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)

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)

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

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...

David Wallace argues that we should take quantum theory seriously as an account of what the world is like--which means accepting the idea that the universe is constantly branching into new universes. He presents an accessible but rigorous account of the 'Everett interpretation', the best way to make coherent sense of quantum physics.

Here the philosopher and physicist David Z Albert argues, among other things, that the difference between past and future can be understood as a mechanical phenomenon of nature and that quantum mechanics makes it impossible to present the entirety of what can be said about the world as a narrative of “befores” and “afters.”.

In _Panpsychism in the West_, the first comprehensive study of the subject, David Skrbina argues for the importance of panpsychism -- the theory that mind exists, in some form, in all living and nonliving things -- in consideration of the nature of consciousness and mind. Despite the recent advances in our knowledge of the brain and the increasing intricacy and sophistication of philosophical discussion, the nature of mind remains an enigma. Panpsychism, with its conception of mind as a general (...) phenomenon of nature, uniquely links being and mind. More than a theory of mind, it is a meta-theory -- a statement about theories of mind rather than a theory in itself. Panpsychism can parallel almost every current theory of mind; it simply holds that, no matter how one conceives of mind, such mind applies to all things. In addition, panpsychism is one of the most ancient and enduring concepts of philosophy, beginning with its pre-historical forms, animism and polytheism. Its adherents in the West have included important thinkers from the very beginning of Greek philosophy through the sixteenth and seventeenth centuries to the present. Skrbina argues that panpsychism is long overdue for detailed treatment, and with this book he proposes to add impetus to the discussion of panpsychism in serious philosophical inquiries. After a brief discussion of general issues surrounding philosophy of mind, he traces the panpsychist views of specific philosophers, from the ancient Greeks and early Renaissance naturalist philosophers through the likes of William James, Josiah Royce, and Charles Sanders Peirce -- always with a strong emphasis on the original texts. In his concluding chapter, "A Panpsychist World View," Skrbina assesses panpsychist arguments and puts them in a larger context. By demonstrating that there is panpsychist thinking in many major philosophers, Skrbina offers a radical challenge to the modern worldview, based as it is on a mechanistic cosmos of dead, insensate matter. _Panpsychism in the West _will be the standard work on this topic for years to come. (shrink)

David Spurrett, David Papineau; A note on the completeness of ‘physics’, Analysis, Volume 59, Issue 1, 1 January 1999, Pages 25–29, https://doi.org/10.1093/anal.

Throughout the darkest moments of human history, evildoers have convinced communities to turn on groups that are regarded as in some way other and, by starting to think of them as less than human, persecute or even eliminate them. We can all recognize the unfathomable evils of dehumanization in slavery, the Holocaust, the Rwandan genocide, and the Jim Crow South, but we are not free from its power today. With climate change and political upheaval driving millions of refugees worldwide to (...) leave their homes, we are likely to see more and more of this ugly and persistent phenomenon. What are we to do? Drawing on his deep and wide-ranging knowledge of the history, psychology, and politics of dehumanization, David Livingstone Smith shows us how to recognize it and how to fight back. (shrink)

More attention has been devoted to providing evolutionary accounts of the development of beliefs, or belief-like states, than for desires or preferences. Here I articulate and defend an evolutionary rationale for the development of psychologically real preference states. Preferences token or represent the expected values available actions given discriminated states of world and agent. The argument is an application of the ‘environmental complexity thesis’ found in Godfrey-Smith and Sterelny, although my conclusions differ from Sterelny’s. I argue that tokening expected utilities (...) can, under specified general conditions, be a powerful design solution to the problem of efficiently allocating the capacities of an agent. Preferences are for efficient action selection, and count as a ‘fuel for success’ in the sense urged by Godfrey-Smith for true beliefs. They will tend to be favoured by selection when environments are complex in ways that matter to an organism, and when organisms have large behavioural repertoires with heterogeneous returns and costs.The rationale suggested here is conditional, especially on contingencies in what design options are available to selection and on trade-offs associated with the costs of generating and processing representations of value. The unqualified efficiency rationale for preferences suggests that organisms should represent expected utilities in a comprehensive and consistent way, but none of them do. In the final stages of the paper I consider some of the ways design trade-offs compromise the implementation of preferences in organisms that have them. (shrink)

Stawarczyk, Bezdek, and Zacks offer neuroscience evidence for a midline default network core, which appears to coordinate internal, top‐down mentation with externally‐triggered, bottom‐up attention in a push‐pull relationship. The network may enable the flexible pursuance of thoughts tuned into or detached from the current environment.

Aware that the representational thesis is more plausible for the attitudinal than for the phenomenal, Dretske courageously focuses on sensory experience, where progress in our philosophical understanding of the mental has lagged. His view, essentially, is that what makes any mental state what it is is not so much what it's like as what it's about.

In this book, David Stump traces alternative conceptions of the a priori in the philosophy of science and defends a unique position in the current debates over conceptual change and the constitutive elements in science. Stump emphasizes the unique epistemological status of the constitutive elements of scientific theories, constitutive elements being the necessary preconditions that must be assumed in order to conduct a particular scientific inquiry. These constitutive elements, such as logic, mathematics, and even some fundamental laws of nature, (...) were once taken to be a priori knowledge but can change, thus leading to a dynamic or relative a priori. Stump critically examines developments in thinking about constitutive elements in science as a priori knowledge, from Kant’s fixed and absolute a priori to Quine’s holistic empiricism. By examining the relationship between conceptual change and the epistemological status of constitutive elements in science, Stump puts forward an argument that scientific revolutions can be explained and relativism can be avoided without resorting to universals or absolutes. (shrink)

David B. Wong proposes that there can be a plurality of true moralities, moralities that exist across different traditions and cultures, all of which address facets of the same problem: how we are to live well together. Wong examines a wide array of positions and texts within the Western canon as well as in Chinese philosophy, and draws on philosophy, psychology, evolutionary theory, history, and literature, to make a case for the importance of pluralism in moral life, and to (...) establish the virtues of acceptance and accommodation. Wong's point is that there is no single value or principle or ordering of values and principles that offers a uniquely true path for human living, but variations according to different contexts that carry within them a common core of human values. We should thus be modest about our own morality, learn from other approaches, and accommodate different practices in our pluralistic society. (shrink)

David Wiggins; IV*—Moral Cognitivism, Moral Relativism and Motivating Moral Beliefs, Proceedings of the Aristotelian Society, Volume 91, Issue 1, 1 June 1991, P.

Stamos squarely confronts the problem of determining what a biological species is, whether species are real, and the nature of their reality. He critically considers the evolution of the major contemporary views of species and also offers his own solution to the species problem.

David Wiggins; II*—Deliberation and Practical Reason, Proceedings of the Aristotelian Society, Volume 76, Issue 1, 1 June 1976, Pages 29–52, https://doi.org/10.

In this new introduction to a classic philosophical text, David Stern examines Wittgenstein's Philosophical Investigations. He gives particular attention to both the arguments of the Investigations and the way in which the work is written, and especially to the role of dialogue in the book. While he concentrates on helping the reader to arrive at his or her own interpretation of the primary text, he also provides guidance to the unusually wide range of existing interpretations, and to the reasons (...) why the Investigations have inspired such a diversity of readings. Following closely the text of the Investigations and meant to be read alongside it, this survey is accessible to readers with no previous background in philosophy. It is well-suited to university-level courses on Wittgenstein, but can also be read with profit by students in other disciplines. (shrink)

This book aims to discuss probability and David Hume's inductive scepticism. For the sceptical view which he took of inductive inference, Hume only ever gave one argument. That argument is the sole subject-matter of this book. The book is divided into three parts. Part one presents some remarks on probability. Part two identifies Hume's argument for inductive scepticism. Finally, the third part evaluates Hume's argument for inductive scepticism. Hume's argument that induction must be either deductively valid or circular because (...) based on experience neglects the possibility that it is an argument of non-deductive logic (logical probability, in the sense of Keynes). (shrink)

Do psychological traits predict philosophical views? We administered the PhilPapers Survey, created by David Bourget and David Chalmers, which consists of 30 views on central philosophical topics (e.g., epistemology, ethics, metaphysics, philosophy of mind, and philosophy of language) to a sample of professional philosophers (N = 314). We extended the PhilPapers survey to measure a number of psychological traits, such as personality, numeracy, well-being, lifestyle, and life experiences. We also included non-technical ‘translations’ of these views for eventual use (...) in other populations. We found limited to no support for the notion that personality or demographics predict philosophical views. We did, however, find that some psychological traits were predictive of philosophical views, even after strict correction for multiple comparisons. Findings include: higher interest in numeracy predicted physicalism, naturalism, and consequentialism; lower levels of well-being and higher levels of mental illness predicted hard determinism; using substances such as psychedelics and marijuana predicted non-realist and subjectivist views of morality and aesthetics; having had a transformative or self-transcendent experience predicted theism and idealism. We discuss whether or not these empirical results have philosophical implications, while noting that 68% of our sample of professional philosophers indicated that such findings would indeed have philosophical value. (shrink)

In response to a recent argument by David Bloor, I argue that denying absolutes does not necessarily lead to relativism, that one can be a fallibilist without being a relativist. At issue are the empirical natural sciences and what might be called “framework relativism”, that is, the idea that there is always a conceptual scheme or set of practices in use, and all observations are theory-laden relative to the framework. My strategy is to look at the elements that define (...) a relativist stance and show where the pragmatic fallibilist disagrees. Defending the pragmatic notion of experience will be central, given that relativists reject the idea that experience can play a role in objectively justifying belief. We can reject all absolutes and start from the premise that everything is historical, contingent, and situated. One of the lessons of pragmatism is that universal and fixed principles are not necessary for objective knowledge. (shrink)

In response to a recent argument by David Bloor, I argue that denying absolutes does not necessarily lead to relativism, that one can be a fallibilist without being a relativist. At issue are the empirical natural sciences and what might be called “framework relativism”, that is, the idea that there is always a conceptual scheme or set of practices in use, and all observations are theory-laden relative to the framework. My strategy is to look at the elements that define (...) a relativist stance and show where the pragmatic fallibilist disagrees. Defending the pragmatic notion of experience will be central, given that relativists reject the idea that experience can play a role in objectively justifying belief. We can reject all absolutes and start from the premise that everything is historical, contingent, and situated. One of the lessons of pragmatism is that universal and fixed principles are not necessary for objective knowledge. (shrink)

Geographies of Exclusion identifies forms of social and spatial exclusion and subsequently examines the fate of knowledge of space and society which has been produced by members of excluded groups. Evaluating writing on urban society by women and black writers, David Sibley asks why such work is neglected by the academic establishment, suggesting that both the practices which result in the exclusion of minorities and those which result in the exclusion of knowledge have important implications for theory and method (...) in human geography. Drawing on a range of ideas from social anthropology, feminist theory, sociology, human geography and psychoanalysis, this book presents a fresh approach to geographical theory, highlighting the tendency of powerful groups to "purify" space and to view minorites as defiled and polluting, and exploring the nature of "difference" and the production of knowledge. (shrink)

David Wiggins; IV*—Moral Cognitivism, Moral Relativism and Motivating Moral Beliefs, Proceedings of the Aristotelian Society, Volume 91, Issue 1, 1 June 1991, P.

Ways of the Hand tells the story of how David Sudnow learned to improvise jazz on the piano. Because he had been trained as an ethnographer and social psychologist, Sudnow was attentive to what he experienced in ways that other novice pianists are not. The result, first published in 1978 and now considered by many to be a classic, was arguably the finest and most detailed account of skill development ever published.Looking back after more than twenty years, Sudnow was (...) struck by the extent to which he had allowed his academic background to shape the book's language. He realized that he could now do a much better job of describing his experiences in a way that would not require facility with formal social science and philosophical discourse. The result is a revised version of the book that carries the same intellectual energy as the original but is accessible to a much wider audience. (shrink)

[A slightly revised version of this paper has been accepted by the BJPS] More attention has been devoted to providing evolutionary scenarios accounting for the development of beliefs, or belief-like states, than for desires or preferences. Here I articulate and defend an evolutionary rationale for the development of psychologically real preference states. Preferences token or represent the expected values of discriminated states, available actions, or action-state pairings. The argument is an application the ‘environmental complexity thesis’ found in Godfrey-Smith and Sterelny, (...) although my conclusions differ from Sterelny’s. I argue that tokening expected utilities can, under specified general conditions, be a powerful design solution to the problem of allocating the capacities of an agent in an efficient way. Preferences are for efficient action selection, and are a ‘fuel for success’ in the sense urged by Godfrey-Smith for true beliefs. They will tend to be favoured by selection when environments are complex in ways that matter to an organism, and when organisms have rich behavioural repertoires with heterogenous returns and costs. The rationale suggested here is conditional, especially on contingencies in what design options are available to selection and on trade-offs associated with the costs of generating and processing representations of value. The unqualified efficiency rationale for preferences suggests that organisms should represent expected utilities in a comprehensive and consistent way, but none of them do. In the final stages of the paper I consider some of the ways in which design trade-offs compromise the implementation of preferences in organisms that have them. (shrink)

A striking feature of the latest version of Dennett’s ‘big picture’ of the evolution of life and mind is frequent reference to ‘affordances’. An affordance is, roughly, a possibility for action for a creature in an environment. Given more than one possibility for action, a good question is: what will the creature actually do? I argue that affordances pose a problem of selection, and that a good general solution to this problem of mind-design is to implement a system of preferences.

Many guidelines and commentators endorse the view that clinical research is ethically acceptable only when it has social value, in the sense of collecting data which might be used to improve health. A version of this social value requirement is included in the Declaration of Helsinki and the Nuremberg Code, and is codified in many national research regulations. At the same time, there have been no systematic analyses of why social value is an ethical requirement for clinical research. Recognizing this (...) gap in the literature, recent articles by Alan Wertheimer and David Resnik argue that the extant justifications for the social value requirement are unpersuasive. Both authors conclude, contrary to almost all current guidelines and regulations, that it can be acceptable across a broad range of cases to conduct clinical research which is known prospectively to have no social value. The present article assesses this conclusion by critically evaluating the ethical and policy considerations relevant to the claim that clinical research must have social value. This analysis supports the standard view that social value is an ethical requirement for the vast majority of clinical research studies and should be mandated by applicable guidelines and policies. (shrink)

David Wiggins; XV*—Weakness of Will Commensurability, and the Objects of Deliberation and Desire, Proceedings of the Aristotelian Society, Volume 79, Issue 1, 1.

David Kaplan distinguishes between character and content in his theory of demonstratives and indexicals. This paper argues that David Kaplan's theory of demonstratives contains two different, incompatible, descriptions of what character is. It argues that one of them is superior. It argues that, ultimately, a theory of indexicals needs a theory of structured characters.

Rae Langton and Jennifer Hornsby provide accounts of how pornography silences women by appealing to J.L. Austin's account of speech-acts. Since their accounts focus only on instances of silencing where the hearer does not grasp the type of speech-act the speaker intends to perform, their accounts of silencing do not generalize to explain silencing that arises from what Miranda Fricker calls “testimonial injustice.” I argue that silencing arising from testimonial injustice can only be explained by what we shall call the (...) dialectical account of assertion, according to which assertion is the undertaking of a commitment in reasoned discourse. In doing so, I show that accounts of assertion based on speakers' intentions, proposals to common ground, and constitutive norms do not provide the necessary framework to explain silencing within the context of testimonial injustice. Having shown the strength of the dialectical account in explaining silencing, I conclude that the dialectical account also provides a way to remedy some instances of silencing arising from testimonial injustice providing further evidence that the dialectical account is the correct account of assertion. (shrink)

For this volume David Wiggins has selected and revised eleven of his essays in an area of metaphysics where his work has been particularly influential, and he has added a substantial introduction and one new unpublished essay. Among the subjects treated are substance, identity, persistence, persons, sortals, and artefacts.

This provocative text considers whether evolutionary explanations can be used to clarify some of life’s biggest questions. Examines topics of race, sex, gender, the nature of language, religion, ethics, knowledge, consciousness and ultimately, the meaning of life Each chapter presents a main topic, together with discussion of related ideas and arguments from various perspectives Addresses questions such as: Did evolution make men and women fundamentally different? Is the concept of race merely a social construction? Is morality, including universal human rights, (...) a mass delusion? Can religion and evolution really be harmonized? Does evolution render life meaningless? Written in a clear and informative style, with helpful references for further reading and research. (shrink)

We explore success drivers of reward-based crowdfunding for poverty alleviation in China. The results from our econometric modeling using data from 4375 reward-based crowdfunding campaigns suggest that poverty alleviation campaigns, as compared to ordinary ones, benefit from higher funded amounts, larger backer numbers, and greater success rates. The results also suggest that poverty alleviation campaigns perform better when the products sold originate from poorer (as compared to wealthier) regions and when price premiums are lower (as compared to higher). We corroborate (...) important findings from the field study with an experimental study, showing that the consumer’s feeling of warm glow accounts for the positive effects of poverty alleviation campaigns (as compared to ordinary) campaigns. We expand the applications of warm-glow theory into the context of reward-based crowdfunding campaigns for poverty alleviation and offer new insights into success drivers of such campaigns. (shrink)

'ith the rise of naturalism in the art of the late Middle Ages and the Renaissance there developed an extensive and diverse literature about art which helped to explain, justify, and shape its new aims. In this book, David Summers provides an original investigation of the philosophical and psychological notions invoked in this new theory and criticism. From a thorough examination of the sources, he shows how the medieval language of mental discourse derived from an understanding of classical thought. (...) 'Some of the most striking observations in this impressive book involve stepping outside the history of ideas to ground these theories in a more general social history.' -- British Journal of Aesthetics 'This brilliant, stimulating study in the history of ideas should become indispensible for renaissance art historians, and for philosophers interested in the history of the philosophy of mind and in what might be called thepre-history' of aesthetics.' -- ChoiceWith the rise of naturalism in the art of the late Middle Ages and the Renaissance there developed an extensive and diverse literature about art which helped to explain. (shrink)

German Jewish philosopher Moses Mendelssohn was one of the most influential thinkers of the Enlightenment. Until now, attention was focused on Mendelssohn’s German works—such as his groundbreaking _Jerusalem—_which have been duly translated into English. Edward Breuer and David Sorkin assert that his Hebrew works are essential for understanding both his biography and his oeuvre. This volume offers expertly translated and generously annotated selections from the entire corpus of Mendelssohn’s published Hebrew writings. Mendelssohn wrote in Hebrew throughout his life, but (...) these works—mainly grounded in biblical and other Hebrew classical works—have been hitherto inaccessible to most scholars. In this volume, Breuer and Sorkin make an important contribution to modern Jewish and religious thought, refuting the notion that Mendelssohn led a bifurcated intellectual and spiritual existence and demonstrating Mendelssohn’s ability to transform traditional religious genres into vehicles for philosophical argumentation. (shrink)

This provocative text considers whether evolutionary explanations can be used to clarify some of life’s biggest questions. Examines topics of race, sex, gender, the nature of language, religion, ethics, knowledge, consciousness and ultimately, the meaning of life Each chapter presents a main topic, together with discussion of related ideas and arguments from various perspectives Addresses questions such as: Did evolution make men and women fundamentally different? Is the concept of race merely a social construction? Is morality, including universal human rights, (...) a mass delusion? Can religion and evolution really be harmonized? Does evolution render life meaningless? Written in a clear and informative style, with helpful references for further reading and research. (shrink)