Background: Despite the expansion of ethics consultation services, questions remain about the aims of clinical ethics consultation, its methods and the expertise of those who provide such services.Objective: To describe physicians’ expectations regarding the training and skills necessary for ethics consultants to contribute effectively to the care of patients in intensive care unit .Design: Mailed survey.Participants: Physicians responsible for the care of at least 10 patients in ICU over a 6-month period at a 921-bed private teaching hospital with an established (...) ethics consultation service. 69 of 92 eligible physicians responded.Measurements: Importance of specialised knowledge and skills for ethics consultants contributing to the care of patients in ICU; need for advanced disciplinary training; expectations regarding formal-training programmes for ethics consultants.Results: Expertise in ethics was described most often as important for ethics consultants taking part in the care of patients in ICU, compared with expertise in law , religious traditions , medicine and conflict-mediation techniques . When asked about the formal training consultants should possess, however, physicians involved in the care of patients in ICU most often identified advanced medical training as important.Conclusions: Although many physicians caring for patients in ICU believe ethics consultants must possess non-medical expertise in ethics and law if they are to contribute effectively to patient care, these physicians place a very high value on medical training as well, suggesting a “medicine plus one” view of the training of an ideal ethics consultant. As ethics consultation services expand, clear expectations regarding the training of ethics consultants should be established. (shrink)

Following up on a 1989 paper on the subject, this essay revisits the question of ethical expertise in the court room. Informed by recent developments in the use of ethics experts, the authors argue 1) that the adversarial nature of court proceedings challenges the integrity of the ethicist's pedagogical role; 2) that the use of ethics experts as normative authorities remains dubious; 3) that clarification of the State's interest in “protecting the ethical integrity of the medical profession” is urgently required; (...) and 4) that the expertise of the ethicist may be more appropriately used in advising the legislature than in influencing the court. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

A recently formulated concept of stochastic localizability is shown to be consistent with a concept of stochastic microcausality, which avoids the conclusions of Hegerfeldt's no-go theorem as to the inconsistency of sharp localizability of quantum particles and Einstein causality. The proposed localizability on quantum space-time is shown to lead to strict asymptotic causality. For finite time evolutions, upper bounds on propagation to the exterior of stochastic light cones are derived which show that the resulting probabilities are too small to (...) be actually observable in a realistic context. (shrink)

Carol Gilligan has identified two orientations to moral understanding; the dominant justice orientation and the under-valued care orientation. Based on her discernment of a voice of care, Gilligan challenges the adequacy of a deontological liberal framework for moral development and moral theory. This paper examines how the orientations of justice and care are played out in medical ethical theory. Specifically, I question whether the medical moral domain is adequately described by the norms of impartiality, universality, and equality that characterize the (...) liberal ideal. My analysis of justice -oriented medical ethics, focuses on the libertarian theory of H.T. Engelhardt and the contractarian theory of R.M. Veatch. I suggest that in the work of E.D. Pellegrino and D.C. Thomasma we find not only a more authentic representation of medical morality but also a project that is compatible with the care orientation's emphasis on human need and responsiveness to particular others. (shrink)

Chefs have been recognized as potentially important partners in efforts to promote local food systems. Drawing on the diffusion of innovation framework we (a) examine the characteristics of chefs and restaurants that have adopted local foods; (b) identified local food attributes valued by restaurants; (c) examine how restaurants function as opinion leaders promoting local foods; (d) explored network linkages between culinary and production organizations; and (e) finally, we consider some of the barriers to more widespread adoption of local foods in (...) the culinary community. Analyzing quantitative and qualitative data collected from interviews with individuals from 71 restaurants, we compare and contrast restaurants that utilize relatively large amounts of locally-produced ingredients with restaurants using few, if any, local products. Results reveal that chefs are most interested in intrinsic food qualities, such as taste and freshness, and less interested in production standards. As opinion leaders, chefs utilize signage, wait staff, and cooking classes to promote local foods; however, the diffusion process across restaurants, and between restaurants and producers, is limited by network associations. Structural barriers such as distribution problems and lack of convenience were identified as limiting more widespread use of locally-grown foods. We offer several implications of this research for further work that seeks to engage chefs as opinion leaders who are important to building greater support for local food systems. (shrink)

Political decision theory provides a framework for evaluating three approaches to military research and development: offensive weaponry intended for deterrence, the Strategic Defense Initiative and other weaponry intended fordefense, and cutbacks designed to slow the research and development treadmill. Large-scale R&D does not protect against most of the risks facing national security. Nor does an R&D-intensive approach provide the flexibility necessary to adjust military policy in light of rapidly changing international conditions. Considering all factors together, there is a strong theoretical (...) case for placing sharp constraints on military innovation, not just on the quantities of weapons deployed. (shrink)

Inside What Would Plato Do?, you'll find the basics of philosophy, written in an easy, digestible way we can all understand, along with questions to help you apply these important theories to your own life. So, after you've learned about a philosophical concept, you'll then be challenged to test yourself and see how the results can impact your daily life. For instance, after learning about Kant's theory of morality and the importance of intention you're challenged with questions like: Can good (...) people do bad things? Was there a time when you intended to do something helpful that ended up being hurtful? Does that make you a good person (because you intended to do good) or a bad person (because the results were bad)? What Would Plato Do? will not only help you better understand some of the greatest thinkers ever but will also help you think of the world around you in a whole new way! (shrink)

The lines come from the messenger's speech describing the attack of the Delphians on Neoptolemus, a passage which I have discussed elsewhere in connexion with the tradition of Neoptolemus as inventor of the armed Pyrrhic dance. LSJ seem to be in several minds about the meaning and connexion of some of the words describing the missiles used by the Delphians. S.v. ‘σφαγεύς’, they give ‘sacrificial knife, spit’ uniquely of a word elsewhere meaning ‘slayer, murderer’, etc.. S.v. ‘βουπόρος’, they cite ἀμφωβόλοι (...) σφαγῆς … βουπόροι ‘spitst fit to pierce an ox's throat’—i.e. taking σφαγῆς as gen. sing., rather oddly dependent on βουπόροι. S.v. ‘ἔκλυτος’, they quote this passage, again uniquely, in the sense ‘easy to let go, light, buoyant, of missiles’. This last seems even less likely than Wecklein's ohne Riemen or the Budé's doubles dards sans poignée, which presumably invoke a rather frigid contrast of the true javelins fitted with thongs and the spits, sharp at both ends, which were pressed into service of a similar sort, but of course had to be thrown without this attachment: but these implements could hardly be described as ἔκλυτοι of thongs which they never had at all in the first place!With Murray's punctuation, since a combination of a, b, c τε, d is scarcely credible, σφαγῆς βουπόροι is presumably not to be taken as the description of a separate type of weapon, but as an explanatory appositional phrase with ἀμφώβολοι. This interpretation is found in the schol, ὀβελίσκοι σφάττειν δυνάμενοι and followed by Hermann and Paley. (shrink)

In this paper I offer a counterexample to the so called vagueness argument against restricted composition. This will be done in the lines of a recent suggestion by Trenton Merricks, namely by challenging the claim that there cannot be a sharp cut-off point in a composition sequence. It will be suggested that causal powers which emerge when composition occurs can serve as an indicator of such sharp cut-off points. The main example will be the case of a heap. (...) It seems that heaps might provide a very plausible counterexample to the vagueness argument if we accept the idea that four grains of sand is the least number required to compose a heap—the case has been supported by W. D. Hart. My purpose here is not to put forward a new theory of composition, I only wish to refute the vagueness argument and point out that we should be wary of arguments of its form. (shrink)

In its aim to radicalize the basis of objectivity, Husserl's phenomenological inquiries resemble the "new science" of Vico. But Husserl's renewal of that aim is animated by a peculiarly modern sense of antidogmatism and rigor, and its special problem is to criticize knowledge by starting with the existential a priori of the life-world. The antidogmatism of phenomenology is seen to be a consequence of its antisubjectivism. Semerari's interpretation of Husserl is provocative but sketchy; his appreciations and criticisms of Kant, several (...) analytically-oriented thinkers, Wittgenstein, Sartre, and Heidegger are very sharp, but usually left as ideas for the reader to test and work out.--C. D. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:How Philosophers Trivialize Art: Bleak House, Oedipus Rex, "Leda and the Swan"Michael D. HurleyIIt is a Perverse but unsurprising irony that answers to the question of whether art can give us knowledge characteristically trivialize that which draws us to individual artworks in the first place. The experience of art is sidelined in favor of the apparent after-effect of that experience. Even those writing against each other tend to converge (...) on this. In an essay contesting Nelson Goodman's epistemic claims for art, Gordon Graham nonetheless agrees that, "The question to be asked of such a work is not, 'Does this effectively capture the scene portrayed?', but 'Does this make us see this sort of occasion differently?'"1 Even attempts to distinguish art as "gift" as opposed to commodity predictably figure its value in terms of what might be taken away: "I went to see a landscape painter's works, and that evening, walking among pine trees near my home, I could see the shapes and the colors I had not seen the day before."2This state of affairs is perversely ironic for two reasons. Firstly, because the possibility of art's cognitive content is only prompted at all by the immediate experience it offers: without this, art would not excite us the way it does and there would be no debate to be had. Secondly, and more significantly, because a defining part of what constitutes an interest in art is, I should like to suggest, an experience of knowledge; or, more accurately, an experience of knowing. This irony is unsurprising because it is merely another expression of a recalcitrant prejudice in western epistemology that idealizes knowledge as an objectively true, justified belief—perforce excluding the possibility of knowing as a subjective [End Page 107] experience of believing. No wonder the author of Theætetus elsewhere finds poets incapable of offering anything but lies.Plato's lingering legacy assures that the cognitive content of art be assized according to what might be extracted from the artwork—cashed in like so many casino chips—when we are done with our experience of it. This applies whether the knowledge-bearing being argued for, or against, is conceptual or propositional (e.g., Putnam, Novitz, John),3 or imaginative (e.g., Goodman, Robinson, Currie),4 as well as for the claim that art can offer us moral instruction (e.g., Beardsmore, Eldridge, Nussbaum, Sharpe, Kieran, John).5 There is less consensus as to whether the capacity of art to give us knowledge enriches the aesthetic value of that artwork, but those who would advance this position have been on the back-foot in recent years following a wave of criticisms from, among others, Beardsley, Lamarque and Olsen, Diffey, and Gaut.6This article addresses art's capacity to give us knowledge as well as the conjunct of whether such knowledge might inform its value qua art. In so doing, it presses a case that has already been disallowed by the terms in which the question of the relationship between art and knowledge is typically put. Whatever efferent knowledge art might offer, it also provides the conditions for a kind of knowing that cannot be translated beyond itself. Only such an experience of knowledge-as-knowing, which is realized through the untranslatable singularity of an artwork, may be considered constitutive of art's aesthetic value. Couched another way: epistemology meets aesthetics not where it has most often been located, in the perfective, at the congruence of the thought and the felt, but in the present continuous, in the engagement of thinking and feeling. Connecting the epistemic and the aesthetic in this way is, then, exactly the opposite proposition to that presented by Douglas Morgan, for whom, "although many words in many arts can and do give us knowledge of many kinds, nonetheless if this knowledge were the key and limit to the love of art, the world of art would be even sorrier than it now is."7IILiterature has generated by far the greatest volume of commentary in the debate on art and knowledge. This is to be expected given the bias towards categorizing knowledge as something like data... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Beyond the Ethics of Wealth and a World of Economic InequalityMark D. WoodAnalyzing the ethics of wealth and the relationship between the dominant ethics of wealth and economic inequality is vital to creating a humane mode of global life. We are living during a period in which the unequal concentration of wealth—which is to say, the unequal concentration of the resources that make human existence, development, and fulfillment possible—has (...) never been greater.1 The World Bank reports that almost “1.3 billion people remain below the extreme poverty line with an income of US $1.25 or less a day. Close to 2.5 billion—more than one-third of the world’s population—live on less than US $2 a day, another common measurement of deep deprivation,”2 and a staggering 80 percent of the world’s population struggles to survive on less than US $10 dollars a day.3 Credit Suisse’s 2012 Global Wealth Report indicates “the bottom half of the global population [or more than 3.5 billion persons] possess barely 1 percent of total wealth... In sharp contrast, the richest 10 percent own 86 percent of the world’s wealth, with the top 1 percent alone accounting for 46 percent of global assets.”4 Given the history of international colonial and neocolonial relations, it comes as no surprise that wealth is highly concentrated in Western Europe and North America, while the overwhelming majority of individuals living in poverty are concentrated in Africa, India, Asia, and Central and South America.5The wealth gap between the top 10 percent and the bottom 90 percent is, however, also reaching record levels in developed nations. While in 2012, the United States had the seventh highest average wealth holdings per adult in the world, “among nations with at least a quarter-million adults, only Russia, Ukraine, and Lebanon are more unequal” than the United States.6 A Reuters investigative report published in 2012 reveals that “inequality has risen not just in plutocratic hubs such as Wall Street and Silicon Valley, but also in virtually every corner of the world’s richest nation: Inequality has increased in 49 of 50 states since 1989,” with Mississippi being the only exception, even as it still “ranks worst in the nation on both counts.”7 In 2010, “the top 1 percent of households (the upper class) owned 35.4 percent of all privately held wealth, and the next 19 percent (the managerial, professional, and small business stratum) had 53.5 percent, which means that just 20 percent of the people owned a remarkable 89 percent, leaving only 11 percent of the wealth for the bottom 80 percent [End Page 125] (wage and salary workers).”8 In The Price of Inequality (2012), Nobel Prize–winning economist Joseph E. Stiglitz indicates that the “six heirs to the Walmart empire command wealth of $69.7 billion dollars, which is equivalent to the entire wealth of the bottom 30 percent of U.S. society.”9 In short, six individuals possess more wealth than do ninety-six million individuals—though this figure is misleading inasmuch as most of the ninety-six million own almost nothing but mounting debt. Most significantly, the top 10 percent own between 81 percent and 94 percent of all stocks, bonds, trust funds, and business equity, and almost 80 percent of non-home real estate.10 G. William Domhoff makes the vital point that inasmuch as “financial wealth is what counts as far as the control of income-producing assets,” that is, control of the means of producing wealth, “we can say that just 10 percent of the people own the United States of America.”11 Meanwhile, according to the latest census, fifty million Americans qualify as poor and another 100 million qualify as low income.12The concentration of the lion’s share of wealth in the hands of a tiny fraction of humanity is devastating for the majority of people living on the planet and ultimately for everyone. On the ground, capitalism’s champagne glass–shaped distribution of wealth means that hundreds of millions of persons have barely enough of the basics necessary to exist. Between 24,000... (shrink)

Ever since the work of Otto Miiller it has been generally agreed that the most important manuscript of the Thebaid is Puteaneus, a ninth-century manuscript in the Bibliothèque Nationale. It is not only the earliest extant manuscript but it has a large number of readings not found elsewhere, many of which are obviously preferable to what is offered by the other tradition, normally referred to as ω. Both traditions are early, however, since Lactantius depends on inferior ω material while Priscian (...) seems to have followed the P tradition. (shrink)

There is a common view in medical ethics that the patient's right to be informed entails, as well, a correlative right not to be informed, i.e., to waive one's right to information. This paper argues, from a consideration of the concept of autonomy as the foundation for rights, that there can be no such ‘right’ to refuse relevant information, and that the claims for such a right are inconsistent with both deontological and utilitarian ethics. Further, the right to be informed (...) is shown to be a mandatory right (though not a welfare right); persons are thus seen to have both a right and a duty to be informed. Finally, the consequences of this view are addressed: since the way in which we conceptualize our problems tends to determine the actions we take to resolve them, it is important properly to conceptualize patients' requests not to be informed. There may be many reasons for acting in accord with such a request, but it is a mistake to conceptualize one's act as ‘respecting a right possessed by persons’. Keywords: medical ethics, informed consent, autonomy, information-waivers, rights, obligations CiteULike Connotea Del.icio.us What's this? (shrink)