BackgroundNo standard method exists to assess how many consults a healthcare ethics consultation (HCEC) service should perform. To address this, we developed a method to estimate the volume of HCEC services based on a mixed-methods approach that included a systematic review and survey data on the volume of consult services requested.MethodsOur investigation included a systematic review of studies that reported the volume of HCEC services that were requested from 2000 to 2017, institutional surveys, and statistical analyses that estimated the volume (...) of HCEC services that were adjusted to the size of the hospitals in the survey and to population acuity.ResultsWe contacted the authors of 19 studies that met our inclusion criteria; 17 authors responded to the institutional survey and five provided annualized data points. We found that standard methods of reporting the volume of HCEC services led to inaccuracies in estimating the growth of HCEC services over time. To rectify this, we proposed two means to estimate volume based on either the service goals of HCEC services or hospital size and acuity.DiscussionThe statistical limitations of our study highlight the need to standardize the sharing and reporting of data in clinical ethics. Future work should further standardize methods of HCEC quality assessment using measures similar to those we describe. (shrink)

The field of health care ethics continues to grow as the ethics structures in health care organizations become well established. While the literature is saturated with reports on clinical ethics consultation services, very little is known about the development and success of ethics programs. The following describes the development and growth of an ethics program at the largest health care provider in Georgia. With a focus on nine key components of an ethics program, the paper reviews what one system did (...) on its path to a flourishing program and what others can learn from it. (shrink)

Achieving valid informed consent from a human research participant involves an ongoing process designed to protect the participant and ensure their rights, safety, and well-being are not compromise...

Volume 20, Issue 7, July 2020, Page 193-195.

Understanding how research participants, and by extension, the wider community, perceive and evaluate the risks of research interventions is of paramount importance. The current study (Dawson et al...

Volume 20, Issue 2, February 2020, Page 62-64.

Incapacitated and surrogateless patients are an ever-growing trend in the world of health care. Although the extent of the issue is unknown, 1 out 20 deaths in the intensive care unit (ICU) occurre...

Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of (...) organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics’ professionalization: while some variability is appropriate to the field’s relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners. (shrink)

In this paper, I respond to recent attempts by philosophers to deny the existence of something that is both real and significant: reasonable disagreements between epistemic peers. In their arguments against the possibility of such disagreements, skeptical philosophers typically invoke one or more of the following: indifference reasoning , equal weight principles , and uniqueness theses . I take up each of these in turn, finding ample reason to resist them. The arguments for indifference reasoning and equal weight principles tend (...) to overlook the possibility of a certain kind of agnostic credal state which I call deep agnosticism , the possibility of which derails the arguments. The arguments for uniqueness theses tend to invoke a flawed understanding of the evidential support relation. When these problems and misunderstandings are brought into the light and corrected, the threat to reasonable disagreement vanishes. (shrink)

This article examines two questions about scientists’ search for knowledge. First, which search strategies generate discoveries effectively? Second, is it advantageous to diversify search strategies? We argue pace Weisberg and Muldoon, “Epistemic Landscapes and the Division of Cognitive Labor”, that, on the first question, a search strategy that deliberately seeks novel research approaches need not be optimal. On the second question, we argue they have not shown epistemic reasons exist for the division of cognitive labor, identifying the errors that led (...) to their conclusions. Furthermore, we generalize the epistemic landscape model, showing that one should be skeptical about the benefits of social learning in epistemically complex environments. (shrink)

After a brief overview of what intellectual virtues are, I offer three arguments for the claim that education should aim at fostering ‘intellectual character virtues’ like curiosity, open-mindedness, intellectual courage, and intellectual honesty. I then go on to discuss several pedagogical and related strategies for achieving this aim.

We review recent anticipatory looking and violation-of-expectancy studies suggesting that infants and young preschoolers have spontaneous (implicit) understanding of mind despite their known problems until later in life on elicited (explicit) tests of false-belief reasoning. Straightforwardly differentiating spontaneous and elicited expressions of complex mental state understanding in relation to an implicit-explicit knowledge framework may be challenging; early action predictions may be based on behavior rules that are complementary to the mentalistic attributions under consideration. We discuss that the way forward for (...) diagnosing early mentalism is to analyze whether young candidate mind-readers’ visual orienting cohere across different belief-formation by belief-use combinations. Adopting this formal cognitive analysis, we conclude that whilst some studies come tantalizingly close to sign-posting mentalism in infants and young children’s spontaneous responses, the bulk of evidence for early mentalism grades into behaviorism. (shrink)

Problem one: why, if God designed the human mind, did it take so long for humans to develop theistic concepts and beliefs? Problem two: why would God use evolution to design the living world when the discovery of evolution would predictably contribute to so much nonbelief in God? Darwin was aware of such questions but failed to see their evidential significance for theism. This paper explores this significance. Problem one introduces something I call natural nonbelief, which is significant because it (...) parallels and corroborates well-known worries about natural evil. Problems one and two, especially when combined, support naturalism over theism, intensify the problem of divine hiddenness, challenge Alvin Plantinga’s views about the naturalness of theism, and advance the discussion about whether the conflict between science and religion is genuine or superficial. (shrink)

Sarah Moss argues that degrees of belief, or credences, can amount to knowledge in much the way that full beliefs can. This essay explores a new kind of objective Bayesianism designed to take us some way toward securing such knowledge-constituting credences, or "probabilistic knowledge." Whatever else it takes for an agent's credences to amount to knowledge, their success, or accuracy, must be the product of _cognitive ability_ or _skill_. The brand of Bayesianism developed here helps ensure this ability condition is (...) satisfied. Cognitive ability, in turn, helps make credences valuable in other ways: it helps mitigate their dependence on epistemic luck, for example. What we end up with, at the end of the day, are credences that are particularly good candidates for constituting probabilistic knowledge. What's more, examining the character of these credences teaches us something important about what the pursuit of probabilistic knowledge demands from us. It does _not_ demand that we give hypotheses equal _treatment_, by affording them equal credence. Rather, it demands that we give them equal _consideration_, by affording them an equal chance of being discovered. (shrink)

Open-mindedness enjoys widespread recognition as an intellectual virtue. This is evident, among other ways, in its appearance on nearly every list of intellectual virtues in the virtue epistemology literature.1 Despite its popularity, however, it is far from clear what exactly open-mindedness amounts to: that is, what sort of intellectual orientation or activity is essential to it. In fact, there are ways of thinking about open-mindedness that cast serious doubt on its status as an intellectual virtue. Consider the following description, from (...) Robert Roberts and Jay Wood (2007), of a ‘bright college freshman, taking an introductory course in philosophy.’ Given this student’s ‘taste for ideas,’ she .. (shrink)

Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly considering (...) whether a version of the reason-giving requirement can be salvaged despite this important difficulty. (shrink)

This paper examines the claim made by certain virtue epistemologists that intellectual character virtues like fair-mindedness, open-mindedness and intellectual courage merit an important and fundamental role in epistemology. I begin by considering whether these traits merit an important role in the analysis of knowledge. I argue that they do not and that in fact they are unlikely to be of much relevance to any of the traditional problems in epistemology. This presents a serious challenge for virtue epistemology. I go on (...) to examine the work of two other virtue epistemologists in light of this challenge and then sketch an alternative approach that reveals how the intellectual virtues might merit a substantial role in epistemology even if not a role in connection with more traditional epistemological projects. (shrink)

Open-mindedness enjoys widespread recognition as an intellectual virtue. This is evident, among other ways, in its appearance on nearly every list of intellectual virtues in the virtue epistemology literature. Despite its popularity, however, it is far from clear what exactly openmindedness amounts to: that is, what sort of intellectual orientation or activity is essential to it. In fact, there are ways of thinking about open-mindedness that cast serious doubt on its status as an intellectual virtue.Consider the following description, from Robert (...) Roberts and Jay Wood (2007), of a ‘bright college freshman, taking an introductory course in philosophy.’. (shrink)

Many epistemologists treat knowledge as a binary relation that holds between a subject and a proposition. The contrastive account of knowledge developed by Jonathan Schaffer maintains that knowledge is a ternary, contrastive relation that holds between a subject, a proposition, and a set of contextually salient alternative propositions the subject’s evidence must eliminate. For the contrastivist, it is never simply the case that S knows that p; in every case of knowledge S knows that p rather than q. This paper (...) offers a counterexample to the contrastive account of knowledge. Part 1 summarizes the contrastive theory developed by Schaffer in a series of recent papers. Part 2 presents an example from a class of cases characterized by compatibility between the proposition p and each of the alternative propositions that occupy q. In such cases the alternative propositions that partially constitute the ternary contrastive relation play no role in the acquisition of knowledge. Part 3 considers and rejects potential responses to the counterexample. The paper concludes that the contrastive theory is not a general account of knowledge. (shrink)

Amodel for inventing newsignals is introduced in the context of sender–receiver games with reinforcement learning. If the invention parameter is set to zero, it reduces to basic Roth–Erev learning applied to acts rather than strategies, as in Argiento et al. (Stoch. Process. Appl. 119:373–390, 2009). If every act is uniformly reinforced in every state it reduces to the Chinese Restaurant Process—also known as the Hoppe–Pólya urn—applied to each act. The dynamics can move players from one signaling game to another during (...) the learning process. Invention helps agents avoid pooling and partial pooling equilibria. (shrink)

Evidentialists maintain that epistemic justification is strictly a function of the evidence one has at the moment of belief. I argue here, on the basis of two kinds of cases, that the possession of good evidence is an insuflicient basis for justification. I go on to propose a modification of evidentialism according to which justification sometimes requires intellectually virtuous agency. The discussion thereby underscores an important point of contact between evidentialism and the more recent enterprise of virtue epistemology.

Anti-racist education within the Academy holds the potential to truly reflect the cultural hybridity of our diverse, multi-cultural society through the canons of knowledge that educators celebrate, proffer and embody. The centrality of Whiteness as an instrument of power and privilege ensures that particular types of knowledge continue to remain omitted from our curriculums. The monopoly and proliferation of dominant White European canons does comprise much of our existing curriculum; consequently, this does impact on aspects of engagement, inclusivity and belonging (...) particularly for Black, Asian and Minority Ethnic (BAME) learners. This paper explores the impact of a dominant Eurocentric curriculum and the Decolonising the Curriculum agenda within higher education and its influence upon navigating factors such as BAME attainment, engagement and belonging within the Academy. This paper draws on a Critical Race Theory (CRT) theoretical framework to centralize the marginalized voices of fifteen BAME students and three academics of colour regarding this phenomena. Aspects examined consider the impact of a narrow and restrictive curriculum on BAME students and staff and how the omission of diverse histories and multi-cultural knowledge canons facilitates marginalization and discriminatory cultures. (shrink)

The concept of wisdom is largely ignored by contemporary philosophers. But given recent movements in the fields of ethics and epistemology, the time is ripe for a return to this concept. This article lays some groundwork for further philosophical work in ethics and epistemology on wisdom. Its focus is the distinction between practical wisdom and theoretical wisdom or between phronesis and sophia . Several accounts of this distinction are considered and rejected. A more plausible, but also considerably more complex, account (...) is offered. The discussion sheds light on the relation between practical wisdom and theoretical wisdom, and on the positive character of each. (shrink)

This chapter seeks clarification into how Marion understands “desire,” especially in The Erotic Phenomenon. Philosophies of “objectivity” have lost sight of love and its uniquely supporting evidences, and desire plays a number of roles in restoring to love the “dignity of a concept,” in its contribution to forming selfhood and “individualization,” and in its establishing the paradoxical bases of the erotic reduction and “eroticization.” Since he claims in La Rigueur des Choses that “The Erotic Phenomenon logically completes the phenomenology of (...) the gift and the saturated phenomenon,” it is necessary to conceive of how and to what degree. The erotic reduction demands that one bracket oneself and return to the Ursprung of intuition by asking the important question “can I be the first to love?” This chapter initiates an application of these findings on the manifold of desire back onto Marion’s understanding of “the gift” and his phenomenology of givenness. How might the erotic reduction and the reduction to givenness interrelate? Might love and desire be modes or “capacities” of alteration of one’s experience within intuition? Desire, which is conceived in relation to “lack” as a resource, provides a kind of “negative assurance” that allows the adonné to access an affirmation of love. (shrink)

With the proliferation of private standards many significant decisions regarding public health risks, food safety, and environmental impacts are increasingly taking place in the backstage of the global agro-food system. Using an analytical framework grounded in political economy, we explain the rise of private standards and specific actors – notably supermarkets – in the restructuring of agro-food networks. We argue that the global, political-economic, capitalist transformation – globalization – is a transition from a Fordist regime to a regime of flexible (...) accumulation (Harvey, 1989). We also argue that the standard making process of this new regulatory regime is increasingly moving from the front stage – where it is open to public debate and democratic decision-making bodies – to the backstage – where it is dominated by large supermarket procurement offices. We assert that transnational supermarket chains are increasingly controlling what food is grown where, how, and by whom. We also contend that the decision-making processes of transnational supermarket chains are typically “black-boxed.” The Euro-Retailer Produce Working Group (EUREP) is presented as a case of private governance by transnational supermarket chains. We conclude by examining the limitations and long-term efficacy of a system of private governance in the global agro-food system. (shrink)

One alleged advantage of credit theories of knowledge is that they are capable of explaining why knowledge is essentially more valuable than mere true belief. I argue that credit theories in fact provide grounds for denying this claim and therefore are incapable of overcoming the ‘value problem’ in epistemology. Much of the discussion revolves around the question of whether true belief is always epistemically valuable. I also consider to what extent, if any, my main argument should worry credit theorists.

This chapter contains sections titled: Malevolence Proper An Epistemic Counterpart of Malevolence Epistemic Malevolence and Intellectual Vice Acknowledgments References.

In his article entitled 'Divine hiddenness and the demographics of theism' ("Religious Studies", 42 (2006), 177–191), Stephen Maitzen draws our attention to an important feature that is often overlooked in discussion about the argument from divine hiddenness (ADH). His claim is that an uneven distribution of theistic belief (and not just the mere existence of non-belief) provides an atheological challenge that cannot likely be overcome. After describing what I take to be the most pressing feature of the problem, I argue (...) that a hidden premise causes Maitzen to overlook a Molinist solution. The upshot is a softening of the atheological import of the demographic data. (shrink)

There are a plethora of issues within higher education which continually reinforce aspects of inequality and discrimination. These particular issues are aligned to institutionally racist struc...

I elaborate and critically evaluate the theses of "environmental pragmatism," especially as captured in a recent collection with that title. While I am hopeful about this new approach, I want nonetheless to make reparations for its shortcomings. The primary difficulty is that environmental pragmatists tend to express only implicitly the metaphysical commitments of, say, William James, and yet the claims of environmental pragmatism would be profoundly strengthened by direct appeal to James's metaphysics. The ecosystem approach is particularly amenable to characterization (...) in terms of pragmatic metaphysics. Thus, I offer the thesis of wild ontology in an effort to enrich the empirical basis of environmental philosophy, and also to help cure environmental ethics of its political impotence. (shrink)

After a brief overview of what intellectual virtues are, I offer three arguments for the claim that education should aim at fostering ‘intellectual character virtues’ like curiosity, open‐mindedness, intellectual courage, and intellectual honesty. I then go on to discuss several pedagogical and related strategies for achieving this aim.

In addressing bioethical issues at the beginning of human life, such as abortion, human embryonic stem cell research, and therapeutic cloning, a primary concern is to establish when a developing human embryo or fetus can be considered a “person”; for it is typically held that only persons are the subjects of moral rights, such as a “right to life.” The 13th century philosopher and theologian Thomas Aquinas defines a person as “an individual substance of a rational nature” (ST Ia.29.1); he (...) further asserts that all human beings are persons (ST Ia.16.12 ad 1), but that an embryo or fetus is not a human being until its body is informed by a “rational soul.” Aquinas’s account of human embryogenesis has been generally rejected today due to its dependence upon medieval biological information. A number of scholars, however, have attempted to combine Aquinas’s basic metaphysical account of human nature with current embryological data to develop a contemporary Thomistic account of a human being’s beginning. (shrink)

It is well understood that the analysis of elliptical phenomena has the potential to inform our understanding of the syntax-semantics interface, as it forces the analyst to confront directly the mechanisms for generating meanings without the usual forms that give rise to them. But facts from ellipsis have an equal potential to illuminate our understanding of the structure of the lexicon. A close investigation of nominal ellipses in Greek shows that gender features are not all created equal: the values of (...) some gender features (masculine, feminine) on some nominals must be distinguished from the very same values as they are encoded on other nouns. This conclusion is forced upon us by the following generalization: (1) Gender and ellipsis generalization: When gender is variable (as on determiners, clitics, adjectives, and some nominals under certain conditions), it may be ignored under ellipsis. When gender is invariant (on nouns in argument positions, and on some nominals in predicative uses), it may not be ignored under ellipsis. I argue that this generalization finds a relatively straightforward account in a derivational framework using an LF-copy theory of ellipsis identity and resolution, but not under semantic or LF-identity accounts (whether these latter are.. (shrink)

According to one prominent account of intellectual humility, it consists primarily of a disposition to “own” one’s intellectual limitations. This account has been criticized for neglecting the _interpersonal _dimensions of intellectual humility. We expect intellectually humble persons to be respectful and generous with their interlocutors and to avoid being haughty or domineering. I defend the limitations-owning account against this objection. I do so in two ways: first, by arguing that some of the interpersonal qualities associated with intellectual humility are qualities (...) expressive of virtues _other_ than intellectual humility; and second, by arguing that, when properly described, the kind of limitations-owning characteristic of intellectual humility in fact is robustly interpersonal. The result is a considerably broader and richer notion of the limitations the owning of which is characteristic of intellectual humility. (shrink)

A course in symbolic logic belongs as a requirement in the undergraduate philosophy major. In this paper, which started life as a letter to my departmental colleagues, I consider and respond to several reasons one might have for excluding Logic from the core requirements. I then give several arguments in favor of keeping Logic. The central—and most important—argument is that the lack of a proper background in logic makes it very difficult to approach many relatively straightforward philosophical arguments, let alone (...) the more technical subliteratures of philosophy. In developing this argument, I consider a few core texts and arguments (e.g., Gettier’s classic paper on the analysis of knowledge) and bring out how a student with some background in formal logic would be able to approach the texts and arguments with much greater ease than a student who lacks such a background. (shrink)

Abstract Conventional wisdom holds that the rigors of fiscal competition unleashed by globalization are forcing governments to roll back welfare programs, reduce or eliminate taxes on capital, and reduce regulation on mobile assets. In Freer Markets, More Rules, Steven Vogel attacks the latter contention, arguing that regulatory reform has been more often reregulatory than deregulatory, though it is generally undertaken with an eye to increasing market competition. He also maintains that governments have acted autonomously of social interests and market pressures (...) in formulating regulatory reform. While Vogel is mistaken to contend that there has been no net reduction of government control worldwide, his revision of the conventional wisdom requires a fresh look at how susceptible states really are to the global competition for revenue. (shrink)

This work examines the impoverished image of life presupposed by the legacy of transcendent and representational thinking that continues to frame the limits of curricular thought. Analyzing the ways in which modern institutions colonize desire and overdetermine the life of its subject, this book draws upon the anti- Oedipal philosophy of Gilles Deleuze, revolutionary artistic practice, and an unorthodox curriculum genealogy to rethink the pedagogical project as a task of concept creation for the liberation of life and instantiation of a (...) people yet to come . This book invites academics, artists, and graduate students to engage the contemporary struggles of curriculum theory, educational philosophy, and pedagogical practice with a new set of conceptual tools for thinking radical difference. (shrink)

Drug companies are moving their research from academic medical centers to physicians’ private offices. The shift brings in more subjects, and could mean faster and better results. It also changes the physician's relationship to patients, dangles monetary lures in front of physicians, and could produce subjects who don't understand what they're participating in and results that are unreliable.

Although Eugen Fink often reflected upon the role religion, these reflections are yet to be addressed in secondary literature in any substantive sense. For Fink, religion is to be understood in relation to “play,” which is a metaphor for how the world presents itself. Religion is a non-repetitive, and entirely creative endeavor or “symbol” that is not achieved through work and toil, or through evaluation or power, but rather, through his idea of play and “cult” as the imaginative distanciation from (...) a predictable lifeworld. This paper describes Fink’s understanding of religion and its most relevant aspects found in Spiel als Weltsymbol. The paper is organized into five sections—1: An introduction to his phenomenological approach in general, and description of the role of “play”; 2: investigations into the relation between play and world; 3: a description of his phenomenology of religion; 4: engagements in the idea of cult-play and the sacred sphere, and 5: reflection on his idea of the play of God. (shrink)

Rawls’ theory of justice is paradoxical, for it requires a society to aim directly to maximize the basic goods received by the least advantaged even if directly aiming is self-defeating. Rawls’ reasons for rejecting capitalist systems commit him to holding that a society must not merely maximize the goods received by the least advantaged, but must do so via specific institutions. By Rawls’ own premises, in the long run directly aiming to satisfy the difference principle is contrary to the interests (...) of the poor, though it is meant to aid them. -/- . (shrink)

This article argues that because racial inequalities are embedded in American society, as well as in medicine, more evidence-based investigation of the effects and implications of affirmative action is needed. Residency training programs should also seek ways to recruit medical students from underrepresented groups and to create effective mentorship programs.

This special issue has emerged out of the continuing concern for discriminatory tensions situated within the context of race, education, and social mobility. The institutionally racist structures w...