Professor Lauer at the beginning of his book makes clear what he is doing by indicating what he is not doing. He is not giving a commentary, like Hyppolite, nor a genial discussion of the issue, like Lowenberg. Lauer’s is a reading of the Phenomenology, not the only reading or even the best reading, but a plausible one that he hopes will spare others the tortures he himself had to go through in understanding Hegel and that will facilitate one’s own (...) reading of this difficult work. In the opinion of this reviewer, Lauer largely succeeds in his project. (shrink)

Organ donation after the circulatory determination of death requires the permanent cessation of circulation while organ donation after the brain determination of death requires the irreversible cessation of brain functions. The unified brain-based determination of death connects the brain and circulatory death criteria for circulatory death determination in organ donation as follows: permanent cessation of systemic circulation causes permanent cessation of brain circulation which causes permanent cessation of brain perfusion which causes permanent cessation of brain function. The relevant circulation that (...) must cease in circulatory death determination is that to the brain. Eliminating brain circulation from the donor ECMO organ perfusion circuit in thoracoabdominal NRP protocols satisfies the unified brain-based determination of death but only if the complete cessation of brain circulation can be proved. Despite its medical and physiologic rationale, the unified brain-based determination of death remains inconsistent with the Uniform Determination of Death Act. (shrink)

In this interview, James L. McClelland responds to questions regarding connectionist models of cognition, a theory inspired by information processing in the brain. McClelland explains the distinction between symbolic and non-symbolic processing for a better understanding of mental processes. He argues that connectionist models can perform the computations which we know the brain can perform. In addition, he responds to several general questions on the perspectives of computational models of cognition.

Scepticism about ought simpliciter is the view that there is no such thing as what one ought simpliciter to do. Instead, practical deliberation is governed by a plurality of normative standpoints, each authoritative from their own perspective but none authoritative simpliciter. This paper aims to resist such scepticism. After setting out the challenge in general terms, I argue that scepticism can be resisted by rejecting a key assumption in the sceptic’s argument. This is the assumption that standpoint-relative ought judgments bring (...) with them a commitment to act in accordance with those judgments. Instead, I propose an alternative account of our normative concepts according to which only ought simpliciter judgments commit one to acting in accordance with those judgments. In addition to answering the sceptical challenge, the proposal offers an independently motivated account of what makes a concept normatively authoritative. (shrink)

Metaethical expressivism is typically characterised as the view that normative statements express desire-like attitudes instead of beliefs. However, in this paper I argue that expressivists should claim that normative statements express beliefs in normative propositions, and not merely in some deflationary sense but in a theoretically robust sense explicated by a theory of propositional attitudes. I first argue that this can be achieved by combining an interpretationist understanding of belief with a nonfactualist view of normative belief content. This results in (...) a view I call ‘interpretative expressivism’. I then argue that traditional arguments employed by expressivists that normative statements express noncognitive attitudes can just as well support the claim that normative statements express nonfactual or nonrepresentational beliefs. Finally, I argue that this view has a number of advantages to versions of expressivism that deny that normative statements express non-deflationary normative beliefs. (shrink)

This paper examines the general prospects for conceptual role expressivism, expressivist theories that embrace conceptual role semantics. It has two main aims. The first aim is to provide a general characterisation of the view. The second aim is to raise a challenge for the general view. The challenge is to explain why normative concepts are not a species of defective concepts, where defective concepts are those that cannot meaningfully embed and participate in genuine inference. After rejecting existing attempts to answer (...) the challenge, I propose an alternative solution. However, the solution leaves conceptual role expressivism a far less distinctive and interesting position than its proponents claim. I conclude that we should be sceptical about how much expressivists gain by appealing to conceptual role semantics. (shrink)

Expressivists about normative thought and discourse traditionally deny that there are nondeflationary normative propositions. However, it has recently been suggested that expressivists might avoid a number of problems by providing a theory of normative propositions compatible with expressivism. This paper explores the prospects for developing an expressivist theory of propositions within the framework of cognitive act theories of propositions. First, I argue that the only extant expressivist theory of cognitive propositions—Michael Ridge's ‘ecumenical expressivist’ theory—fails to explain identity conditions for normative (...) propositions. Second, I argue that this failure motivates a general constraint—the ‘unity requirement’—that any expressivist theory of propositions must provide a unified nonrepresentational explanation of that in virtue of which propositional attitudes have the content that they have. Third, I argue that conceptual role accounts of content provide a promising framework in which to develop an expressivist theory of cognitive propositions. (shrink)

Abstract:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)

Over the past quarter century, organ donation after the circulatory determination of death (DCD) has grown in acceptance and prevalence throughout the world (Domínguez-Gil et al. 2021). Notwithstan...

Nair-Collins and Joffe (2023) highlighted the noncongruence between the language of the Uniform Determination of Death Act (UDDA) and the accepted brain death bedside testing standard by showing th...

Ariane Lewis provided an insightful review of several controversial cases of death by neurologic criteria (“brain death”) in the UK, focusing on Archie Battersbee, a boy whose tragic illness provok...

The shape of a life hypothesis holds that the temporal sequence of good or bad times in a life can itself be a valuable feature of that life. This is generally thought to be incompatible with additivism about lifetime well-being, which holds that lifetime well-being is fully determined by momentary well-being. This discussion examines Dale Dorsey’s recent argument that these views are in fact compatible. I argue that accepting the conjunction of these views requires stronger commitments than Dorsey recognizes. After (...) arguing that these commitments are problematic, I conclude that we should reject the compatibility claim. (shrink)

Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that (...) paralleled advances in intensive care unit treatment. The century‐old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death. (shrink)

This paper examines the integration and unification of the philosophy and psychology of well-being. For the most part, these disciplines investigate well-being without reference to each other. In recent years, however, with the maturing of each discipline, there have been a growing number of calls to integrate the two. While such calls are welcome, what it means to integrate well-being philosophy and psychology can vary greatly depending on one’s theoretical and practical ends. The aim of this paper is to provide (...) a novel conceptual framework for thinking about integrating well-being philosophy and psychology that systematically categorizes different kinds of integration projects. We divide existing attempts in the literature into three broad categories according to the perspective from which the integration takes place: (1) top-down meta-theoretical unification; (2) psychological integration within philosophy; and (3) philosophical integration within psychology. These categories are then broken down into various further subcategories. Our aim in providing this framework is both to facilitate the assessment and comparison of existing integration attempts and to provide a roadmap for future integration attempts. For each category, we discuss one or two representative examples of the approaches. By doing so, we hope to generate interest in the wide variety of existing integration projects, as well as to generate discussion concerning the benefits and pitfalls of different approaches. (shrink)

After his father passed away, James Nolan's mother gave him a box of materials that his dad had kept private. To Nolan's complete surprise, the contents revealed the role his grandfather had played as a doctor in the Manhattan Project. Dr. Nolan, it turned out, had been a significant figure. A talented radiologist, he cared for the scientists on the Project, helped organize the safety and evacuation plans for the Trinity Test at Alamogordo, escorted the "Little Boy" bomb from (...) Los Alamos to Japan, and was one of the first Americans to enter the irradiated ruins of Hiroshima and Nagasaki. The documents set Nolan on a hunt for more information about his grandfather and more generally about the conflicted role that medical personnel played in the early years of atomic testing. The result is a compelling history of the dawn of the atomic age as seen through the eyes of men and women torn between their duty and desire to win the war and their oath to protect life. Nolan follows his grandfather and medical colleagues as they seek to maximize safety while serving leaders determined to minimize delays, and as they consider the ethics of ending the deadliest of all wars with the most lethal of all weapons. The result, Nolan shows, was a very human pattern of caution, co-optation, and complicity. A vital and vivid account of a largely unknown chapter in atomic history, Delivering Little Boy is also a profound meditation on the professional and moral dilemmas that ordinary people face in extraordinary times. (shrink)

'The interpretours of Plato,' wrote Sir Thomas Elyot in The Governour, 'do think that the wonderful and incomprehensible order of the celestial bodies, I mean sterres and planettes, and their motions harmonicall, gave to them that intensifly and by the deepe serche of raison beholde their coursis, in the sondrye diversities of number and tyme, a forme of imitation of a semblable motion, which they called daunsigne or sltation.' The image of the planets and stars engaged in an ordered and (...) measured dance is an ancient one. Plato articulated it in a passage in the Timaeus, where he likened the apparent motions of the planets and stars to 'choreiai'. Through the centuries the analogy has challenged Plator's interpreters to define and elaborate the image. Miller has examined a range of poetic and philosophical texts influenced by Plato cosmology, and has discovered frequent comparisons of the cosmic order to 'daunsigne.' He suggests that the vision of the cosmic dance did not develop at random in Western intellectual history but originated in a specific philosophical context and passed through stages of evolution that reflect Gnostic, Christian, Stoic, and Neoplatonic responses to Plato. He argues that the historical variations of the image were often closely related to adaption or criticisms of Plato's theories of visual perception and intellectual vision. The dance, in conjunction with images such as the Great chain of Being and the Lyre of the Heavens, became the dominant image of a peculiarly Late Antique world-view which Miller has called the 'poetic universe'; a world where metaphors, metonymies, and personifications could exist in fact as well as in word. The result of Miller's analysis is vast in scope. The nine chapters of the book each present a thesis on a particular author, but all function together like links in a chain. Miller has been described as 'an historian of visions'; the book has been likened to Auerbach's Mimesis. It is a remarkable contribution to an understanding of the complex interaction of ideas and images in time. (shrink)

This paper compares the preface of Columella’s Res rustica with that of the earliest fully extant Chinese agricultural treatise, the Qimin yaoshu (‘Essential Techniques for the Common People’) of Jia Sixie. I argue that both prefaces have a similar function: to present to the reader the social world in which the author wishes his agricultural work to be understood. By drawing on authoritative literary and historical traditions, each author projects an idealized vision of farming in which the discipline acquires a (...) deep moral significance. Granting these striking similarities, the authors’ views also diverge in certain illuminating respects: these include the moral agency of agriculture, the social location of expertise, and the historical development of agriculture in relation to society. (shrink)

The locked-in syndrome is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple (...) medical decisions but not for consequential medical decisions such as whether to refuse further life-sustaining therapy. Emerging technologies including computer-tracking assistance of retained partial motor function and brain-computer interfaces promise to improve the communication ability of LIS patients and, when better developed, will allow them to fully exercise their right to actively participate in consequential medical decisions about their own medical care. Although so-called “covert cognition” patients clinically diagnosed as vegetative state that are shown to be aware by functional neuroimaging maybe metaphorically considered locked-in, it is nosologically more coherent not to categorize them formally as LIS. (shrink)

This paper explores the place of evil in Plato’s thought through the lens of the Philebus. I show that the concept of evil in this dialogue is in broad agreement with the classic Christian position which accents metaphysically its privative and derivative character and morally its rebellious and self-oriented character. The entryway into the issue is 29d9–e1, where a “power of dissolution” is proposed in addition and opposition to the power of generation and mixture, and then quickly rejected. Such a (...) power would be both metaphysically and ethically subversive, or in short, evil. Plato appears to suppress the possibility of evil, but in fact, he relocates the power of dissolution within the unlimited genos in order to show its necessary subordination to and dependence on the limiting and causal principles within generated beings. Evil, on a metaphysical level, is subject to good. On an ethical level, however, the possibility of subversion remains and is exemplified in the dialogue in the radical hedonism of Philebus. After showing how hedonism manifests the power of dissolution in human life, I conclude by remarking the ultimate practical proof towards which this dialogue, and others, points in defense of its claims. (shrink)

This paper explores a possible Platonic grounding of human freedom in the Philebus. The Philebus presents a particularly intruiging account of the humangood and freedom alike in terms of the right relation of nous and pleasure. Through a close analysis of key passages in this dialogue I show how Plato conceives of freedom in terms of the intellect’s ordering and directing of desire and pleasure to genuinely fulfilling ends. The greatest fulfillment of desire comes together with the purest pleasure in (...) the highest actualization of reason in lifelong philosophic activity: the mixed life and good life for human beings. (shrink)

Despite the popularity, success, and growth of programs of organ donation after the circulatory determination of death (DCDD), a long‐standing controversy persists over whether the organ donor is truly dead at the moment physicians declare death, usually following five minutes of circulatory and respiratory arrest. Advocates of the prevailing death determination standard claim that the donor is dead when declared because of permanent cessation of respiration and circulation. Critics of this standard argue that while the cessation of respiration and circulation (...) may be permanent, it may not be irreversible at the moment death is declared because, if cardiopulmonary resuscitation were performed, it might succeed. And because irreversibility of cessation of respiration and circulation is required by both the statute and the biological concept of death, the donor must be alive. Who is correct?Making two related distinctions clarifies the cause of the disagreement over whether the DCDD donor is dead and points to a possible resolution. First, in a determination of death, there is an important distinction between the permanent and the irreversible cessation of circulation and respiration—two associated phenomena that are often confounded. Second, there is an important distinction between the medical practice standard for death determination, in which physicians certify the permanent cessation of vital functions as sufficient for death declaration, and the underlying biological concept of death that requires the irreversible cessation of vital functions because death, by definition, is an irreversible event. (shrink)

Pre-existing medical conditions and co-infections are common to all human populations, although the natures of the pre-existing conditions and the types of co-infections vary. For these reasons, among others, the arrival of a highly infectious pathogenic agent may differentially affect the disease burden in different sub-populations, as a function of varying combinations of endemic disease, chronic disease, genetic or epigenetic vulnerabilities, compromised immunological status, and socially determined risk exposure. The disease burden may also vary considerably by age cohort and socio-economic (...) status. The social consequences of infection, the medical sequelae, and the paths of recovery from infection may also vary, according to these variables. As a result, different sub-populations may have different experiences of a disease process, including when and how an epidemic comes to an end. This essay suggests that historians' engagement with path-breaking biological and medical anthropological research will allow new approaches to understanding disease processes that will enrich the study of epidemics and their endings. It is organized in three sections. The first discusses some general approaches to and assumptions about epidemics that are used by many historians. The second introduces new perspectives on the study of historical epidemics opened up by the medical anthropological concept of syndemic disease interactions and by an engagement with biological scientific perspectives. It briefly discusses two rural epidemics-one of anemia caused by the syndemic interaction of hookworm and malaria co-infections in early 20th-century British Malaya, and the other of rebound infections caused by the loss of acquired immunity to falciparum malaria in mid-20th-century Liberia-that illustrate, respectively, the utility of the concept of syndemic disease interactions and the centrality of immunological status in understanding epidemic outbreaks in these discrete populations. The third section addresses some of the research considerations involved in moving beyond the single pathogen model of epidemic disease. (shrink)

The leaders of many prominent health and mental health organizations have issued policy statements about the appropriateness of members of their professions being involved in assisted suicide, whether assisted suicide is ever an acceptable option for people, and what roles a professional can or should play when a client is considering assisted suicide. This article argues that only the latter focus-providing suggestions about how a professional can assist a person considering hastening death-is appropriate for an organization whose members are clinical (...) practitioners rather than theorists. The former 2 positions, it is contended, are merely political posturing and are counterproductive to providing proper care to clients in need. (shrink)

Book reviewed in this article: Animal Experimentation: The Moral Issues. Edited by Robert M. Baird and Stuart E. Rosenbaum.

This paper contends that, even though Husserl demonstrated that consciousness intends objects in the world rather than mental representations, he ultimately failed to provide a convincing account of how the ego constitutes itself and other egos. By reconfiguring consciousness as an operation rather than as a container, Husserl opened consciousness to the world and thereby overcame previous solipsistic frameworks. But despite his attention to the “things themselves,” his fidelity to another maxim—that all sense-bestowing activity be traced back to the operations (...) of the ego—prohibited him from fulfilling his goal of describing otherness accurately. This paper examines the tension between Husserl’s desire to describe phenomena and his mandate to constitute phenomena, to show that both cannot be accomplished simultaneously. If phenomenology is to come to terms with the challenge of otherness and describe self and other adequately, the demand that self and other be constituted within the ego must be relinquished. (shrink)