The opening sentence of Christopher Meyers’ Target Article is “Lying to one’s patient is wrong”. The author continues, “This truism is one that bioethicists have heartedly endorsed fo...

To paraphrase Lewis Carroll’s poem “The Walrus and the Carpenter” from his Through the Looking Glass, “The time has come to talk of many things.” Not as the Walrus did in the nursery rhyme, “of sho...

This paper examines and critiques the ethical issues in postmortem sperm retrieval and the use of postmortem sperm to create new life. The article was occasioned by the recent request of the parents of a West Point cadet who died in a skiing accident at the Academy to retrieve and use his sperm to honor his memory and perpetuate the family name. The request occasioned national media attention. A trial court judge in New York in a two-page order authorized both (...) the retrieval and use of the postmortem sperm. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

It took nearly two thousand years for society to recognize the Hippocratic insistence that “the doctor knows best”1 was an inadequate approach to medical decisionmaking. Today, patient-centered medicine has come to understand that the individual patient has a significant role in the decisionmaking process.2.

We consider the desirability, or otherwise, of various forms of induction in the light of certain principles and inductive methods within predicate uncertain reasoning. Our general conclusion is that there remain conflicts within the area whose resolution will require a deeper understanding of the fundamental relationship between individuals and properties.

The opinion of Mr. Justice Francis of the English High Court which denied the parents of Charlie Gard, who had been born with an extremely rare mutation of a genetic disease, the right to take their child to the United States for a proposed experimental treatment occasioned world wide attention including that of the Pope, President Trump, and the US Congress. The case raise anew a debate as old as the foundation of Western medicine on who should decide and on (...) what standard when there is a conflict between a family and the treating physicians over a possible treatment. This paper will explore the different approaches of the British and American courts on the issue and the various proposals from that of John Rawls in his A Theory of Justice to a processed-based approach for resolving such disputes. As carefully crafted as the opinion of Mr Justice Nicholas Francis in the Gard case proved to be, it left commentators unsatisfied. A widespread criticism, captured in an article by Michael Dougherty in The National Review was for the state to ‘get out of the way of the parents trying to act in the best interests of the child’.1 Although he conceded the parents could be adding to the suffering of the child by taking Charlie to America for an experimental therapy and agreed that such a choice ‘may be the wrong decision,’ in Dougherty’s view, it should still be ‘their decision’. Dougherty’s stand was the popular response to the question of ‘Who should decide?’ It fails, however, to propose any rationale for the decision. It provided no norms, no standards and no guidelines for the parents. Their motive could equally well be indifference to the suffering of the child as concern for his well-being. Furthermore, even good, loving parents may make …. (shrink)

We extend the framework of Inductive Logic to Second Order languages and introduce Wilmers' Principle, a rational principle for probability functions on Second Order languages. We derive a representation theorem for functions satisfying this principle and investigate its relationship to the first order principles of Regularity and Super Regularity.

In Pure Inductive Logic, the rational principle of Predicate Exchangeability states that permuting the predicates in a given language L and replacing each occurrence of a predicate in an L-sentence phi according to this permutation should not change our belief in the truth of phi. In this paper we study when a prior probability function w on a purely unary language L satisfying Predicate Exchangeability also satisfies the principle of Unary Language Invariance.

The children were nestled all snug in their beds.While visions of sugar-plums danced in their heads.Clement Moore's cherished ‘Twas the Night Before Christmas captures the hopes, dreams and visions...

Iconic signs are overrepresented in the vocabularies of young deaf children, but it is unclear why. It is possible that iconic signs are easier for children to learn, but it is also possible that adults use iconic signs in child-directed signing in ways that make them more learnable, either by using them more often than less iconic signs or by lengthening them. We analyzed videos of naturalistic play sessions between parents and deaf children aged 9–60 months. To determine whether iconic (...) signs are overrepresented during child-directed signing, we compared the iconicity of actual parent productions to the iconicity of simulated vocabularies designed to estimate chance levels of iconicity. For almost all dyads, parent sign types and tokens were not more iconic than the simulated vocabularies, suggesting that parents do not select more iconic signs during child-directed signing. To determine whether iconic signs are more likely to be lengthened, we ran a linear regression predicting sign duration, and found an interaction between age and iconicity: while parents of younger children produced non-iconic and iconic signs with similar durations, parents of older children produced non-iconic signs with shorter durations than iconic signs. Thus, parents sign more quickly with older children than younger children, and iconic signs appear to resist that reduction in sign length. It is possible that iconic signs are perceptually available longer, and their availability is a candidate hypothesis as to why iconic signs are overrepresented in children’s vocabularies. (shrink)

Thirty years later we seem no closer to a consensus on the ethics of sterilizing profoundly mentally compromised young girls than was Judge Blumenfeld.

Volume 19, Issue 12, December 2019, Page 49-51.

This proceedings volume contains most of the invited talks presented at the colloquium. The main topics treated are the model theory of arithmetic and algebra, the semantics of natural languages, and applications of mathematical logic to complexity theory. The volume contains both surveys by acknowledged experts and original research papers presenting advances in these disciplines.

We apply methods of abduction derived from propositional probabilistic reasoning to predicate probabilistic reasoning, in particular inductive logic, by treating finite predicate knowledge bases as potentially infinite propositional knowledge bases. It is shown that for a range of predicate knowledge bases and several key propositional inference processes this procedure is well defined, and furthermore yields an explanation for the validity of the induction in terms of 'reasons'.

“Playing God” is the charge frequently leveled when physicians and patients agree to withdraw life-sustaining medical treatments and let the patient die. The accusation rings hollow in the context of four hundred years of moral reflection on the duty of an individual to undergo medical treatments to preserve life. From the teachings of Soto and Banez in the 16th century through the President's, Commission 1983 report ‘deciding to forego life-sustaining treatments’ there is a clear and constant teaching that though life (...) is sacred it is not an absolute and our moral duty to preserve it is limited and based on rational reflection. No patient need undergo any treatment or procedure that is “disproportionately” costly, burdensome, or painful. The assessment of whether to accept or reject a proposed treatment is in part subjective and belongs to the individual patient. The only remaining issue is how to make that judgment for those unable to speak for themselves. (shrink)

Rosoff and Schneiderman's essay “Irrational Exuberance: Cardiopulmonary Resuscitation as Fetish” (2017) raises an issue first posed by the then Chairman of the Federal Reserve Board, Alan Greenspan...

Acceptance of elderly or marginal health individuals as kidney donors is debated, with practices varying between centres. Transplant recipients, live kidney donors and health-care professionals caring for patients with renal failure were surveyed regarding their views on live donor kidney transplantation (LDKT) of marginal health (diabetes, hypertension, atherosclerosis, obesity, etc.) and elderly donors. Participants were recruited within a tertiary renal and transplant centre and invited to participate in focus groups and structured interviews. They also completed an anonymous questionnaire. Of 464 (...) participants who completed the questionnaire (36% health-care professionals and 64% patients), 49% and 64%, respectively, stated that marginal and elderly donors should be accepted for LDKT. In the structured interviews, emphasis was given to presenting to donor, recipient and their respective families a calculated risk regarding the effect that either a nephrectomy or transplant has on long-term quality of life. Participants stated that an independent third party in addition to the transplant team should discuss involved risks. Issues of ‘how desperate’ the recipient's situation is should also be considered. Health-care professionals stated that regardless of the strength of will of an individual to donate a kidney (despite age, health problems or personal risk), they should always have the right to say ‘no’ if performing a specific LDKT was against their professional and ethical values. About half of those surveyed considered that marginal health and elderly donors were acceptable for LDKT. Emphasis was given to the explanation to donors and recipients of the risks involved in such transplantation. (shrink)

Volume 20, Issue 7, July 2020, Page 147-150.

Clinical trials of xenotransplantation may begin early in the next decade, with kidneys from genetically modified pigs transplanted into adult humans. If successful, transplanting pig hearts into children with advanced heart failure may be the next step. Typically, clinical trials have a specified end date, and participants are aware of the amount of time they will be in the study. This is not so with XTx. The current ethical consensus is that XTx recipients must consent to lifelong monitoring. While this (...) presents challenges to the right to withdraw in the adult population, additional and unanswered questions also linger in the paediatric population. In paediatric XTx, parents or guardians consent not only to the initial treatment of the child but also to lifelong monitoring, thus making a decision whose consequences will remain present as the child develops the capacity for assent, and finally the capacity for informed consent or refusal. This article presents and evaluates unanswered paediatric ethical questions in regard to the right to withdraw from XTx follow-up in the paediatric population. (shrink)

In Neutrality and the Academic Ethic, distinguished philosopher Robert L. Simon explores the claim that universities can and should be politically neutral. He examines conceptual questions about the meaning of neutrality, distinguishes different conceptions of what neutrality involves, and considers in what sense, if any, institutional neutrality is both possible and desirable. In Part II, a collection of original and previously published essays provides different views on these and related issues.

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)

We answer some problems set by Priest in [11] and [12], in particular refuting Priest's Conjecture that all LP-models of Th(N) essentially arise via congruence relations on classical models of Th(N). We also show that the analogue of Priest's Conjecture for I δ₀ + Exp implies the existence of truth definitions for intervals [0,a] ⊂ₑ M ⊨ I δ₀ + Exp in any cut [0,a] ⊂e K ⊆ M closed under successor and multiplication.

On the concept of Pariṇāma (change and permanence) in Indic philosophy; a study.