Much of the sustained attention on pandemic preparedness has focused on the ethical justification for plans for the “crisis” phase of a surge when, despite augmentation efforts, the demand for life...

When patients are admitted to the hospital, they are generally expected to remain in or within close proximity to their assigned rooms in order to promote their safety and appropriate medical care. Although there are circumstances when patients may safely leave their hospital room or floor, guidance within the medical literature for the management of patient movement within the hospital are lacking. Excessive restrictions on patient movement may be seen as overly paternalistic, while lax requirements may interfere with high quality (...) care, patient safety and efficient hospital practice. As a result, guidance in the form of institutional policy is warranted. Such policy development should take into consideration the potential clinical, legal, and ethical concerns in balancing the competing values of patients’ preferences and respect for autonomy, while ensuring high quality, safe, and efficacious medical care. This paper will provide a framework for hospitals to create institution-specific patient movement policies that are fair, systematic, and transparent. (shrink)

The American Journal of Bioethics, Volume 12, Issue 5, Page 9-11, May 2012.

Patients rely on, benefit from, and are strongly influenced by physicians’ recommendations. In spite of the centrality and importance of physicians’ recommendations to clinical care, there is only a scant literature describing the conceptual process of forming a clinical recommendation, and no discrete professional standards for making individual clinical recommendations. Evidence-based medicine and shared decision making together are intended to improve medical decision making, but there has been limited attention to how a recommendation is discretely formulated from either of those (...) processes or how patients’ preferences ought to be considered and how much weight they should hold. Moreover, physicians’ bias has been reported to strongly influence how a recommendation is derived, thereby undermining the quality of healthcare decisions and patients’ trust. To demonstrate a potential for improving the quality of decisions, this article proposes a conceptual framework for how physicians should reach a clinical recommendation and apply the process in practice. For preference-sensitive clinical decisions—that is, clinical decisions when patients’ values and preferences are relevant—the process for reaching a recommendation should be transparent to patients and should be based solely on the medical evidence and patients’ values and preferences. When patients’ preferences for care do not prioritize health, physicians decide whether their recommendation will prioritize a welfare-enhancing versus an autonomy-enhancing approach. When there are gaps in understanding how physicians derive their clinical recommendations and how to further improve the quality of the decisions, the author calls for further empiric research. (shrink)

This is a complex case of a younger man with unclear social supports and a disabling diabetic infection that is limiting his ability to be and possibly feel productive. The patient appears to be ha...

Because the process of moving from moral principles and facts to action-guiding moral conclusions has not been articulated clearly enough to be useful in a practical way, we designed a systematic approach to aid learners and clinicians in their application of ethical principles to the resolution of clinical dilemmas. Our model for clinical moral reasoning is intended to provide a clear and replicable structure that makes the thought process involved in reasoning about clinical cases explicit. In this paper we present (...) the model and demonstrate how it can be used in three clinical cases. (shrink)

Volume 20, Issue 7, July 2020, Page 145-147.

The Ethics Consultation Quality Assessment Tool (ECQAT) establishes standards by which the quality of ethics consultation records (ECRs) can be assessed. These standards relate to the ethics question, consultation-specific information, ethical analysis, and recommendations and/or conclusions, and result in a score associated with one of four levels of ethics consultation quality. For the ECQAT to be useful in assessing and improving the quality of healthcare ethics consultations, individuals who rate the quality of ECRs need to be able to reliably use (...) the tool.We developed a short course to train ethics consultants in using the ECQAT, and evaluated whether the participants (1) achieved an acceptable level of calibration in matching expert-established quality scores for a set of ethics consultations, and (2) were satisfied with the course. We recruited 28 ethics consultants to participate in a virtual, six-session course. At each session participants and faculty reviewed, rated, and discussed one to two ECRs. The participants’ calibration in matching expert-established quality scores improved with repeated exposure at all levels of ethics consultation quality. Participants were generally more accurate when assessing consultation quality at the dichotomous level of “acceptable” (scores of three or four) versus “unacceptable” (scores of one or two) than they were with a more specific score. Participants had higher rates of accuracy with the extreme ratings of “strong” (level four) or “poor” (level one). Although participants were highly satisfied with the course, only a minority of participants achieved the prespecified acceptable level of calibration (that is, 80 percent or greater accuracy between their score and expert-established scores). These results suggest that ECQAT training may require more sessions or need modification in the protocol to achieve higher reliability in scoring. Such trainings are an important next step in ensuring that the ECQAT is a tool that can be used to promote improvement in ethics consultation quality. (shrink)

Patients who leave the hospital prior to their medically recommended endpoint (i.e., a discharge against medical advice, or “AMA”) typically prompt considerable consternation among physicians and o...

Alfandre et al. helpfully outlines the case for attending to contingency planning as well as to crisis measures during a pandemic. The authors provides a helpful framework for reflecting on...

The target article by David Alfandre et al. offers a new ethical framework to guide COVID-19 contingency surge planning and response, and applies this ethical framework to three case example...

_ Convention_ was immediately recognized as a major contribution to the subject and its significance has remained undiminished since its first publication in 1969. Lewis analyzes social conventions as regularities in the resolution of recurring coordination problems-situations characterized by interdependent decision processes in which common interests are at stake. Conventions are contrasted with other kinds of regularity, and conventions governing systems of communication are given special attention.

We propose a formal framework for interpretable machine learning. Combining elements from statistical learning, causal interventionism, and decision theory, we design an idealised explanation game in which players collaborate to find the best explanation for a given algorithmic prediction. Through an iterative procedure of questions and answers, the players establish a three-dimensional Pareto frontier that describes the optimal trade-offs between explanatory accuracy, simplicity, and relevance. Multiple rounds are played at different levels of abstraction, allowing the players to explore overlapping causal (...) patterns of variable granularity and scope. We characterise the conditions under which such a game is almost surely guaranteed to converge on a optimal explanation surface in polynomial time, and highlight obstacles that will tend to prevent the players from advancing beyond certain explanatory thresholds. The game serves a descriptive and a normative function, establishing a conceptual space in which to analyse and compare existing proposals, as well as design new and improved solutions. (shrink)

Why study notations, diagrams, or more broadly the variety of nonverbal “representations” or “signs” that are used in mathematical practice? This chapter maps out recent work on the topic by distinguishing three main philosophical motivations for doing so. First, some work (like that on diagrammatic reasoning) studies signs to recover norms of informal or historical mathematical practices that would get lost if the particular signs that these practices rely on were translated away; work in this vein has the potential to (...) broaden our view of the specific normativity of mathematics beyond logical proof. Second, some work focuses on signs to highlight the open-ended and “nonrigorous” aspects of mathematical practice, and the role of these aspects in the historical development of mathematics. The third motivation is based on the following observation: the reason differences in signs matter in mathematics is that humans are finite agents, with cognitive and computational limitations. Accordingly, studying signs can be a way to study how human computational constraints shape the mathematics that we do, and to tackle the topic of mathematical understanding. (shrink)

According to dispositionalism about modality, a proposition <p> is possible just in case something has, or some things have, a power or disposition for its truth; and <p> is necessary just in case nothing has a power for its falsity. But are there enough powers to go around? In Yates (2015) I argued that in the case of mathematical truths such as <2+2=4>, nothing has the power to bring about their falsity or their truth, which means they come out both (...) necessary and not possible. Combining this with axiom (T), it is easy to derive a contradiction. I suggested that dispositionalists ought to retreat a little and say that <p> is possible just in case either p, or there is a power to bring it about that p, grounding the possibility of mathematical propositions in their truth rather than in powers. Vetter’s (2015) has the resources to provide a response to my argument, and in her (2018) she explicitly addresses it by arguing for a plenitude of powers, based on the idea that dispositions come in degrees, with necessary properties a limiting case of dispositionality. On this view there is a power for <2+2=4>, without there being a power to bring about its truth. In this paper I argue that Vetter’s case for plenitude does not work. However, I suggest, if we are prepared to accept metaphysical causation, a case can be made that there is indeed a power for <2+2=4>. (shrink)

Epistemologists have recently proposed a number of norms governing rational inquiry. My aim in this paper is to unify and explain recently proposed norms of inquiry by developing a general account of the conditions under which inquiries are rational, analogous to theories such as evidentialism and reliabilism for rational belief. I begin with a reason-responsiveness conception of rationality as responding correctly to possessed normative reasons. I extend this account with a series of claims about the normative reasons for inquiry that (...) we possess. I apply the account to shed light on two classes of norms that have featured prominently in recent discussions: norms of clutter avoidance forbidding agents from engaging in trivial inquiries, and norms of logical non-omniscience governing properties such as the deductive closure and consistency of an agent's belief state. I conclude with a discussion of the sense in which norms of inquiry should be regarded as epistemic norms. (shrink)

Longtermism is the thesis that in a large class of decision situations, the best thing we can do is what is best for the long-term future. The scope question for longtermism asks: how large is the class of decision situations for which this is true? In this paper, I suggest that the scope of longtermism may be narrower than many longtermists suppose. I identify a restricted version of longtermism: swamping axiological strong longtermism (swamping ASL). I identify three scope-limiting factors - (...) probabilistic and decision-theoretic phenomena which, when present, tend to reduce the prospects for swamping ASL. I argue that these scope-limiting factors are often present in human decision problems, then use two case studies from recent discussions of longtermism to show how the scope-limiting factors lead to a restricted, if perhaps nonempty, scope for swamping ASL. (shrink)

This is a corrected version of the final proofs. I've fixed a number of typos, and corrected a blunder in chapter 4. In chapter 4 I say that 'this is this' is analytic, and 'this is not this' is antonymous. This is inconsistent with what I say in chapter 5, and not what I actually think. Rather, 'this is this' is taugologous, and 'this is not this' is contradictory. Analyticity and autnonmy are sense properties while tautologousness and contradictoriness are formal (...) logical properties. Heading, ToC and Index updated accordingly. (Oxford will make these corrections in their online version and in future print runs.). (shrink)

This chapter develops Moral Occasionalism, according to which moral facts are grounded in certain natural facts, which are called sub-moral grounds, and these sub-moral grounds influence us in such a way as to induce largely correct moral beliefs. Moral Occasionalism is designed to explain the correlation of moral beliefs with the moral facts—and to do so in a way that is consistent with non-interactionist views, according to which moral facts neither influence nor are influenced by moral beliefs. It is argued (...) that moral non-naturalists and others who are committed to non-interactionist views ought to be in the business of defending Moral Occasionalism. The chapter shows that Moral Occasionalism has major advantages over its chief non-interactionist rival, namely David Enoch’s “godless pre-established harmony” view. The chapter anticipates and responds to several objections. (shrink)

We apply a familiar distinction from philosophy of language to a class of material artifacts that are sometimes said to “speak”: statues. By distinguishing how statues speak at the locutionary level versus at the illocutionary level, or what they say versus what they do, we obtain the resource for addressing two topics. First, we can explain what makes statues distinct from street art. Second, we can explain why it is mistaken to criticize—or to defend—the continuing presence of statues based only (...) on what they represent. Both explanations are driven by the same core idea: the significance of statues arises primarily from what they do, and not what they say. (shrink)

People are often offended by beliefs, expect apologies for beliefs, apologize for their own beliefs. In many mundane cases, people are morally criticized for their beliefs. Intuitively, then, beliefs seem to sometimes wrong people. Recently, the philosophical literature has picked up on this theme, and has started to discuss it under the heading of doxastic wrongdoing. In this paper we argue that despite the strength of such initial intuitions, at the end of the day they have to be rejected. If (...) it can be ever truthfully asserted that beliefs wrong, this is always derivative – beliefs wrong only in virtue of other things (like evidence-gathering actions) wronging. We distinguish between modest and ambitious doxastic wrongdoing theories (the former deny, while the latter accept, the possibility of a morally wrong yet epistemically permissible belief); we argue that each of these options faces insurmountable problems; and we offer partly debunking explanations of the intuitions purportedly supporting doxastic wrongdoing. (shrink)

Christian pro-lifers often respond to Thomson’s defense of abortion that the violinist is allowed to die while the embryo is killed. Boonin and McMahan counter that this distinction does not provide an objection to extraction abortions that disconnect embryos and allow them to die. I disagree. I first argue that letting die and killing are not to be distinguished by differences between acts and omissions, moral and immoral motives, intentional or unintentional deaths, and causing or not causing a pathology. I (...) offer a taxonomy in which hysterotomies turn out to be killings. I then argue that if either the placenta is considered an organ of the embryo or the embryo is construed as a part of the pregnant woman, then abortion pills kill rather than allow death. So, assuming that killing people is morally worse than letting them die, extraction abortions can be condemned to the same degree as other abortions. (shrink)

20世纪初是德语世界正式出版关于中国哲学史著作的起点。1909—1924年之间德语世界出版了若干关于中国哲学史的论文和专著，通过调查作者们的教育背景和研究成果，以及其代表作的写作背景、内容框架及其影响 ，可以勾勒出这一时期德语学界中国哲学研究的概况。从分析当时德语学界对中国哲学的认识范围和中国哲学史框架构建的一般情况，可以看出欧洲对中国哲学和哲学史研究的一些核心问题所在。前现代中国哲学史在德语地区接 纳和传播的过程与方式，这一至今德国与中国学界尚未涉足的空白领域，值得研究并填补。[The beginning of the twentieth century was the starting point for the production of works on the history of Chinese philosophy in the German-speaking world. Between 1909 and 1924, a number of essays and monographs on the history of Chinese philosophy were published in the German-speaking contexts, and by investigating the educational backgrounds and research results of the authors, as well as the backgrounds of the authors, the frameworks for presenting the content, and the influence of these works, an overview (...) of the study of Chinese philosophy in in the German language during that period can be outlined. By analyzing the scope of knowledge of Chinese philosophy and the general construction of the framework for the history of Chinese philosophy in German-speaking academia at that time, it is possible to discern some of the core issues at stake in the study of Chinese philosophy and the history of philosophy in Europe. The process and manner of the reception and dissemination of the history of pre-modern Chinese philosophy in the German-speaking region, a field that has not yet been addressed sufficiently by German and Chinese academics, deserves to be studied and completed.]. (shrink)

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

This volume offers a carefully argued, compelling theory of bioethics while eliciting practical implications for a wide array of issues including medical assistance-in-dying, the right to health care, abortion, animal research, and the definition of death. The authors' dual-value theory features mid-level principles, a distinctive model of moral status, a subjective account of well-being, and a cosmopolitan view of global justice. In addition to ethical theory, the book investigates the nature of harm and autonomous action, personal identity theory, and the (...) 'non-identity problem' associated with many procreative decisions. Readers new to particular topics will benefit from helpful introductions, specialists will appreciate in-depth theoretical explorations and a novel take on various practical issues, and all readers will benefit from the book's original synoptic vision of bioethics. This title is also available as Open Access on Cambridge Core. (shrink)

According to the Principle of Sufficient Reason, every fact has an explanation. An important challenge to this principle is that it risks being a counterexample to itself. What explains why everything needs to be explained? My first goal is to distinguish two broad kinds of answers to this question, which I call “Humean Rationalism” and “Non-Humean Rationalism”. My second goal will be to defend the prospects of Humean Rationalism.

Consciousness and Mind presents David Rosenthal's influential work on the nature of consciousness. Central to that work is Rosenthal's higher-order-thought theory of consciousness, according to which a sensation, thought, or other mental state is conscious if one has a higher-order thought that one is in that state. The first four essays develop various aspects of that theory. The next three essays present Rosenthal's homomorphism theory of mental qualities and qualitative consciousness, and show how that theory fits with and helps (...) sustain the HOT theory. A crucial feature of homomorphism theory is that it individuates and taxonomizes mental qualities independently of the way we're conscious of them, and indeed independently of our being conscious of them at all. So the theory accommodates the qualitative character not only of conscious sensations and perceptions, but also of those which fall outside our stream of consciousness. Rosenthal argues that, because this account of mental qualities makes no appeal to consciousness, it enables us to dispel such traditional quandaries as the alleged conceivability of undetectable quality inversion, and to disarm various apparent obstacles to explaining qualitative consciousness and understanding its nature. Six further essays build on the HOT theory to explain various important features of consciousness, among them the complex connections that hold in humans between consciousness and speech, the self-interpretative aspect of consciousness, and the compelling sense we have that consciousness is unified. Two of the essays, one an extended treatment of homomorphism theory, appear here for the first time. There is also a substantive introduction, which draws out the connections between the essays and highlights their implications. (shrink)

As business and society is an inherently multi-disciplinary scholarly area, the book will draw from work in areas outside of business and management, such as psychology, sociology, philosophy, religious studies, economics and other related fields, as well as the natural sciences, education, and other professional areas of study.

In the twenty-first century, the debate about life on other worlds is quickly changing from the realm of speculation to the domain of hard science. Within a few years, as a consequence of the rapid discovery by astronomers of planets around other stars, astronomers very likely will have discovered clear evidence of life beyond the Earth. Such a discovery of extraterrestrial life will change everything. Knowing the answer as to whether humanity has company in the universe will trigger one of (...) the greatest intellectual revolutions in history, not the least of which will be a challenge for at least some terrestrial religions. Which religions will handle the discovery of extraterrestrial life with ease and which will struggle to assimilate this new knowledge about our place in the universe? Some religions as currently practiced appear to only be viable on Earth. Other religions could be practiced on distant worlds but nevertheless identify both Earth as a place and humankind as a species of singular spiritual religious importance, while some religions could be practiced equally well anywhere in the universe by any sentient beings. Weintraub guides readers on an invigorating tour of the world's most widely practiced religions. It reveals what, if anything, each religion has to say about the possibility that extraterrestrial life exists and how, or if, a particular religion would work on other planets in distant parts of the universe. (shrink)

Foreword: Synchronicity is more than a happy accident by Brian Tart -- The quest -- Cycles of history and the law of one -- What is synchronicity? -- Understanding the sociopath -- The global adversary -- Karma is real -- Reincarnation -- Mapping out the afterlife -- The hero and his story -- The first and second acts of the hero -- Facing your fear and completing the quest -- Joan of arc rises again -- The 2,160-year cycle between rome (...) and the usa -- Vietnam, watergate and the fall of the iron curtain -- The sky is not falling-only our blindfolds -- September 11th-from both sides of the veil -- The thirteen years' war repeats in america -- 9/11 and the defeat of the cabal-the cycle perspective -- History gets a wicked case of deja vu -- Fomenko's cycles of history-and the Book of Daniel -- Explaining the cycles and the fourth-density shift. (shrink)

Calling is a very important concept in Christianity. In the medieval era, calling was restricted to ecclesiastical work alone, a devotion to the life of contemplation. Ordinary work or physical labour was not considered qualified to be a calling. Martin Luther was the one who taught that the ordinary work of the ordinary people was also God’s calling and equally spiritual as the ecclesiastical work. However, Miroslav Volf, a Croatian theologian, criticised Luther that his view of calling was too static (...) and irrelevant to the modern context where people often choose to quit a job because of its negative effects and some people have to do multiple jobs in order to make ends meet. While recognising the validity of Volf’s critique, this article seeks to demonstrate that even in the modern context, calling is still a very important theological concept to reflect upon work. Luther’s vocational view of work could be retrieved in discussing the theology of work by putting it in dialogue with Calvin, Kuyper, and other theologians.Contribution: This article seeks to show that the concept of calling is indispensable in constructing a sound theology of work for the modern context. By understanding work as calling, Christian workers are enabled to see how they are participating in God’s redemptive work through their jobs. (shrink)

Between 1873 and 1876, Felix Klein published a series of papers that he later placed under the rubric anschauliche Geometrie in the second volume of his collected works (1922). The present study attempts not only to follow the course of this work, but also to place it in a larger historical context. Methodologically, Klein’s approach had roots in Poncelet’s principle of continuity, though the more immediate influences on him came from his teachers, Plücker and Clebsch. In the 1860s, Clebsch reworked (...) some of the central ideas in Riemann’s theory of Abelian functions to obtain complicated results for systems of algebraic curves, most published earlier by Hesse and Steiner. These findings played a major role in enumerative geometry, whereas Plücker’s work had a strongly qualitative character that imbued Klein’s early studies. A leitmotif in these works can be seen in the interplay between real curves and surfaces as reflected by their transformational properties. During the early 1870s, Klein and Zeuthen began to explore the possibility of deriving all possible forms for real cubic surfaces as well as quartic curves. They did so using continuity methods reminiscent of Poncelet’s earlier approach. Both authors also relied on visual arguments, which Klein would later advance under the banner of intuitive geometry (anschauliche Geometrie). (shrink)

In the Garden of Eden, we had unmediated contact with the world. We were directly acquainted with objects in the world and with their properties. Objects were simply presented to us without causal mediation, and properties were revealed to us in their true intrinsic glory.

According to a popular idea, freedom is grounded in orthonomy – the ability to be responsive to normative demands. But how exactly must an agent’s action relate to their reasons in order for this orthonomous relationship to hold? In this paper, I propose a novel explanationist answer to this question. I argue that extant answers – causalism and modalism about orthonomy – fail because they fail to account for the fact that intuitions about freedom and orthonomy track facts about explanation. (...) And these facts cannot be reduced to either causal or modal facts. Instead, I propose that we should understand freedom as grounded in special accidentality-dispersing explanations in terms of normative reasons. The resultant view is to be understood as following a Frankfurtian intuition: only factors that explain action can be relevant to whether the action is free. (shrink)

Experiences and beliefs are different sorts of mental states, and are often taken to belong to very different domains. Experiences are paradigmatically phenomenal, characterized by what it is like to have them. Beliefs are paradigmatically intentional, characterized by their propositional content. But there are a number of crucial points where these domains intersect. One central locus of intersection arises from the existence of phenomenal beliefs: beliefs that are about experiences.

This is the first sustained, whole-Bible treatment on the theme of meeting God face to face. Starting with Genesis and ending with Revelation, the author systematically covers the major events in salvation history, all of which reveal the beauty of encountering God's grace in abundance.

This essay examines the philosophical significance of $\Omega$-logic in Zermelo-Fraenkel set theory with choice (ZFC). The categorical duality between coalgebra and algebra permits Boolean-valued algebraic models of ZFC to be interpreted as coalgebras. The hyperintensional profile of $\Omega$-logical validity can then be countenanced within a coalgebraic logic. I argue that the philosophical significance of the foregoing is two-fold. First, because the epistemic and modal and hyperintensional profiles of $\Omega$-logical validity correspond to those of second-order logical consequence, $\Omega$-logical validity is genuinely (...) logical. Second, the foregoing provides a hyperintensional account of the interpretation of mathematical and metamathematical vocabulary. (shrink)

This paper explores the human experience of game-playing and its implications for artificial intelligence. The author uses phenomenology to examine game-playing from a human-centered perspective and applies it to language games played by artificial intelligences and humans. The paper argues that AI cannot truly play games because it lacks the intentionality, embodied experience, and social interaction that are fundamental to human game-playing. Furthermore, current AI lacks the ability to converse, which is argued to be equivalent to Wittgenstein’s view of engaging (...) in “language games.” The author presents a formal ontology of game playing, agents, and their intentional states, and contrasts human agents playing games with artificial agents “playing games.” The paper concludes that while artificial intelligence can simulate some aspects of human language games, it lacks the essential capacities for game playing, such as cognition, creativity, will, intentionality, understanding, and personhood. (shrink)