THE MOST SACRED FREEDOM includes eight essays that were first presented at the 2014 A.V. Elliott Conference on Great Books and Ideas, the seventh annual conference sponsored by Mercer Universitys Thomas C. and Ramona E. McDonald Center for Americas Founding Principles. Together, these essays explore the great principle of religious liberty by charting its development in the Western tradition and reconsidering its place at Americas founding. The book begins with a comparison between the flood accounts in Genesis and the Mesopotamian (...) Atra-Has's and advances all the way to the 2014 Supreme Court case Burwell v. Hobby Lobby. The intervening chapters examine the contributions of figures such as Emperor Julian, Roger Williams, Cecilius Calvert, John Locke, Jean-Jacques Rousseau, and the American Founders. Contributors to the volume are Steven Grosby, Jeremiah H. Russell, Maura Jane Farrelly, Daniel Cullen, John Witte, Jr., Scott Yenor, David Ramsey, and Michael Novak. (shrink)

Background When anti-cancer treatments have been given market authorization, but are not (yet) reimbursed within a healthcare system, physicians are confronted with ethical dilemmas. Arranging access through other channels, e.g., hospital budgets or out-of-pocket payments by patients, may benefit patients, but leads to unequal access. Until now, little is known about the perspectives of physicians on access to non-reimbursed treatments. This interview study maps the experiences and moral views of Dutch oncologists and hematologists.Methods A diverse sample of oncologists and hematologists (...) (n = 22) were interviewed. Interviews were analyzed thematically using Nvivo 12 qualitative data software.Results This study reveals stark differences between physicians’ experiences and moral views on access to anti-cancer treatments that are not (yet) reimbursed: some physicians try to arrange other ways of access and some physicians do not. Some physicians inform patients about anti-cancer treatments that are not yet reimbursed, while others wait for reimbursement. Some physicians have principled moral objections to out-of-pocket payment, while others do not.Conclusion Oncologists and hematologists in the Netherlands differ greatly in their perspectives on access to expensive anti-cancer treatments that are not (yet) reimbursed. As a result, they may act differently when confronted with dilemmas in the consultation room. Physicians working in different healthcare systems may face similar dilemmas. (shrink)

This interview study investigates the short- and long-term implications of incidental findings detected through brain imaging on research participants’ lives and their surroundings. For this study, nine participants of the Rotterdam Scan Study with an incidental finding were approached and interviewed. When examining research participants’ narratives on the impact of the disclosure of incidental findings, the authors identified five sets of tensions with regard to motivations for and expectations of research participation, preferences regarding disclosure, short- and long-term impacts and impacts (...) on self and others. The paper shows: that the impact of incidental findings may be greater than participants at first let on; incidental findings can have significant effects on participants’ social environment; and participants may not feel prepared for disclosure even if incidental findings have been discussed during the informed consent process. The authors call for investigators to be aware of research participants’ experiences and these short- and long-term impacts when designing suitable courses of action for the detection and management of incidental findings in research settings. (shrink)

Abstract: Presentism is the view that whatever exists presently exists. Without defending Presentism, I argue first that Presentists should be Time-Free Presentists – Presentists whose views do not imply that there exist irreducible times. Second, I argue that Presentists should accept Limited Thick Presentism, the view that 'the present' has some extension and is thereby neither durationlessly thin nor unlimitedly 'thick'. Third, before addressing several objections to Limited Time-Free Thick Presentism [LTFTP], I argue that defenders of LTFTP should accept that (...) 'temporal becoming' involves an overlapping succession of present entities, not a 'skipping' from one set of present entities to the next discrete set. (shrink)

There has been much recent debate about Presentism among those who believe the doctrine to be nontrivial and true, those who believe it to be nontrivial and false, and those who believe it to be trivial — either trivially true or trivially false. Formulating Presentism precisely is problematic, which accounts for some of the controversy.

Arguing that the universe is absolutely directioned and that there exist spatial (directional) relations that Leibniz overlooked, H. Scott Hestevold formulates a new relationalist theory of space, exploring its implications for the Special Composition Question, reductivism regarding boundaries and holes, and the nature of spacetime.

First published in 1993. Routledge is an imprint of Taylor & Francis, an informa company.

When is it that two objects compose a whole? Or, put another way, if Z is an object composed of X and Y, then what must be done to bring it about that X and Y both exist and Z does not exist? The author defends an answer to what is now know as the Special Composition Question.

We note in Section I that an acceptable formulation of Presentism must preserve its consistency with Transient Time and inconsistency with Static Time. After arguing in Section II that certain formulations of Presentism are unacceptable, we offer in Section III a formulation of Presentism that we defend against the charge of triviality.

There have emerged two distinct approaches to preserving the coherence of theism. The most common approach involves explicating the concept of an absolutely perfect God in terms of the divine attributes and then analyzing the divine-attribute concepts in such a way that they are rendered mutually consistent. According to this ‘multiple-attribute’ approach, the coherence of theism ultimately turns both on whether each divine-attribute concept can be coherently analyzed independently of the other divine-attribute concepts and on whether the divine attributes are (...) then mutually consistent. (shrink)

Priority setting is inevitable to control expenditure on expensive medicines, but citizen support is often hampered by the workings of the ‘identified victim effect’, that is, the greater willingness to spend resources helping identified victims than helping statistical victims. In this paper we explore a possible cognitive debiasing strategy that is being employed in discussions on healthcare priority setting, which we call ‘empathy counterbalancing’ (EC). EC is the strategy of directing attention to, and eliciting empathy for, those who might be (...) harmed as a result of one-sided empathy for the very ill who needs expensive treatment. We argue that governments have good reasons to attempt EC because the identified victim effect distorts priority setting in ways that undermine procedural fairness. We briefly outline three areas of application for EC and suggest some possible mechanisms that might explain how EC might work, if at all. We then discuss four potential ethical concerns with EC. First, EC might have the counterproductive effect of reducing overall citizen support for public funding of expensive medical treatments, thereby undermining solidarity. Second, EC may give rise to a ‘competition in suffering’, which may have unintended side effects for patients who feature in attempts at EC. Third, there may be doubts about whether EC is effective. Fourth, it may be objected that EC comes down to emotional manipulation, which governments should avoid. We conclude that insofar these concerns are valid they may be adequately addressed, and that EC seems a promising strategy that merits further investigation. (shrink)

Roderick M. Chisholm’s A Realistic Theory of Categories is a metaphysics treatise of extraordinary breadth and precision. Published in the year of its author’s eightieth birthday, Categories is a lean exposition of Chisholm’s systematic metaphysics, including his views on attributes, propositions, possible worlds, numbers, classes, relations, intentionality, events, time, space, material objects, persons, appearances, fictitious objects, and God. Chisholm develops his metaphysics with the resourcefulness, elegance, and intellectual integrity that have been a hallmark of his work.

“States have no morality, they have interests,” remarked an overzealous diplomat. And in this same manner we sometimes see that reasons of state take priority over moral rules. A sweet young thing testifying before a committee of the United State Congress said “sometimes you have to put yourself above the law,” no doubt repeating something that had been said to her. At a time when unrestrained application of the reasons of state can only lead to violence that can no longer (...) be sustained, we can judge to what extent such remarks are without foundation. (shrink)

Healthcare is experiencing significant global changes in the organization of delivery services, leading to a quest for ways to enhance providers' work and the quality of their patient care. Organiz...

Graphical AbstractDriving patterns of coral bleaching over reefs are a suite of biophysical interactions where the physical environment modulates organism response through an interplay with intrinsic biological functioning. Flow conditions over reefs can mitigate the physiological impacts of thermal stress across multiple spatial scales. More details can be found in article number 1800226 by Charlotte E. Page et al., Seeking Resistance in Coral Reef Ecosystems: The Interplay of Biophysical Factors and Bleaching Resistance under a Changing Climate, DOI: 10.1002/bies.201800226.

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Florijn’s helpful discussion of the Heringa case illustrates the difficulties in drawing a boundary on eligibility conditions for EAS. In Heringa, the Dutch Supreme Court reaffirmed...

How do Dutch people let each other know that they disagree? What do they say when they want to resolve their difference of opinion by way of an argumentative discussion? In what way do they convey that they are convinced by each other’s argumentation? How do they criticize each other’s argumentative moves? Which words and expressions do they use in these endeavors? By answering these questions this short essay provides a brief inventory of the language of argumentation in Dutch.

Should the assessment of decision‐making capacity (DMC) be risk sensitive, that is, should the threshold for DMC vary with risk? The debate over this question is now nearly five decades old. To many, the idea that DMC assessments should be risk sensitive is intuitive and commonsense. To others, the idea is paternalistic or incoherent, or both; they argue that the riskiness of a given decision should increase the epistemic scrutiny in the evaluation of DMC, not increase the threshold for DMC. (...) We respond to the critics’ main concerns by providing a comprehensive account of how risk‐sensitive DMC is coherent, avoids paternalism, and best fulfills the epistemic goal of DMC evaluations. (shrink)

In this paper, faculty librarians at an academic institution explore the ethical dimensions of conducting research with user-generated social networking service (SNS) data. In an effort to guide librarian-researchers, this paper first offers a background discussion of privacy ethics across disciplines and then proposes a library-specific ethical framework for conducting SNS research.,By surveying the literature in other disciplines, three key considerations are identified that can inform ethical practice in the field of library science: context, expectation, and value analysis. For each (...) of these considerations, the framework is tailored to consider ethical issues, as they relate to libraries and our practice as librarian-researchers.,The unique role of the librarian-researcher demands an ethical framework specific to that practice. The findings of this paper propose such a framework.,Librarian-researchers are at a unique point in our history. In exploring SNSs as a source of data to conduct research and improve services, we become challenged by conflicting and equally cherished values of patron privacy and information access. By evaluating research according to context, expectations, and value, this framework provides an ethical path forward for research using SNS data.,As of this paper’s publication, there is no existing ethical framework for conducting SNS research in libraries. The proposed framework is informed both by library values and by broader research values, and therefore provides unique guidelines for the librarian-researcher. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)