There is a well-known American legal maxim, hard cases make bad law. If we agree that Mr. J’s case is hard, what lessons follow from the application of current ECMO guidelines and what kind of supp...

The term compassion fatigue has come to be applied to a disengagement or lack of empathy on the part of care-giving professionals. Empathy and emotional investment have been seen as potentially costing the caregiver and putting them at risk. Compassion fatigue has been equated with burnout, secondary traumatic stress disorder, vicarious traumatization, secondary victimization or co-victimization, compassion stress, emotional contagion, and counter-transference. The results of a Canadian qualitative research project on nurses? experience of compassion fatigue are presented. Nurses, self-identified as (...) having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families. Time to help patients and families cope with suffering seemed unavailable, and many felt they were running on empty and, ultimately, impotent as nurses. Feelings of irritability, anger, and negativity arose, though participants described denying or ignoring these emotions as a way to try to survive their work day. Difficulties with work carried over into the nurses? personal lives, affecting their relationships with family and friends. Such experiences invariably called into question the participants? identity, causing them to reflect on the kind of nurse they were. The participants? compassion fatigue created a sense of hopelessness regarding positive change, although some nurses described strategies that seemed to help alleviate their compassion fatigue. (shrink)

Marshall et al. (2024) raise questions regarding patient refusals of care. In this commentary we address refusals of care from the lens of patient autonomy and provide suggestions for patient cente...

Evolutionary fitness threats and rewards are associated with subjectively unpleasant and pleasant sensations, respectively. Initially, these correlations appear explainable via adaptation by natural selection. But here I analyse the major metaphysical perspectives on consciousness – physicalism, dualism, and panpsychism – and conclude that none help to understand the adaptive-seeming correlations via adaptation. I also argue that a recently proposed explanation, the phenomenal powers view, has major problems that mean it cannot explain the adaptive-seeming correlations via adaptation either. So the mystery (...) – call it the evolutionary paradox of consciousness – remains. Some have used this mystery to argue for non-naturalistic (e.g. theistic) explanations. But I propose a naturalistic, non-adaptive explanation of the adaptive-seeming correlations: namely, ‘sensational associative learning’ during development. In this perspective, pairing of particular sensations with unconditioned stimuli – fitness rewards or threats – cause the sensations themselves to come to be interpreted as good or bad, respectively. Sensations, like colours, that are not reliably paired with either fitness rewards or threats remain largely unvalenced. Sensational associative learning also provides explanations for adaptive-seeming structural aspects of sensations, such as the observation that sounds of different pitch are experienced as ordinal in correspondence to their wavelengths while the same is not true of colours of different hue. The sensational associative learning perspective appears compatible with physicalism, panpsychism, and dualism (though not epiphenomenalism). (shrink)

The paper describes the approach by which ethics are integrated into the undergraduate curriculum at Northern Illinois University''s College of Business. Literature is reviewed to identify conceptual frameworks for, and issues associated with, the teaching of business ethics. From the review, a set of guidelines for teaching ethics is developed and proposed. The objectives and strategies implemented for teaching ethics is discussed. Foundation and follow-up coursework, measurement issues and ancillary programs are also discussed.

Burt's argument relies on a motte-and-bailey fallacy. Burt aims to argue against the value of genetics for social science; instead she argues against certain interpretations of a specific kind of genetics tool, polygenic scores (PGSs). The limitations, previously identified by behavioural geneticists including ourselves, do not negate the value of PGSs, let alone genetics in general, for social science.

ARISTOTLE often claims that words are "homonymous" or "multivocal". He claims this about some of the crucial words and concepts of his own philosophy—"cause," "being," "one," "good," "justice," "friendship." Often he claims it with a polemical aim; other philosophers have wrongly overlooked homonymy and supposed that the same word is always said in the same way. Plato made this mistake; his accounts of being, good, and friendship are rejected because they neglect homonymy and multivocity. In Aristotle’s view Plato shared the (...) Socratic assumption about words and definitions. Socrates thought that when he asked "What is F?" some single definition of F could always be found to match the name "F." Aristotle thinks the Socratic question is important, but argues that it must be controlled by awareness of homonymy and multivocity. (shrink)

Christian hope of resurrection requires that the one raised be the same person who died. Philosophers and theologians alike seek to understand the coherence of bodily resurrection and what accounts for numerical identity between the earthly and risen person. I address this question from the perspective of disability. Is a person with a disability raised in the age to come with that disability? Many theologians argue that disability is essential to one's identity such that it could not be eliminated in (...) the resurrection. What anthropology undergirds these claims is not often explicated. I argue that Thomistic hylemorphic anthropology provides the best context to understand the human person such that disability is not essential to identity. In the resurrection, we shall become truly ourselves. The marks of disability may remain, but Thomistic anthropology expresses the coherence of bodily resurrection in which one may hope for healing which eliminates the disability but not numerical identity. (shrink)

This paper argues that promises are proposals in joint practical deliberation, the activity of deciding together what to do. More precisely: to promise to ϕ is to propose (in a particular way) to decide together with your addressee(s) that you will ϕ. I defend this deliberative theory by showing that the activity of joint practical deliberation naturally gives rise to a speech act with exactly the same properties as promises. A certain kind of proposal to make a joint decision regarding (...) one's own actions turns out to have the very same normative effects, under the very same conditions, as a promise. I submit that this cannot be a coincidence: we should conclude that promises and the relevant kind of proposals in joint practical deliberation are one and the same. (shrink)

Evidence-based medicine (EBM) makes use of explicit procedures for grading evidence for causal claims. Normally, these procedures categorise evidence of correlation produced by statistical trials as better evidence for a causal claim than evidence of mechanisms produced by other methods. We argue, in contrast, that evidence of mechanisms needs to be viewed as complementary to, rather than inferior to, evidence of correlation. In this paper we first set out the case for treating evidence of mechanisms alongside evidence of correlation in (...) explicit protocols for evaluating evidence. Next we provide case studies which exemplify the ways in which evidence of mechanisms complements evidence of correlation in practice. Finally, we put forward some general considerations as to how the two sorts of evidence can be more closely integrated by EBM. (shrink)

By recourse to the fundamentals of preference orderings and their numerical representations through linear utility, we address certain questions raised in Nover and Hájek 2004, Hájek and Nover 2006, and Colyvan 2006. In brief, the Pasadena and Altadena games are well-defined and can be assigned any finite utility values while remaining consistent with preferences between those games having well-defined finite expected value. This is also true for the St Petersburg game. Furthermore, the dominance claimed for the Altadena game over the (...) Pasadena game, and that would have been claimed for the St Petersburg game over the Altadena, can be contradicted without fear of inconsistency with the axioms of utility theory. However, insistence upon dominance can be made to yield a contradiction of the Archimedean axiom of utility theory. CiteULike Connotea Del.icio.us What's this? (shrink)

Large Language Models (LLMs) have been transformative. They are pre-trained foundational models that are self-supervised and can be adapted with fine tuning to a wide range of natural language tasks, each of which previously would have required a separate network model. This is one step closer to the extraordinary versatility of human language. GPT-3 and more recently LaMDA can carry on dialogs with humans on many topics after minimal priming with a few examples. However, there has been a wide range (...) of reactions and debate on whether these LLMs understand what they are saying or exhibit signs of intelligence. This high variance is exhibited in three interviews with LLMs reaching wildly different conclusions. A new possibility was uncovered that could explain this divergence. What appears to be intelligence in LLMs may in fact be a mirror that reflects the intelligence of the interviewer, a remarkable twist that could be considered a Reverse Turing Test. If so, then by studying interviews we may be learning more about the intelligence and beliefs of the interviewer than the intelligence of the LLMs. As LLMs become more capable they may transform the way we interact with machines and how they interact with each other. Increasingly, LLMs are being coupled with sensorimotor devices. LLMs can talk the talk, but can they walk the walk? A road map for achieving artificial general autonomy is outlined with seven major improvements inspired by brain systems. LLMs could be used to uncover new insights into brain function by downloading brain data during natural behaviors. (shrink)

Recent work in moral philosophy has emphasized the foundational role played by interpersonal accountability in the analysis of moral concepts such as moral right and wrong, moral obligation and duty, blameworthiness, and moral responsibility (Darwall 2006; 2013a; 2013b). Extending this framework to the field of moral psychology, we hypothesize that our moral attitudes, emotions, and motives are also best understood as based in accountability. Drawing on a large body of empirical evidence, we argue that the implicit aim of the central (...) moral motives and emotions is to hold people - whether oneself or others - accountable for compliance with the demands of morality. Moral condemnation is based in a motive to get perpetrators to hold themselves accountable for their wrongdoing, not, as is commonly supposed, a mere retributive motive to make perpetrators suffer (�2). And moral conscience is based in a genuine motive to hold oneself accountable for behaving in accordance with moral demands, not, as is commonly supposed, a mere egoistic motive to appear moral to others (�3). The accountability-based theory of the moral motives and emotions we offer provides better explanations of the extant empirical data than any of the major alternative theories of moral motivation. Moreover, conceiving of moral psychology in this way gives us a new and illuminating perspective on what makes morality distinctive: its essential connection to our practice of holding one another accountable (�4). (shrink)

In this paper, we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1993; 2001; 2008) entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive desires are acquired, (...) which in turn affects their strength. We examine these “incentive salience” desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account, the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents – though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways in which it might be strengthened. This helps elucidate a general model of intentional action. (shrink)

What accounts for the capacity of ordinary speakers to comprehend utterances of their language? The phenomenology of hearing speech in one’s own language makes it tempting to many epistemologists to look to perception for an answer to this question. That is, just as a visual experience as of a red square is often taken to give the perceiver immediate justification for believing that there is a red square in front of her, perhaps an auditory experience as of the speaker asserting (...) that p gives the competent hearer immediate justification for believing that the speaker has asserted that p. My aim here is to offer reasons for resisting this temptation. I argue that the perceptual model cannot adequately account for the hearer’s justification in many cases. The arguments here also allow us to draw certain further morals about the role of phenomenology in the epistemology of perception. (shrink)

Should a brain-dead woman be artificially maintained for the sake of her fetus? Does a physician have the right to administer a life-saving transfusion despite the patient's religious beliefs? Can a family request a hysterectomy for their retarded daughter? Physicians are facing moral dilemmas with increasing frequency. But how should these delicate questions be resolved and by whom? A Casebook of Medical Ethics offers a real-life view of the central issue involved in clinical medical ethics. Since the analysis of cases (...) plays a critical role in this study, the authors have assembled a broad collection of histories encountered in their work as medical ethics educators and consultants. The cases are developed in substantial detail to reflect the rich medical and psychosocial complexity involved, and each is brought to a decision point at which a course of action must be chosen. Among the issues examined are conflicts between patients' wishes and respect for their well-being, tensions concerning duties to patients unable to care for themselves and obligations to family members, and clashes between patient care obligations and the interests of other persons, including physicians, third parties, and the general public. The book also includes commentaries that combine general discussion of ethical principles with specific analysis of the cases examined in the text, as well as various options for resolving conflicts. Readers are invited to assess the comparative merits and liabilities of these approaches. An ideal text for undergraduate and medical school courses, A Casebook of Medical Ethics brings readers to the forefront of medicine, where they share in the determination of crucial ethical decisions. (shrink)

Professional Ethics: A Trust-Based Approach explores the unique nature of professional duty and virtue in light of the trust that professionals must invite, develop, and honor from those they intend to serve.

To explore how molecules became signs I will ask: “What sort of process is necessary and sufficient to treat a molecule as a sign?” This requires focusing on the interpreting system and its interpretive competence. To avoid assuming any properties that need to be explained I develop what I consider to be a simplest possible molecular model system which only assumes known physics and chemistry but nevertheless exemplifies the interpretive properties of interest. Three progressively more complex variants of this model (...) of interpretive competence are developed that roughly parallel an icon-index-symbol hierarchic scaffolding logic. The implication of this analysis is a reversal of the current dogma of molecular and evolutionary biology which treats molecules like DNA and RNA as the original sources of biological information. Instead I argue that the structural characteristics of these molecules have provided semiotic affordances that the interpretive dynamics of viruses and cells have taken advantage of. These molecules are not the source of biological information but are instead semiotic artifacts onto which dynamical functional constraints have been progressively offloaded during the course of evolution. (shrink)

When in the sixth century Dionysius the Areopagite declared beauty to be a name for God, he gave birth to something that had long been gestating in the womb of philosophical and theological thought. In doing so, Dionysius makes one of his most pivotal contributions to Christian theological discourse. It is a contribution that is enthusiastically received by the schoolmen of the Middle Ages, and it comes to permeate the thought of scholasticism in a multitude of ways. But perhaps nowhere (...) is the Dionysian influence more pronounced than in the thought of Thomas Aquinas. This book examines both the historical development of beauty's appropriation as a name for God in Dionysius and Thomas, and the various contours of what it means. The argument that emerges from this study is that given the impact that the divine name theological tradition has within the development of Christian theological discourse, beauty as a divine name indicates the way in which beauty is most fundamentally conceived in the Christian theological tradition as a theological theme. As a phenomenon of inquiry, beauty proves itself to be enigmatic and elusive to even the sharpest intellects in the Greek philosophical tradition. When it is absorbed within the Christian theological synthesis, however, its enigmatic content proves to be a powerful resource for theological reasoning. (shrink)

In the context of transgender health, most people are not comfortable with allowing a twelve‐year‐old child with gender dysphoria to elect to undergo gender reassignment surgery. The likelihood is too high that the child would be unable to fully comprehend the scope of a decision that carries significant, permanent consequences, particularly because the decision to surgically change gender is based upon a conception of gender that can fluctuate during adolescent years. Conversely, however, most people would not contend that this fluidity (...) is reason to wholly deny certain medical care such as hormonal treatments to transgender youth, a demographic with extremely high rates of violent behavior, self‐harm, and suicide. This paper will explore ethical considerations to this emerging debate of what therapeutic options should be offered to transgender children and adolescents.Pediatric endocrinologists have been treating gender dysphoric adolescents with puberty‐suppressing drugs and, to a lesser extent, with cross‐sex hormone therapies for more than twenty years. Clinicians and thought leaders have mentioned ethical components of this emerging practice in the few cohort studies and clinical review articles about the subject. However, ethics have generally been a secondary consideration in the medical academic literature. In this paper, I will provide a brief overview of the practice, summarize the current research on hormone treatment for transgender minors, and provide an ethical analysis of the practice. (shrink)

Philosophy and Kafka is a collection of original essays interrogating the relationship of literature and philosophy. The essays either discuss specific philosophical commentaries on Kafka’s work, consider the possible relevance of certain philosophical outlooks for examining Kafka’s writings, or examine Kafka’s writings in terms of a specific philosophical theme, such as communication and subjectivity, language and meaning, knowledge and truth, the human/animal divide, justice, and freedom.

According to current hierarchies of evidence for EBM, evidence of correlation is always more important than evidence of mechanisms when evaluating and establishing causal claims. We argue that evidence of mechanisms needs to be treated alongside evidence of correlation. This is for three reasons. First, correlation is always a fallible indicator of causation, subject in particular to the problem of confounding; evidence of mechanisms can in some cases be more important than evidence of correlation when assessing a causal claim. Second, (...) evidence of mechanisms is often required in order to obtain evidence of correlation. Third, evidence of mechanisms is often required in order to generalise and apply causal claims. While the EBM movement has been enormously successful in making explicit and critically examining one aspect of our evidential practice, i.e., evidence of correlation, we wish to extend this line of work to make explicit and critically examine a second aspect of our evidential practices: evidence of mechanisms. (shrink)

Police killings of unarmed Black people have ignited a national and international response unlike any in decades. But differing from their civil rights-oriented predecessors, today’s activists do not think that the institutions and values of liberal democracy can eradicate structural racism. They draw instead on a Black radical tradition that, Terrence L. Johnson argues, derives its force from its unacknowledged ethical and religious dimensions. We Testify with Our Lives traces Black religion’s sustained influence from SNCC to the present, reconstructing (...) a radical lived ethics of freedom and justice. Johnson demonstrates that Black Power fundamentally contests liberalism’s abstract understanding of democracy, calling instead for new embodied frameworks to achieve human flourishing and dignity. Black bodies represent the primary form of resistance against violent and oppressive regimes of white supremacy and exploitation, and the individual and collective struggles of Black life bear witness to the dogged determination to cultivate beauty, rage, and joy. Considering the writings of Audre Lorde, Toni Cade Bambara, Stokely Carmichael, Martin Luther King Jr., Malcolm X, and James Baldwin, We Testify with Our Lives makes its case through a new narrative of the evolution of Black radicalism from the civil rights movement through the Movement for Black Lives. It forges new insights into Black Power’s vital contributions to debates on ethics, transnational politics, democracy, political solidarity, and freedom—and its potent resources for the ongoing struggle to build democratic possibilities for all. (shrink)

Mechanistic philosophy of science views a large part of scientific activity as engaged in modelling mechanisms. While science textbooks tend to offer qualitative models of mechanisms, there is increasing demand for models from which one can draw quantitative predictions and explanations. Casini et al. (Theoria 26(1):5–33, 2011) put forward the Recursive Bayesian Networks (RBN) formalism as well suited to this end. The RBN formalism is an extension of the standard Bayesian net formalism, an extension that allows for modelling the hierarchical (...) nature of mechanisms. Like the standard Bayesian net formalism, it models causal relationships using directed acyclic graphs. Given this appeal to acyclicity, causal cycles pose a prima facie problem for the RBN approach. This paper argues that the problem is a significant one given the ubiquity of causal cycles in mechanisms, but that the problem can be solved by combining two sorts of solution strategy in a judicious way. (shrink)

One way to challenge the substantiveness of a particular philosophical issue is to argue that those who debate the issue are engaged in a merely verbal dispute. For example, it has been maintained that the apparent disagreement over the mind/brain identity thesis is a merely verbal dispute, and thus that there is no substantive question of whether or not mental properties are identical to neurological properties. The goal of this paper is to help clarify the relationship between mere verbalness and (...) substantiveness. I first argue that we should see mere verbalness as a certain kind of discourse defect that arises when the parties differ as to what each takes to be the immediate question under discussion. I then argue that mere verbalness, so understood, does not imply that the question either party is attempting to address is a non-substantive one. Even if it turns out that the parties to the mind/brain dispute are addressing subtly different questions, these might both be substantive questions to which their respective metaphysical views provide substantive answers. One reason it is tempting to reach deflationary conclusions from the charge of mere verbalness is that we fail to distinguish it from the claim that a sentence under dispute is, in a certain sense, indisputable. Another reason is that we fail to distinguish mere verbalness from a certain sort of indeterminacy. While indisputability and indeterminacy plausibly capture forms of nonsubstantiveness, I argue that mere verbalness is insufficient to establish either indisputability or indeterminacy. (shrink)

Theses on the semiotic study of life as presented here provide a collectively formulated set of statements on what biology needs to be focused on in order to describe life as a process based on semiosis, or sign action. An aim of the biosemiotic approach is to explain how life evolves through all varieties of forms of communication and signification (including cellular adaptive behavior, animal communication, and human intellect) and to provide tools for grounding sign theories. We introduce the concept (...) of semiotic threshold zone and analyze the concepts of semiosis, function, umwelt, and the like as the basic concepts for theoretical biology. (shrink)

In this article, we document the growing influence of non-governmental organizations (NGOs) in the realm of socially responsible investing (SRI). Drawing from ethical and economic perspectives on stakeholder management and agency theory, we develop a framework to understand how and when NGOs will be most influential in shaping the ethical and social responsibility orientations of business using the emergence of SRI as the primary influencing vehicle. We find that NGOs have opportunities to influence corporate conduct via direct, indirect, and interactive (...) influences on the investment community, and that the overall influence of NGOs as major actors in socially responsible investment is growing, with attendant consequences for corporate strategy, governance, and social performance. (shrink)

Shared views regarding the moral respect which is owed to children in family life are used as a guide in determining the moral permissibility of nontherapeutic clinical research procedures involving children. The comparison suggests that it is not appropriate to seek assent from the preadolescent child. The analogy with interventions used in family life is similarly employed to specify the permissible limit of risk to which children may be exposed in nontherapeutic research procedures. The analysis indicates that recent writers misconceive (...) how certain moral principles, such as respect for personal autonomy, require us to act toward children. The results are also used to assess proposed federal regulations on research with children. (shrink)

Category theory reveals commonalities between structures of all sorts. This book shows its potential in science, engineering, and beyond.