Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelong thyroid replacement hormone, monitoring, surgical complications and other side (...) effects. These harms seem to outweigh any putative benefit of knowing about a cancer that would not have caused problems if left undiscovered. In addition to harms to patients, thyroid cancer overdiagnosis leads to significant opportunity costs at a societal level, due to costs of diagnosis and treatment. Unlike many other overdiagnosed cancers, accurate risk stratification is possible with thyroid cancer. At the individual patient level, use of this risk information might support informed choice and/or shared decision-making, as mandated by clinical ethics frameworks. And this approach might, to some extent, help to reduce rates of diagnosis and intervention. In practice, however, it is unlikely to stem the rising incidence and associated harms and costs of overdiagnosed thyroid cancer, especially in situations where health professionals have conflicts of interest. We argue in this article that thyroid cancer overdiagnosis may be usefully understood as a public health problem, and that some public health approaches will be readily justifiable and are more likely to be effective in minimising its harms. (shrink)

Understanding the intersections of science and publics has led to research on how diverse publics interpret scientific information and form positions on science-related issues. Research demonstrates that attitudes toward science, political and religious orientation, and other social factors affect adult interactions with science, which has implications for how adults influence K-12 STEM (science, technology, engineering, and mathematics) education. Based on a statewide survey of adults in Idaho (n = 407), a politically and religiously conservative western state, we demonstrate how attitudes (...) toward science, measured through a composite measure “orientation toward science,” and other social factors are correlated with support for STEM education. Results show that “orientation toward science,” along with political orientation and respondents’ perceptions of feeling informed about science, predicts behavior intentions to support STEM education. Our findings suggest that a nuanced and localized approach to fostering support for K-12 STEM education would resonate with populations regardless of political orientation, and they illuminate new ways of thinking about how political orientation more generally impacts thinking about science in the context of complicated “socio-scientific relations.” In exploring how people think about science in a politically and religiously conservative state, we provide insights on potential outcomes in other states, should conservative ideology spread. We argue that the publics’ relationship with science and, by extension, support for science education, is more fluid, as many of us suspect, than ideological polemics suggest. (shrink)

Stakeholder theory, as a method of management based on morals and behavior, must be grounded by a theory of ethics. However, traditional ethics of justice and rights cannot completely ground the theory. Following and expanding on the work of Wicks, Gilbert, and Freeman (1994), we believe that feminist ethics, invoking principles of caring, provides the missing element that allows moral theory to ground the stakeholder approach to management. Examples are given to support the suggested general principle for making business decisions (...) under feminist moral theory. (shrink)

In this paper I describe the context and goals of Francisco Vallés' In IV librum Meteorologicorum commentaria. Vallés' work stands as a landmark because it interprets a work of Aristotle's natural philosophy specifically for medical doctors and medical theory. Vallés' commentary is representative of new understandings of Galenic-Hippocratic medi-cine that emerged as a result of expanding textual knowledge. These approaches are evident in a number of sixteenth-century commentaries on Meteorologica IV; in particular the works of Pietro Pomponazzi, Lodovico Boccadiferro, Jacob (...) Schegk, and Francesco Vimercati. Vallés' conviction that Meteorologica IV is relevant to medical knowledge depends on his understanding of Aristotle's theory of homeomerous substances and their relation to composite substances. The application of Meteorologica IV to medical topics became commonplace in the following years, and this Aristotelian book became widely known as a bridge between natural philosophy and medicine. (shrink)

The subject of meteorology was central to Girolamo Cardano’s thought. It held together his encyclopedism by tying the celestial realm to the sublunary world and human action. Meteorology, for Cardano, links abstract knowledge to the practical and operative. While many of his Aristotelian predecessors understood weather prediction as distinct from meteorology as a natural philosophical field, Cardano’s profound interest in conjectural arts and probabilistic reasoning led him to tie causal explanations to methods of forecasting future conditions of the air and (...) their effects on humans, especially regarding health and disease. While it might be expected that Cardano would have emphasized astrological tools for weather forecasting, instead he went in a different direction, namely, embracing the ancient tradition of weather signs and revising Aristotelian theories of winds. At the end of his career, which he mostly spent writing commentaries on Hippocratic writings, he integrated his understanding of weather signs with Hippocratic rules of prognosis, revising traditional understandings of the causes of winds. (shrink)

The logic of the commons is applied to the U.S. labor pool. lt is argued that the labor pool is an “active” commons, a commons in whichthe resource as weil as the users of the resource can change voluntarily. For this commons to be tended properly, technical solutions are ineffective and inappropriate; both employer and employee must have trust in the mechanisms that tie them together. Collaborative control is given as a possible framework for making the morality shift necessary to (...) avoid ultimate tragedy. (shrink)

Within a year of each other, three one-volume general dictionaries of philosophy have recently appeared; when our future colleagues in philosophy look back on the 1990s they may well think of it as the decade of reference works. But however productive these years may prove to be in this genre, clearly visible somewhere around the top of the heap will be this handy, useful, entertaining, and instructive contribution from Simon Blackburn. Its two immediate competitors are the Cambridge Dictionary of Philosophy, (...) edited by Robert Audi, and the Oxford Companion to Philosophy, edited by Ted Honderich. No detailed comparison will be attempted here, but two points stand out as obviously giving Blackburn’s dictionary a rather different use and flavor from the others: while containing a closely comparable number of entries, it is distinctly shorter and handier in format; and it has all been written by a single author. (shrink)

These essays showcase the value of the narrative arts in investigating complex conflicts of value in moral and political life, and explore the philosophical problem of moral dilemmas as expressed in ancient drama, classic and contemporary novels, television, film, and popular fiction. From Aeschylus to Deadwood, from Harriet Beecher Stowe to Harry Potter, the authors show how the narrative arts provide some of our most valuable instruments for complex and sensitive moral inquiry.

It has been suggested that moral courage in the workplace supports more robust application of regulatory principles. A workforce with the courage to act on moral imperative, it is argued, can bolster corporate governance and promote both more stable business organisations and greater economic stability at large. Research in the area investigates the bases of moral courage, a central implication being that businesses should invest in ethical training as a matter of public policy. It is standard to present moral courage (...) as the strength of will to do the morally right thing. From a managerial perspective, however, this distorts the normative character of the kind of issues managers typically face. Doing the morally right thing commonly entails inflicting permissible harms. Such harms, though permissible, can be a source of moral concern to the conscientious manager. A difficulty for the standard account, then, is that moral courage may be expected in scenarios in which the moral implications of the manager's action have not been fully assessed. In this paper, an alternative account of moral evaluation is presented that incorporates the concern around permissible harms. The basis of such concern is found to be manager-regret. Building on this foundation, we can establish a new definition of moral courage, that understands the right action to be that which entails defensible harms, and requires courage because those harms will likely have to be defended. It should be recognised in the academic literature that moral courage has this intellectual dimension. Furthermore, managerial training and practice should reflect this understanding of moral courage if its benefits to public policy, in particular corporate governance, are to be realised. The thesis takes a novel approach to the topic that draws, centrally, on the work of Bernard Williams, Martha Nussbaum and Søren Kierkegaard. (shrink)

Alan Hájek has recently argued that certain assignments of vague probability defeat Pascals Wager. In particular, he argues that skeptical agnostics – those whose probability for God''s existence is vague over an interval containing zero – have nothing to fear from Pascal. In this paper, I make two arguments against Hájek: (1) that skeptical agnosticism is a form of dogmatism, and as such should be rejected; (2) that in any case, choice situations with vague probability assignments ought to be treated (...) as second-order cases of choice under uncertainty, with the result that belief in God is the favored option in a very wide range of cases. (shrink)

This article responds to Tibor Machan's criticisms of government provision for needy citizens. It argues that although charity may be morally worthy, private charity is inadequate to the task of providing our fellow citizens with the security they deserve; the tremendous social good of secure access to a life of dignity can only be produced by a public social safety net. Moreover, individual rights to property do not stand in the way of providing a public social safety net. Since there (...) are social inputs in wealth creation, reasonable levels of taxation do not violate people's rights to their wealth. (shrink)

By questions of “canon,” we mean questions of what is fictionally true of some character, story, or world. What is canon is treated as authoritative or official, usually by creators and fans alike. But disputes about canon have arisen as storytellers and publishers have sought to capitalize on the popularity of their characters, churning out more and more stories to meet public demand, and at the same time engaging with growing fan bases. As audiences have become more involved, and as (...) fictional worlds have become messier, the authoritative nature of canon—and who authorizes it—has begun to erode. In this paper, we characterize canon as an article in the evolving relation between authors and audiences. More specifically, we characterize canon as an intangible good, subject to a form of cultural negotiation, resting on a power relation between producers and consumers of fictions. In Part I, we consider the author’s evolving role, and the rights of the creator to a story, character, or world. In Part II, we discuss the emerging activities of fans, particularly as they weigh on issues of canon. In Part III, we discuss canon as being subject to cultural negotiation, highlighting the importance of power dynamics in this negotiation. (shrink)

Background: Legislation on physician-assisted suicide is being considered in a number of states since the passage of the Oregon Death With Dignity Act in 1994. Opinion assessment surveys have historically assessed particular subsets of physicians.Objective: To determine variables predictive of physicians’ opinions on PAS in a rural state, Vermont, USA.Design: Cross-sectional mailing survey.Participants: 1052 physicians licensed by the state of Vermont.Results: Of the respondents, 38.2% believed PAS should be legalised, 16.0% believed it should be prohibited and 26.0% believed it should (...) not be legislated. 15.7% were undecided. Males were more likely than females to favour legalisation . Physicians who did not care for patients through the end of life were significantly more likely to favour legalisation of PAS than physicians who do care for patients with terminal illness . 30% of the respondents had experienced a request for assistance with suicide.Conclusions: Vermont physicians’ opinions on the legalisation of PAS is sharply polarised. Patient autonomy was a factor strongly associated with opinions in favour of legalisation, whereas the sanctity of the doctor–patient relationship was strongly associated with opinions in favour of not legislating PAS. Those in favour of making PAS illegal overwhelmingly cited moral and ethical beliefs as factors in their opinion. Although opinions on legalisation appear to be based on firmly held beliefs, approximately half of Vermont physicians who responded to the survey agree that there is a need for more education in palliative care and pain management. (shrink)

A difficulty for a view of divine eternity as timelessness is that if time is tensed, then God, in virtue of His omniscience, must know tensed facts. But tensed facts, such as It is now t, can only be known by a temporally located being.Defenders of divine atemporality may attempt to escape the force of this argument by contending either that a timeless being can know tensed facts or else that ignorance of tensed facts is compatible with divine omniscience. Kvanvig, (...) Wierenga, and Leftow adopt both of these strategies in their various defenses of divine timelessness. Their respective solutions are analyzed in detail and shown to be untenable.Thus, if the theist holds to a tensed view of time, he should construe divine eternity in terms of omnitemporality. (shrink)

According to appraisal theory, emotions result from an individual's meaning analysis of the implications of his/her circumstances for personal well-being, and individual differences in emotion arise when individuals appraise similar situations differently. Relational models of appraisal attempt to describe the situational and dispositional antecedents of appraisals, and should allow one to predict such individual differences. In this article, we review three examples of our efforts toward developing relational appraisal models. In two, we start with a particular appraisal component, motivational relevance (...) and problem-focused coping potential (Smith & Lazarus, 1990), respectively, and describe and test the relational model proposed for that component. In the third, as a precursor to developing a true relational model, we examine another appraisal component, emotion-focused coping potential, from a more dispositional perspective. We conclude by considering both the potential value of relational appraisal models, and future directions in the development of these models. (shrink)

A review of medical ethics literature relating to the importance of the participation of patients in decision-making introduces the role of rights-based mediation as a voluntary process now being developed innovatively in America. This is discussed in relation to the theory of communicative ethics and moral personhood. References are then made to the work of medical ethics committees and the role of mediation within these. Finally it is suggested that mediation is part of an eirenic ethic already being used informally (...) in good patient care, and that there is a case for developing it further. (shrink)

We explore the classical philosophical problem of the “paradox of tragedy”—the problem of accounting for our apparent pleasure in feeling pity and terror as audiences of staged tragedies. After outlining the history of the problem in philosophy, we suggest that Apter’s reversal theory offers great potential for resolving the paradox, while explaining some of the central intuitions motivating philosophical proposals—an ideal starting point to bridge a narrowing gap between philosophy and psychology.

A difficulty for a view of divine eternity as timelessness is that if time is tensed, then God, in virtue of His omniscience, must know tensed facts. But tensed facts, such as It is now t, can only be known by a temporally located being.Defenders of divine atemporality may attempt to escape the force of this argument by contending either that a timeless being can know tensed facts or else that ignorance of tensed facts is compatible with divine omniscience. Kvanvig, (...) Wierenga, and Leftow adopt both of these strategies in their various defenses of divine timelessness. Their respective solutions are analyzed in detail and shown to be untenable.Thus, if the theist holds to a tensed view of time, he should construe divine eternity in terms of omnitemporality. (shrink)

This study examines the presence and roles of female directors of U.S. Fortune 500 firms, focusing on committee assignments and director background. Prior work from almost two decades ago concludes that there is a systematic bias against females in assignment to top board committees. Examining a recent data set with a logistic regression model that controls for director and firm characteristics, director resource-dependence roles and interaction between director gender and director characteristics, we find that female directors are less likely than (...) male directors to sit on executive committees and more likely than male directors to sit on public affairs committees. There is little if any evidence of systematic gender bias in director assignment to other board committees. We find some evidence that boards evaluate resource dependence differently for women than men. (shrink)

In a pair of recently published articles, Thomas Talbott has presented a carefully constructed case for universalism. He contends that from the principle Necessarily, God loves a person S at a time t only if God's intention at t and every moment subsequent to t is to do everything within his power to promote supremely worthwhile happiness in S, provided that the actions taken are consistent with his promoting the same kind of happiness in all others whom he also loves (...) and the propositions 1. God exists 2. God is both omniscient and omnipotent 3. God loves every created person 4. God will irrevocably reject some persons and subject those persons to ever-lasting punishment a contradiction may be deduced. For given, entails 5. For any created person S and time t subsequent to the creation of S, God's intention at t is to do all that he properly can to promote supremely worthwhile happiness in S. (shrink)

In a pair of recent articles, William Hasker has attempted to defend Robert Adams’s new anti-Molinist argument. But I argue that the sense of explanatory priority operative in the argument is either equivocal or, if a univocal sense can be given to it, it is either so generic that we should have to deny its transitivity or so weak that it would not be incompatible with human freedom.

Vaccination complacency occurs when perceived risks of vaccine-preventable diseases are sufficiently low so that vaccination is no longer perceived as a necessary precaution. Disease outbreaks can once again increase perceptions of risk, thereby decrease vaccine complacency, and in turn decrease vaccine hesitancy. It is not well understood, however, how change in perceived risk translates into change in vaccine hesitancy. -/- We advance the concept of vaccine propensity, which relates a change in willingness to vaccinate with a change in perceived risk (...) of infection—holding fixed other considerations such as vaccine confidence and convenience. (shrink)

El artículo trata sobre el 'reavivamiento hermeneútico' de Agustín, es decir, acerca de la significación filosófica que tiene el influjo histórico y metodológico de san Agustín sobre la obra de Martin Heidegger "Sein und Zeit", y cómo esto se ha vuelto más evidente con las aportaciones de fenomenólogos y patrólogos, especialmente a partir de 1993.

This chapter contains sections titled: * The Fundamental Question * 1 Whatever Begins to Exist Has a Cause * 2 The Universe Began To Exist * 3 The Cause of the Universe * Notes.

This chapter contains sections titled: The Intensifying Dangers of International Anarchy Global Governance Versus a World State Is a World Government Possible? Acknowledgments References.

A vision of law and justice that is rooted in relationality stands at the heart of this paper. To tribal people, such as the Lakota and Dakota, what sustains the lives of people are bonds of kinship relations that bind human and nonhuman life together with a sense of mutual responsibility and caring that is most aptly captured by the Lakota phrase Mitakuye Oysain, "all are relatives." What are important to tribal communities are collective rights and obligations as embodied in (...) Indian law and justice. Indian societies, thereby, have established their own tribal courts and legal systems that are markedly different from mainstream society. Indian people, it is argued, have much to teach about the limitations of the dominant legal culture and ways in which relationality serves a far better basis for law and justice than an adversarial system that demands winners and losers. (shrink)

A sample of 552 first year undergraduate students, attending a universitysector college in Wales specialising in teacher education and liberal arts subjects, completed the Myers-Briggs Type Indicator together with the Francis Scale of Attitude toward Christianity. The data demonstrated that judging types held a more positive attitude toward Christianity than perceiving types. No significant differences in attitude toward Christianity were found between introverts and extraverts, between sensers and intuitives, or between thinkers and feelers.

On a deflationary view of truth the truth predicate does not ascribe a property of any explanatory significance to statements. The truth predicate is merely a device of semantic ascent, by means of which we talk about a statement rather than assert that statement. Such a device is useful for blind truth ascriptions to statements that we cannot explicitly state. Such a view is compatible with truth as correspondence and so does not imply postmodern antirealism, since statements directly asserted are (...) descriptive of the world as it actually is. Getting rid of propositional truth has the advantage of ridding us of abstract truth-bearers that are uncreated by God. (shrink)

A Previous article in this journal gave some account of Terence quotations in Priscian. A similar account for Servius is necessary. Umpf en bach's summary is far from accurate; and it has the serious defect that no distinction is made between Servius proper and the material peculiar to the enlarged Commentary. With Thilo's warning that the evidence is all against the assumption that the enlarged Commentary is a truer representation of what Servius himself wrote, we should, in any problem relating (...) to Servius, confine ourselves strictly to what we know to be his work. (shrink)

A Previous article in this journal gave some account of Terence quotations in Priscian. A similar account for Servius is necessary. Umpf en bach's summary is far from accurate; and it has the serious defect that no distinction is made between Servius proper and the material peculiar to the enlarged Commentary. With Thilo's warning that the evidence is all against the assumption that the enlarged Commentary is a truer representation of what Servius himself wrote, we should, in any problem relating (...) to Servius, confine ourselves strictly to what we know to be his work. (shrink)

Reappraising ideas associated with Ernst Bloch, Roland Barthes and Gaston Bachelard within the context of a utopian pedagogy, Hope, Utopia and Creativity in Higher Education reframes the transformative, creative and collaborative potential of education offering new concepts, tactics and pedagogical possibilities. Craig A. Hammond explores ways of analysing and democratising not only pedagogical conception, knowledge and delivery, but also the learning experience, and processes of negotiation and peer-assessment. Hammond shows how the incorporation of already existent learner hopes, daydreams, and (...) creative possibilities can open up new opportunities for thinking about popular culture and memory, learning and knowledge, and collaborative communities of support. Drawing together theoretical and cultural material in a teaching and learning environment of empowerment, Hammond illustrates that formative articulations of alternative, utopian futures, across sociological, humanities, and education studies subjects and curricula, becomes possible. (shrink)

It has long been a commonly held belief among classicists that traditional Romans frowned upon male homosexuality and associated it with the influence of Greek culture. There have always been exceptions to this belief, but when Paul Veyne published the following remarks in his 1978 article ‘La famille et l'amour sous le hautempire romain’, his views were quite heterodox: Il est faux que l'amour ‘grec’ soit, à Rome, d'origine grecque: comme plus d'une société méditerranéenne de nos jours encore, Rome n'a (...) jamais opposé l'amour des femmes à celui des garçons: elle a opposé l'activité à la passivité; être actif, c'est être un mâle, quel que soit le sexe du partenaire passif. (shrink)