Abstract Medical futility is commonly understood as treatment that would not provide for any meaningful benefit for the patient. While the medical facts will help to determine what is medically appropriate, it is often difficult for patients, families, surrogate decision-makers and healthcare providers to navigate these difficult situations. Often communication breaks down between those involved or reaches an impasse. This paper presents a set of practical strategies for dealing with cases of perceived medical futility at a major cancer center. Content (...) Type Journal Article Pages 1-8 DOI 10.1007/s10730-011-9168-3 Authors Colleen M. Gallagher, Section for Integrated Ethics in Cancer Care, Unit 1430, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX 77230-1402, USA Ryan F. Holmes, St. Louis University, St. Louis, MO, USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737. (shrink)

Working the night shift can be fraught and experienced as demanding and, yet, is often dismissed as babysitting. Few researchers have explored the social and cultural meanings of night nursing, including storytelling rituals. In 2019, a narrative study was undertaken. The aim was to explore the stories recalled by nurses about working night shifts. Thirteen Australian nurses participated. Data were gathered using the Biographical Narrative Interview Method, and narrative analysis produced forty stories and three themes: strange and challenging experiences; colleagues (...) can be mentors (or not); and textbook knowledge is only part of what is needed on night shift. Nursing students who engage with these stories may come to understand the challenges of the night shift, and the valuable work that nurses engage in throughout a 24‐hr period, work that involves adept psychosocial and interpersonal skills alongside technical and physical competence. (shrink)

When are morally good actions beautiful, when indeed they are? In this paper, it is argued that morally good actions are beautiful when they appear to express the deep or true self, and in turn tend to give rise to an emotion which is characterised by feelings of being moved, unity, inspiration, and meaningfulness, inter alia. In advancing the case for this claim, it is revealed that there are additional sources of well-formedness in play in the context of moral beauty (...) in addition to those that have tended to be focused on to date: one which is connected to imagining a deep location for the goodness concerned, and another which is connected to imagining that the goodness stems from capacities which are essential to the person. (shrink)

What is the nature of the concept BEAUTY? Does it differ fundamentally from nearby concepts such as PRETTINESS? It is argued that BEAUTY, but not PRETTINESS, is a dual-character concept. Across a number of contexts, it is proposed that BEAUTY has a descriptive sense that is characterised by, inter alia, having intrinsically pleasing appearances; and a normative sense associated with deeply-held values. This account is supported across two, pre-registered, studies (N=500), and by drawing on analysis of corpus data. It is (...) suggested that this can help to explain why beauty, unlike prettiness, is thought to be deep in both the sense of being important, and in the sense of being less closely tied to sensory surfaces. (shrink)

Why are moral actions beautiful, when indeed they are? This paper assesses the view, found most notably in Schiller, that moral actions are beautiful just when they present the appearance of freedom by appearing to be the result of internal harmony (the Schillerian Internal Harmony Thesis). I argue that while this thesis can accommodate some of the beauty involved in contrasts of the ‘continent’ and the ‘fully’ virtuous, it cannot account for all of the beauty in such contrasts, and so (...) needs to be weakened considerably (to the Internal Harmony Thesis). To account for the remaining beauty that cannot be fully accommodated even by this revised thesis, as well as the beauty contained in contrasts that involve agents who experience internal conflict as a result of being sensitive to different sources of moral value to an appropriate extent, a number of further theses need to be posited: namely, that the beauty of some moral actions is to be accommodated in terms of internal disharmony (the Internal Disharmony Thesis), and in terms of a felt harmony between the appreciator of the action and the executor of the action (the Affective Harmony Thesis). As such, in contrast to Schiller, I suggest that we need to take a pluralist and context-sensitive approach to accommodating the beauty of moral actions. (shrink)

What is a language? What do scientific grammars tell us about the structure of individual languages and human language in general? What kind of science is linguistics? These and other questions are the subject of Ryan M. Nefdt's Language, Science, and Structure. -/- Linguistics presents a unique and challenging subject matter for the philosophy of science. As a special science, its formalisation and naturalisation inspired what many consider to be a scientific revolution in the study of mind and language. (...) Yet radical internal theory change, multiple competing frameworks, and issues of modelling and realism have largely gone unaddressed in the field. Nefdt develops a structural realist perspective on the philosophy of linguistics which aims to confront the aforementioned topics in new ways while expanding the outlook toward new scientific connections and novel philosophical insights. On this view, languages are real patterns which emerge from complex biological systems. Nefdt's exploration of this novel view will be especially valuable to those working in formal and computational linguistics, cognitive science, and the philosophies of science, mathematics, and language. (shrink)

Most accounts of cognitive scaffolding focus on ways that external structure can support or augment an agent’s cognitive capacities. We call cases where the interests of the user are served benign scaffolding and argue for the possibility and reality of hostile scaffolding. This is scaffolding which depends on the same capacities of an agent to make cognitive use of external structure as in benign cases, but that undermines or exploits the user while serving the interests of another agent. We develop (...) criteria for scaffolding being hostile and show by reference to examples including the design features of electronic gambling machines and casino management systems that hostile scaffolding exists and can be highly effective. In cases where the scaffolding is deep and permits the offloading of significant cognitive work, hostile scaffolding exploitatively manipulates cognitive processing itself. Given the extent of human reliance on scaffolding this is an important and neglected vulnerability. [This is an updated version of the paper, added in February 2023.]. (shrink)

In 2006, a WHO survey found evidence of a substantial increase in patient-led litigation against health authorities and funders over access to medicines around the world. New Zealanders have seldom litigated denials of access to health care. Part of the explanation lies in the fact that New Zealand has a legislated patients' "bill of rights", with enforcement through a complaints mechanism. Although the separate regime does not afford patients substantive legal protection in respect of complaints about lack of access to (...) care, this form of alternative, low-level resolution of health care disputes does condition disgruntled patients not to turn to the courts for legal redress in relation to their rights. But given the increasing need for prioritization arising from serious concern about the sustainability of the public health system, as well as a trend towards greater explicitness when it occurs, increased disappointment on behalf of patients and the public when care is denied or limited seems inevitable. This may well translate into increased patient-led litigation against health boards and funders. Part 1 provides an overview of the New Zealand health system, with a focus on the points at which resource allocation decisions are made, the identity of the decision-maker, and the methods by which priority-setting occurs. Part 1.1 describes inequalities between population groups in New Zealand, both in health outcomes and in access to health care. Part 2 describes the legal framework surrounding the health and disability sector, and discusses the lack of legislated rights to health and the limited right of access to health care in legislation, despite the existence of a legally enforceable Code of Health and Disability Services Consumers' Rights. (shrink)

While the focus examines multiple levels and perspectives on care, it will go beyond description and analysis to discuss ethical, intersectional, and life-sustaining ways in which care may be enhanced.

This edited collection recalls the events that led up to the Fitzgerald Inquiry and examines the extraordinary influence the ‘watershed' inquiry has had on police and public sector reform at the state, national and international levels.

Ryan Wasserman explores a range of fascinating puzzles raised by the possibility of time travel, with entertaining examples from physics, science fiction, and popular culture, and he draws out their implications for our understanding of time, tense, freedom, fatalism, causation, counterfactuals, laws of nature, persistence, change, and mereology.

This volume concerns the status and ambitions of metaphysics as a discipline.

Does the formation of delusions involve abnormal reasoning? According to the prominent ‘two-factor’ theory of delusions (e.g. Coltheart, 2007), the answer is yes. The second factor in this theory is supposed to affect a deluded individual's ability to evaluate candidates for belief. However, most published accounts of the two-factor theory have not said much about the nature of this second factor. In an effort to remedy this shortcoming, Coltheart, Menzies and Sutton (2010) recently put forward a Bayesian account of inference (...) in delusions. I outline some criticisms of this important account, and sketch an alternative account of delusional inference that, I argue, avoids these criticisms. Specifically, I argue that the second factor in delusion formation involves a systematic deviation from Bayesian updating, a deviation that may be characterized as a bias towards ‘explanatory adequacy’. I present a numerical model of this idea and show that my alternative account is broadly consistent with prominent prediction error models of delusion formation (e.g. Corlett, Murray et al., 2007). (shrink)

The problem : commerce and corruption -- Smith's defense of commercial society -- What is corruption? : political and psychological perspectives -- Smith on corruption : from the citizen to the human being -- The solution : moral philosophy -- Liberal individualism and virtue ethics -- Social science vs. moral philosophy -- Types of moral philosophy : natural jurisprudence vs. ethics -- Types of ethics : utilitarianism, deontology, and virtue ethics -- Virtue ethics : modern, ancient, and Smithean -- Interlude (...) : the what and the how of TMS VI -- The what : Sith's "practical system of morality" -- The how : rhetoric, audience, and the methods of practical ethics -- The how : the ascent of self-love in three stages -- Prudence or commercial virtue -- The challenge : from praise to prudence -- Educating the vain : fathers and sons -- Self-interest rightly understood -- The advantages and disadvantages of prudence -- Magnanimity or classical virtue -- The problems of prudence and the therapy of magnanimity -- Up from individualism : desert, praiseworthiness, conscience -- Modernity, antiquity, and magnanimity -- The dangers of magnanimity -- Beneficence or christian virtue -- Between care and caritas -- Benevolence and beneficence and the human telos -- The character and purposes of the wise and virtuous man -- Wisdom and virtue and Adam Smith's apology -- Epilogue: The "economy of greatness". (shrink)

Effective Altruism is a rapidly growing and influential contemporary philosophical movement committed to updating utilitarianism in both theory and practice. The movement focuses on identifying urgent but neglected causes and inspiring supererogatory giving to meet the need. It also tries to build a broader coalition by adopting a more ecumenical approach to ethics which recognizes a wide range of values and moral constraints. These interesting developments distinguish Effective Altruism from the utilitarianism of the past in ways that invite cooperation and (...) warrant a fresh look from Thomists. Nonetheless Effective Altruism’s fundamentally consequentialist and aggregative model for ethics precludes more foundational agreement with Thomistic ethics in ways that limit the extent of practical cooperation. (shrink)

: In recent literature supporting a hybrid view between metaethical cognitivism and noncognitivist expressivism, much has been made of an analogy between moral terms and pejoratives. The analogy is based on the plausible idea that pejorative slurs are used to express both a descriptive belief and a negative attitude. The analogy looks promising insofar as it encourages the kinds of features we should want from a hybrid expressivist view for moral language. But the analogy between moral terms and pejorative slurs (...) is also problematic. In this paper, I argue for two main ways in which we should distinguish between two different types of pejorative terms: slurs, on the one hand, and what I call general pejorative terms, on the other. I examine the problems with the analogy between slurs and moral terms and conclude that general pejorative terms like ‘jerk’ are a better candidate on which to model the potential dual-use behavior of moral terms. So if hybrid theorists are looking for a dual-use model for moral language, they should be careful to base their analogies on general pejoratives, rather than slurs. (shrink)

The purpose of this study was to assess student perceptions of self-plagiarism. Students at three university campuses offering graduate and undergraduate classes in a residential and online format were queried; 284 students responded. Overwhelmingly, students perceived they owned their own previous published works and over half reported they believed self-plagiarism should not be considered an academic honesty offense. Most faculty members did not provide information about self-plagiarism to their students. Only about one-fourth of the students reported recycling parts of an (...) assignment in the past. Students who took online courses were more likely to have been educated about self-plagiarism than those who took residential courses. Understanding students’ perceptions about academic honesty offenses such as plagiarism can help institutions develop effective policies and interventions. (shrink)

Why must incompatibility be symmetric? An odd question, but recent work in the semantics of non-classical logic, which appeals to the notion of incompatibility as a primitive and defines negation in terms of it, has brought this question to the fore. Francesco Berto proposes such a semantics for negation argues that, since incompatibility must be symmetric, double negation introduction must be a law of negation. However, he offers no argument for the claim that incompatibility really must be symmetric. Here, I (...) provide such an argument, showing that, insofar as we think of incompatibility in normative pragmatic terms, it can play its basic pragmatic function only if it is symmetric. The upshot is that we can vindicate Berto’s claim about the symmetry of incompatibility but only if we, pace Berto, think about incompatibility, in the first instance, as a pragmatic relation between acts rather than a semantic relation between contents. (shrink)

Many countries have attempted to transition to democracy following conflict or repression, but the basic meaning of transitional justice remains hotly contested. In this book, Colleen Murphy analyses transitional justice - showing how it is distinguished from retributive, corrective, and distributive justice - and outlines the ethical standards which societies attempting to democratize should follow. She argues that transitional justice involves the just pursuit of societal transformation. Such transformation requires political reconciliation, which in turn has a complex set of (...) institutional and interpersonal requirements including the rule of law. She shows how societal transformation is also influenced by the moral claims of victims and the demands of perpetrators, and how justice processes can fail to be just by failing to foster this transformation or by not treating victims and perpetrators fairly. Her book will be accessible and enlightening for philosophers, political and social scientists, policy analysts, and legal and human rights scholars and activists. (shrink)

Invaluable wisdom on living a good life from the founder of modern economics Adam Smith is best known today as the founder of modern economics, but he was also an uncommonly brilliant philosopher who was especially interested in the perennial question of how to live a good life. Our Great Purpose is a short and illuminating guide to Smith's incomparable wisdom on how to live well, written by one of today's leading Smith scholars. In this inspiring and entertaining book, (...) class='Hi'>Ryan Patrick Hanley describes Smith's vision of "the excellent and praiseworthy character," and draws on the philosopher's writings to show how each of us can go about developing one. For Smith, an excellent character is distinguished by qualities such as prudence, self-command, justice, and benevolence—virtues that have been extolled since antiquity. Yet Smith wrote not for the ancient polis but for the world of market society—our world—which rewards self-interest more than virtue. Hanley shows how Smith set forth a vision of the worthy life that is uniquely suited to us today. Full of invaluable insights on topics ranging from happiness and moderation to love and friendship, Our Great Purpose enables modern readers to see Smith in an entirely new light—and along the way, learn what it truly means to live a good life. (shrink)

René Girard, Theology, and Pop Culture provides a fresh and engaging introduction to and the application of René Girard's mimetic theory. From movies to social media, television to graphic novels, the contributors explore popular culture's theological depths and challenge readers to consider what culture reveals about them.

In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The “gold standard” method, the randomised, controlled trial (RCT), imbues medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame the problem of method (...) as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM. (shrink)

This paper proposes epistemic environmentalism as a novel framework for accounting for the contribution of the environment – broadly construed – to epistemic standings and which can be used to improve or protect epistemic environments. The contribution of the environment to epistemic standings is explained through recent developments in epistemology and cognitive science, including embodied cognition, embedded cognition, extended cognition and distributed cognition. The paper examines how these developments support epistemic environmentalism, as well as contributes theoretical resources to make epistemic (...) assessments of dynamic environments. The epistemic environmentalist procedure from the assessment of an individual environment to changes made to that environment based on promoting the attainment of epistemic goods is also discussed. (shrink)

Ryan Recalls is not a typical autobiography for while it contains personal memoirs and preoccupations, it also contains book reviews, book launches, published and unpublished papers as well as various newspaper articles put together by the author" --Page 2 of cover.

During his long and continuing scholarly career, Patrick Suppes contributed significantly both to the sciences and to their philosophies. The volume consists of papers by an international group of Suppes colleagues, collaborators, and students in many of the areas of his expertise, building on or adding to his insights. Michael Friedman offers an overview of Suppes accomplishments and of his unique perspective on the relation between science and philosophy. Paul Humphreys, Stephen Hartmann, and Tom Ryckman present essays in the philosophy (...) of physics. Jens-Erik Fenstad, Harvey Friedman, and Jaako Hintikka consider problems in the foundations of mathematics, while the late Duncan Luce, Jean-Claude Falmagne, Brian Skyrms, and Hannes Leitgeb have contributed essays in theory of measurement, decision theory and probability. Foundations of economics and political theory are addressed by Adolfo Garcia de la Sienra, Russell Hardin, and Kenneth Arrow. Psychology, language, and philosophy of language are addressed by Elizabeth Loftus, Anne Fagot-Largeault, Willem Levelt, Dagfinn Follesdal, and Marcos Perreau-Guimares and some of Suppes most recent research in neurobiology is addressed in essays by Colleen Crangle, Acadio de Barros and Claudio Carvalhes. Finally Nancy Cartwright and Alexandre Marcelles consider the alignment (or misalignment) of method and policy. Each of the essays is accompanied by a response from Suppes.". (shrink)

[T]he essays collected here... further determine the limits of experience as well as salvage something essential from that which takes place at the very limit of political and aesthetic experience. Included here are critical readings of such seminal figures as Locke, Kant, Nietzsche, Adorno, Foucault, Fanon, Lacoue-Labarthe, Badiou, and Rancière." -Cover.

Drawing on perspectives ranging from generative syntax, optimality theory, computational linguistics, sign language phonology, and language evolution studies, this book explores the current philosophical issues in theoretical linguistics. It is an essential read for linguists, cognitive scientists and philosophers working in language studies.

Drawing on his extensive classroom experience and linguistic expertise, Paul Ryan offers a commentary that is both rich in detail and—in contrast to earlier, more austere commentaries on the Phaedrus—fully engaging. Line by line, he explains subtle points of language, explicates difficulties of syntax, and brings out nuances of tone and meaning that students might not otherwise notice or understand.

This book explores the constraints which justice imposes on immigration policy. Like liberal nationalists, Ryan Pevnick argues that citizens have special claims to the institutions of their states. However, the source of these special claims is located in the citizenry's ownership of state institutions rather than in a shared national identity. Citizens contribute to the construction and maintenance of institutions, and as a result they have special claims to these institutions and a limited right to exclude outsiders. Pevnick shows (...) that the resulting view justifies a set of policies - including support for certain types of guest worker programs - which is distinct from those supported by either liberal nationalists or advocates of open borders. His book provides a framework for considering a number of connected topics including issues related to self-determination, the scope of distributive justice and the significance of shared national identity. (shrink)

Hegemonic masculinity, a framework where stereotypically masculine traits are over-emphasized, plays a central role in sport, partly due to an excessive focus on winning. This type of masculinity marginalizes those that do not possess specific traits, including many women and men. I argue sport reform focused on mitigating hypercompetitive attitudes can reduce this harmful and marginalizing hegemonic masculinity in sport. I make this argument first by challenging the dichotomous nature of sport, especially in recognizing that all outcomes are a blend (...) of winning and losing, that ties are relevant and informative outcomes to contests, and that winning and losing do not always tell accurate stories of the outcome. Secondly, I contend that expanding the potential outcomes in sport can help broaden the emphasis of competitive sport to take into account playing well and improving, in terms of both the test and the contest. I conclude that these reforms decrease hegemonic masculinity, making sport better for all. (shrink)

In an effort to think through possible impossibilities, and enfold current problems within Catholicism into the luminous darkness of the cloud of the im/possible, this response to Catherine Keller's Cloud of the Impossible considers what might happen should Keller's cloud of mindful unknowing and nonseparable difference billow over and through one particular Catholic conundrum: how to respond to the terrifying reality of domestic violence in the context of a marriage defined as indissoluble, imperishable—inescapable.

Are mandatory lockdown measures, which place restrictions on one’s freedom to move and assemble, justifiable? Offhand, such measures appear to compromise important rights to secure goals of public health. Proponents of such measures think the trade-off is worth it; opponents think it isn’t. However, one might think that casting the debate in these terms concedes too much to the opponents. Mandatory lockdown measures don’t infringe important rights because no one has a right to impose a risk of grievous harm on (...) others—and, in the context of a pandemic, participating in the prohibited activities (e.g., going out to the bar) does just that. -/- This chapter explores whether this defense of mandatory lockdown measures holds up. It, first, considers whether we have a right against risk imposition—and, if so, how such a right is best understood. It then considers the objection that, even if there is such a right, people who voluntarily choose to engage in the prohibited activities—at least if fully appraised of the risks involved—effectively waive it. The chapter argues that this objection fails. (shrink)

This article explores the personal responsibility of soldiers for fighting in unjust wars. Its reference point is the position developed by Jeff McMahan in his recent Killing in War. I claim that McMahan fails to give sufficient importance to institutional justifications on this matter. I argue for this by developing what I call the argument to democratic duty, which I claim embodies much current thinking about the obligations of soldiers in a democratic culture. The upshot of my argument is that (...) soldiers are placed in a contradictory position, between personal and institutional obligations. This is one sense in which soldiers can be victimized by the institution of war itself. (shrink)

In their article “Racial Justice Requires Ending the War on Drugs,” Earp, Lewis, and Hart argue for the end of our War on Drugs in order to alleviate our reliance on mass incarceration, harm...