Background: Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors’ decisions. Associations between physicians’ religious characteristics and their weighting of the criteria were also examined. Methods: Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association masterfile. (...) Physicians were asked how much weight should be given to the following: (1) the patient’s expressed wishes and values, (2) the physician’s own judgment about what is in the patient’s best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. Results: Response rate 51% (446/879). Half of physicians (55%) gave the patient’s expressed wishes and values “the highest possible weight”. In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient’s expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the “highest possible weight”, versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). Conclusions: Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians’ decisions as much as is often recommended in the ethics literature. (shrink)

Hume's is/ought distinction has long limited the role of empirical research in ethics, saying that data about what something is cannot yield conclusions about the way things ought to be. However, interest in empirical research in ethics has been growing despite this countervailing principle. We attribute some of this increased interest to a conceptual breakdown of the is/ought distinction. MacIntyre, in reviewing the history of the is/ought distinction, argues that is and ought are not strictly separate realms but exist in (...) a close relationship that is clarified by adopting a teleological orientation. We propose that, instead of recovering a teleological orientation, society tends to generate its own goals via democratic methods like those described by Rousseau or adopt agnosticism about teleology such as described by Richard Rorty. In both latter scenarios, the distinction between is and ought is obscured, and the role for empirical research grows, but for controversial reasons. MacIntyre warns that the is/ought distinction should remain, but reminds ethicists to make careful arguments about when and why it is legitimate to move from is to ought. (shrink)

The General Data Protection Regulation (GDPR) was introduced in 2018 to harmonize data privacy and security laws across the European Union (EU). It applies to any organization collecting personal data in the EU. To date, service-level consent has been used as a proportionate approach for clinical trials, which implement low-risk, routine, service-wide interventions for which individual consent is considered inappropriate. In the context of public health research, GDPR now requires that individuals have the option to choose whether their data may (...) be used for research, which presents a challenge when consent has been given by the clinical service and not by individual service users. We report here on development of a pragmatic opt-out solution to this consent paradox in the context of a partner notification intervention trial in sexual health clinics in the UK. Our approach supports the individual’s right to withhold their data from trial analysis while routinely offering the same care to all patients. (shrink)

Political argument and institutions in the UnitedKingdom have frequently been represented as the products of ablend of nationalistic conservatism, liberal individualism andsocialism, in which consensus has been prized over ideology. This situation changed, as the standard story has it, with therise of Thatcherism in the late 1970s, and again with the arrivalof Tony Blair's ``New Labour'' pragmatism in the late 1990s. Solidarity as an element of political discourse makes itsappearance in the UK late in the day. It has been most (...) stronglylinked to the Third Way debate, as framed most influentially inthe work of Prof. Anthony Giddens.In this paper we review the history and pre-history of the debateon solidarity in the UK, focussing mostly on its implications forwelfare state reform. In particular we discuss the proposals forthe long-term care of the Elderly issued by the Royal Commissionon long-term care in 1999. In this context we critically examinethe idea that solidarity is a new concept in British politicalculture, and that it is a concept which has real political ``bite''in the project of welfare reform. We examine this through aconsideration of Giddens's attempted synthesis of politicalargument and social theory. (shrink)

The Islamic Medieval Philosopher al-Ghazᾱlî, known to the Latins as Algazel, was influential in the shaping of the intellectual philosophic movements in the thirteenth century. Though Ghazali’s predecessor Ibn Sînᾱ and successor Ibn Rushd received the philosophic credit due to them, Ghazali’s own philosophic ideas have not been significantly assessed; and hence Ghazali’s “fame” lies, we are told, in being responsible for the decline of Medieval Philosophy, especially Islamic Philosophy, a claim that is extremely difficult to prove. But be that (...) as it may, the intellectual movement in Europe during the thirteenth century pursued the intellectual Islamic heritage, not just of Avicenna and Averroës, but also that of Ghazali. Granted that Ghazali’s philosophic ideas did not assume a definite pattern in the philosophic literature—as was the case with Avicenna and Averroës—still a careful study of Ghazali’s works will reveal how profound and widespread his influence was on Western Medieval scholars. A case in point is the influence of Ghazali on Saint Thomas Aquinas—who studied the works of the Islamic philosophers, especially Ghazali’s, at The University of Naples. Thus in the course of the subsequent analysis, similarities between Ghazali and Aquinas will reveal themselves. The aim of this paper, however, does not consist in delineating their refutations of the arguments of the philosophers that one finds in Ghazali’s and Aquinas’s works. Rather I shall primarily deal with their discussion of the principle of causality and then indicate how the works of Ghazali have played an important role in the shaping of the philosophic ideas of Aquinas. (shrink)

In a detailed and careful manner, Taylor sets about an analysis of the notions of causation, human action, purpose, and a whole host of other conceptions such as deliberation, willing, mental acts, and reasons that relate to these key concepts in the philosophy of human action. The issue is, of course, what sort of explanation is suited to grasping the inherent intelligibility of human action. Having argued his way through to a notion of agent causality, which differs little from that (...) of Aristotle, and having concluded to the irreducibility of purpose that this conception implies, Taylor maintains that logical reductionism, behaviorism, and/or mechanism are logically deficient and leave human action unexplained; however, the non-reducibility of common sense, teleological and free will concepts does not imply, for Taylor, a dualism Taylor does leave it open as a matter to be empirically decided whether or not ontological reductionism is a viable alternative. While the book is an extraordinarily skillful and dialectical handling of current discussion in the philosophy of action, there is distressingly little mention of the sources and supports of this discussion. The effect is to make some of Taylor's more controversial pronouncements appear a bit more dogmatic than should be the case; but in the end, content triumphs sufficiently over style to make this book important reading for anyone interested in having some clear light thrown on the thorny problems surrounding the philosophy of action.—E. A. R. (shrink)

The thesis of this article is that there has never been any ground for the controversy between the doctrine of free will and determinism, that it is based upon a misapprehension, that the two assertions are entirely consistent, that one of them strictly implies the other, that they have been opposed only because of our natural want of the analytical imagination. In so saying I do not tamper with the meaning of either phrase. That would be unpardonable. I mean free (...) will in the natural and usual sense, in the fullest, the most absolute sense in which for the purposes of the personal and moral life the term is ever employed. I mean it as implying responsibility, merit and demerit, guilt and desert. I mean it as implying, after an act has been performed, that one " could have done otherwise " than one did. I mean it as conveying these things also, not in any subtly modified sense but in exactly the sense in which we conceive them in life and in law and in ethics. These two doctrines have been opposed because we have not realised that free will can be analysed without being destroyed, and that determinism is merely a feature of the analysis of it. And if we are tempted to take refuge in the thought of an "ultimate ", an "innermost" liberty that eludes the analysis, then we have implied a deterministic basis and constitution for this liberty as well. For such a basis and constitution lie in the idea of liberty. -/- The thesis is not, like that of Green or Bradley, that the contending opinions are reconciled if we adopt a certain metaphysic of the ego, as that it is timeless, and identifies itself with a desire by a " timeless act". This is to say that the two are irreconcilable, as they are popularly supposed to be, except by a theory that delivers us from the conflict by taking us out of time. Our view on the contrary is that from the natural and temporal point of view itself there never was any need of a reconciliation but only of a comprehension of the meaning of terms. (The metaphysical nature of the self and its identity through time is a problem for all who confront memory, anticipation, etc.; it has no peculiar difficulties arising from the present problem.) -/- I am not maintaining that determinism is true; only that it is true insofar as we have free will. That we are free in willing is, broadly speaking, a fact of experience. That broad fact is more assured than any philosophical analysis. It is therefore surer than the deterministic analysis of it, entirely adequate as that in the end appears to be. But it is not here affirmed that there are no small exceptions, no slight undetermined swervings, no ingredient of absolute chance. All that is here said is that such absence of determination, if and so far as it exists, is no gain to freedom, but sheer loss of it; no advantage to the moral life, but blank subtraction from it. -- When I speak below of "the indeterminist" I mean the libertarian indeterminist, that is, him who believes in free will and holds that it involves indetermination. (shrink)

This study represents an improvement in the ethics scales inventory published in a 1988 Journal of Business Ethics article. The article presents the distillation and validation process whereby the original 33 item inventory was reduced to eight items. These eight items comprise the following ethical dimensions: a moral equity dimension, a relativism dimension, and a contractualism dimension. The multidimensional ethics scale demonstrates significant predictive ability.

Few studies have examined how trait emotion dysregulation relates to momentary affective experiences and the emotion regulation strategies people use in daily life. In the current study, 112 c...

Another edition of the Essay with little, outside of the fact that it is abridged, to distinguish it from various other editions already out in paper.—E. A. R.

Embodiment, Vesey maintains, is the term applied to our experience of an unmediated movement of our body and an unmediated awareness within perceptual experience. Vesey argues for embodiment as the most satisfying explanation of the mind-body relationship chiefly by arguing against substance dualism as presented by the Local Sign theory of sensation and the Ideo-motor theory of bodily movement. The former is deficient because it rests on the false empirical assumption that all perceptual capacities are learned; the latter is inadequate (...) for more complex reasons, the development of which leads Vesey through his own theory of perception and movement. Vesey's own theory rests on contrast between causal, substance dualism and his own favored, non-causal, subject-object duality, which avoids an absolute dualism because of the internal relatedness of its key terms from the outset. The first half of the book presents a concise review and criticism of current non-dualistic views of the mind-body relation other than that of embodiment; here Vesey has a brief and somewhat unsatisfying skirmish with double aspect and identity theories.—E. A. R. (shrink)

An attractive student edition of the Kritik. The text follows the Akademie edition but with an eye on both of the original editions of 1781 and 1787. The Preface, Deduction, etc. of the A edition are, of course, appended. There is some cause for complaint in that the A and B edition page numbers are included at the bottom of the page and not marginally, an oversight which will make reference inconvenient or inaccurate. A regular index and a valuable analytical (...) index of Kant's own definitions of key terms are included. In addition, the editors have added an appendix detailing the apparatus employed in arriving at this particular edition. Unfortunately the price of the hard-cover edition was not indicated, but the paper edition was given at 10.80 DM.—E. A. R. (shrink)

The translation is that of G. C. Richards with a number of incidental changes. The Introduction is valuable for providing an historical perspective on More's classic. The notes are reduced in the paperback edition.—E. A. R.

The five chapters in this volume were originally delivered in lecture form at the University of Genoa and have previously appeared in French, German, and English translations. An appendix, "What the Philosopher May Learn from the Study of Law," has also appeared before in English. The book is basically a digest, with some modifications, of Perelman's earlier work Justice et Raison. The chief modification involves a supposed shift away from positivism toward a greater emphasis on the cognitive status of primary (...) values. Through the mediation of his consideration of the nature of practical reason in the Traité de l'Argumentation, Perelman now wishes to argue that values are subject to dialectical justification. The analysis of justice, thus, need not be restricted to merely formal specifications such as the rule of justice or to such inherently nonuniversalizable and nonanalyzable principles as that of equity. Dialectical justification falls short of demonstration, but only someone still under the spell of Cartesianism would wish to maintain that rationality is adequately summarized in the model provided by mathematics and science. Jurisprudence, therefore deals with judgments that have cognitive and not arbitrary or merely historical value. So much for the scheme of Perelman's argument. What about its execution? It must be said that its substance is slight and the base of discussion extraordinarily narrow. Thus, Perelman says he wishes to avoid the Scylla of nominalism and the Charybdis of realism; but his own analysis winds up squarely in a conventionalism that is only minutely distinguishable from the nominalism he presumably attacks: e.g., "the idea of [practical] reason must not be linked to that of truth", "reason is but an attempt to convince the members of [the universal] audience--whom common sense would define as well-informed and reasonable men". The only defense offered by Perelman for the first statement is a flaunting of the bogey of dogmatism. The vicious circle in the second statement is barred from rising to the level of the fruitful Aristotelian paradox by a peremptory dismissal of natural law: "The theorists of natural law... have not convinced the majority of those philosophers of law who are endowed with critical minds." This kind of "you-don't-belong-to-the-club" argument makes the book practically worthless from a truly dialectical point of view. The only critical sparks generated are in Perelman's discussion of Rawls' theory of "justice as fair play." His points here are well taken. But, as this is the only saving grace in the book--the rest being merely a statement of Perelman's own doxa about justice--it would have been better to leave the whole interred in the journals where it had already been published.--E. A. R. (shrink)

This is a translation of Carnap's early classic, Der Logische Aufbau der Welt and his less technical but also important article from the same period, Scheinprobleme in der Philosophie. It is no secret that Carnap abandoned the phenomenalism of the Aufbau for the physicalism of Logische Syntax der Sprache, but there is no doubt that the real message of the Aufbau—which is punctuated with the Messianic spirit of early logical positivism—is the program of "rational reconstruction" which becomes, on an inverted (...) reading and with the addition of a bias in favor of the universal descriptive and explanatory power of scientific discourse, the program of scientific reductionism. In this light, the continuities between the Aufbau and Carnap's later work completely dwarf in importance the discrepancies between these two periods of his creative output. The Aufbau remains an important book in its own right, and is not simply a detailed manifesto of a now defunct program; it is a pleasure to have it in English.—E. A. R. (shrink)

The theme of this series is given a human touch in Medieval Masters. All of the contributors in this memorial volume are paying tribute to their mentor, former University of Toronto (St. Michael's College) professor, Rev. Edward A. Synan. These essays provide ample proof that Synan's legacy of excellence will continue to influence students of philosophy for decades to come. In addition to ten essays, the volume contains a Synan bibliography and a very heartfelt opening remembrance from M. Jean Kitchel. (...) The essays are wide ranging, exploring Bonaventure, John Duns Scotus, Averroes, and Albert the Great, as well as the Thomistic themes of essence and existence; creation, numbers, and natures; and friendship and Christology. There is also a discussion of the treatment of the problem of universals in Boethius, Porphyry, and Abelard. Anyone who studies philosophy, whether a Thomist or not, will find this a valuable volume. That is as much a tribute to Father Synan as it is to the contributors, who were the grateful recipients of his generous and sage teaching. (shrink)