Fifty years ago, in 1961, Feinstein published his first path-breaking articles leading to his seminal work Clinical Judgement and to the establishment of clinical epidemiology. Feinstein had an Aristotelian approach to scientific method: methods must be adapted to the material examined. Feinstein died 10 years ago and few years before his death he concluded that efforts to promote a person-oriented medicine had failed. He criticised medicine for not having recognized that only persons can suitably observe, evaluate and rate their own (...) health status. Feinstein’s position was—as in Clinical Judgement—methodological. He didn’t espouse ethical principles. He pointed to methodological deficiencies in clinical epidemiology and evidence-based medicine. In this article we’ll provide a framework for understanding and justifying Feinstein’s call for a person-oriented medicine which recognizes patients as co-actors in clinical reasoning. It’s argued that craftsmanship and practical wisdom are integrated in clinical judgement and reasoning and that clinical reasoning is not only about means to achieve the end, health. We do also reason and deliberate about ends. The ‘defining end’ of medicine (health) has continuously been negotiated and so been the object of deliberation. For centuries among professionals, in recent years among professionals and patients. These negotiations and deliberations lead to ongoing specifications of health as a ‘guiding end’, i.e. an end guiding clinical reasoning about what to do in particular situations. Feinstein’s self-critical account to clinical epidemiology at the end of his professional career reflects the fact that patients during the last 30–40 years (i.e. in the period after the publication of Clinical Judgement) widely have been recognized as persons with rights to autonomy. Feinstein’s lesson is, however, that espousing and recognizing ethical ideals is not enough. A change of clinical practice and its methods is necessary. His critique also implies that clinical epidemiology and evidence-based medicine as practiced haven’t provided such a turn. (shrink)
Wesley Wildman: Religious philosophy as multidisciplinary comparative inquiry: envisioning a future for the philosophy of religion Content Type Journal Article Category Book Review Pages 1-4 DOI 10.1007/s11153-012-9339-4 Authors Jeppe Sinding Jensen, Department of Culture and Society, Faculty of Arts, Aarhus University, Tasingegade 3, 8000 Aarhus C, Denmark Journal International Journal for Philosophy of Religion Online ISSN 1572-8684 Print ISSN 0020-7047.
In this collection of interviews, Derrick Jensen discusses the destructive dominant culture with ten people who have devoted their lives to undermining it. Whether it is Carolyn Raffensperger and her radical approach to public health, or Thomas Berry on perceiving the sacred; be it Kathleen Dean Moore reminding us that our bodies are made of mountains, rivers, and sunlight; or Vine Deloria asserting that our dreams tell us more about the world than science ever can, the activists and philosophers (...) interviewed in How Shall I Live My Life? each bravely present a few of the endless forms that resistance can and must take. (shrink)
Numerous studies provide evidence that brief training programmes have been successful in quickly advancing moral reasoning in specific areas. In most of these studies children are asked to respond to moral dilemmas that are presented while in a highly structured laboratory setting (Bandura and McDonald, 1963; Jensen and Hafen, 1973; Jensen and Hughston, 1972; Jensen and Rytting, 1972; Jensen and Vance, 1972). At the present time it is uncertain if such training approaches are effective outside the (...) laboratory in a natural context such as the classroom. The purpose of this study was to determine the effectiveness of brief training programmes in the classroom using an indirect approach where the correct responses are not directly identified and reinforced. Two areas of moral thinking were selected for testing: children's reasons for doing good and delay of gratification. (shrink)
This introduction to the Common Knowledge symposium titled “Comparative Relativism” outlines a variety of intellectual contexts where placing the unlikely companion terms comparison and relativism in conjunction offers analytical purchase. If comparison, in the most general sense, involves the investigation of discrete contexts in order to elucidate their similarities and differences, then relativism, as a tendency, stance, or working method, usually involves the assumption that contexts exhibit, or may exhibit, radically different, incomparable, or incommensurable traits. Comparative studies are required to (...) treat their objects as alike, at least in some crucial respects; relativism indicates the limits of this practice. Jensen argues that this seeming paradox is productive, as he moves across contexts, from Lévi-Strauss's analysis of comparison as an anthropological method to Peter Galison's history of physics, and on to the anthropological, philosophical, and historical examples offered in symposium contributions by Barbara Herrnstein Smith, Eduardo Viveiros de Castro, Marilyn Strathern, and Isabelle Stengers. Comparative relativism is understood by some to imply that relativism comes in various kinds and that these have multiple uses, functions, and effects, varying widely in different personal, historical, and institutional contexts that can be compared and contrasted. Comparative relativism is taken by others to encourage a “comparison of comparisons,” in order to relativize what different peoples—say, Western academics and Amerindian shamans—compare things “for.” Jensen concludes that what is compared and relativized in this symposium are the methods of comparison and relativization themselves. He ventures that the contributors all hope that treating these terms in juxtaposition may allow for new configurations of inquiry. (shrink)
K.J. Devlin has extended Jensen's construction of a model ofZFC andCH without Souslin trees to a model without Kurepa trees either. We modify the construction again to obtain a model with these properties, but in addition, without Kurepa trees inccc-generic extensions. We use a partially defined ◊-sequence, given by a fine structure lemma. We also show that the usual collapse ofκ Mahlo toω 2 will give a model without Kurepa trees not only in the model itself, but also inccc-extensions.
I argue that Merleau-Ponty’s use of the case of Schneider in his arguments for the existence of non-conconceptual and non-representational motor intentionality contains a problematic methodological ambiguity. Motor intentionality is both to be revealed by its perspicuous preservation and by its contrastive impairment in one and the same case. To resolve the resulting contradiction I suggest we emphasize the second of Merleau-Ponty’s two lines of argument. I argue that this interpretation is the one in best accordance both with Merleau-Ponty’s general (...) methodology and with the empirical case of Schneider as it was described by Gelb and Goldstein. (shrink)
Can one consistently deny the permissibility of abortion while endorsing the killing of human embryos for the sake of stem cell research? The question is not trivial; for even if one accepts that abortion is prima facie wrong in all cases, there are significant differences with many of the embryos used for stem cell research from those involved in abortion—most prominently, many have been abandoned in vitro, and appear to have no reasonably likely meaningful future. On these grounds one might (...) think to maintain a strong position against abortion but endorse killing human embryos for the sake of stem cell research and its promising benefits. I will argue, however, that these differences are not decisive. Thus, one who accepts a strong view against abortion is committed to the moral impermissibility of killing human embryos for the sake of stem cell research. I do not argue for the moral standing of either abortion or the killing of embryos for stem cell research; I only argue for the relation between the two. Thus the conclusion is relevant to those with a strong view in favor of the permissibility of killing embryos for the sake of research as much as for those who may strongly oppose abortion; neither can consider their position in isolation from the other. (shrink)
It is common to define egalitarianism in terms of an inequality ordering, which is supposed to have some weight in overall evaluations of outcomes. Egalitarianism, thus defined, implies that levelling down makes the outcome better in respect of reducing inequality; however, the levelling down objection claims there can be nothing good about levelling down. The priority view, on the other hand, does not have this implication. This paper challenges the common view. The standard definition of egalitarianism implicitly assumes a context. (...) Once this context is made clear, it is easily seen that egalitarianism could be defined alternatively in terms of valuing a benefit to a person inversely to how well off he is relative to others. The levelling down objection does not follow from this definition. Moreover, the common definition does not separate egalitarian orderings from prioritarian ones. It is useful to do this by requiring that on egalitarianism, additively separable orderings should be excluded. But this requirement is stated as a condition on the alternative definition of egalitarianism, from which the levelling down objection does not follow. (shrink)
Is it legitimate for a business to concentrate on profits under respect for the law and ethical custom? On the one hand, there seems to be good reasons for claiming that a corporation has a duty to act for the benefit of all its stakeholders. On the other hand, this seems to dissolve the notion of a private business; but then again, a private business would appear to be exempted from ethical responsibility. This is what Kenneth Goodpaster has called the (...) stakeholder paradox: either we have ethics without business or we have business without ethics. Through a different route, I reach the same solution to this paradox as Goodpaster, namely that a corporation is the instrument of the shareholders only, but that shareholders still have an obligation to act ethically responsibly. To this, I add discussion of Friedman’s claim that this responsibility consists in increasing profits. I show that most of his arguments fail. Only pragmatic considerations allow to a certain extent that some of the ethical responsibility is left over to democratic regulation. (shrink)
A number of researchers have begun to demonstrate that the widely discussed ?Knobe effect? (wherein participants are more likely to think that actions with bad side-effects are brought about intentionally than actions with good or neutral side-effects) can be found in theory of mind judgments that do not involve the concept of intentional action. In this article we report experimental results that show that attributions of knowledge can be influenced by the kinds of (non-epistemic) concerns that drive the Knobe effect. (...) Our findings suggest there is good reason to think that the epistemic version of the Knobe effect is a theoretically significant and robust effect, and that the goodness or badness of side-effects can often have greater influence on participant knowledge attributions than explicit information about objective probabilities. Thus, our work sheds light on important ways in which participant assessments of actions can affect the epistemic assessments participants make of agents? beliefs. (shrink)
This paper analyzes the number of procedural and substantive tension points with which a conscientious whistleblower struggles. Included in the former are such questions as: (1) Am I properly depicting the seriousness of the problem? (2) Have I secured the information properly, analyzed it appropriately, and presented it fairly? (3) Are my motives appropriate? (4) Have I tried fully enough to have the problem corrected within the organization? (5) Should I blow the whistle while still a member of the organization (...) or after having left it? (6) Should I keep anonymity? (7) How ethical is it to assume the role of a judge? (8) How ethical is it to set in motion an act which will likely be very costly to many people? Substantive tension points include such questions as: (1) How fully am I living up to my moral obligations to my organization and my colleagues? (2) Am I appropriately upholding the ethical standards of my profession? (3) How adversely will my action affect my family and other primary groups? (4) Am I being true to myself? (5) How will my action affect the health of such basic values as freedom of expression, independent judgment, courage, fairness, cooperativeness, and loyalty? (shrink)
Several studies have indicated that scientists are likely to have an outlook on both facts and values that are different to that of lay people in important ways. This is one significant reason it is currently believed that in order for scientists to exercise a reliable ethical reflection about their research it is necessary for them to engage in dialogue with other stakeholders. This paper reports on an exercise to encourage a group of scientists to reflect on ethical issues without (...) the presence of external stakeholders. It reports on the use of a reflection process with scientists working in the area of animal disease genomics (mainly drawn from the EADGENE EC Network of Excellence). This reflection process was facilitated by using an ethical engagement framework, a modified version of the Ethical Matrix. As judged by two criteria, a qualitative assessment of the outcomes and the participants’ own assessment of the process, this independent reflective exercise was deemed to be successful. The discussions demonstrated a high level of complexity and depth, with participants demonstrating a clear perception of uncertainties and the context in which their research operates. Reflection on stakeholder views and values appeared to be embedded within the discussions. The finding from this exercise seems to indicate that even without the involvement of the wider stakeholder community, valuable reflection and worthwhile discourse can be generated from ethical reflection processes involving only scienitific project partners. Hence, the previous assumption that direct stakeholder engagement is necessary for ethical reflection does not appear to hold true in all cases; however, other reasons for involving a broad group of stakeholders relating to governance and social accountability of science remain. (shrink)
Moral cognitivism, internalism about moral judgements, and Humeanism about motivating reasons all possess attractions.Yet they cannot all be true.This is the so-called moral problem. Dancy offers an interesting particularist response to the moral problem. However, we argue that this response, first, provides an inadequate basis for the distinction between motivating states and states necessary for motivation although not themselves motivators; second, draws no support from considerations about weakness of the will; and third, involves an implausible account of desire.We conclude that (...) particularism ú whatever other attractions it may have ú does not solve the moral problem. (shrink)
Thomas Nagel recognizes that it is commonly believed that people can neither be held morally responsible nor morally assessed for what is beyond their control. Yet he is convinced that although such a belief may be intuitively plausible, upon reflection we find that we do make moral assessments of persons in a large number of cases in which such assessments depend on factors not under their control. Of such factors he says: (p. 26).
Abstract: In this article, I offer a proposal to clarify what I believe is the proper relation between value maximization and stakeholder theory, which I call enlightened value maximization. Enlightened value maximization utilizes much of the structure of stakeholder theory but accepts maximization of the long-run value of the firm as the criterion for making the requisite tradeoffs among its stakeholders, and specifies long-term value maximization or value seeking as the firm’s objective. This proposal therefore solves the problems that arise (...) from the multiple objectives that accompany traditional stakeholder theory. I also discuss the Balanced Scorecard, which is the managerial equivalent of stakeholder theory, explaining how this theory is flawed because it presents managers with a scorecard that gives no score—that is, no single-valued measure of how they have performed. Thus managers evaluated with such a system (which can easily have two dozen measures and provides no information on the tradeoffs between them) have no way to make principled or purposeful decisions. The solution is to define a true (single dimensional) score for measuring performance for the organization or division (and it must be consistent with the organization’s strategy), and as long as their score is defined properly, (and for lower levels in the organization it will generally not be value) this will enhance their contribution to the firm. (shrink)
The general public in Europe seems tohave lost its confidence in food safety. Theremedy for this, as proposed by the Commissionof the EU, is a scientific rearmament. Thequestion, however, is whether more science willbe able to overturn the public distrust.Present experience seems to suggest thecontrary, because there is widespread distrustin the science-based governmental controlsystems. The answer to this problem is thecreation of an independent scientificFood Authority. However, we argue thatindependent scientific advice alone is unlikelyto re-establish public confidence. It is muchmore (...) important to make the scientific advicetransparent, i.e., to state explicitlythe factual and normative premises on which itis based. Risk assessments are based on arather narrow, but well-defined notion of risk.However, the public is concerned with a broadervalue context that comprises both benefits andrisks. Transparency and understanding of thepublic's perception of food risks is anecessary first step in establishing theurgently required public dialogue about thecomplex value questions involved in foodproduction. (shrink)
The Commission's recentinterpretation of the Precautionary Principleis used as starting point for an analysis ofthe moral foundation of this principle. ThePrecautionary Principle is shown to have theethical status of an amendment to a liberalprinciple to the effect that a state only mayrestrict a person's actions in order to preventunacceptable harm to others. The amendmentallows for restrictions being justified even incases where there is no conclusive scientificevidence for the risk of harmful effects.However, the liberal tradition has seriousproblems in determining when a (...) risk of harm isunacceptable. Nevertheless, reasonable liberalarguments in favor of precaution can be basedon considerations of irreversible harm andgeneral fear of harm. But it is unclear whenthere considerations can be overridden. (shrink)
From a certain philosophical perspective, one that is at least as old as Plato but which is addressed also by Aristotle and Kant, business ethics – to the extent that it is marketed as form of enlightened self-interest — constitutes a Thrasymachean compromise: to argue that it is to our advantage to conduct business ethically, perhaps even advantageous to the bottom-line, comes curiously close to endorsing what Plato called the 'shadow of virtue' — i.e., of becoming temperate for the sake (...) of illtemperance. And yet it also seems true that moralistic campaigns to achieve the impossible, e.g., pursuing justice for its own sake or eradicating egoism, often "detract from attaining really important things." This essay explores the need, in business ethics as well as elsewhere, to make — what Dewey and Niebuhr considered to be — painful if not principled philosophical compromises in order to secure is a society in which there would be "enough justice to avoid complete disaster.". (shrink)
A main objection – perhaps the foremost – to Kant's theory of moral worth is that whereas he claims that only actions performed from the motive of duty have moral worth, most people are convinced that right actions performed out of.
Following a detailed study of the views of reid and wittgenstein on philosophy and language, I conclude that reid's position represents an extremely pivotal stage in the upgrading of the importance of language in philosophy which, Taken up and carried along by moore, Culminates in the later philosophy of wittgenstein and that the latter owes much to views on philosophy and language which have their origin in reid.
This paper aims to reexamine Nietzsche’s early interpretation of Heraclitus in an attempt to resolve some longstanding scholarly misconceptions. Rather than articulate similarities or delineate the lines of influence, this study engages Nietzsche’s interpretation itself in its historical setting, for the first time acknowledging the contextual framework in which he was working. This framework necessarily combines Nietzsche’s reading in philology, post-Kantian scientific naturalism, and of the romantic worldviews of Schopenhauer and Wagner. What emerges is not the acceptance of the metaphysical-flux (...) doctrine so much as a natal form of his physiognomic theory ofperspectivism, a naturalistic and anti-teleological conception of flux, and a theory of justice as cosmodicy. (shrink)
Mental and behavioral disorders represent a signiﬁcant portion of the public health burden in all countries. The human cost of these disorders is immense, yet treatment options for sufferers are currently limited, with many patients failing to respond sufﬁciently to available interventions and drugs. High quality ontologies facilitate data aggregation and comparison across different disciplines, and may therefore speed up the translation of primary research into novel therapeutics. Realism-based ontologies describe entities in reality and the relationships between them in such (...) a way that – once formulated in a suitable formal language – the ontologies can be used for sophisticated automated reasoning applications. Reference ontologies can be applied across different contexts in which different, and often mutually incompatible, domain-speciﬁc vocabularies have traditionally been used. In this contribution we describe the Mental Functioning Ontology (MF) and Mental Disease Ontology (MD), two realism-based ontologies currently under development for the description of humanmental functioning and disease. We describe the structure and upper levels of the ontologies and preliminary application scenarios, and identify some open questions. (shrink)
In February 1992, The (Portland) Oregonian announced it would no longer use sports team names that readers may find offensive, such as Redskins, Redmen, Indians, and Braves. Many journalists have criticized The Oregonian's decision, calling it an abandonment of the journalistic principles of objectivity and neutrality. This article addresses the ethical/political issues involved in the controversy through an examination of commentaries by journalists published in newspapers and public comments made by journalists critical of The Oregonian. After evaluating the explicit and (...) implicit assumptions behind those criticisms of The Oregonian, a defense of the newspaper's decision that relies on more overtly political arguments than the paper's managers used will be offered. (shrink)
Consider a sequence of outcomes of descending value, A > B > C > . . . > Z. According to Larry Temkin, there are reasons to deny the continuity axiom in certain cases, i.e. cases of triplets of outcomes A, B and Z, where A and B differ little in value, but B and Z differ greatly. But, Temkin argues, if we assume continuity for cases, i.e. cases where the loss is small, we can derive continuity for the case (...) by applying the axiom of substitution and the axiom of transitivity. The rejection of continuity for cases therefore renders the triad of continuity in cases, the axiom of substitution and the axiom of transitivity inconsistent. (shrink)