The concept of moral distress can be extended from clinical settings to larger environmental concerns affecting health care. Moral distress—a common experience in complex societies—arises when individuals have clear moral judgments about societal practices, but have difficulty in finding a venue in which to express concerns. Since health care is large in scale and climate change is proving to be a major environmental problem, scaling down health care is inevitably a necessary element for mitigating climate change. Because it is extremely (...) challenging to discuss these concerns in health care settings, those concerned about climate change and health care experience distress. This article outlines some philosophical concepts and perspectives that may be useful in mitigating this distress. (shrink)

The article by Jessica Pierce and Christina Kerby, raises some important but seldom asked questions about the use of natural resources in healthcare. They take for their example latex gloves, which are in wide everyday use, especially since the establishment of principles of universal precautions in infection control as a reaction to the spread of HIV. They trace the production of latex gloves back through rubber processing to their origins in Malaysian rubber plantations and elsewhere. They then ask, but do (...) not answer, some hard questions about the ethics of our relationship as patients to the impact of the materials we use on communities and the environment. To draw out their theme more starkly, consider the rumor widespread in South America that some babies purportedly adopted by Northerners are sold and cut up for their organs. Suppose this story were true; suppose your donated organ were obtained in this way. You would probably be so revolted by the immorality of its acquisition that you would refuse to accept it. But now take a morally more ambiguous case, as Pierce and Kerby intend. Suppose that the process of obtaining latex gloves is part of the gradual erosion of the Malaysian environment, and that workers in latex factories are poorly paid. Now, should or would you refuse to use latex gloves? Should or would you even be more selective in their use? The practice of universal precautions presumes a virtually unlimited supply of gloves; yet to react to resource scarcity with selective precautions hazards discrimination. Is there any way philosophically to balance the local justice issue of discrimination in comparison to injustice on a global scale and to future generations? (shrink)

At the September 1992 Birth of Bioethics conference observing the 30th anniversary of the Seattle kidney dialysis program, Warren Reich discussed the “bilocated” birth of the term bioethics. He showed that the term bioethics was coined in Michigan by Van Rensselaer Potter and that the term was also apparently conceived of independently at about the same time in 1970–1971 in Washington, D.C., by Andre Hellegers and Sargent Shriver. Potter's work, like many similar works in the early 1970s, was concerned with (...) the growing global biological crisis of human overpopulation, the destruction of species, and how to respond to these. He prefaced his book Bioethics with a “Bioethical Creed for Individuals,” outlining duties to respond to this crisis in a meaningful and scientific way. Hellegers and Shriver used the neologism to name the new Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics. The Center was to study concerns somewhat different from Potter's: the technological revolution in healthcare and its impact on reproduction, investigator-patient relations, and medical ethics. (shrink)

In addition to good medical services, all aspects of an economy must work together to ensure a high level of public health. However, the abundant economies of the North are contributing heavily to global environmental disaster, with increasing concomitant damage to human health. Environmental health problems result from toxicity (i.e., pollution), scarcity (i.e., poverty), and energy degradation (i.e., entropy). Common to these three factors in environmental demise are the limits of the Earth. Production has evolved to a point where the (...) Earth is no longer safe from radical depletion. Therefore, simple living is a necessary feature of global public health. Rarely do readers of this journal see these limits first hand, but they are real. Our limited perceptions and efforts hinder our ability to understand how to reduce the impact of production on natural ecosystems. Contrary to standard media portrayals, growth and technology cannot solve our public health problems, because they are unequally distributed across the world and neither can they solve the problem of limits. The need for modest consumption in developed nations is an essential and almost completely ignored element of the answer to environmental and associated health problems. A radical and rapid change to public health is needed in order to avoid abysmal global health consequences during the next century. These changes involve a restructuring of our economy, including the health care industry. In the short run, this is an ethical demand. In the long run, this is an inevitability. The actual and appropriate role of bioethicists in championing these changes is unclear. (Abstract by Bruce R. Smith). (shrink)

About 1970, Van Rensselaer Potter coined the term bioethics to bring under one heading broad questions of human survival, environment, and biology. In 1971, Potter outlined a statement of principles that linked the ethics of the biological sciences with the ethics of environmental concern. Regrettably, the field that adopted his rubric bioethics immediately diverged from Potter’s interests. Bioethics has become for the most part identified with medical ethics or health care ethics and in so doing has developed few ethical principles (...) and analyses in relationship to environmental ethics. Similarly, environmental ethics seldom touches on clinical or health care issues, even though the field of environmental health has grown greatly in recent decades. It is the purpose of this article to indicate briefly some of the topics that could be treated effectively as part of a project to reconnect medical ethics and environmental ethics into what may be called sustainable bioethics. (shrink)

Professor Brooks’ paper projects an aura of inevitable catastrophe. He correctly notes that the climate is always changing and that somewhere in the near or far future there will always be somethin...

Between inventing the concept of a universal computer in 1936 and breaking the German Enigma code during World War II, Alan Turing, the British founder of computer science and artificial intelligence, came to Princeton University to study mathematical logic. Some of the greatest logicians in the world--including Alonzo Church, Kurt Gödel, John von Neumann, and Stephen Kleene--were at Princeton in the 1930s, and they were working on ideas that would lay the groundwork for what would become known as computer science. (...) Though less well known than his other work, Turing's 1938 Princeton PhD thesis, "Systems of Logic Based on Ordinals," which includes his notion of an oracle machine, has had a lasting influence on computer science and mathematics. This book presents a facsimile of the original typescript of the thesis along with essays by Andrew Appel and Solomon Feferman that explain its still-unfolding significance. A work of philosophy as well as mathematics, Turing's thesis envisions a practical goal--a logical system to formalize mathematical proofs so they can be checked mechanically. If every step of a theorem could be verified mechanically, the burden on intuition would be limited to the axioms. Turing's point, as Appel writes, is that "mathematical reasoning can be done, and should be done, in mechanizable formal logic." Turing's vision of "constructive systems of logic for practical use" has become reality: in the twenty-first century, automated "formal methods" are now routine. Presented here in its original form, this fascinating thesis is one of the key documents in the history of mathematics and computer science. (shrink)

This article considers the potential for a researcher to use their own creative practice as a method of data collection. Much of the published material in this field focuses on more theoretical positions, with limited use being made of specific PhDs that illustrate the context in which practice was undertaken by the researcher. It explores strategies for data collection and researcher motivation during what the author identifies as "researcher practice." This is achieved through the use of three PhD case studies. (...) Methods of data collection focus on: the use of output from practice for quantitative data collection, the use of output from practice for qualitative data collection, and the use of output from practice for data translation. The article discusses the methodologies employed in the case studies to identify themes which enable the definition of a generic researcher practitioner methodology. It notes the significance of creative practice in support of data collection and the differences between researcher practice and commercial practice, and emphasises the contribution of researcher practice towards personal motivation. (shrink)

There have been recurrent reports of fragilities in the Brazilian health system, especially in public institutions. In this commentary, I argue that moral distress in nursing in Brazil can still be considered an innovative and important subject of study. I also highlight the relevance of engaging educational institutions in the development of policies about environmental sustainability. It is relevant to continue studying moral distress in nursing and in health care generally in order to contribute to the transformation of reality by (...) confronting the multiple common situations in the work environment that are recognized by many as morally problematic because they infringe upon the rights of people, patients, and health care professionals and are an affront to environmental health. (shrink)

Resenha do livro The Ethics of Environmentally Responsible Health Care.

Quão próxima está a ética do cuidado com a saúde da ética da responsabilidade ambiental? Enxergamos os problemas ambientais e também os problemas de saúde das pessoas, mas conseguimos ver realmente uma ligação entre eles?

The first edition was awarded the '2005 Textbook Award of the Association of University Professors of Management (Verband der Hochschullehrer fur ...

How should politicians act? When should they try to lead public opinion and when should they follow it? Should politicians see themselves as experts, whose opinions have greater authority than other people's, or as participants in a common dialogue with ordinary citizens? When do virtues like toleration and willingness to compromise deteriorate into moral weakness? In this innovative work, Andrew Sabl answers these questions by exploring what a democratic polity needs from its leaders. He concludes that there are systematic, (...) principled reasons for the holders of divergent political offices or roles to act differently. Sabl argues that the morally committed civil rights activist, the elected representative pursuing legislative results, and the grassroots organizer determined to empower ordinary citizens all have crucial democratic functions. But they are different functions, calling for different practices and different qualities of political character. To make this case, he draws on political theory, moral philosophy, leadership studies, and biographical examples ranging from Everett Dirksen to Ella Baker, Frances Willard to Stokely Carmichael, Martin Luther King Jr. to Joe McCarthy. Ruling Passions asks democratic theorists to pay more attention to the "governing pluralism" that characterizes a diverse, complex democracy. It challenges moral philosophy to adapt its prescriptions to the real requirements of democratic life, to pay more attention to the virtues of political compromise and the varieties of human character. And it calls on all democratic citizens to appreciate "democratic constancy": the limited yet serious standard of ethical character to which imperfect democratic citizens may rightly hold their leaders--and themselves. (shrink)

We all face death, but how many of us are actually ready for it? Whether our own death or that of a loved one comes first, how prepared are we, spiritually or practically? In Preparing to Die, Andrew Holecek presents a wide array of resources to help the reader address this unfinished business. Part One shows how to prepare one's mind and how to help others, before, during, and after death. The author explains how spiritual preparation for death can (...) completely transform our relationship to the end of life, dissolving our fear and helping us to feel open and receptive to letting go in the dying process. Daily meditation practices, the stages of dying and how to work with them, and after-death experiences are all detailed in ways that will be particularly helpful for those with an interest in Tibetan Buddhism and in Tibetan approaches to conscious dying. Part Two addresses the practical issues that surround death. Experts in grief, hospice, the funeral business, and the medical and legal issues of death contribute chapters to prepare the reader for every practical concern, including advance directives, green funerals, the signs of death, warnings about the funeral industry, the stages of grief, and practical care for the dying. Part Three contains heart-advice from twenty of the best-known Tibetan Buddhist masters now teaching in the West. These brief interviews provide words of solace and wisdom to guide the dying and their caregivers during this challenging time. Preparing to Die is for anyone interested in learning how to prepare for death from a Buddhist perspective, both spiritually and practically. It is also for those who want to learn how to help someone else who is dying, both during the time of illness and death as well as after death. (shrink)

A satisfactory theory of linguistic communication must explain how it is that, through the interpersonal exchange of auditory, visual, and tactile stimuli, the communicative preconditions for the acquisition of testimonial knowledge regularly come to be satisfied. Without an account of knowledge-yielding communication this success condition for linguistic theorizing is left opaque, and we are left with an incomplete understanding of testimony, and communication more generally, as a source of knowledge. This paper argues that knowledge-yielding communication should be modelled on knowledge (...) itself. It is argued that knowledge-yielding communication occurs iff interlocutors coordinate on truth values in a non-lucky and non-deviant way. This account is able to do significant explanatory work: it sheds light on the nature of referential communication, and it allows us to capture, in an informative way, the sense in which interlocutors must entertain similar propositions in order to communicate successfully. (shrink)

In this paper I argue that the enkratic principle in its classic formulation may not be a requirement of rationality. The investigation of whether it is leads to some important methodological insights into the study of rationality. I also consider the possibility that we should consider rational requirements as a subset of a broader category of agential requirements.

This paper argues that the dominance of linear models has led many sociologists to construe the social world in terms of a "general linear reality." This reality assumes (1) that the social world consists of fixed entities with variable attributes, (2) that cause cannot flow from "small" to "large" attributes/events, (3) that causal attributes have only one causal pattern at once, (4) that the sequence of events does not influence their outcome, (5) that the "careers" of entities are largely independent, (...) and (6) that causal attributes are generally independent of each other. The paper discusses examples of these assumptions in empirical work, consider standard and new methods addressing them, and briefly explores alternative models for reality that employ demographic, sequential, and network perspectives. (shrink)

A Physicalist Manifesto is a full treatment of the comprehensive physicalist view that, in some important sense, everything is physical. Andrew Melnyk argues that the view is best formulated by appeal to a carefully worked-out notion of realization, rather than supervenience; that, so formulated, physicalism must be importantly reductionist; that it need not repudiate causal and explanatory claims framed in non-physical language; and that it has the a posteriori epistemic status of a broad-scope scientific hypothesis. Two concluding chapters argue (...) in detail that contemporary science provides no significant empirical evidence against physicalism and some considerable evidence for it. Written in a brisk, candid and exceptionally clear style, this 2003 book should appeal to professionals and students in philosophy of mind, metaphysics and philosophy of science. (shrink)

This introduction to mathematical logic starts with propositional calculus and first-order logic. Topics covered include syntax, semantics, soundness, completeness, independence, normal forms, vertical paths through negation normal formulas, compactness, Smullyan's Unifying Principle, natural deduction, cut-elimination, semantic tableaux, Skolemization, Herbrand's Theorem, unification, duality, interpolation, and definability. The last three chapters of the book provide an introduction to type theory (higher-order logic). It is shown how various mathematical concepts can be formalized in this very expressive formal language. This expressive notation facilitates proofs (...) of the classical incompleteness and undecidability theorems which are very elegant and easy to understand. The discussion of semantics makes clear the important distinction between standard and nonstandard models which is so important in understanding puzzling phenomena such as the incompleteness theorems and Skolem's Paradox about countable models of set theory. Some of the numerous exercises require giving formal proofs. A computer program called ETPS which is available from the web facilitates doing and checking such exercises. Audience: This volume will be of interest to mathematicians, computer scientists, and philosophers in universities, as well as to computer scientists in industry who wish to use higher-order logic for hardware and software specification and verification. (shrink)

Kant holds that in order to have knowledge of an object, a subject must be able to “prove” that the object is really possible—i.e., prove that there is neither logical inconsistency nor “real repugnance” between its properties. This is (usually) easy to do with respect to empirical objects, but (usually) impossible to do with respect to particular things-in-themselves. In the first section of the paper I argue that an important predecessor of Kant’s account of our ignorance of real possibility can (...) be found in Locke’s Essay Concerning Human Understanding. In the middle sections I discuss the way in which our inability to prove the real possibility of things-in-themselves motivates Kant’s famous prohibition on certain kinds of knowledge-claims about them. In the final section I examine Hegel’s attempts to dissolve this problem of real repugnance and thereby remove an inherited obstacle to speculative knowledge of the supersensible. -/- . (shrink)

Empirical work has lately confirmed what many philosophers have taken to be true: people are ‘biased toward the future’. All else being equal, we usually prefer to have positive experiences in the future, and negative experiences in the past. According to one hypothesis, the temporal metaphysics hypothesis, future-bias is explained either by our beliefs about temporal metaphysics—the temporal belief hypothesis—or alternatively by our temporal phenomenology—the temporal phenomenology hypothesis. We empirically investigate a particular version of the temporal belief hypothesis according to (...) which future-bias is explained by the belief that time robustly passes. Our results do not match the apparent predictions of this hypothesis, and so provide evidence against it. But we also find that people give more future-biased responses when asked to simulate a belief in robust passage. We take this to suggest that the phenomenology that attends simulation of that belief may be partially responsible for future-bias, and we examine the implications of these results for debates about the rationality of future-bias. (shrink)

Empirical evidence suggests that a majority of people believe that time robustly passes, and that many also report that it seems to them, in experience, as though time robustly passes. Non-dynamists deny that time robustly passes, and many contemporary non-dynamists—deflationists—even deny that it seems to us as though time robustly passes. Non-dynamists, then, face the dual challenge of explaining why people have such beliefs and make such reports about their experiences. Several philosophers have suggested the stable-self explanation, according to which (...) what partly explains one or both of the explananda is that people believe themselves to have a stable persisting self which is imagined either as moving through time, or as being stationary, with time moving around it. This paper empirically investigates this explanation. We found, however, no evidential support for the stable-self explanation, leaving the non-dynamist but also, we will argue, the dynamist, with an extant explanatory challenge. (shrink)

This is a discussion of the state of discussion on pragmatic reasons for belief.

This is the first book-length treatment of the relationship between citizenship and the environment. Andrew Dobson argues that ecological citizenship cannot be fully articulated in terms of the two great traditions of citizenship - liberal and civic republican - with which we have been bequeathed. He develops an original theory of citizenship, which he calls 'post-cosmopolitan', and argues that ecological citizenship is an example and an inflection of it. Ecological citizenship focuses on duties as well as rights, and these (...) duties are owed non-reciprocally, by those individuals and communities who occupy unsustainable amounts of ecological space, to those who occupy too little. (shrink)

This book offers an exciting re-interpretation of Auguste Comte, the founder of French sociology. Following the development of his philosophy of positivism, Comte later focused on the importance of the emotions in his philosophy resulting in the creation of a new religious system, the Religion of Humanity. Andrew Wernick provides the first in-depth critique of Comte's concept of religion and its place in his thinking on politics, sociology and philosophy of science. He places Comte's ideas in the context of (...) post-1789 French political and intellectual history, and of modern philosophy, especially postmodernism. Wernick relates Comte to Marx and Nietzsche as seminal figures of modernity and examines key features of modern and postmodern French social theory, tracing the inherent flaws and disintegration of Comte's system. Wernick offers original and fascinating insights in this rich study which will attract a wide audience from sociologists and philosophers to cultural theorists and historians. (shrink)

Vagueness is the study of concepts that admit borderline cases. The epistemology of vagueness concerns attitudes we should have towards propositions we know to be borderline. On this basis Andrew Bacon develops a new theory of vagueness in which vagueness is fundamentally a property of propositions, explicated in terms of its role in thought.

In this book, Andrew Inkpin considers the disclosive function of language—what language does in revealing or disclosing the world. His approach to this question is a phenomenological one, centering on the need to accord with the various experiences speakers can have of language. With this aim in mind, he develops a phenomenological conception of language with important implications for both the philosophy of language and recent work in the embodied-embedded-enactive-extended tradition of cognitive science. -/- Inkpin draws extensively on the (...) work of Martin Heidegger, Maurice Merleau-Ponty, and Ludwig Wittgenstein, showing how their respective conceptions of language can be combined to complement each other within a unified view. From the early Heidegger, Inkpin extracts a basic framework for a phenomenological conception of language, comprising both a general picture of the role of language and a specific model of the function of words. Merleau-Ponty’s views are used to explicate the generic “pointing out”—or presentational—function of linguistic signs in more detail, while the late Wittgenstein is interpreted as providing versatile means to describe their many pragmatic uses. Having developed this unified phenomenological view, Inkpin explores its broader significance. He argues that it goes beyond the conventional realism/idealism opposition, that it challenges standard assumptions in mainstream post-Fregean philosophy of language, and that it makes a significant contribution not only to the philosophical understanding of language but also to 4e cognitive science. (shrink)

Foucault is often thought to have a great deal to say about the history of madness and sexuality, but little in terms of a general analysis of government and the state.; This volume draws on Foucault's own research to challenge this view, demonstrating the central importance of his work for the study of contemporary politics.; It focuses on liberalism and neo- liberalism, questioning the conceptual opposition of freedom/constraint, state/market and public/private that inform liberal thought.