutic fictionalist, in contrast, reads fictionalism into our actual use of the problematic discourse. According to her, normal use of the problematic discourse involves a pretense. According to the pretense, and only according to the pretense, there exist the objects to which the discourse would commit its users, were no pretense involved. My purpose in this paper is to argue that hermeneutic fictionalism is not a viable strategy in ontology. My argument proceeds in two steps. First, I discuss in detail several problematic consequences of any interesting application of hermeneutic fictionalism. Of course, if there is good evidence that hermeneutic fictionalism is correct in some cases, then some of these drastic consequences would have to be accepted.. (shrink)

As technology improves, artificial systems are increasingly able to behave in human-like ways: holding a conversation; providing information, advice, and support; or taking on the role of therapist, teacher, or counsellor. This enhanced behavioural complexity, we argue, encourages deeper forms of affective engagement on the part of the human user, with the artificial agent helping to stabilise, subdue, prolong, or intensify a person's emotional condition. Here, we defend a fictionalist account of human/AI interaction, according to which these encounters involve an (...) elaborate practise of imaginative pretence: a make-believe in which the artificial agent is attributed a life of its own. We attend, specifically, to the temporal characteristics of these fictions, and to what we imagine artificial agents are doing when we are not looking at them. (shrink)

Routledge is now re-issuing this prestigious series of 204 volumes originally published between 1910 and 1965. The titles include works by key figures such asC.G. Jung, Sigmund Freud, Jean Piaget, Otto Rank, James Hillman, Erich Fromm, Karen Horney and Susan Isaacs. Each volume is available on its own, as part of a themed mini-set, or as part of a specially-priced 204-volume set. A brochure listing each title in the "International Library of Psychology" series is available upon request.

In the contemporary debate on free will, most philosophers assume that the defense of libertarianism implies the defense of the notion of alternative possibilities. This article discusses this presupposition by showing that it is possible to build a libertarianism without alternative possibilities, apparently more robust than libertarianism with alternative possibilities. Inspired by Bergson, this nonclassical libertarianism challenges the idea that all causation implies the actualization of a predetermined possibility (an idea shared by determinism and classical libertarianism). Moreover, it challenges the (...) idea that free will is a mere choice between prefixed possibilities: for this libertarianism, free will is the result of a creative process of the mind—an entirely causal process whose outcome is not, however, predetermined. This nonclassical libertarianism describes the process of forming a will in a more realistic way than classical libertarianism does. Furthermore, it is not threatened by the problem of chance. (shrink)

An introduction to the philosophy of mathematics grounded in mathematics and motivated by mathematical inquiry and practice. In this book, Joel David Hamkins offers an introduction to the philosophy of mathematics that is grounded in mathematics and motivated by mathematical inquiry and practice. He treats philosophical issues as they arise organically in mathematics, discussing such topics as platonism, realism, logicism, structuralism, formalism, infinity, and intuitionism in mathematical contexts. He organizes the book by mathematical themes--numbers, rigor, geometry, proof, computability, incompleteness, (...) and set theory--that give rise again and again to philosophical considerations. (shrink)

Grace A. de Laguna was an American philosopher of exceptional originality. Many of the arguments and positions she developed during the early decades of the twentieth century later came to be central to analytic philosophy. These arguments and positions included, even before 1930, a critique of the analytic-synthetic distinction, a private language argument, a critique of type physicalism, a functionalist theory of mind, a critique of scientific reductionism, a methodology of research programs in science and more. Nevertheless, de Laguna identified (...) herself as a defender of the speculative vision of philosophy, a vision which, in her words, “analytic philosophy condemns.” I outline her speculative vision of philosophy as well as what is, in effect, an argument she offers against analytic philosophy. This is an argument against the view that key parts of established opinion, e.g., our best theoretical physics or most certain common sense, should be assumed to be true in order to answer philosophical questions. I go on to bring out the implications of her argument for the approaches to philosophy of Bertrand Russell, Willard V. Quine and David Lewis, and I also compare the argument to recent, related arguments against analytic philosophy. I will suggest that de Laguna offers a viable critique of analytic philosophy and an alternative approach to philosophy that meets this critique. (shrink)

In this classic collection of wide-ranging and interdisciplinary essays, Stanley Cavell explores a remarkably broad range of philosophical issues from politics and ethics to the arts and philosophy. The essays explore issues as diverse as the opposing approaches of 'analytic' and 'Continental' philosophy, modernism, Wittgenstein, abstract expressionism and Schoenberg, Shakespeare on human needs, the difficulties of authorship, Kierkegaard and post-Enlightenment religion. Presented in a fresh twenty-first century series livery, and including a specially commissioned preface, written by Stephen Mulhall, illuminating (...) its continuing importance and relevance to philosophical enquiry, this influential work is now available for a new generation of readers. (shrink)

College students struggle with the switch from thinking of mathematics as a calculation based subject to a problem solving based subject. This book describes how the introduction to proofs course can be taught in a way that gently introduces students to this new way of thinking. This introduction utilizes recent research in neuroscience regarding how the brain learns best. Rather than jumping right into proofs, students are first taught how to change their mindset about learning, how to persevere through difficult (...) problems, how to work successfully in a group, and how to reflect on their learning. With these tools in place, students then learn logic and problem solving as a further foundation. Next various proof techniques such as direct proofs, proof by contraposition, proof by contradiction, and mathematical induction are introduced. These proof techniques are introduced using the context of number theory. The last chapter uses Calculus as a way for students to apply the proof techniques they have learned. (shrink)

Drawing upon the life and work of S. Kay Toombs, I explore the impact and import of phenomenological accounts of disability for the existentialist tradition. Through the case of multiple sclerosis, a noncongenital, late-onset, and degenerative disability, I show how the general structures that emerge from its lived experience largely support a mere-difference view of disability and highlight the need for an equitably habitable world. I further argue that phenomenological accounts of disability demonstrate accessibility to be the defining feature of (...) what it means to be embodied as we are. I conclude with a discussion of the more general philosophical relationship between disability, embodiment, and existentialism. (shrink)

Ethical extensionism is a common argument pattern in environmental and animal ethics, which takes a morally valuable trait already recognized in us and argues that we should recognize that value in other entities such as nonhuman animals. I exposit ethical extensionism’s core argument, argue for its validity and soundness, and trace its history to 18th century progressivist calls to expand the moral community and legal franchise. However, ethical extensionism has its critics. The bulk of the paper responds to recent criticisms, (...) including (1) environmental ethicists’ objection against its austere conception of moral value (2), feminist ethicists’ claim that extensionism fails to account for the moral significance of difference, (3) disability theorists’ concern that ethical extensionist arguments are offensive, and (4) animal rights theorists’ lament that extensionism is a practical failure. While something is to be gained from each criticism, I argue that they ultimately fail and that extensionism remains compelling. (shrink)

I develop Tetsurō Watsuji’s relational model of the self as “betweenness”. I argue that Watsuji’s view receives support from two case studies: solitary confinement and dementia. Both clarify the constitutive interdependence between the self and the social and material contexts of “betweenness” that define its lifeworld. They do so by providing powerful examples of what happens when the support and regulative grounding of this lifeworld is restricted or taken away. I argue further that Watsuji’s view helps see the other side (...) of this deprivation, how reconstructing aspects of betweenness is, at the same time, a reconstruction of the self. I conclude by briefly indicating further consequences of this view. (shrink)