In normative decision theory, the weight of an uncertain event in a decision is governed solely by the probability of the event. A large body of empirical research suggests that a single notion of probability does not accurately capture peoples' reactions to uncertainty. As early as the 1920s, Knight made the distinction between cases where probabilities are known and where probabilities are unknown. We distinguish another case –- the unknowable uncertainty –- where the missing information is unavailable to all. We (...) propose that missing information influences the attractiveness of a bet contingent upon an uncertain event, especially when the information is available to someone else. We demonstrate that the unknowable uncertainty –- falls in preference somewhere in between the known and the known uncertainty. (shrink)

Familialism is a significant mindset within Singaporean culture. Its effects through the practice of familial determination and filial piety, which calls for a family centric approach to care determination over and above individual autonomy, affect many elements of local care provision. However, given the complex psychosocial, political and cultural elements involved, the applicability and viability of this model as well as that of a physician-led practice is increasingly open to conjecture. This article will investigate some of these concerns before proffering (...) a decision-making process based upon a multidisciplinary team approach. It will be shown that such a multidimensional and multiprofessional approach is more in keeping with the inclusive and patient-centred ethos of palliative care than prevailing practices. It will be shown that such an approach will also be better placed to deliver holistic, coherent and sensitive end-of-life care that palliative care espouses. (shrink)

I examine the foundations of a just society using the lens of decision theory. The conception of just society is from an individual’s viewpoint: where would I rather live if I have an equal chance of being any individual? Three alternative designs for a just society are examined. These are: laissez-faire, maximin and social minimum. Two assumptions about human nature clarify the distinction among three societies. The first assumption is that a representative individual’s utility function is concave. The second assumption (...) recognizes that redistribution to achieve equality reduces total wealth. A rational individual would prefer a society where one is free to maximize one’s expected utility. A social minimum that includes both the provision of essential human needs and equality of opportunity (education, healthcare, access to capital) for a flourishing life emerges as a candidate solution for the basic structure of society. (shrink)

For decisions whose consequences accrue over time, there are several possible techniques to compute total utility. One is to discount utilities of future consequences at some appropriate rate. The second is to discount per-period certainty equivalents. And the third is to compute net present values (NPVs) of various possible streams and to then apply the utility function to these net present values. We find that the best approach is to first compute NPVs of various possible income streams and then take (...) the utility of such NPVs. We show the drawbacks of other alternative models of evaluating income streams. The article discusses the advantages of the power and logarithmic forms in the modeling of time preference. These are the only forms for which utility of income and utility of consumption are strategically equivalent. Further, these forms permit the flexibility in the choice of a time period (e.g., monthly or quarterly) without modifying the utility function, thus simplifying analysis. (shrink)

This article attempts to examine the portrayal of the character of Arthur Fleck in Todd Phillips’s Joker (2019). In the initial part of the film, Arthur exhibits signs that reveal he is headed towards committing a violent crime. Arthur displays signs of psychopathy and a lack of empathy. This article links criminal behaviour analysis to the Bible of the Arya Samaj, an Indian text, to find out how ancient Indian literature’s empirical theories, which are intertwined with philosophical and religious content, (...) shed light on criminal behaviour. The primary purpose of this article is to analyse the behavioural pattern in the character of Fleck and establish links to Dayanand Saraswati’s Satyarth Prakash, which discusses different types of Avidyas, a key concept in Indian philosophy that can be translated as ignorance or unwisdom, which is seen as a fundamental cause of suffering and bondage. It is certainly a significant factor in a person’s personality and behaviour. The major aim of this character analysis is not only to establish the link between Indian ancient texts and criminological behavioural patterns but also to reconceptualize evil through the lenses of Vedic hermeneutics. Vedic hermeneutics is the study of interpreting and understanding the ancient Vedic texts of Hinduism, where an important aspect is the recognition of different levels of meaning within the texts. (shrink)

Like nuclear energy, most technologies could have dual use—for health and well being and disaster and terror. Some research publications have brought to the forefront the tragic consequences of the latter potential through their possible use. Monitoring life science research and development (R&D) to prevent possible misuse is a challenging task globally, more so in developing economies like India, which are emerging as major biotech hubs. As a signatory to the Biological and Toxin Weapons Convention, India has put in motion (...) a process of evolving a series of measures to manage dual-use technology. The Indian Council of Medical Research (ICMR) has taken a lead in drafting model codes of conduct, ethics and practice for use by other S&T agencies to tailor them as per their requirements. Taking cue from the discussions held by the editors of the various medical and science journals in the developed world, the Indian Journal of Medical Research, the official publication of the ICMR, is working on policy and uniform practice of publication of dual-use research results. The Government of India too has promulgated legal provisions to minimize the risks of misuse of technology, like the Weapons of Mass Destruction Act. Clearly, no single agency would be able to manage the dual-use of technology effectively. Multiple agencies have to come together to work in tandem for effective implementation of various measure and also like Janus, ensure that they are neither too restrictive nor intrusive to discourage the development of science. (shrink)

“At-own-risk discharges” or “self-discharges” evidences an irretrievable breakdown in the patient–clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician’s duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent to invoke an (...) at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care’s use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient’s decision-making capacity and raises questions as to the patient’s decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient’s welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient’s specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for assessing the validity of at-own-risk discharge requests on a case-by-case basis. (shrink)

A historical investigation of the exclusion of Africa and Asia from modern histories of philosophy.

Application of sedation at the end of life has been fraught with ethical and clinical concerns, primarily focused on its potential to hasten death. However, in the face of clinical data that assuage most of these concerns, a new threat to this treatment of last resort has arisen. Concern now pivots on its effects on the personhood of the patient, underpinned by the manner in which personhood has been conceptualised. For many authors, it is consciousness that is seen to be (...) the seat of personhood, thus its loss is seen to rob a patient of their moral and ethical worth, leaving them in a state that cannot ethically be differentiated from death. Here I proffer a clinically based alternative to this view, the Ring Theory of Personhood, which dispels these concerns about sedation at the end of life. The Ring Theory envisages personhood as a coadunation of three domains of concern: the innate, the individual and the relational elements of personhood. The innate element of personhood is held to be present among all humans by virtue of their links with the Divine and or their human characteristics. The individual elements of personhood pivot on the presence of consciousness-dependent features such as self-awareness, self-determination and personality traits. The relational component of personhood envisages an individual as being ‘socially embedded’ replete with social and familial ties. It is these three equally important inter-related domains that define personhood. (shrink)

Facing the possibility of a surge of COVID-19-infected patients requiring ventilatory support in Intensive Care Units, the Singapore Hospice Council and the Chapter of Palliative Medicine Physicians forward its position on the guiding principles that ought to drive the allocation of ICU beds and its role in care of these patients and their families.

The use of Nasogastric (NG) feeding in the provision of artificial nutrition and hydration at the end of life has, for the most part, been regarded as futile by the medical community. This position has been led chiefly by prevailing medical data. In Singapore, however, there has been an increase in its utilization supported primarily by social, religious and cultural factors expressly to prolong life of the terminally ill patient. Here this article will seek to review the ethical and clinical (...) impact of this treatment and provide some understanding for such decisions in the light of the Duty of Palliative Care [DoPC]. Complemented by virtue ethics theory, the DoPC highlights and seeks to realize the individual case specific goals of care that maximize comfort and quality of life of the patient in the face of rapid attenuation of treatment options and the eminence of the final outcome by considering each of these factors individually in order to provide the best outcome for the patient and the family. (shrink)

We experimentally investigate the disposition of decision makers to use case-based reasoning as suggested by Hume and formalized by case-based decision theory. Our subjects face a monopoly decision problem about which they have very limited information. Information is presented in a manner which makes similarity judgements according to the feature matching model of Tversky plausible. We provide subjects a “history” of cases. In the 2×2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$2\times 2$$\end{document} between-subject design, we vary whether information (...) about the current market is given and whether immediate feedback about obtained profits is provided. The results provide support for the predictions of case-based decision theory, particularly when no immediate feedback is provided. (shrink)

An ongoing debate in the United States relating to COVID-19 features the purported tension between containing the coronavirus to save lives or opening the economy to sustain livelihoods, with ethical overtones on both sides. Proponents of opening the economy argue that sustaining livelihoods should be prioritized over virus containment, with ethicists asking, “What about the risk to human life?” Defendants of restricting the spread of the virus endorse saving lives through virus containment but contend with the ethical concern “What about (...) people’s livelihoods and individual freedoms?” A commonly held belief is that political ideology drives these differential preferences: liberals are more focused on saving lives, whereas conservatives favor sustaining livelihoods with no additional government intervention in the free-market economy. We examine these lay beliefs among US residents in four studies and find that economic system justification (ESJ), an ideology that defends the prevailing economic system when under threat, is a reliable psychological predictor beyond political ideology. Specifically, compared to those who scored low on ESJ, people who scored high on ESJ judged China as more justified in downplaying the spread of virus to protect its interest in the global free-market economy, supported in-person over online learning, viewed shelter in place as less desirable, and perceived the opening of the Texas economy as more legitimate. We also find that multiple psychological mechanisms might be at work—resistance to market interventions, perceived legitimacy of opening the economy, perceived seriousness of the health crisis, and violation of human rights. (shrink)

Marchetti offers a revisionist account of James's contribution to moral thought in the light of his pragmatic conception of philosophical activity. He sketches a composite picture of a Jamesian approach to ethics revolving around the key notion and practice of a therapeutic critique of one's ordinary moral convictions and style of moral reasoning.

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

The application of continuous deep sedation in the treatment of intractable suffering at the end of life continues to be tied to a number of concerns that have negated its use in palliative care. Part of the resistance towards use of this treatment option of last resort has been the continued association of CDS with physician-associated suicide and/or euthanasia, which is compounded by a lack clinical guidelines and a failure to cite this treatment under the aegis of a palliative care (...) approach. I argue that reinstituting a palliative care-inspired approach that includes a holistic review of the patient’s situation and the engagement of a multidisciplinary team guided by clearly defined practice requirements that have been lacking amongst many prevailing guidelines will overcome prevailing objections to this practice and allow for the legitimization of this process. (shrink)

In normative decision theory, the weight of an uncertain event in a decision is governed solely by the probability of the event. A large body of empirical research suggests that a single notion of probability does not accurately capture peoples' reactions to uncertainty. As early as the 1920s, Knight made the distinction between cases where probabilities are known and where probabilities are unknown. We distinguish another case –- the unknowable uncertainty –- where the missing information is unavailable to all. We (...) propose that missing information influences the attractiveness of a bet contingent upon an uncertain event, especially when the information is available to someone else. We demonstrate that the unknowable uncertainty –- falls in preference somewhere in between the known and the known uncertainty. (shrink)

The turn of the twentieth century witnessed the birth of two distinct philosophical schools in Europe: analytic philosophy and phenomenology. The history of 20th-century philosophy is often written as an account of the development of one or both of these schools, as well as their overt or covert mutual hostility. What is often left out of this history, however, is the relationship between the two European schools and a third significant philosophical event: the birth and development of pragmatism, the indigenous (...) philosophical movement of the United States. Through a careful analysis of seminal figures and central texts, this book explores the mutual intellectual influences, convergences, and differences between these three revolutionary philosophical traditions. The essays in this volume aim to show the central role that pragmatism played in the development of philosophical thought at the turn of the twentieth century, widen our understanding of a seminal point in the history of philosophy, and shed light on the ways in which these three schools of thought continue to shape the theoretical agenda of contemporary philosophy. (shrink)

Putative counterexamples to the Principle of Identity of Indiscernibles (PII) are notoriously inconclusive. I establish ground rules for debate in this area, offer a new response to such counterexamples for friends of the PII, but then argue that no response is entirely satisfactory. Finally, I undermine some positive arguments for PII.

“At-own-risk discharges” or “self-discharges” evidences an irretrievable breakdown in the patient–clinician relationship when patients leave care facilities before completion of medical treatment and against medical advice. Dissolution of the therapeutic relationship terminates the physician’s duty of care and professional liability with respect to care of the patient. Acquiescence of an at-own-risk discharge by the clinician is seen as respecting patient autonomy. The validity of such requests pivot on the assumptions that the patient is fully informed and competent to invoke an (...) at-own-risk discharge and that care up to the point of the at-own-risk discharge meets prevailing clinical standards. Palliative care’s use of a multidisciplinary team approach challenges both these assumptions. First by establishing multiple independent therapeutic relations between professionals in the multidisciplinary team and the patient who persists despite an at-own-risk discharge. These enduring therapeutic relationships negate the suggestion that no duty of care is owed the patient. Second, the continued employ of collusion, familial determinations, and the circumnavigation of direct patient involvement in family-centric societies compromises the patient’s decision-making capacity and raises questions as to the patient’s decision-making capacity and their ability to assume responsibility for the repercussions of invoking an at-own-risk discharge. With the validity of at-own-risk discharge request in question and the welfare and patient interest at stake, an alternative approach to assessing at-own-risk discharge requests are called for. The welfare model circumnavigates these concerns and preserves the patient’s welfare through the employ of a multidisciplinary team guided holistic appraisal of the patient’s specific situation that is informed by clinical and institutional standards and evidenced-based practice. The welfare model provides a robust decision-making framework for assessing the validity of at-own-risk discharge requests on a case-by-case basis. (shrink)

Familial determination, replete with its frequent usurping of patient autonomy, propagation of collusion, and circumnavigation of direct patient involvement in their own care deliberations, continues to impact clinical practice in many Asian nations. Suggestions that underpinning this practice, in Confucian-inspired societies, is the adherence of the populace to the familial centric ideas of personhood espoused by Confucian ethics, provide a novel means of understanding and improving patient-centred care at the end of life. Clinical experience in Confucian-inspired Singapore, however, suggests that (...) personhood is conceived in broader terms. This diverging view inspired a study of local conceptions of personhood and scrutiny of the influence of the family upon it. From the data gathered, a culturally appropriate, clinically relevant and ethically sensitive concept of personhood was proposed: the Ring Theory of Personhood that better captures the nuances of local conceptions of personhood. The Ring Theory highlights the fact that, far from being solely dependent upon familial centric ideals, local conceptions of personhood are dynamic, context dependent, evolving ideas delineated by four dimensions. Using the Ring Theory, the nature of familial influences upon the four dimensions of personhood – the Innate, Individual, Relational and Societal – are examined to reveal that, contrary to perceived knowledge, conceptions of personhood within Confucian societies are not the prime reason for the continued presence of this decision-making model but remain present within local thinking and practices as a sociocultural residue and primarily because of inertia in updating ideas. (shrink)

Covers the major aspects of James's thought, from his early influences to his legacy, with over 40 chapters by an outstanding roster of international contributors. An indispensable resource for anyone studying and researching James's philosophy.

The present issue of the EJPAP hosts a symposium on the theme of Pragmatist Ethics: Theory and Practice, exploring the many ways in which the contribution of pragmatism to moral philosophy and the moral life has been thought of and argued for. In particular, the symposium explores the distinctive nature, reaches, and limits of a pragmatist mindset in moral matters: the plurality of voices represented showcases the extent of approaches possible, within pragmatism, to the very question of how m...

This study tries to check the degree of basic human values among management professionals in India with considerable cultural and linguistic differences and how it varies across the different demographic influences. We have checked the impact of demographic variables like gender, age, education, type of organisation, place of residence, and work experience on basic human values. Hypotheses testing were conducted using MANOVA. It was inferred that the perception regarding the degree of basic human values differs among different management professionals based (...) on their age, gender, education, type of organisation, and place of residence. Surprisingly, the work experience of the person does not have a significant influence on basic human values. Consequently, we imply that the demographics of an individual carve their basic human values. The findings and inferences of the proposed study will be of great importance to policymakers and recruiting managers to fetch the right candidate. (shrink)

Meno’s paradox raises serious challenges against most fundamental epistemological quest regarding the possibility of inquiry and discovery. In his response, Socrates proposes the theory of anamnesis and his ingenious distinction between doxa and episteme. But, he fails in his attempt to solve the paradox and some recent responses have also not succeeded in settling it, satisfactorily. We shall argue that epistemological issues approached in a Darwinian spirit offer a therapeutic resolution without rejecting the basic tenets of Plato’s epistemology. Drawing from (...) Popper’s evolutionary theory of knowledge, Darwinism is regarded as a metaphysical research program, rather than using it to collapse Plato’s metaphysics into biology. (shrink)

In what follows I shall investigate how the notions of truth and invention inform our moral life. In particular, I will show how this idea has been explored by William James in his seminal essay The Moral Philosopher and the Moral Life (MPML), by far his most clear-cut piece of moral philosophy. I will claim that the dialectics of the essay cannot be apprehended independently from the understanding of the moral psychology and epistemology James elaborates in his writings on pragmatism (...) and the philosophy of mind. In fact, once framed in the relevant perspective, the essay conveys a very different and more radical position that the one usually acknowledged. In MPML James engages in an inquiry into the nature of moral thought and its ability to meet the difficulties of the moral life it should address. The essay criticizes a certain image of moral reflection by questioning its underlying assumptions about the nature of mindedness and the place of truth in the moral life. I shall thus articulate the discussion of James’ essay along two directions, one methodological and one substantive. They are, respectively, the anti-foundational and anti-theoretical character of moral reflection, and the rethinking of the relationship we have with our interiority that is relevant for ethics as informed by the notion of truth. (shrink)

We seek to understand how third-party observers respond to allegations of sexual transgressions, whether their responses vary and if so why, how they determine perpetrator sanctions, who is more forgiving of them, and what is the psychological mechanism underlying this preference. We draw on one dimension of Hofstede's theory of cultural orientations—power distance belief, and one dimension of Haidt's work on moral reasoning—moral decoupling. Results from three studies on recent real-life cases—those pertaining to Harvey Weinstein, Brett Kavanaugh, and Peter Martins—reveal (...) interesting, consistent, and dramatic findings pertaining to these research questions. Specifically, compared to observers who endorse a low power distance belief, high PDB observers selectively suspend judgments of culpability and express higher evaluations of the alleged perpetrators, are significantly more forgiving of them, convey a lower preference for naming and shaming them, and consider the alleged transgressions as less serious. These outcomes are predicated on the psychological mechanism of moral decoupling. Both high and low PDB respondents decouple the perpetrators’ competence and morality. However, high PDB observers gauge the actions of the perpetrators by emphasizing competence, while low PDB observers gauge their actions by emphasizing morality. (shrink)