End-of-life decision making is fraught with ethical challenges. Withholding or withdrawing life support therapy is widely considered ethical in patients with high treatment burden, poor premorbid status, or significant projected disability even when such treatment is not “futile.” Whether such withdrawal of therapy in the aftermath of attempted suicide is ethical is not well established in the literature. We provide a clinical vignette and propose criteria under which such withdrawal would be ethical. We suggest that it is appropriate to withdraw (...) life support, regardless of the cause of the critical illness or disability, when the following criteria are met: (1) Surrogates request withdrawal of care and the adequacy of surrogates is confirmed, (2) an external reasonability standard is met, (3) passage of time, perhaps 72 hours, to allow certainty regarding the patient's wishes, and (4) psychiatric morbidity should be considered as grounds for withdrawal only in truly treatment-refractory cases. Fundamentally, we believe the question to ask is, “If this were not an attempted suicide, would a request to withdraw care be reasonable?” We believe that under these circumstances, such withdrawal of life support, even in an individual who has attempted suicide, does not constitute physician assistance with suicide and is distinct from physician aid-in-dying in several important respects. (shrink)

End-of-life decision making is fraught with ethical challenges. Withholding or withdrawing life support therapy is widely considered ethical in patients with high treatment burden, poor premorbid status, or significant projected disability even when such treatment is not ?futile.? Whether such withdrawal of therapy in the aftermath of attempted suicide is ethical is not well established in the literature. We provide a clinical vignette and propose criteria under which such withdrawal would be ethical. We suggest that it is appropriate to withdraw (...) life support, regardless of the cause of the critical illness or disability, when the following criteria are met: (1) Surrogates request withdrawal of care and the adequacy of surrogates is confirmed, (2) an external reasonability standard is met, (3) passage of time, perhaps 72 hours, to allow certainty regarding the patient's wishes, and (4) psychiatric morbidity should be considered as grounds for withdrawal only in truly treatment-refractory cases. Fundamentally, we believe the question to ask is, ?If this were not an attempted suicide, would a request to withdraw care be reasonable?? We believe that under these circumstances, such withdrawal of life support, even in an individual who has attempted suicide, does not constitute physician assistance with suicide and is distinct from physician aid-in-dying in several important respects. (shrink)

For Plato and Aristotle, arete (traditionally translated as "virtue") was the essential object of human admiration and striving, and even the key to happiness. Their work continues to inspire reflection on fundamental questions of ethics and politics today, as the fourteen new essays collected here demonstrate. -/- Contributors: Lidia Palumbo, Eva Anagnostou-Laoutides, Ryan M. Brown, Jay R. Elliott, Guilherme Domingues da Motta, Federico Casella, Jonathan A. Buttaci, George Harvey, Mark Ralkowski, Gary S. Beck, Paula Gottlieb, Giulio di Basilio, (...) Audrey L. Anton, and Elena Bartolini. (shrink)

We are grateful for the careful reading and insightful responses of the several peer commentaries to our proposed approach to requests to withhold or withdraw life support therapies among patients...

We are grateful for the careful reading and insightful responses of the several peer commentaries to our proposed approach to requests to withhold or withdraw life support therapies among patients...

This response addresses the excellent responses to my book provided by Heather Douglas, Janet Kourany, and Matt Brown. First, I provide some comments and clarifications concerning a few of the highlights from their essays. Second, in response to the worries of my critics, I provide more detail than I was able to provide in my book regarding my three conditions for incorporating values in science. Third, I identify some of the most promising avenues for further research that flow out (...) of this interchange. (shrink)

In this article, we examine conceptual and practical issues pertaining to relationship boundaries within the helping profession. Although our focus is primarily on relationships between mental health professionals and clients, there are considerable implications for a new approach to ethically structuring and understanding the construct of "required distance" in many human-interactive professions, such as teaching, religious leadership, public administration, and others. We define the concept of boundary as applied to human relationships, provide examples of boundary breaks, and raise questions regarding (...) how to evaluate the significance and morality issues raised by specific boundary breaks. Questions and dilemmas are presented regarding boundary setting and accidental or deliberate boundary breaking. Representative dangers present in boundary breaks are identified, and examples are provided. Possible beneficial outcomes are also discussed. Finally, a suggested protocol for assessing a proposed boundary break is provided, much of which is drawn from the work and thinking of Laura Brown, applied more generally in this article, with additions from our perspectives. (shrink)

I critically analyze Kevin Elliott’s A Tapestry of Values in order to tease out his views on the nature and status of values or value judgments in the text. I show there is a tension in Elliott’s view that is closely connected to a major lacuna in the philosophical literature on values in science: the need for a better theory of values.

Each of these hospice officials makes several criticisms of my paper, Philosophy of Hospice I will treat these criticisms in turn.

This book (edited by Jonathan Y. Tsou, Jamie Shaw, and Carla Fehr) offers eighteen original historical and philosophical essays focused on values in science, scientific pluralism, and pragmatism. These themes have been central in the work of Matthew J. Brown, and the book frames these topics through an engagement with Brown’s broadly ranging work on values in science. The themes of this book are integrated and unified in the pragmatic and value-laden ideal of science defended by Professor (...) class='Hi'>Brown in his fascinating 2020 book, Science and Moral Imagination. Brown's ideal of moral imagination prescribes that scientists should recognize the contingencies in their work as unforced choices, examine morally salient aspects of these decisions, recognize the various interests of relevant stakeholders, explore and construct alternative options, and exercise fair and warranted value judgments to guide those decisions. The interdisciplinary essays in this volume engage with different aspects of Brown's philosophical research on scientific values as well as his historical research on figures such as John Dewey and Paul K. Feyerabend. The international contributors to this volume include distinguished and familiar voices from the values in science literature (e.g., Kevin Elliott, Janet Kourany, and Don Howard) as well as newer voices. The resulting book showcases some of the latest innovative research being done on values, pluralism, and pragmatism, and it will be an important resource for researchers working on values in science. Specific topics addressed in the book include: moral imagination, inductive risk, epistemic priority, the value free ideal of science, values in the contexts of artificial intelligence and medicine, varieties of pluralism (e.g., epistemic, ethical, and cultural), and the structure of scientific communities. The book also features novel historical research on important figures in the traditions of pragmatism, pluralism, and values in science, such as John Dewey, John Stuart Mill, Paul Feyerabend, W. V. O. Quine, Ludwig Fleck, among others. The contributions to the volume represent a broad range of contemporary history and philosophy of science perspectives, which have guided Brown's own work, including socially relevant philosophy of science (SRPoiSE), history of philosophy of science (HOPOS), feminist philosophy of science, and philosophy of science in practice (SPSP). The book will be of interest to a broad audience of researchers working in philosophy of science, philosophy of medicine, history and philosophy of science, and science and technology studies. (shrink)

Adaptationism is a doctrine that has meant different things to different people. In this essay, I want to isolate and discuss a reading of adaptationism that makes it a non-trivial empirical thesis about the history of life. I'll take adaptationism to be the following claim: natural selection has been the only important cause of most of the phenotypic traits found in most species. I won't try to determine whether adaptationism, so defined, is true. Rather, my task will be one of (...) clarification. What does this statement mean, and how is it related to various remarks that biologists have made about adaptationism, pro and con? (shrink)

In contrast to the traditional view of Kant as apure retributivist, the recent interpretations ofKant's theory of punishment (for instance Byrd's)propose a mixed theory of retributivism and generalprevention. Although both elements are literallyright, I try to show the shortcomings of each. I thenargue that Kant's theory of punishment is notconsistent with his own concept of law. Thus I proposeanother justification for punishment: specialdeterrence and rehabilitation. Kant's critique ofutilitarianism does not affect this alternative, whichmoreover has textual support in Kant and is (...) fullyconsistent with his concept of law. (shrink)

First published in 1987, Althusser, The Detour of Theory was widely received as the fullest account of its subject to date. Drawing on a wide range of hitherto untranslated material, it examined the political and intellectual contexts of Althusser's `return to Marx' in the mid-1960s and proclamaed of a `crisis of Marxism'. It concluded with a balance-sheet of Althusser's contribution to historical materialism. In this second edition, Gregory Elliott has added a substantial postscript in which he surveys the posthumous (...) edition of the French philosopher's work. (shrink)

Experimental research has shown that pairs of stimuli which are congruent and assumed to 'go together' are recalled more effectively than an item presented in isolation. Will this multisensory memory benefit occur when stimuli are richer and longer, in an ecological setting? In the present study, we focused on an everyday situation of audio-visual learning and manipulated the relationship between audio guide tracks and viewed portraits in the galleries of the Tate Britain. By varying the gender and narrative style of (...) the voice-over, we examined how the perceived congruency and assumed unity of the audio guide track with painted portraits affected subsequent recall. We show that tracks perceived as best matching the viewed portraits led to greater recall of both sensory and linguistic content. We provide the first evidence that manipulating crossmodal congruence and unity assumptions can effectively impact memory in a multisensory ecological setting, even in the absence of precise temporal alignment between sensory cues. (shrink)

The Fourth Edition of this long-established text retains all the key features of the previous editions, covering the basic topics of a solid first course in ...

By looking closely at the ideas of Rosseau, Kant, and Mill, Autonomy and Patients' Decisions traces the modern concept of autonomy from its historical roots, ...

In ‘Two Dogmas of Empiricism’, Quine attacks the analytic/synthetic distinction and defends a doctrine that I call epistemological holism. Now, almost fifty years after the article’s appearance, what are we to make of these ideas? I suggest that the philosophical naturalism that Quine did so much to promote should lead us to reject Quine’s brief against the analytic/synthetic distinction; I also argue that Quine misunderstood Carnap's views on analyticity. As for epistemological holism, I claim that this thesis does not follow (...) from the logical point that Duhem and Quine made about the role of auxiliary assumptions in hypothesis testing, and that the thesis should be rejected. (shrink)

Critical-set views avoid the Repugnant Conclusion by subtracting some constant from the welfare score of each life in a population. These views are thus sensitive to facts about biographical identity: identity between lives. In this paper, I argue that questions of biographical identity give us reason to reject critical-set views and embrace the total view. I end with a practical implication. If we shift our credences towards the total view, we should also shift our efforts towards ensuring that humanity survives (...) for the long term. (shrink)

I explain and motivate the shutdown problem: the problem of creating artificial agents that (1) shut down when a shutdown button is pressed, (2) don’t try to prevent or cause the pressing of the shutdown button, and (3) otherwise pursue goals competently. I then propose a solution: train agents to have incomplete preferences. Specifically, I propose that we train agents to lack a preference between every pair of different-length trajectories. I suggest a way to train such agents using reinforcement learning: (...) we give the agent lower reward for repeatedly choosing same-length trajectories. (shrink)

Person-affecting views in population ethics state that (in cases where all else is equal) we’re permitted but not required to create people who would enjoy good lives. In this paper, I present an argument against every possible variety of person-affecting view. The argument takes the form of a dilemma. Narrow person-affecting views must embrace at least one of three implausible verdicts in a case that I call ‘Expanded Non-Identity.’ Wide person-affecting views run into trouble in a case that I call (...) ‘Two-Shot Non-Identity.’ One plausible practical upshot of my argument is as follows: we individuals and our governments should be doing more to reduce the risk of human extinction this century. (shrink)