Building Better Health Care Leadership for Canada explains the development and implementation of the Executive Training in Research Application program. Managed and funded by the Canadian Health Services Research Foundation in partnership with the Canadian Medical Association, the Canadian Nursing Association, and the Canadian College of Health Care executives, EXTRA is a two-year national fellowship program that uses the principles of adult learning theory as well as practical projects to educate senior health care leaders in making more consistent use of (...) research evidence in their management roles. Fellows apply the theory learned in residency sessions and educational activities to projects within their home organizations. The authors identify the imperative for better use of evidence, outline the core elements of the curriculum, and capture the real-world experience of regional leaders and fellows involved in making specific changes informed by research-based evidence within their organization. Contributors include Jean-Louis Denis, Terrence Sullivan, Owen Adams, Malcolm Anderson, Lynda Atack, Robert Bell, Sam G Campbell, Sylvie Cantin, Ward Flemons, Dorothy Forbes, J. Sonja Glass, Paula Goering, Karen Golden-Biddle, Jeffrey S. Hoch, Paul Lamarche, Ann Langley, John N. Lavis, Jonathan Lomas, Margo Orchard, Raynald Pineault, Brian D. Postl, Christine Power, Trish Reay, Jean Rochon, Denis A. Roy, Andrea Seymour, Samuel B. Sheps, Micheline Ste-Marie, Nina Stipich, David Streiner, Carl Taillon, and Muriah Umoquit. (shrink)

ARISTOTLE often claims that words are "homonymous" or "multivocal". He claims this about some of the crucial words and concepts of his own philosophy—"cause," "being," "one," "good," "justice," "friendship." Often he claims it with a polemical aim; other philosophers have wrongly overlooked homonymy and supposed that the same word is always said in the same way. Plato made this mistake; his accounts of being, good, and friendship are rejected because they neglect homonymy and multivocity. In Aristotle’s view Plato shared the (...) Socratic assumption about words and definitions. Socrates thought that when he asked "What is F?" some single definition of F could always be found to match the name "F." Aristotle thinks the Socratic question is important, but argues that it must be controlled by awareness of homonymy and multivocity. (shrink)

The paper describes the approach by which ethics are integrated into the undergraduate curriculum at Northern Illinois University''s College of Business. Literature is reviewed to identify conceptual frameworks for, and issues associated with, the teaching of business ethics. From the review, a set of guidelines for teaching ethics is developed and proposed. The objectives and strategies implemented for teaching ethics is discussed. Foundation and follow-up coursework, measurement issues and ancillary programs are also discussed.

Large Language Models (LLMs) have been transformative. They are pre-trained foundational models that are self-supervised and can be adapted with fine tuning to a wide range of natural language tasks, each of which previously would have required a separate network model. This is one step closer to the extraordinary versatility of human language. GPT-3 and more recently LaMDA can carry on dialogs with humans on many topics after minimal priming with a few examples. However, there has been a wide range (...) of reactions and debate on whether these LLMs understand what they are saying or exhibit signs of intelligence. This high variance is exhibited in three interviews with LLMs reaching wildly different conclusions. A new possibility was uncovered that could explain this divergence. What appears to be intelligence in LLMs may in fact be a mirror that reflects the intelligence of the interviewer, a remarkable twist that could be considered a Reverse Turing Test. If so, then by studying interviews we may be learning more about the intelligence and beliefs of the interviewer than the intelligence of the LLMs. As LLMs become more capable they may transform the way we interact with machines and how they interact with each other. Increasingly, LLMs are being coupled with sensorimotor devices. LLMs can talk the talk, but can they walk the walk? A road map for achieving artificial general autonomy is outlined with seven major improvements inspired by brain systems. LLMs could be used to uncover new insights into brain function by downloading brain data during natural behaviors. (shrink)

By recourse to the fundamentals of preference orderings and their numerical representations through linear utility, we address certain questions raised in Nover and Hájek 2004, Hájek and Nover 2006, and Colyvan 2006. In brief, the Pasadena and Altadena games are well-defined and can be assigned any finite utility values while remaining consistent with preferences between those games having well-defined finite expected value. This is also true for the St Petersburg game. Furthermore, the dominance claimed for the Altadena game over the (...) Pasadena game, and that would have been claimed for the St Petersburg game over the Altadena, can be contradicted without fear of inconsistency with the axioms of utility theory. However, insistence upon dominance can be made to yield a contradiction of the Archimedean axiom of utility theory. CiteULike Connotea Del.icio.us What's this? (shrink)

Professional Ethics: A Trust-Based Approach explores the unique nature of professional duty and virtue in light of the trust that professionals must invite, develop, and honor from those they intend to serve.

To explore how molecules became signs I will ask: “What sort of process is necessary and sufficient to treat a molecule as a sign?” This requires focusing on the interpreting system and its interpretive competence. To avoid assuming any properties that need to be explained I develop what I consider to be a simplest possible molecular model system which only assumes known physics and chemistry but nevertheless exemplifies the interpretive properties of interest. Three progressively more complex variants of this model (...) of interpretive competence are developed that roughly parallel an icon-index-symbol hierarchic scaffolding logic. The implication of this analysis is a reversal of the current dogma of molecular and evolutionary biology which treats molecules like DNA and RNA as the original sources of biological information. Instead I argue that the structural characteristics of these molecules have provided semiotic affordances that the interpretive dynamics of viruses and cells have taken advantage of. These molecules are not the source of biological information but are instead semiotic artifacts onto which dynamical functional constraints have been progressively offloaded during the course of evolution. (shrink)

Theses on the semiotic study of life as presented here provide a collectively formulated set of statements on what biology needs to be focused on in order to describe life as a process based on semiosis, or sign action. An aim of the biosemiotic approach is to explain how life evolves through all varieties of forms of communication and signification (including cellular adaptive behavior, animal communication, and human intellect) and to provide tools for grounding sign theories. We introduce the concept (...) of semiotic threshold zone and analyze the concepts of semiosis, function, umwelt, and the like as the basic concepts for theoretical biology. (shrink)

For more than 20 years, Western science education has been incorporated into Tibetan Buddhist monastics’ training. In this time, there have been a number of fruitful collaborations between Buddhist monastics and neuroscientists, neurologists, and psychologists. These collaborations are unsurprising given the emphasis on phenomenological exploration of first-person conscious experience in Buddhist contemplative practice and the focus on the mind and consciousness in Buddhist theory. As such, Tibetan monastics may have underappreciated intuitions on the intersection of science, medicine, and ethics. Yet (...) despite their overlapping interests, Buddhist perspectives are largely absent in contemporary neuroethical analysis, apart from conceptual arguments for their relevance. This article attempts to fill this gap by presenting the results of eleven semi-structured interviews with Tibetan Buddhist monastics in India on three issues in neuroethics: identity and authenticity, enhancement, and disorders of consciousness. The results of this empirical study reinforce the conclusions of theoretical work on Buddhism and neuroethics while also identifying future areas of inquiry, including the importance of community, the challenges in acting from compassion, and the value of self-directed mental cultivation. (shrink)

Should a brain-dead woman be artificially maintained for the sake of her fetus? Does a physician have the right to administer a life-saving transfusion despite the patient's religious beliefs? Can a family request a hysterectomy for their retarded daughter? Physicians are facing moral dilemmas with increasing frequency. But how should these delicate questions be resolved and by whom? A Casebook of Medical Ethics offers a real-life view of the central issue involved in clinical medical ethics. Since the analysis of cases (...) plays a critical role in this study, the authors have assembled a broad collection of histories encountered in their work as medical ethics educators and consultants. The cases are developed in substantial detail to reflect the rich medical and psychosocial complexity involved, and each is brought to a decision point at which a course of action must be chosen. Among the issues examined are conflicts between patients' wishes and respect for their well-being, tensions concerning duties to patients unable to care for themselves and obligations to family members, and clashes between patient care obligations and the interests of other persons, including physicians, third parties, and the general public. The book also includes commentaries that combine general discussion of ethical principles with specific analysis of the cases examined in the text, as well as various options for resolving conflicts. Readers are invited to assess the comparative merits and liabilities of these approaches. An ideal text for undergraduate and medical school courses, A Casebook of Medical Ethics brings readers to the forefront of medicine, where they share in the determination of crucial ethical decisions. (shrink)

Christian hope of resurrection requires that the one raised be the same person who died. Philosophers and theologians alike seek to understand the coherence of bodily resurrection and what accounts for numerical identity between the earthly and risen person. I address this question from the perspective of disability. Is a person with a disability raised in the age to come with that disability? Many theologians argue that disability is essential to one's identity such that it could not be eliminated in (...) the resurrection. What anthropology undergirds these claims is not often explicated. I argue that Thomistic hylemorphic anthropology provides the best context to understand the human person such that disability is not essential to identity. In the resurrection, we shall become truly ourselves. The marks of disability may remain, but Thomistic anthropology expresses the coherence of bodily resurrection in which one may hope for healing which eliminates the disability but not numerical identity. (shrink)

Shared views regarding the moral respect which is owed to children in family life are used as a guide in determining the moral permissibility of nontherapeutic clinical research procedures involving children. The comparison suggests that it is not appropriate to seek assent from the preadolescent child. The analogy with interventions used in family life is similarly employed to specify the permissible limit of risk to which children may be exposed in nontherapeutic research procedures. The analysis indicates that recent writers misconceive (...) how certain moral principles, such as respect for personal autonomy, require us to act toward children. The results are also used to assess proposed federal regulations on research with children. (shrink)

Recent studies have explored the effectiveness of open-label placebos for a variety of conditions, including chronic pain, cancer-related fatigue and irritable bowel syndrome. OLPs are thought to sidestep traditional ethical worries about placebos because they do not involve deception: with an OLP, patients or subjects are told outright that they are not given an active substance. As deception is framed as the primary hurdle to ethical placebo use, the door is ostensibly opened to ethical studies of OLPs. In this article, (...) I suggest that even though OLPs seemingly do not involve deception, there are other ethical considerations in their clinical investigation and subsequent use. Research ethics often focusses on informed consent—of which, deception and honesty are a piece—as a means to justify research practices with human subjects. Yet, it is but one of the ethical considerations that should be taken into account. With research into placebo effects in particular, I argue that the history of clinical placebo use grounds special considerations for OLP research that go beyond respect for the autonomy of individual patients through informed consent and encompass structural concerns about the type of patient for whom a placebo has historically been thought appropriate. (shrink)

This paper argues that the concept of paternalism is currently overextended to include a variety of actions that, while resembling paternalistic actions, are importantly different. I use the example of Japanese physicians’ non-disclosures of cancer diagnoses directly to patients, arguing that the concept of maternalism better captures these actions. To act paternalistically is to substitute one's own judgement for that of another person and decide in place of that person for his/her best interest. By contrast, to act maternalistically is to (...) decide for another person based on a reasonable understanding of that person's own preferences. The concept of maternalism allows for a more thorough assessment of the moral justification of these types of actions. I conclude that it is possible, at least in principle, to justify Japanese physicians’ non-disclosures, and that this justification must be based on an understanding of these actions as maternalistic. (shrink)

A simple molecular system is described consisting of the reciprocal linkage between an autocatalytic cycle and a self-assembling encapsulation process where the molecular constituents for the capsule are products of the autocatalysis. In a molecular environment sufficiently rich in the substrates, capsule growth will also occur with high predictability. Growth to closure will be most probable in the vicinity of the most prolific autocatalysis and will thus tend to spontaneously enclose supportive catalysts within the capsule interior. If subsequently disrupted in (...) the presence of new substrates, the released components will initiate production of additional catalytic and capsule components that will spontaneously re-assemble into one or more autocell replicas, thereby reconstituting and sometimes reproducing the original. In a diverse molecular environment, cycles of disruption and enclosure will cause auto-cells to incidentally encapsulate other molecules as well as reactive substrates. To the extent that any captured molecule can be incorporated into the autocatalytic process by virtue of structural degeneracy of the catalytic binding sites, the altered autocell will incorporate the new type of component into subsequent replications. Such altered autocells will be progenitors of “lineages” with variant characteristics that will differentially propagate with respect to the availability of commonly required substrates. Autocells are susceptible to a limited form of evolution, capable of leading to more efficient, more environmentally fitted, and more complex forms. This provides a simple demonstration of the plausibility of open-ended reproduction and evolvability without self-replicating template molecules or maintenance of persistent nonequilibrium chemistry. This model identifies an intermediate domain between prebiotic and biotic systems and bridges the gap from nonequilibrium thermodynamics to life. (shrink)

This paper explores Stein’s treatment of truth and art as a way of approaching her philosophy of the self. Stein argues that one can distinguish between the truthof what something is and the truth of what something ought to be. She maintains that the work of art helps us to understand this distinction because it can serve as a revelation of the truth of what something is, but the work of art only succeeds when it also reflects what its subject (...) ought to be. Stein makes an analogous distinction regarding the self as it is and as it ought to be. In her anthropology she argues that human beings are individuated not only by matter but also by form and that understanding our individuating form is the key to becoming the person we ought to be. Stein develops the theory that persons are called to be their true selves through their relationship to the divine. The paper argues that for Stein art and life are related in such a way that striving to be one’s true self transformsone’s life into a work of art. (shrink)

Police killings of unarmed Black people have ignited a national and international response unlike any in decades. But differing from their civil rights-oriented predecessors, today’s activists do not think that the institutions and values of liberal democracy can eradicate structural racism. They draw instead on a Black radical tradition that, Terrence L. Johnson argues, derives its force from its unacknowledged ethical and religious dimensions. We Testify with Our Lives traces Black religion’s sustained influence from SNCC to the present, reconstructing (...) a radical lived ethics of freedom and justice. Johnson demonstrates that Black Power fundamentally contests liberalism’s abstract understanding of democracy, calling instead for new embodied frameworks to achieve human flourishing and dignity. Black bodies represent the primary form of resistance against violent and oppressive regimes of white supremacy and exploitation, and the individual and collective struggles of Black life bear witness to the dogged determination to cultivate beauty, rage, and joy. Considering the writings of Audre Lorde, Toni Cade Bambara, Stokely Carmichael, Martin Luther King Jr., Malcolm X, and James Baldwin, We Testify with Our Lives makes its case through a new narrative of the evolution of Black radicalism from the civil rights movement through the Movement for Black Lives. It forges new insights into Black Power’s vital contributions to debates on ethics, transnational politics, democracy, political solidarity, and freedom—and its potent resources for the ongoing struggle to build democratic possibilities for all. (shrink)

Like many critics of Rawls, Habermas believes that the Original Position (OP) implicitly utilizes normative (and unargued for) assumptions. The author defends the OP by arguing that its basic concepts are the product of a rational reconstruction of the everyday know-how, or common sense, employed by citizens in democratic practices. The author identifies this reconstruction in Rawls's work but suggests that while this answers the charge of circularity, it raises the problem of contextual relativism. It is concluded that Rawls can (...) avoid such relativism only on a stronger commitment to social scientific research in support of a more transcendental form of rational reconstruction. (shrink)

The presence or absence of consciousness is the linchpin of taxonomy for disorders of consciousness (DOCs), as well as a focal point for end-of-life decision making for patients with DOCs. Focus on consciousness in this latter context has been criticized for a number of reasons, including the uncertainty of the diagnostic criteria for consciousness, the irrelevance of some forms of consciousness for determining a patient’s interests, and the ambiguous distinction between consciousness and unconsciousness. As a result, there have been recent (...) suggestions that perhaps consciousness ought not to play the focal role that it does in decision making for persons with DOCs, and that other considerations, such as patient and family values, ought to take center stage. In this article, I take a step back and reexamine the meaning of consciousness in the DOC taxonomy. I propose that, while consciousness in DOC taxonomy is defined as “wakeful awareness,” this definition, while clinically expedient, occasions ethical misunderstanding. Using resources from non-Western philosophy of mind, I argue that the form of consciousness that is ethically relevant in DOCs is intransitive, or pure. I contrast this pure experience with transitive consciousness to highlight why ethical conclusions ought not define consciousness solely as “wakeful awareness,” even if clinical criteria do. (shrink)

Offers an analysis of Jacques Lacan's thought for the English-speaking world. Using empirical data as well as Lacan's texts, this title demonstrates how Lacan's teachings constitute a new epistemology that goes far beyond conventional thinking in psychoanalysis, psychology, philosophy, and linguistics.