The concept of moral distress can be extended from clinical settings to larger environmental concerns affecting health care. Moral distress—a common experience in complex societies—arises when individuals have clear moral judgments about societal practices, but have difficulty in finding a venue in which to express concerns. Since health care is large in scale and climate change is proving to be a major environmental problem, scaling down health care is inevitably a necessary element for mitigating climate change. Because it is extremely (...) challenging to discuss these concerns in health care settings, those concerned about climate change and health care experience distress. This article outlines some philosophical concepts and perspectives that may be useful in mitigating this distress. (shrink)

About 1970, Van Rensselaer Potter coined the term bioethics to bring under one heading broad questions of human survival, environment, and biology. In 1971, Potter outlined a statement of principles that linked the ethics of the biological sciences with the ethics of environmental concern. Regrettably, the field that adopted his rubric bioethics immediately diverged from Potter’s interests. Bioethics has become for the most part identified with medical ethics or health care ethics and in so doing has developed few ethical principles (...) and analyses in relationship to environmental ethics. Similarly, environmental ethics seldom touches on clinical or health care issues, even though the field of environmental health has grown greatly in recent decades. It is the purpose of this article to indicate briefly some of the topics that could be treated effectively as part of a project to reconnect medical ethics and environmental ethics into what may be called sustainable bioethics. (shrink)

Professor Brooks’ paper projects an aura of inevitable catastrophe. He correctly notes that the climate is always changing and that somewhere in the near or far future there will always be somethin...

The article by Jessica Pierce and Christina Kerby, raises some important but seldom asked questions about the use of natural resources in healthcare. They take for their example latex gloves, which are in wide everyday use, especially since the establishment of principles of universal precautions in infection control as a reaction to the spread of HIV. They trace the production of latex gloves back through rubber processing to their origins in Malaysian rubber plantations and elsewhere. They then ask, but do (...) not answer, some hard questions about the ethics of our relationship as patients to the impact of the materials we use on communities and the environment. To draw out their theme more starkly, consider the rumor widespread in South America that some babies purportedly adopted by Northerners are sold and cut up for their organs. Suppose this story were true; suppose your donated organ were obtained in this way. You would probably be so revolted by the immorality of its acquisition that you would refuse to accept it. But now take a morally more ambiguous case, as Pierce and Kerby intend. Suppose that the process of obtaining latex gloves is part of the gradual erosion of the Malaysian environment, and that workers in latex factories are poorly paid. Now, should or would you refuse to use latex gloves? Should or would you even be more selective in their use? The practice of universal precautions presumes a virtually unlimited supply of gloves; yet to react to resource scarcity with selective precautions hazards discrimination. Is there any way philosophically to balance the local justice issue of discrimination in comparison to injustice on a global scale and to future generations? (shrink)

At the September 1992 Birth of Bioethics conference observing the 30th anniversary of the Seattle kidney dialysis program, Warren Reich discussed the “bilocated” birth of the term bioethics. He showed that the term bioethics was coined in Michigan by Van Rensselaer Potter and that the term was also apparently conceived of independently at about the same time in 1970–1971 in Washington, D.C., by Andre Hellegers and Sargent Shriver. Potter's work, like many similar works in the early 1970s, was concerned with (...) the growing global biological crisis of human overpopulation, the destruction of species, and how to respond to these. He prefaced his book Bioethics with a “Bioethical Creed for Individuals,” outlining duties to respond to this crisis in a meaningful and scientific way. Hellegers and Shriver used the neologism to name the new Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics. The Center was to study concerns somewhat different from Potter's: the technological revolution in healthcare and its impact on reproduction, investigator-patient relations, and medical ethics. (shrink)

In addition to good medical services, all aspects of an economy must work together to ensure a high level of public health. However, the abundant economies of the North are contributing heavily to global environmental disaster, with increasing concomitant damage to human health. Environmental health problems result from toxicity (i.e., pollution), scarcity (i.e., poverty), and energy degradation (i.e., entropy). Common to these three factors in environmental demise are the limits of the Earth. Production has evolved to a point where the (...) Earth is no longer safe from radical depletion. Therefore, simple living is a necessary feature of global public health. Rarely do readers of this journal see these limits first hand, but they are real. Our limited perceptions and efforts hinder our ability to understand how to reduce the impact of production on natural ecosystems. Contrary to standard media portrayals, growth and technology cannot solve our public health problems, because they are unequally distributed across the world and neither can they solve the problem of limits. The need for modest consumption in developed nations is an essential and almost completely ignored element of the answer to environmental and associated health problems. A radical and rapid change to public health is needed in order to avoid abysmal global health consequences during the next century. These changes involve a restructuring of our economy, including the health care industry. In the short run, this is an ethical demand. In the long run, this is an inevitability. The actual and appropriate role of bioethicists in championing these changes is unclear. (Abstract by Bruce R. Smith). (shrink)

There have been recurrent reports of fragilities in the Brazilian health system, especially in public institutions. In this commentary, I argue that moral distress in nursing in Brazil can still be considered an innovative and important subject of study. I also highlight the relevance of engaging educational institutions in the development of policies about environmental sustainability. It is relevant to continue studying moral distress in nursing and in health care generally in order to contribute to the transformation of reality by (...) confronting the multiple common situations in the work environment that are recognized by many as morally problematic because they infringe upon the rights of people, patients, and health care professionals and are an affront to environmental health. (shrink)

Resenha do livro The Ethics of Environmentally Responsible Health Care.

Quão próxima está a ética do cuidado com a saúde da ética da responsabilidade ambiental? Enxergamos os problemas ambientais e também os problemas de saúde das pessoas, mas conseguimos ver realmente uma ligação entre eles?

This paper examines the idea of objective phenomenology, or a way of understanding the phenomenal character of conscious experiences that doesn’t require one to have had the kinds of experiences under consideration. My central thesis is that structural facts about experience—facts that characterize purely how conscious experiences are structured—are objective phenomenal facts. I begin by precisifying the idea of objective phenomenology and diagnosing what makes any given phenomenal fact subjective. Then I defend the view that structural facts about experience are (...) objective. I also argue that structural facts about experience, despite being objective, nevertheless still give rise to an explanatory gap. (shrink)

Perception is riddled with cases of reliable misperception. These are cases in which a perceptual state is tokened inaccurately any time it is tokened under normal conditions. On the face of it, this fact causes trouble for theories that provide an analysis of perceptual content in non-semantic, non-intentional, and non-phenomenal terms, such as those found in Millikan (1984), Fodor (1990), Neander (2017), and Schellenberg (2018). I show how such theories can be extended so that they cover such cases without giving (...) up their core commitments. (shrink)

Some accounts of moral responsibility hold that an agent's responsibility is completely determined by some aspect of the agent's mental life at the time of action. For example, some hold that an agent is responsible if and only if there is an appropriate mesh among the agent's particular psychological elements. It is often objected that the particular features of the agent's mental life to which these theorists appeal (such as a particular structure or mesh) are not necessary for responsibility. This (...) is because there appear to be cases in which an agent acts at an earlier time which causes her to lack the appropriate psychological features at some later time and yet, intuitively, she is responsible at that later .. (shrink)

We are all familiar with the phenomenon of a proposition seeming true. Many think that these seeming states can yield justified beliefs. Very few have seriously explored what these seeming states are. I argue that seeming states are not plausibly analyzed in terms of beliefs, partial beliefs, attractions to believe, or inclinations to believe. Given that the main candidates for analyzing seeming states are unsatisfactory, I argue for a brute view of seemings that treats seeming states as irreducible propositional attitudes.

This is a discussion of the state of discussion on pragmatic reasons for belief.

This book brings together an international group of scholars to discuss the ramifications of Heidegger's Black Notebooks for philosophy and the humanities. In contrast to both those who seek to exonerate Heidegger and those who simply condemn him, they urge careful reading and rereading of his work to turn Heideggerian thought against itself.

For Kant, knowledge involves certainty. If “certainty” requires that the grounds for a given propositional attitude guarantee its truth, then this is an infallibilist view of epistemic justification. Such a view says you can’t have epistemic justification for an attitude unless the attitude is also true. Here I want to defend an alternative fallibilist interpretation. Even if a subject has grounds that would be sufficient for knowledge if the proposition were true, the proposition might not be true. And so there (...) is sometimes still rational room for doubt. The goal of this paper is to present four different models of what “certainty” amounts to, for Kant, each of which is compatible with fallibilism. (shrink)

While many aspects of cognition have been shown to be shared between humans and non-human animals, there remains controversy regarding whether the capacity to mentally time travel is a uniquely human one. In this paper, we argue that there are four ways of representing when some event happened: four kinds of temporal representation. Distinguishing these four kinds of temporal representation has five benefits. First, it puts us in a position to determine the particular benefits these distinct temporal representations afford an (...) organism. Second, it provides the conceptual resources to foster a discussion about which of these representations is necessary for an organism to count as having the capacity to mentally time travel. Third, it enables us to distinguish stricter from more liberal views of mental time travel that differ regarding which kind(s) of temporal representation is taken to be necessary for mental time travel. Fourth, it allows us to determine the benefits of taking a stricter or more liberal view of mental time travel. Finally, it ensures that disagreement about whether some species can mentally time travel is not merely the product of unrecognised disagreement about which temporal representation is necessary for mental time travel. We argue for a more liberal view, on the grounds that it allows us to view mental time travel as an evolutionarily continuous phenomenon, and to recognise that differences in the ways that organisms mentally time travel might reflect different temporal representations, or combinations thereof, that they employ. Our ultimate aim, however, is to create the conceptual framework for further discussion regarding what sorts of temporal representations are required for mental time travel. (shrink)

The aim of the Analytic of Concepts is to derive and deduce a set of pure concepts of the understanding, the categories, which play a central role in Kant’s explanation of the possibility of synthetic a priori cognition and judgment. This chapter is structured around two questions. First, what is a pure concept of the understanding? Second, what is involved in a deduction of a pure concept of the understanding? In answering the first, we focus on how the categories differ (...) from the pure forms of sensibility and examine whether they are known only to be the pure forms of human thinking or rather the forms of discursive cognition as such. In answering the second, we draw a distinction between the application and the exemplification of the categories and use it to identify different ways of understanding Kant’s project in the Transcendental Deduction of the Categories. These questions connect because the answer to the first determines how we should understand the kind of entitlement which is to be established in the Deduction. (shrink)

This chapter addresses an ambiguity in some of the literature on rational peer disagreement about the use of the term 'rational'. In the literature 'rational' is used to describe a variety of normative statuses related to reasons, justification, and reasoning. This chapter focuses most closely on the upshot of peer disagreement for what is rationally required of parties to a peer disagreement. This follows recent work in theoretical reason which treats rationality as a system of requirements among an agent's mental (...) states. It is argued that peer disagreement has either no, or a very limited, affect on what rationality requires of an agent in a given circumstance. This is in part because of difficulties generated by a novel example of evidence of evidence of p being evidence against p. This example calls into question the mechanisms whereby peer disagreement might affect what is rationally required of an agent. The chapter also reevaluates the importance of actual peer disagreement against the backdrop of prior expectations about whether disagreement is believed to be likely, arguing that peer disagreement is most likely to change what is rationally required of an agent when it is believed to be unlikely. (shrink)

This is a critical, but sympathetic, examination of the manifesto for naturalized metaphysics that forms the first chapter of James Ladyman and Don Ross's 2006 book, Every Thing Must Go, but it has wider implications than this description suggests.

The norm of monogamy is pervasive, having remained widespread, in most Western cultures at least, in spite of increasing tolerance toward more diverse relationship types. It is also puzzling. People willingly, and often with gusto, adhere to it, yet it is also, prima facie at least, highly restrictive. Being in a monogamous relationship means agreeing to give up certain sorts of valuable interactions and relationships with other people and to severely restrict one’s opportunities for sex and love. It is this (...) restrictiveness which has led for calls among some philosophers for the justification of the norm, and some have argued that it cannot be justified. John McMurtry, for example, writing in 1972, compared monogamy to private property and argued that it serves the capitalist order (McMurtry 1972, 596–97). More recently, Harry Chalmers (2019) has argued that monogamy is morally impermissible. In this chapter we argue that rather than justify the norm, we ought to explain and understand its pervasiveness. Not everyone who follows the norm is doing so blindly, irrationally, or immorally. Indeed, many people are monogamous because being monogamous supports their needs and best enables them to flourish. We suggest that the human need for trust and attachment could underlie many people’s desires for monogamy and, therefore, explain monogamy’s pervasiveness. Focusing on the human need for trust and attachment security can also help us to understand why sexual infidelity can feel like such a betrayal. It can make sense to mutually agree to exclusivity in relationships, in spite of the apparent restrictions this brings. In a sense, not all restrictions are restrictive, because holding ourselves to limits on our behavior can in fact help us to invest in and experience the things we value most. (shrink)

European Journal of Philosophy, EarlyView.

To be conscious—according to a common metaphor—is for the “lights to be on inside.” Is this a good metaphor? I argue that the metaphor elicits useful intuitions while staying neutral on controversial philosophical questions. But I also argue that there are two ways of interpreting the metaphor. Is consciousness the inner light itself? Or is consciousness the illuminated room? Call the first sense subjectivity (where ‘consciousness’ =def what makes an entity feel some way at all), and the second sense phenomenal (...) character (where ‘consciousness’ =def what it feels like to be an entity). I use this distinction—as well as the metaphor of the inner light—to clarify some philosophical questions about whether consciousness comes in degrees, whether consciousness is multidimensional, and whether there are borderline cases of consciousness. (shrink)

I argue that the following theses are both popular among evidentialists but also jointly inconsistent with evidentialism: 1) Time-Slice Mentalism: one’s justificational properties at t are grounded only by one’s mental properties at t; 2) Experience Ultimacy: all ultimate evidence is experiential; and 3) Sleep Justification: we have justified beliefs while we have dreamless, nonexperiential sleep. Although I intend for this paper to be a polemic against evidentialists, it can also be viewed as an opportunity for them to clarify their (...) views. Furthermore, the paper is not only relevant to evidentialists. For example, the arguments of this paper could give Time-Slice Mentalists a reason to deny evidentialism. (shrink)

The Stoics are traditionally regarded as the founders of propositional logic. However, this is not entirely correct. They developed a theory of inference from signs (omens). And their theory became a continuation of the logical technique of Babylonian divination (in particular, of Babylonian medical forecasting). The Stoic theory was not so much propositional logic as it was a technique of propositional logic for databases consisting of IF-THEN expert rules. In the Babylonian divination, each event has a positive or negative value (...) and all events are connected to each other. The Stoics also developed this idea and proposed a special modal logic in which logical determinism is considered an axiom. The paper reconstructs the sign-inference of the Stoics, as well as their modal logic. In particular, two Stoic squares of oppositions are proposed (for signs and for modal operators), which differ markedly from Aristotle’s square. (shrink)

Let a smooth experience be an experience with perfectly gradual changes in phenomenal character. Consider, as examples, your visual experience of a blue sky or your auditory experience of a rising pitch. Do the phenomenal characters of smooth experiences have continuous or discrete structures? If we appeal merely to introspection, then it may seem that we should think that smooth experiences are continuous. This paper (1) uses formal tools to clarify what it means to say that an experience is continuous (...) or discrete, and (2) develops a discrete model of the phenomenal characters of smooth experiences. As a result, I'll argue that introspection leaves open whether smooth experiences are continuous or discrete. Yet I’ll also argue—perhaps surprisingly—that the discrete theory may better fit our introspective evidence. (shrink)

Source [1] Andrew E. P. Mitchell, Federica Galli, Sondra Butterworth. (2023). Editorial: Equality, diversity and inclusive research for diverse rare disease communities. Front. Psychol., vol. 14. doi:10.3389/fpsyg.2023.1285774. "It is also important to recognize that certain mental health disorders are classified as rare conditions and have their own cultural concepts of distress, as defined in the DSM-5 (American Psychiatric Association, 2013)" and require “equal attention and support for individuals and their families, both physically and emotionally”. [1].

The greater good -- The intellectual and the existential -- The problem of evil and the problem of the slightest toothache -- The God of love -- Is God an agent? -- The real God.

Can war be justified? Pacifists answer that it cannot; they oppose war and advocate for nonviolent alternatives to war. But defenders of just war theory argue that in some circumstances, when the effectiveness of nonviolence is limited, wars can be justified. -/- In this book, two philosophers debate this question, drawing on contemporary scholarship and new developments in thinking about pacifism and just war theory. Andrew Fiala defends the pacifist position, while Jennifer Kling defends just war traditions. Fiala argues (...) that pacifism follows from the awful reality of war and the nonviolent goal of building a more just and peaceful world. Kling argues that war is sometimes justified when it is a last-ditch, necessary effort to defend people and their communities from utter destruction and death. Pulling from global traditions and histories, their debate will captivate anyone who has wondered or worried about the morality of political violence and military force. Topics discussed include ethical questions of self-defense and other-defense, the great analogy between individuals and states, evolving technologies and methods of warfighting, moral injury and post-traumatic stress disorder, broader political and communal issues, and the problem of regional security in a globalizing world. The authors consider cultural and religious issues as well as the fundamental question of moral obligation in a world saturated in military conflict. The book was written in the aftermath of the war on terrorism and includes reflection on lessons learned from the past decades of war, as well as hopes for the future in light of emerging threats in Europe and elsewhere. -/- The book is organized in a user-friendly fashion. Each author presents a self-contained argument, which is followed by a series of responses, replies, and counter-arguments. Throughout, the authors model civil discourse by emphasizing points of agreement and remaining areas of disagreement. The book includes reader-friendly summaries, a glossary of key concepts, and suggestions for further study. All of this will help students and scholars follow the authors’ dialogue so they may develop their own answer to the question of whether war can be justified. (shrink)

The official definitions that appear at the beginning of four of the five parts of the "Ethics" do not include an account of "existence." However Spinoza does provide a definition of “existence” in the scholium to proposition 45 of Part 2. This is an odd place for such an important doctrine, and all the more so given that the account there differs from anything resembling commonsense. In this paper I show that, for Spinoza, to exist is to be eternal. Existence (...) in the strict sense is eternal existence. (shrink)

The philosophical tradition has given rise to many competing moral theories. Virtue ethics encourages the flourishing of the person, theories of justice and rights tell us to act according to principles, and consequentialist theories advise that we seek to bring about good ends. These varied theories highlight the morally relevant features of the problems that we encounter both in everyday personal interactions and on a broader social scale. When used together, they allow us to address moral conflicts by balancing a (...) plurality of reasons in order to reach nuanced ethical decisions. In _Ethical Reasoning: Theory and Application_, Andrew Kernohan guides the reader through the basics of these moral theories, showing their strengths and weaknesses and emphasizing the ways in which competing moral reasons can be collectively employed to guide decision-making. Throughout, the focus is on practical applications and on how each theory can play a role in solving problems and addressing issues. Numerous questions and exercises are provided to encourage active reflection and retention of information. (shrink)

The mystery of Aquinas's virtue ethics -- The gifts as second-personal dispositions -- Virtues and the second-person perspective -- The fruition of the virtues and gifts -- Conclusions and implications.