The term compassion fatigue has come to be applied to a disengagement or lack of empathy on the part of care-giving professionals. Empathy and emotional investment have been seen as potentially costing the caregiver and putting them at risk. Compassion fatigue has been equated with burnout, secondary traumatic stress disorder, vicarious traumatization, secondary victimization or co-victimization, compassion stress, emotional contagion, and counter-transference. The results of a Canadian qualitative research project on nurses? experience of compassion fatigue are presented. Nurses, self-identified as (...) having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families. Time to help patients and families cope with suffering seemed unavailable, and many felt they were running on empty and, ultimately, impotent as nurses. Feelings of irritability, anger, and negativity arose, though participants described denying or ignoring these emotions as a way to try to survive their work day. Difficulties with work carried over into the nurses? personal lives, affecting their relationships with family and friends. Such experiences invariably called into question the participants? identity, causing them to reflect on the kind of nurse they were. The participants? compassion fatigue created a sense of hopelessness regarding positive change, although some nurses described strategies that seemed to help alleviate their compassion fatigue. (shrink)

Marshall et al. (2024) raise questions regarding patient refusals of care. In this commentary we address refusals of care from the lens of patient autonomy and provide suggestions for patient cente...

There is a well-known American legal maxim, hard cases make bad law. If we agree that Mr. J’s case is hard, what lessons follow from the application of current ECMO guidelines and what kind of supp...

One way to challenge the substantiveness of a particular philosophical issue is to argue that those who debate the issue are engaged in a merely verbal dispute. For example, it has been maintained that the apparent disagreement over the mind/brain identity thesis is a merely verbal dispute, and thus that there is no substantive question of whether or not mental properties are identical to neurological properties. The goal of this paper is to help clarify the relationship between mere verbalness and (...) substantiveness. I first argue that we should see mere verbalness as a certain kind of discourse defect that arises when the parties differ as to what each takes to be the immediate question under discussion. I then argue that mere verbalness, so understood, does not imply that the question either party is attempting to address is a non-substantive one. Even if it turns out that the parties to the mind/brain dispute are addressing subtly different questions, these might both be substantive questions to which their respective metaphysical views provide substantive answers. One reason it is tempting to reach deflationary conclusions from the charge of mere verbalness is that we fail to distinguish it from the claim that a sentence under dispute is, in a certain sense, indisputable. Another reason is that we fail to distinguish mere verbalness from a certain sort of indeterminacy. While indisputability and indeterminacy plausibly capture forms of nonsubstantiveness, I argue that mere verbalness is insufficient to establish either indisputability or indeterminacy. (shrink)

Recent work in moral philosophy has emphasized the foundational role played by interpersonal accountability in the analysis of moral concepts such as moral right and wrong, moral obligation and duty, blameworthiness, and moral responsibility (Darwall 2006; 2013a; 2013b). Extending this framework to the field of moral psychology, we hypothesize that our moral attitudes, emotions, and motives are also best understood as based in accountability. Drawing on a large body of empirical evidence, we argue that the implicit aim of the central (...) moral motives and emotions is to hold people - whether oneself or others - accountable for compliance with the demands of morality. Moral condemnation is based in a motive to get perpetrators to hold themselves accountable for their wrongdoing, not, as is commonly supposed, a mere retributive motive to make perpetrators suffer (�2). And moral conscience is based in a genuine motive to hold oneself accountable for behaving in accordance with moral demands, not, as is commonly supposed, a mere egoistic motive to appear moral to others (�3). The accountability-based theory of the moral motives and emotions we offer provides better explanations of the extant empirical data than any of the major alternative theories of moral motivation. Moreover, conceiving of moral psychology in this way gives us a new and illuminating perspective on what makes morality distinctive: its essential connection to our practice of holding one another accountable (�4). (shrink)

The paper describes the approach by which ethics are integrated into the undergraduate curriculum at Northern Illinois University''s College of Business. Literature is reviewed to identify conceptual frameworks for, and issues associated with, the teaching of business ethics. From the review, a set of guidelines for teaching ethics is developed and proposed. The objectives and strategies implemented for teaching ethics is discussed. Foundation and follow-up coursework, measurement issues and ancillary programs are also discussed.

Should a brain-dead woman be artificially maintained for the sake of her fetus? Does a physician have the right to administer a life-saving transfusion despite the patient's religious beliefs? Can a family request a hysterectomy for their retarded daughter? Physicians are facing moral dilemmas with increasing frequency. But how should these delicate questions be resolved and by whom? A Casebook of Medical Ethics offers a real-life view of the central issue involved in clinical medical ethics. Since the analysis of cases (...) plays a critical role in this study, the authors have assembled a broad collection of histories encountered in their work as medical ethics educators and consultants. The cases are developed in substantial detail to reflect the rich medical and psychosocial complexity involved, and each is brought to a decision point at which a course of action must be chosen. Among the issues examined are conflicts between patients' wishes and respect for their well-being, tensions concerning duties to patients unable to care for themselves and obligations to family members, and clashes between patient care obligations and the interests of other persons, including physicians, third parties, and the general public. The book also includes commentaries that combine general discussion of ethical principles with specific analysis of the cases examined in the text, as well as various options for resolving conflicts. Readers are invited to assess the comparative merits and liabilities of these approaches. An ideal text for undergraduate and medical school courses, A Casebook of Medical Ethics brings readers to the forefront of medicine, where they share in the determination of crucial ethical decisions. (shrink)

According to current hierarchies of evidence for EBM, evidence of correlation is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a causal claim. Second, (...) evidence of mechanisms is often required in order to obtain evidence of correlation. Third, evidence of mechanisms is often required in order to generalise and apply causal claims. While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms. (shrink)

To explore how molecules became signs I will ask: “What sort of process is necessary and sufficient to treat a molecule as a sign?” This requires focusing on the interpreting system and its interpretive competence. To avoid assuming any properties that need to be explained I develop what I consider to be a simplest possible molecular model system which only assumes known physics and chemistry but nevertheless exemplifies the interpretive properties of interest. Three progressively more complex variants of this model (...) of interpretive competence are developed that roughly parallel an icon-index-symbol hierarchic scaffolding logic. The implication of this analysis is a reversal of the current dogma of molecular and evolutionary biology which treats molecules like DNA and RNA as the original sources of biological information. Instead I argue that the structural characteristics of these molecules have provided semiotic affordances that the interpretive dynamics of viruses and cells have taken advantage of. These molecules are not the source of biological information but are instead semiotic artifacts onto which dynamical functional constraints have been progressively offloaded during the course of evolution. (shrink)

Several times, when faced with a difficult passage of scripture in Sermones ad populum, Augustine implores his audience, “knock and it shall be opened” (Matt. 7:7c; par. Luke 11:9c). Augustine uses this phrase to stress humility and the human need for God’s activity when interpreting scripture. Studying the archeological record of domestic architecture of locked doors in Roman North Africa elucidates Augustine’s message. Knowledge of the material culture shows that Augustine calls upon Christians to “knock” upon scripture as if it (...) were a door, locked and barred in such a way that it could only be opened from inside. Thus, a reader of scripture is like a petitioner calling from outside a locked door, needing God to open its meaning. Augustine’s use of “knocking” contrasts with the metaphor of “keys” to scripture, which was favored by Tyconius and other early Christian writers. In De doctrina Christiana, Augustine expresses concern that “keys” could lead a person into overconfidence, expecting to unlock obscure passages of the Bible by his or her own power. Augustine’s frequent use of Matt. 7:7c is a call for exegetes to approach scripture with humility. All members of the totus Christus, great and small, must humbly knock. The image of “knocking” provides a versatile theological message: human effort is important, but the meaning of the Bible is ultimately unlocked by God’s activity. (shrink)

Dr. Martin Luther King Jr.’s theology and rights-based activism remain highly relevant in a constitutional democracy. However, King’s use of human dignity in his early sermons as an extension of political rights faces serious challenges from Black leftist political writers and the Black Lives Matter movement. At issue is the extent to which human dignity should be examined as a distinct political, aesthetic, and moral category that must be explored and embraced more explicitly and wholeheartedly in Black politics and political (...) theory. Bracketing human dignity inside the category of political rights, which King often did in his early writings, undermines the comprehensive nature of antiblack racism and limits the scope and range of questions and resources we might employ to address the social ontology of Blackness. A sustained attention to human dignity provides an opportunity for new scholarly direction in the study of Black politics and political thought by expanding the boundaries of the political and creating space for morality and Black religion in the political (leftist) imaginary. (shrink)

Burt's argument relies on a motte-and-bailey fallacy. Burt aims to argue against the value of genetics for social science; instead she argues against certain interpretations of a specific kind of genetics tool, polygenic scores (PGSs). The limitations, previously identified by behavioural geneticists including ourselves, do not negate the value of PGSs, let alone genetics in general, for social science.

Political conspiracy theories—e.g., unsupported beliefs about the nefarious machinations of one’s cunning, powerful, and evil opponents—are adopted enthusiastically by a great many people of widely varying political orientations. In many cases, these theories posit that there exists a small group of individuals who have intentionally but secretly acted to cause economic problems, political strife, and even natural disasters. This group is often held to exist “in the shadows,” either because its membership is unknown, or because “the real nature” of its (...) members’ allegiances, motives, and methods has been concealed from the public at large. Paradigmatic examples of these political conspiracy theories include anti-Semitic beliefs of the sort associated with The Protocols of the Elder of Zion, the “Red Scare” of the 1950s, claims about the “New World Order,” and many others. -/- Why do these theories attract so many adherents? In this essay, I’ll attempt to spread some light on this issue by applying Kahneman and Tversky’s highly influential work on reasoning under uncertainty. I’ll proceed by first providing a brief introduction to Kahneman and Tversky’s work on reasoning under uncertainty, and the way in which this relates to standard economic and philosophic accounts of rational behavior, as well as philosophical ideas about the role of intuition. Next, I’ll move onto some specific interconnected aspects of this work that are relevant to understanding conspiracy theories, including errors involving probabilistic reasoning (“Prospect Theory”), those involving the inappropriate use of heuristics, and those related to the “framing” of certain outcomes as losses from a baseline. This essay will conclude by making two related points. First, some of the most important reasoning errors committed by adherents of conspiracy theories are errors that many of us regularly commit. Given that self-awareness of these errors provides only minimal protection from committing them, this suggests that many of use may be more vulnerable to conspiratorial reasoning than we may like to believe. Second, in the light of this danger, I will outline a few steps that might be taken to help inoculate ourselves against the appeal of these theories, and to help respond to the conspiratorial arguments of others. (shrink)

This is the text of a paper (along with appendixes) delivered at the 2019 annual meeting of the Minnesota Philosophical Society on Oct 26 in Cambridge, MN. -/- Beauchamp and Childress’s “Four Principles” (or “Principlism”) approach to bioethics has become something of a standard not only in bioethics classrooms and journals, but also within medicine itself. In this teaching-focused workshop, I’ll be doing the following: (1) Introducing the basics of the “Four Principles” approach, with a special focus on its relation (...) to the common morality and the importance to weighing and balancing of competing norms. (2) Comparing and contrasting this to other potential approaches, such as those provided by virtue ethics, act utilitarianism, casuistry, and competing versions of principles-based ethics. (3) Considering the ways in which the principles-based approach can best be implemented for lower-level, introductory bioethics classes, where the average student may have little background knowledge in either philosophy or medicine. I’ll be presenting sample activities, case studies, and lesson plans. There will be considerable time reserved for discussion at the end, so that participants can exchange ideas relating to the teaching of both bioethics and other varieties of applied ethics. (shrink)

Over the course of its six seasons, the Netflix show the House of Cards (HOC) details the rise to power of Claire and Frank Underwood in a fictional United States. They achieve power not by winning free and fair elections, but by exploiting various weaknesses of the U.S. political system. Could such a thing happen to our own democracies? This chapter argues that it is a threat that should be taken seriously, as the structure of HOC’s democratic institutions closely mirrors (...) our own, and the flaws that the Underwoods exploit are precisely those that have allowed autocrats to capture democracies “from the inside.” Of even greater concern, these flaws may flow from the nature of democracy itself. This possibility is explored by considering the events of the HOC in the light of the anti-democratic arguments of Plato and Hobbes. The chapter concludes by briefly considering responses to these arguments. (shrink)

ARISTOTLE often claims that words are "homonymous" or "multivocal". He claims this about some of the crucial words and concepts of his own philosophy—"cause," "being," "one," "good," "justice," "friendship." Often he claims it with a polemical aim; other philosophers have wrongly overlooked homonymy and supposed that the same word is always said in the same way. Plato made this mistake; his accounts of being, good, and friendship are rejected because they neglect homonymy and multivocity. In Aristotle’s view Plato shared the (...) Socratic assumption about words and definitions. Socrates thought that when he asked "What is F?" some single definition of F could always be found to match the name "F." Aristotle thinks the Socratic question is important, but argues that it must be controlled by awareness of homonymy and multivocity. (shrink)

What accounts for the capacity of ordinary speakers to comprehend utterances of their language? The phenomenology of hearing speech in one’s own language makes it tempting to many epistemologists to look to perception for an answer to this question. That is, just as a visual experience as of a red square is often taken to give the perceiver immediate justification for believing that there is a red square in front of her, perhaps an auditory experience as of the speaker asserting (...) that p gives the competent hearer immediate justification for believing that the speaker has asserted that p. My aim here is to offer reasons for resisting this temptation. I argue that the perceptual model cannot adequately account for the hearer’s justification in many cases. The arguments here also allow us to draw certain further morals about the role of phenomenology in the epistemology of perception. (shrink)

In this thesis, I give a metascientific account of causality in medicine. I begin with two historical cases of causal discovery. These are the discovery of the causation of Burkitt’s lymphoma by the Epstein-Barr virus, and of the various viral causes suggested for cervical cancer. These historical cases then support a philosophical discussion of causality in medicine. This begins with an introduction to the Russo- Williamson thesis (RWT), and discussion of a range of counter-arguments against it. Despite these, I argue (...) that the RWT is historically workable, given a small number of modifications. I then expand Russo and Williamson’s account. I first develop their suggestion that causal relationships in medicine require some kind of evidence of mechanism. I begin with a number of accounts of mechanisms and produce a range of consensus features of them. I then develop this consensus position by reference to the two historical case studies with an eye to their operational competence. In particular, I suggest that it is mechanistic models and their representations which we are concerned with in medicine, rather than the mechanism as it exists in the world. -/- I then employ these mechanistic models to give an account of the sorts of evidence used in formulating and evaluating causal claims. Again, I use the two human viral oncogenesis cases to give this account. I characterise and distinguish evidence of mechanism from evidence of difference-making, and relate this to mechanistic models. I then suggest the relationship between types of evidence presents us with a means of tackling the reference-class problem. This sets the scene for the final chapter. Here, I suggest the manner in which these two different classes of evidence become integrated is also reflected in the way that developing research programmes change as their associated causal claims develop. (shrink)

This paper argues that promises are proposals in joint practical deliberation, the activity of deciding together what to do. More precisely: to promise to ϕ is to propose (in a particular way) to decide together with your addressee(s) that you will ϕ. I defend this deliberative theory by showing that the activity of joint practical deliberation naturally gives rise to a speech act with exactly the same properties as promises. A certain kind of proposal to make a joint decision regarding (...) one's own actions turns out to have the very same normative effects, under the very same conditions, as a promise. I submit that this cannot be a coincidence: we should conclude that promises and the relevant kind of proposals in joint practical deliberation are one and the same. (shrink)

In a world filled with information overload and complex problems, the ability to think logically is a superpower. "A Little More Logical" is your guide to mastering this essential skill. This engaging and accessible open educational resource is perfect for students, teachers, and lifelong learners who want to improve their critical thinking abilities and make better decisions in all aspects of life. -/- Through a series of fun and interactive chapters, "A Little More Logical" covers a wide range of topics, (...) from the basics of constructing sound arguments to the application of logic in fields like ethics, science, and computing. You'll learn how to spot and avoid common fallacies, analyze real-world arguments, and use logical reasoning to solve problems and make informed choices. -/- But this book isn't just about abstract concepts – it's about the human story behind logic. You'll discover the fascinating lives and ideas of diverse thinkers, from ancient philosophers to modern-day pioneers, who have shaped the development of logical reasoning throughout history. With thought-provoking examples, engaging exercises, and plenty of humor along the way, "A Little More Logical" makes the study of logic both rigorous and entertaining. -/- Whether you're a student looking to ace your philosophy class, a teacher searching for high-quality educational resources, or a curious reader who wants to sharpen your mind, "A Little More Logical" is the perfect companion on your journey to becoming a more effective thinker. Unlock the power of logical thinking today with this one-of-a-kind open educational resource! (shrink)

Over the course of its six seasons, the Netflix show House of Cards (HOC) details the rise to power of Claire and Frank Underwood in a fictional United States. They achieve power not by winning free and fair elections, but by exploiting various weaknesses of the US political system. Could such a thing happen to our own democracies? This chapter argues that it is a threat that should be taken seriously, as the structure of HOC’s democratic institutions closely mirrors our (...) own, and the flaws that the Underwoods exploit are precisely those that have allowed autocrats to capture democracies “from the inside.” Of even greater concern, these flaws may flow from the nature of democracy itself. This possibility is explored by considering the events of HOC in light of the antidemocratic arguments of Plato and Hobbes. The chapter concludes by briefly considering responses to these arguments. (shrink)

By recourse to the fundamentals of preference orderings and their numerical representations through linear utility, we address certain questions raised in Nover and Hájek 2004, Hájek and Nover 2006, and Colyvan 2006. In brief, the Pasadena and Altadena games are well-defined and can be assigned any finite utility values while remaining consistent with preferences between those games having well-defined finite expected value. This is also true for the St Petersburg game. Furthermore, the dominance claimed for the Altadena game over the (...) Pasadena game, and that would have been claimed for the St Petersburg game over the Altadena, can be contradicted without fear of inconsistency with the axioms of utility theory. However, insistence upon dominance can be made to yield a contradiction of the Archimedean axiom of utility theory. CiteULike Connotea Del.icio.us What's this? (shrink)

Large Language Models (LLMs) have been transformative. They are pre-trained foundational models that are self-supervised and can be adapted with fine tuning to a wide range of natural language tasks, each of which previously would have required a separate network model. This is one step closer to the extraordinary versatility of human language. GPT-3 and more recently LaMDA can carry on dialogs with humans on many topics after minimal priming with a few examples. However, there has been a wide range (...) of reactions and debate on whether these LLMs understand what they are saying or exhibit signs of intelligence. This high variance is exhibited in three interviews with LLMs reaching wildly different conclusions. A new possibility was uncovered that could explain this divergence. What appears to be intelligence in LLMs may in fact be a mirror that reflects the intelligence of the interviewer, a remarkable twist that could be considered a Reverse Turing Test. If so, then by studying interviews we may be learning more about the intelligence and beliefs of the interviewer than the intelligence of the LLMs. As LLMs become more capable they may transform the way we interact with machines and how they interact with each other. Increasingly, LLMs are being coupled with sensorimotor devices. LLMs can talk the talk, but can they walk the walk? A road map for achieving artificial general autonomy is outlined with seven major improvements inspired by brain systems. LLMs could be used to uncover new insights into brain function by downloading brain data during natural behaviors. (shrink)

Evolutionary fitness threats and rewards are associated with subjectively unpleasant and pleasant sensations, respectively. Initially, these correlations appear explainable via adaptation by natural selection. But here I analyse the major metaphysical perspectives on consciousness – physicalism, dualism, and panpsychism – and conclude that none help to understand the adaptive-seeming correlations via adaptation. I also argue that a recently proposed explanation, the phenomenal powers view, has major problems that mean it cannot explain the adaptive-seeming correlations via adaptation either. So the mystery (...) – call it the evolutionary paradox of consciousness – remains. Some have used this mystery to argue for non-naturalistic (e.g. theistic) explanations. But I propose a naturalistic, non-adaptive explanation of the adaptive-seeming correlations: namely, ‘sensational associative learning’ during development. In this perspective, pairing of particular sensations with unconditioned stimuli – fitness rewards or threats – cause the sensations themselves to come to be interpreted as good or bad, respectively. Sensations, like colours, that are not reliably paired with either fitness rewards or threats remain largely unvalenced. Sensational associative learning also provides explanations for adaptive-seeming structural aspects of sensations, such as the observation that sounds of different pitch are experienced as ordinal in correspondence to their wavelengths while the same is not true of colours of different hue. The sensational associative learning perspective appears compatible with physicalism, panpsychism, and dualism (though not epiphenomenalism). (shrink)

David Enoch has recently proposed that the deliberative indispensability of irreducibly normative facts suffices to support their inclusion in our ontology, even if they are not necessary for the explanation of any observable phenomena. He challenges dissenters to point to a relevant asymmetry between explanation and deliberation that shows why explanatory indispensability, but not deliberative indispensability, is a legitimate guide to ontology. In this paper, I aim to do just that. Given that an entity figures in the actual explanation of (...) some phenomenon, it is not an open question whether that entity exists. Thus, if you can manage to find actual explanations, you can find answers to ontological questions. In contrast, even if some entity is indispensable to deliberation, it still might not exist. For example, even if some form of libertarian free will is deliberatively indispensable, we still might not have libertarian free will. So even if you manage to discover the indispensable commitments of deliberation, there is still more work to do to get to the bottom of things. That additional work is explanatory work, and so deliberative indispensability is not an independent guide to what there is. (shrink)

Evolutionary debunking arguments purport to undercut the justification of our moral judgments by showing why a tendency to make moral judgments would evolve regardless of the truth of those judgments. Machery and Mallon (2010. Evolution of morality. In J.M. Doris and The Moral Psychology Research Group (Eds.), The Moral Psychology Handbook (pp. 3-46). Oxford: Oxford University Press) have recently tried to disarm these arguments by showing that moral cognition – in the sense that is relevant to debunking – is not (...) the product of natural selection. Specifically, they present a barrage of increasingly influential challenges against reciprocity-based approaches to moral nativism. In the present paper I defend the nativist account of moral cognition against these criticisms, thereby bolstering the skeptical conclusions of evolutionary debunking arguments. However, Machery and Mallon's critique does successfully highlight several vulnerabilities in Richard Joyce's approach to debunking, suggesting several ways in which it can be revised toward generating a more robust version of the argument. (shrink)

Shared views regarding the moral respect which is owed to children in family life are used as a guide in determining the moral permissibility of nontherapeutic clinical research procedures involving children. The comparison suggests that it is not appropriate to seek assent from the preadolescent child. The analogy with interventions used in family life is similarly employed to specify the permissible limit of risk to which children may be exposed in nontherapeutic research procedures. The analysis indicates that recent writers misconceive (...) how certain moral principles, such as respect for personal autonomy, require us to act toward children. The results are also used to assess proposed federal regulations on research with children. (shrink)

Logical theory – and philosophical theory generally – is just that, theory. Generations of logic students felt a sort of unease about it without knowing what to do about it. Nowadays, students of mathematical logic feel a similar unease when faced with the fact that in standard predicate calculus, “All unicorns are sneaky” is true precisely because there are no unicorns. Blanché’s analysis reminds us that such feelings of unease may indicate a shortcoming in the theory rather than in the (...) student’s understanding. (shrink)