Unfortunately, there is broad confusion regarding the justification for healthcare professionals unilaterally limiting or withdrawing life-prolonging interventions. Many mistakenly believe that suc...

The American Society for Bioethics and Humanities promulgated standards for clinical ethics consultants and is currently developing a national Quality Attestation in Clinical Ethics Consultation to assist facilities in ensuring that those performing clinical ethics consultations meet minimum standards. As the field moves towards such professionalization, there is a need to provide access to qualified clinical ethicists at a broad range of medical facilities. Currently, however, there are insufficient numbers of trained clinical ethicists to staff all healthcare facilities, and many (...) facilities lack the necessary resources to hire staff clinical ethicists. In this review, we describe several models for providing expert clinical ethics support to remote facilities that lack access to qualified clinical ethicists. Based on this analysis, we recommend telemedicine as the optimal model providing expert support to local ethics committee members tasked with providing clinical ethics consultation services. (shrink)

In the United States, patients have a clear right to determine what is done to them by doctors. Starting in the early 20th century, multiple court cases paved the way for our current understanding...

Volume 20, Issue 6, June 2020, Page 30-32.

This article reviews the possible role of the universal basic income in the transformation of experience in gender and age perspectives. The universal basic income has been particularly hotly debated in recent decades. Regardless of the position, the common tone of the debates is the imperative “we must experiment.” Such a close interest in the universal basic income derives from the fact that it threatens to change the “generic” for humans situation of finiteness of resources and the need to work. (...) Thus, it is able to change the experience of what it means to be human. Since the universal basic income allows to separate labor from income, it is likely that its introduction will return value to the currently stigmatized or devalued types of labor, such as child care, elderly care or domestic work. It creates opportunities for experience redistribution in gender perspective: care and leaving, affective connection, and sensitivity could become the business of both parents, not just mothers. Another experience redistribution is possible in age perspective. Along with automation of labor, population ageing is a universal process that will sooner or later affect all the countries. Alarmist narratives that present this process as a threat and a problem now prevail. They are largely based on outdated ideas about old age and what it means to be old. However, in fact, ageing is the maturation of the population as a whole. With a proper re-evaluation of the meaning and significance of old age, the introduction of the universal basic income could create material conditions for the transfer of experience from the elderly to the younger – for the first time since traditional societies. (shrink)

This paper takes on several distinct but related tasks. First, I present and discuss what I will call the “Ignorance Thesis,” which states that whenever an agent acts from ignorance, whether factual or moral, she is culpable for the act only if she is culpable for the ignorance from which she acts. Second, I offer a counterexample to the Ignorance Thesis, an example that applies most directly to the part I call the “Moral Ignorance Thesis.” Third, I argue for a (...) principle—Don’t Know, Don’t Kill—that supports the view that the purported counterexample actually is a counterexample. Finally, I suggest that my arguments in this direction can supply a novel sort of argument against many instances of killing and eating certain sorts of animals. (shrink)

Throughout the 20th century, many doctors did not view pain management as an important aspect of their practice. Because pain cannot be objectively measured by the doctor, many doctors found it dif...

Volume 20, Issue 3, March 2020, Page 19-21.

There has long been tension between bioethicists whose work focuses on classical philosophical inquiry and those who perform empirical studies on bioethical issues. While many have argued that empirical research merely illuminates current practices and cannot inform normative ethics, others assert that research-based work has significant implications for refining our ethical norms. In this essay, I present a novel construct for classifying empirical research in bioethics into four hierarchical categories: Lay of the Land, Ideal Versus Reality, Improving Care, and Changing (...) Ethical Norms. Through explaining these four categories and providing examples of publications in each stratum, I define how empirical research informs normative ethics. I conclude by demonstrating how philosophical inquiry and empirical research can work cooperatively to further normative ethics. (shrink)

Shocking. There seems no other response to the Fox findings. The bioethics community has been working for decades to improve the quality of, and access to, competent healthcare ethics consultation....

I argue that Hubert Dreyfus’ work on embodied coping, the intentional arc, solicitations and the background as well as his anti-representationalism rest on introspection. I denote with ‘introspection’ the methodological malpractice of formulating ontological statements about the conditions of possibility of phenomena merely based on descriptions. In order to illustrate the insufficiencies of Dreyfus’ methodological strategy in particular and introspection in general, I show that Heidegger, to whom Dreyfus constantly refers as the foundation of his own work, derives ontological statements (...) about the conditions of possibility of phenomena not merely from descriptions, but also from analyses. I further show that deriving ontological statements directly from descriptions entails implausible results. I do so by discussing representative cases. Based on these general methodological considerations, I show that Dreyfus’ work on action, skill and understanding is introspective. First, I demonstrate that Dreyfus’ influential claim that rules and representations do not govern skillful actions is the result of introspection, because it is merely founded on the absence of rules and representations in representative descriptions of skillful actions. Second, I show that Dreyfus’ work on embodied coping, the intentional arc, solicitations and the background is also based on introspection. These ontological structures are merely reifications of descriptions and are not further substantiated by analyses. (shrink)

There has been a great deal of philosophical discussion about using people, using people intentionally, using people as a means to some end, and using people merely as a means to some end. In this paper, I defend the following claim about using people: NOT ALWAYS WRONG: using people—even merely as a means—is not always morally objectionable. Having defended that claim, I suggest that the following claim is also correct: NO ONE FEATURE: when it is morally objectionable to use people, (...) this is for many different kinds of reasons—there is no one wrong-making feature that every morally objectionable using has in common. After discussing these claims, I use them to present and motivate what I call the “precaution” theory of norms against using people. I conclude by considering a few cases from the criminal law context—cases that are naturally described as using people—to assess the moral appropriateness of this kind of use in these cases, and to demonstrate how the theory applies to the real world. (shrink)

This paper connects the question of the rationality of voting to the question of what it is morally permissible for elected representatives to do. In particular, the paper argues that it is rational to vote to increase the strength of the manifest normative mandate of one's favored candidate. I argue that, due to norms of political legitimacy, how representatives ought to act while in office is tied to how much support they have from their constituents, where a representative’s “support” is (...) a function of the percentage of adults living in the political jurisdiction who voted for her. In a representative system, whether a particular law or policy is legitimate is in part a function of how much support the particular representative government has, rather than simply being a function of the governmental structure or the normative content of the law or policy. Representatives with more support can permissibly act more like trustees (doing what they think is best) and less like delegates (doing what their constituents presently prefer). I argue that this fact provides a reason for individuals to vote, even given the incredibly small chance an individual voter has of casting a pivotal vote. (shrink)

The American Journal of Bioethics, Volume 11, Issue 11, Page 22-23, November 2011.

In most common-law and civil-law jurisdictions, mistakes of law do not excuse. That is, the fact that one was ignorant of the content or requirements of some law does not excuse violations of that law. Many have argued that this doctrine is mistaken. In particular, many have argued that if an individual’s ignorance or false belief is blameless, if she held the false belief reasonably, then she ought to be able to use that ignorance as an excuse for violating the (...) law. It is much harder to find defenders of the doctrine, despite its prevalence. Pragmatic considerations are occasionally offered on its behalf, but these are generally not impressive. In this paper, I consider a more direct kind of justification for the doctrine, one that attempts to identify something more immediately normatively objectionable about being ignorant of the law. In particular, I consider an argument that suggests that legal ignorance is more like moral ignorance than like nonmoral ignorance and maintains that even nonculpable moral ignorance does not excuse. (shrink)

Modern scholars have been concerned with the hostility shown to Alexander by the Hellenistic schools of philosophy. Two literary portraits have been distinguished, the Peripatetic and the Stoic, the former deriving from Theophrastus' book on Callisthenes, or starting with this work the Peripatetics worked out a theory of and applied it to Alexander, in order to belittle his achievements. It was a case of giving sophisticated expression to the kind of crude resentment expressed by Demades.

To figure out whether the main empirical question “Is our brain hardwired to believe in and produce God, or is our brain hardwired to perceive and experience God?” is answered, this paper presents systematic critical review of the positions, arguments and controversies of each side of the neuroscientific-theological debate and puts forward an integral view where the human is seen as a psycho-somatic entity consisting of the multiple levels and dimensions of human existence (physical, biological, psychological, and spiritual reality), allowing (...) consciousness/mind/spirit and brain/body/matter to be seen as different sides of the same phenomenon, neither reducible to each other. The emergence of a form of causation distinctive from physics where mental/conscious agency (a) is neither identical with nor reducible to brain processes and (b) does exert “downward” causal influence on brain plasticity and the various levels of brain functioning is discussed. This manuscript also discusses the role of cognitive processes in religious experience and outlines what can neuroscience offer for study of religious experience and what is the significance of this study for neuroscience, clinicians, theology and philosophy. A methodological shift from “explanation” to “description” of religious experience is suggested. This paper contributes to the ongoing discussion between theologians, cognitive psychologists and neuroscientists. (shrink)

The present study investigated whether individual differences between psychologists in thinking styles are associated with accuracy in diagnostic classification. We asked novice and experienced clinicians to classify two clinical cases of clients with two co-occurring psychological disorders. No significant difference in diagnostic accuracy was found between the two groups, but when combining the data from novices and experienced psychologists accuracy was found to be negatively associated with certain decision making strategies and with a higher self-assessed ability and preference for a (...) rational thinking style. Our results underscore the idea that it might be fruitful to look for explanations of differences in the accuracy of diagnostic judgments in individual differences between psychologists (such as in thinking styles or decision making strategies used), rather than in experience level. (shrink)

A new interpretation of quantum mechanics, the interpretation which became popular in XXI, has been taken under consideration. This is the quantum baysinism (QBism) which may be taken as an extrapolation of the baysian philosophy of probability over the interpretation of quantum mechanics. The baysian philosophy of quantum mechanics has been compared with the Copenhagen interpretation of quantum mechanics, the interpretation which can been treated as standard as it is represented in the main textbooks. In contrast to the Copenhagen interpretation (...) which proceeds from the triplets – nature, apparatus and observer (agent), QBism emphasizes the conscious of the observer: the quantum state is the observer’s state, and by means of the quantum conceptual technique the observer constructs his/her own image of quantum processes. By means of measurement the observer updates his/her quantum state, the measuring apparatus being an extension of the observer’s sensuality. From the point of the QBism’s view the phenomenon of decoherence which is widely discussed in the contemporary literature is not essential for the theory of measurement in quantum mechanics. The decoherence explains why the macroscopic phenomena don’t expose the interference behavior which is characteristic for quantum superposition. From the historicо-philosophical point of view Qbism can be traced back to American instrumentalism and operationalism. (shrink)

The value of resting electroencephalogram (EEG) in revealing neural constitutes of consciousness (NCC) was examined. We quantified the dynamic repertoire, duration and oscillatory type of EEG microstates in eyes-closed rest in relation to the degree of expression of clinical self-consciousness. For NCC a model was suggested that contrasted normal, severely disturbed state of consciousness and state without consciousness. Patients with disorders of consciousness were used. Results suggested that the repertoire, duration and oscillatory type of EEG microstates in resting condition quantitatively (...) related to the level of consciousness expression in brain-damaged patients and healthy-conscious subjects. Specifically, results demonstrated that (a) decreased number of EEG microstate types was associated with altered states of consciousness, (b) unawareness was associated with the lack of diversity in EEG alpha-rhythmic microstates, and (c) the probability for the occurrence and duration of delta-, theta- and slow-alpha-rhythmic microstates were associated with unawareness, whereas the probability for the occurrence and duration of fast-alpha-rhythmic microstates were associated with consciousness. In conclusion, resting EEG has a potential value in revealing NCC. This work may have implications for clinical care and medical–legal decisions in patients with disorders of consciousness. (shrink)

Recently, five major critical care professional organizations in North America and Europe published a consensus policy statement on how intensive care unit clinicians should respond to patient or surrogate requests for potentially inappropriate treatments. Subsequently, the Society for Critical Care Medicine, the largest multidisciplinary critical care organization and one of the authors of the Multiorganization Policy Statement, issued a companion statement defining futile and potentially inappropriate interventions. These statements support previous work published by the SCCM Ethics Committee 20 years ago. (...) The critical care... (shrink)

The article is devoted to the rule-following problem and its impact on the sociology of science as K.A. Rodin presents them in his article. It is known that L. Wittgenstein in “Philosophical Studies”, using the rule of arithmetic addition as an example, formulated the rule-following problem, which has acquired the ultimate form of skepticism thanks to S. Kripke. This problem was transferred to the sociology of science by D. Bloor, where it received the following sociological explanation: rule-amenably activity can be (...) understood only by incorporating rules into social institutions. P. Winch rejected a skeptical interpretation of this problem, and as K.A. Rodin shows in the article, most adequately showed the consequences of Wittgenstein’s ideas for sociology. In his answer, A.A. Sanzhenakov draws attention to two circumstances. Firstly, sociology was influenced not only by late but also early ideas of Wittgenstein. Secondly, the rule-following problem as an important factor in the sociological turn can also be found in the phenomenology of E. Husserl. The author concludes about the need for additional research, which will draw a line between the influence of Wittgenstein and Husserl on sociology. (shrink)

The growing support for voluntary active euthanasia is evident in the recently approved Dutch Law on Termination of Life on Request. Indeed, the debate over legalized VAE has increased in European countries, the United States, and many other nations over the last several years. The proponents of VAE argue that when a patient judges that the burdens of living outweigh the benefits, euthanasia can be justified. If some adults suffer to such an extent that VAE is justified, then one may (...) conclude that some children suffer to this extent as well. In an attempt to alleviate the suffering of extremely ill neonates, the University Medical Center Groningen developed a protocol for neonatal euthanasia. In this article, I first present the ethical justifications for VAE and discuss how these arguments relate to euthanizing ill neonates. I then argue that, even if one accepts the justification for VAE in adults, neonatal euthanasia cannot be supported, primarily because physicians and parents can never accurately assess the suffering of children. I argue that without the testament of the patient herself as to the nature and magnitude of her suffering, physicians can never accurately weigh the benefits and burdens of a child’s life, and therefore any such system would condemn to death some children whose suffering is not unbearable. I conclude that because the primary duty of physicians is to never harm their patients, neonatal euthanasia cannot be supported. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 41-42, June 2011.

In the Soviet scientific literature of 1920‒30 the concept of probability was holly debated. The frequency concept which was proposed by R. von Mises became popular among Soviet physicists belonging to the L.I. Mandelstam community. Landau and Lifshitz were also close to this concept in their famous course of theoretical physics. A.Khinchin, a mathematician who cooperated with Kolmogorov, opposed to the frequency conception. In this paper we try to demonstrate that the frequency position was connected with the anthropomorphous approach to (...) physics, whereas Khinchin’s positions implied the criticism of anthropomorphism and put forward the ideal of objective knowledge. (shrink)

Mandelstam’s criticism of the Rayleigh theory of the blue color of the sky (1907) and his polemic with M. Planck (1907–1908) did not become notable events in the history of physics. However, the method of their coverage in the Soviet and in the post-Soviet physics literature is remarkable. Most of Soviet physicists and historians of physics supported Mandelstam's point of view in his criticism of both Raleigh and Planck. The situation changed only at the beginning of the 21st century: in (...) the Russian literature the publications appeared emphasizing that in the Raleigh–Mandelstam and Planck–Mandelstam controversies Mandelstam was not right, Raleigh and Planck were closer to the truth. Which presumptions of this trend can be noted? This was patriotism of the scientific school peculiar to Mandelstam’s graduate students and the former graduate students, the patriotism connected with solidarity which helped Mandelstam’s community to survive in the Soviet totalitarian regime and in the totalitarian organization of science. This was also progressionism which was popular among academics and among men in the street. The phenomenon of common knowledge, mutual knowledge among the members of a scientific community should be taken under consideration. Common knowledge is connected with the non-thematized anonymous inclusion of the ideological terminology into scientific discourse. (shrink)

A common objection to the very idea of conceptual engineering is the topic continuity problem: whenever one tries to “reengineer” a concept, one only shifts attention away from one concept to another. Put differently, there is no such thing as conceptual revision: there’s only conceptual replacement. Here, I show that topic continuity is compatible with conceptual replacement. Whether the topic is preserved in an act of conceptual replacement simply depends on what is being replaced (a conceptual tool or a conceptual (...) role) and what the topic under discussion is. Thus, the topic continuity problem only arises from a failure to specify these two things. (shrink)

I develop an expressivist account of verbal disagreements as practical disagreements over how to use words rather than factual disagreements over what words actually mean. This account enjoys several advantages over others in the literature: it can be implemented in a neo-Stalnakerian possible worlds framework; it accounts for cases where speakers are undecided on how exactly to interpret an expression; it avoids appeals to fraught notions like subject matter, charitable interpretation, and joint-carving; and it naturally extends to an analysis of (...) metalinguistic negotiations. (shrink)

Adequate assessment of (un)consciousness is not only of theoretical interest but also has a practical and ethical importance, especially when it comes to disorders of consciousness (DOC). Accurately determining the presence or absence of consciousness in patients with DOC allows informed decisions to be made about long-term care support, referral for rehabilitation, pain management and withdrawal of life support. We believe that a theoretical account of what conscious experience is and how it emerges within the brain will advance the search (...) for appropriate neuromarkers of the presence or absence of consciousness in non-communicative brain-damaged patients. (shrink)