BackgroundThe principal aim of this study was to investigate the function and effectiveness of an institutional policy that outlines a procedure to limit medically futile interventions. We were interested in the attitudes and opinions of careproviders and the members of the Yale New Haven Hospital Ethics Committee that use this policy, the Conscientious Practice Policy (CPP), to address questions on appropriate interventions in the setting of medical futility.MethodsIn 2019, we conducted three focus groups of members of the Yale New Haven (...) Hospital Ethics Committee and critical care physicians. We asked the participants questions concerning their use of the Yale New Haven Hospital’s policy on limiting futile interventions. Focus group transcript results were coded into common themes using a conventional analysis approach.ResultsThe overarching finding was that the CPP had various levels of interpretation that prevented its effective and consistent use. This was supported by the four main themes from the focus groups: (1) Mixed perceptions regarding communication between careproviders and family members and surrogates before the CPP was invoked contributed to complexity in decision making. (2) It was ineffective to use an ethics consultation to decide whether or not to invoke the CPP. (3) It was necessary to address moral distress in the absence of a policy. (4) The use of the CPP was inconsistent for different patients, based on the degree to which family members and surrogates persisted in their resistance to limiting medically futile interventions, careproviders’ comfort with directly making decisions, and bias towards members of certain groups.ConclusionThe CPP, as it has been used at the Yale New Haven Hospital, has been ineffective in rationally, fairly, and consistently resolving conflicts regarding the appropriateness of ending medically futile interventions. The CPP, as well as similar policies at other institutions, may benefit from restructuring the policy to more closely align with policies at other institutions where outcomes have been more successful. (shrink)

Few institutions have published reviews concerning the case consultation history of their ethics committees, and policies used by ethics committees to address inappropriate treatment are infrequently reviewed. We sought to characterize the operation of our institution’s ethics committee as a representative example of a volunteer ethics committee, and outline its use of a policy to address inappropriate treatment, the Conscientious Practice Policy. Patients were identified for retrospective review from the ethics consultation database. Patient demographics, medical admission information, and consultation information (...) were obtained from the medical record. Consultation notes were analyzed with directed content analysis. The use of the CPP was documented in each case. Groups of interest were compared via two-sample t-tests. There were 178 consultations between 2013 and 2018. The majority originated from medicine services. The most common consultation reasons were end-of-life balances of acute and palliative care, best interest standard, medical futility, and code status and intubation status. Average age was 65.5 years and average hospitalization before consultation was 51.4 days. 92 patients had a code status change that occurred after consultation. A policy to address inappropriate treatment was used in 42 of the consultations. Bivariate analysis demonstrated a reduction in policy use over time, with use in 32.1% of consultations from 2013 to 2016 and 11.4% of consultations 2017–2018, p = 0.002. End-of-life issues were the most common reason for consultation. Our consultation volume was lower than previously-published reports. A policy used to address inappropriate treatment was frequently used, although use decreased over time. (shrink)

Since the 1970s Gary Watson has published a series of brilliant and highly influential essays on human action, examining such questions as: in what ways are we free and not free, rational and irrational, responsible or not for what we do? Moral philosophers and philosophers of action will welcome this collection, representing one of the most important bodies of work in the field.

The first part of the essay explores the relations between the will and practical reason or judgement. The second part takes up decision in the realm of belief, i.e. deciding that such and such is so. This phenomenon raises two questions. Since we decide that as well as to, should we speak of a doxastic will? Secondly, should we regard ourselves as active in the formation of our judgements as in the formation of our intentions? The author's answer to these (...) two further questions is ‘no’ and ‘yes’, respectively: the boundaries between the active and the passive are not marked by the will. (shrink)

This book offers a detailed look at Guattari's working methods in transdisciplinary experimentation from the time of his youth to his final years.His youthful adventures in the post-war Youth Hostels movement, decisive contact with institutional pedgagogy and the mentor figures of Fernand Oury and his brother Jean, give rise to an extraordinary penchant for organizational innovation in his life at Clinique de La Borde in Cour-Cheverny, France, and collective forms of expression manifested in publishing ventures and diverse collaborative research formations.Guattari's (...) highly original and hitherto neglected theories of a-signifyng semiotics and minor cinema are explored in depth with reference to the political goals of the critique of infoculture and the molecular revolutionary tendencies that are released in the search for a people to come.Guttari's engagement with eco-politics and art practices displays his originality as a political thinker and is firmly grounded on his exporation of how subjectivity is produced inlate capitalism.Guattari's ground-breaking conception of transversal politics is fully explored in relation to Michel Foucault's sense of the concept and its role in global political theory. (shrink)

With its unique combination of depth, clarity, and humor that has enchanted millions, this beloved classic by bestselling author Gary Zukav opens the fascinating world of quantum physics to readers with no mathematical or technical background. "Wu Li" is the Chinese phrase for physics. It means "patterns of organic energy," but it also means "nonsense," "my way," "I clutch my ideas," and "enlightenment." These captivating ideas frame Zukav's evocative exploration of quantum mechanics and relativity theory. Delightfully easy to read, (...) The Dancing Wu Li Masters illuminates the compelling powers at the core of all we know. (shrink)

How do middle-class Americans become aware of distant social problems and act against them? US colleges, congregations, and seminaries increasingly promote immersion travel as a way to bridge global distance, produce empathy, and increase global awareness. But does it? Drawing from a mixed methods study of a progressive, religious immersion travel organization at the US-Mexico border, Empathy Beyond US Borders provides a broad sociological context for the rise of immersion travel as a form of transnational civic engagement. Gary J. (...) Adler, Jr follows alongside immersion travelers as they meet undocumented immigrants, walk desert trails, and witness deportations. His close observations combine with interviews and surveys to evaluate the potential of this civic action, while developing theory about culture, empathy, and progressive religion in transnational civic life. This timely book describes the moralization of travel, the organizational challenges of transnational engagement, and the difficulty of feeling transformed but not knowing how to help. (shrink)

This book explores the effects of technology on the education of digital generations and the technology-mediated interaction that will prepare these generations for an unpredictable future. It discusses strategies and approaches for curriculum design, professional development, and other aspects of school organization involving technology.

This book identifies the character of human predators who violate others or themselves. The contagion of violence infects values that affect behavior. But we may call upon the intrinsic values of love, compassion, and creativity to oppose such violence. The book boldly argues for a renewal of the spiritual energy that gave rise to civilization.

The goal of perceptual systems is to allow organisms to adaptively respond to ecologically relevant stimuli. Because all perceptual inputs are ambiguous, perception needs to rely on prior knowledge accumulated over evolutionary and developmental time to turn sensory energy into information useful for guiding behavior. It remains controversial whether the guidance of perception extends to cognitive states or is locked up in a “cognitively impenetrable” part of perception. I argue that expectations, knowledge, and task demands can shape perception at multiple (...) levels, leaving no part untouched. The position advocated here is broadly consistent with the notion that perceptual systems strive to minimize prediction error en route to globally optimal solutions :181–204, 2013). On this view, penetrability should be expected whenever constraining lower-level processes by higher level knowledge is minimizes global prediction error. Just as Fodor feared cognitive penetration of perception threatens theory-neutral observation and the distinction between observation and inference. However, because theories themselves are constrained by the task of minimizing prediction error, theory-laden observation turns out to be superior to theory-free observation in turning sensory energy into useful information. (shrink)

The distinction between occurrent and non-occurrent mental states is frequently appealed to by contemporary philosophers, but it has never been explicated in any significant detail. In the literature, two accounts of the distinction are commonly presupposed. One is that occurrent states are conscious states. The other is that non-occurrent states are dispositional states, and thus that occurrent states are manifestations of dispositions. I argue that neither of these accounts is adequate, and therefore that another account is needed. I propose that (...) occurrent states are active states. (shrink)

The topic of divine providence is back on the theological agenda. Even a cursory review of the recent debates will reveal an increasing interest in this issue. A closer look at the literature of the last five or so decades indicates, however, that there is a considerable disagreement about the conceptualisation of providence and, consequently, how to approach the topic best. What does ‘providence’ in the theological context actually mean, and are there models available to help understand and appropriate the (...) thus conceived doctrine of providence? (shrink)

Theories of language production propose that utterances are constructed by a mechanism that separates linguistic content from linguistic structure, Linguistic content is retrieved from the mental lexicon, and is then inserted into slots in linguistic structures or frames. Support for this kind of model at the phonological level comes from patterns of phonological speech errors. W present an alternative account of these patterns using a connectionist or parallel distributed proceesing (PDP) model that learns to produce sequences of phonological features. The (...) model's errors exhibit some of the properties of human speech errors, specifically, properties that have been attributed to the action of phonological rules, frames, or other structural generalizations. (shrink)

Dallas Willard was a personal mentor and inspiration to hundreds of pastors, philosophers, and average churchgoers. In Gary W. Moon’s candid and inspiring biography, we read about the development of Willard's personal character, philosophical writing, and spiritual teaching, and how he has inspired some of the most influential books on spirituality of the last generation.

This introduction recognises the breadth of Iris Murdoch’s thought. Murdoch was a prolific and dynamic thinker, who held expertise and interest in a number of areas including philosophy, politics, morality, art and literature. Her philosophical writings, novels and letters are of significance in conveying her thought on a variety of subjects. The various essays that compose this volume are seen as responding to the breadth of Murdoch’s thinking and also as dealing with the paradoxes that arise out of her concern (...) to trace connections between distinct aspects of experience. The essays of the volume are described and shown to fit together. The Introduction ends by indicating how Murdoch’s late engagement with Heidegger reflects her concern to develop a unified sense of experience. (shrink)

This book strongly challenges the Western philosophical tradition's assertion that humans are superior to nonhuman animals. It provides a full and direct moral status of nonhuman animals. The book provides basis for a radical critique of the entire trajectory of animal studies over the past fifteen years. The key idea explored is of 'felt kinship' a sense of shared fate with and obligations to all sentient life. It will help to inspire some deep rethinking on the part of leading exponents (...) of animal studies. The book's strong outlook is expressed through an appeal for radical humility on the side of humans rather than a constant reference to the 'human-animal divide'. Historical figures examined in depth include Aristotle; Seneca, and Kant; contemporary figures examined include Christine Korsgaard and Martha Nussbaum. This book presents an account in which the tradition has proceeded based on impartial motivations at all, but instead has made a set of pointedly self-serving assumptions about the proper criteria for assessing moral worth. Readers of this book will gain exposure to a wide variety of thinkers in the Western philosophical tradition, historical as well as contemporary. This book is suitable for professionals working in nonhuman animal studies, students, advanced undergraduates, and practitioners working in the fields of philosophy, environmental studies, law, literature, anthropology, and related fields. (shrink)

1. Introduction : humanity's urge to understand -- 2. Elements of scientific thinking : skepticism, careful reasoning, and exhaustive evaluation are all vital. Science Is universal -- Maintaining a critical attitude. Reasonable skepticism -- Respect for the truth -- Reasoning. Deduction -- Induction -- Paradigm shifts -- Evaluating scientific hypotheses. Ockham's razor -- Quantitative evaluation -- Verification by others -- Statistics : correlation and causation -- Statistics : the indeterminacy of the small -- Careful definition -- Science at the frontier. (...) When good theories become ugly -- Stuff that just does not fit -- 3. Christopher Columbus and the discovery of the "Indies" : it can be disastrous to stubbornly refuse to recognize that you have falsified your own hypothesis -- 4. Antoine Lavoisier and Joseph Priestley both test the befuddling phlogiston theory : junking a confusing hypothesis may be necessary to clear the way for new and productive science -- 5. Michael Faraday discovers electromagnetic induction but fails to unify electromagnetism and gravitation : it is usually productive to simplify and consolidate your hypotheses -- 6. Wilhelm Röntgen intended to study cathode rays but ended up discovering X-rays : listen carefully when Mother Nature whispers in your ear : she may be leading you to a Nobel Prize -- 7. Max Planck, the first superhero of quantum theory, saves the universe from the ultraviolet catastrophe : assemble two flawed hypotheses about a key phenomenon into a model that fits experiment exactly and people will listen to you even if you must revolutionize physics -- 8. Albert Einstein attacks the problem "Are atoms real?" from every angle : solving a centuries-old riddle in seven different ways can finally resolve it -- 9. Niels Bohr models the hydrogen atom as a quantized system with compelling exactness, but his later career proves that collaboration and developing new talent can become more significant than the groundbreaking research of any individual -- 10. Conclusions, status of science, and lessons for our time. Conclusions from our biographies -- What thought processes lead to innovation? -- Is the scientist an outsider? -- The status of the modern scientific enterprise -- Lessons for our time -- Can the scientific method be applied to public policy? -- Why so little interest in science? -- Knowledge is never complete. (shrink)

We model happiness as a measurement tool used to rank alternative actions. Evolution favors a happiness function that measures the individual’s success in relative terms. The optimal function, in particular, is based on a time-varying reference point –or performance benchmark –that is updated over time in a statistically optimal way in order to match the individual’s potential. Habits and peer comparisons arise as special cases of such updating process. This updating also results in a volatile level of happiness that continuously (...) reverts to its long-term mean. Throughout, we draw a parallel with a problem of optimal incentives, which allows us to apply statistical insights from agency theory to the study of happiness. (shrink)

Quantum mechanics - central not only to physics, but also to chemistry, materials science, and other fields - is notoriously abstract and difficult. Essential Quantum Mechanics is a uniquely concise and explanatory book that fills the gap between introductory and advanced courses, between popularizations and technical treatises.By focusing on the fundamental structure, concepts, and methods of quantum mechanics, this introductory yet sophisticated work emphasizes both physical and mathematical understanding. A modern perspective is adopted throughout - the goal, in part, being (...) to gain entry into the world of 'real' quantum mechanics, as used by practicing scientists.With over 60 original problems, Essential Quantum Mechanics is suitable as either a text or a reference. It will be invaluable to physics students as well as chemists, electrical engineers, philosophers, and others whose work is impacted by quantum mechanics, or who simply wish to better understand this fascinating subject. (shrink)

Made-Up Minds addresses fundamental questions of learning and concept invention by means of an innovative computer program that is based on the cognitive ...

Is capitalist production unjust? It is easy to think, upon first reading Marx, that he answers this question in the affirmative. And I shall argue that this naive reading is correct. This needs to be argued, however, for a more careful scrutiny of Marx's writings reveals passages in which he seems to call capitalist production just or fair. Relying upon these passages, Robert Tucker and Allen W. Wood have urged that, in Wood's words,it is simply not the case that Marx's (...) condemnation of capitalism rests on some conception of justice, and those who attempt to reconstruct a “Marxian idea of justice” from Marx's manifold charges against capitalism are at best only translating Marx's critique of capitalism, or some aspect of it, into what Marx himself would have consistently regarded as a false, ideological, or “mystified” form.What Marx regarded as false and mystified, however, is not the practice of assessing social institutions as just or unjust, but rather the picture of those institutions, and especially of capitalist production, to be found in bourgeois ideology. (shrink)

Zika virus infection in a pregnant woman may cause severe brain malformations and other birth defects in her child, and women living in or traveling to areas where it is endemic are urged to postpone pregnancy. Do the dangers posed by microcephaly justify the use of contraceptives under the principle of double effect? The author discusses ambiguities in Humanae vitae n. 14 and the claim that the use of contraceptives was approved by Pope Paul VI for nuns at risk of (...) rape, and uses the principle of double effect to show that the answer to this question is no: the use of the anovulant pill by married couples for the purpose of preventing conception of a microcephalic child cannot be licit. (shrink)

This paper argues (a) that the concept of “potential being” is central to the theory and practice of contemporary cosmology and evolutionary science, and (b) that the reality of potential being points to the existence of an intelligent and purposive cause of the intelligible order among potential beings that existed from the first moments of the Big Bang. The paper introduces and explains the concept of “potential being” and then traces the existence of potential beings back to the beginnings of (...) the cosmos at the instant of the Big Bang. This primeval existence of potential beings is shown to possess a character and order that points to a cause external to that order. The paper concludes with a consideration of the features that must be possessed by that external cause in order to make sense of what we know. (shrink)