This paper considers the responsibilities of the FDA with regard to disseminating information about the benefits and harms of e-cigarettes. Tobacco harm reduction advocates claim that the FDA has been overcautious and has violated ethical obligations by failing to clearly communicate to the public that e-cigarettes are far less harmful than cigarettes. We argue, by contrast, that the FDA’s obligations in this arena are more complex than they may appear at first blush. Though the FDA is accountable for informing the (...) public about the health risks and benefits of products it regulates, it also has other roles that inform when and how it should disseminate information. In addition to being a knowledge purveyor, it is also a knowledge producer, an advisor to the public, and a practical agent shaping the material conditions in which people make health-related choices. In our view, those other roles call for caution in the way the FDA interprets and communicates the available evidence. (shrink)

In The Minority Body, Elizabeth Barnes rejects prevailing social constructionist accounts of disability for two reasons. First, because they understand disability in terms of oppressive social responses to bodily impairment, they cannot make sense of disability pride. Second, they maintain a problematic distinction between impairment and disability. In response to these challenges, this paper defends a version of the social model of disability, which we call the Social Exclusion Model. On our account, to be disabled is to be in a (...) bodily or psychological state that is represented as an impairment in the prevailing ideology of one’s society, and to be excluded from valuable activities on the basis of this representation. While this model refers to a distinction between disability and impairment, it makes no presuppositions about which bodies function ‘normally’ and which do not. It is the ideology of impairment rather than impairment itself that does any work to determine whether a person is disabled. We argue that this model answers some of the important objections that Barnes raises against prevailing social constructionist accounts of disability, and that it’s focus on the oppressive social positioning of disabled people gives it explanatory power that Barnes’s own account lacks. (shrink)

When people are making certain medical decisions – especially potentially transformative ones – the specter of regret may color their choices. In this paper, I ask: can predicting that we will regret a decision in the future serve any justificatory role in our present decision-making? And if so, what role? While there are many pitfalls to such reasoning, I ultimately conclude that considering future retrospective emotions like regret in our decisionmaking can be both rational and authentic. Rather than indicating that (...) one is about to make a mistake or that there is some underlying value that one already cares about but is overlooking, the prediction that one will regret a decision in the future makes one confront how her present values and priorities may change as a result of her choice in ways she cannot presently anticipate. (shrink)

Background: Current practice frequently fails to provide care consistent with the preferences of decisionally-incapacitated patients. It also imposes significant emotional burden on their surrogates. Algorithmic-based patient preference predictors (PPPs) have been proposed as a possible way to address these two concerns. While previous research found that patients strongly support the use of PPPs, the views of surrogates are unknown. The present study thus assessed the views of experienced surrogates regarding the possible use of PPPs as a means to help make (...) treatment decisions for decisionally-incapacitated patients. -/- Methods: This qualitative study used semi-structured interviews to determine the views of experienced surrogates [n=26] who were identified from two academic medical centers and two community hospitals. The primary outcomes were respondents’ overall level of support for the idea of using PPPs and the themes related to their views on how a PPP should be used, if at all, in practice. -/- Results: Overall, 21 participants supported the idea of using PPPs. The remaining five indicated that they would not use a PPP because they made decisions based on the patient’s best interests, not based on substituted judgment. Major themes which emerged were that surrogates, not the patient’s preferences, should determine how treatment decisions are made, and concern that PPPs might be used to deny expensive care or be biased against minority groups. -/- Conclusions: Surrogates, like patients, strongly support the idea of using PPPs to help make treatment decisions for decisionally-incapacitated patients. These findings provide support for developing a PPP and assessing it in practice. At the same time, patients and surrogates disagree over whose preferences should determine how treatment decisions are made, including whether to use a PPP. These findings reveal a fundamental disagreement regarding the guiding principles for surrogate decision-making. Future research is needed to assess this disagreement and consider ways to address it. (shrink)

John Rawls, among others, has argued that one of aims political philosophy is that it provides reasonable hope in the possibility of justice in the future. But what makes hope reasonable? What sorts of theories of justice are best suited to foster reasonable hope in us? To answer these questions, this paper investigates Rawls’s conception of reasonable hope and the kinds of unreasonableness Rawls sought to guard against with his account of a realistic utopia. Rawls's idea of reasonable hope goes (...) beyond the weaker kind of “reconciliation” put forward by Rousseau’s account of a conjectural history that sketches a picture of how we could have developed into the kind of people and the kind of society where justice is possible. It is one thing to believe, with Rousseau, that our deep natures are not incompatible with the possibility of a just society. It is something further to harbor any hope for this in the future. I argue that this temporal aspect, which is built into what Kant and Rawls mean by reasonable hope, is useful approach to the practice of political philosophy. An approach that takes the need for reasonable hope seriously is one that moves political theorizing from a more passive framework of theoretical imagination toward a more active one that entails political anticipation. (shrink)

Context Opioid treatment agreements (OTAs) are documents that clinicians present to patients when prescribing opioids that describe the risks of opioids and specify requirements that patients must meet to receive their medication. Notwithstanding a lack of evidence that OTAs effectively mitigate opioids’ risks, professional organizations recommend that they be implemented, and jurisdictions increasingly require them. We sought to identify the jurisdictions that require OTAs, how OTAs might affect the outcomes of lawsuits that arise when things go wrong, and instances in (...) which the law permits flexibility for clinicians and health care institutions to adopt best practices. -/- Methods We surveyed the laws and regulations of all 50 states and the District of Columbia to identify which jurisdictions require the use of OTAs, the circumstances in which OTA use is mandatory, and the terms OTAs must include (if any). We also surveyed criminal and civil judicial decisions in which OTAs were discussed as evidence on which a court relied to make its decision to determine how OTA use influences litigation outcomes. -/- Findings Results show that a slight majority (27) of jurisdictions now require OTAs. With one exception, the jurisdictions’ requirements for OTA use are triggered at least in part by long-term prescribing. There is otherwise substantial variation and flexibility within OTA requirements. Results also show that even in jurisdictions where OTA use is not required by statute or regulation, OTA use can inform courts’ reasoning in lawsuits involving patients or clinicians. Sometimes, but not always, OTA use legally protects clinicians from liability. -/- Conclusions -/- Our results show that OTA use is entwined with legal obligations in various ways. Clinicians and health care institutions should identify ways for OTAs to enhance clinician–patient relationships and patient care within the bounds of relevant legal requirements and risks. (shrink)

We often find ourselves in situations where it is up to us to make decisions on behalf of others. How can we determine whether such decisions are morally justified, especially if those decisions may change who it is these others end up becoming? In this paper, I will evaluate one plausible kind of justification that may tempt us: we may want to justify our decision by appealing to the likelihood that the other person will be glad we made that specific (...) choice down the line. Although it is tempting, I ultimately argue that we should reject this sort of appeal as a plausible justification for the moral permissibility of our vicarious decisions. This is because the decisions that we make on behalf of another may affect the interests and values that that person will hold in the future. As I will show, this complicates the justificatory relationship between present decisions and future attitudes, since the latter can depend on the former. This is not to say that the predicted future attitudes of others can play no significant role in justifying our decisions on others’ behalf. Rather, appealing to the future attitudes in our moral justifications may play an important role in our practical thinking but only when we consider the future attitudes of all relevant possible futures. (shrink)

We appreciate that all our commentators accepted the central framework we argued for, namely that the FDA has multiple roles and attendant responsibilities, and we are excited to see this framework...

Those arguing that conscientious objection in medicine should be declared unethical by professional societies face the following challenge: conscientious objection can function as an important reforming mechanism when it involves health care workers refusing to participate in certain medical interventions deemed standard of care and legally sanctioned but which undermine patients’ rights. In such cases, the argument goes, far from being unethical, conscientious objection may actually be a professional duty. I examine this sort of challenge and ultimately argue that these (...) acts of conscience done in the interest of reforming professional norms or medical regulations are best understood as episodes of civil disobedience rather than episodes of conscientious objection. In contrast to the private, exempting nature of conscientious objection, civil disobedience is a public breach of a norm or law undertaken with the aim of bringing about a change in governmental policies or professional standards. Consequently, clinicians may have a duty to engage in civil disobedience even while professional societies are right to declare limitations on the ethical appropriateness of conscientious objection. (shrink)

Many people view disabilities as misfortunes, call this the standard view. In this paper, I examine one criticism that has been launched against the Standard View. Rather than determine in advance whether having a disability is good or bad for a person, some critics argue that the Standard View is reflective of and brings about inappropriate emotional responses toward people with disabilities and their circumstances. For instance, philosophers have recently argued that in holding the standard view, we become prone to (...) a destructive kind of unwarranted pity or that the view leads us to hold certain untenable or inappropriate hopes for our children and for our society. I think this sort of challenge to the Standard View has a lot of appeal, but I worry that if it is not properly articulated, the approach is vulnerable to what has been known as “The Wrong Kind of Reason” problem. The paper highlights and addresses this worry. (shrink)

Within bioethics, two prevailing approaches structure how we think about the role of medical surrogates and the decisions that they must make on behalf of incompetent patients. One approach views the surrogate primarily as the patient's agent, obediently enacting the patient's predetermined will. The second approach views the surrogate as the patient's custodian, judging for herself how to best safeguard the patient's interests. This paper argues that both of these approaches idealize away some of the ethically relevant features of advance (...) care planning that make patient preferences so inscrutable and surrogate decision-making so burdensome. It proposes a new approach to surrogate decision-making, the Fiduciary Agency Approach. On this novel approach, the surrogate has authority to not only act on the patient's behalf as the patient's agent but also to decide on the patient's behalf as the patient's fiduciary. One upshot of this new approach is that surrogates must sometimes go against the expressed dictates of the patients' advance directives not necessarily because doing so would be in the patient's best interest but rather because doing so would best represent the patients' will. (shrink)

Alex John London’s new book, For the Common Good: Philosophical Foundations of Research Ethics highlights the fact that establishing just social arrangements is not only a matter of incentivizing popular will to act for the common good; it also requires filling in informational gaps about which policies, arrangements, and interventions will advance the basic interests of members in an equitable, effective and efficient manner. Promoting justice requires, in part, acquiring the knowledge for how to do so. In developing this point, (...) London carefully traces these missteps in the main philosophical debates and then resuscitates the importance of questions of justice at the heart of research ethics. In doing so, it provides a transformative corrective for the field. This review critically examines one of the central pillars of London’s egalitarian research imperative approach: the way in which the social value of research is closely linked with minimizing uncertainty among reasonable experts. (shrink)

This chapter explores whether it is possible to treat incompetent persons paternalistically. What is often seen to be wrong about acting paternalistically towards others is that one is treating these others as if they cannot make their own decisions about their own good. So how should one think about situations where one must make decisions on behalf of people who indeed cannot make their own decisions about their own good – especially if these people are still to some extent capable (...) of expressing their desires and concerns about what happens to them? This is often the case in the medical setting, when a patient has lost decisional capacity or has not developed such a capacity in the first place. Focusing on the medical setting, this chapter argues that insofar as someone has the component elements of agency, they can be the target of unjustified paternalism. The chapter first explores the ways in which patients may lack decisional capacity and whether such patients nevertheless retain a sense of agency that can be disrespected. It then examines whether, on some plausible accounts of paternalism, what constitutes disrespect towards the competent constitutes a similar disrespect to the agential capacities of the incompetent. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

As the age of genomic medicine has advanced rapidly, many questions pertaining to the reportability of both clinical and research findings have emerged. For example, the integration of genomic test...

The WHO recently made news by apparently advising couples in Zika affected areas to delay pregnancy. On closer inspection, however, it is not so clear what advice was actually being offered in their interim guidance regarding the prevention of the sexual transmission of Zika. In this paper, we lay out a framework for considering the ethical issues that arise in the context of advising and use it to evaluate the WHO guidance. We argue that advising is not merely an informative (...) act. The choices that agencies make in how and whom they advise are ethical choices with practical implications; these choices change not only how people ought to think about their options but also how they indeed ought to act. While we focus on these interim guidance updates from the WHO, the framework we provide can shed light more generally on the ethical issues surrounding advising in other public health contexts. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

Danielle Spencer's book, "Metagnosis: Revelatory Narratives of Health and Identity," does many things. It is a work of autotheory, putting Spencer's own embodied narrative in constant conversation with the testimony of others along with a remarkably diverse set of critical and theoretical approaches. In the book, Spencer coins a new term, "metagnosis", which occurs when one is newly diagnosed in adulthood with a lifelong condition. The book explores Spencer's own metagnostic experience involving her eyesight along with chronicling the experiences of (...) others to highlight the ways in which newfound knowledge of a diagnosis can in itself transform us.Born with strabismus—"misaligned eyes," Spencer is practiced at... (shrink)

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

AbstrctSean Aas, Dana Howard, and Leslie Francis raise compelling and interesting objections to the definition of disability I defend in The Minority Body. In this paper, I reply to these objections and elaborate on my criticisms of the disability/impairment distinction.

In this paper, I begin with a familiar puzzle about forgiveness, namely, how to distinguish forgiveness from excuse on the one hand and “letting go” on the other. After considering three recent and influential accounts of forgiveness that offer answers to this challenge among others, I develop an alternative model of forgiveness as a kind of personal release from debt or obligation. I argue that this model has a number of distinct advantages, including offering a new explanation of the subtle (...) connections between forgiveness, resentment and perspective taking, as well as helping to provide plausible answers to normative questions such as whether forgiveness is ever morally required. Finally, I draw connections between the debate about forgiveness and the debate about free will, and suggest one way in which the compatibility of forgiveness and understanding of an action’s causes can illuminate the debate about the compatibility of freedom and determinism. (shrink)

Benardete paradoxes involve infinite collections of Grim Reapers, assassins, demons, deafening peals, or even sentences. These paradoxes have recently been used in arguments for finitist metaphysical theses such as temporal finitism, causal finitism, and discrete views of time. Here we develop a new _finite_ Benardete-like paradox. We then use this paradox to defend a companions in guilt argument that challenges recent applications of patchwork principles on behalf of the aforementioned finitist arguments. Finally, we develop another problem for those applications by (...) examining the notion of exact duplication. (shrink)

To describe phenomena that occur at different time scales, computational models of the brain must incorporate different levels of abstraction. At time scales of approximately 1/3 of a second, orienting movements of the body play a crucial role in cognition and form a useful computational level embodiment level,” the constraints of the physical system determine the nature of cognitive operations. The key synergy is that at time scales of about 1/3 of a second, the natural sequentiality of body movements can (...) be matched to the natural computational economies of sequential decision systems through a system of implicit reference called deictic in which pointing movements are used to bind objects in the world to cognitive programs. This target article focuses on how deictic bindings make it possible to perform natural tasks. Deictic computation provides a mechanism for representing the essential features that link external sensory data with internal cognitive programs and motor actions. One of the central features of cognition, working memory, can be related to moment-by-moment dispositions of body features such as eye movements and hand movements. (shrink)

This essay is a response to Robert Scharff’s “Before Empirical Turns and Transcendental Inquiry: pre-philosophical Considerations”. Scharff digs beneath the empirico-transcendental debate between Ihde and Stiegler in order to critique this debate’s Cartesian presuppositions. He uses the work of Nietzsche and the early Heidegger to further his critique. There is much to like in Scharff’s rich and intricate analytic interpretation but this is also the crux of my critique. The detour into Nietzsche’s and the early Heidegger’s work is ultimately unnecessary. (...) If Scharff looks closer, he will see that Feenberg’s revised theory of instrumentalization already accomplishes the return to technical experience and the critique of Cartesian techno scientific rationality that Scharff desires. (shrink)

In this paper, I endorse the idea that age is a defensible criterion for eligibility to vote, where age is itself a proxy for having a broad set of cognitive and motivational capacities. Given the current (and defeasible) state of developmental research, I suggest that the age of 16 is a good proxy for such capacities. In defending this thesis, I consider alternative and narrower capacity conditions while drawing on insights from a parallel debate about capacities and age requirements in (...) the criminal law. I also argue that the expansive capacity condition I adopt satisfies a number of powerful and complementary rationales for voting eligibility, and conclude by addressing challenging arguments that, on the one hand, capacity should not underlie voting eligibility in the first place, and, on the other, that capacity should do so directly and not via any sort of proxy, including age. (shrink)

Published in 1982 by CUP (pb. 2009) it discusses the forms of materialism then current, including Davidson, early Rorty, but concentrating on Smart and Armstrong, and arguing that central state materialism fails to give a better 'occurrent' account of conscious states than does behaviourism/functionalism, as Armstrong claims. The book starts with a version of the 'knowledge argument' and ends with a chapter claiming that our conception of matter/the physical is more problematic than our conception of mind.

Infallibilism is the view that a belief cannot be at once warranted and false. In this essay we assess three nonpartisan arguments for infallibilism, arguments that do not depend on a prior commitment to some substantive theory of warrant. Three premises, one from each argument, are most significant: if a belief can be at once warranted and false, then the Gettier Problem cannot be solved; if a belief can be at once warranted and false, then its warrant can be transferred (...) to an accidentally true belief; if a belief can be at once warranted and false, then it can be warranted and accidentally true. We argue that each of these is either false or no more plausible than its denial. Along the way, we offer a solution to the Gettier Problem that is compatible with fallibilism. (shrink)

[This book offers] compilation of examples from TV, newspapers, magazines, advertisements, and our nation's political dialogue.

Uses cinema both to depict a variety of situations in which questions of media ethics arise, and to illustrate classic and contemporary ethical theories.

Animate vision systems have gaze control mechanisms that can actively position the camera coordinate system in response to physical stimuli. Compared to passive systems, animate systems show that visual computation can be vastly less expensive when considered in the larger context of behavior. The most important visual behavior is the ability to control the direction of gaze. This allows the use of very low resolution imaging that has a high virtual resolution. Using such a system in a controlled way provides (...) additional constraints that dramatically simplify the computations of early vision. Another important behavior is the way the environment “behaves‘. Animate systems under real-time constraints can further reduce their computational burden by using environmental cues that are perspicuous in the local context. A third source of economy is introduced when behaviors are learned. Because errors are rarely fatal, systems using learning algorithms can amortize computational cost over extended periods. Further economies can be achieved when the learning system uses indexical reference, which is a form of dynamic variable binding. Animate vision is a natural way of implementing this dynamic binding. (shrink)

For William James, work was the problem. Ultimately, going to work was the resolution, and James's quest for meaningful work remains as relevant at the end of the twentieth century as it was in the nineteenth. Weaving letters, diaries, drawings, and published texts, Becoming William James provides a convincing biographical analysis rich in detail and tone. In his new introduction, Howard M. Feinstein adds biological psychiatry to psychoanalytic and family systems theories to inform our understanding of a complex man. (...) In addition, he discusses whether James's mental illness might have been treated with drugs. (shrink)

Hannah Arendt was one of the foremost political thinkers of the twentieth century, and her particular interests have made her one of the most frequently cited thinkers of our time. This Companion examines the primary themes of her multi-faceted work, from her theory of totalitarianism and her controversial idea of the 'banality of evil' to her classic studies of political action and her final reflections on judgment and the life of the mind. Each essay examines the political, philosophical, and historical (...) concerns which shaped Arendt's thought, and which prompted her to become one of the most unapologetic champions of the political life in the history of Western thought. (shrink)

The cerebral cortex is a rich and diverse structure that is the basis of intelligent behavior. One of the deepest mysteries of the function of cortex is that neural processing times are only about one hundred times as fast as the fastest response times for complex behavior. At the very least, this would seem to indicate that the cortex does massive amounts of parallel computation.This paper explores the hypothesis that an important part of the cortex can be modeled as a (...) connectionist computer that is especially suited for parallel problem solving. The connectionist computer uses a special representation, termed value unit encoding, that represents small subsets of parameters in a way that allows parallel access to many different parameter values. This computer can be thought of as computing hierarchies of sensorimotor invariants. The neural substrate can be interpreted as a commitment to data structures and algorithms that compute invariants fast enough to explain the behavioral response times. A detailed consideration of this model has several implications for the underlying anatomy and physiology. (shrink)

There is considerable evidence that the hippocampal system contributes both to (1) the temporary maintenance of memories and to (2) the processing of a particular type of memory representation. The findings on amnesia suggest that these two distinguishing features of hippocampal memory processing are orthogonal. Together with anatomical and physiological data, the neuropsychological findings support a model of cortico-hippocampal interactions in which the temporal and representational properties of hippocampal memory processing are mediated separately. We propose that neocortical association areas maintain (...) shortterm memories for specific items and events prior to hippocampal processing as well as providing the final repositories of long-term memory. The parahippocampal region supports intermediate-term storage of individual items, and the hippocampal formation itself mediates an organization of memories according to relevant relationships among items. Hippocampal-cortical interactions produce (i) strong and persistent memories for events, including their constituent elements and the relationships among them, and (ii) a capacity to express memories flexibly across a wide range of circumstances. (shrink)

The concept of a reason is now central to many areas of contemporary philosophy. Key theses in ethics, epistemology, political philosophy, philosophy of action, and the philosophy of the emotions, among others, have come to be framed in terms of reasons. And yet, despite their centrality, theorists seem to take inconsistent things for granted about how reasons work, what kinds of things can be reasons, what reasons favor, and more. Somehow reasons have come to be both indispensable and impenetrable. -/- (...) The Fundamentals of Reasons offers a comprehensive introduction to the philosophy of reasons. Focusing on the twin roles of reasons in explanation and deliberation, the book not only emphasizes what has made reasons central across philosophy but it also explores why philosophers have such incompatible pictures about what reasons are and how they work. Working from the inside out, Howard and Schroeder identify contentious assumptions about not only the internal structure of reasons but also their relationship to other important concepts, and then show how these contentious assumptions shape the many downstream applications of reasons in ethics, epistemology, political philosophy, and beyond. -/- This mildly opinionated exploration of key questions about the significance and nature of reasons helps the reader to navigate this important part of the philosophical landscape and to get clearer about why reasons seem important and what their import, ultimately, is. (shrink)

This book is collection of published and unpublished essays on the philosophy of religion by Howard Wettstein, who is a widely respected analytic philosopher. Over the past twenty years, Wettstein has attempted to reconcile his faith with his philosophy, and he brings his personal investment in this mission to the essays collected here. Influenced by the work of George Santayana, Wittgenstein, and A.J. Heschel, Wettstein grapples with central issues in the philosophy of religion such as the relationship of religious (...) practice to religious belief, what is at stake in the debate between atheists and theists, and the place of doctrine in religion. His discussions draw from Jewish texts as well as Christianity, Islam, and classical philosophy. The challenge Wettstein undertakes throughout the volume is to maintain a philosophical naturalism while pursuing an encounter with God and traditional religion. In the Introduction to this volume, Wettstein elucidates the uniting themes among the collected essays. (shrink)

The first full-length study in English of Gassendi's life and work. I. The Man and his Work - II. Gassendi the Critic (separate chapters devoted to the Aristoteleans, Herbert of Cherbury and Descartes) - III. Gassendi the Philosopher. (Bibliotheca Humanistica & Reformatorica, Vol. XXXIV).

Since 1962 Kuhn's concept of incommensurability has undergone a process of transformation. His current account of incommensurability has little in common with his original account of it. Originally, incommensurability was a relation of methodological, observational and conceptual disparity between paradigms. Later Kuhn restricted the notion to the semantical sphere and assimilated it to the indeterminacy of translation. Recently he has developed an account of it as localized translation failure between subsets of terms employed by theories.

The paper presents a realist account of the epistemic objectivity of science. Epistemic objectivity is distinguished from ontological objectivity and the objectivity of truth. As background, T.S. Kuhn’s idea that scientific theory-choice is based on shared scientific values with a role for both objective and subjective factors is discussed. Kuhn’s values are epistemologically ungrounded, hence provide a minimal sense of objectivity. A robust account of epistemic objectivity on which methodological norms are reliable means of arriving at the truth is presented. (...) The problem remains that deliberative judgement is required to determine the relevance and relative significance of a range of methodological norms. A role is sketched for cognitive virtues which may be exercised in the course of the deliberative judgement. (shrink)

Faith in God conflicts with reason—or so we’re told. We focus on two arguments for this conclusion. After evaluating three criticisms of them, we identify an assumption they share, namely that faith in God requires belief that God exists. Whether the assumption is true depends on what faith is. We sketch a theory of faith that allows for both faith in God without belief that God exists, and faith in God while in belief-cancelling doubt God’s existence. We then argue that (...) our theory, unlike the theory of Thomas Aquinas, makes sense of four central items of faith-data: (i) pístis in the Synoptics, (ii) ʾemunāh in the Hebrew scriptures, (iii) exemplars of faith in God, including Abraham, Jesus, and Mother Teresa, and (iv) the widespread experience of people of faith today. We close by assessing revisions of the two arguments we began with, revisions that align with our theory of faith, and find them dubious, at best. (shrink)

Trust in the doctor-patient relationship is an indispensable structural element for the medical profession. The discourse concerning trust and its importance in the healthcare context, although quite old, elicits increasingly more interest in research, especially for empirical approaches. The importance of trust in the doctor and in the medical profession can be demonstrated by starting from the Christian meaning of illness and medicine ; generally, the patristic sources see medicine and physicians as God’s gifts. T he perception of Christian physicians (...) as dedicated, unselfish and compassionate preservers or restorers of health, always committed to the good of their patients is well known. The model of the Christian physician is a Hippocratic model, of one who seeks the sick so that he may bring relief to them and strengthen them. When illness occurs, Christianity affirms an ethical duty to struggle against sickness, which if unaddressed can lead to death. The moral requirement to care for the health of the body indicates it is appropriate to use healing methods that will enhance health and maintain life. The aim of this paper is to explore the dimensions of the concept of trust in the doctor-patient relationship, by starting from the Christian meaning of illness and of the role of the doctor. The paper presents a number of essential theoretical elements related to trust, as presented in the literature dealing with the doctor-patient relationship: the meaning of trust, its dimensions, its stages of development, its impact, its sources, the patient’s perspectives on trust, the importance of trust for healthcare systems. (shrink)

Socrates engages his audience in Phaedrus with speeches that include revised or newly composed myths that express his theory of philosophical eros. The aim of the speeches is to generate a love for truth that spills over into dialogue. Speeches are a starting point for dialogue, just like physical attraction is the beginning of love. In the case of Phaedrus, the beginning of philosophy is portrayed using playful and rhetorically rich speeches that serve as "love potions" awakening the novice's soul, (...) and ultimately leading Phaedrus to higher rungs on the ladder of love through the palinode, a medicinal speech. It is thinking about speeches, not the speeches themselves, which moves Socrates' student Phaedrus from the love of speeches to the love of Beauty itself. This is a stark contrast to the purpose of speechmaking for the sophist. The sophist seeks to enchant the soul, while the philosopher seeks to charm the soul into loving wisdom through stimulating discussions. Socrates also uses role reversals in the lover-beloved relationship to model the soul's ascent, contrasting the traditional roles with the way the lover and beloved are presented in Socrates' speeches. The novice must actively recollect Beauty itself in order to ascend, rather than passively listening to speeches that provide an image of beauty. Socrates' interlocutors must move themselves up the ladder of love from their own philosophical eros; wisdom is not attained by merely being pushed all the way up the ladder of love. (shrink)

In this chapter I defend a methodological view about how we should conduct substantive ethical inquiries in the fields of normative and practical ethics. I maintain that the direct plausibility and implausibility of general ethical principles – once fully clarified and understood – should be foundational in our substantive ethical reasoning. I argue that, in order to expose our ethical intuitions about particular cases to maximal critical scrutiny, we must determine whether they can be justified by directly plausible principles. To (...) expose apparently plausible principles to maximal critical scrutiny, we must determine whether their direct plausibility can survive careful clarification of what they are really saying. This means that intuitions about cases are useful only in (a) suggesting principles that must stand on their own two feet, and (b) illustrating or otherwise helping us clarify what a principle is really saying. We should not reject principles that seem most directly plausible after we have fully clarified their content simply because they conflict with our intuitions about cases, because to do so is to side with uncritical prejudices over the teachings of critical scrutiny. (shrink)