In this article, we discuss the ethical dimensions for the prescribing behaviours of opioids for a chronic pain patient, a scenario commonly witnessed by many physicians. The opioid epidemic in the USA and Canada is well known, existing since the late 1990s, and individuals are suffering and dying as a result of the easy availability of prescription opioids. More recently, this problem has been seen outside of North America affecting individuals at similar rates in Australia and Europe. We argue that (...) physicians are also confronted with an ethical crisis where a capitalist-consumerist society is contributing to this opioid crisis in which societal, legal and business interests push physicians to overprescribe opioids. Individual physicians often find themselves unequipped and unsupported in attempts to curb the prescribing of opioid medications and balance competing goals of alleviating pain against the judicious use of pain medications. Physicians, individually and as a community, must reclaim the ethical mantle of our profession, through a more nuanced understanding of autonomy and beneficence. Furthermore, physicians and the medical community at large have a fiduciary duty to patients and society to play a more active role in curbing the widespread distribution of opioids in our communities. (shrink)

Jones & Love (J&L) suggest that Bayesian approaches to the explanation of human behavior should be constrained by mechanistic theories. We argue that their proposal misconstrues the relation between process models, such as the Bayesian model, and mechanisms. While mechanistic theories can answer specific issues that arise from the study of processes, one cannot expect them to provide constraints in general.

This study described parent participation in the informed consent conference for randomized clinical trials (RCTs) in childhood leukemia and documented the relationship of physician communication to parent participation. Parents of 140 children with newly diagnosed leukemia who were eligible for RCTs were studied at six sites using comprehensive methods involving direct observation and transcripts of parent-physician communication based on audiotapes. Parent participation during the informed consent conference reflected a wide range of content categories. Consistent with hypotheses, Physician Rapport and Partnership (...) Building related to parent participation in the informed consent conference but Information Giving did not. Higher parent socioeconomic status also was related to greater parent participation for two of three measures of parent participation. Findings suggest that physician behaviors that provide support and facilitate communication may enhance parental participation in the informed consent conference for RCTs in childhood leukemia. (shrink)

This narrative review summarizes the empirical literature on children's competence for consent and assent in research and treatment settings. Studies varied widely regarding methodology, particularly in the areas of participant sampling, situational context studied (e.g., psychological versus medical settings), procedures used (e.g., lab-based vs. real-world approaches), and measurement of competence. This review also identified several fundamental dilemmas underlying approaches to children's informed consent. These dilemmas, including autonomy versus best interests approaches, legal versus psychological or ethical approaches, child- versus family-based approaches, (...) and approaches that emphasize consent versus those that emphasize assent, have implications for the measurement of children's competence and interpretation of findings. Recommendations for future research in the area of children's informed consent include the use of diverse samples and control groups, development of multidimensional and standardized measures of competence, utilization of observational methods and longitudinal designs, examination of noncognitive aspects of children's competence, and comparison of children's competence for treatment and research decisions. (shrink)

An outline of the material covered in courses on Formal and Informal Logic. The outline includes chapters on mathematical approaches to logic as well as on fallacies, deduction and induction, probability, and other major topics. Logic is traditionally taught by means of problem solving exercises, so the subject is well suited to a Schaum's Outline approach.

We describe how the set of tools, practices, and social relations known as “precision agriculture” is defined, promoted, and debated. To do so, we perform a critical discourse analysis of popular and trade press websites. Promoters of precision agriculture champion how big data analytics, automated equipment, and decision-support software will optimize yields in the face of narrow margins and public concern about farming’s environmental impacts. At its core, however, the idea of farmers leveraging digital infrastructure in their operations is not (...) new, as agronomic research in this vein has existed for over 30 years. Contemporary discourse in precision ag tends to favour emerging digital technologies themselves over their embeddedness in longstanding precision management approaches. Following several strands of science and technology studies research, we explore what rhetorical emphasis on technical innovation achieves, and argue that this discourse of novelty is a reinvention of precision agriculture in the context of the growing “smart” agricultural economy. We overview six tensions that remain unresolved in this promotional rhetoric, concerning the definitions, history, goals, adoption, uses, and impacts of precision agriculture. We then synthesize these in a discussion of the extent to which digital tools are believed to displace farmer decision-making and whether digital agriculture addresses the biophysical heterogeneity of farm landscapes or land itself has become an “experimental technology”—a way to advance the general development of artificial intelligence. This discussion ultimately helps us name a larger dilemma: that the smart agricultural economy is perhaps less about supporting land and its stewards than promising future tech and profits. (shrink)

Gene therapy approaches have great promise in the treatment of neurodegenerative disorders and malignant brain tumors. Neuwelt et al. review available viral-mediated gene therapy methods and their blood-brain-barrier (BBB) disruption delivery technique, briefly mentioning nonviral mediated gene therapy methods. This commentary discussed the BBB disruption delivery technique, viral and nonviral mediated gene therapy approaches to Parkinson's disease, and the potential use of antisense oligo to suppress malignant brain tumors.

Tests of economic theory often focus on choice outcomes and find significant individual differences in these outcomes. This variability may mask universal psychological processes that lead to different choices because of differences across cultures in the information people have available when making decisions. On this view, decision making research within and across cultures must focus on the processes underlying choice.

In the year 1471 a member of the Sorbonne, Guillaume Fichet, looking back on the history of what today we should call communication technology, divided it into three periods: antiquity , a subsequent period which we should identify as the Middle Ages , and a period just beginning . Just over five hundred years later an American scholar, Walter J. Ong, looking back on a longer historical span, divided it into orality, writing, printing, and electronic communications. No matter how much (...) these two figures may differ over details, they occupy a similar position: each stands at the start of a communications shift which has alerted him to changes in the past, and Ong claims explicitly that contrasts “between electronic media and print have sensitized us to the earlier contrast between writing and orality.” We do not have to go as far as Eric A. Havelock, who suggests that our new awareness can be precisely dated by a number of publications appearing in the annus mirabilis 1963 , in order to accept the general point that recent work has been stimulated by recent technology. (shrink)

Most philosophers writing about personal identity in recent years claim that what it takes for us to persist through time is a matter of psychology. In this groundbreaking new book, Eric Olson argues that such approaches face daunting problems, and he defends in their place a radically non-psychological account of personal identity. He defines human beings as biological organisms, and claims that no psychological relation is either sufficient or necessary for an organism to persist. Olson rejects several famous thought-experiments (...) dealing with personal identity. He argues, instead, that one could survive the destruction of all of one's psychological contents and capabilities as long as the human organism remains alive--as long as its vital functions, such as breathing, circulation, and metabolism, continue. (shrink)

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

I’m going to argue that omniscience is impossible and therefore that there is no God. The argument turns on the notion of grounding. After illustrating and clarifying that notion, I’ll start the argument in earnest. The first step will be to lay out five claims, one of which is the claim that there is an omniscient being, and the other four of which are claims about grounding. I’ll prove that these five claims are jointly inconsistent. Then I’ll argue for the (...) truth of each of them except the claim that there is an omniscient being. From these arguments it follows that there are no omniscient beings and thus that there is no God. (shrink)

The traditional verbal/nonverbal dichotomy is inadequate for completely describing cerebral lateralization. Musical functions are not necessarily mediated by the right hemisphere; evidence for a specialist left-hemisphere mechanism dedicated to the encoded speech signal is weakening, and the right hemisphere possesses considerable comprehensional powers. Right-hemisphere processing is often said to be characterized by holistic or gestalt apprehension, and face recognition may be mediated by this hemisphere partly because of these powers, partly because of the right hemisphere's involvement in emotional affect, and (...) possibly through the hypothesized existence of a specialist face processor or processors in the right. The latter hypothesis may, however, suffer the same fate as the one relating to a specialist encodedness processor for speech in the left. Verbal processing is largely the province of the left because of this hemisphere's possession of sequential, analytic, time-dependent mechanisms. Other distinctions are special cases of an analytic/holistic dichotomy. More fundamentally, however, the left hemisphere is characterized by its mediation of discriminations involving duration, temporal order, sequencing, and rhythm, at thesensory level, and especially at themotorlevel. Spatial aspects characterize the right, the mapping of exteroceptive body space, and the positions of fingers, limbs, and perhaps articulators, with respect to actual and target positions. Thus there is a continuum of function between the hemispheres, rather than a rigid dichotomy, the differences being quantitative rather than qualitative, of degree rather than of kind. (shrink)

This paper argues that epistemologists should theorize about wisdom and critically examines a number of attempts to do as much. It then builds and argues for a particular theory of what wisdom is.

This article critically examines numerous attempts to build a knowledge-first ethics of belief. These theories specify a number of potential "knowledge norms for belief".

I start with a critical discussion of some attempts to ground epistemic normativity in curiosity. Then I develop three positive proposals. The first of these proposals is more or less purely philosophical; the second two reside at the interdisciplinary borderline between philosophy and psychology. The proposals are independent and rooted in different literatures. Readers uninterested in the first proposal (and the critical discussion preceding it) may nonetheless be interested in the second two proposals, and vice versa. -/- The proposals are (...) as follows. First I argue that, among several ways in which the notion of curiosity might be used to delineate significant truths from trivial ones, a particular way is the most promising. Second, I argue that curiosity has some underappreciated epistemic roles involving memory. Third, I argue that curiosity has some underappreciated epistemic roles involving coherence. (shrink)

Suppose that you are engaging with someone who is your oppressor, or someone who espouses a heinous view like Nazism or a ridiculous view like flat-earthism. In contexts like these, there is a disparity between you and your interlocutor, a dramatic normative difference across which you are in the right and they are in the wrong. As theorists of humility, we find these contexts puzzling. Humility seems like the *last* thing oppressed people need and the *last* thing we need in (...) dealing with those whose views are heinous or ridiculous. Responding to such people via humility seems uncalled for, even inappropriate. But how could this be, given that humility is a *virtue*? The purpose of the paper is to explore this puzzle. We explain what the puzzle is and then attempt to draw some lessons from it: first, the lesson that the importance of humility is limited in several ways, and second, the lesson that humility nonetheless has several important roles to play, even for people who are in the right in contexts of disparity. (shrink)

We argue that the gap between an authentically ethical conviction of sustainability and a behaviour that avoids confronting the terrifying reality of its ethical point of reference is characteristic of the field of business sustainability. We do not accuse the field of business sustainability of ethical shortcomings on the account of this attitude–behaviour gap. If anything, we claim the opposite, namely that there resides an ethical sincerity in the convictions of business scholars to entrust capitalism and capitalists with the mammoth (...) task of reversing, the terrifying reality of ecological devastation. Yet, the very illusory nature of this belief in capitalism’s captains to save us from the environmentally devastating effects of capitalism gives this ethical stance a tragic beauty. While sincere and authentic, it nevertheless is an ethical stance that relies on an “exclusionary gesture of refusing to see”, what in psychoanalysis is referred to as a fetishist disavowal of reality. We submit that this disavowal is fetishistic because the act is not simply one of repressing the real. If it was, we would rightly expect that we could all see the truth if we only provide more or better information to fill the subject’s lack of knowledge. The problem is that the fetishist transfers a fantasy of the real as the real. In the case of destructive capitalism, the fetishist disavows that particular reality by believing in another, thus subjectively negating the lack. Therefore, from the perspective of psychoanalytic theory, we submit that the gap between attitude and behaviour is best understood not only as an ethical flaw, but also as an essential component of an ethics that makes possible the field of business sustainability. (shrink)

This article offers an approach to advance the use of virtue ethics in the training of business managers and leaders, as well as in the education of business students. A thesis is that virtue ethics offers a valuable way to think about how we want to be and what we should strive to become qua businessperson, manager, and leader. The article provides a framework for thinking about virtue ethics in the context of business and leadership, with emphasis on building trust (...) in organizations. It includes a brief summary of Aristotelian virtue ethics, core concepts, and how they apply to management and leadership decision-making. The article concludes with a summary of an approach for teaching a virtue ethics module, which has evolved over the past 20 years. Included are exercises, a survey tool, and a business case as components of the module. The module has been used in corporate training, as well as graduate and undergraduate business education. It is hoped this approach will spur others to explore other ways to bring virtue ethics to business and business education. (shrink)

St. Paul says that same-sex sexual acts are “contrary to nature.” Plainly this is intended as a condemnation, but beyond that its meaning is obscure. In particular, we are given no general account of what it means to be contrary to nature, including what other acts might fit this description. This article attempts to provide such an account. It relies for this purpose on the biblical and classical sources of this idiom as well as its subsequent use within the Greek (...) patristic tradition. It argues that the core meaning of “contrary to nature” is that of violating the integrity of structure and function of the human body. The article further contrasts this biblical and Greek patristic understanding with that of the “sin against nature” developed in the West during the Middle Ages. It argues that they are different in important ways and that a recovery of the biblical and Greek patristic view can help restore the concept of the unnatural to its proper place within Christian ethics. (shrink)

Epistemology is normative. This normativity has been widely recognized for a long time, but it has recently come into direct focus as a central topic of discussion. The result is a recent and large turn towards focusing on epistemic value. I’ll start by describing some of the history and motivations of this recent value turn. Then I’ll categorize the work within the value turn into three strands, and I’ll discuss the main writings in those strands. Finally, I’ll explore some themes (...) that are ripe for further development. (shrink)

In The Elm and the Expert, Jerry Fodor tries to reconcile three philosophical positions he is presently committed to: a computational theory of mind, intentional realism and a denotational theory of meaning. One problem he faces is this: a denotational semantics, according to which the meaning of a singular term like a name is exhausted by its referent, seems to rule out there being true intentional generalizations, or generalizations which advert to the contents of a subject's mental states. That there (...) are such true generalizations is a major element in Fodor's intentional realism. Accordingly, Fodor is forced to find a way of dissolving this apparent incompatibility. This paper looks at his attempts to do so and concludes that they fail. (shrink)

In June 2008 the UK government, supported by the Royal College of Nursing, stated that nursing care would be measured for compassion. This paper considers the implications of this statement by critically examining the relationship of compassion to care from a variety of perspectives. It is argued that the current market-driven approaches to healthcare involve redefining care as a pale imitation, even parody, of the traditional approach of the nurse as “my brother’s keeper”. Attempts to measure such parody can only (...) measure artificial techniques and give rise to a McDonald’s-type nursing care rather than heartfelt care. The arguments of this paper, although applied to nursing, also apply to medicine and healthcare generally. (shrink)

This paper is a response to Peter Allmark's thesis that 'there can be no "caring" ethics'. It argues that the current preoccupation in nursing to define an ethics of care is a direct result of breaking nursing tradition. Subsequent attempts to find a moral basis for care, whether from subjective experimental perspectives such as described by Noddings, or from rational and detached approaches derived from Kant, are inevitably flawed. Writers may still implicitly presuppose a concept of care drawn from the (...) Judaeo-Christian tradition but without explicit recourse to its moral basis nursing is left rudderless and potentially without purpose. The very concept of 'care' cut off from its roots becomes a meaningless term without either normative or descriptive content. (shrink)

In 2012, chief nursing officers (CNO) in England published a policy on compassion in response to serious criticisms of patients’ care. Because their objective is fundamentally to shape nursing, this study argues, following Popper, that the policy should be analysed. An appraisal tool, developed from Popper, Gadamer, Jauss and Thiselton, is the framework for this analysis. The CNO policy document identified six values and behaviours, termed ‘6Cs’, required by all nurses, midwives and care staff. The document contains no data, references (...) or acknowledgements, but is similar to the 6Cs defined by the Canadian nursing nun, Sister M. Simone Roach, in her theory of caring published 30 years earlier. Roach considered caring and the components of it, including compassion, to be moral virtues, an inner motivation to care. This study suggests that without explicit reference to Roach's ideas, and her underlying theoretical base, the CNO requirement has the effect of turning virtues into commodities and a form of external control, described by Ritzer as a McDonaldized dehumanization. This study, which has international relevance beyond England and the UK, suggests that the CNO revise their policy by acknowledging Roach's 6Cs and openly discuss the implications of her work for their policy. (shrink)

This study proposes a conceptual model to explain persistent, accepted-as-normal corporate wrongdoing (hereafter banality of wrongdoing), particularly for high performance organizations. The model describes five explanatory variables: the culture of competition, ends-biased leadership, missionary zeal, legitimizing myth, and the corporate cocoon. Our thesis is that the nature of competition drives both legitimate and illegitimate goal-seeking to adopt an iconoclastic (rule-breaking) orientation. High performance organizations are favorable hosts for wrongdoing because high performance requires aggressive behavior at the ethical margins of what (...) is acceptable. The way leadership reacts to competition sets the stage for ethical or unethical cultures to develop. Ends-biased leadership will project strong vision, using ideology and legitimizing myth as tools to inspire and motivate. The resulting missionary zeal justifies using questionable means because of the perceived value of the end. One critical method for building strong culture is creating a sense of being separate and apart from the ordinary. This cocoon effect may create a self-referential value system that is significantly at odds with mainstream culture and in which wrongdoing is banal. We intend an empirical study of the variables described in this model. (shrink)

Abstract:This study explores a phenomenon that has been shown to adversely affect managers’ decisions—competitive irrationality. Managers are irrationally competitive in their decisions when they focus on damaging the profits of competitors, rather than improving their own profit performance. Studies by Armstrong and Collopy (1996) and Griffith and Rust (1997) suggest that the phenomenon is common but not universal. We examine the question of why some individuals exhibit competitive irrationality when making decisions, while others do not by focusing on four aspects (...) of moral philosophy—deontological orientation, cognitive moral development, idealism, and relativism. Results suggest that individuals high in deontological orientation, high in cognitive moral development, high in idealism, and low in relativism will be less competitively irrational than those who are not. (shrink)

Promoting the use of contact tracing technology will be an important step in global recovery from the COVID-19 pandemic. Across two studies, we assessed two messaging strategies as motivators of intended contact tracing uptake. In one sample of 1117 Australian adults and one sample of 888 American adults, we examined autonomy-supportive and controlling message framing and the presence or absence of information safety as predictors of intended contact tracing application uptake, using an online randomized 2 × 2 experimental design. The (...) results suggested that the provision of data safety assurances may be key in affecting people’s intentions to use contact tracing technology, an effect we found in both samples regardless of whether messages were framed as autonomy-supportive or controlling. Those in high information safety conditions consistently reported higher intended uptake and more positive perceptions of the application than those in low information safety conditions. In Study 2, we also found that perceptions of government legitimacy related positively to intended application uptake, as did political affiliation. In sum, individuals appeared more willing to assent to authority regarding contact tracing insofar as their data safety can be assured. Yet, public messaging strategies alone may be insufficient to initiate intentions to change behavior, even in these unprecedented circumstances. (shrink)

There has recently been a revival of interest in ‘naturalizing’ ethics. A naturalization seeks to vindicate ethical realism — the idea that ethical judgments can be true reflections of a moral reality — without violating the naturalist constraint that science sets the limits of ontology. The recent revival has been prompted by examples of successful scientific reduction (e.g. temperature, water), and by the emergence of new, nonreductive naturalist strategies (e.g. for biological and mental properties). In this paper, I argue against (...) such naturalist approaches to ethics. My argument builds on the traditional one offered by G.E. Moore, namely that a naturalization would fail to respect an existing difference between the meanings of moral and naturalistic terms. I defend this line of argument against the common claim that it cannot block ‘synthetic’ property identities, ones grounded not in meaning equivalences but in empirical discoveries (as in the cases of temperature and water). I then go on to show that the Moorean argument can make trouble even for recent revisionist and nonreductive naturalist approaches. (shrink)

The transhumanist literature encompasses diverse nonnovel positions on questions of disability and obligation reflecting long-running political philosophical debates on freedom and value choice, complicated by the difficulty of projecting values to enhanced beings. These older questions take on a more concrete form given transhumanist uses of biotechnologies. This paper will contrast the views of Hughes and Sandberg on the obligations persons with "disabilities" have to enhance and suggest a new model. The paper will finish by introducing a distinction between the (...) responsibility society has in respect of the presence of impairments and the responsibility society has not to abandon disadvantaged members, concluding that questions of freedom and responsibility have renewed political importance in the context of enhancement technologies. (shrink)

The paper attempts to provide a basis for exploring the continued relevance of Catholic social teaching to business ethics, byinterpreting the historic development of a Catholic work ethic and the traditions of Catholic social teaching in light of contemporary discussions of economic globalization, notably those of Robert Reich and Peter Drucker. The paper argues that the Catholic work ethic and the Church’s tradition of social teaching has evolved dynamically in response to the structural changes involved in the history of modern (...) economic development, and thus is well poised to speak to the ethical challenges implicit in the advent of a knowledge-based society. In order to test this thesis, the author sketches an approach to the ethical challenge of corporate downsizing that he believes illustrates the continued relevance of Catholic social teaching to business ethics. (shrink)

Timothy Williamson has a marvelously precise account of epistemic justification in terms of knowledge and probability. I argue that the account runs aground on certain cases involving the probability values 0 and 1.