Although hope is a pervasive concept in cancer treatment, we know little about how ambulatory patients with cancer define or experience hope. We explored hope through semistructured interviews with ten patients with advanced (some curable, some incurable) colon cancer at one Midwestern, university–based cancer center. We conducted a thematic analysis to identify key concepts related to patient perceptions of hope. Although we did ask specifically about hope, patients also often revealed their hopes in response to indirect questions or by telling (...) stories about their cancer experience. We identified four major themes related to hope: 1) hope is essential, 2) a change in perspective, 3) the content of hope, and 4) communicating about hope. The third theme, the content of hope, included three subthemes: a) the desire for normalcy, b) future plans, and c) hope for a cure. We conclude that hope is an essential concept for patients undergoing treatment for cancer as it pertains to their psychological well–being and quality of life, and hope for a cure is not and should not be the only consideration. In a clinical context, the exploration of patients’ hopes and aspirations in light of their cancer diagnosis is important because it provides a frame for understanding their goals for treatment. Exploration of the content of patients’ hope can not only help to illuminate misunderstandings but also clarify how potential treatments may or may not contribute to achieving patients’ goals. (shrink)

The primary objective was to review pediatric ethics consultations at a large academic health center over a nine year period, assessing demographics, ethical issues, and consultant intervention. The secondary objective was to describe the evolution of PECs at our institution. This was a retrospective review of Consultation Summary Sheets compiled for PECs at our Academic Health Center between January 2008 and April 2017. There were 165 PECs reviewed during the study period. Most consult requests came from the inpatient setting, with (...) the Pediatric and Neonatal Intensive Care Units being the highest utilizers. Consultation utilization increased over the study period. The most common patient age was less than one year. Physicians were most likely to request consultation. Patient Best Interest, Withholding/Withdrawing of Life Sustaining Therapy, and Provider Moral Distress were ethical issues most commonly identified by the consultants. Making recommendations was the most common consultant intervention. The ethics consultation process evolved over time from informal provider discussions, to a hospital infant care review committee, to a pediatric only consultation service, to a combined adult/pediatric consultation service, with variable levels of salary support for consultants. Ethics consultation requests are growing at our institution. Similarities in identified ethical issues exist between our findings and existing literature, however meaningful comparisons remains elusive secondary to variability in approaches to investigation and reporting. A combined paid/volunteer/trainee ethics consultation service model appears sustainable and real time ethics consultation is feasible using this approach. (shrink)

The concept of brain death — first defined decades ago — still presents medical, ethical, and legal challenges despite its widespread acceptance in clinical practice and in law. This article reviews the medicine, law, and ethics of brain death, including the current inconsistencies in brain death determinations, which a lack of standardized federal policy promotes, and argues that a standard brain death policy to be used by all hospitals in all states should be created.

The concept of brain death evolved because advancements in medical science permitted unprecedented artificial maintenance of vital body functions by external means. Although the concept of brain death is accepted clinically, ethically, and legally in the United States, there is no national standard for the determination of brain death. There is evidence that variability and inconsistency in the process of determining brain death exist both in clinical settings and in State statutes. Several studies demonstrate that medical personnel determine brain death (...) in variable ways, and have variable understandings of the definition of brain death. The declaration of death has significant legal consequences such as probate proceedings and liability issues for wrongful death. Inconsistencies in the determination of death may therefore be medically, ethically, and legally problematic. (shrink)

In the United States at this time, no uniform federal law exists regarding commercial surrogacy, and state statutory schemes vary vastly, ranging from criminalization to legal recognition with contract enforcement. The authors examine how commercial surrogacy agencies utilize the Internet as a means for attracting parents and surrogates by employing emotional cultural rhetoric. By inducing both parents and surrogates to their jurisdiction, agencies circumvent vast discrepancies in state statutory regulative schemes and create a distinct interstate business, absent an efficient regulatory (...) framework or legal recourse in some circumstances. The authors propose a uniform federal regulatory scheme premised upon regulating interstate business transactions to create accountability and legal remedies for both the parents and the surrogate. (shrink)

In July of 2005, Indianapolis witnessed streaming headlines in the local newspaper attempting to distill the confusion surrounding the adoption of two premature infants by an adoptive parent. Thirteen articles and opinion pieces introduced the public to a murky legal and ethical transaction. Stating his overwhelming desire to have children, a New Jersey schoolteacher hired the services of a local attorney. The attorney procured a South Carolina woman for a compensated gestational surrogacy contract. Under the contract, the surrogate and the (...) attorney would meet in Indiana to complete the execution of the contract and transfer parental rights via adoption after the birth of the twins. (shrink)

To all appearances, the basic building blocks of reality tend to keep existing unless something intervenes to destroy them. In other words, basic things seem to have existential inertia. But why might this be? This paper considers a number of arguments for and against existential inertia. It discusses arguments inspired by Aquinas, Descartes, and Spinoza, as well as considerations deriving from Occam’s Razor, entropy, and certain views about the nature of time and change.

"Evidence of a flight from reason is as old as human record-keeping: the fact of it certainly goes back an even longer way. Flight from science specifically, among the forms of rational inquiry, goes back as far as science itself... But rejection of reason is now a pattern to be found in most branches of scholarship and in all the learned professions."--from the introduction In the widely acclaimed Higher Superstition: The Academic Left and Its Quarrels with Science, Paul R. (...) Gross and Norman Levitt offered a spirited response to the "science bashers," raising serious questions about the growing criticism of scientific practice from humanists and social scientists on the academic left. Now, in The Flight from Science and Reason, Gross and Levitt are joined by Martin W. Lewis to bring together a diverse and distinguished group of scholars, scientists, and experts to engage these questions from a wide variety of perspectives. The authors take on critics of science whose views range from moderate to extreme, from social constructivists to deconstructionists, from creationists and feminists to Afro-centrists. They discuss the rise of "alternative medicine" and radical environmentalism (here skewered as "ecosentimentalism"). They explain why the "uncertainty principle" does not work as a metaphor for ambiguity, and why "chaos theory" cannot be invoked without an understanding of mathematics. Throughout, they grapple with the paradox inherent in arguing with opponents who contend that reason itself, and thus logic, is suspect. Distributed for the New York Academy of Sciences. (shrink)

In this book Paul Hinlicky suggests that to the detriment of the church as a whole Martin Luthers legacy did not unfold as he himself would have hoped or ...

ABSTRACTI argue that, according to just war theory, those who work as administrative personnel in the private military industry can be permissibly harmed while at work by enemy combatants. That is, for better or worse, a just war theorist should consider all those who work as administrative personnel in the private military industry as either: individuals who may be permissibly restrained with lethal force while at work; or individuals who may be harmed by permissible attacks against their workplace. In doing (...) so, I also provide some critical analysis of the relevant just war concepts. (shrink)

H. L. A. Hart famously claimed that part of the appeal of natural law “doctrine” is the “independence” of natural law from divine and human authority. God, according to Hart, is not necessary to natural law. By way of contrast, J. Budziszewski argues that natural law really is law and that law qua law requires an enactor. Moreover, the only plausible candidate for the enactor of natural law as law is the author of nature—that is, God. In this essay I (...) argue that Budziszewski is right and Hart wrong. Law imposes obligations upon those under it, and obligations qua obligation are categorical rather than hypothetical imperatives. Categorical imperatives, in turn, require prescription. Consequently, prescription is necessary to any intelligible account of moral obligation. And prescription, finally, requires an authoritative prescriber. (shrink)

In Pagans & Christians in the City, Steven D. Smith argues that in contrast to ancient Rome, ancient Christianity, following Judaism, located the sacred outside the world, desacralizing the cosmos and everything in it—including the political order. It thereby introduced a political dualism and potentially contending allegiances. Although Smith’s argument is right so far as it goes, it underplays the role of Christianity’s immanent dimension in subverting the Roman empire and the sacral pattern of antiquity. This division of authority not (...) only undermined the Roman empire and antique sacral political order more generally—it also subverts the modern state, which, in the work of Hobbes and Rousseau, sought to remarry what Western Christianity divorced. (shrink)

Many scholars view political contractarianism as a distinctly modern account of the foundations of political order. Ideas such as popular sovereignty, the right of revolution, the necessity of the consent of the governed for rightful political authority, natural equality, and a pre-civil state of nature embody the modern rupture with classical political philosophy and traditional Christian theology. At the headwaters of this modern revolution stands Thomas Hobbes. Since the American founders subscribed to the social contract theory, they are often said (...) to reject classical political philosophy and traditional Christian political theology as well. In America on Trial, Robert Reilly rejects the usual argument. He maintains that the building blocks of the American founding originate in medieval Christian political theology. In this essay, I argue that a morally and metaphysically realist contractarian tradition—one that affirms natural equality, the authority of the society over government, the necessity of consent for legitimate government, the right to resist tyrannical rulers, and the idea of a pre-civil state of nature—predates Hobbes and also that the voluntarist contractarian tradition inaugurated by Hobbes is self-referentially incoherent. A coherent political contractarianism logicially depends on the sort of metaphysics and moral ontology Hobbes rejects. (shrink)

There have been a number of attempts to apply mechanism-related concepts to the notion of extended cognition. Such accounts appeal to the idea that extended cognitive routines are realized by mechanisms that transcend some salient border or boundary. The present paper describes some of the challenges confronting the effort to develop a mechanistic account of extended cognition. In particular, it describes five problems that must be resolved if we are to make sense of the idea that extended cognition can be (...) understood via an appeal to extended mechanisms. These problems are intended to guide the philosophical effort to develop a mechanistic account of extended cognition. (shrink)

This article explores the notion of the Web-extended mind, which is the idea that the technological and informational elements of the Web can sometimes serve as part of the mechanistic substrate that realizes human mental states and processes. It is argued that while current forms of the Web may not be particularly suited to the realization of Web-extended minds, new forms of user interaction technology as well as new approaches to information representation do provide promising new opportunities for Web-based forms (...) of cognitive extension. In addition, it is suggested that extended cognitive systems often rely on the emergence of social practices and conventions that shape how a technology is used. Web-extended minds may thus depend on forms of socio-technical co-evolution in which social forces and factors play just as important a role as do the processes of technology design and development. (shrink)

Mandevillian intelligence is a specific form of collective intelligence in which individual cognitive vices are seen to play a positive functional role in yielding collective forms of cognitive success. The present paper introduces the concept of mandevillian intelligence and reviews a number of strands of empirical research that help to shed light on the phenomenon. The paper also attempts to highlight the value of the concept of mandevillian intelligence from a philosophical, scientific and engineering perspective. Inasmuch as we accept the (...) notion of mandevillian intelligence, then it seems that the cognitive and epistemic value of a specific social or technological intervention will vary according to whether our attention is focused at the individual or collective level of analysis. This has a number of important implications for how we think about the design and evaluation of collective cognitive systems. For example, the notion of mandevillian intelligence forces us to take seriously the idea that the exploitation of individual cognitive shortcomings could, in some situations, provide a productive route to collective forms of cognitive and epistemic success. (shrink)

Using astrology as a case study, this paper attempts to establish a criterion for demarcating science from pseudoscience. Numerous reasons for considering astrology to be a pseudoscience are evaluated and rejected; verifiability and falsifiability are briefly discussed. A theory is said to be pseudoscientific if and only if (1) it has been less progressive than alternative theories over a long period of time, and faces many unsolved problems, but (2) the community of practitioners makes little attempt to develop the theory (...) towards solutions of the problems, shows no concern for attempts to evaluate the theory in relation to others, and is selective in considering confirmations and disconfirmations. This criterion has the interesting consequence that a theory can be scientific at one time but pseudoscientific at another. (shrink)

This study investigates how patterns of media use and exposure to media messages are related to attitudes about artificial intelligence (AI) image generators. In doing so, it builds on theoretical accounts of media framing and public opinion about science and technology topics, including AI. The analyses draw on data from a survey of the US public (N = 1,035) that included an experimental manipulation of exposure to tweets framing AI image generators in terms of real art, artists’ concerns, artists’ outrage, (...) or competing interpretations. The results show that technology news use and science fiction viewing predicted support for AI art but also predicted belief that AI image generators will take jobs and steal art styles from human artists. In addition, the experimental results demonstrate that exposure to specific media messages can influence these responses. The findings carry implications for understanding the future adoption, use, and regulation of AI image generators. (shrink)

The U.S. Constitution provides a framework for our laws, but what does it have to say about morality? Paul DeHart ferrets out that document’s implicit moral assumptions as he revisits the notion that constitutions are more than merely practical institutional arrangements. In _Uncovering the Constitution’s Moral Design_, he seeks to reveal, elaborate, and then evaluate the Constitution’s normative framework to determine whether it is philosophically sound—and whether it makes moral assumptions that correspond to reality. Rejecting the standard approach of (...) the intellectual historian, DeHart for the first time in constitutional theory applies the method of inference to the best explanation to ascertaining our Constitution’s moral meaning. He distinguishes the Constitution’s intention from the subjective intentions of the framers, teasing out presuppositions that the document makes about the nature of sovereignty, the common good, natural law, and natural rights. He then argues that the Constitution constrains popular sovereignty in a way that entails a real common good, transcendent of human willing and promotive of human well-being, but he points out that while the Constitution presupposes a real common good, it also implies a natural law that prescribes the common good. In critiquing previous attempts at describing and evaluating the Constitution’s normative framework, DeHart demonstrates that the Constitution’s moral framework corresponds largely to classical moral theory. He challenges the logical coherency of modern moral philosophy, normative positivism, and other theories that the Constitution has been argued to embody and offers a groundbreaking methodology that can be applied to uncovering the normative framework of other constitutions as well. This cogently argued study shows that the Constitution presupposes a natural law to which human law must conform, and it takes a major step in resolving current debates over the Constitution’s normative framework while remaining detached from the social issues that divide today’s political arena. _Uncovering the Constitution’s Moral Design_ is an original approach to the Constitution that marks a significant contribution to understanding the moral underpinnings of our form of government. (shrink)

We argue that mereological essentialism for events is independent of mereological essentialism for objects, and that the philosophical fallout of embracing mereological essentialism for events is minimal. We first outline what we should consider to be the parts of events, and then highlight why one would naturally be inclined to think that the object-question and the event-question are linked. Then, we argue that they are not. We also diagnose why this is the case and emphasize the upshot. In particular, we (...) argue that the way we evaluate modal claims which concern events differs from the way we evaluate modal claims which concern objects. Ultimately, then, to our title question we say: the answer does not matter as much as you might think. (shrink)

While the dominant approaches to the current study of political philosophy are various, with some friendlier to religious belief than others, almost all place constraints on the philosophic and political role of revelation. Mainstream secular political theorists do not entirely disregard religion. But to the extent that they pay attention, their treatment of religious belief is seen more as a political or philosophic problem to be addressed rather than as a positive body of thought from which we might derive important (...) insights about the nature of politics and the truth of the human condition. In a one-of-a-kind collection, DeHart and Holloway bring together leading scholars from various fields, including political science, philosophy, and theology, to challenge the prevailing orthodoxy and to demonstrate the role that religion can and does play in political life. Contributing authors include such important thinkers as Peter Augustine Lawler, Robert C. Koons, J. Budziszewski, Francis J. Beckwith, and James Stoner. (shrink)

This peer reviewed reference article is an annotated online bibliography on mereology with 80+ entries. It's aim is to provide a selective and balanced guide to the subject. It contains thematic headings with commentaries. The reader should come away cognizant of what the most influential work in mereology are. Topics highlighted herein include, but are not limited to: the history of mereology, classical extensional mereology and its challenges, parthood, connections with location relations, mereological simples and gunk, composition as identity, as (...) well as mereological essentialism, nihilism, and universalism. (shrink)

In The Langoliers, passengers on an airline flight wake to find that they’ve mysteriously travelled a few minutes back in time… a few minutes behind everyone else. They find that the world still exists, after ‘the present’ has moved on, but only for a short duration before the Langoliers—the timekeepers of eternity—arrive to remove it permanently from existence. This story prompts two interesting questions: How should we understand the nature of time in The Langoliers? Could the nature of time in (...) our world be the same as in The Langoliers? And, are the characters in The Langoliers really time travellers? In answering these questions, we can gain a greater understanding of the world depicted in The Langoliers, as well as of our own world. (shrink)

Most scholars who write on social contract and classical natural law perceive an irreconcilable tension between them. Social contract theory is widely considered the political-theoretic concomitant of modern philosophy. Against the regnant view, The Social Contract in the Ruins, argues that all attempts to ground political authority and obligation in agreement alone are logically self-defeating. Political authority and obligation require an antecedent moral ground. But this moral ground cannot be constructed by human agreement or created by sheer will-human or divine. (...) All accounts of morality as constructed or made collapse into self-referential incoherence. Only an uncreated, real good can coherently ground political authority and obligation or the proposition that rightful government depends on the consent of the governed. Government by consent requires classical natural law for its very coherence. (shrink)

The difficulty about the naive realism which most people take for granted and which some empirical philosophers try to defend is that its proponents, in seeking to preserve the objective world of common sense, virtually read out of the picture the contribution of the perceiving subject and all that is involved in the relatedness of sense experience. The visual phenomena of perspective, distortion and hallucination, and the dependence of all other sense experience upon varying physiological factors in the percipient make (...) it well nigh impossible to believe that everything is just what we observe it to be; and the physicist's account of a world of electrical charges symbolized by mathematical formulae deals in conceptual terms which transcend sensual imagery. The resort to the sense-datum theory was but a desperate attempt on the part of philosophers to preserve the plain man's view of reality, though it left wholly obscure the relationship between the world of common sense experience and that of physical science, as well as positing a fantastic multiplication of entities corresponding to everything that could be observed under any circumstances. (shrink)

According to proponents of the extended mind, bio-external resources, such as a notebook or a smartphone, are candidate parts of the cognitive and mental machinery that realises cognitive states and processes. The present chapter discusses three areas of ethical concern associated with the extended mind, namely mental privacy, mental manipulation, and agency. We also examine the ethics of the extended mind from the standpoint of three general normative frameworks, namely, consequentialism, deontology, and virtue ethics.

Neuronal signalling involves multiple neuropeptides that are diverse in structure and function. Complex patterns of tissue‐specific expression arise from alternate RNA splicing of neuropeptide‐encoding gene transcripts. The pattern of expression and its role in cell signalling is diffecult to study at the level of single neurons in the complex vertebrate brain. However, in the model molluscan system, Lymnaea, it is possible to show that alternate mRNA expression of the FMRFamide gene is specific to single identified neurons. Two different transcripts are (...) expressed in a mutually exclusive manner in different neurons. Post‐translational processing of the two precursor proteins leads to completely distinct sets of neuropeptide transmitters. The function of these transmitter cocktails, resulting from alternate mRNA splicing, was studied physiologically in identified neurons forming part of a behaviourally important network regulating heartbeat. (shrink)