This chapter contains sections titled: Side‐Effects of Wykstra's Noseeum Defense Verdict on Noseeum Defenses Evaluating van Inwagen's Second Skeptical Defense Overall Verdict on Skeptical Defenses On to Substantive Defenses Suggested Reading.

This essay discusses unlimited insurance subrogation (UIS) as a means of improving the deterrence and compensation results of medical malpractice law. Under UIS, health care insureds could assign their entire potential medical malpractice claims to their first-party commercial and government insurers. UIS should improve deterrence by establishing first-party insurers as plaintiffs to confront liability insurers on the defense side, leading to more effective prosecution of meritorious claims and reducing meritless and unnecessary litigation. UIS should improve compensation outcomes by converting (...) litigation cost- and risk- laden “tort insurance” into cheaper and enhanced first-party insurance. UIS also promises dynamic benefits through further reforms by contract between the first-party and liability insurers that would take charge of system. No UIS-related costs are apparent that would outweigh these benefits. (shrink)

A person drives her well‐maintained car cautiously and alertly to the movies. Freak circumstances send the car out of control. It veers in the direction of a pedestrian whom it will kill unless she, or a third party, blows it up with a grenade. Whether the driver is liable to be thusly killed polarizes debates about the ethics of self‐defense. But debaters frequently conflate the questions of whether and by what means the driver is liable to be killed. The (...) paper separates these questions: it argues the driver's liability to lethal harm need not entail her liability to the grenade. (shrink)

A recent study published in the American Journal of Organ Transplantation proposes that an organ donor application in Facebook can increase the rates at which individuals donate organs. While I offer support for the use of social media mechanisms in the service of the promotion of organ donation public health initiatives, there are several ethical concerns surrounding informed consent.While Facebook has made a noble effort to aid public health initiatives focused on organ donation, the current application does not promote decisions (...) that are based on individuals’ personal values and goals. Without an intervention that promotes an understanding and appreciation of a decision for or against donation, the application does not obtain informed consent. Without first ensuring that a Facebook member has registered with her or his own state donor registry, this social media mechanism may create more confusion than clarity about an individual’s organ donor status.If Facebook desires to have a positive impact on the rates of organ donation, it must do so in a manner that obtains proper consent and promotes ethically informed decisions. (shrink)

In global business, business organizations and their representatives frequently encounter corruption and may be the perpetrators, victims, or simply participants in such acts. While international corruption has existed in multiple forms for several years, many individuals, companies, nations, and international organizations are currently attempting to reduce or eliminate corrupt acts because of their harmful effects on local economies and the quality of life of citizens. Several of these corruption curtailment efforts have been directed toward the supply-side of corruption, i.e., those (...) who make corrupt payments. In developing an understanding of corruption, however, and formulating strategies for its reduction, consideration must also be given to the demand-side of corruption, i.e., those who demand and accept corrupt payments. Accordingly, this study examined the demand-side of corruption and several related factors in the categories of government, economy and poverty, education, geography, and culture. Analysis of these factors employed the Corruption Perceptions Index (CPI), formulated annually by Transparency International (TI), and other sources. Several factors in each of the five categories were found to correlate significantly with perceived corruption, and strategies for addressing these issues were developed and discussed. (shrink)

This target article argues that the Turing test implicitly rests on a "naive psychology," a naturally evolved psychological faculty which is used to predict and understand the behaviour of others in complex societies. This natural faculty is an important and implicit bias in the observer's tendency to ascribe mentality to the system in the test. The paper analyses the effects of this naive psychology on the Turing test, both from the side of the system and the side of the observer, (...) and then proposes and justifies an inverted version of the test which allows the processes of ascription to be analysed more directly than in the standard version. (shrink)

Determinist thought with its sui generis view on life, nature and being as a whole is a point of view that could be observed in many different cultures and beliefs. It was thanks to Greek thought that it ceased to be a cultural element and transformed into a systematic cosmology. Schools such as Leucippos, then Democritos and Stoa attempted to integrate the determinist philosophy into ontology and cosmology. In the course of time, physics and metaphysics-based determinism approaches were introduced, and (...) a wide spectrum has emerged from genetics to behaviorism, from culture to psychology, from atomism to divinity. Determinism, whether physical or metaphysical origin, ignores freedom of will and deny agency competence over human behavior. Due to this feature, it is opposed by ethical theories, legal philosophies and religions. When the arguments for determinism are possible to disprove logically and philosophically, this is not so easy when the claims base themselves on scientific base. As the logical consequence of this novel fact, it is important to question the epistemological value of scientific knowledge and critically analyze the data of experiments and clinical studies in terms of methodology when answering any hypothesis such as neuro-biological, neuro-psychological, or neuro-theological argumentations. On the other hand, it is necessary to reach alternative experiments on the same subject or to show that it is possible to interpret them in different ways, as in the example of the Libet experiment. The neurobiological determinism based on biological reductionism, emerged as the result of ignoring the ontological difference of the mind, equating the mind with the brain, or defining mentality as an epiphenomenon of the brain. The main divergence stems from the acceptance of materialist philosophy. Paradigms that reduce existence only to matter do not take the metaphysical possibilities into account. In this case, although the problems called qualia or subjective experience stand there unresolved, the claim is preserved. Although many new developments such as the discovery of the entropy law, the big bang theory, and quantum physics have shaken the materialist philosophy, modern science resists an epistemological revision. However, with the current epistemology, it does not seem possible to grasp both the universe and the being as a whole. This is the most important reason why every attempt to understand the nature and spiritual side of human beings fails despite numerous experiments on the brain. However, the human brain is an organ that seems sophisticated and its secrets cannot be easily solved. Since there is not enough information about the brain, there is not enough evidence to claim that the brain, and therefore the mind, are part of the deterministic universe. Increasing brain researches since the last quarter of the twentieth century has revealed that genes, neurons and particularly brain chemistry claim much greater role than expected in human behavior. These results have been instrumentalized by some researchers for a radical claim that free will is an illusion, while by others it has led to the acceptance of will as less important over actions than was thought. Both ideas adopted a model of biological determinism in which freedom of will was ignored. Hypotheses based on controversial interpretations of various experiments raised concerns about religious, moral, and legal responsibility. Although man cannot be thought of as a non-free being from the point of view of common sense, the smog screen over the truth would not be lifted unless the scientific data in question had a correct interpretation. At first glance, it seems unreasonable to discuss universal determinism in the quantum universe. Nevertheless, the claim that strong causality prevails in the material world, including consciousness, remains in place. Therefore, firstly criticizing determinism and then examining biological determinism will help to fix the conceptual framework. This article aims to explain why genetics and neurobiology, while acknowledging their importance in the realization of behavior, can’t completely abolish moral agency. Some hypotheses attribute consciousness and free will to the physico-shimic structure of the brain, the random activity of neurons, or the ability to automatically transform inputs into outputs with the advantage of genetic information. This is the most sensitive and important point of being human; it attacks free will. Paradoxically, while global civilization of our time promises infinite freedom to human beings the science of the same age tries to prove that it is not free. (shrink)

In this paper we (1) define and describe the practice of narrative medicine, (2) reveal the need for narrative medicine by exposing the presuppositions that give rise to its discounting, including a reductive empiricism and a strict dichotomy between scientific fact and narrative value, (3) show evidence of the effects of education in narrative competence in the medical clinic, and (4) present Peircean realism as the proper conceptual model for our argument that the medical school curriculum committees should give space (...) to the employment of the scientific and literary knowledge in medical practice. On account of our argument, we contend that the medical community should tend to latitude and openness with regard to the tools we use to resolve medical problems. These tools include both biomedical and narrative knowledge. (shrink)

An account and development of Arthur Murphy's Theory of Practical Reason and its application to contemporary moral problems. Chapter II gives a schematic account of Murphy's theory of normative discourse. Chapter III contrasts this theory with other theories and approaches. The author justly remarks that "Murphy's intent has been primarily to restore proper balance among considerations that play a role in practical discourse and to steer clear of the pitfalls which would impair or diminish the effectiveness of reason in human (...) actions." Chapter IV deals with "the contemporary erosion of practical reason and critique of existentialistic [[sic]] ethics." Chapter V contains an interesting discussion of Murphy's conception of developing and dynamic self as responsible agent. It gives recognition to the moral self as basic condition that underlies the activity of practical justification. The final chapter undertakes practical applications of the theory expounded. The monograph is a good exposition and defense of Murphy's important contribution to contemporary moral philosophy.--A. S. C. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Not Only Sub Specie Aeternitatis, but Equally Sub Specie DurationisA Defense of Hegel's Criticisms of Spinoza's PhilosophyJ. M. Fritzman and Brianne RileyIn what seem like halcyon days, when William Jefferson Clinton was America's President, James Carville wrote We're Right, They're Wrong: A Handbook for Spirited Progressives, arguing against the Republican Party's "Contract with America" (derided by the Left as a "Contract on America") and for progressivism. In the (...) present philosophical conjuncture, what is required is a precisely analogous intervention—"Hegel's Right, Spinoza's Wrong: An Article for Spirited Hegelians." Hegel criticizes Spinoza's philosophy at various places in his writings.1 Spinozists have made several major challenges to Hegel's criticisms.2 Although there have been explications of Hegel's criticisms, there has been no effective response to the Spinozists' challenges.3 Until now. This article defends Hegel's criticisms of Spinoza's philosophy and shows that the challenges to his criticisms fail.This article presents a précis of Spinoza's system and shows the senses in which Hegel is not wholly enamored with it. It defends Hegel's criticism of Spinoza's system as an acosmism from Parkinson's challenges to it. It considers both Myers's view that Hegel's system begins where Spinoza's system ends and McMinn's charge that the systems of Spinoza and Hegel are fundamentally identical. Myers and McMinn misunderstand Hegel's dialectical method, and so they incorrectly believe that the methods of Spinoza and Hegel are complementary. Hegel's dialectics can sublate the systematic pluralism that Myers and Armour propose as its alternative. The penultimate section discusses the modifications that must be made to Spinoza's system to advance from his substance to Hegel's subject.Clinton successfully appropriated what was worthwhile in the "Contract with America," but he also effectively argued that the "Contract" would be a disaster for America. Similarly, Hegel assimilates the truth in his predecessors' philosophies while demonstrating how those philosophies remain [End Page 76] one-sided and partial. This article concludes by showing how this happens to Spinoza's philosophy.Everybody Loves SpinozaSpinoza's philosophy is a metaphysical monism. That is, he thinks that there is only one basic substance. Although there is only one substance, it necessarily expresses itself through an infinite number of attributes, and an attribute is the essence of substance as experienced by the intellect.4 Humans are capable of knowing only two of these attributes: thought and extension. Objects, ideas, and relations—Spinoza refers to all of these as "modes"—are presented through some attribute or other. Spinoza denies that a thing presented through one attribute can cause or be affected by anything presented through another attribute. Rather, each thing which is presented through an attribute has an infinite number of counterparts presented through the infinite number of attributes. Indeed, those infinite counterparts are that thing, presented through the other attributes. Substance necessarily expresses itself through the attributes and modes, according to Spinoza, and everything that is possible is also actual.5Spinoza's substance expresses itself through its attributes and modes, but what occurs at the level of the attributes and modes has no reciprocal effect on substance. Like unrequited love, expression is a one-way street. Not e pluribus unum (out of many, one), but e unibus plurum (out of one, many). Unlike the relation of the states to the federal government, the attributes and modes do not possess a relative or circumscribed autonomy vis-à-vis substance.6 Substance expressing itself through its attributes and modes is nature, according to Spinoza, and nature in turn is God. Hence, Spinoza's God is wholly immanent within the world—for him, God is the world—and so he rejects that traditional God of theism, who transcends and is wholly independent from the world. Spinoza rejects as illusory all notions of purpose and intention.7 Although individuals generally believe that their actions are performed in order to fulfill some goal, Spinoza instead maintains that human actions are entirely determined and necessary and that the belief that actions are done to accomplish something is entirely mistaken. He believes that all happenings—physical... (shrink)

During the past few years considerable debate has arisen within academic journals with respect to the use of smart drugs or cognitive enhancement pharmaceuticals. The following paper seeks to examine the foundations of this cognitive enhancement debate using the example of methylphenidate use among college students. The argument taken is that much of the enhancement debate rests upon inflated assumptions about the ability of such drugs to enhance and over-estimations of either the size of the current market for such drugs (...) or the rise in popularity as drugs for enhancing cognitive abilities. This article provides an overview of the empirical evidence that methylphenidate has the ability to significantly improve cognitive abilities in healthy individuals, and examines whether the presumed uptake of the drug is either as socially significant as implied or growing to the extent that it requires urgent regulatory attention. In addition, it reviews the evidence of side-effects for the use of methylphenidate which may be an influential factor in whether an individual decides to use such drugs. The primary conclusions are that neither drug efficacy, nor the benefit-to-risk balance, nor indicators of current or growing demand provide sufficient evidence that methylphenidate is a suitable example of a cognitive enhancer with mass appeal. In light of these empirically based conclusions, the article discusses why methylphenidate might have become seen as a smart drug or cognitive enhancer. (shrink)

Treatment-resistant symptoms complicate the clinical course of schizophrenia, and a large proportion of patients do not reach functional recovery. In consequence, polypharmacy is frequently used in treatment-refractory cases, addressing psychotic positive, negative and cognitive symptoms, treatment-emergent side effects caused by antipsychotics and comorbid depressive or obsessive-compulsive symptoms. To a large extent, such strategies are not covered by pharmacological guidelines which strongly suggest antipsychotic monotherapy. Add-on strategies comprise combinations of several antipsychotic agents and augmentations with mood stabilizers; moreover, antidepressants and experimental (...) substances are applied. Based on the accumulated evidence of clinical trials and meta-analyses, combinations of clozapine with certain second-generation antipsychotic agents and the augmentation of antipsychotics with antidepressants seem recommendable, while the augmentation with mood stabilizers cannot be considered superior to placebo. Forthcoming investigations will have to focus on innovative pharmacological agents, the clinical spectrum of cognitive deficits and the implementation of cognitive behavioral therapy. (shrink)

The relevance of the study has two sides — individual and general. In its essential aspect, it is the development of achievements of predecessors by consistently taking into account the latest data on trends and changes in the interconnected spheres of education, economics and culture. In the individual aspect, it is about improving the professional means of improving the efficiency of teaching foreign languages in order to form students with a high level of linguistic-professional competence. Public relevance is the goal (...) of educating young people in a new patriotic direction, because today, due to various global influences, the classical principles of life in the agrarian system, created in recent centuries, or in the industrial society, are devalued due to various global influences. The purpose of the study in a broad sense was to highlight the causes and consequences of the European religious Reformation as the main factor in accelerating the movement of the whole of Western Europe to the position of the world leader that previously belonged to China. We see precis e tasks in the integrated analysis on the basis of the latest discoveries of many humanities and exact sciences in the educational, economic and cultural systems of Germany and other successful European states. On this basis, we hope to fulfill the public task which is to make significant proposals in the plans and practice of higher education reform in Ukraine. The methodology of the study relies on the best classical means, on the principle of historicism and the continuity of the connection between the material and the ideal, a modern multidisciplinary approach. For the highest effectiveness of the research, we will use the latest scientific data and recommendations of the innovators who collect and use these data. The results of the study mostly follow from the mentioned new discoveries. They testify that in ancientt history, in the role of locomotives of civilizational progress in the western part of Eurasia, direct descendants of the inventors of agriculture acted, among which the especially great contribution belongs to the ancestors of Ukrainians from the territories of Trypillya and the Great Trypillya. It is indicated that during the existence of the Great Trypillya, future German farmers acquainted themselves with the technologies of the Great Trypillya, so the German language, through borrowed words, became part of the Indo-European family. It is noted that after the collapse of the Great Trypillya, the Germans and Slavs became neighbors along the meridian Elbe. In the age of steppe invasions, future Ukrainians and Germanic tribes did not get in contact, and the influence of the Roman Empire was mostly experienced by western lands. Emphasis was placed on the evolution of ideological, religious and other paradigms in the territory of Germany after the collapse of the Holy Roman Empire, which determined the development of the nation for the next hundreds of years. The religious and philosophical paradigmatic origins of those unique features of culture and education that during the nineteenth century were emphasized. brought Germany to the position of the scientific and technological leader of the world. The high role of German neo-humanism and the Berlin Research University were noted. In the final section, special attention is paid to religious issues and to the destructive impact on social and other processes in the German immigration flows of Islamists. The conclusions focus on the competition of several important paradigms in the education of modern Germany and the proposals made to incorporate German experience in legislation and the use of the Bologna process. An important caution is made regarding the choice of Germany's strategy for the development of the scientific and educational complex 'within the framework of the Lisbon project. This country has become a world leader not only in alternative energy, but also in the implementation of the fourth industrial revolution. We consider an example of this leadership like the regular world conferences in Davos, which involve the majority of influential politicians and economists. (shrink)

This paper considers the argument that if the ban on doping in sports was abolished it would be possible to have doping under medical control, i.e. open doping, prescribed by doctors with collection of reliable information about effects and side-effects. A game-theoretic argument is developed showing that this positive scenario is very unlikely to be instantiated given reasonable assumptions about the motivation of sportspersons and sports doctors. It is furthermore shown that the standard arguments against the current ban on doping (...) also entail that if doping was made legal any requirements that it should be open doping could not be justified. (shrink)

When a physician acts as both doctor and researcher conflicts can develop. When a doctor does not know whether a patient is taking active drug or placebo, any new medical problems can result in a dilemma. Is the patient's suffering a side effect of the medication or is this a new medical problem? Mrs W's case demonstrates the problem that can occur when the physician is blinded in the name of research.

In a recent article, Gross argues that physicians in decent societies have a civic duty to aid in the torturing of suspected terrorists during emergency conditions. The argument presupposes a communitarian society in which considerations of common good override questions of individual rights, but it is also utilitarian. In the event that there is a ticking bomb and no other alternative available for defusing it, torture must be used, and physicians must play their part. In an earlier article, Jones also (...) argues in favour of physician participation in torture, going so far as to enthusiastically endorse the allocation of research resources as well to ensure that the ability to meet emergency situations is as efficient as scientifically possible. I argue against both these views and defend the absolute prohibition against torture generally, and against any participation by physicians in particular. I show that these arguments are incompatible with liberal or decent societies, and that the institutional requirements for making torture effective would constitute an unacceptable degradation both of medical ethics and practice, as well as of political institutions in general. (shrink)

The issues of the ethics of germ line modification in general and of enhancement by germ line modification in particular have been the subject of hundreds of articles in the bioethical literature. Both because the techniques are far from perfected and because the potential long term side effects are unkown, there is a widespread consensus that germ line modification for enhancement is absolutely unethical and beyond the pale at the present time. The author considers a thought expperiment projecting into the (...) future in which perhaps the safety and reversibility of germ line modification have been clearly demonstrated. Under such circumstances it is contended that the dividing line between treatment and enhancement is difficult and indeed perhaps impossible to maintain. The Jewish tradition is examined and from the various sources cited it would seem that the benefits of certain kinds of genetic enhancements might well outweigh the objections to such manipulations. (shrink)

Chapter one is an introduction. In chapter two, I argue that, due to a lack of knowledge of Newton, Hume is unable to use the "Science of Man" to provide a foundation for the other sciences. Hume's account of causality and the missing shade of blue receive special attention. Hume tries, without paying attention to scientific practice, to constrain what science can be about. ;In chapter three, I reconstruct Adam Smith's epistemology. The major theoretical concept of Smith's moral psychology, the (...) "Impartial Spectator," illuminates his views on the articulation and reception of scientific theories; it brings out the open-ended, social and norm-governed nature of science. Sentiments motivate inquiry, but adopting its results can still be reasonable. After Newton, Smith is not a skeptic, but a realist. ;In chapter four, I explain Smith's methodology in Wealth of Nations . Smith employs a model to enable observed deviations from expected regularities to uncover genuine social causes and aid in improving theory in a potentially open-ended process of successive approximation. I draw on The History of Astronomy where Smith attacks Descartes for trying to explain away deviations from general rules. ;In Chapter five, I explain the political aims of Smith's WN. Smith is an Incremental Redistributionist . Smith's reform proposals and the values that guide his theorizing are in aid of the working poor. I attack a possible political counter-argument against this by attending to Smith's historical understanding of property; Smith's defense of property rights, following Hume's critique of Locke, is by no means absolute. Yet, Smith's appeals to "humanity" appear without justification in WN. ;In chapter six, I investigate the purpose of philosophy in commercial society. In the debate between Rousseau and Hume on philosophic self-understanding, between self-sufficiency and independence, Smith sides with the latter. Smith emphasizes, however, that once basic needs are met, friendship among equals is a more valuable than wealth; it provides happiness and is within every one's reach. Philosophers can enjoy immortality after death if they attempt to be benefactors to humanity, but Smith believes that philosophic friendship is its own and highest reward. (shrink)

A distinction is commonly drawn between continuous sedation until death and physician-assisted suicide/euthanasia. Only the latter is found to involve killing, whereas the former eludes such characterization. I argue that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia in that both involve killing. This is established by first defining and clarifying palliative sedation therapies in general and continuous sedation until death in particular. A case study analysis and a look at current practices are provided. This is followed by a (...) defense of arguments in favor of definitions of death centering on higher brain (neocortical) functioning rather than on whole brain or cardiopulmonary functioning. It is then shown that continuous sedation until death simulates higher brain definitions of death by eliminating consciousness. Appeals to reversibility and double effect fail to establish any distinguishing characteristics between the simulation of death that occurs in continuous sedation until death and the death that occurs as a result of physician-assisted suicide/euthanasia. Concluding remarks clarify the moral ramifications of these findings. (shrink)

Most of us have two strong intuitions (or sets of intuitions) in relation to fairness in health care systems that are funded by public money, whether through taxation or compulsory insurance. The first intuition is that such a system has to treat patients (and other users) fairly, equitably, impartially, justly and without discrimination. The second intuition is that doctors, nurses and other health care professionals are allowed to, and may even in some cases be obligated to give preference to the (...) interests of their particular patients or clients over the interests of other patients or clients of the system. These two intuitions are in potential conflict. One of the most obvious ways in which to ensure impartiality in a health care system is to require impartiality of all actors in the system, i.e. to give health care professionals a duty to treat everyone impartially and to deny them the ‘right’ to give their patients preferential treatment. And one of the possible side-effects of allowing individual health care professionals to give preference to ‘their clients’ is to create inequality in health care. This paper explores the conflict and proposes that it can be right to give preference to ‘your’ patients in certain circumstances. (shrink)

We describe the informed consent procedures in a research clinic in Santiago, Chile, and a qualitative study that evaluated these procedures. The recruitment process involves information, counseling and screening of volunteers, and three or four visits to the clinic. The study explored the decision‐making process of women participating in contraceptive trials through 36 interviews. Women understood the research as experimentation or progress. The decision to participate was facilitated by the information provided; time to consider it and to discuss it with (...) partners or relatives; and perceived benefits such as quality of care, non‐cost provision of methods and medical care. For some women, participation was an opportunity to express altruism. The main obstacles for participation were perceived side effects or risks. The final risk‐benefit balance was strongly influenced by women’s needs. Women perceived that the consent form benefited the clinic, proving that participants had made a free decision, and benefited the volunteers by warranting their right to free medical care. The most important problem detected was occasional misunderstanding of the information given on the form. We concluded that a full decision‐making process enhances women’s ability to exercise their right to choose, and assures research institutions that trials are conducted without coercion and that the participants are committed to the study. Researchers have the responsibility of conducting this process. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Intention and Wrongdoing: A Defense of the Principle of Double Effect by Joshua StuchlikMichael J. DegnanSTUCHLIK, Joshua. Intention and Wrongdoing: A Defense of the Principle of Double Effect. Cambridge: Cambridge University Press, 2021. xvi + 220 pp. Cloth, $99.99In this book Joshua Stuchlik vigorously defends the principle of double effect (PDE), which states, "There is a strict moral constraint against bringing about serious evil (harm) to (...) an innocent person intentionally, but it is permissible in a wider range of circumstances to act in a way that brings about serious evil incidentally, as a foreseen but non-intended side effect." After defining the terms of the principle and considering an intuitive case-based defense, he supports its truth based on a standard of solidarity. Since the PDE requires the distinction between intended consequences and nonintended side effects, he explains Elizabeth Anscombe's theory of intention, which supports the distinction's moral significance. He uses her theory to treat the closeness problem, the irrelevance of intention critique, and a challenge from Joshua Greene's empirical moral psychology that purports to undermine deontological constraints on causing harm.I present Stuchlik's grounding for the PDE followed by an uncontroversial example of its application. After this I consider two important objections to the PDE that Stuchlik critiques: the closeness problem and James Rachels's argument that intentions are irrelevant to judging the moral permissibility of actions. I conclude by examining Stuchlik's treatment of these challenges.Stuchlik interprets the PDE's very strict constraint against intentional killing or seriously harming the innocent as a near absolute prohibition, for he believes innocent persons are not suitable recipients of intentional harm. He grounds this constraint on the principle of solidarity. Being in solidarity with another is possessing concern for that other's sake. The ground for this concern is a shared human nature that enables members to think of themselves as making a "we." Human nature consists in the structured potentialities for knowing and freely choosing. Evidence of these rational potentialities is the human orientation toward the transcendent values of truth and goodness. Such embodied potentialities have inviolable worth.The scenarios of the precision bomber and the terror bomber illustrate the moral significance of the intended harm versus the nonintended but foreseen harm that Stuchlik adopts from Elizabeth Anscombe's action theory. Each bombers' goal is to help his country win a just war. The precision bomber pursues that goal by targeting a munitions factory. Though he foresees that many noncombatants will be killed or seriously [End Page 367] injured from the bomb, he does not necessarily intend these harms. By contrast, the terror bomber targets a civilian center necessarily intending harm for noncombatants. The PDE rules out his conduct.Anscombe's account of intention can lead to the problem of closeness in which the content of an intention is sufficiently fine-grained that an agent need not intend harm in almost any situation. Stuchlik illustrates the problem with Alexander Pruss's zookeeper scenario.An eccentric literalistic but always truthful magnate tells Sam he will donate to famine relief saving a hundred lives if and only if Sam follows his directions to the iota. Sam is to purchase a gun, sneak at night into a zoo owned by the magnate and kill the first mammal he sees. Sam sneaks into the zoo, sees a mammal in the distance, and forms the intention to shoot it. Then he notices that the mammal is human but shoots nonetheless on utilitarian grounds.In this case applying the PDE shows that Sam is simply intending that a mammal be killed. The fact that the mammal is a human is irrelevant, according to Anscombe's action theory.Stuchlik's response clarifies the scope of intention in the PDE. As stated above, the intention's content includes seriously harming an innocent human. However, if the intention ranges only over an intention to bring about an effect, E, and it turns out that E is a serious harm for an innocent human being, then applying the principle shows that Sam's action is wrong. The intended effect of killing the mammal is, as a matter of fact, an... (shrink)

In this article, tragedy and utopia are juxtaposed, and it is proposed that the problem of “medicalisation” is better understood in a framework of tragedy than in a utopian one. In utopia, it is presupposed that there is an error behind every setback and every side effect, whereas tragedy brings to light how side effects can be the result of irreconcilable conflicts. Medicalisation is to some extent the result of such a tragic conflict. We are given power by medical progress, (...) but are also confronted with our fallibility, thus provoking insecurity. This situation is illustrated by the sudden infant death syndrome . Recent epidemiological investigations have shown that infants sleeping in a prone position have a 15–20 times higher risk of dying from SIDS than infants sleeping in a supine position. A simple means of preventing infant death is suggested by this discovery, but insecurity is also created. What else has been overlooked? Perhaps a draught, or wet diapers, or clothes of wool are just as dangerous as sleeping prone? Further investigations and precautions will be needed, but medicalisation prevails. (shrink)

Deep brain stimulation is a well-established therapy for the motor symptoms of Parkinson’s disease, but there remains an opportunity to improve symptom relief. The temporal pattern of stimulation is a new parameter to consider in DBS therapy, and we compared the effectiveness of Temporally Optimized Patterned Stimulation to standard DBS at reducing the motor symptoms of PD. Twenty-six subjects with DBS for PD received three different patterns of stimulation while on medication and using stimulation parameters optimized for standard DBS. Side (...) effects and motor symptoms were assessed after 30 min of stimulation with each pattern. Subjects experienced similar types of side effects with TOPS and standard DBS, and TOPS were well-tolerated by a majority of the subjects. On average, the most effective TOPS was as effective as standard DBS at reducing the motor symptoms of PD. In some subjects a TOPS pattern was the most effective pattern. Finally, the TOPS pattern with low average frequency was found to be as effective or more effective in about half the subjects while substantially reducing estimated stimulation energy use. TOPS DBS may provide a new programing option to improve DBS therapy for PD by improving symptom reduction and/or increasing energy efficiency. Optimizing stimulation parameters specifically for TOPS DBS may demonstrate further clinical benefit of TOPS DBS in treating the motor symptoms of Parkinson’s disease. (shrink)

The use of language models in Web applications and other areas of computing and business have grown significantly over the last five years. One reason for this growth is the improvement in performance of language models on a number of benchmarks — but a side effect of these advances has been the adoption of a “bigger is always better” paradigm when it comes to the size of training, testing, and challenge datasets. Drawing on previous criticisms of this paradigm as applied (...) to large training datasets crawled from pre-existing text on the Web, we extend the critique to challenge datasets custom-created by crowdworkers. We present several sets of criticisms, where ethical and scientific issues in language model research reinforce each other: labour injustices in crowdwork, dataset quality and inscrutability, inequities in the research community, and centralized corporate control of the technology. We also present a new type of tool for researchers to use in examining large datasets when evaluating them for quality. (shrink)

John Harris is one of the prominent philosophers and bioethicists of our time. He has published tens of books and hundreds of papers throughout his professional life. This paper aims to take a ‘deep-look’ at Harris' works to argue that it is possible to find some principles of Islamic ethics in Harrisian philosophy, namely in his major works, as well as in his personal life. This may be surprising, or thought of as a ‘big’ and ‘groundless’ claim, since John Harris (...) has nothing to do with any religion in his intellectual works. The major features of Harrisian philosophy could be defined as consequentialism or utilitarianism with liberal overtones. Despite some significant and fundamental differences in the application of principles (ie, abortion, euthanasia), the similarities between the major principles in Harrisian philosophy and Islamic ethics are greater at some points than the similarities between Islamic ethics and some other religious ethics (ie, Christian, Judaism). In this study I compare Harrisian teachings with major Islamic principles on ‘Responsibility’, ‘Side-effects and Double-effects’, ‘Equality’, ‘Vicious choice, guilt and innocence’, ‘Organ transplantation and property rights’ and ‘Advance directives’. (shrink)

Efforts for better services are achieved by small steps such as analyzing data of the customer. What is significant for the customer should as well significant for the banking institution. Transparency and a better understand- ding of the pattern behavior of customers can be used for the good of both partners such as good relationships in the fu- ture eventually be beneficial for the customer as well as a banking institution. The responsibility of both sides is crucial to understand the (...) accountability of customers and banking institutions. The method of identification of user messages of the banking application proposed in the article involves the use of user data for information processing, taking into account the peculiarities of the use of mobile devices and the user's dialogue with bank messages. Also, the proposed method allows you to rank messages to identify the most important messages and get the desired result by providing ef- fective recommendations in favor of each of the participants in customer interaction with the bank. The introduction of modern educational programs "Information Control Systems and Technologies", "Artificial Intelligence Systems" and "Systems Analysis" in the field of information technology, allows users and managers to interact with the bank's custo- mers sufficient information to make informed recommendations for effective management decisions. The article consi- ders the conceptual model of interaction of users and managers on interaction with users of the bank, use of technolo- gies and algorithms of artificial intelligence, machine learning processes to formalize the process of dialogue, systema- tization and ranking of messages and notifications between customers and managers. The Conceptual model of inter- action of the user of banking services with messages is presented. The article also describes the features of the dialogue between the user of banking services and the manager for the implementation of algorithms for interaction with custo- mers. The example of the city block of bank users considers and takes into account the difference in the amount of in- formation received by the bank, which must be sent during different periods of the week and take into account the amount of information to be sent, which will be significantly less and, consequently, the number of necessary services. will also be smaller. In this example, taking into account the amount of information that can be consumed during differ- rent periods of the week, the number of services that can be provided to the user will also be much smaller. The reflec- tion of such interactions in the model is an important aspect, as noted in the article. (shrink)

Pharmacological substances used to improve cognition and brain function range from dietary supplements and caffeine to drugs targeted at altering particular neurochemical concentrations in the brain. This article considers current scientific research into pharmaceutical cognitive enhancement and likely future directions. Then it discusses the trends in the use of PCEs within patients groups for whom they were intended, as well as in those for whom they were not originally intended, including healthy adults and children. Finally, it provides an overview of (...) current and future ethical considerations and concludes that the use of PCE will likely continue both within patient and healthy individuals in the foreseeable future. Information regarding actual use, benefits, and harms in various populations is severely lacking. Therefore, more emphasis should be placed on obtaining the relevant empirical data, for example, by the long-term monitoring of effectiveness and side effects, and by accurate large-scale surveys to assess actual usage. (shrink)

The doctrine (or principle) of double effect is often invoked to explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end. According to the principle of double effect, sometimes it is permissible to cause a harm as a side effect (or “double effect”) of bringing about a good result even though it would not be permissible to cause such a harm as a (...) means to bringing about the same good end. Does the principle of double effect play the important explanatory role that has been claimed for it? To consider this question, one must be careful to clarify just what the principle is supposed to explain. Three misinterpretations of the principle’s force or range of application are common. 1. To ensure that Double Effect is not misunderstood as principle issuing a blanket permission on causing any unintended harm that yields a benefit, applications must require that the agent seek to minimize the harm involved. 2. Since it is widely accepted that it is wrong to aim to produce harm to someone as an end, to rule this out is not part of double effect’s distinctive content. 3. Harms that were produced regretfully and only for the sake of producing a good end may be prohibited by double effect because they were brought about as part of the agent’s means to realizing the good end. (shrink)

Background: Mental fatigue can impact physical demands and tactical behavior in sport-related contexts. Small-sided games are often used to develop a specific sport-related context. However, the effects of mental fatigue on physical demands and tactical behaviors during soccer SSGs have not been aggregated for systematical assessment.Objective: This systematic review was conducted to compare the effects of mental fatigue vs. control conditions in terms of the total running distance and tactical behavior of soccer players during SSGs.Methods: The data sources utilized were (...) PubMed, PsycINFO, Scielo, Scopus, SPORTDiscus, and Web of Science. The study eligibility criteria were established based on PICOS: Population: healthy youth and young adult men soccer players with regular training practice and belonging to teams with regular competitions; Intervention: exposed to mental fatigue-induced protocols only before SSGs; Comparator: control conditions before SSGs; Outcomes: physical demands and tactical behavior ; Study design: counterbalanced cross-over design; and only full-text and original articles written in English.Results: The database search initially identified 111 titles. From those, six articles were eligible for the systematic review and meta-analysis. Results showed no significant effect of fatigue on total running distance and tactical behavior.Conclusions: A non-significant effect of mental fatigue on total running distance and tactical behaviors performed by soccer players during SSGs was found in this systematic review. (shrink)

Monetary intelligence theory asserts that individuals apply their money attitude to frame critical concerns in the context and strategically select certain options to achieve financial goals and ultimate happiness. This study explores the dark side of monetary Intelligence and behavioral economics—dishonesty. Dishonesty, a risky prospect, involves cost–benefit analysis of self-interest. We frame good or bad barrels in the environmental context as a proxy of high or low probability of getting caught for dishonesty, respectively. We theorize: The magnitude and intensity of (...) the relationship between love of money and dishonest prospect may reveal how individuals frame dishonesty in the context of two levels of subjective norm—perceived corporate ethical values at the micro-level and Corruption Perceptions Index at the macro-level, collected from multiple sources. Based on 6382 managers in 31 geopolitical entities across six continents, our cross-level three-way interaction effect illustrates: As expected, managers in good barrels, mixed barrels, and bad barrels display low, medium, and high magnitude of dishonesty, respectively. With high CEV, the intensity is the same across cultures. With low CEV, the intensity of dishonesty is the highest in high CPI entities —the Enron Effect, but the lowest in low CPI entities. CPI has a strong impact on the magnitude of dishonesty, whereas CEV has a strong impact on the intensity of dishonesty. We demonstrate dishonesty in light of monetary values and two frames of social norm, revealing critical implications to the field of behavioral economics and business ethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 22 (2002) 133-135 [Access article in PDF] Response to Harry L. Wells Frances S. Adeney Louisville Presbyterian Theological Seminary Current understandings of how religions may reflect divine truth often use a model developed in England by Alan Race that designates attitudes toward other religions as exclusive, inclusive, or pluralist. John Hick's use of this seemingly simple paradigm, in conversation with scholars in the United States, presupposes the (...) reality of the divine, along with the unknowability of that reality through any human effort or religious tradition. Hick mediates that tension by calling on practitioners of all religions to recognize the relativity of their beliefs and, on that basis, tolerate the religions of others. Both use of and critiques of that model have generated lively discussion among scholars and practitioners of religions.Consider, for example, two possible ways to move beyond this model. The first is theological. Attempts to describe the divine by speaking of transcendence, immanence, or emptiness stretch human ability to conceptualize and communicate. Enlarging the understanding of God from within a tradition itself to a view that understands God's presence to be active in all traditions, moves us beyond the pluralist category. A second way of going beyond the current model does not attempt to elucidate pan-religious conceptions of the divine but strives to analyze particular traditions themselves. The history of particular traditions and their encounters with one another influence the theologies of the religions themselves and shape theories of religious otherness purported by those traditions. Finding a particular historical set of conditions and beliefs conducive to a positive pluralism that maintains the integrity of each tradition without relativizing all positions would move us beyond Hick's current relativizing pluralist position. These two approaches each struggle with a different side of the tension resulting from presuppositions in the theory of religions put forward in the exclusivist, inclusivist, pluralist model. The first grapples with the ontological issues and the second addresses the epistemological issues of that tension.Harry Wells chooses to work with the first—the ontological assumption of divine reality. He outlines a Christian Trinitarian relational view of God that not only encompasses but goes beyond the pluralist category as outlined by John Hick. At the same time, he finds the source for that view in a particular historical tradition of Christianity—the early church fathers. [End Page 133]Wells begins by wondering how he can move beyond Raimon Panikkar's pluralism, which, he claims, already moves beyond Hick's understanding of the pluralist category. Wells then outlines his own pluralist understanding by describing a dynamic and relational understanding of the divine. In so doing, he entertains the notion of knowing something of noumenal reality, no matter how indirectly, through the eyes of a particular tradition. By drawing the circle of divine presence very widely, Wells attempts to express from within the Christian tradition a view of God that allows for a distinctive divine work through other traditions. The practitioner, through experience, encounters a reality that changes perceptions both of the divine and of the religious other.Here Wells moves beyond the necessity of deconstructing all absolute claims to truth by different religions in order to maintain a pluralist position. Rather than relativize all particular religious traditions, as Hick suggests, Wells utilizes a perspectival approach and projects from it a view of the divine that allows for truth in other traditions. In this way he removes the debilitating necessity of embracing agnosticism by all religious traditions and shows, rather, how pluralist claims may be formed from within a single deeply held tradition.This broader understanding of the divine, rooted in early Christian mysticism according to Wells, does not rule out tolerance of other religions but embraces tolerance for reasons of faith, rather than through agnosticism. In effect, Wells argues that a theological orientation growing from an encounter with divine mystery influences the articulation of a specific tradition and its stance toward other religions.While avoiding the dualism inherent in studying religions only phenomenonologically and, at the same time, postulating a noumenal reality, this approach is not without its dangers. One... (shrink)

Lady Mary Shepherd holds that the relation of cause and effect consists of the combination of two objects to create a third object. She also holds that this account implies that causes are synchronous with their effects. There is a single instant in which the objects that are causes combine to create the object which is their effect. Hume argues that cause and effect cannot be synchronous because if they were then the entire chain of successive causes and effects would (...) all collapse into a single moment, and succession would not be possible. I argue that Shepherd has a ready, although implicit response, to Hume’s argument. Since causation is combination on Shepherd’s view, she is free to hold that there are times in between those instants in which combinations occur, during which times other, non-combinatory changes occur, which changes account for succession. (shrink)

I am very grateful to the five commentators for taking the time to respond to my article ‘The Active Recruitment of Health Workers: A Defense’.1 I have learned a great deal from each of their commentaries, and I am sorry to say that I will be unable to address all their important comments and criticisms in detail. In this response, I will focus on replying to the commentators’ major objections.In my paper, I suggested that the emigration of health workers (...) from poor countries might not have harmful effects on health outcomes in general, or may only have relatively small negative effects in a wide range of cases. Several commentators challenge my analysis. Carwyn Rhys Hooper suggests that it is prima facie plausible that the emigration of health workers causes harm, and that there is insufficient evidence to reject this claim.2 Gilian Brock3 and Iain Bassington4 argue that my paper failed to consider the full range of possible harms that the active recruitment of health workers brings about. These commentators are correct in that we need more evidence about the effects of migration, and that it may be too soon to arrive at the all-things-considered judgment that the emigration of health workers does not generally enable serious harm.Nonetheless, I believe that the active recruitment of health workers is still permissible. For one thing, I am less confident than Brock that the empirical research on skilled migration clearly establishes that the migration of skilled professionals causes harm to sending countries. There is a sizable body of empirical research that is inconsistent with many of Brock's claims. It is not obvious that the emigration of skilled workers depletes human capital in the sending country.5 ,6 In fact, there is evidence that the opportunity to emigrate …. (shrink)

Whereas indirect euthanasia is a common clinical practice, active euthanasia remains forbidden in most countries. The reason for this differentiation is usually seen in the principle of double-effect (PDE). PDE states that there is a morally relevant difference between the intended consequences of an action and merely foreseen, unintended side-effects. This article discloses the fundamental assumptions presenting the basis for this application of the PDE and examines whether these assumptions are compatible with the PDE. It is shown that neither a (...) liberal nor a utilitarian point of view makes the utilization of the PDE possible. In accordance with philosophical tradition, only within the doctrine of the sanctity of life does the PDE seem to be applicable. By analysing the premises of this doctrine, and comparing them with those of the PDE, the inconsistency of this idea is demonstrated. It is suggested that the role of the PDE in the current discussion on euthanasia is largely exaggerated. (shrink)

The number of people who survive critical illness is increasing. In parallel, a growing body of literature reveals a broad range of side-effects following intensive care treatment. Today, more attention is needed to improve the quality of survival. Based on nine individual stories of illness experiences given by participants in two focus groups and one individual interview, this paper elaborates how former critically ill patients craft and recraft their personal stories throughout their illness trajectory. The analysis was conducted from a (...) phenomenological perspective and led to the meaning structure; a quest to find oneself after critical illness. In this structure, illness represented a breakdown of the participants’ lives, forcing them to develop a new understanding of themselves. Despite acute illness, they felt safe in hospital. Coming home, however, meant a constant balancing between health and illness, and being either in or out of control. To gain a deeper understanding of the participants’ narratives of survival, the meaning structure was developed from a phenomenological life world perspective, Heidegger’s concept of homelikeness and Arthur Frank’s typologies of illness narratives. In conclusion listening to and acknowledging the patients’ lived experiences of critical illness may support the patient efforts to establish the newly defined self and hence be vital for recovery. Phenomenology is one approach facilitating care tailored to the patients’ lived experience of critical illness and its aftermaths. (shrink)

Rewards are reinforcement mechanisms that organizations use to shape desirable employee behaviors. However, rewards may also have unintended consequences, such as building expectations for receiving extra benefits and weakening employee barriers to unethical acts. This article investigates the dark side of the reward–behavior association, and exploring what is referred to as the reward–theft parity effect (RTPE). The authors hypothesize that receiving rewards induces a corresponding type of theft. In Study 1, survey results (n = 634) show initial support for the (...) RTPE between rewards and same‐category theft, and that perceptions of procedural justice attenuate this association. Study 2 involved a 2 (reward) × 2 (theft opportunity) between‐subjects experimental design (n = 300) and provides further support for the RTPE by revealing greater theft under a reward–theft parity condition than under a reward–theft disparity condition. Study 3 replicates these findings in a field experiment (n = 285) and finds that the RTPE is exacerbated when the reward–behavior task is perceived as unjust. Collectively, these findings provide new theoretical insights while also giving managers a more complete understanding of the dark side of behavioral reinforcement mechanisms. (shrink)

This book is a detailed examination of Thomistic objectivist aesthetics in the context of a criticism of contemporary subjective theories. The thesis of the book is developed logically with many, and often detailed, references to the history of aesthetics. There are numerous useful footnotes and a large bibliography and index. In the context of his realist position, Kovach seeks "... the ultimate principles or causes of the beauty of things" which he argues entail the "... extramental, objective reality of beauty." (...) His thesis rests on empirical fact; "... while seeing and/or hearing certain objects, some people experience delight" and the beauty "in" the things causes this delight. After discussing problems of causality, Kovach defends the argument that beauty is similar to other physical qualities which the realist believes are in necessary cause-and-effect relationships. This involves him in a criticism of subjectivism and relativism. He does this by means of a thorough description and treatment of thirty-six reasons for aesthetic disagreement. I would agree that relationism is a form of objectivism but not, as he claims, "ill-disguised." Aesthetic perception may be a way of perceiving things that have the required components to elicit this response. Such a relation might be described phenomenologically. Beauty for Kovach is explained cosmologically; we reach an understanding of absolutely universal beauty by determining the essence of material beauty through progressively complex instances. His defense is interesting. For example, he diagrams the most plausible divisions of beauty from the history of aesthetics and argues that all things in creation participate in beauty by a clever examination of theories of ugliness.—P.S. (shrink)

We formulate and analyze the dynamics of an influenza pandemic model with vaccination and treatment using two preventive scenarios: increase and decrease in vaccine uptake. Due to the seasonality of the influenza pandemic, the dynamics is studied in a finite time interval. We focus primarily on controlling the disease with a possible minimal cost and side effects using control theory which is therefore applied via the Pontryagin’s maximum principle, and it is observed that full treatment effort should be given while (...) increasing vaccination at the onset of the outbreak. Next, sensitivity analysis and simulations (using the fourth order Runge-Kutta scheme) are carried out in order to determine the relative importance of different factors responsible for disease transmission and prevalence. The most sensitive parameter of the various reproductive numbers apart from the death rate is the inflow rate, while the proportion of new recruits and the vaccine efficacy are the most sensitive parameters for the endemic equilibrium point. (shrink)

The problem of non-compliance with treatment and its repercussions on the clinical evolution of different conditions has been widely investigated.1–4 Non-compliance has also been shown to have significant economic implications, not only as a result of product loss but also indirectly through the complication of disease management and its subsequent healthcare and social costs.5–7Non-compliance as a health problemThe term “non-compliance” might be taken to refer both to the failure to follow a drug regimen and to the failure to adopt other (...) measures that contribute to improvement in health—for example, changes in lifestyle or diet. This letter focuses on the former.Non-compliance with a drug regimen can be the result of a number of different factors9–11 and a variety of techniques have been developed in an attempt to control it.12,13 Of these, the few techniques that have been shown to be effective have only managed to solve the problem in specific situations over short periods of time. The use of such techniques to control non-compliance, particularly where these are effective, raises interesting ethical questions about the extent to which their application constitutes an infringement of the patient’s right to decide on how to manage their own health.8 Here we suggest that in some cases one factor that leads to non-compliance is the tendency to provide extensive and exhaustive information on side effects in …. (shrink)

Retrieval of relevant unstructured information from the ever-increasing textual communications of individuals and businesses has become a major barrier to effective litigation/defense, mergers/acquisitions, and regulatory compliance. Such e-discovery requires simultaneously high precision with high recall (high-P/R) and is therefore a prototype for many legal reasoning tasks. The requisite exhaustive information retrieval (IR) system must employ very different techniques than those applicable in the hyper-precise, consumer search task where insignificant recall is the accepted norm. We apply Russell, et al.’s cognitive (...) task analysis of sensemaking by intelligence analysts to develop a semi-autonomous system that achieves high IR accuracy of F1 ≥ 0.8 compared to F1 < 0.4 typical of computer-assisted human-assessment (CAHA) or alternative approaches such as Roitblat, et al.’s. By understanding the ‘Learning Loop Complexes’ of lawyers engaged in successful small-scale document review, we have used socio-technical design principles to create roles, processes, and technologies for scalable human-assisted computer-assessment (HACA). Results from the NIST-TREC Legal Track’s interactive task from both 2008 and 2009 validate the efficacy of this sensemaking approach to the high-P/R IR task. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Standards of Music Education and the Easily Administered Child/Citizen: The Alchemy of Pedagogy and Social Inclusion/Exclusion Thomas S. Popkewitz and Ruth Gustafson University of Wisconsin-Madison Educational standards are forsome a corrective device to promote the twin goals of excellence and equity by making explicit the performance outcomes ofschooling. For others, performance standards do not do what they say and install the wrong goals for teaching. But various sides in (...) the debate assume that school subjects teach the subjects and what is needed are more effective and efficient classroom practices. Our approach is different. We consider the standards of school subjects as related to the conditions of state governing. School subjects inscribe principles that administer the conduct ofthe child who is to grow into the "reasonable citizen." The Standards Movement is more than what is publicly discussed. Pedagogy embodies particular ways ofthinking or a system ofreason in which pedagogy orders who we are, who we should become, and who are not qualifiedto become that "we." If we think of modern schooling as an inscription device in the fonning of the citizen through the development ofthe child, the crux of the debate is not whether to have standards. It is how particular standards are inscribed through pedagogicalpractices. Ifwe treat school subjects as analogous to a uniform system of taxes, the developmentofuniformmeasurements, andurban planning in the modem state, our concern is with the boundaries created about the rules and standards of reason and the reasonable person. Pedagogygoverns inadoublesense: schoolmusic embodies representations that constitute the objects that children act on as real, and it generates principles to orderand patrol the borders that qualify and disqualify individuals for participation. The standards that govern music education can be thought about as an alchemy.1 The field of music is transported and translated into school subjects andpedagogical content. As the sorcerer ofthe middle ages sought to turn lead into gold, a specializedpedagogyplaces children in a new set ofrelations that is no longerthe academic field of music. Why is the alchemy important? First, the alchemy ofschool subjects is a particular system of reason that fabricates the kinds of people administered in schooling. Second, the alchemy reconfigures the sensitivities and awarenesses of the field of music to make the child's "soul" the site of administration. That soul in music and other school subjects is talked about today as personaldevelopment, self-reflection,personality, and character. Third, school subjects are sites in which the relations between the state, society, community, and individuality are worked and reworked to produce the borders ofinclusion and exclusion. The first section of this paper considers school subjects as a practice of governing that administersprinciples (orstandards ifwecanplay with that word) about who we are and should be. The second section considers psychology as the translation device that transports academic disciplines into school subjects. It may seem odd at firstglancebutthesamepsychologicaltransportation systems exist across school subjects. The historical intervention of the transportation system, we argue in the third section, has little to do with understanding music or science, but with governing the soul. In that section we examine the different cultural practices that overlap to©Philosophy ofMusic Education Review 10, no. 2 (Fall, 2002): 80-91. Thomas S. Popkewitz/Ruth Gustafson 81 generate principles that orderthe nature ofmusic, the child/childhood, teaching, and reflection and subjectivity in music education. The discussion is not about the internal structure or the goodness ofmusic education but the particular frames of reference that form the evidence and possibilities of reform in school subjects. We take up the task ofinquiry into the alchemy of music as part of a broader project to show the contingency ofthe arrangement that we live by showing how thought has played a part in holding those arrangements together and to contestthe strategiesthatgovernthehumanpossibilities. The Art ofGoverning: Standards as Mapping Who We are/to Become Themodern state governs through developing a precise system of classifications and the correct sorting devices to chart a course ofaction that will change society for the better and which will prevent any futurejoining ofthe ranks ofthe poorly performing. To govern is to develop systems ofclassification that calculate and make legiblepeople fortheadministrationofthe society and the citizen. Mass schooling is a central institution in... (shrink)

Germany has just started a public debate on priority-setting, rationing and cost-effectiveness due to the cost explosion within the German health care system. To date, the costs for German health care run at 11,6 % of its Gross Domestic Product (GDP, 278,3 billion €) that represents a significant increase from the 5,9 % levels present in 1970. In response, the German Parliament has enacted several major and minor legal reforms over the last three decades for the sake of cost containment (...) and maintaining stability of the health care system. The Statutory Health Insurance—SHI (Gesetzliche Krankenversicherung—GKV) is based on the fundamental principle of solidarity and provides an ethical and legal framework for implementing equity, comprehensiveness and setting the principles and rules for financing and providing health care services and benefits. Within the SHI system, several major actors can be identified: the Federal Ministry of Health, the 16 state ministries of health, the Federal Joint Committee (G-BA), the physicians (with their associations) and the hospitals (with their organizations) on the provider side, and the sickness funds with their associations on the purchasers’ side. This article reviews the structure and complexities of the German health care system with its major players and participants. The focus will be put on relevant ethical, legal and economic aspects for prioritization, rationalization, rationing and cost-effectiveness of medical benefits and services. In conclusion, this article pleads for open discussion on the challenging subject of priority-setting instead of accepting the implicit and non-transparent rationing of medical services that currently occurs at many different levels within the health care system, as it stands today. (shrink)

This article is divided into two main sections. In section 1, I highlight some of the most significant results of Parfit's discussion of self-defeating theories in Part I of Reasons and Persons. I then argue, against Parfit, that, depending on the nature of the good, the structure of consequentialist, or agent-neutral, theories does not preclude the possibility that such theories may be self-defeating. In section 2, I discuss Parfit's ingenious argument against the self-interest theory, to the effect that as a (...) “hybrid” theory, which is “partial” with respect to people but “neutral” with respect to time, the self-interest theory occupies a dangerous middle ground that is open to attack from two sides: on one side, by a “pure” theory that is partial with respect to both people and times, and on the other side, by a “pure” theory that is neutral with respect to both people and times. I then raise doubts, prompted by the form of Parfit's argument, as to whether there is a general requirement that we treat people, places and times the same, except, perhaps, in cases involving special relations. Specifically, I suggest that there may be reason to treat space differently than time, and that there are compelling reasons to treat persons differently than time. (shrink)

In _The American Way of Peace, _Jan S. Prybyla traces the implementation of an idea derived from bedrock American values that has shaped the American character from the nation’s beginning. The idea—simple, generous, optimistic, and effective—was and remains to give people realizable hope, an attainable dream, by creating a peaceful, secure, and materially comfortable world, a Pax Americana, the American Way of Peace. In the period surveyed, beginning with the end of World War II, this objective was achieved through American (...) initiative and with American leadership, despite resistance from Nazi barbarism, Soviet serfdom, and, more recently, Islamic extremist inhumanity. There has also been opposition from some of those in the western confines of Europe whom Pax Americana helped raise from the ashes to which they had been reduced. _The American Way of Peace _examines the work of reconstruction, the enemy bombardment, as well as the hurtful sniping along the way by the beneficiaries of American support. Prybyla recommends a reevaluation of American relations with those to whom friendship is but a utilitarian device, in light of the present eruption of terrorism worldwide. The need for America to act wisely and resolutely in defense of civilized values, to stem the third tidal wave of terrorist savagery, and to venture where others fear to tread is more compelling now than it has been in the six decades past, for today America’s very survival as a force for immense good in the world is being put to the test. (shrink)

In Roman Catholic Moral Theology, a direct abortion is never permitted. An indirect abortion, in which a life threatening pathology is treated, and the treatment inadvertently leads to the death of the fetus, may be permissible in proportionately grave situations. In situations in which a mother’s life is endangered by the pregnancy before the fetus is viable, there is some debate about whether the termination of the pregnancy is a direct or indirect abortion. In this essay a recent case from (...) a Roman Catholic sponsored hospital in Phoenix is reviewed along with the justifications for and arguments against viewing the pregnancy termination as an indirect abortion. After review of several arguments on both sides of the debate, it is concluded that termination of the pregnancy itself as the means of saving the mother cannot be considered an indirect abortion and that the principle of “double effect” does not justify the termination. In addition, the importance of a breakdown in communication between the local bishop and the administration of the hospital is shown to have contributed to the ultimate loss of Catholic sponsorship of the hospital. (shrink)

It has long been thought that the central nervous system is able to influence the progression of disease. Furthermore, there is now overwhelming evidence that the communication pathways are bidirectional. A variety of immune system peptides are now known to be capable of transmitting information from the immune system to the central nervous system. These immunotransmitters include interleukins, interferons and thymosine peptides which have the capability of modulating slow‐wave sleep as well as the release of neuro‐ and pituitary peptides. In (...) some instances, release of these peptides during early development may have long lasting, if not permanent effects upon the normal development of neuro‐endocrine circuits. Collectively these various brain mediated events appear to contribute in various and diverse ways to defense against pathogens. It is becoming more and more apparent that certain abnormalities within the immune system may be the consequence of a neurological abnormality. The converse is also true. (shrink)