Professional associations, like the Academy of Management, exist to foster and promote scholarship, exchange among faculty, and an environment conducive to member professional ethics development. However, this last purpose of such organizations has received the least amount of attention. Moreover, previous research has demonstrated that there are differences in perceived needs for professional ethics development between tenured and untenured faculty. In the current research 260 Academy of Management members were surveyed. The research identified differences between tenured and untenured management (...) faculty with respect to expectations for the Academy of Management to provide ethics education and research with respect to the professional code of conduct. Implications of the findings are discussed from a developmental perspective. Directions for future research are provided. (shrink)

Professional associations, like the Academy of Management, exist to foster and promote scholarship, exchange among faculty, and an environment conducive to member professional ethics development. However, this last purpose of such organizations has received the least amount of attention. Moreover, previous research has demonstrated that there are differences in perceived needs for professional ethics development between tenured and untenured faculty. In the current research 260 Academy of Management members were surveyed. The research identified differences between tenured and untenured management (...) faculty with respect to expectations for the Academy of Management to provide ethics education and research with respect to the professional code of conduct. Implications of the findings are discussed from a developmental perspective. Directions for future research are provided. (shrink)

Management Ethics: Integrity at Work redefines what it means for a manager to function with integrity in the private and public sectorsùdomestically and globally. It integrates the latest theoretical work in both descriptive and normative ethics, and incorporates legal, communication, quality, and organizational theories into a conceptual framework that improves managerial judgment in the handling of moral complexity at work. The authors use their organizational ethics consulting and academic research experience to provide practical assessment and decision-making tools that convert ethics (...) theories into sound action steps. The book examines three key dimensions of management integrityùjudgment, process, and developmental dimensionsùand applies them to individual chapters devoted to the subprocesses of ethical planning, organizing, leading, and controlling. The authors focus their theories and tools on 28 ethics minicases related to each management function in seven allied management application clusters: accounting, auditing management; finance, investment management; marketing, advertising management; business management, business law, human resource management; technology, quality operations, organizational behavior management; public, nonprofit, health care management; and international, environmental, public policy management. Management Ethics: Integrity at Work builds management integrity by linking and enhancing both ethics and management competence in responsible planning, organizing, leading, and controlling for use by professionals and students in the private and public sectorsùdomestically and globally. (shrink)

The authors identify the challenge of holding contemporary business leaders accountable for enhancing the intangible strategic asset of integrity capacity in organizations. After defining integrity capacity and framing it as part of a strategic resource model of sustainable global competitive advantage, the stakeholder costs of integrity capacity neglect are delineated. To address this neglect issue, the authors focus on the cultivation of judgment integrity to handle behavioral, moral and hypothesized economic complexities as key dimensions of integrity capacity. Finally, the authors (...) recommend two leadership practices to build competence in business leaders to enhance integrity capacity as an organizational strategic asset. (shrink)

The authors propose the integrity capacity construct with its four dimensions (process, judgment, development and system dimensions) as a framework for analyzing and resolving behavioral, moral and legal complexity in business ethics' issues at the individual and collective levels. They claim that moral progress in business comes about through the increase in stakeholders who regularly handle moral complexity by demonstrating process, judgment, developmental and system integrity capacity domestically and globally.

The author identifies the major micro-, meso-, and macro-level financial risk shifting factors that contributed to the Great Global Recession and how the absence of a compelling moral vision of responsible financial risk management perpetuated the economic crisis and undermined the recovery by blind reliance upon insufficiently accountable bailouts. The author offers a new theoretical model of Sustainable Stakeholder Capitalism by exercising moral imagination which inclusively and moderately balances four multi-level factors: types of capitalism, moral theories, human nature drives, and (...) credit risk profiles. Finally, the author recommends micro-, meso-, and macro-level practical reforms to prevent a recurrence of the current economic freefall, to re-create systemic global financial institution integrity, and to promote responsible risk management for sustainable global prosperity for current and future generations. (shrink)

The authors delineate the nature and neglect of integrity capacity and global business citizenship by world business leaders. They discuss how the philosophical analysis of moral and economic complexity enhances judgment integrity capacity and global business citizenship. Finally, the authors recommend positive action steps to improve global business citizenship and leadership integrity capacity through a balanced and inclusive pluralistic economic philosophy.

The authors delineate the nature and neglect of integrity capacity and global business citizenship by world business leaders. They discuss how the philosophical analysis of moral and economic complexity enhances judgment integrity capacity and global business citizenship. Finally, the authors recommend positive action steps to improve global business citizenship and leadership integrity capacity through a balanced and inclusive pluralistic economic philosophy.

Is there a relationship between the psychological construct of hierarchic managerial role motivation and the moral construct of role-related ethical orientation? In this study we examine this question using responses from a sample of 147 business students in Hong Kong. Managerial role motivation or motivation to manage is defined as an internal force that leads select individuals to pursue, enjoy, and succeed in management positions in relatively large hierarchical organizations. As hypothesized, respondents with higher levels of managerial role motivation demonstrated (...) greater managerial role-related ethical orientation as compared with their less managerially motivated counterparts. Similarly, respondents with higher levels of respect for authority figures, competitive games, competitive situations, assertive role, imposing wishes, and a liking for routine administrative functions possessed greater ethical orientations. The research significance, limitations and future field applications are discussed. (shrink)

Using 15 years of data (1995–2009) from literature reviews, survey questionnaires, personal interviews, and desktop research, the authors examine North American (Canada, Mexico, and the United States of America) regional trends in business ethics research, teaching and training. The patterns indicate that business ethics continues to flourish in North America with high levels of productivity in both quantity and quality of teaching, training and research publication outputs. Topics/themes that have been covered during the time period are treated with an acknowledgement (...) of the concomitant marginal impact on improving ethical business behavior and contexts—as recurring domestic and global scandals attest. Major North American business ethics challenges/issues to be addressed in the future are identified. (shrink)

Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

This paper examines the law relating to healthcare resource allocation in England. The National Health Service Act 1977 does not impose an absolute duty to provide specified healthcare services. The courts will only interfere with a resource allocation decision made by an NHS body if that decision is frankly irrational is engaged). Such irrationality is very difficult to establish. The ECHR has made no significant contribution to domestic English law in the arena of healthcare provision. The decision of the European (...) Court in the Yvonne Watts case establishes that, in relation to the question of entitlement to seek treatment abroad at the expense of the NHS, a clinical judgment about the urgency of treatment trumps an administrative decision about waiting list targets. That decision goes against the grain of domestic law about healthcare allocation, but is not likely to have wide ramifications in domestic law. (shrink)

A defining characteristic of Alzheimer’s disease is difficulty in retrieving semantic memories, or memories encoding facts and knowledge. While it has been suggested that this impairment is caused by a degradation of the semantic store, the precise ways in which the semantic store is degraded are not well understood. Using a longitudinal corpus of semantic fluency data, we derive semantic network representations of patients with Alzheimer’s disease and of healthy controls. We contrast our network-based approach with analyzing fluency data with (...) the standard method of counting the total number of items and perseverations in fluency data. We find that the networks of Alzheimer’s patients are more connected and that those connections are more randomly distributed than the connections in networks of healthy individuals. These results suggest that the semantic memory impairment of Alzheimer’s patients can be modeled through the inclusion of spurious associations between unrelated concepts in the semantic store. We also find that information from our network analysis of fluency data improves prediction of patient diagnosis compared to traditional measures of the semantic fluency task. (shrink)

Each Local Research Ethics Committee (LREC) is expected to produce an annual report for its establishing authority. Reports from 145 LRECs were examined with regard to (a) whether the committees were working within the terms of the most recent guidelines from the Department of Health and (b) observations on the role of LRECs with particular reference to accountability. Most LRECs had produced a report, although their length varied greatly. Most reports showed how seriously the committee took its task. Most committees (...) met many of the guidelines; for example, almost all had two or more lay-members. The guideline most frequently not met was that committees should have no more than 12 members. Many committees review very large numbers of projects (maximum 351). Approximately two-thirds provide details in the annual report of individual project titles, their author and the committee decision; all reports should contain this information. Although it may in fact happen more generally, only 23 per cent of the reports referred to any form of monitoring of the eventual outcome of the research. A significant issue to arise from the reports is the extent to which the framework for the operation of LRECs has been confused by the development of the purchaser-provider split. The paper concludes with suggestions for remedying the situation. (shrink)

The argument is that (1) the spiritual crisis that Zhu Xi discussed with Zhang Shi 張栻 (1133–1180) and the other “gentlemen of Hunan” from about 1167 to 1169, which was resolved by an understanding of what we might call the interpenetration of the mind’s stillness and activity (dong-jing 動靜) or equilibrium and harmony (zhong-he 中和), (2) led directly to his realization that Zhou Dunyi’s thought provided a cosmological basis for that resolution, and (3) this in turn led Zhu Xi to (...) understand (or construct) the meaning of taiji in terms of the polarity of yin and yang; i.e. the Supreme Polarity as the most fundamental ordering principle (li 理). (shrink)

As human beings age, they become weak, fragile, and feeble. It is a slowly progressing yet complex syndrome in which old age or some disabilities are not prerequisites; neither does loss of human parts lead to frailty among the physically fit older persons. This paper aims to describe the influences of transhumanist perspectives on human‐technology enhancements and replacements in the transcendence of human frailties, including those of older persons, in which technology is projected to deliver solutions toward transcending these frailties. (...) Through technologies including genetic screening and other technological manipulations, intelligent machines and augmented humans improve, maintain, and remedy human‐linked susceptibilities. Furthermore, other technologies replace parts fabricated through inorganic‐mechanical processes such as 3D‐printing. Advancing technologies are reaching the summit of technological sophistication contributing to the transhumanist views of being human in a technological world. Technologies enhance the transcendence of human frailties as essential expressions of the symbiosis between human beings and technology in a transcendental world. (shrink)

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further (...) questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined. (shrink)

ABSTRACT For changing opinion, represented by an assignment of probabilities to propositions, the criterion proposed is motivated by the requirement that the assignment should have, and maintain, the possibility of matching in some appropriate sense statistical proportions in a population. This ‘tracking’ criterion implies limitations on policies for updating in response to a wide range of types of new input. Satisfying the criterion is shown equivalent to the principle that the prior must be a convex combination of the possible posteriors. (...) Furthermore, this is equivalent to the requirement that prior expected values must fall inside the range spanned by possible posterior expected values. The tracking criterion is liberal; it allows for, but does not require, a policy such as Bayesian conditionalization, and can be offered as a general constraint on policies for managing opinion over time. Examples are given of non-Bayesian policies, both ones that satisfy and ones that violate the criterion. _1_ Introduction _2_ Alternative Updating Policies _3_ Modelling the Situation for Normal Updating _4_ Tracking: A Criterion for Updating Policies _5_ Tracking: Precise Formulation and Relation to Convexity _6_ The Spanning Criterion _7_ Non-Bayesian Policies that Satisfy the Spanning and Tracking Criteria _8_ Policies that Violate the Spanning and Tracking Criteria Appendix Appendix. (shrink)

We examined how the cultural dimension of universalism–particularism influences managers’ attitudes toward relational favoritism. Paradoxically, we found in a survey study that Brazilian and Chinese managers perceived more negative consequences of relational favoritism than did American managers—even though the Brazilians and the Chinese perceived stronger particularistic cultural norms in their countries than Americans did in the United States. We attribute this pattern of results to “cultural reflexivity”—the ability of people from transforming economies to be culturally self-critical during a period of (...) dramatic societal change. This pattern of results also emerged in a scenario study in which we asked these same Brazilian, Chinese, and American participants to assess managerial succession decisions made by a General Manager. We varied the scenarios so that the promoted manager was either a colleague with no pre-existing relation with the GM or a colleague who was a relative, a close friend, from the same town, or from the same school. Consistent with the results of the survey study, we found that perceived cultural norms of particularism were negatively related to perceptions of fairness. In other words, Brazilians and Chinese, even while living in more particularistic cultures, were more harsh in judging relational favoritism. We conclude with a discussion on the implications of these paradoxical relationships. (shrink)

For changing opinion, represented by an assignment of probabilities to propositions, the criterion proposed is motivated by the requirement that the assignment should have, and maintain, the possibility of matching in some appropriate sense statistical proportions in a population. This ‘tracking’ criterion implies limitations on policies for updating in response to a wide range of types of new input. Satisfying the criterion is shown equivalent to the principle that the prior must be a convex combination of the possible posteriors. Furthermore, (...) this is equivalent to the requirement that prior expected values must fall inside the range spanned by possible posterior expected values. The tracking criterion is liberal; it allows for, but does not require, a policy such as Bayesian conditionalization, and can be offered as a general constraint on policies for managing opinion over time. Examples are given of non-Bayesian policies, both ones that satisfy and ones that violate the criterion. 1 Introduction2 Alternative Updating Policies3 Modelling the Situation for Normal Updating4 Tracking: A Criterion for Updating Policies5 Tracking: Precise Formulation and Relation to Convexity6 The Spanning Criterion7 Non-Bayesian Policies that Satisfy the Spanning and Tracking Criteria8 Policies that Violate the Spanning and Tracking Criteria AppendixAppendix. (shrink)

This essay has three main goals: to introduce and somewhat contextualize the papers that follow; to bring out some implicit dialogues among them; and, in order to encourage further discussion in future issues of the Journal of Consciousness Studies, to introduce some new perspectives, including the historical development of Western art, cognitive linguistics, and the sacred. The remarks pertaining to the third goal are necessarily personal, and should not be confused with Journal of Consciousness Studies editorial policy, except insofar as (...) their goal is to promote debate across the gap that separates the sciences and the humanities -- the ‘two cultures'. This gap was perhaps first pointed out in the late 1950s by C.P. Snow, who was noted as both a novelist and scientist. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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In lieu of an abstract, here is a brief excerpt of the content:Dependent Co-Origination and Universal IntersubjectivityJoseph A. Bracken, SJTwo essays in a recent issue of Buddhist-Christian Studies dealt with the topic "Buddhist and Christian Views of Community." The first essay, by Rita Gross, was a careful analysis of the way in which the separation of home and workplace in contemporary Western society has tended to reduce effective community life to the nuclear family and thus pose significant disadvantages to everyone (...) involved (not only mothers, fathers, and their children but also non–family members, friends, and neighbors) within the broader civic community.1 A consumer-oriented culture catering to individual needs and desires has arisen to compensate for the pervasive feeling of loneliness and emptiness created by the relative lack of significant interpersonal relationships. In the second essay Donald Mitchell recounted the origin and unexpected growth of the International Focolare movment of which he is a longtime member.2 He noted how the founder of the movement, Chiara Lubich, and her women friends found inspiration for living together and working for the poor and the homeless around them in what they saw as the self-giving love of the three divine persons of the Christian doctrine of the Trinity both for one another and for all their creatures. This movement over time broadened to include first Protestant members, then Jews, Muslims, Buddhists, and Hindus, all drawn by the goal of richer life in community along with group efforts to assist the underprivileged of this world.My own contribution to the topic of Buddhist and Christian views of community will focus on the same communitarian model of the doctrine of the Trinity that originally inspired Lubich and her followers in the years during and after World War II, but my remarks will be more philosophically oriented. Following the lead of the late Colin Gunton in his book The One, the Three and the Many,3 I will analyze the communitarian model of the Trinity for its value in setting forth a new paradigm for the relationship of the One and the Many. As Gunton perceptively notes in the early chapters of his book, Western civilization seems to be still preoccupied with a basically Platonic understanding of the One and the Many in which the One enjoys primacy over the Many as their transcendent principle of order and intelligibility.4 As a result, even though freedom and individual self-expression are theoretically prized in Western societies, in point of [End Page 3] fact there is a great deal of uniformity and even repression of individual differences so as to conform to the cultural standards imposed by some dominant individual or minority group within each society. In the end people seem to fear the threat to personal security represented by wide diversity and plurality more than they value their individual liberty.Looking to the doctrine of the Trinity set forth by the Greek-speaking fathers of the Church, however, Gunton finds a new paradigm for the One and the Many whereby the One is emergent out of the interplay of the Many with one another rather than transcendent over the Many as their necessary principle of order and intelligibility.5 The Many are defined by their internal relations to one another rather than by their common relation to an external One. The community thus achieved is a differentiated unity, not only tolerating differences of the Many among themselves, but even fostering those differences so as to produce in the end a more complex form of community. The application to the Christian doctrine of the Trinity is obvious. The three divine persons are strictly defined with respect to one another; each of them has no self-identity apart from relation to the other two persons. Yet together they co-constitute the reality of the one God, a richly differentiated rather than blandly homogeneous unity.6The application to human beings and their membership in various communities, of course, is not so obvious. But Gunton believes that three principles or "transcendentals" for the understanding of the relation of human beings with one another and with God are at hand, given careful study of this communitarian model of the Trinity: namely, perichoresis, substantiality or... (shrink)

The paper attempts to schematize, in the form of abductive inferences, the major changes in the developing picture of the atom during the modem period of scientific investigation. The aim of this presentation is to enable students in logic or the philosophy of science to see how a sustained application of abduction might be seen as operative in the development of changing conceptions of the atom, a development which may well be seen as a scientific revolution. The sustained example also (...) illustrates, in pedagogic fashion, the role of images in abduction, the theory-observation distinction, and the analytic-synthetic distinction. (shrink)

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role (...) of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances. (shrink)