Resumo A concepção sobre livre-arbítrio em Abelardo foi definida na obra Theologia scholarium como a própria deliberação do indivíduo em fazer ou renunciar a algo. Na Ethica, essa ideia foi desenvolvida a partir da noção de voluntário. Em se tratando de pecado, base das discussões da Ethica, Abelardo desenvolveu o conceito que conhecemos hoje como “moral da intenção”. Nessa perspectiva de moral, o pecado só se sustentaria a partir da intenção do indivíduo, fruto do seu consentimento, ação livre e voluntária. (...) A proposta do artigo é analisar de forma introdutória como a ideia de livre-arbítrio foi compreendida por Abelardo em relação ao pecado e em relação à vontade de Deus, posicionamento que colaborou para sua condenação no Concílio de Sens, em 1140.Abelard’s conception of free will was defined in the work Theologia scholarium as the deliberation of the individual to do or renounce something. In Abelard’s ethical writings, this idea was developed on the basis of the notion of the voluntary. In his treatment of sin, the basis of Abelard’s discussions, Abelard developed the concept currently known as “intentionalist morals”. In this moral perspective, sin would only result from the intention of the individual, as the result of his or her consent and of free and voluntary action. The purpose of this article is to introduce Abelard’s idea of free will in relation to sin and God’s will, a position that contributed to his condemnation at the Council of Sens in 1140. (shrink)

Are there, in addition to the various actual objects that make up the world, various possible objects? Are there merely possible people, for example, or merely possible electrons, or even merely possible kinds? We certainly talk as if there were such things. Given a particular sperm and egg, I may wonder whether that particular child which would result from their union would have blue eyes. But if the sperm and egg are never in fact brought together, then there is no (...) actual object that my thought is about.1 Or again, in the semantics for modal logic we presuppose an ontology of possibilia twice over.2 For first, we countenance various possible worlds, in addition to the actual world; and second, each of these worlds is taken to be endowed with its own domain of objects. These will be the actual objects of the world in question, but they need not be actual simpliciter, i.e., actual objects of our world. What are we to make of such discourse? There are four options: (i) the discourse is taken to be unintelligible; (ii) it is taken to be intelligible but nonfactual, i.e. as not in the business of stating facts; (iii) it is taken to be factual but reducible to discourse involving no reference to possibilia; (iv) it is taken to be both factual and irreducible.3 These options range from a fullblooded form of actualism at one extreme to a full-blooded form of possibilism at the other. The two intermediate positions are possibilist in that they accept the intelligibility of possibilist discourse but actualist in that they attempt to dispense with its prima facie commitment to possibilia. All four positions have found advocates in the literature. Quine, in his less irenic moments, favors option (i); Forbes ([85], p. 94) advocates option (ii), at least for certain parts of possibilist discourse; many philosophers, including Adams [74] and myself, opt for (iii); while Lewis [86] and Stalnaker [75] have endorsed versions of (iv), that differ in how full-blooded they take the possible objects to be. My focus in the present article is on the third option.. (shrink)

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...) ethical vignettes.The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles.This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings. (shrink)

Few conditions have sparked as much controversy as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Professional consensus has long suggested that the condition should be classified as psychiatric, while patients and advocacy groups have insisted it is a serious biological disease that requires medical care and research to develop it. This longstanding debate shifted in 2015, when U.S. governmental health authorities fully embraced medical classification and management. Given that some globally respected health authorities now insist that ME/CFS is a serious biological disease, (...) this paper asks whether it can be ethical for the U.K. practice guideline now in development to characterize the condition as a mental health disorder. Following a brief history of ME/CFS controversy, I offer three arguments to show that it would be unethical for the U.K. to now characterize ME/CFS as a mental health condition, considering the relevance of that conclusion for ME/CFS guidelines elsewhere and for other contested conditions. (shrink)

Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) is a highly contested illness. This paper analyzes the discursive production of knowledge about, and recognition of ME/CFS. By mobilizing insights from social epistemology and epistemic injustice studies, this paper reveals how actors, through their social-discursive practices, attribute to establishing, sustaining, and disregarding their own and others’ epistemological position. In focusing on the case of the Dutch newspaper reporting about ME/CFS, this paper shows that the debate about this condition predominantly revolves around the ways (...) in which people who make truth claims are represented. In being portrayed as gendered, affectatious, formerly very able, fanatical, or benevolent, people with ME/CFS are constructed as non-/credible. In the debate about what causes ME/CFS, by contrast, the production of non-/credible knowledge focuses more on the content of epistemic positions. Actors in this debate argue that they know the (clear) causes for the illness, something which functions as a discursive strategy to establish and enhance their credibility. This paper contends, however, that since this discursive demarcation of causes is consistently infused with uncertainty – with multi-interpretability, with diffuse explanations, and absence of current knowledge – the credibility of these actors’ epistemic position is undercut rather than established. (shrink)

Myalgic encephalomyelitis or chronic fatigue syndrome is a contested illness category. This paper investigates the common claim that patients with ME/CFS—and by extension, ME/CFS patient organizations —exhibit “militant” social and political tendencies. The paper opens with a history of the protracted scientific disagreement over ME/CFS. We observe that ME/CFS POs, medical doctors, and medical researchers exhibit clear differences in opinion over how to conceptualize this illness. However, we identify a common trope in the discourse over ME/CFS: the claim of “militant” (...) patient activism. Scrutinizing this charge, we find no compelling evidence that the vast majority of patients with ME/CFS, or the POs representing them, have adopted any such militant political policies or behaviours. Instead, we observe key strategic similarities between ME/CFS POs in the United Kingdom and the AIDs activist organizations of the mid-1980s in the United States which sought to engage scientists using the platform of public activism and via scientific publications. Finally, we explore the contours of disagreement between POs and the medical community by drawing on the concept of epistemic injustice. We find that widespread negative stereotyping of patients and the marginalization and exclusion of patient voices by medical authorities provides a better explanation for expressions of frustration among patients with ME/CFS. (shrink)

This paper points to a more expansive conception of grief by arguing that the losses of illness can be genuine objects of grief. I argue for this by illuminating underappreciated structural features of typical grief — that is, grief over a bereavement — which are shared but under-recognized. I offer a common chronic illness, chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), as a striking case study. I then use this analysis to highlight some clinical challenges that arise should this claim receive uptake (...) in clinical practice. Extant literature on CFS/ME tells us that rates of comorbid depression are atypically high. If one accepts that people with CFS/ ME can grieve over losses associated with the condition, and that grief can be easily mistaken for depression in this context, this might suggest that rates of comorbid depression are inflated. I show, however, that the challenge of distinguishing between healthy and pathological grief arises in its place, and is just as tricky to solve. (shrink)

We obtain an improvement of some coloring theorems from Eisworth (Fund Math 202:97–123, 2009; Ann Pure Appl Logic 161(10):1216–1243, 2010), Eisworth and Shelah (J Symb Logic 74(4):1287–1309, 2009) for the case where the singular cardinal in question has countable cofinality. As a corollary, we obtain an “idealized” version of the combinatorial principle Pr1(μ +, μ +, μ +, cf(μ)) that maximizes the indecomposability of the associated ideal.

In this paper, we define a first-order logic CFʹ with strong negation and bounded static quantifiers, which is a variant of Thomason's logic CF. For the logic CFʹ, the usual Kripke formal semantics is defined based on situations, and a sound and complete axiomatic system is established based on the axiomatic systems of constructive logics with strong negation and Thomason's completeness proof techniques. With the use of bounded quantifiers, CFʹ allows the domain of quantification to be empty and allows for (...) nondenoting constants. CFʹ is intended as a fragment of a logic for situation theory. Thus the connection between CFʹ and infon logic is discussed. (shrink)