Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of (...) medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals. (shrink)

I. On the morning of 28 November 1979 flight TE-901, a DC-10 operated by Air New Zealand Limited, took off from Auckland, New Zealand, on a sightseeing passenger flight over a portion of Antarctica. The pilot in command was Captain Collins. The following are paragraphs from the official Report of the Royal Commission that inquired into the events surrounding that flight.

It is argued that causal understanding originates in experiences of acting on objects. Such experiences have consistent features that can be used as clues to causal identification and judgment. These are singular clues, meaning that they can be detected in single instances. A catalog of 14 singular clues is proposed. The clues function as heuristics for generating causal judgments under uncertainty and are a pervasive source of bias in causal judgment. More sophisticated clues such as mechanism clues and repeated interventions (...) are derived from the 14. Research on the use of empirical information and conditional probabilities to identify causes has used scenarios in which several of the clues are present, and the use of empirical association information for causal judgment depends on the presence of singular clues. It is the singular clues and their origin that are basic to causal understanding, not multiple instance clues such as empirical association, contingency, and conditional probabilities. (shrink)

Three experiments investigated the processing of the implicature associated with some using a “gumball paradigm.” On each trial, participants saw an image of a gumball machine with an upper chamber with 13 gumballs and an empty lower chamber. Gumballs then dropped to the lower chamber and participants evaluated statements, such as “You got some of the gumballs.” Experiment 1 established that some is less natural for reference to small sets and unpartitioned sets compared to intermediate sets. Partitive some of was (...) less natural than simple some when used with the unpartitioned set. In Experiment 2, including exact number descriptions lowered naturalness ratings for some with small sets but not for intermediate size sets and the unpartitioned set. In Experiment 3, the naturalness ratings from Experiment 2 predicted response times. The results are interpreted as evidence for a Constraint-Based account of scalar implicature processing and against both two-stage, Literal-First models and pragmatic Default models. (shrink)

In an effort to reduce risk and uncertainty, we hypothesize that investors avoid countries where high corruption exists. We investigate this issue by examining the relationship of levels of perceived corruption on Japanese Foreign Direct Investment (FDI) in both industrialized and emerging economies. The analysis presented utilizes a sample of 29,546 investments in 59 countries. Results suggest that in emerging nations, where comprehensive legal and regulatory frameworks do not exist to effectively curtail fraudulent activity, corruption serves to reduce FDI. Managers (...) need to consider the level of perceived corruption in their assessment of any market prior to potential investment. (shrink)

For more than 100 years, metaethicists have overlooked the best version of G. E. Moore’s Open Question argument. This despite the fact that it appears on the same page of Principia Ethica as his other, weaker versions of the argument. This better Open Question Argument does not rely on introspection of the meanings of ethical terms, and so does not fall to the standard criticisms of Moore. In this paper, I present this ‘new’ Open Question Argument and show that Moore (...) has done to naturalistic ethics something like what Plato’s Euthyphro does to supernaturalistic ethics. (shrink)

In this paper I sketch an account of moral blame and blameworthiness. I begin by clarifying what I take blame to be and explaining how blameworthiness is to be analyzed in terms of it. I then consider different accounts of the conditions of blameworthiness and, in the end, settle on one according to which a person is blameworthy for φ-ing just in case, in φ-ing, she violates one of a particular class of moral requirements governing the attitudes we bear, and (...) our mental orientation, toward people and other objects of significant moral worth. These requirements embody the moral stricture that we accord to these others a sufficient level of respect, one that their moral worth demands. This is a familiar theme which has its roots in P. F. Strawson’s pioneering views on moral responsibility. My development of it leads me to the conclusion that acting wrongly is not a condition of blameworthiness: violating a moral requirement to perform, or refrain from performing, an action is neither necessary nor sufficient for being blameworthy. All we are ever blameworthy for, I will argue, are certain aspects of our mental bearing toward others. We can be said to be blameworthy for our actions only derivatively, in the sense that those actions are the natural manifestations of the things for which we are strictly speaking blameworthy. (shrink)

While assessment is regarded as integral to enhancing the quality of teaching and learning, it is also a practice fraught with moral and ethical issues. An analysis is made of current assessment practices of teachers in South Africa which seem to straddle the domains of accountability and professional codes of conduct. In the process the position of the teacher as mediator between policies and diverse learner needs is explored in the light of moral and ethical considerations. Based on the notions (...) of ethical caring and caring about, the article suggests the infusing of principles of ubuntu in assessment practices may provide a framework to embed and strengthen morality and ethics in South African school assessment practices. (shrink)

: The move from a notion that community values ought to play a role in health care decision making to the creation of health care policies that in some way reflect such values is a challenging one. No single method will adequately measure community values in a way appropriate for setting health care priorities. Consequently, multiple methods to measure community values should be employed, thereby allowing the strengths and weaknesses of the various methods to complement each other. A preliminary research (...) agenda to bring together empirical research on community values with more traditional research on health care ethics is outlined, with the goal of identifying and measuring acceptable community values that are relatively consistent across measurement methods and, ultimately, developing ways to incorporate these values into health care priority decision making. (shrink)

Psychological Metaphysics is an exploration of the most basic and important assumptions in the psychological construction of reality, with the aim of showing what they are, how they originate, and what they are there for. Peter White proposes that people basically understand causation in terms of stable, special powers of things operating to produce effects under suitable conditions. This underpins an analysis of people's understanding of causal processes in the physical world, and of human action. In making a radical (...) break with the Heiderian tradition, Psychological Metaphysics suggests that causal attribution is in the service of the person's practical concerns and any interest in accuracy or understanding is subservient to this. Indeed, a notion of regularity in the world is of no more than minor importance, and social cognition is not a matter of cognitive mechanisms or processes but of cultural ways of thinking imposed upon tacit, unquestioned, universalassumptions. Incorporating not only research and theory in social cognition and developmental psychology, but also philosophy and the history of ideas, Psychological Metaphysics will be challenging to everyone interested in how we try to understand the world. (shrink)

There is a debate in normative ethics about whether or not our moral obligations depend solely on either our evidence concerning, or our beliefs about, the world. Subjectivists maintain that they do and objectivists maintain that they do not. I shall offer some arguments in support of objectivism and respond to the strongest argument for subjectivism. I shall also briefly consider the significance of my discussion to the debate over whether one’s future voluntary actions are relevant to one’s current moral (...) obligations. (shrink)

Every domain-specific ontology must use as a framework some upper-level ontology which describes the most general, domain-independent categories of reality. In the present paper we sketch a new type of upper-level ontology, which is intended to be the basis of a knowledge modelling language GOL (for: 'General Ontological Language'). It turns out that the upper- level ontology underlying standard modelling languages such as KIF, F-Logic and CycL is restricted to the ontology of sets. Set theory has considerable mathematical power and (...) great flexibility as a framework for modelling different sorts of structures. At the same time it has the disadvantage that sets are abstract entities (entities existing outside the realm of time, space and causality), and thus a set-theoretical framework should be supplemented by some other machinery if it is to support applications in the ripe, messy world of concrete objects. In the present paper we partition the entities of the real world into sets and urelements, and then we introduce several new ontological relations between these urelements. In contrast to standard modelling and representation formalisms, the concepts of GOL provide a machinery for representing and analysing such ontologically basic relations. (shrink)

It was a little over ten years ago, 1967–8, that H. D. Lewis delivered the first series of Gifford lectures, The Elusive Mind, in the University of Edinburgh. It was my privilege that year to be an auditor in the Seminar at King's College that Professor Lewis was conducting with his students in the area of this topic. I had already read the works in which, in the midst of neo-orthodox and existentialist religious movements, he had devoted himself to critical (...) valuation of those doctrines - witness his Morals and the New Theology, and Morals and Revelation. This earlier work prepared for a comprehensive interpretation of religious experience in his book in 1960: Our Experience of God. (shrink)

In the past few decades, scholars have offered positive, normative, and most recently, interpretive theories of contract law. These theories have proceeded primarily from deontological and consequentialist premises. In A Theory of Contract Law: Empirical Understandings and Moral Psychology, Professor Peter A. Alces confronts the leading interpretive theories of contract and demonstrates their interpretive doctrinal failures. Professor Alces presents the leading canonical cases that inform the extant theories of Contract law in both their historical and transactional contexts and, argues (...) that moral psychology provides a better explanation for the contract doctrine than do alternative comprehensive interpretive approaches. (shrink)

The purpose of this study is to examine the relationship between the corporate social performance of an organization and three variables: the size of the organization, the financial performance of the organization, and the environmental performance of the organization. By empirically testing data from 1987 to 1992, the results of the study show that a firm's corporate social performance is indeed impacted by the size of the firm, the level of profitability of the firm, and the amount of pollution emissions (...) released by the firm. (shrink)

The systems Kα of transfinite cumulative types up to α are extended to systems K∞α that include a natural infinitary inference rule, the so-called limit rule. For countable α a semantic completeness theorem for K∞α is proved by the method of reduction trees, and it is shown that every model of K∞α is equivalent to a cumulative hierarchy of sets. This is used to show that several axiomatic first-order set theories can be interpreted in K∞α, for suitable α.

We study the proof-theoretic strength and effective content of the infinite form of Ramsey's theorem for pairs. Let RT n k denote Ramsey's theorem for k-colorings of n-element sets, and let RT $^n_{ denote (∀ k)RT n k . Our main result on computability is: For any n ≥ 2 and any computable (recursive) k-coloring of the n-element sets of natural numbers, there is an infinite homogeneous set X with X'' ≤ T 0 (n) . Let IΣ n and BΣ (...) n denote the Σ n induction and bounding schemes, respectively. Adapting the case n = 2 of the above result (where X is low 2 ) to models of arithmetic enables us to show that RCA 0 + IΣ 2 + RT 2 2 is conservative over RCA 0 + IΣ 2 for Π 1 1 statements and that $RCA_0 + I\Sigma_3 + RT^2_{ , is Π 1 1 -conservative over RCA 0 + IΣ 3 . It follows that RCA 0 + RT 2 2 does not imply BΣ 3 . In contrast, J. Hirst showed that $RCA_0 + RT^2_{ does imply BΣ 3 , and we include a proof of a slightly strengthened version of this result. It follows that $RT^2_{ is strictly stronger than RT 2 2 over RCA 0. (shrink)

: Samia Hurst and Marion Danis provide a thoughtful framework for how to judge the morality of bedside rationing decisions. In this commentary, I applaud Hurst and Danis for advancing the level of debate about bedside rationing. But when I attempt to apply the framework to my own clinical practice, I conclude that the framework comes up short.

This volume, an expanded edition of the philosophy of language issue of the journal Midwest Studies in Philosophy (1977), includes essays by some of the ...