This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers’ moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation. There were 60 patients in (...) the interventional group and 66 patients in the historical control group. We evaluated the impact of weekly meetings to establish goals of care for patients with longer than 10 days length of stay in the ICU for a year. Moral distress was measured intermittently and reported moral distress thermometer scores fluctuated. "Clinical situations" represented the most frequent contributing factor to moral distress. Post intervention, overall moral distress scores, measured on the moral distress scale revised, were lower for respondents in all categories, and on three specific items. Patient outcomes before and after PEACE intervention showed a statistically significant decrease in PRISM indexed LOS, a statistically significant increase in both code status changes DNR, and in-hospital death, with no change in patient 30 or 365 day mortality. The addition of a clinical ethicist and senior intensivist to weekly inter-professional team meetings facilitated difficult conversations regarding realistic goals of care. The study demonstrated that the PEACE intervention had a positive impact on some factors that contribute to moral distress and can shorten PICU length of stay for some patients. (shrink)
In this article I present two arguments from Brian Hebblethwaite for the conclusion that multiple incarnations are impossible, as well as the analyses of those arguments provided by three other thinkers: Oliver Crisp, Peter Kevern, and Robin Le Poidevin. I argue that both of Hebblethwaite's arguments are unsound.
Essays on Wittgensteinian Themes Dedicated to Brian McGuinness Joachim Schulte, Göran Sundholm. PREFACE For thirty-five years the international community of philosophers have known Brian McGuinness as a major authority on the ...
Human beings are peculiar. In laboratory experiments, they often cooperate in one-shot prisoners’ dilemmas, they frequently offer 1/2 and reject low offers in the ultimatum game, and they often bid 1/2 in the game of divide-the-cake All these behaviors are puzzling from the point of view of game theory. The first two are irrational, if utility is measured in a certain way.1 The last isn’t positively irrational, but it is no more rational than other possible actions, since there are infinitely (...) many other Nash equilibria besides the one in which both players bid 1/2. At the same time, these behaviors seem to indicate that people are sometimes inclined to be cooperative, fair, and just. In his stimulating new book, Brian Skyrms sets himself the task of showing why these inclinations evolved, or how they might have evolved, under the pressure of natural selection. The goal is not to justify our ethical intuitions, but to explain why we have them.2.. (shrink)
Brian Z. Tamanaha has written extensively on realism in jurisprudence, but in his Realistic Theory of Law (2018), he uses "realism" in a commonplace way to ground a rough outline of legal history. While he refers to his method as genealogical, he does not acknowledge the complex tensions in the development of the philosophical use of that term from Nietzsche to Foucault, and the complex epistemological issues that separate them. While the book makes many interesting points, the methodological concerns (...) outweigh them in the overall assessment of the value of the work. (shrink)
In this paper, I present a new argument against the compatibility of human free will and divine timelessness when conceiving of eternity in terms of an additional dimension as presented by brian leftow. The paper is organized as follows: After giving a brief sketch of leftow’s model, I argue that assuming libertarianism, free will presupposes presentism, since metaphysical indeterminism is only compatible with a presentist A-theory of physical time. Given this result, I make a case for the incompatibility of (...) presentism and divine eternity modelled as a frame of reference, implying the incompatibility of the latter with human free will. (shrink)
As the author of Justice as Impartiality, I am not ashamed to admit that I was delighted by the liveliness of the discussion generated by it at the meeting on which this symposium is based. I am likewise grateful to the six authors for finding the book worthy of the careful attention that they have bestowed on it. Between them, the symposiasts take up many more points than I can cover in this response. I shall therefore focus on some themes (...) that cluster round the contractual device that I associate with the notion of justice as impartiality. Is it necessary? If it is not necessary is it nevertheless useful? Within an overall contractual framework is the form of contract that I propose uniquely justifiable? And does the form of contract that I defend generate the implications that I claim for it? (shrink)
In teaching jurisprudence, I typically distinguish between two different families of theories of adjudication—theories of how judges do or should decide cases. “Formalist” theories claim that the law is “rationally” determinate, that is, the class of legitimate legal reasons available for a judge to offer in support of his or her decision justifies one and only one outcome either in all cases or in some significant and contested range of cases ; and adjudication is thus “autonomous” from other kinds of (...) reasoning, that is, the judge can reach the required decision without recourse to nonlegal normative considerations of morality or political philosophy. I also note that “formalism” is sometimes associated with the idea that judicial decision-making involves nothing more than mechanical deduction on the model of the syllogism—Beccaria, for example, expresses such a view. I call the latter “Vulgar Formalism” to emphasize that it is not a view to which anyone today cares to subscribe. (shrink)
William Hasker replies to my arguments against Social Trinitarianism, offers some criticism of my own view, and begins a sketch of another account of the Trinity. I reply with some defence of my own theory and some questions about his.
In "the semantics of singular terms," brian loar described and criticized a "causal" theory of reference and offered a new "description" theory. It is argued that the particular causal theory described is not to be found in the papers by donnellan and kripke cited as evidence for it, And is a straw man. Further "prima facie", Loar's new description theory fails to meet kripke's noncircularity condition. Should loar attempt to meet it, His theory is likely to run foul of (...) kripke's usual "arguments from ignorance and error" against description theories. (shrink)
In his recent article, ‘A Gift to Theology? Jean-Luc Marion's ‘Saturated Phenomena’ in Christological Perspective’, Brian Robinette has critiqued Marion's phenomenology for confining theology to a one-sided approach to Christology, one that stresses only the passive, mystical reception of Christ. To correct this imbalance, Robinette brings Marion into dialogue with those more active Christologies or ‘prophetical-ethical’ liberation theologies of Gustavo Gutierrez, Johann Baptist Metz and others that stress a life-praxis focused on confronting evil and suffering. In this essay I (...) am arguing that Robinette has not fully developed the ‘logic’ of Marion's phenomenology of the ‘call and the gifted’, in which both a passive and an active element are operative. I explore more fully that very dynamic phenomenological process of the call-and-the-gifted as developed in Marion's work Being Given: Toward a Phenomenology of Givenness. Once viewed in Christological perspective, and especially in light of Christ's death and resurrection, Marion's phenomenology entails an ethical trope consistent with the mission of Christ as rendered in Scriptural revelation, and thus the gap between Marion's work and the prophetical-ethical theologies of Gutierrez and Baptist Metz becomes narrowed. (shrink)
In ‘The ethics of belief and Christian faith as commitment to assumptions’, Rik Peels attacks the views that I advanced in ‘Christianity and the ethics of belief’. Here, I rebut his criticisms of the claim that it is wrong to believe without sufficient evidence, of the contention that Christians are committed to that claim, and of the notion of that faith is not belief but commitment to assumptions in the hope of salvation. My original conclusions still stand.
In The Ant Trap, Brian Epstein proposes a bold new systematic strategy for developing social ontology. He explores the history and current state of the art and provides pointed critiques of leading theories in the field. His framework, incompassing frames that provide principles for grounding social facts, is developed in some detail across a variety of social practices and applied to revealing real world as well as hyporthetical examples. If Epstein's account holds, it should provide new directions and standards (...) of inquiry in both social sciecne and social philiosophy. (shrink)
Brian Trainor argues that the current hostility of political theorists towards the idea of the common good is in part due to the influence of Isaiah Berlin's concept of `value pluralism', or the incommensurability of basic human values. I agree with Trainor's opposition to the `agonistic' interpretation of pluralism, associated with thinkers like Chantal Mouffe. However, it is not the case that the only alternative to the pluralism— agonism thesis is the monist defence of a thick common good advocated (...) by Trainor. Between these extremes there is a middle way that accepts the deep plurality of values in Berlin's sense, but recognizes a case for a thin conception of the common good — that is, a liberal political framework. (shrink)
Like feuding relatives at a family barbecue, economists and moral philosophers often like to pretend they have nothing to do with each other. Economists pose as value-neutral scientists who have no need for airy-fairy moral theory; yet they regularly dispense the sorts of prescription and advice that cry out for ethical analysis. Philosophers likewise view themselves as having loftier concerns than vulgar economics; but by conducting their ethical and political theorizing in ignorance of economic principles, they are unable to avoid (...) recommending policies that would be unworkable or disastrous in practice. This, at any rate, is how Leland Yeager sees the situation, and it is hard to disagree with him; ethics and economics need to learn from one another. (shrink)
Brian Loar argues that we can account for the conceptual independence of coextensive terms purely psychologically, by appealing to conceptual rather than semantic differences between concepts, and that this leaves room for assuming that phenomenal and physical concepts can be coextensive on a posteriori grounds despite the fact that both sorts of concepts refer directly . I argue that Loar does not remove the mystery of the coextensiveness of those concepts because he does not offer any explanation of why (...) they should be coextensive. Secondly, I argue that even if we grant that phenomenal and physical concepts can be coextensive on a posteriori grounds, we are committed to holding that there are two different and essential modes of presentation of phenomenal properties, the physical and the phenomenal, and that this precludes us from seeing phenomenal properties as essentially physical in an unrelativized sense. (shrink)
I am grateful to Alan Madry and Joel Richeimer for their intelligent and stimulating critique of my article “Heidegger and the Theory of Adjudication.” It is the most interesting commentary I have seen on the paper, and I have learned much from it. It may facilitate discussion, and advance debate, to state with some clarity where exactly we agree and disagree. I leave to the footnotes discussion of certain minor points where Madry and Richeimer are guilty of some critical overreaching.
Brian Leiter and Peter Kail have delivered thoughtful critiques of my book, Nietzsche’s Naturalism: Philosophy and the Life Sciences in the Nineteenth Century.1 It is a great pleasure to respond to these critiques, since they raise some crucial issues with regard to Nietzsche’s understanding of naturalism and normativity. On the one hand, there are many areas of agreement: Nietzsche’s philosophical project is best understood along the lines of naturalism; developments in the nineteenth-century life sciences, broadly speaking, play a crucial (...) role in the formation of Nietzsche’s naturalism; and Nietzsche’s relationship to both Darwin and Darwin’s neo-Kantian interpreters is more complex than generally assumed. On the... (shrink)
Espen Hammer’s exceptionally fine book explores modern temporality, its problems and prospects. Hammer claims that how people experience time is a cultural/historical phenomenon, and that there is a peculiarly modern way of experiencing time as a series of present moments each indefinitely leading to the next in an ordered way. Time as measured by the clock is the paradigmatic instance of this sense of time. In this perspective time is quantifiable and forward-looking, and the present is dominated by the future. (...) Hammer argues that this manner of experiencing time provides a way of living that brings with it not only the basis for great successes in technology, but also great costs—specifically, what he calls the problems of transience and of meaning. Hammer goes about his task by considering the ways some of the great modern philosophers have characterized present-day temporality and have responded to the problems he has identified. Specifically, he considers what Kant, Hegel, Schopenhauer, Nietzsche, Heidegger, Habermas, Bloch, and Adorno provide in response to our peculiarly modern predicaments. The book is remarkable for its clarity and perceptiveness, but in the process in crucial places it simplifies the matters at hand or fails to push its insights as far as it ought, and in the end promises more than it can deliver. In this it betrays a rationalist confidence in the power of reason that founders on what in many ways remains a mystery. (shrink)
Brian Barry's Culture and Equality is probably the most powerful liberal egalitarian critique of multiculturalism addressing the pathologies of recognizing difference of ethnicity, religion, race, and culture. In this essay, I examine Barry's approach to the law, which underpins his theory of egalitarianism to determine whether it is enough — as Barry thinks it is — to insist on either applying the same law for everyone so that exemptions are foreclosed in general, or repealing the law since the case (...) for its existence is not justified. I find that Barry's effort is inadequate. Because the conditions for exemptions are not specified, exemptions are merely defensible, not just. Using the headscarf controversy in France to illustrate why Barry's approach backfires, I argue how enforcing the same law for all leads to undermining the very politics of redistribution that Barry champions. (shrink)
I take as my text propostion 4.0312 of the Tractatus : The possibility of propositions is based on the principle that objects have signs as their representatives. My fundamental idea is that the ‘logical constants’ are not representatives; that there can be no representatives of the logic of facts. Practically the same words occur in Wittgenstein's Notebook for 25 December 1914, where Miss Anscombe translates them: The possibility of the proposition is, of course, founded on the principle of signs as (...) going proxy for objects. Thus in the proposition something has something else as its proxy. But there is also the common cement. My fundamental thought is that the logical constants are not proxies. That the logic of the fact cannot have anything as its proxy. (shrink)
In the preface to his book God the Problem , Gordon Kaufman writes ‘Although the notion of God as agent seems presupposed by most contemporary theologians … Austin Farrer has been almost alone in trying to specify carefully and consistently just what this might be understood to mean.’.
In this interview Prof. Brian Leftow answers questions concerning the causes of the emergence of Analytic Philosophical Theology within the analytic tradition; the advantages of maintaining the traditional picture of perfect being theology with regards to divine attributes; his conception about the origin of necessary truths; the problem of evil; and the importance for universities of investing in research on philosophical theology.
The Philosophical Challenge from China, edited by Brian Bruya, undoubtedly occupies an important place in the discourse about what practices and authorities are relevant to Philosophy as an academic discipline. Its confident reorientation of philosophical relevance in the context of Anglophone academics will hopefully speak meaningfully to any remaining skeptics of the usefulness of Chinese philosophy. The intended audience of this effort, however, is shrinking, or, more accurately, those willing to be convinced are increasingly few, and what remains is (...) simply and haplessly the staunch traditionalists of the so-called Western paradigm. This evokes the thought that anthologies that strive to show relevance... (shrink)
Patrick O'Brian, the Aubrey-Maturin Series of twenty novels (Norton, 1970-1999). My appreciation written for WIRED magazine: "I re-read this extraordinary series of novels because of the depth of portrayal of the major and minor characters, but also because they teach me so much about what science and technology were like two centuries ago. O'Brian shows you the world-that-was through the eyes of a Tory naval captain (Jack Aubrey), at sea since the age of 12, working his way up (...) to admiral, dealing with the height of 18th-century technology (sailing ships and celestial navigation). I identify more strongly with his liberally-educated, physician-scientist friend (Stephen Maturin), who went to medical school in Paris during the French Revolution. You see natural history turning into a biological science, bleeding-and-purging medicine starting to learn some physiology -- and, because Maturin is also an intelligence agent for the Admiralty, you see statecraft at work during the Napoleonic Wars. These books strongly remind you about what scientific ignorance and social conventions can do to your mindset, and how the future will likely judge us as well." -- William H. Calvin You can get them all at once, so you can: The Complete Aubrey/Maturin Series (20 volumes). Depending on amazon.com's current discount, this works out to US$15-20 each (and in hardcover). (shrink)
At first sight it would seem difficult to find two philosophers as different as Brian Barry and Richard Rorty. It is widely held that the former is one of the most forceful proponents of liberal universalism, whereas the latter is typically viewed as the quintessential relativist. In this essay, different usages of the term univeralism are considered, and it is argued that Rorty's position is much closer to that of Barry than is generally supposed. Indeed, the article concludes by (...) suggesting that it is Rorty who offers the less question-begging philosophical account of political liberalism. (shrink)
Brian Rotman argues that (one) “mind” and (one) “god” are only conceivable, literally, because of (alphabetic) literacy, which allowed us to designate each of these ghosts as an incorporeal, speaker-independent “I” (or, in the case of infinity, a notional agent that goes on counting forever). I argue that to have a mind is to have the capacity to feel. No one can be sure which organisms feel, hence have minds, but it seems likely that one-celled organisms and plants do (...) not, whereas animals do. So minds originated before humans and before language --hence, a fortiori, before writing, whether alphabetic or ideographic. (shrink)