In Minker and Rajasekar (J Log Program 9(1):45–74, 1990), Minker proposed a semantics for negation-free disjunctive logic programs that offers a natural generalisation of the fixed point semantics for definite logic programs. We show that this semantics can be further generalised for disjunctive logic programs with classical negation, in a constructive modal-theoretic framework where rules are built from _claims_ and _hypotheses_, namely, formulas of the form \(\Box \varphi \) and \(\Diamond \Box \varphi \) where \(\varphi \) is a literal, respectively, (...) yielding a “base semantics” for general disjunctive logic programs. Model-theoretically, this base semantics is expressed in terms of a classical notion of logical consequence. It has a complete proof procedure based on a general form of the cut rule. Usually, alternative semantics of logic programs amount to a particular interpretation of nonclassical negation as “failure to derive.” The counterpart in our framework is to complement the original program with a set of hypotheses required to satisfy specific conditions, and apply the base semantics to the resulting set. We demonstrate the approach for the answer set semantics. The proposed framework is purely classical in mainly three ways. First, it uses classical negation as unique form of negation. Second, it advocates the computation of logical consequences rather than of particular models. Third, it makes no reference to a notion of preferred or minimal interpretation. (shrink)

What is the source of aesthetic knowledge? Empirical knowledge, it is generally held, bottoms out in perception. Such knowledge can be transmitted to others through testimony, preserved by memory, and amplified via inference. But perception is where the rubber hits the road. What about aesthetic knowledge? Does it too bottom out in perception? Most say “yes”. But this is wrong. When it comes to aesthetic knowledge, it is appreciation, not perception, where the rubber hits the road. The ultimate source of (...) aesthetic knowledge is feeling. In this essay, we articulate and defend the very idea of affective knowledge and reveal aesthetic knowledge to be a species of the genus. We then show how the view resolves a thorny problem that has bedeviled aesthetic epistemologists: how to reconcile the seemingly direct character of aesthetic knowledge with the possibility of acquiring such knowledge from criticism. One learns from criticism, we argue, when it guides one’s engagement with an object so that one can appreciate it in virtue of those of its features that render it worthy of appreciation. (shrink)

Physicians place significant weight on the distinction between acts and omissions. Most believe that autonomous refusals for procedures, such as blood transfusions and resuscitation, ought to be respected, but they feel no similar obligation to accede to requests for treatment that will, in the physician’s opinion, harm the patient (e.g., assisted death). Thus, there is an asymmetry. In this paper, we challenge the strength of this distinction by arguing that the ordering of values should be the same in both cases. (...) The reason for respecting refusals is that, in such cases, autonomy outweighs well-being. We argue that the same should be true in request cases, which means that requests should not be denied only due to the treatment being too harmful in the physician’s opinion. Our strategy is to consider and reject a number of arguments for the asymmetrical view, including an appeal to the doing–allowing distinction and positive and negative rights. The duty to respect refusals is still greater than the duty to grant requests on our view, but, by arguing that the ordering of values is the same in both cases, we show that there is less of a distinction in healthcare between requests and refusals than many currently believe. (shrink)

Journal of Political Philosophy, Volume 29, Issue 4, Page 539-563, December 2021.

Standard conditionals $\varphi > \psi$, by which I roughly mean variably strict conditionals à la Stalnaker and Lewis, are trivially true for impossible antecedents. This article investigates three modifications in a doxastic setting. For the neutral conditional, all impossible-antecedent conditionals are false, for the doxastic conditional they are only true if the consequent is absolutely necessary, and for the metaphysical conditional only if the consequent is ‘model-implied’ by the antecedent. I motivate these conditionals logically, and also doxastically by properties of (...) conditional belief and belief revision. For this I show that the Lewisian hierarchy of conditional logics can be reproduced within ranking semantics, provided we slightly stretch the notion of a ranking function. Given this, acceptance of a conditional can be interpreted as a conditional belief. The epistemic and the neutral conditional deviate from Lewis’ weakest system $V$, in that ID or even CN are dropped, and new axioms appear. The logic of the metaphysical conditional is completely axiomatised by $V$ to which we add the known Kripke axioms T5 for the outer modality. Related completeness results for variations of the ranking semantics are obtained as corollaries. (shrink)

The standard associative account of implicit bias posits that the mind unavoidably mirrors the biased co-occurrences that are present in the environment. The resulting fatalistic view of implicit bias as inevitable and immutable is both scientifically unwarranted and societally counterproductive.

In the debate on the ethics of the non-medical use of pharmaceuticals for cognitive performance enhancement in healthy individuals there is a clear division between those who view “cognitive enhancement” as ethically unproblematic and those who see such practices as fraught with ethical problems. Yet another, more subtle issue, relates to the relevance and quality of the contribution of scholarly bioethics to this debate. More specifically, how have various forms of speculation, anticipatory ethics, and methods to predict scientific trends and (...) societal responses augmented or diminished this contribution? In this paper, we use the discussion of the ethics of cognitive enhancement to explore the positive and negative contribution of speculation in bioethics scholarship. First, we review and discuss how speculation has relied on different sets of assumptions regarding the non-medical use of stimulants, namely: terminology and framing; scientific aspects such as efficacy and safety; estimates of prevalence and consequent normalization; and the need for normative reflection and regulatory guidelines. Second, three methodological guideposts are proposed to alleviate some of the pitfalls of speculation: acknowledge assumptions more explicitly and identify the value attributed to assumptions; validate assumptions with interdisciplinary literature; and adopt a broad perspective to promote more comprehensive reflection. We conclude that, through the examination of the controversy about cognitive enhancement, we can employ these methodological guideposts to enhance the value of contributions from bioethics and minimize potential epistemic and practical pitfalls in this case and perhaps in other areas of bioethical debate. (shrink)

Neuroethics is an interdisciplinary field that arose in response to novel ethical challenges posed by advances in neuroscience. Historically, neuroethics has provided an opportunity to synergize different disciplines, notably proposing a two-way dialogue between an ‘ethics of neuroscience’ and a ‘neuroscience of ethics’. However, questions surface as to whether a ‘neuroscience of ethics’ is a useful and unified branch of research and whether it can actually inform or lead to theoretical insights and transferable practical knowledge to help resolve ethical questions. (...) In this article, we examine why the neuroscience of ethics is a promising area of research and summarize what we have learned so far regarding its most promising goals and contributions. We then review some of the key methodological challenges which may have hindered the use of results generated thus far by the neuroscience of ethics. Strategies are suggested to address these challenges and improve the quality of research and increase neuroscience's usefulness for applied ethics and society at large. Finally, we reflect on potential outcomes of a neuroscience of ethics and discuss the different strategies that could be used to support knowledge transfer to help different stakeholders integrate knowledge from the neuroscience of ethics. (shrink)

Common understandings of neuroethics, i.e., of its distinctive nature, are premised on two distinct sets of claims: (1) neuroscience can change views about the nature of ethics itself and neuroethics is dedicated to reaping such an understanding of ethics; (2) neuroscience poses challenges distinct from other areas of medicine and science and neuroethics tackles those issues. Critiques have rightfully challenged both claims, stressing how the first may lead to problematic forms of reductionism while the second relies on debatable assumptions about (...) the nature of bioethics specialization and development. Informed by philosophical pragmatism and our experience in neuroethics, we argue that these claims are ill-founded and should give way to pragmatist reconstructions. Namely, neuroscience, much like other areas of empirical research on morality, can provide useful information about the nature of morally problematic situations but it does not need to promise radical and sweeping changes to ethics based on neuroscientism. Furthermore, the rationale for the development of neuroethics as a specialized field need not to be premised on the distinctive nature of the issues it tackles or of neurotechnologies. Rather, it can espouse an understanding of neuroethics as both a scholarly and a practical endeavor dedicated to resolving a series of problematic situations raised by neurological and psychiatric conditions. (shrink)

The application of neurostimulation techniques such as deep brain stimulation —often called a brain pacemaker for neurological conditions like Parkinson's disease —has generated “currents of hope.” Building on this hope, there is significant interest in applying neurostimulation to psychiatric disorders such as major depression and obsessive-compulsive disorder. These emerging neurosurgical practices raise a number of important ethical and social questions in matters of resource allocation, informed consent for vulnerable populations, and commercialization of research.

In lieu of an abstract, here is a brief excerpt of the content:Spring Fishing Song, Prehistoric Paros JOHN ERIC HAMEL Come, tuna, iridescent whorl, Spin color through our rain-locked sea. Come, scatter winter’s smoke and spitting hail, The brazier’s headache, days of coiling clay, The endless shuttle. Let the restless needle be. Come, return the sea to life. The days of winter card our limbs to rope. Restore the muscle with your flesh, unfurl The cold’s crushing boredom into the (...) sun. We’ve burnished long enough our winter soul. The heat begins to double back. The stars That mark the Oar re-stroke at last the salt. All turns. By island and straight you loop and belt, In time with star and turning tide. Shake sail, Bring oar and rope. The barley weaves new fleece. Come, bless our boats, wake us from the hours Of dropping lines over bleached gunnel, The nights of damp and cold breathing sea. Raw mackerel for days to eat, until A line is bumped like a lover’s finger touch, And fins cut water fast as breakers flash. The circled sea within our fleet erupts With flailing fins as sharp as swords. We gaff the bleeding gills into our boats. arion 28.3 winter 2021 44 spring fishing song, prehistoric paros Come, strong fish with gemstone scale, Blow on the coals of our blood, renew our strength. The deep obsidian light of winter clouds Begins to pour molten copper thick as oil All down the sea. We’re born for sails and shrouds, We’re born in waters of a mother’s wave, And return our marble souls into the grave. 2017... (shrink)

Free will has been the object of debate in the context of addiction given that addiction could compromise an individual’s ability to choose freely between alternative courses of action. Proponents of the brain-disease model of addiction have argued that a neuroscience perspective on addiction reduces the attribution of free will because it relocates the cause of the disorder to the brain rather than to the person, thereby diminishing the blame attributed to the person with an addiction. Others have worried that (...) such displacement of free will attribution would make the person with a drug addiction less responsible. Using the paradigmatic literature on the seductive allure of neuroscience explanations, we tested whether neuroscience information diminishes attributions of free will in the context of addiction and whether respondent characteristics influence these attributions and modulate the effect of neuroscience information. We performed a large-scale, web-based experiment with 2,378 German participants to explore how attributions of free will in the context of addiction to either alcohol or cocaine are affected by: (1) a text with a neurobiological explanation of addiction, (2) a neuroimage showing effects of addiction on the brain, and (3) a combination of a text and a neuroimage, in comparison to a control group that received no information. Belief in free will was measured using the FAD-Plus scale and was, subsequent to factor analysis, separated into two factors: responsibility and volition. The investigated respondent characteristics included gender, age, education, self-reported knowledge of neuroscience, substance-use disorder (SUD), and having a friend with SUD. We found that attributions of volition (in the cocaine-subsample) were reduced in the text and neuroimage-treatment compared to the control group. However, respondent characteristics such as education and self-reported knowledge of neuroscience were associated with lower attributions of responsibility for both substances, and education was associated with lower attribution of volition for the alcohol sub-sample. Interaction analyses showed that knowledge of neuroscience was found to generally decrease attribution of responsibility. Further research on attribution of free will should consider the effects of context and respondent characteristics, which appeared surprisingly larger than those induced by experimental treatments. (shrink)

Health inequalities are embedded in a complex array of social, political, and economic inequalities. Responding to health inequalities will require systematic action targeting all the underlying (“upstream”) social determinants that powerfully affect health and well‐being. Systemic inequalities are a major reason for the rise of modern populism that has deeply divided polities and infected politics, perhaps nowhere more so than in the United States. Concerted action to mitigate shocking levels of inequality could be a powerful antidote to nationalist populism. A (...) basic yet critical start to addressing health inequalities is to recognize them, which demands improving data collection and analysis. Certainly, global indicators show vast progress in reducing poverty and extending life. Yet aggregate health data mask a deeper reality: health gains have disproportionately benefited the well‐off, leaving the poor and middle‐class behind. (shrink)

Central aspects of Hume’s proposed “system of the sciences” as described in the Treatise are modeled on Newton’s Principia. But, as recent scholarship has suggested, Hume’s Treatise also bears a deeply subversive message with respect to Newtonian science. This chapter offers a revised overview of what Hume takes from Newton and what he rejects: The first part of the chapter argues that in the Treatise Hume adopts a version of Newton’s “analytic and synthetic method” for philosophy, thereby placing a distinctively (...) Newtonian form of explanatory reduction at the center of his own philosophical method. The second part of the chapter, on the other hand, shows that many of the most important aspects of Hume’s argument in Book 1 of the Treatise can be understood as critical of core conceptual and ontological commitments of Newton’s mechanics as developed in the Principia. (shrink)

The concept of free will has been heavily debated in philosophy and the social sciences. Its alleged importance lies in its association with phenomena fundamental to our understandings of self, such as autonomy, freedom, self-control, agency, and moral responsibility. Consequently, when neuroscience research is interpreted as challenging or even invalidating this concept, a number of heated social and ethical debates surface. We undertook a content analysis of media coverage of Libet’s et al.’s :623–642, 1983) landmark study, which is frequently interpreted (...) as posing a serious challenge to the existence of free will. Media descriptions of Libet et al.’s experiment provided limited details about the original study. Overall, many media articles reported that Libet et al.’s experiments undermined the existence of free will, despite acknowledging that several methodological limitations had been identified in the literature. A propensity to attribute greater credibility than warranted to neurobiological explanations could be at stake. (shrink)

In this paper we compare Leitgeb’s stability theory of belief and Spohn’s ranking-theoretic account of belief. We discuss the two theories as solutions to the lottery paradox. To compare the two theories, we introduce a novel translation between ranking functions and probability functions. We draw some crucial consequences from this translation, in particular a new probabilistic belief notion. Based on this, we explore the logical relation between the two belief theories, showing that models of Leitgeb’s theory correspond to certain models (...) of Spohn’s theory. The reverse is not true. Finally, we discuss how these results raise new questions in belief theory. In particular, we raise the question whether stability is rightly thought of as a property pertaining to belief. (shrink)

Orthodox Bayesianism endorses revising by conditionalization. This paper investigates the zero-raising problem, or equivalently the certainty-dropping problem of orthodox Bayesianism: previously neglected possibilities remain neglected, although the new evidence might suggest otherwise. Yet, one may want to model open-minded agents, that is, agents capable of raising previously neglected possibilities. Different reasons can be given for open-mindedness, one of which is fallibilism. The paper proposes a family of open-minded propositional revisions depending on a parameter ϵ. The basic idea is this: first (...) extend the prior to the newly suggested possibilities by mixing the prior with the uniform probability on these possibilities, then conditionalize. This may put the agent back on the right track when her beliefs or evidence happen to be false. The paper justifies this family of equivocal epsilon-conditionalizations as minimal non-biased open-minded modifications of conditionalization. Several variations are discussed, such as mixing with an ad hoc or silent prior instead of the uniform prior, and a generalization to probabilistic information is given. The approach is compared to other accounts, such as Jeffrey’s Bayesianism, Gärdenfors’s probabilistic revision, maximizing entropy, and minimal revision. _1_ Introduction _2_ Downsides of Certainty Conservation _3_ Why Raise Zeros? _3.1_ Accuracy defects _3.2_ Fallibilism and dissolutions _3.3_ Weak fallibilism and partial solutions _4_ Epsilon-Conditionalization _4.1_ Definitions _4.2_ Revision types and information assumptions _4.3_ Epsilon interpretation and flavours _5_ Justifications _5.1_ Open-minded orthodox Bayesianism _5.2_ Minimal revision _5.3_ Transitivity _6_ Conclusion Appendix. (shrink)

This is a study of Plato's use of the character Socrates to model what philosophy is. The study focuses on the Apology, and finds that philosophy there is the love of wisdom, where wisdom is expertise about how to live, of the sort that only gods can fully have, and where Socrates loves wisdom in three ways, first by honoring wisdom as the gods' possession, testing human claims to it, second by pursuing wisdom, examining himself as he examines others, to (...) achieve a more well justified set of beliefs about how to live, and third by trying to live wisely, insofar as he can, which includes exhorting others to care about living wisely than anything else. The essay also includes some suggestions about how Plato criticizes and revises this model of philosophy outside the Apology. (shrink)

The concept of vulnerability is widely used in research ethics to signal attention to participants who require special protections in research. However, this concept is vague and under‐theorized. There is also growing concern that the dominant categorical approach to vulnerability (as exemplified by research ethics regulations and guidelines delineating vulnerable groups) is ethically problematic because of its assumptions about groups of people and is, in fact, not very guiding. An agreed‐upon strategy is to move from categorical towards analytical approaches (focused (...) on analyzing types and sources of vulnerability) to vulnerability. Beyond this agreement, however, scholars have been advancing competing accounts of vulnerability without consensus about its appropriate operationalization in research ethics. Based on previous debates, we propose that a comprehensive account of vulnerability for research ethics must include four components: definition, normative justifications, application, and implications. Concluding that no existing accounts integrate these components in a functional (i.e., practically applicable) manner, we propose an integrative and functional account of vulnerability inspired by pragmatist theory and enriched by bioethics literature. Using an example of research on deep brain stimulation for treatment‐resistant depression, we illustrate how the integrative‐functional account can guide the analysis of vulnerability in research within a pragmatist, evidence‐based approach to research ethics. While ultimately there are concerns to be addressed in existing research ethics guidelines on vulnerability, the integrative‐functional account can serve as an analytic tool to help researchers, research ethics boards, and other relevant actors fill in the gaps in the current landscape of research ethics governance. (shrink)

International media have reported cases of pregnant women who have had their children apprehended by social services, or who were incarcerated or forced into treatment programs based on a history of substance use or lack of adherence to addiction treatment programs. Public discourse on the biology of addiction has been criticized for generating stigma and a diminished perception of self-control in individuals with an addiction, potentially contributing to coercive approaches and criminalization of women who misuse substances during pregnancy. We explored (...) whether this is the case based on literature from social psychology, ethics, addiction research, science communication, and philosophy. The literature shows that the relationship between public discourse on biological aspects of addiction and issues such as stigma and perceptions of diminished self-control are unclear, largely due to the complexity of these phenomena. However, concerns about the biological approach are nevertheless legitimate given the broader social and policy context of women’s health. (shrink)

The paper discusses the pros and cons of inductive research methods. It is argued that, despite the profusion of good arguments against this scientific strategy, it is frequently employed, for example in psychology. A case probe taken from the realm of cognitive psychology is used as an illustration.

Some ethical imperatives pertaining to climate change are mostly uncontroversial. Humanity has caused the problem and must do something to mitigate it and this job must to a large extent be carried by the current generations, as time is short. There is also wide agreement, at least among climate justice scholars, that the reason for why this is so is a combination of causal responsibility and ability to pay, and that the affluent therefore must lead the transition away of fossil (...) fuels. However, when it comes to implementing a just transition to a low-car- bon and sustainable future, most policies are ethically and politically contentious. (shrink)

Antidoping policy regulates and punishes the use of substances that are listed on a Prohibited List (PL). These substances are colloquially known as ‘performance-enhancing substances’. There is very little empirical evidence of enhancement for most of the substances on the PL raising the possibility that the perceived enhancement of performance experienced by an athlete is a placebo effect. A placebo effect is a response to an inert substance that is strongly influenced by psychological and social cues in the surrounding environment. (...) It is our contention that, given the lack of proper empirical testing of the substances on the PL, it is in fact the appearance of a substance on the PL that has the strongest performance-enhancing effect in elite athletes. This disconnect between science and WADA’s code raises the question of what we really object to: real performance enhancement achieved using substances on the PL or performance enhancement that occurs because WADA has told us that the substance will enhance performance by placing it on the PL? In this case, antidoping policy would punish those who believe the performance-enhancing myth at the heart of the PL thus leading to a deeply flawed policy that creates its own victims. (shrink)

Bioethics has made a compelling case for the role of experience and empirical research in ethics. This may explain why the movement for empirical ethics has such a firm grounding in bioethics. However, the theoretical framework according to which empirical research contributes to ethics—and the specific role it can or should play—remains manifold and unclear. In this paper, we build from pragmatic theory stressing the importance of experience and outcomes in establishing the meaning of ethics concepts. We then propose three (...) methodological steps according to which the meaning of ethics concepts can be refined based on experience and empirical research: function identification, function enrichment, and function testing. These steps are explained and situated within the broader commitment of pragmatic ethics to a perspective of moral growth and human flourishing. We hope that this proposal will give specific direction to the bridging of theoretical and empirical research in ethics and thus support stronger actualization of ethics concepts. (shrink)

In _Civilization and Its Discontents_, Freud made abundantly clear what he thought about the biblical injunction, first articulated in Leviticus 19:18 and then elaborated in Christian teachings, to love one's neighbor as oneself. “Let us adopt a naive attitude towards it,” he proposed, “as though we were hearing it for the first time; we shall be unable then to suppress a feeling of surprise and bewilderment.” After the horrors of World War II, the Holocaust, and Stalinism, Leviticus 19:18 seems even (...) less conceivable—but all the more urgent now—than Freud imagined. In _The Neighbor_, three of the most significant intellectuals working in psychoanalysis and critical theory collaborate to show how this problem of neighbor-love opens questions that are fundamental to ethical inquiry and that suggest a new theological configuration of political theory. Their three extended essays explore today's central historical problem: the persistence of the theological in the political. In “Toward a Political Theology of the Neighbor,” Kenneth Reinhard supplements Carl Schmitt’s political theology of the enemy and friend with a political theology of the neighbor based in psychoanalysis. In “Miracles Happen,” Eric L. Santner extends the book's exploration of neighbor-love through a bracing reassessment of Benjamin and Rosenzweig. And in an impassioned plea for ethical violence, Slavoj Žižek’s “Neighbors and Other Monsters” reconsiders the idea of excess to rehabilitate a positive sense of the inhuman and challenge the influence of Levinas on contemporary ethical thought. A rich and suggestive account of the interplay between love and hate, self and other, personal and political, _The Neighbor_ has proven to be a touchstone across the humanities and a crucial text for understanding the persistence of political theology in secular modernity. This new edition contains a new preface by the authors. (shrink)

The controversy around the accommodation of conscientious objections in medicine persists, especially for such contentious services as abortions. COs are typically considered in their negativ...

According to what I call the Traditional View, there is a fundamental semantic distinction between counting and measuring, which is reflected in two fundamentally different sorts of scales: discrete cardinality scales and dense measurement scales. Opposed to the Traditional View is a thesis known as the Universal Density of Measurement: there is no fundamental semantic distinction between counting and measuring, and all natural language scales are dense. This paper considers a new argument for the latter, based on a puzzle I (...) call the Fractional Cardinalities Puzzle: if answers to ‘how many’-questions always designate cardinalities, and if cardinalities are necessarily discrete, then how can e.g. ‘2.38’ be a correct answer to the question ‘How many ounces of water are in the beaker?’? If cardinality scales are dense, then the answer is obvious: ‘2.38’ designates a fractional cardinality, contra the Traditional View. However, I provide novel evidence showing that ‘many’ is not uniformly associated with the dimension of cardinality across contexts, and so ‘how many’-questions can ask about other kinds of measures, including e.g. volume. By combining independently motivated analyses of cardinal adjectives, measure phrases, complex fractions, and degrees, I develop a semantics intended to defend the Traditional View against purported counterexamples like this and others which have received a fair amount of recent philosophical attention. (shrink)

One reason for the persistent appeal of Don Marquis' ‘future like ours’ argument is that it seems to offer a way to approach the debate about the morality of abortion while sidestepping the difficult task of establishing whether the fetus is a person. This essay argues that in order to satisfactorily address both of the chief objections to FLO – the ‘identity objection’ and the ‘contraception objection’ – Marquis must take a controversial stand on what is most essential to being (...) the kind of entity that an adult human being is. Such a stand amounts to a controversial account of personhood. To the extent that FLO's success depends on accepting such a controversial metaphysical view, one apparent attraction of FLO proves illusory. (shrink)

The process by which auditors consider fraud risk in assessing management’s motivation and character remains under-addressed. This is problematic given the rising tide of narcissism, as well as recent research documenting that both self- and other-perceptions of narcissism influence an array of judgments. While a skeptical attitude is fundamental to the auditor’s gatekeeper role, it remains unclear how auditors form and act on perceptions of client narcissism. With a large sample of experienced accountants as participants, we leverage insights from current (...) narcissism and perceiver effects research to predict (and find) that auditor skepticism responds in a divergent manner to both the auditor’s (1) own antagonistic versus agentic narcissism and (2) perceptions of the client’s antagonistic and agentic narcissism. We discuss the observed opposing behavioral externalities related to these distinct forms of grandiose narcissism, particularly in dynamic interactions between clients and auditors. (shrink)

Because “rape” has such a powerful appraisive meaning, how one defines the term has normative significance. Those who define rape rigidly so as to exclude contemporary feminist understandings are therefore seeking to silence some moral perspectives “by definition.” I argue that understanding rape as an essentially contested concept allows the concept sufficient flexibility to permit open moral discourse, while at the same time preserving a core meaning that can frame the discourse.

For each one of the approximately 800,000 people who die from suicide every year, an additional twenty people attempt suicide. Many of these attempts result in hospitalization or in contact with other healthcare services. However, many personal, educational, and institutional barriers make it difficult for healthcare professionals to care for suicidal individuals. We reviewed literature that discusses suicidal patients in healthcare settings in order to highlight common ethical issues and to identify knowledge gaps. A sample was generated via PubMed using (...) keywords “[(ethics OR *ethic*) AND suicid*] AND [English (Language) OR French (Language)]” (final N = 52), ethics content was extracted according to scoping review methodology, and categorized thematically. We identified three main areas posing ethical challenges for health professionals caring for suicidal individuals and their families. These were: (1) making clinical decisions for patients in acute care or when presented with specific circumstances; (2) issues arising from therapeutic relationships in chronic care, and (3) organizational factors. There is considerable uncertainty about how to resolve ethical issues when caring for someone who is suicidal. The stigma associated with suicide and mental illness, problems associated with risk–benefit assessments, and the fear of being held liable for malpractice should a patient die by suicide were overarching themes present across these three categories. Caring for suicidal patients is clinically and ethically challenging. The current literature highlights the complexity and range of decisions that need to be made. More attention should be paid to the difficulties faced by healthcare professionals and the development of solutions. (shrink)

Richard Swinburne’s formulation of the argument from evil is representative of a pervasive way of understanding the challenge evil poses for theistic belief. But there is an error in Swinburne’s formulation : he fails to consider possible deontological constraints on God’s legitimate responses to evil. To demonstrate the error’s significance, I show that some important objections to Swinburne’s theodicy admit of a novel answer once we correct for Swinburne’s Lapse. While more is needed to show that the resultant “deontological theodicy” (...) succeeds, its promise highlights the significance of Swinburne’s Lapse and the prospects for theodicy it has obscured. (shrink)

Concerns about the possibility of a sharp rise in the prevalence of Alzheimer’s disease in Western nations have led to both the significant deployment of resources and the development of national research and healthcare plans. Although often focused on treatment, substantial efforts have also been dedicated toward preventing or delaying AD onset. As a result, recent technological and biomedical advances have greatly improved the understanding of AD pathophysiology. While some new tests can assess only risk ), some tests for certain (...) biomarkers (e.g., amyloid beta accumulation in the brain detected via positron... (shrink)

The Type VI secretion system is a multiprotein and mosaic apparatus that delivers protein effectors into prokaryotic or eukaryotic cells. Recent data on the enteroaggregative Escherichia coli T6SS have provided evidence that the TssA protein is a key component during T6SS biogenesis. The T6SS comprises a trans-envelope complex that docks the baseplate, a cytoplasmic complex that represents the assembly platform for the tail. The T6SS tail is structurally, evolutionarily and functionally similar to the contractile tails of bacteriophages. We have shown (...) that TssA docks to the membrane complex, recruits the baseplate complex and initiates and coordinates the polymerization of the inner tube with that of the sheath. Here, we review these recent findings, discuss the variations within TssA-like proteins, speculate on the role of EAEC TssA in T6SS biogenesis and propose future research perspectives. In the environment, bacteria have to cope with other microbial species and therefore have evolved anti-microbial mechanisms. The bacterial Type VI secretion system transports toxins into bacterial and/or eukaryotic cells using a contractile mechanism. At the architectural level, the T6SS could be viewed as a nano-speargun assembled in the bacterial cytoplasm and anchored to a trans-envelope complex. We describe and speculate on recent findings demonstrating that the TssA subunit is involved in the different stages of T6SS biogenesis. (shrink)

Brain death or determination of death based on the neurological criterion has been an enduring source of controversy in academic and clinical circles. The controversy chiefly concerns how death is defined, and it also bears on the justification of the proposed criteria for death determination and their interpretation. Part of the controversy on brain death and death determination stems from disputed crucial medical facts, but in this paper I formulate another hypothesis about the nature of ongoing controversies. At stake is (...) a misunderstood relationship between, on the one hand, the nature of our lay views about death and, on the other hand, the nature of scientific insights into death and its determination. The misunderstanding of this relationship has partly anchored the controversy and continues to fuel it. Based on a perspective inspired by pragmatism, which stresses the positive contribution of science to ethical and policy debates but also challenges different forms of scientism in science and philosophy found in foundationalist interpretations, I scrutinize three different stances regarding the relationship between lay and scientific perspectives about the definition of death: foundational lay views, foundational expert views, and co-evolving views. I argue that only the latter is sustainable given recent challenges to foundationalist interpretations. (shrink)

BackgroundIn its 2015 decision in Montgomery v. Lanarkshire Health Board, the Supreme Court of the United Kingdom overruled the long-standing, paternalistic prudent doctor standard of care in favour of a new reasonable patient standard which obligates doctors to make their patients aware of all material risks of the recommended treatment and of any reasonable alternative treatment. This landmark judgment has been of interest to the rest of the common law world. A judicial trend of invoking Montgomery to impose more stringent (...) requirements on doctors is discernible in subsequent decisions since then.Main bodyIn this narrative review, without questioning the idea that properly informed patients should play a more active role in procedures affecting their own health in furtherance of their autonomy, safety, and consumer rights, we identify and analyse, with the aid of realistic clinical thought experiments, three practical conundrums that the Montgomery standard may inflict on the daily work of doctors, unfairly exposing them to arbitrary legal risks.ConclusionsThese conundrums pertain to the ascertainment of the risks that must be disclosed to the patient under the test of ‘materiality’; the legal uncertainty as to the scope of the exceptions; and the actual ability of doctors to cope with the pressures of time. These conundrums offer ripe opportunities to rethink the proper role of judicially developed medical law in modern health care practice. (shrink)

We apply a critical perspective on leadership development discourses and practices to the case of student leadership development programs in the US universities and colleges. We leverage the first author’s personal experiences as a facilitator in such programs to focus on the manner in which they adapt and deploy a variety of commodified pop and positive psychology techniques—including prominently among them icebreakers and psychological assessment tests—that encourage participants to share personal and emotional insights about themselves as the necessary prerequisite for (...) becoming leaders. We draw on Foucault’s notion of pastoral power to argue that these quasi-therapeutic practices help to produce and to normalize what we describe as a confessional culture of leadership development that prepares would-be student leaders to submit themselves to similarly or even more psychologically demanding regimes of governmentality in the workplace after they graduate. We conclude with a call for future research on the central role of such leadership development practices—and the institutions, industries, and actors that promote them—in folding together the ways that individuals seek to claim agency and to develop themselves as leaders with the ways that organizations function to constrain that agency and to govern them as willing but compliant subjects. (shrink)

IntroductionIn highly developed countries, as many as 16 percent of children are physically abused each year. Traumatic brain injury (TBI) is the most common injury in non-accidental trauma (NAT) and is responsible for 80 percent of fatal NAT cases, with most deaths occurring in children younger than three years old. Cases of abusers who refuse withdrawal of life-sustaining medical treatment (LSMT) to avoid criminal charges have previously been reported. Therefore, we hypothesized that NAT is associated with a lower risk for (...) withdrawal LSMT in pediatric TBI.MethodsThe pediatric Trauma Quality Improvement Program database was analyzed (2014 to 2016) for patients aged 16 and younger with TBI and Glasgow Coma Scale (GCS) of 8 and lower on admission. Patients with a head Abbreviated Injury Scale (AIS) of 2 or less or who died within 48 hours were excluded. A multivariable logistic regression model was used for analysis.ResultsOf 2,209 TBI patients, 92 (4.2 percent) had withdrawal of LSMT. Compared to those without withdrawal of LMST, those with LMST had statistically similar median age (three years of age versus seven years, p = 0.07) and a higher rate of NAT (33.7 percent versus 13.5 percent, p < 0.001). The most common specified perpetrator was a father/stepfather/ male partner (70 percent). After adjusting for covariates, factors associated with higher risk for withdrawal of LSMT included age of less than three years (OR 2.38, CI 1.34-4.23, p < 0.05) and NAT (OR 1.86, CI 1.02-3.41, p < 0.05).ConclusionNAT is associated with increased risk for withdrawal of LSMT in pediatric TBI. Age of less than three years is similarly associated with a higher risk for withdrawal of LSMT. Future research in this population is needed to determine what other factors predict withdrawal of LSMT and what resources, such as social workers and/or ethics consults, are utilized. (shrink)