G. E. Moore's ‘A Defence of Common Sense’ has generated the kind of interest and contrariety which often accompany what is new, provocative, and even important in philosophy. Moore himself reportedly agreed with Wittgenstein's estimate that this was his best article, while C. D. Broad has lamented its very great but largely unfortunate influence. Although the essay inspired Wittgenstein to explore the basis of Moore's claim to know many propositions of common sense to be true, A. J. Ayer judges its (...) enduring value to lie in provoking a more sophisticated conception of the very type of metaphysics which disputes any such unqualified claim of certainty. (shrink)
The concept of selecting for a disability, and deafness in particular, has triggered a controversial and sometimes acrimonious debate between key stakeholders. Previous studies have concentrated on the views of the deaf and hard of hearing, health professionals and ethicists towards reproductive selection for deafness. This study, however, is the first of its kind examining the views of hearing children of deaf adults towards preimplantation genetic diagnosis and prenatal diagnosis to select for or against deafness. Hearing children of deaf adults (...) straddle both the deaf and hearing worlds, and this dual perspective makes them ideally placed to add to the academic discourse concerning the use of genetic selection for or against deafness. The study incorporated two complementary stages, using initial, semistructured interviews with key informants as a means to guide the subsequent development of an electronic survey, completed anonymously by 66 individuals. The participants shared many of the same views as deaf individuals in the D/deaf community. The similarities extended to their opinions regarding deafness not being a disability, their ambivalence towards having hearing or deaf children and their general disapproval of the use of genetic technologies to select either for or against deafness. (shrink)
This book is less about disjunction than about the English word ‘or’, and it is less for than against formal logicians—more exactly, against those who maintain that formal logic can be applied in certain ways to the evaluation of reasoning formulated in ordinary English. Nevertheless, there are many things to interest such of those persons who are willing to overlook the frequent animadversions directed against their kind in the book, and this review will concentrate on them.
This study represents an improvement in the ethics scales inventory published in a 1988 Journal of Business Ethics article. The article presents the distillation and validation process whereby the original 33 item inventory was reduced to eight items. These eight items comprise the following ethical dimensions: a moral equity dimension, a relativism dimension, and a contractualism dimension. The multidimensional ethics scale demonstrates significant predictive ability.
The thesis of this article is that there has never been any ground for the controversy between the doctrine of free will and determinism, that it is based upon a misapprehension, that the two assertions are entirely consistent, that one of them strictly implies the other, that they have been opposed only because of our natural want of the analytical imagination. In so saying I do not tamper with the meaning of either phrase. That would be unpardonable. I mean free (...) will in the natural and usual sense, in the fullest, the most absolute sense in which for the purposes of the personal and moral life the term is ever employed. I mean it as implying responsibility, merit and demerit, guilt and desert. I mean it as implying, after an act has been performed, that one " could have done otherwise " than one did. I mean it as conveying these things also, not in any subtly modified sense but in exactly the sense in which we conceive them in life and in law and in ethics. These two doctrines have been opposed because we have not realised that free will can be analysed without being destroyed, and that determinism is merely a feature of the analysis of it. And if we are tempted to take refuge in the thought of an "ultimate ", an "innermost" liberty that eludes the analysis, then we have implied a deterministic basis and constitution for this liberty as well. For such a basis and constitution lie in the idea of liberty. -/- The thesis is not, like that of Green or Bradley, that the contending opinions are reconciled if we adopt a certain metaphysic of the ego, as that it is timeless, and identifies itself with a desire by a " timeless act". This is to say that the two are irreconcilable, as they are popularly supposed to be, except by a theory that delivers us from the conflict by taking us out of time. Our view on the contrary is that from the natural and temporal point of view itself there never was any need of a reconciliation but only of a comprehension of the meaning of terms. (The metaphysical nature of the self and its identity through time is a problem for all who confront memory, anticipation, etc.; it has no peculiar difficulties arising from the present problem.) -/- I am not maintaining that determinism is true; only that it is true insofar as we have free will. That we are free in willing is, broadly speaking, a fact of experience. That broad fact is more assured than any philosophical analysis. It is therefore surer than the deterministic analysis of it, entirely adequate as that in the end appears to be. But it is not here affirmed that there are no small exceptions, no slight undetermined swervings, no ingredient of absolute chance. All that is here said is that such absence of determination, if and so far as it exists, is no gain to freedom, but sheer loss of it; no advantage to the moral life, but blank subtraction from it. -- When I speak below of "the indeterminist" I mean the libertarian indeterminist, that is, him who believes in free will and holds that it involves indetermination. (shrink)
Corporate social responsibility is a recognised and common part of business activity. Some of the regularly cited motives behind CSR are employee morale, recruitment and retention, with employees acknowledged as a key organisational stakeholder. Despite the significance of employees in relation to CSR, relatively few studies have examined their engagement with CSR and the impediments relevant to this engagement. This exploratory case study-based research addresses this paucity of attention, drawing on one to one interviews and observation in a large UK (...) energy company. A diversity of engagement was found, ranging from employees who exhibited detachment from the CSR activities within the company, to those who were fully engaged with the CSR activities, and to others who were content with their own personal, but not organisational, engagement with CSR. A number of organisational context impediments, including poor communication, a perceived weak and low visibility of CSR culture, and lack of strategic alignment of CSR to business and personal objectives, served to explain this diversity of employee engagement. Social exchange theory is applied to help explore the volition that individual employees have towards their engagement with CSR activities, and to consider the implications of an implicit social, rather than explicit economic, contract between an organisation and its employees in their engagement with CSR. (shrink)
This is a comprehensive study of the English word 'or', and the logical operators variously proposed to present its meaning. Although there are indisputably disjunctive uses of or in English, it is a mistake to suppose that logical disjunction represents its core meaning. 'Or' is descended from the Anglo-Saxon word meaning second, a form which survives in such expressions as "every other day." Its disjunctive uses arise through metalinguistic applications of an intermediate adverbial meaning which is conjunctive rather than disjunctive (...) in character. These conjunctive uses have puzzled philosophers and logicians, and have been discussed extensively under such headings as "free choice permission." This study examines the textbook myths that have clouded our understanding of how or and other "logical" vocabulary comes to have something approaching its logical meaning in natural languages. It considers the various historical conceptions of disjunction and its place in logic from the Stoics to the present day. (shrink)
This essay explores the role of informal logicand its application in the context of currentdebates regarding evidence-based medicine. This aim is achieved through a discussion ofthe goals and objectives of evidence-basedmedicine and a review of the criticisms raisedagainst evidence-based medicine. Thecontributions to informal logic by StephenToulmin and Douglas Walton are explicated andtheir relevance for evidence-based medicine isdiscussed in relation to a common clinicalscenario: hypertension management. This essayconcludes with a discussion on the relationshipbetween clinical reasoning, rationality, andevidence. It is argued that (...) informal logic hasthe virtue of bringing explicitness to the roleof evidence in clinical reasoning, and bringssensitivity to understanding the role ofdialogical context in the need for evidence inclinical decision making. (shrink)
Evidence based medicine has been a topic of considerable controversy in medical and health care circles over its short lifetime, because of the claims made by its exponents about the criteria used to assess the evidence for or against the effectiveness of medical interventions. The central epistemological debates underpinning the debates about evidence based medicine are reviewed by this paper, and some areas are suggested where further work remains to be done. In particular, further work is needed on the theory (...) of evidence and inference; causation and correlation; clinical judgment and collective knowledge; the structure of medical theory; and the nature of clinical effectiveness. (shrink)
No one is excused from doing what he ought to do merely because he is unwilling to do it. But what if others are unwilling to play their necessary role in some joint venture that you all ought to undertake: might that excuse you from doing what you yourself ought to do as part of that? It would, if you were genuinely willing to play your necessary part if they were. But the unwillingness of everyone involved cannot reciprocally serve to (...) excuse one another from doing what they ought to do. (shrink)
“To whom is the Consecration of Medal, Stature or even Pyramid more jusly due, than to … the late Illustraious Boyle? … for the happy Improvement of Otto Guericks Magdeburg Exhausterm and for his Profound and Noble Researches into all the abstruser Parts and Recesses of the most useful Philosophy … I have named the Illustrious Boyle, and fix his Trophy here.”John Evelyn, Numismata, 1697.
Translational research in medicine requires researchers to identify the steps to transfer basic scientific discoveries from laboratory benches to bedside decision-making, and eventually into clinical practice. On a parallel track, philosophical work in ethics has not been obliged to identify the steps to translate theoretical conclusions into adequate practice. The medical ethicist A. Cribb suggested some years ago that it is now time to debate ‘the business of translational’ in medical ethics. Despite the very interesting and useful perspective on the (...) field of medical ethics launched by Cribb, the debate is still missing. In this paper, I take up Cribb’s invitation and discuss further analytic distinctions needed to base an ethics aiming to translate between theory and practice. (shrink)
There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order to ensure (...) that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines’ recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients’ claims on health care resources. Moreover, I suggest the basic structure of such a framework. (shrink)
Corporations are moral persons to the extent that they have rights and duties, but their moral personality is severely limited. As artificial persons, they lack the emotional make-up that allows natural persons to show virtues and vices. That fact, taken with the representative function of management, places significant limitations on what constitutes ethical behavior by management. A common misunderstanding of those limitations can lead ethical managers to behave unethically and can lead the public to have improper expectations of corporations.
Background: Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors’ decisions. Associations between physicians’ religious characteristics and their weighting of the criteria were also examined. Methods: Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association masterfile. (...) Physicians were asked how much weight should be given to the following: (1) the patient’s expressed wishes and values, (2) the physician’s own judgment about what is in the patient’s best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. Results: Response rate 51% (446/879). Half of physicians (55%) gave the patient’s expressed wishes and values “the highest possible weight”. In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient’s expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the “highest possible weight”, versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). Conclusions: Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians’ decisions as much as is often recommended in the ethics literature. (shrink)
An apparent paradox proposed by Aharonov and Vaidman in which a single particle can be found with certainty in two (or more) boxes is analyzed by way of a simple thought experiment. It is found that the apparent paradox arises from an invalid counterfactual usage of the Aharonov-Bergmann-Lebowitz (ABL) rule and effectively attributes conflicting properties not to the same particle but no different particles. A connection is made between the present analysis and the consistent histories formulation of Griffiths. Finally, a (...) critique is given of some recent counterarguments by Vaidman against the rejection of the counterfactual usage of the ABL rule. (shrink)
In this article we show that it is possible to completely classify the degrees of r.e. bases of r.e. vector spaces in terms of weak truth table degrees. The ideas extend to classify the degrees of complements and splittings. Several ramifications of the classification are discussed, together with an analysis of the structure of the degrees of pairs of r.e. summands of r.e. spaces.
Did Plato abandon, or sharply modify, the Theory of Forms in later life? In the _Phaedo, Symposium, _and _Republic_ it is generally agreed that Plato held that universals exist. But in Parmenides, he subjected that theory to criticism. If the criticism were valid, and Plato knew so, then the _Parmenides_ marks a turning point in his thought. If, however, Plato became aware that there are radical differences in the logical behaviour of concepts, and the later dialogues are a record of (...) his attempt to analyse those differences, then Plato’s thought can be said to have moved in a new and vitally important direction after the _Parmenides_. _Studies in Plato’s Metaphysics_ brings together twenty essays by leading philosophers from the UK and the USA reflecting upon this important issue and upon the questions arising from it. (shrink)
Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt to capture a comprehensive (...) overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)
The overall aim of this article is to discuss the organization of limit setting in healthcare in terms of legitimacy. We argue there is a strong ethical demand that such processes should be arranged to provide adversely affected people well-justified reasons to confer legitimacy to the processes despite favouring a different decision-making outcome. Two increasingly popular approaches, Accountability for Reasonableness (A4R) and Multi-Criteria Decision Analysis (MCDA), can both be applied to support legitimate decision-making processes. However, the role played by ‘fair-minded (...) people’ in the A4R framework can be shown to undermine an adequate conceptualization of legitimacy according to the ethical demand. We discuss and specify conditions enabling A4R to meet this ethical demand when being implemented in a real-world setting without having to renounce the aim of striving for ‘reasonableness’ and impartiality. The methodological approach MCDA describes how to arrange for transparent resource allocation. This approach does not encompass any normative guidance on how to shape limit settings in terms of ‘reasonableness’; it basically promotes ‘rational’ decisions. We discuss how this practical methodology can be integrated with the theoretical A4R framework to meet the ethical demand while at the same time promoting politically required impartiality of healthcare limit setting. (shrink)
Charles Foster and Jonathan Herring are to be congratulated on their useful presentation of the roles played by concepts of personhood and identity in English medical law. 1 However, I fear that the project they have undertaken here is misconceived. It is an interesting and important misconception, which is widely shared in the literature on medical law and ethics; but a misconception it remains. The problem is this. What we call ‘the Law’ is in fact a complex assemblage of institutions, (...) rules, accredited persons, practices and systems. What it is not is a self-sufficient, integrated and self-interpreting system of doctrine. As such it does not have a clear structure which we can excavate and the idea that we can find concepts which explain and unify that structure at some deep level is thus quixotic. To approach ‘the Law’ in that way is to pursue a chimaera. We should instead... (shrink)