It is uncontroversial that something goes wrong with the blaming practices of hypocrites. However, it is more difficult to pinpoint exactly what is objectionable about their blaming practices. I contend that, just as epistemologists have recently done with blame, we can constructively treat hypocrisy as admitting of an epistemic species. This paper has two objectives: first, to identify the epistemic fault in epistemically hypocritical blame, and second, to explain why epistemically hypocritical blamers lose their standing to epistemically blame. I tackle (...) the first problem by appealing to an epistemic norm of consistency. I address the second by arguing that the epistemically hypocritical blamer commits to an opting-out of the set of shared epistemic standards that importantly underlies our standing to epistemically blame. I argue further that being epistemically hypocritical undermines a blamer’s standing even to judge epistemically blameworthy. (shrink)

We can contrast rationalising explanations of the form S φs because p with those of the form S φs because S believes that p. According the Common Kind View, the two sorts of explanation are the same. The Disjunctive View denies this. This paper sets out to elucidate the sense in which the Common Kind Theorist asserts, but the Disjunctivist denies, that the two explanations are the same. I suggest that, in the light of the distinction between kinds of explanation (...) and particular explanations, the relevant sameness thesis is ambiguous, thus giving us two distinct versions of the Common Kind View. I then argue that the only direct arguments for Disjunctivism available in the literature fail because they only succeed in undermining one version of the Common Kind View. I finish, however, by providing a fresh argument for the Disjunctive View which aims to undermine both versions of its competitor. (shrink)

Purpose Although surrogate decision-making is prevalent in intensive care units and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. Subjects and methods We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death. We developed and applied a (...) coding framework to identify normative statements by clinicians regarding what considerations should guide surrogates’ decisions, including whether clinicians explained one or more of Buchanan and Brock’s three standard principles of SDM to family members. Results Clinicians made at least one statement about how to perform the surrogate role in 24 conferences ). We observed three general types of normative guidance provided to surrogates, with some conferences containing more than one type of guidance: counselling about one or more standard principles of SDM ; counselling surrogates to make decisions centred on the patient as a person, without specifying how to accomplish that ; and counselling surrogates to make decisions based on the family’s values. Conclusions Clinicians did not provide normative guidance about the surrogate role in two-thirds of family conferences for incapacitated patients at high risk for death. When they did, clinicians’ guidance was often incomplete and sometimes conflicted with standard principles of SDM. Future work is needed to understand whether providing explicit guidance on how to perform the surrogate role improves decision-making or mitigates surrogates’ psychological distress. (shrink)

Purpose Although surrogate decision-making is prevalent in intensive care units and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. Subjects and methods We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death. We developed and applied a (...) coding framework to identify normative statements by clinicians regarding what considerations should guide surrogates’ decisions, including whether clinicians explained one or more of Buchanan and Brock’s three standard principles of SDM to family members. Results Clinicians made at least one statement about how to perform the surrogate role in 24 conferences ). We observed three general types of normative guidance provided to surrogates, with some conferences containing more than one type of guidance: counselling about one or more standard principles of SDM ; counselling surrogates to make decisions centred on the patient as a person, without specifying how to accomplish that ; and counselling surrogates to make decisions based on the family’s values. Conclusions Clinicians did not provide normative guidance about the surrogate role in two-thirds of family conferences for incapacitated patients at high risk for death. When they did, clinicians’ guidance was often incomplete and sometimes conflicted with standard principles of SDM. Future work is needed to understand whether providing explicit guidance on how to perform the surrogate role improves decision-making or mitigates surrogates’ psychological distress. (shrink)

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

There are at least a few plausible grounds for our use of the term Beta in our title, notwithstanding that there is a key departure, in our framework, from classical Beta Existential Graphs. The situation, in brief, is as follows.The reader accustomed to Peirce’s graphical development of quantificational logic may, if desired, continue to think of formulas being written on a “sheet of assertion.” We retain the “cut” notation for negation and continue to represent conjunction simply by juxtaposition of diagrams. (...) However, on the side of departure, we dispense with the sometimes problematic “lines of identity” of classical Beta and instead represent a quantification by a.. (shrink)

This paper purports to provide a fresh cashing out of Debasing Scepticism: the type of Scepticism put on the map in a recent article by Jonathan Schaffer, with a view to demonstrating that the Debasing Sceptic’s argument is not so easily dismissed as many of Schaffer’s commentators have thought. After defending the very possibility of the Debasing Sceptic’s favoured sceptical scenario, I lay out a framework for thinking of the agent’s power to hold their beliefs in the light of reasons (...) which I argue has initial plausibility. I then attempt to show that with this framework in tow, the Debasing Sceptic has an argument for their sceptical conclusion available to them which Schaffer’s commentators have failed to undermine, and which is independently interesting. (shrink)

Journalism and media ethics texts commonly invoke Aristotle's Golden Mean as a principal ethical theory that models such journalistic values as balance, fairness, and proportion. Working from Aristotle's text, this article argues that the Golden Mean model, as widely understood and applied to media ethics, seriously belies Aristotle's intent. It also shortchanges the reality of our moral agency and epistemic responsibility. A more authentic rendering of Aristotle's theory of acting rightly, moreover, has profound implications for communication ethicists and media practitioners.

Most mainstream psychologists consider philosophy irrelevant to their work, but see themselves as realists. Various opposition movements embrace philosophy but reject realism, either completely or partially, despite upholding ideas consistent with a realist philosophy. Many on both sides see the Tower of Babel that constitutes psychology as a sign of healthy diversity, not fragmentation. We argue that relations among the three factors – philosophy, realism and fragmentation – deserve closer scrutiny. With philosophy’s core method of conceptual analysis deprioritized, both mainstream (...) psychology and the opposition fracture into an array of “partial realisms”, falling away from a realism that is thoroughly consistent. These are the source of psychology’s fragmentation. The conceptual neglect and resulting confusions can be seen in psychology’s recent replicability crisis, and in the widespread adoption of a representationalist approach to the mind/brain. We argue that the metatheoretical coherence and methodological maturity required for genuine scientific progress involves a consistent adherence to realism. We spell out what that involves and consider several reasons why this has been so difficult for psychology. (shrink)

The article “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Marshall et al. (2024) highlights the critical issue of care after an opioid overdose. “Revive and Re...

Central to the thought of C.B. Macpherson are his critique of the culture of ‘possessive individualism’ and his defence of liberal-democratic socialism. Resurgence of interest in his works is in reaction to the rise of neoliberalism and efforts to find an alternative to societies dominated by capitalist markets. Macpherson’s theories are explained and applied to 21st century challenges.

It is now standard in the literature on reasons and rationality to distinguish normative reasons from motivating reasons. Two issues have dominated philosophical theorising concerning the latter: (i) whether we should think of them as certain (non-factive) psychological states of the agent – the dispute over Psychologism; and (ii) whether we should say that the agent can Φ for the reason that p only if p – the dispute over Factivism. This paper first introduces a puzzle: these disputes look very (...) much like merely verbal disputes about the meaning of phrases like `S’s reason’ in motivating reasons ascriptions, and yet charity requires us to think that something substantive is afoot. But what? The second aim of the paper is to extract substantive theses from certain natural arguments for Psychologism and Anti-Factivism – theses which are versions of a controversial view of the nature and normative structure of rationality. The paper ends by arguing against these substantive theses on phenomenological and ethical grounds. The upshot is that proponents of Psychologism and Anti-Factivism are either engaged in the project of defending merely verbal theses or they’re engaged in the project of defending false substantive ones. (shrink)

The concepts, health and disease, have received considerable attention in philosophy of medicine. The first goal of this paper is to demonstrate that three prominent analyses of health and disease can be synthesized if one assumes that medicine is both theoretical and practical, and, therefore, value-laden. The second goal of this paper is to give an account of one route by which evaluative and factual claims come together in medical knowledge, during medical conversations between clinicians and patients. Accomplishing these two (...) goals together yields an epistemology of medicine that moves past debates about health and disease. On this view the conceptual foundations of medicine rest on subjective and objective claims about health states and their evaluations. By making subjective and objective claims, patients and clinicians negotiate whether patients’ health states are sufficiently dysfunctional to warrant medical intervention, leading to the formation of complementary illness narratives, which are anchored to different degrees in personal experience and medical theory. On this view, health and disease are supplanted as the conceptual foundations of medicine. Rather, medicine is better understood in terms of two basic aims: The first aim of medicine is to fully understand patients in scientific and personal terms; the second aim is to intervene upon patients’ states of illness in ways that are consistent with full understanding. (shrink)

In this article, I argue for an historical understanding of the relationship between ideology and utopia/utopianism that positions the latter as a specifically modern compensation for the loss of the cosmologically grounded, unitary ideology supplied by the late medieval Christian Church. This claim relies upon but revises Fredric Jameson’s early theorization of the collaboration between ideology and utopia/utopianism, which emphasizes that utopian elements allow ideology to offer subjects a ‘compensatory exchange’ for their complicity. Developing my central argument requires considering the (...) current viability of the ‘secularization thesis’, which classically associated modernization with secularization but which has undergone heavy criticism and revision by social scientists over the past half-century. These theoretical discussions, finally, are couched within a critical appraisal of the status of utopianism in contemporary politics. (shrink)

Book reviewed in this article: The New Health Care For Profit: Doctors and Hospitals in a Competitive Environment. Edited by Bradford H. Gray The Healing Mission and the Business Ethic. By Robert M. Cunningham The Medical Industrial Complex. By Stanley Wohl.

This thesis concerns our standing to epistemically blame. We have reason to think three claims hold true: we only have the standing to epistemically blame when it’s our epistemic business, other people’s epistemic errors are rarely our epistemic business, and we often have the standing to epistemically blame. These jointly inconsistent claims generate the puzzle which motivates this thesis. I begin in Chapter II by offering a novel account of epistemic blame. Chapters III and IV represent my argument against the (...) second of the above claims. I argue for two standing conditions on epistemic blame in order to demonstrate that others’ epistemic errors are often our epistemic business. Finally, in Chapter V, I examine a distinctly epistemic conception of hypocrisy to clarify one way in which we can lose the standing to epistemically blame. In sum, this thesis is meant to explain and defend our entitlement to epistemically blame. (shrink)

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In lieu of an abstract, here is a brief excerpt of the content:Sweating the Small StuffTim CunninghamAs an emergency nurse, I often do not notice the small stressors as compared to the loads of intense physical and emotional suffering I witness while working at a level–one–trauma center. The horrendous deaths and injuries caused by gun violence, motorized vehicles, people in emotional distress and those suffering from chronic diseases build up on the mind as a veritable ‘scrapbook of nightmares.’ Emergency providers (...) know, in taking on this profession, that this is ‘all in a day’s work.’ Consequently, we put our selves at risk for emotional burnout as we bear witness to profound suffering while trying to improve lives.I see the traumas, the end–of–life decision making thrust upon families amidst a medical crisis and the other aspects of emergent suffering as bails of hay, against which I tried to build coping mechanisms in order to experience them but also be able to let go. For the most part I am confident to report that I have been able to work through major traumatic situations without belaboring the emotional residue. What I have failed to notice though are not the bails of hay, but individual straws of which they are made.A straw that nearly broke my back came to my pediatric emergency room as a 9–year–old girl who was involved in a low speed motor vehicle collision. She was restrained in the passenger seat; and although she was walking at the scene and crying, she was backboarded by EMS and placed in a cervical spine brace. On arrival to our emergency department she presented with normal vital signs and mutation. Her only complaint was diffuse abdominal pain. We preformed a FAST (Focused Assessment with Sonography for Trauma) exam, which was negative for free abdominal blood. Despite our efforts to make the patient comfortable, we were unable to ease her pain. The patient reported that her pain decreased after we took her off the backboard, but she still did not feel herself.Our attending and resident physicians decided that this child should have an abdominal computed tomography scan (CT) to rule out organ damage with subsequent bleeding. According to hospital protocol, this decision was within our standards of care. I stood by the family when the physician team discussed the plan of care and noticed the parents’ collective body language, which was troubled. I left the room with the physicians but not long after, the family subtly requested that I speak with them.The family was concerned about the radiation to which their child would be exposed. At the same time, they too were concerned about her abdominal pain and understood that a CT could confirm serious abdominal injury. They knew the gravity of the worst–case scenario and wanted to do what was best for their child.The mother asked me if this girl were my child what would I do.My first thought was: No CT, go home, watch her and return if symptoms worsen. My second thought conflicted with the first as I realized this was instruction that fell out of protocol differing from the opinions of the physician team. I paused before responding and found myself sputtering some pointless information about CT scans and mechanisms of injuries sustained from car accidents—I [End Page E9] was filling space, avoiding their question as I pondered the best answer.The girl’s parents told me that one was leaning towards the CT and the other against, they wanted my advice to make a decision. They pressed me saying, “What would you do.” Although I felt an uneasiness and nausea in that moment, I told them my truth, which was that I would go home without the CT.The family appeared relieved and I felt the sensation of stress leaving my body as if I had just taken a deep breath. Contented, but a daughter still with abdominal pain, the family left that evening with specific instructions to watch for adverse symptoms.In that moment, I felt like I had done the right thing but by the end of my shift I left work questioning my choice. I lost sleep that night because of... (shrink)

In this paper we seek to provide elements of an axiomatic theory for a sentient consciousness as a quantified form of introspective awareness. A crucial step for its formulation is use of an interval temporal logic to give expression to on-going conditions such as those represented by the progressive aspect in natural language. In this way we are able to enrich more stative mental models so that an agent's internal activities and its perception of external processes can be represented more (...) faithfully. The need for agent consciousness research is briefly discussed. (shrink)

Abstract:Although Angelina Weld Grimké's 1916 play, Rachel, has historically been read as a sentimental, anti-lynching drama, such classifications might limit the play's anarchic potential. Instead of viewing the characters as responding to anti-Black violence, this paper proposes reframing the play's discussion within a context of Black maternity and its necessary engagement with the Afro-pessimist concept of social death. Such reorientation suggests that Rachel works within the theater's very materiality in order to explore the effects of anti-Blackness on Black life. Specifically, (...) this paper argues that the play's performances of abiological Black maternity—and, particularly, the titular character's performances—fugitively evade the natal alienation of social death. Furthermore, such performances link past, present, and future stage productions as well as character representations, recreating kinship formations within Black social life to stage spatio-temporal disruptions on the equation of Blackness as social death. In this way, Rachel offers modern scholars an understanding of how older works might yet be read in light of the more recent theoretical work of radical Black feminist and Afro-pessimist scholars. (shrink)