ObjectivesThe purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records.MethodsPregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses. Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic (...) models were evaluated for the associations between substance use and each birth outcome.ResultsThe average maternal age was 30 years, 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance u... (shrink)

Current advances in connectivity, sensor technology, computing power and the development of complex algorithms for processing health-related data are paving the way for the delivery of innovative long-term health care services in the future. Such technological developments will, in particular, assist the elderly and infirm to live independently, at home, for much longer periods. The home is, in fact, becoming a locus for health care innovation that may in the future compete with the hospital. However, along with these advances come (...) valid privacy and security questions arising from the fact that the data collected and transmitted through these technologies could also allow for individual monitoring as well as unauthorized access to critical diagnostic and other health data. (shrink)

Thomas Reid uses the notion of exertion in various ways that have not been distinguished in the secondary literature. Sometimes he uses it to refer to the exercise of a capacity or power, sometimes to the turning on or activitating of a capacity or power, and still other times to the attempt to activate a capacity or power. Getting clear on Reid's different uses of the term 'exertion' is essential to understanding his account of the sequence of events in human (...) action. It is also helpful in defending Reid against the objection that his account of action is subject to an infinite regress. (shrink)

Objective: To identify the frequency and nature of care conflict dilemmas that United States long-term care providers encounter, response strategies, and use of ethics resources to assist with dispute resolution. Design: An online cross-sectional survey was distributed to the Society for Post-Acute and Long-Term Care Medicine (AMDA). Results: Two-thirds of participants, primarily medical directors, have rejected surrogate instructions and 71% have managed family conflict. Conflict over treatment decisions and issues interpreting advance directives were frequently reported. Half of facilities lack a (...) formal dispute mediation policy. Only five respondents have called an ethics consult for assistance. Conclusion: Ethically tense care conflicts commonly arise in long-term and post-acute care facilities. Few facility procedures incorporate ethics resources into actual practice. Recommendations are made to create actionable policy, increase access to ethics services, and support staff skill development in order to improve the end-of-life care experiences for patients, families, and care facility staff. (shrink)

Mystery: the scalpel that split consciousness -- Beauty: sirens of the gene -- Reality: capers of the unseen sun -- Sensory: fitness beats truth -- Illusory: the bluff of a desktop -- Gravity: spacetime is doomed -- Virtuality: inflating a holoworld -- Polychromy: mutations of an interface -- Scrutiny: you get what you need, in both life and business -- Community: the network of conscious agents -- Precisely: the right to be wrong.

In Chapter One I present an interpretation of Descartes' theory of distinction. I argue that the best understanding of the notion of separate existence at stake in the real distinction between mind and body is not that each can exist without the other existing, nor that each can exist without a real union with the other, but that each can exist without the attributes of the other. However, the only notion of separate existence which can provide an adequate acccount of (...) all three kinds of distinction--real, modal, and of reason--is that of one thing existing without a real union with another thing. ;In Chapter Two I examine Descartes' claims about the dependence of created substances on God and their independence from other creatures. The pure substances, those which are not composed of parts, can be caused to come into existence and go out of existence only by God, and they can perish only by annihilation. These substances include individual created minds and the extended universe considered as a whole. In contrast, bodies and human beings, which are composed of parts, can be caused to go out of existence by other creatures, and they can perish without being annihilated. Nevertheless, I argue that Descartes thinks bodies and human beings are full-fledged substances. ;In Chapter Three I discuss the union of mind and body. I argue that Descartes thinks the human soul is the only substantial form and that it inheres in the body as form inheres in matter. I defend his account of how two substances can form a unity by comparing it with medieval accounts of the unity of composites. ;Chapter Four examines Descartes' arguments for rejecting substantial forms and the so-called real qualities. I argue that his earliest series of arguments, those from perception and scientific explanation, is the most successful. ;Finally, in Chapter Five, I consider Descartes' positive account of the status of those so-called real qualities which he asserts are merely sensations, for example, color, sound, and heat. I argue that he is best understood as holding that they are modes of both thought and extension which are property ascribed to the composite of mind and body. (shrink)

Data science is characterized by engaging heterogeneous data to tackle real world questions and problems. But data science has no data of its own and must seek it within real world domains. We call this search for data “prospecting” and argue that the dynamics of prospecting are pervasive in, even characteristic of, data science. Prospecting aims to render the data, knowledge, expertise, and practices of worldly domains available and tractable to data science method and epistemology. Prospecting precedes data synthesis, analysis, (...) or visualization, and is constituted by the upstream work of discovering disordered or inaccessible data resources, thereafter to be ordered and rendered available for computation. Through this work, data science positions itself in the middle of all things—capable of engaging this, that, or any domain—and thus prospecting is a key driver of data science’s ongoing formation as a universal science. (shrink)

Photo by Jonathan Ford on Unsplash ABSTRACT Since 2008, an average of twenty million people per year have been displaced by weather events. Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. This paper analyzes the idea of expanding a duty to rescue to climate migration. We address who should have (...) the duty and to whom the duty should extend. The paper discusses ways to define and apply the duty to rescue as well as its limitations, arguing that it may take the form of an ethical duty to prepare. INTRODUCTION Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. Examples of circumstances range from person-to-person intimate rescue to saving those in poverty, even in distant parts of the world.[1] Since 2008, an average of twenty million people per year have been displaced by weather events.[2] Circumstances like being thrust from homes under the threat of fire, mudslide, and flooding vary greatly from long-term changes like land becoming too arid for crops or temperatures increasing annually gradually pushing up the number of heat-related deaths, with the area slowly becoming uninhabitable. Imminence in fleeing affects resettling and need for rescue with important implications for how the duty to rescue might apply. This paper reevaluates the ethical framing of the duty to rescue and, while it is arguably a stretch, applies it to climate migration. Climate migration has become common and is expected to increase due to rises in sea level, increases in weather events that make areas uninhabitable, and changes to land that preclude farming or other necessary land uses. We argue that a duty to rescue may help highlight who has moral obligations to whom. Because the problem is so large in scope, we suggest a change in the ethical limits to humans' duty to rescue other humans who are in distress. We imagine an expansion or extension of the duty to rescue to meet some of the basic needs created by climate migration. Yet how it should expand, and how much depend on ethical framing and practical limitations. l. Expanding the Geographical Boundaries Two commonly recognized emergencies, Hurricane Katrina in the case of weather events and the current COVID-19 pandemic, provide a historical and current backdrop to evaluate ethical obligations as more disasters displace people. A significant reassessment of the ethical scope of an obligation to rescue in the case of weather events will be limited by the ability to render aid to those in distress in the case of a planet-wide weather catastrophe. The problems may overwhelm the ability to rescue or the reasonableness of attempting rescue. The extent of the moral obligation borne by humans to other humans in the case of a weather event has been largely defined by its locality and limited geographic influence. Whether we are imagining the scope of ethical obligation in the case of hurricane, flood, tornado, drought, or wildfire events, the perceived ethical obligation is significantly defined by the limited impact of these weather events on people outside the zone of the weather event's direct impact, yet close to that zone. A hurricane affecting New Orleans will not have immediate impact on the residents of California or even those on the northeast coast of the United States until a later time. Wildfires in the Pacific Northwest do not impair the ability of those in the rest of the country to come forward with assistance. But as climate migration crosses international borders, and climate events occur simultaneously in many regions, a more expansive duty to rescue may provide the ethical impulse to help those who live afar or migrate long distances. In this respect, the need for help in the event of widespread climate migration due to global warming is more like a pandemic than a weather event. Its broad impact area diminishes the capability of nearly the entire balance of the human population to help due to those populations' awareness that they will, in short order, have the same need for the same resources, from the same cause. Those living near current flood zones may find their historically safe havens are also a flood zone. Those previously best positioned to rescue may find themselves also needing to relocate. Thus, we may observe the need for new rescuers. ll. The Rule of Rescue The Rule of Rescue as defined by Al Jonsen describes the moral impetus or knee jerk reaction to save identifiable people facing death.[3] A duty to rescue has since been expanded beyond imminent death and beyond the near and identifiable. But there are limitations. For example, by most accounts, the ethical duty tends not to require extreme bodily risk or financial depletion. In comparing Good Samaritans to humanitarians, Scott M. James argues the duty to rescue arises from unique dependence, but the ethical obligation to help strangers through humanitarian aid is of a different nature.[4] The wrongness of failing to help is arguably more egregious when one is in a unique position to help. Like in the tragedy of the commons, where there is no unique positioning, when the global community is called upon to help, each individual in it may feel less obliged to do so. Climate migration falls in between—it requires helping strangers, yet it may move forward without anyone seeing themselves as uniquely positioned to help until those strangers become part of communities, at which time, there may be more moral justification to help a community member in need. Generally, arguments about Good Samaritans hinge on extraordinary acts, praiseworthy because they are acts of compassion, not obligation. Now all US states have Good Samaritan laws[5] which protect helpers from liability for help gone wrong or for a failure to succeed once engaged in an act of rescue. Extraordinary help as a moral good is thus somewhat encouraged through legal protection, but not imposed. Conversely, jobs like firefighting, search and rescue, and emergency medical care tend to oblige employees to take on risks that would be extraordinary if undertaken by the average bystander, yet they are rendered ordinary rescue as part of the job. Three states, Minnesota, Rhode Island, and Vermont have a broad duty to rescue, adding legal considerations to an otherwise moral conundrum. The laws do not require bystanders to take on risk for the sake of rescuing strangers.[6] The moral duty will require looking beyond law, but it is unclear how the moral duty to rescue should be distributed in the case of climate migration. A bare minimum would prevent taking advantage of newcomers, paying sub-minimum wage, and discriminating against them. Yet such a minimum is hardly rescue. lll. An Ethical Rather than Legal Duty The difficulty in defining the duty to rescue as a legal obligation is that it is difficult to determine the extent of risk a rescuer ought to be required to take. The nature of this ethical duty is also arguably tied to the experiences of both the rescuer and the rescued. There are subjective aspects like what someone perceives as a danger that make it difficult to write enforceable laws requiring rescue. It is one thing to expect a rescuer to step into several inches of relatively warm water to lift a person lying face down in a pond and enable them to breathe. It is something altogether different to expect that rescuer to dive into frigid water and attempt to extricate someone trapped in a submerged automobile. As the legal philosopher H.L.A. Hart observed, it is always easier to define application of the core intention of any rule, whether law or ethical norm. It is more difficult to create legal certainty about how the law applies to what he described as “penumbra circumstances”. In the case of a hurricane, it is easier to define what surplus resources are available in areas geographically remote from the impact of the storm and demand, as a moral obligation, that those nearby but outside the area provide assistance. It is more difficult to obligate people, organizations, or governments to supply a quantity of medication or some number of ventilators to an adjacent community when they expect to imminently need them for their own community. In the early stages of climate migration, the ethics of extreme weather event assistance, a common application of the duty to rescue, will be useful and appropriate. The rising sea levels first experienced by island nations in the South Pacific[7] will not render those living in other coastal communities, those with greater available “high ground”, unable to supply resources to those in need. But when sea level rise and climate change affect more communities simultaneously, albeit in varying degree, the task of defining what response is ethically obligatory becomes increasingly complicated. Pinpointing the obligations of those communities which are resource rich to those communities which are resource deprived, and of those partly affected to those more severely affected may become necessary. The limitations of the traditional duty to rescue could expand to meet the needs. lV. Contribution to the Problem Many argue that the duty to rescue may depend on any appropriate claim of those needing rescue. One issue is whether preferential claims among those who can identify the source of the harm should call for a greater duty or whether everyone in need should be approached as like candidates for rescue, shaping the duty as equal across those on the receiving end. As climate change does have human-made causes, there are strong arguments to impose a greater ethical duty on any entity that caused the climate-related problems leading to the mass exodus. While the global north is often implicated in pollution that causes migration, industries like energy, transportation, and agriculture are tied to climate change and associated with significant greenhouse gas emissions.[8] Practices like directing agriculture to less sustainable single crop growth generally made land less farmable. Yet it is difficult to place blame and identify specific causal relationships as most migration is due to many factors. A movement toward greater accountability can be reframed as a greater duty to rescue, a duty to engage in the extraordinary. The fossil fuel industry, for example, should have a larger obligation than the average person. Similarly, some may argue anyone unjustly enriching themselves while contributing to climate change or people who over-consume have an elevated duty to rescue.[9] Climate change lawsuits demonstrate an eagerness to hold governments and corporations accountable, despite difficulty proving causation. V. The Most Vulnerable One ethical dimension of climate migration that remains unexplored is how a duty to rescue applies to vulnerable populations who stand to be left behind or unable to migrate without assistance. Researchers from the Global North working across the Global South are increasingly observing the phenomenon of ethics dumping, where the research ethics of some countries are imposed on research subjects in other countries.[10] In that vein, rescuers should be careful not to impose unwelcome cultural standards or exploit people who are in the process of migrating. There is a gap in discussions reflecting voices that have been left out. The duty to rescue is incomplete without an attempt to understand the ethical experiences of those being rescued. The actual people affected by climate migration who are the least likely to have the means to migrate, or to do so without extreme hardship, should have a voice informing the global community including those in a position to carry out rescue. People who have the means and are young and healthy may easily make decisions to avoid the catastrophic consequences that climate migration brings. However, what about those who are left behind? For example, especially recognizing cultural differences, the homeless community, disabled community, refugees, the elderly community, and women[11] and children may suffer differently and call for more attention. In some parts of the world, human rights are severely constrained. An ethical duty to rescue, with many considerations and variables, may be more justified in the case of those most in need. As climate migration continues and increases significantly, it may be reasonable to ask the local and global community to focus on those least well positioned to migrate successfully. In this context, the use of phenomenology to understand the lived experiences of those migrating, sometimes termed “ethical experiences”, may help flesh out how a duty to rescue takes shape. The discussion of duty and obligation requires an articulation of the ethical experiences (how the local community in need of rescue views the proposed rescue). Then, the obligation to interpret the duty as ‘one shall not’ or ‘one must’ can be focused on the migrants’ needs rather than the rescuers’ feelings of obligation.[12] A revised theory of the duty to rescue taking into account the asymmetrical experiences of communities involved could ensure that the needs of people whose living situations, gender, ethnicity, age, or race impact their ability to even begin the migration process are considered. In this discussion, the rescuing is directed toward communities /collectives of persons migrating, whether at once or across a period of time. Often, the climate migrant may not be in a state to articulate the nature of this event when it happens, given its subjective proximity. Yet, when communities are given the space and opportunity to articulate their shared values, the ethical action of rescue derives its meaningfulness from the community rather than the rescuers. In other words, allowing climate migrants to explain their feelings can add complexity to what some see as a binary receiver-giver (of rescue) dynamic. This is necessary because the concept of vulnerable populations is fraught with problematic assumptions. There have been various definitions and criteria to determine what would constitute vulnerable populations.[13] For example, the United Nations Framework Convention on Climate Change[14] identifies and assesses vulnerable populations. These criteria may be helpful. However, they do not provide the full picture. Rather than identifying categorical criteria of vulnerable populations, engaging with people who are experiencing climate migration and listening to their current experiences and concerns helps determine need. Knowing what people need may prevent the kneejerk reaction to label people who are quite resilient yet have appropriate needs “vulnerable”. Proceeding with caution is important because the duty to rescue has hierarchical underpinnings of "us" and "them." Often when people swoop in to save, there are good and bad consequences of the intervention. We should proceed with caution because often the helper misses the actual needs of those in need. The only way to combat this would be to make sure that people are empowered to inform those agencies that are able to help. In addition to more practical approaches, large scale oral histories could allow those who have migrated already to share their experiences. It would be important to capture the lived experiences of people who are already experiencing the consequences of climate migration or of other migration like that due to political or economic extreme events. These experiences could shape our analysis of whether people in fact wish for rescue. If so, further conversations can determine best actions as well as give important insight into what resources might be necessary to empower people now and in the future. Vl. A Duty to Rescue as a Duty to Prepare If we view Good Samaritans as going above and beyond, then a duty to rescue, something ethically compelled, must bring rescue out of the framework of charity and place it in the context of humanity and obligations. Such a view would also support expanding the geographical reach of the otherwise more proximate duty. The duty may be stronger and take shape in a more workable way if it applies to preparing places expecting to see an influx of people due to climate migration and to helping those most in need. The duty may arise out of expectations of what type of community the place welcoming those migrating due to climate should be—does it want to offer good housing, schooling, and medical care as well as economic opportunity to new people? And if so, at what cost, or with which risks? If the newcomers are viewed as community members rather than strangers, a model of acceptance may lead to better preparation. Some considerations like whether the actions will reasonably help the persons in need of rescue[15] will shape the application of a duty to rescue in the context of climate migration. Similarly, ensuring that people have the chance to articulate their values may help communities support the newcomers. New relationships should not be defined as migrant and rescuer. Voluntariness in participation and not forcing any action deemed rescue would help ensure the human rights of those migrating. In the United States, President Biden issued an executive order addressing impending climate migration steeped in a duty to prepare by making plans for resettlement and to address the impact of climate migration.[16] Vll. At What Risk? As we investigate the ethical obligations to meet even basic needs, we must also ask what level of risk is ethically compelled. There is an extraordinary need to integrate newcomers successfully, but it is difficult to stretch an ethical duty to rescue to require all the prerequisites for successful climate migration. Even defining success would create deep ethical arguments. As observed in almost all migrations, extraordinary charitable acts may be the key to success, while an ethical duty to rescue must try to require the important government and community-based basics and ensuring respect for human rights. That is, the migrating people should be rescued from circumstances that contradict basic human rights. Rather than comparing communities to bystanders, mere places where people will arrive and need to hash out how to find housing, jobs, education, and opportunity, a duty of preparation may be the key to rescue those disenfranchised by migration. There are cultural, personal, physical, psycho-social, and geopolitical issues surrounding how to best help those needing to permanently relocate. Ethics arguments will certainly range from “do nothing”, which may fail people, to “do everything”, which could waste taxpayer money in futile over-preparation while failing to actually help. Communities must avoid planning exclusively for one scenario only to have it not take place. Striking the balance, a duty to rescue as it could apply to climate migration should set goals of societal integration, and providing the basics like education, housing, food, health care, and job opportunity, the precursors to flourishing. Recommending the extraordinary, morally preferred but perhaps not compulsory, when charitable actors are participating, or when wrongdoers are compensating, may be more workable than seeing the duty to rescue as compelling people or local governments to take on significant financial and personal risk for newcomers. While humanitarian ethics supports helping everyone, it is likely that people who resettle in advance of a need to flee will find themselves with more choices and opportunities. Help is warranted for those with more dire needs. Preparing for them may do just that. Vlll. Rescue Prior to Migration and Rescue in the Process of Resettlement The duty to enable the migration in the first-place hints to the inadequacy of a duty to prepare. The traditional duty to rescue perhaps steps in if rescue looks like those geographically just out of harm's way rescuing those in danger. That resembles the traditional moral requirement, or duty to rescue according to the Rule of Rescue. Humanitarian aid typically provided by many institutions makes sense and is in place, although financial support for additional humanitarian aid is always needed. Despite having moved to purportedly more capable communities, migrant communities may be able to develop more egalitarian orders of living. Rather than continually being identified as having been rescued, it is important to make sure people keep or make social ties during and after migration. Immigrants often face social isolation.[17] Small shifts in gestural language also have the potential to welcome people and show they are valued. For instance, some migrants may not like questions like “Where are you from?” and “What brings you here?” as they emphasize differences over fitting in. CONCLUSION The ethical duty to rescue should be expanded to better match those in need of relocation with a welcome environment and the resources needed to achieve success and fully integrate socially and culturally. Expanding a dialogue that includes the voices of people who have recently migrated whether due to violence, poverty, or climate, could properly frame the extent of the duty. If we are to apply the duty of rescue to climate migration, rescuers should avoid labeling people vulnerable, dependent, or needy, although there is reason to focus on those whose needs are the most dire. A soft duty to rescue people during the course of climate migration can come in the form of preparation. People will need help finding housing, education, access to food, and employment. Ultimately, to help them help themselves may be the best goal. While the obligations should be borne differently by people, whether due to a special responsibility, or a special relationship that creates a clearer duty, the global community must prepare for its role in rescuing those displaced by climate events. By helping those displaced at the start of the climate migration process according to a more commonly held notion of the duty to rescue, and by preparing to incorporate newcomers successfully according to an expanded duty to rescue, effectively a duty to prepare, countries that take on climate refugees may find themselves rewarded by the cultural diversity and workplace talents that people bring. A duty to those at a distance is a reasonable expansion of the duty to rescue. But what one ought to do in the global community varies somewhat from the traditional Rule of Rescue. - [1] Singer, P. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(3): 229-43. [2] Irfan, U. (2022, March 16). Why We Still Don’t Yet Know How Bad Climate Migration Will Get. Vox. https://www.vox.com/2022/3/16/22960468/ipcc-climate-change-migration-migrant-refugee, citing the International Panel on Climate Change (IPCC) (2022). Sixth Assessment Report, Climate Change 2022, Impacts, Adaptation, and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ [3] McKie, J., Richardson, J. (2003) The Rule of Rescue. Social Science & Medicine, 56(12): 2407-2419. https://doi.org/10.1016/S0277-9536(02)00244-7. [4] James, S.M. (2007). Good Samaritans, Good Humanitarians. Journal of Applied Philosophy, 24(3):238-254. [5] Overview of Good Samaritan laws. https://worldpopulationreview.com/state-rankings/good-samaritan-law-states [6] Fifield, J. (2017, Sept. 19). Why It’s Hard to Punish ‘Bad Samaritans’. Stateline Blog, Pew Charitable Trusts, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/09/19/why-its-hard-to-punish -bad-samaritans [7] Cassella, C. (2019). There’s a Climate Threat Facing Pacific Islands That’s More Dire Than Losing Land, Science Alert, https://www.sciencealert.com/pacific-islanders-are-in-a-climate-crisis-as-rising-sea-levels-threaten -water; Hassan, H. R., and Cliff, V. (2019). For Small Island Nations, Climate Change is not a Threat. It’s Already Here, World Economic Forum, https://www.weforum.org/agenda/2019/09/island-nations-maldives-climate-change/ [8] For example, Lyons, K. (2019). Australia Coal use is Existential threat to Pacific Islanders, The Guardian. https://www.theguardian.com/world/2019/aug/12/australia-coal-use-is-existential-threat-to-pacific-is lands-says-fiji-pm [9] Cripps, E. (2013). Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. [10] Schroeder, D., Chatfield, K., Singh, M., Chennells, R., and Herissone-Kelly, P.. Ethics Dumping and the Need for a Global Code of Conduct. In Cham. (Ed.)(2019). Equitable Research Partnerships. SpringerBriefs in Research and Innovation Governance. Springer. 2019. https://doi.org/10.1007/978-3-030-15745-6_1 [11] Giudice L.C., Llamas-Clark E.F., DeNicola N., Pandipati, S., Zlatnik, M.G., Decena, D.C.D., Woodruff, T.J., Conry, J.A. (2021). Climate Change, Women’s Health, and the Role of Obstetricians and Gynecologists in Leadership, International J Gynecol Obstet, 155(3), 345-356. 10.1002/ijgo.13958 [12] See Ferrarello, S. and Zapien, N. (2020). Ethical Experience: A Phenomenology, Bloomsbury. (for understanding phenomenological determinants of ethical action). [13] McLeman, R.A., Hunter, L.M., (2010). Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change, 1(3): 450-461. [14] Least Developed Countries Expert Group. (2018). Considerations Regarding Vulnerable Groups, Communities and Ecosystems in the Context of the National Adaptation Plans: United Nations Framework Convention on Climate Change. [15] Jecker, N.S. 2013. "The Problem with Rescue Medicine." J Med Philos, 38(1):64-81. [16] White House Report. (February 9, 2021), Executive Order (E.O.) 14013, “Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration.” (calls on the National Security Advisor to prepare a report on climate change and its impact on migration. “This report marks the first time the U.S. Government is officially reporting on the link between climate change and migration.” https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/executive-order-on-tackling -the-climate-crisis-at-home-and-abroad/ [17] Torres, J.M., Casey, J.A. (2017) The centrality of social ties to climate migration and mental health. BMC Public Health, 17: 600. https://doi.org/10.1186/s12889-017-4508-0. (shrink)

I examine Descartes's theory of cognition, taking as a starting point his account of how misperception is possible. In the Third Meditation Descartes introduces the hypothesis that there are ideas (such as the idea of cold) which seem to be of something real but which in fact represent nothing (if, for example, cold is a privation or absence of heat, rather than the presence of a positive quality). I argue, against Margaret Wilson, that Descartes does not think there are any (...) such ideas and that he introduces the hypothesis only in order to formulate an objection to his argument for the existence of God. I argue further that while he agrees with Arnauld in accepting the Aristotelian account of cognition according to which the very objects in the world that we perceive exist in the soul or its ideas objectively, he still has a satisfactory response to Arnauld's objection that since an idea can represent only what it appears to be of, all error must reside solely in our judgment. I claim that Arnauld's objection that an idea represents what it appears to be of is based on the assumption that an idea appears to be of what exists in it objectively. But Descartes makes room for the possibility of misrepresentation by distinguishing between what exists objectively in an idea and what that idea appears to be of. First, he thinks that it is at least coherent to suppose that an idea lacking objective reality could appear to be of something in virtue of its material reality. Since an idea lacking objective reality would not represent any thing that exists in the world, Descartes concedes that it would not misrepresent any actually existing thing, but it could still appear to be of some thing and in that way misrepresent the way the world is. Second, there is reason to claim that like some of his Aristotelian predecessors Descartes holds that what exists in the soul objectively can appear to be other than it is. This interpretation has the implication that Descartes's theory of ideas, in contrast to sense datum theories, is not driven by the motive of finding some entity which is exactly as it appears to serve as the object of immediate awareness. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Cartesian CompositesPaul HoffmanTowards the end of a paper in which I argued that Descartes thinks a human being is a genuine unity, I invited other commentators to come to Descartes’s defense by accounting for his apparently contradictory claims that a human being is an ens per se and that it is an ens per accidens.1 These claims seem to be contradictory, because in saying that a human being is (...) an ens per se, Descartes appears to be asserting that a human being is genuinely one, and in saying that a human being is an ens per accidens, he appears to assert that a human being is not genuinely one, but instead is a mere heap or aggregate. In the ensuing eleven years no one has taken up my invitation, except to argue that I was mistaken in claiming that Descartes thinks a human being has per se unity in any robust sense.2In this paper I will take up the challenge myself, having noticed a similarity between Descartes’s account of the unity of composite substances and his account of composite figures having true and immutable natures. After showing how he can consistently maintain that a human being is both an ens per se and ens per accidens in roughly the same way he can consistently maintain that composite figures both do and do not have true and immutable natures, I will try to respond to criticisms of my claim that he thinks of a human being as a substance or an ens per se.Let me begin with an analysis and comparison of two passages from the Objections and Replies. In the first, from the Replies to the First Objections, Descartes [End Page 251] discusses composite figures. In the second, from the Replies to the Fourth Objections, Descartes discusses composite substances.Next, to remove the other part of the difficulty, it should be noted that those ideas which do not contain true and immutable natures, but contain only ones which are fictitious and composed by the intellect, can be divided by the same intellect, not only through abstraction, but through a clear and distinct operation, so that any ideas which the intellect cannot so divide were undoubtedly not composed by it. As, for example, when I think of a winged horse, or an actually existing lion, or a triangle inscribed in a square, I easily understand that I can also in opposition think of a horse without wings, a non-existing lion, a triangle without a square, and so on; from which it follows that these do not have true and immutable natures. But if I think of a triangle or a square (I do not speak here of a lion or horse because their natures are not clearly evident to us), then certainly whatever I apprehend as contained in the idea of a triangle, as that its three angles are equal to two right angles, etc., I will truly affirm of the triangle, and of the square whatever is found in the idea of the square. For even if I can understand a triangle, abstracting from the fact that its angles should equal two right angles, I cannot nevertheless deny that of it by a clear and distinct operation, that is, correctly understanding this is what I say. Furthermore, if I consider a triangle inscribed in a square, not in order to attribute to the square those things which pertain only to the triangle or to the triangle those things which pertain to the square, but in order to examine only those things which arise from the conjunction of the two, then its nature will be no less true and immutable than the square or triangle alone, and it will be permitted to affirm that the square is not less than twice the triangle inscribed in it and similar things which pertain to the nature of this composite figure. (AT VII 117–8; CSM II 83–4)3I am not unaware that some substances are commonly called ‘incomplete.’ But if they are said to be incomplete because they cannot exist per se alone, I confess that it seems contradictory to me that... (shrink)

: Thomas Reid uses the notion of exertion in various ways that have not been distinguished in the secondary literature. Sometimes he uses it to refer to the exercise of a capacity or power, sometimes to the turning on or activitating of a capacity or power, and still other times to the attempt to activate a capacity or power. Getting clear on Reid's different uses of the term 'exertion' is essential to understanding his account of the sequence of events in (...) human action. It is also helpful in defending Reid against the objection that his account of action is subject to an infinite regress. (shrink)

The essays in this collection are all studies in the history of modern philosophy. Together they provide a cross-section of current efforts to reconstruct ...

Lectures on law presented by the author to students. The text represents a significant contribution to American legal literature & was an important text relied upon by lawyers of the day. Bibliographic Reference: Warren, HISTORY OF THE AMERICAN BAR 356 (1911).

This book celebrates the work of Patricia Werhane, an iconic figure in business ethics. This festschrift is a collection of articles that build on Werhane’s contributions to business ethics in such areas as Employee Rights, the Legacy of Adam Smith, Moral Imagination, Women in Business, the development of the field of business ethics, and her contributions to such fields as Health Care, Education, Teaching, and Philosophy. All papers are new contributions to the management literature written by well-known business ethicists, such (...) as Norman Bowie, Richard De George, Ronald Duska, Edwin Hartman, Michael Hoffman, Mollie Painter-Morland, Mark Schwartz, Andrew Wicks, and others. The volume is comprised of articles that reflect on Werhane’s work as well as build on it as a way to advance further research. At the end of the festschrift, Pat Werhane provides responses to each chapter. The first chapter of the book also includes the overview of Patricia Werhane’s work and her academic career. The book is written to appeal to management scholars and graduate students interested in the areas of Business Ethics, Modern Capitalism, and Human Rights. Patricia Werhane is one of the most distinguished figures in the field of business ethics. She was a founder of the field, she is one of its leading scholars, and she has had a profound impact on the world of business practice. Among her many accomplishments, Pat is known for her original work on moral imagination, she is an acclaimed authority on employee rights in the workplace, and she is one of the leading scholars on Adam Smith. Having been active in Academia for over 50 years, Werhane is a prolific author of over a hundred articles and book chapters, and the author or editor of twenty-seven books, including Adam Smith and his Legacy for Modern Capitalism, Moral Imagination and Management Decision-Making, and co-authored books Organization Ethics in Health Care, Alleviating Poverty Through Profitable Partnerships, Obstacles to Ethical Decision-Making, Corporate Responsibility: The American Experience, and Research Approaches to Business Ethics and Corporate Responsibility. (shrink)

In 1988 the Journal of Business Ethics published a paper by David Mathison entitled Business Ethics Cases and Decision Models: A Call for Relevancy in the Classroom. Mathison argued that the present methods of teaching business ethics may be inappropriate for MBA students. He believes that faculty are teaching at one decision-making level and that students are and will be functioning on another (lower) level. The purpose of this paper is to respond to Mathison's arguments and offer support for (...) the present methods and materials used to teach Master level ethics classes. The support includes suggested class discussion ideas and assignments. (shrink)

Philosophers have devoted a great deal of discussion to the question of whether an inverted spectrum thought experiment refutes functionalism. (For a review of the inverted spectrum and its many philosophical applications, see Byrne, 2004.) If Ho?man is correct the matter can be swiftly and conclusively settled, without appeal to any empirical data about color vision (or anything else). Assuming only that color experiences and functional relations can be mathematically represented, a simple mathematical result.

In this volume, Stephen M. Gardiner and David A. Weisbach present arguments for and against the relevance of ethics to global climate policy. Gardiner argues that climate change is fundamentally an ethical issue, since it is an early instance of a distinctive challenge to ethical action, and ethical concerns are at the heart of many of the decisions that need to be made. Consequently, climate policy that ignores ethics is at risk of.

A primary purpose of argument is to increase the degree of reasonable confidence that one has in the truth of the conclusion. A question begging argument fails this purpose because it violates what W. E. Johnson called an epistemic condition of inference. Although an argument of the sort characterized by Robert Hoffman in his response (Analysis 32.2, Dec 71) to Richard Robinson (Analysis 31.4, March 71) begs the question in all circumstances, we usually understand the charge that an argument (...) is question begging with reference to the beliefs of the person, or the sort of person, to whom the argument is directed. (shrink)

This volume examines Rawls's theory of international justice as worked out in his controversial last book, The Law of Peoples.

We articulate a holistic understanding of hope, going beyond the common conceptualization of hope in terms of positive affect and cognition by considering what hope means for the underprivileged. In the recognition that hope is always situated in a particular place, we explore the perspective of the privileged and the underprivileged, clarifying how spatial contexts shape their goals for the future and their agency toward attaining these goals. Where some people experience precarity due to their disability, race, gender, sexuality, and (...) social class, others enjoy enhanced agency due to their privilege. In our analysis, this loss of agency does not mean the underprivileged are hopeless; instead, it suggests that hope can incorporate negative affect and cognition. In our view, a spatial understanding acknowledges the power of hope in discouraging situations, and it points to practical measures through which hope can be cultivated by marginalized communities. (shrink)

We examine the role of the American Psychological Association (APA) in the weaponization of American psychology post-9/11. In 2004, psychologists’ involvement in the detention and interrogation of terrorist suspects generated controversy over psychological ethics in national security (PENS). Two signal events inflamed the controversy. The 2005 APA PENS Report legitimized clinical psychology consultation in support of military/intelligence operations with detained terrorist suspects. An independent review, the 2015 Hoffman Report, found APA collusion with the US Department of Defense in producing (...) the APA PENS Report and subsequent policies. Ongoing activities within APA to weaponize psychology sharpened the controversy. The authors—two psychologists and four former military/intelligence professionals—bring a military/intelligence operational perspective to detail two neglected areas of collateral damage. The first is the toll on psychology as a scientific enterprise. The second is covert influence on professional associations for incompatible security-sector objectives. We establish epistemic, historical, institutional, legal, and operational foundations for evaluation of these damages, as well as implications for APA and related professional associations in the ongoing Global War on Terror. (shrink)

Using the concept of social denial, this article puts the American Psychological Association's (APA’s) pattern of willful blindness, identified by independent reviewer David Hoffman, in historical context by examining the contributions of Cold War social scientists to the CIA's KUBARK torture manual, and discusses the implications of this history for the reform of the APA's ethics policies. David Hoffman found that the leadership of the APA colluded with Department of Defense (DoD) to ensure that the APA's (...) ethical policies were no stronger than those issued by the DoD. While the independent reviewer did not find evidence of collaboration between the CIA and the APA, this was not due to a lack of effort on the part of the APA, which was anxious to establish good relations and so promote the use of psychology in the national security arena. While Hoffman did not find that the APA knew that its collaborations would facilitate the development of abusive interrogation techniques, it showed a marked, motivated lack of interest in whether or not the DoD or CIA was abusing prisoners. The APA maintained its strategic ignorance even while engaging in a public relations campaign designed to give the impression that it was deeply concerned about multiple reports of psychologist involvement in a system of torture. This willful ignorance was not unprecedented and follows a predictable pattern of knowing and not-knowing to which all psychologists should attend. (shrink)

“I think there’s a big strong belief in [...] the community … and maybe it’s in the world at large that somehow the doctors are more concerned about harvesting the organs than what’s best for the patient.”1 In the past 45 years, organ and tissue recovery and transplantation have moved from the occasional and experimental to a standard of care for end-stage organ failure; receiving an organ transplant is for many the only opportunity for increased quantity and/or quality of life. (...) The increasing prevalence of diseases such as viral hepatitis, diabetes, and hypertension has significantly increased the incidence of end-organ failure. Additionally, surgical advances have permitted less stringent qualification criteria, so that people of advanced age or patients who may be in a physiologically fragile state are now eligible to be organ recipients. These changes have created a significant demand for organs. (shrink)

This chapter contains section titled: Background John Rawls History of The Law of Peoples Rawls's Law of Peoples The Importance of The Law of Peoples and its Reception How the Book is Organized Some Areas Still to Be Addressed Notes.

Brexit activists demonstrating outside the British Houses of Parliament were studied in situ to examine their potential for pro-group extreme behavior. This involved activists of two polarized, opposing views; those of Leave and Remain. The research engaged concepts linking the different theoretical perspectives of identity fusion and personal construct psychology. The study measured participants' degree of fusion to their group using a verbal measure. Willingness to undertake extreme acts was assessed in several ways: a measure of willingness to fight for (...) the group, adaptations of the trolley dilemma and questions regarding political violence. Individual construing was examined using repertory grid technique and a semi-structured interview. Results were similar for both Leave and Remain participants. The majority of activists identified as “fused” to their group and, if so, were more likely to undertake hypothetical extreme behavior compared to those who did not identify as “fused.” Repertory grid technique indicated that becoming an activist provided individuals with a clearer and more positive view of themselves. Opposition activists were construed more negatively and extremely than fellow activists, and this construal was associated with an increased willingness to undertake extreme pro-group behavior. This was consistent with the personal construct model of radicalization and was heightened in those who were “fused.” Interview data provided support for the constructivist model and revealed characteristics and concerns of the two groups. Overall, the findings indicate that campaigning organizations contain fused individuals, who are more likely to undertake hypothetical pro-group violence including self-sacrifice. This has broader implications which may be particularly pertinent, given the violent impact of extremist activists around the globe. (shrink)

Chaïm Perelman, alone, and in collaboration with Lucie Olbrechts-Tyteca, developed the New Rhetoric Project, which is in use throughout the world. This book offers the first deep contextualization of the project’s origins and original translations of their work from French into English.

Historically, entities with a vested interest in a product that critics have suggested is harmful have consistently used research to back their claims that the product is safe. Prominent examples are: tobacco, lead, bisphenol A, and atrazine. Research literature indicates that about 80–90 % of studies with industry affiliation found no harm from the product, while only about 10–20 % of studies without industry affiliation found no harm. In parallel to other historical debates, recent studies examining a possible relationship between (...) mercury exposure and autism spectrum disorder show a similar dichotomy. Studies sponsored and supported by industry or entities with an apparent conflict of interest have most often shown no evidence of harm or no “consistent” evidence of harm, while studies without such affiliations report positive evidence of a Hg/autism association. The potentially causal relationship between Hg exposure and ASD differs from other toxic products since there is a broad coalition of entities for whom a conflict of interest arises. These include influential governmental public health entities, the pharmaceutical industry, and even the coal burning industry. This review includes a systematic literature search of original studies on the potential relationship between Hg and ASD from 1999 to date, finding that of the studies with public health and/or industry affiliation, 86 % reported no relationship between Hg and ASD. However, among studies without public health and/or industry affiliation, only 19 % find no relationship between Hg and ASD. The discrepancy in these results suggests a bias indicative of a conflict of interest. (shrink)

In Conversations with Cinematographers, David Ellis has assembled interviews with some of the most influential and highly regarded cameramen of the last half century and more.

This book is an attempt to show how innovation in the "post-Google generation" is often catalyzed by those who cross a conventional line so firmly drawn between ...

We examine the compromises that are actually made in modern scientific discourse concerning atoms. We conclude that even the ideals of clarity and consistency can be legitimately compromised in order to obtain other advantages.