Nocebo effects occur when an adverse effect on the patient arises from the patient's own negative expectations. In accordance with informed consent, providers often disclose information that results in unintended adverse outcomes for the patient. While this may adhere to the principle of autonomy, it violates the doctrine of “primum non nocere,” given that side-effect disclosure may cause those side effects. In this article we build off previous work, particularly by Wells and Kaptchuk and by Cohen :3–11.[Taylor & Francis Online], (...) [Web of Science ®] [Google Scholar]), to suggest ethical guidelines that permit nondisclosure in the case when a nocebo effect is likely to occur on of the basis of nonmaleficence. We accept that that autonomy vis-à-vis informed consent must be forestalled, but salvage much of its role by elaborating a practical clinical approach to postencounter follow-up. In doing so, we reconcile a clinically practicable process of determining conditions of disclosure with long-standing ethical commitments to patients. (shrink)

We raise various puzzles about the relationship between God and the meaning of life. These difficulties suggest that, even if we assume that God exists, and even if God’s existence would entail that our lives have meaning, God is not and could not be the source of the meaning of life. We conclude by discussing implications of our arguments: these claims can be used in a novel argument for atheism; these claims undermine an extant argument for God’s existence; and they (...) suggest that atheism is consistent with our lives having meaning. (shrink)

We first argue that there are cases of “blameless non-belief.” That is, some people—through no fault of their own—fail to enter into a conscious relationship with God. But if so, then it would be unjust of God to make certain particular goods depend upon one having a conscious relationship with God. So, given that God is just, then despite what some theists believe, a relationship with God cannot be a necessary condition for the attainment of these goods; there might, e.g., (...) be atheists in heaven, even assuming that theism is true. This implies that religion is a far less important component of people’s lives than many might think. (shrink)

We first argue that there are cases of “blameless non-belief.” That is, some people—through no fault of their own—fail to enter into a conscious relationship with God. But if so, then it would be unjust of God to make certain particular goods depend upon one having a conscious relationship with God. So, given that God is just, then despite what some theists believe, a relationship with God cannot be a necessary condition for the attainment of these goods; there might, e.g., (...) be atheists in heaven, even assuming that theism is true. This implies that religion is a far less important component of people’s lives than many might think. (shrink)

What, if anything, is wrong with acquiring moral beliefs on the basis of testimony? Most philosophers think that there is something wrong with it, and most point to a special problem that moral testimony is supposed to create for moral agency. Being a good moral agent involves more than bringing about the right outcomes. It also involves acting with "moral understanding" and one cannot have moral understanding of what one is doing via moral testimony. And so, adherents to this view (...) claim, relying on moral testimony is problematic. Importantly, the problem that afflicts moral testimony, according to this view, is not a problem for testimonial knowledge in general. Indeed, critics of moral testimony acknowledge that a vast amount of our knowledge comes, completely unproblematically, from testimony. Call this the Asymmetry Thesis. We argue that while the diagnosis of what is wrong with moral testimony (when there is something wrong with it) in terms of moral understanding is correct, the lesson many of its adherents draw from it, namely that there is a principled difference between moral an non-moral testimony which renders the first, but not the second, problematic, is not. In other words, we argue that the Asymmetry Thesis is false. (shrink)

This chapter considers an epistemological argument from disagreement which concludes that many of most people’s moral beliefs do not amount to knowledge. Various ways of understanding the argument are considered and it is argued that each relies on an epistemic principle that is under-motivated, overgeneralizes, and is indeed self-incriminating. These problems, it is suggested, infect many conciliationist theses in the epistemology of disagreement. Knowledge, it is argued, can withstand not only acknowledged peer disagreement, but also disagreement with the acknowledged experts. (...) If this is right, then the sort of epistemic principle that is required to move from moral disagreement to the conclusion that many of most people’s moral beliefs do not amount to knowledge has landed well off the mark. (shrink)

Some physicians refuse to perform life-sustaining interventions, such as tracheostomy, on patients who are very likely to remain permanently unconscious. To explain their refusal, these clinicians often invoke the language of “futility”, but this can be inaccurate and can mask problematic forms of clinical power. This paper explores whether such refusals should instead be framed as conscientious objections. We contend that the refusal to provide interventions for patients very likely to remain permanently unconscious meets widely recognized ethical standards for the (...) exercise of conscience. We conclude that conscientious objection to tracheostomy and other life-sustaining interventions on such patients can be ethical because it does not necessarily constitute a form of invidious discrimination. Furthermore, when a physician frames their refusal as conscientious objection, it makes transparent the value-laden nature of their objection and can better facilitate patient access to the requested treatment. (shrink)

Recently, many critics have argued that disgust is a morally harmful emotion, and that it should play no role in our moral and legal reasoning. Here we defend disgust as a morally beneficial moral capacity. We believe that a variety of liberal norms have been inappropriately imported into both moral psychology and ethical studies of disgust: disgust has been associated with conservative authors, values, value systems, and modes of moral reasoning that are seen as inferior to the values and moral (...) emotions that are endorsed by liberal critics. Here we argue that the meta-ethical assumptions employed by the critics of disgust are highly contentious and in some cases culture bound. Given this, we should avoid adopting simplified meta-ethical positions in experimental moral psychology, as these can skew the design and interpretation of experiments, and blind us to the potential value of moral disgust harnessed in the service of liberal ends. (shrink)

Baruch Spinoza is one of the most influential and controversial political philosophers of the early modern period. Though best-known for his contributions to metaphysics, Spinoza’s _Theological-Political Treatise_ and his unfinished _Political Treatise_ were widely debated and helped to shape the political writings of philosophers as diverse as Rousseau, Kant, Marx, Nietzsche, and even Locke. In addition to its enormous historical importance, Spinoza’s political philosophy is also strikingly contemporary in its advocacy of toleration of unpopular religious and political views and his (...) concern with stabilizing religiously diverse democratic societies. The first Guidebook to Spinoza’s political writings, _The Routledge Philosophy Guidebook to Spinoza on Politics_ covers the following key points: Spinoza’s life and the background to his philosophy the key themes and arguments of the _Theological-Political-Treatis_e and _Political Treatise _ the continuing importance of Spinoza’s work to philosophy. This book is an ideal starting point for anyone new to Spinoza and essential reading for students of political philosophy and seventeenth-century philosophy. (shrink)

Insight experiences are sudden, persuasive, and can accompany valuable new ideas in science and art. In this preregistered experiment, we aim to validate a novel visceral and continuous measure of insight problem solving and to test whether real-time and embodied feelings of insight can predict correct solutions. We report several findings. Consistent with recent work, we find a strong positive relationship between Aha moments and accuracy for problems that demand implicit processing. We also found that the intensity of the insight (...) experience further predicted the accuracy of solutions and participants naturally embodied the intensity of their insight experiences by squeezing the dynamometer more tightly. Intriguingly, this unintentional embodiment further predicted the accuracy of solutions. We suggest that the dynamometer complements previous measures by (1) simultaneously capturing both process and feeling in real-time, (2) highlights the value of measuring Aha moments on a continuum of intensity, and (3) firmly establishes that the impulsive feeling of Aha can carry information about the veracity of an idea. We discuss the findings in light of a recent theoretical account of how feelings of insight may act as a heuristic to select ideas from the stream of consciousness. (shrink)

Vaesen asks whether goal maintenance and planning ahead are critical for innovative tool use. We suggest that these aptitudes may have an evolutionary foundation in motor planning abilities that span all primate species. Anticipatory effects evidenced in the reaching behaviors of lemurs, tamarins, and rhesus monkeys similarly bear on the evolutionary origins of foresight as it pertains to tool use.

Recent scholarship in intellectual humility (IH) has attempted to provide deeper understanding of the virtue as personality trait and its impact on an individual's thoughts, beliefs, and actions. A limitations-owning perspective of IH focuses on a proper recognition of the impact of intellectual limitations and a motivation to overcome them, placing it as the mean between intellectual arrogance and intellectual servility. We developed the Limitations-Owning Intellectual Humility Scale to assess this conception of IH with related personality constructs. In Studies 1 (...) (n= 386) and 2 (n = 296), principal factor and confirmatory factor analyses revealed a three-factor model – owning one's intellectual limitations, appropriate discomfort with intellectual limitations, and love of learning. Study 3 (n = 322) demonstrated strong test-retest reliability of the measure over 5 months, while Study 4 (n = 612) revealed limitations-owning IH correlated negatively with dogmatism, closed-mindedness, and hubristic pride and positively with openness, assertiveness, authentic pride. It also predicted openness and closed-mindedness over and above education, social desirability, and other measures of IH. The limitations-owning understanding of IH and scale allow for a more nuanced, spectrum interpretation and measurement of the virtue, which directs future study inside and outside of psychology. (shrink)

ObjectivesThe end of life is an ethically challenging time requiring complex decision-making. This study describes ethical frameworks among physician trainees, explores how these frameworks manifest and relates these frameworks to experiences delivering end-of-life care.DesignWe conducted semistructured in-depth exploratory qualitative interviews with physician trainees about experiences of end-of-life care and moral distress. We analysed the interviews using thematic analysis.SettingAcademic teaching hospitals in the United States and United Kingdom.ParticipantsWe interviewed 30 physician trainees. We purposefully sampled across three domains we expected to be (...) associated with individual ethics in order to elicit a diversity of ethical and experiential perspectives.ResultsSome trainees subscribed to a best interest ethical framework, characterised by offering recommendations consistent with the patient’s goals and values, presenting only medically appropriate choices and supporting shared decision-making between the patient/family and medical team. Others endorsed an autonomy framework, characterised by presenting all technologically feasible choices, refraining from offering recommendations and prioritising the voice of patient/family as the decision-maker.ConclusionsThis study describes how physician trainees conceptualise their roles as being rooted in an autonomy or best interest framework. Physician trainees have limited clinical experience and decision-making autonomy and may have ethical frameworks that are dynamic and potentially highly influenced by experiences providing end-of-life care. A better understanding of how individual physicians’ ethical frameworks influences the care they give provides opportunities to improve patient communication and advance the role of shared decision-making to ensure goal-aligned end-of-life care. (shrink)

What is intellectual humility? In this essay, we aim to answer this question by assessing several contemporary accounts of intellectual humility, developing our own account, offering two reasons for our account, and meeting two objections and solving one puzzle.

Throughout the biological and biomedical sciences there is a growing need for, prescriptive ‘minimum information’ (MI) checklists specifying the key information to include when reporting experimental results are beginning to find favor with experimentalists, analysts, publishers and funders alike. Such checklists aim to ensure that methods, data, analyses and results are described to a level sufficient to support the unambiguous interpretation, sophisticated search, reanalysis and experimental corroboration and reuse of data sets, facilitating the extraction of maximum value from data sets (...) them. However, such ‘minimum information’ MI checklists are usually developed independently by groups working within representatives of particular biologically- or technologically-delineated domains. Consequently, an overview of the full range of checklists can be difficult to establish without intensive searching, and even tracking thetheir individual evolution of single checklists may be a non-trivial exercise. Checklists are also inevitably partially redundant when measured one against another, and where they overlap is far from straightforward. Furthermore, conflicts in scope and arbitrary decisions on wording and sub-structuring make integration difficult. This presents inhibit their use in combination. Overall, these issues present significant difficulties for the users of checklists, especially those in areas such as systems biology, who routinely combine information from multiple biological domains and technology platforms. To address all of the above, we present MIBBI (Minimum Information for Biological and Biomedical Investigations); a web-based communal resource for such checklists, designed to act as a ‘one-stop shop’ for those exploring the range of extant checklist projects, and to foster collaborative, integrative development and ultimately promote gradual integration of checklists. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

We examined participants' reading and recall of informed consent documents presented via paper or computer. Within each presentation medium, we presented the document as a continuous or paginated document to simulate common computer and paper presentation formats. Participants took slightly longer to read paginated and computer informed consent documents and recalled slightly more information from the paginated documents. We concluded that obtaining informed consent online is not substantially different than obtaining it via paper presentation. We also provide suggestions for improving (...) informed consent-in both face-to-face and online experiments. (shrink)

Suppose that you are engaging with someone who is your oppressor, or someone who espouses a heinous view like Nazism or a ridiculous view like flat-earthism. In contexts like these, there is a disparity between you and your interlocutor, a dramatic normative difference across which you are in the right and they are in the wrong. As theorists of humility, we find these contexts puzzling. Humility seems like the *last* thing oppressed people need and the *last* thing we need in (...) dealing with those whose views are heinous or ridiculous. Responding to such people via humility seems uncalled for, even inappropriate. But how could this be, given that humility is a *virtue*? The purpose of the paper is to explore this puzzle. We explain what the puzzle is and then attempt to draw some lessons from it: first, the lesson that the importance of humility is limited in several ways, and second, the lesson that humility nonetheless has several important roles to play, even for people who are in the right in contexts of disparity. (shrink)

This paper analyzes what may have been a mistake by pianist Thelonious Monk playing a jazz solo in 1958. Even in a Monk composition designed for patterned mayhem, a note can sound out of pattern. We reframe the question of whether the note was a mistake and ask instead about how Monk handles the problem. Amazingly, he replays the note into a new pattern that resituates its jarring effect in retrospect. The mistake, or better, the mis-take , was “saved” by (...) subsequent notes. Our analysis, supported by reflections from jazz musicians and the philosopher John Dewey, encourages a reformulation of plans, takes, and mis-takes as categories for the interpretation of contingency, surprise, and repair in all human activities. A final section suggests that mistakes are essential to the practical plying and playing of knowledge into performances, particularly those that highlight learning. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

ABSTRACTIt is proposed that experts are able to integrate prior contextual knowledge with emergent visual information to make complex predictive judgments about the world around them, often under heightened levels of uncertainty and extreme time constraints. However, limited knowledge exists about the impact of anxiety on the use of such contextual priors when forming our decisions. We provide a novel insight into the combined impact of contextual priors and anxiety on anticipation in soccer. Altogether, 12 expert soccer players were required (...) to predict the actions of an oncoming opponent while viewing life-sized video simulations of 2-versus-2 defensive scenarios. Performance effectiveness and processing efficiency were measured under four conditions: no contextual priors about the action tendencies of the opponent and low anxiety ; no CP and high anxiety ; CP and LA; CP and HA. The provision of contextual priors did not affect processing efficiency, but it improved performance effectiveness... (shrink)

Practical wisdom (hereafter simply “wisdom”) is the intellectual virtue that enables a person to make reliably good decisions about how, all-things-considered, to live and conduct herself. Because wisdom is such an important and high-level achievement, we should wonder: what is the nature of wisdom? What kinds of skills, habits and capacities does it involve? Can real people actually develop it? If so, how? I argue that we can answer these questions by modeling wisdom on expert decision-making skill in complex areas (...) like firefighting. I develop this expert skill model of wisdom using philosophical argument informed by relevant empirical research. I begin in Chapter 1 by examining the historical roots of analogies between wisdom and practical skills in order to motivate the expert skill model. In Chapter 2, I provide the core argument for the expert skill model. I then use the remaining chapters to pull out the implications of the expert skill model. In Chapter 3, I show that the expert skill model yields practical guidance about how to develop wisdom. In Chapter 4, I address the objection, due to Daniel Jacobson, that wisdom is not a skill that humans could actually develop, since skill development requires a kind of feedback in practice that is not available for all-things-considered decisions about how to live. Finally, in Chapter 5, I apply the expert skill model to the question, much discussed by virtue ethicists, of whether a wise person deliberates using a comprehensive and systematic conception of the good life. (shrink)

An engaging and accessible introduction to mathematical proof incorporating ideas from real analysis A mathematical proof is an inferential argument for a mathematical statement. Since the time of the ancient Greek mathematicians, the proof has been a cornerstone of the science of mathematics. The goal of this book is to help students learn to follow and understand the function and structure of mathematical proof and to produce proofs of their own. An Introduction to Proof through Real Analysis is based on (...) course material developed and refined over thirty years by Professor Daniel J. Madden and was designed to function as a complete text for both first proofs and first analysis courses. Written in an engaging and accessible narrative style, this book systematically covers the basic techniques of proof writing, beginning with real numbers and progressing to logic, set theory, topology, and continuity. The book proceeds from natural numbers to rational numbers in a familiar way, and justifies the need for a rigorous definition of real numbers. The mathematical climax of the story it tells is the Intermediate Value Theorem, which justifies the notion that the real numbers are sufficient for solving all geometric problems. • Concentrates solely on designing proofs by placing instruction on proof writing on top of discussions of specific mathematical subjects • Departs from traditional guides to proofs by incorporating elements of both real analysis and algebraic representation • Written in an engaging narrative style to tell the story of proof and its meaning, function, and construction • Uses a particular mathematical idea as the focus of each type of proof presented • Developed from material that has been class-tested and fine-tuned over thirty years in university introductory courses An Introduction to Proof through Real Analysis is the ideal introductory text to proofs for second and third-year undergraduate mathematics students, especially those who have completed a calculus sequence, students learning real analysis for the first time, and those learning proofs for the first time. Daniel J. Madden, PhD, is an Associate Professor of Mathematics at The University of Arizona, Tucson, Arizona, USA. He has taught a junior level course introducing students to the idea of a rigorous proof based on real analysis almost every semester since 1990. Dr. Madden is the winner of the 2015 Southwest Section of the Mathematical Association of America Distinguished Teacher Award. Jason A. Aubrey, PhD, is Assistant Professor of Mathematics and Director, Mathematics Center of the University of Arizona. (shrink)

This article challenges a particular form of Eliminative Materialism as presented in the work, "Quining Qualia" where Dr. Daniel Dennett argues that qualia, as he defines it, does not exist. The paper underscores the contradictory nature of Dennett's "Intuition Pumps" and shows how he assumes the very notion he proports to defeat namely, that first-person (or subjective) conscious experience, commonly termed "qualia," exists.

In response to prominent criticisms of virtue ethical accounts of right action, Daniel Russell has argued that these criticisms are misguided insofar as they rest on an incorrect understanding of what virtue ethicists mean by ‘right action’, drawing on Rosalind Hursthouse’s influential account of the term. Liezl van Zyl has explored, though not fully-endorsed, a similar approach. The response holds that virtue ethicists do not embrace a strong connection between (i) right action and (ii) what any given agent ought to (...) do in a given set of circumstances. Rather, ‘right action’ is a matter of action assessment, and indicates that a given action is morally excellent and praiseworthy. More generally, the proposed account of rightness emphasizes both (i) an agent’s past and how she came to be in certain circumstances - is it a result of her own vice or wrong actions? and (ii) the agent’s own future happiness and well-being - will an action be so terrible that her life is marred and ruined? The narrative structure of an agent’s life thus plays a significant role in determining whether an action is right. This revisionary conception of right action is the focus of the current chapter. (shrink)

Blindsight is a hot topic in philosophy, especially in discussions of consciousness. Here I critically examine various attempts to bring blindsight to bear on debates about qualia -- the raw constituents of consciousness. I argue that blindsight does not unequivocally support any particular theory of qualia. It does, however, vindicate the view that there are qualia, despite arguments -- most notably by Daniel Dennett -- to the contrary.

Do extraordinary crisis situations requiring life-and-death decisions create a “state of exception” in which ordinary social, political, and ethical norms must be altered or suspended altogether? Daniel Sulmasy contends that the extraordinary circumstances of a pandemic do not require abandoning or altering ethical values and principles. Rather, “ethics as usual” ought to guide policy formation and clinical decision-making. One critical question raised by the current pandemic, and which stresses ordinary ethical standards, is whether ventilators or other scarce life-sustaining resources may (...) be unilaterally withdrawn from a patient in order to be reallocated to another who is estimated to have a superior chance of survival or better satisfies other triage criteria. In this type of situation, it is unclear what constitutes “ethics as usual.”. (shrink)