This article describes the process engaged by 17 expert scholars in the development of a set of six consensus recommendations about the normative foundations of pediatric decision-making. The process began with a robust pre-reading assignment, followed by three days of in-person symposium discussions that resulted in a publication in _Pediatrics_ entitled “Pediatric Decision-Making: Consensus Recommendations” (Salter et al. 2023). This article next compares the six recommendations to existing statements about pediatric decision-making (specifically those developed by the American Academy of Pediatrics), (...) highlighting similarities and differences. Finally, the article discusses the value of finding consensus in the field of pediatric bioethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Issue on Pediatric Decision-MakingErica K. SalterUnlike in the traditional decisional dyad in adult-based care, pediatric decision-making typically involves a triadic relationship among the patient, their parents, and the health-care providers. This complex relationship raises questions and concerns regarding each party’s expectations, obligations, and authority. For example, should a parent be allowed to withhold a poor diagnosis from an adolescent patient? Should an HLA-matched six-year-old sister (...) be permitted to serve as a bone marrow donor for her older sibling with lysosomal storage disease? Or, should parents be given decisional authority to consent to gender-affirming care for an adolescent with gender dysphoria? Cases like these are among the most ethically challenging decisions faced by parents and health-care providers because they present competing interests and values, and it’s not always clear what is in the best interests of the child.In the context of American medicine, the best interest standard has been identified as the primary ethical and legal guide for decision-making. In its most prominent form, the best interest standard requires parents and pediatric practitioners to choose the medical treatment that maximizes benefits and minimizes harms to the particular child in question. However, over the past few decades, the standard has come under significant scrutiny, with discussions and debate in the academic bioethics literature asking whether the standard is able to serve the [End Page 181] purposes it is thought to serve and whether alternative standards might be better suited to the task(s). Despite vigorous interest in these issues, the academic literature did not seem to generate any sense of identifiable consensus about how others ought to make health-care decisions on behalf of children.Thus, in June 2022, 17 scholar-experts on pediatric decision-making standards gathered in St. Louis, MO, for a three-day symposium of discussion and consensus-building. The participating authors represented different disciplinary perspectives and different viewpoints in the debate about guidance principles that underlie pediatrics. Despite apparent disagreement about such standards in the literature, the group was able to generate a set of six consensus-based recommendations (see Table 1) for pediatric decision-making. These recommendations, as well as their application, justification, and limitations, were published as a special article in Pediatrics in August 2023 (Salter et al. 2023), which was composed with the primary goals of accessibility, teachability, and implementability for practicing pediatric clinicians. Click for larger view View full resolutionTable 1.Six consensus recommendations for pediatric decision-makingWhile the group was able to find agreement about these six central principles of pediatric decision-making, there remained several related issues that were outside of the scope of the symposium aims. For example, should these recommendations apply to neonates, children in state custody, or adolescents, and if so, how would their application be operationalized? What specific conditions should justify state intervention on parental authority? How should parents and health-care providers think about obligations to siblings in health-care decisions? This [End Page 182] special issue of Perspectives in Biology and Medicine provides a forum for our authors and collaborators to further explore these, and other, important questions.The issue opens with a piece by the symposium organizers and editors of this special issue, Erica Salter, Lainie Friedman Ross, and D. Micah Hester, describing the symposium’s inspiration and design, its execution, and the implications it might have for pediatric ethics. This contribution compares the six symposium recommendations with existing statements about pediatric decision-making, in particular the statements developed by the American Academy of Pediatrics (AAP). In “How We Found Consensus on Pediatric Decision-Making and Why It Matters,” readers will find a detailed account of the process engaged to develop the six consensus-based recommendations, as well as a discussion of the value and limitations of such a process, which may serve as a model of consensus-building useful for other unsettled topics of interest in the bioethics community.The issue’s second article, “Childhood Interests: What They Are, and Why It Matters,” by Johan Bester and Jeffrey Blustein, dives into the conceptual foundation of the symposium’s first two recommendations. This... (shrink)

In this commentary, the author discusses two strengths and two weaknesses of “Better than Best (Interest Standard) in Pediatric Decision-Making,” in which Lainie Friedman Ross critiques the best interest standard and proposes her own model of constrained parental autonomy (CPA) as a preferable replacement for both an intervention principle and a guidance principle in pediatric decision making. The CPA’s strengths are that it detaches from the language and concept of “best” and that it better respects the family as a (...) distinct and intimate decision-making unit. The first weakness of the framework, as an intervention principle, is that because it imports a Rawlsian understanding of basic interests, it neglects certain populations of children (for example, children with intellectual disabilities). The second weakness is that, as a guidance principle, it is unclear what actual guidance the CPA is positioned to offer and how that guidance would be justified. To conclude, this commentary offers suggestions for what should be required of both an intervention principle and a guidance principle in pediatric decision making. (shrink)

There is not, of course, a one-to-one relation between policy conclusions and the conclusions of positive economics; if there were, there would be no ...

Perhaps this is due to the belief that technology has a value-neutral nature, and that issues of value are better left to philosophers.

One of the most interesting aspects of McDowell’s very interesting book is the way in which it locates the problems of late-twentieth-century Anglo-American philosophy within the historical development of the Western philosophical tradition. Beginning with an opposition between Coherentism and the Myth of the Given exemplified in recent work of Donald Davidson’s, McDowell proceeds to frame his discussion in terms of the Kantian distinction between concepts and intuitions, understanding and sensibility, spontaneity and receptivity. McDowell’s basic idea is that we can (...) satisfactorily overcome the opposition between Coherentism and the Myth of the Given only by recognizing, with Kant, that concepts and intuitions, understanding and sensibility, must be integrated together in every cognitive act or process—even in the mere intake of experiential content characteristic of sense perception. There is thus no room, according to McDowell, for either unconceptualized sensory input standing in no rational relation to conceptual thought or purely intellectual thought operating independently of all rational constraint from sense experience. (shrink)

We define a class of functions, the descent recursive functions, relative to an arbitrary elementary recursive system of ordinal notations. By means of these functions, we provide a general technique for measuring the proof-theoretic strength of a variety of systems of first-order arithmetic. We characterize the provable well-orderings and provably recursive functions of these systems, and derive various conservation and equiconsistency results.

There are two standard ways to establish consistency in set theory. One is to prove consistency using inner models, in the way that Gödel proved the consistency of GCH using the inner model L. The other is to prove consistency using outer models, in the way that Cohen proved the consistency of the negation of CH by enlarging L to a forcing extension L[G].But we can demand more from the outer model method, and we illustrate this by examining Easton's strengthening (...) of Cohen's result:Theorem 1. There is a forcing extensionL[G] of L in which GCH fails at every regular cardinal.Assume that the universe V of all sets is rich in the sense that it contains inner models with large cardinals. Then what is the relationship between Easton's model L[G] and V? In particular, are these models compatible, in the sense that they are inner models of a common third model? If not, then the failure of GCH at every regular cardinal is consistent only in a weak sense, as it can only hold in universes which are incompatible with the universe of all sets. Ideally, we would like L[G] to not only be compatible with V, but to be an inner model of V.We say that a statement is internally consistent iff it holds in some inner model, under the assumption that there are innermodels with large cardinals. (shrink)

Kant's original version of transcendental philosophy took both Euclidean geometry and the Newtonian laws of motion to be synthetic a priori constitutive principles—which, from Kant's point of view, function as necessary presuppositions for applying our fundamental concepts of space, time, matter, and motion to our sensible experience of the natural world. Although Kant had very good reasons to view the principles in question as having such a constitutively a priori role, we now know, in the wake of Einstein's work, that (...) they are not in fact a priori in the stronger sense of being fixed necessary conditions for all human experience in general, eternally valid once and for all. And it is for precisely this reason that Kant's original version of transcendental philosophy must now be either rejected entirely or radically reconceived. Most philosophy of science since Einstein has taken the former route: the dominant view in logical empiricism, for example, was that the Kantian synthetic a priori had to be rejected once and for all in the light of the general theory of relativity. (shrink)

The continuum function αmaps to2α on regular cardinals is known to have great freedom. Let us say that F is an Easton function iff for regular cardinals α and β, image and α<β→F≤F. The classic example of an Easton function is the continuum function αmaps to2α on regular cardinals. If GCH holds then any Easton function is the continuum function on regular cardinals of some cofinality-preserving extension V[G]; we say that F is realised in V[G]. However if we also wish (...) to preserve measurable cardinals, new restrictions must be put on F. We say that κ is F-hypermeasurable iff there is an elementary embedding j:V→M with critical point κ such that H)Vsubset of or equal toM; j will be called a witnessing embedding. We will show that if GCH holds then for any Easton function F there is a cofinality-preserving generic extension V[G] such that if κ, closed under F, is F-hypermeasurable in V and there is a witnessing embedding j such that j≥F, then κ will remain measurable in V[G]. (shrink)

Hayek developed two contradictory epistemologies. The epistemology for which he is famous attributed dispersed knowledge to economic actors and credited the price system for aggregating and communicating this knowledge. The other epistemology attributed to human and non-human organisms alike the error-prone interpretation of stimuli, which could never truly be said to be “knowledge.” Several of the paradoxes of Hayek's economic and political thought that are explored in this symposium can be explained by the triumph of the first epistemology over the (...) second, including his historical interpretation of socialism as a planning mentality; his tendentious definitions of “liberty” and “justice”; and his opposition to economic redistribution even as he endorsed all manner of economic and social regulations. (shrink)

A discussion of L.A. Paul's 'Transformative Experience' from an Author Meets Critics session at the 2015 Pacific APA.

ABSTRACT This essay considers the relationship between history of science and philosophy of science from Thomas Kuhn to the present. This relationship, of course, has often been troubled, but there is now new hope for an ongoing productive interaction—due to an increasing awareness, among other things, of the mutual entanglement between the development of modern science and the development of modern philosophy on the part of both professional (historically minded) philosophers and professional historians of science. This idea is illustrated with (...) several examples, including the entanglement of Einstein's theory of relativity with logical empiricism and its precursors and the entanglement of the analytic tradition in philosophy first with mathematical logic and then (through mathematical logic) with the cognitive sciences. Against this background, finally, the essay considers the emergence of contemporary social and cultural history of science from the Kantian and neo‐Kantian philosophical traditions. (shrink)

This article addresses the question of whether the relation of moral preference is transitive. I argue, following Larry Temkin and Stuart Rachels, that any ethical theory complex enough to be even minimally plausible allows us to generate intransitive sets of preferences. Even act utilitarianism cannot avoid this predicament unless we accept its least plausible version. We must reevaluate the assumption that an ethical theory must be transitive in order to be rational. This problem amounts to a foundational crisis in ethics. (...) However, it has not been taken seriously for two reasons—the belief that the problem has limited scope; and the claim that arguments against transitivity are 'merely' Sorites arguments. This article responds to both of these objections. I also point out some connections between intransitivity and the debate surrounding skepticism about the moral significance of numbers. (shrink)

Deontological (as opposed to consequentialist) liberals treat freedom of action as an end in itself, not a means to other ends. Yet logically, when one makes a deliberate choice, one treats freedom of action as if it were not an end in itself, for one uses this freedom as a means to the ends one hopes to achieve through one's action. The tension between deontology and the logic of choice is reflected in the paradoxical nature of the ?right to do (...) wrong?; and in Rawls's unsuccessful attempts to justify to acting agents their interest in such a right, embodied in his conception of agents as ?self-validating sources of claims.? A self-validating source of claims is akin to God as envisioned by voluntarist theologians such as Ockham. Leibniz's critique of voluntarism, then, is applicable to the Rawlsian subject: like the voluntarist God, she would be unable to act if it were indeed the case that her action validated itself. (shrink)

The Infinite Time Turing Machine model [8] of Hamkins and Kidder is, in an essential sense, a "Σ₂-machine" in that it uses a Σ₂ Liminf Rule to determine cell values at limit stages of time. We give a generalisation of these machines with an appropriate Σ n rule. Such machines either halt or enter an infinite loop by stage ζ(n) = df μζ(n)[∃Σ(n) > ζ(n) L ζ(n) ≺ Σn L Σ(n) ], again generalising precisely the ITTM case. The collection of (...) such machines taken together computes precisely those reals of the least model of analysis. (shrink)

Can men who dominate women nevertheless be happy or lead flourishing lives? Building on Claudia Card's exploration of moral luck, this paper considers the belief that male dominators cannot be happy. The discussion ranges over both virtue theory and empirical research into the "belief in a just world." I conclude that there are reasons to avoid believing that male dominators cannot be happy or flourish, and that feminism does not need that belief.

Informal statements of Gödel's Second Incompleteness Theorem, referred to here as Informal Second Incompleteness, are simple and dramatic. However, current versions of Formal Second Incompleteness are complicated and awkward. We present new versions of Formal Second Incompleteness that are simple, and informally imply Informal Second Incompleteness. These results rest on the isolation of simple formal properties shared by consistency statements. Here we do not address any issues concerning proofs of Second Incompleteness.

Gödel's definitive results and his essays leave us with a rich legacy of philosophical programs that promise to be subject to mathematical treatment. After surveying some of these, we focus attention on the program of circumventing his demonstrated impossibility of a consistency proof for mathematics by means of extramathematical concepts.

This topic has been discussed earlier on the FOM email list in various guises. The common theme is: big numbers and long sequences associated with mathematical objects. See..

An open U ⊆ ℝ is produced such that (ℝ, +, ·, U) defines a Borel isomorph of (ℝ, +, ·, ℕ) but does not define ℕ. It follows that (ℝ, +, ·, U) defines sets in every level of the projective hierarchy but does not define all projective sets. This result is elaborated in various ways that involve geometric measure theory and working over o-minimal expansions of (ℝ, +, ·). In particular, there is a Cantor set E ⊆ ℝ (...) such that (ℝ, +, ·, E) defines a Borel isomorph of (ℝ, +, ·, ℕ) and, for every exponentially bounded o-minimal expansion $\germ{R}$ of (ℝ, +, ·), every subset of ℝ definable in ( $\germ{R}$ , E) either has interior or is Hausdorff null. (shrink)

If A is an admissible set, let HC(A) = {x∣ x ∈ A and x is hereditarily countable in A}. Then HC(A) is admissible. Corollaries are drawn characterizing the "real parts" of admissible sets and the analytical consequences of admissible set theory.

This article reviews recent cognitive and neurological approaches to the study of attention. It argues that such research is based on the notion that attention has a positive cognitive function selecting, like a sieve or a filter, elements from the background and foreground, to then be processed by the brain and made conscious when required. These approaches fail to explain cognitive overload and recent findings demonstrating that recognition and understanding—sensory, visual and semantic—also occur prior to attention. Merleau-Ponty and Freud offer (...) a different model: a negative distractive attention. Negative distractive attention serves as a threshold for stimuli excluded by neurological processes regulating overload and ensuring that consciousness can concentrate on the singularity of its objects. Such approach to attention explains how one can drive and talk. It is not a positive multi-tasking model but a negative distractive one. (shrink)

Feminist ethics supports the contemporary educational trend toward increased multiculturalism and a diminished emphasis on the Western canon. First, I outline a feminist ethical justification for this development. Second, I argue that Western canon studies should not be altogether abandoned in a multicultural curriculum. Third, I suggest that multicultural education should help combat oppression in addition to simply promoting awareness of diversity. Fourth, I caution against an arrogant moralism in the teaching of multiculturalism.

Since 1991 the Franciscan Francis of Marchia, master of theology at the University of Paris (fl. 1320), has begun receiving his due attention as an exciting and innovative thinker. This volume examines his doctrines in cosmology, physics, metaphysics, ethics, and politics.

"Moses and Monotheism" is Freud's last book on religion. It was published in its entirety only after his flight from Nazi-occupied Vienna. Moses is perhaps Freud's most controversial book on religion. It is both an apology and a curse. It is a critique of traditional Judaism (by way of an Oedipal analysis of a deified Moses), a defence of a modern humanistic Judaism (a Judaism of moral and intellectual values), and a bitter critique of Christianity (a religion not of the (...) Father but of the sons, a failed religion, which expresses its failure in anti-Semitism). A defiant and rebellious book, one might say, one in which an old man rises to meet his fate and does so with surprising wilfulness and vigour. But Moses also reveals a dogmatic Freud defending a critique of religion that is intellectually flawed and politically misdirected. (shrink)

Should women’s terrorist acts be understood differently than similar acts carried out by men? Does the gender identity of a terrorist make a difference to the meaning of a terrorist’s acts? Commentators who explain women’s involvement in terrorism often offer explanations other than political commitment. They often refer instead to factors in the women’s personal relationships, thereby drawing on gender stereotypes and diminishing the women’s political commitments. I suggest instead that terrorism by a woman involves symbolic political “testimony.” It amounts (...) to saying that someone who is a typically nonviolent sort of person has engaged in violence on behalf of a political cause. Because of this significance, women’s terrorism merits a more serious consideration as testimony than similar acts by men. (shrink)