There is an inconsistency in the ways that doctors make clinical decisions regarding the treatment of babies born extremely prematurely. Many experts now recommend that clinical decisions about the treatment of such babies be individualized and consider many different factors. Nevertheless, many policies and practices throughout Europe and North America still appear to base decisions on gestational age alone or on gestational age as the primary factor that determines whether doctors recommend or even offer life-sustaining neonatal intensive care treatment. These (...) policies are well intentioned. They aim to guide doctors and parents to make decisions that are best for the baby. That is an ethically appropriate goal. But in relying so heavily on gestational age, such policies may actually do the babies a disservice by denying some babies treatment that might be beneficial and lead to intact survival. In this paper, we argue that such policies are unjust to premature babies and ought to be abolished. In their place, we propose individualized treatment decisions for premature babies. This would treat premature babies as we treat all other patients, with clinical decisions based on an individualized estimation of likelihood that treatment would be beneficial. (shrink)

Coronavirus disease 2019 can lead to respiratory failure. Some patients require extracorporeal membrane oxygenation support. During the current pandemic, health care resources in some cities have been overwhelmed, and doctors have faced complex decisions about resource allocation. We present a case in which a pediatric hospital caring for both children and adults seeks to establish guidelines for the use of extracorporeal membrane oxygenation if there are not enough resources to treat every patient. Experts in critical care, end-of-life care, bioethics, and (...) health policy discuss if age should guide rationing decisions. (shrink)

A recent American Academy of Pediatrics (AAP) clinical report states that it is an acceptable option for pediatric care clinicians to dismiss families who refuse vaccines. This is a clear shift in guidance from the AAP, which previously advised clinicians to “endeavor not to discharge” patients solely because of parental vaccine refusal. While this new policy might be interpreted as encouraging or recommending dismissal of vaccine-refusing families, it instead expresses tolerance for diverse professional approaches. This is unlike the earlier guidance, (...) which promoted a unified response to vaccine refusal. In fact, the resolution (which was presented at the AAP’s Annual Leadership Forum) that led to this clinical report also calls on the AAP “to continue to support pediatricians who continue to provide health care to children of parents who refuse to immunize their children.” However, the shift toward embracing dismissal as an acceptable response to vaccine refusal may erode professional solidarity. Pediatricians are clearly divided on this question; most do not dismiss vaccine-refusing families. By declaring that dismissal is an acceptable option, the AAP has sanctioned a practice that may be unfair to the many clinicians who do not dismiss these families. Clinicians who adopt a policy of dismissal toward families who refuse vaccines might impose burdens on colleagues who remain willing to offer care to those families, and their actions might show insufficient commitment to the efforts of their profession to promote health for all children. (shrink)

Marshall and O’Leary’s thoughtful response to our article suggests that dismissal policies are ethically justifiable because they might induce parents to immunize their children. This outcome is conceivable, but we have only anecdotes about how often it occurs. Such evidence became the thin reed on which the American Academy of Pediatrics rested its new policy of tolerating the practice of dismissing vaccine-hesitant parents. It seems likely that relatively few parents would agree to vaccinate because they were threatened with dismissal. Other (...) heavy-handed interventions have failed to move most such parents. When Washington state made nonmedical exemptions more difficult to obtain, nearly two-thirds of vaccine refusers were unmoved and their children remained unvaccinated. Even if dismissal threats led some parents to accept vaccines, this alone would not justify a dismissal policy. The benefits would still have to be weighed against the risks of dismissing those families who do not change their minds. (shrink)

Parents respond to the death of a child in very different ways. Some parents may be violent or angry, some sad and tearful, some quiet and withdrawn, and some frankly delusional. We present a case in which a father’s reaction to his daughter’s death is a desire to protect his wife from the stressful information. The wife is in the second trimester of a high-risk pregnancy and so is particularly fragile. We asked pediatricians and bioethicists to discuss the ways in (...) which they might respond to the father’s understandable but troubling request. -/- The death of a young child is one of the most stressful events that can happen to parents. The stress of such a loss is compounded if the parents are in a foreign country, far from home, and without a network of family and friends to provide social support. The stress may be more difficult to deal with if the parents have acute health problems of their own. In this month’s “Ethics Rounds,” we present a case in which a father whose daughter died requested that the doctors delay telling his wife. His reason: She is pregnant, in the second trimester, and on bed rest because of preterm labor. He does not want to add to her stress. We asked both pediatricians and bioethicists to respond to this request. (shrink)

In this article, we first review the development of clinical ethics in pediatrics in the United States. We report that, over the last 40 years, most children’s hospitals have ethics committees but that those committees are rarely consulted. We speculate that the reasons for the paucity of ethics consults might be because ethical dilemmas are aired in other venues. The role of the ethics consultant, then, might be to shape the institutional climate and create safe spaces for the discussion of (...) difficult and sometimes contentious issues. Finally, we report how pediatric clinical ethics has evolved differently in a number of other countries around the world. (shrink)

A commentary on “Were There ‘Additional Foreseeable Risks’ in the SUPPORT Study?,” by Henry J. Silverman and Didier Dreyfuss; “SUPPORT: Risks, Harms, and Equipoise,” by Robert M. Nelson; “The Controversy over SUPPORT Continues and the Hyperbole Increases,” by Alan R. Fleischman; and “SUPPORT and Comparative Effectiveness Trials: What's at Stake?,” by Lois Shepherd, all in the January‐February 2015 issue.

Liver transplantation is the treatment of choice for many forms of liver disease. Unfortunately, the scarcity of cadaveric donor livers limits the availability of this technique. To improve the availability of liver transplantation, surgeons have developed the capability of removing a portion of liver from a live donor and transplanting it into a recipient. A few liver transplants using living donors have been performed worldwide.Our purpose was to analyze the ethics of liver transplants using living donors and to propose guidelines (...) for the procedure before it was introduced in the United States. We used a process of research ethics consultation that involves a collaboration between clinical investigators and clinical ethicists. We concluded that it was ethically appropriate to perform liver transplantation using living donors in a small series of patients on a trial basis, and we published our ethical guidelines in a medical journal before the procedure was introduced. We recommend this prospective, public approach for the introduction of other innovative therapies in medicine and surgery. (shrink)

This chapter addresses the issues that motivate representationalist accounts, and it describes the different versions of representationalism as responses to these issues. It argues that the representationalist views do not adequately respond to the epistemological problems that motivate them and that they engender some ontological problems. The chapter presents an alternative ‘presentationalist’ account that preserves the straightforward sense of the mind's openness to the world. While representationalism and presentationalism agree that the relation between mental events or states is direct but (...) mediated, they radically differ in their views of the nature of the mediation involved in the mind's intentional directedness to the world. This difference and the preferability of the presentationalist account are explored. (shrink)

Charles S. Peirce, William James, Josiah Royce, George Santayana, John Dewey, and George Herbert Mead: each of these individuals is an original and historically important thinker; each is an essential contributor to the period, perspective, and tradition of classical American philosophy; and each speaks directly, imaginatively, critically, and wisely to our contemporary global society, its distant possibilities for improvement, and its massive, pressing problems. From the initiative of pragmatism in approximately 1870 to Dewey's final work after World War II, (...) classical American philosophy has come to represent the critical articulation of attitudes, outlooks, and forms of life imbedded in the culture from which it arose. John Stuhr brings together the works of these foremost thinkers to present a comprehensive collection in American philosophy. Extensive introductory essays, written especially for this volume by leading scholars of the subject, provide not only the bibliographical and cultural contexts necessary to a full appreciation of each thinker, but also original critical and interpretive philosophical observations. (shrink)

Here, in a single volume, is a comprehensive and definitive account of pragmatism and classical American philosophy. Pragmatism and Classical American Philosophy, now revised and expanded in this second edition, presents the essential writings of the major philosophers of this tradition: Charles S. Peirce, William James, Josiah Royce, George Santayana, John Dewey, and George Herbert Mead. Illuminating introductory essays, written especially for this volume by distinguished scholars of American philosophy, provide biographical and cultural context as well as original critical (...) and interpretive perspectives. This edition also includes all new selections and interpretive essays that situate pragmatism and classical American philosophy in a wider American philosphical context, including: Ralph Waldo Emerson and transcendentalism; Jane Addams, feminism, and writings of American women; Borden Parker Bowne, personalism, and idealism; Alain Locke and Afro-American thought; and John Herman Randall, Jr., nationalism and realism. Up-to-date suggestions for further reading will benefit both introductory and advanced readers. This American intellectual tradition speaks insightfully, creatively, and critically to our contemporary global society and its pressing problems. In unmatched quality and quantity, Pragmatism and Classical American Philosophy provides the resources necessary to understand and act on these insights. (shrink)

Pragmatism, Postmodernism and the Future of Philosophy is a vigorous and dynamic confrontation with the task and temperament of philosophy today. In this energetic and far-reaching new book, Stuhr draws persuasively on the resources of the pragmatist tradition of James and Dewey, and critically engages the work of Continental philosophers like Adorno, Foucault, and Deleuze, to explore fundamental questions of how we might think and live differently in the future. Along the way, the book addresses important issues in public policy, (...) university administration, spirituality, and the notion of community and its meaning in a global world of difference. This book is essential reading for anyone concerned with the future of philosophy, and the ways in which philosophical thinking can help us live better, more fulfilling lives. (shrink)

[If you find this article interesting, let me mention another of my articles, “On Deducing Ethical Egoism from Psychological Egoism” (Theoria, 2023), which in many ways is a more thorough treatment of the topic. But it’s not an expanded version of this one. For instance, each article addresses arguments not addressed in the other.] Philosophers generally reject the view that psychological egoism (suitably supplemented with further premises) entails ethical egoism. Their rejections are generally unsatisfying. Some are too brief to win (...) confidence; others employ an uncharitable statement of psychological egoism. This is unfortunate, for the view that psychological egoism entails ethical egoism is philosophically significant (and not without proponents). Although it ultimately deserves rejection, it warrants better treatment than it typically receives. I thus examine it in some detail. Among other things, I carefully consider some original, sophisticated attempts to establish it, having first taken care to produce proper formulations of ethical and psychological egoism. (shrink)

In discussions of practical reason we often encounter the view that a fact is a reason for an agent to act only if the fact is capable of moving the agent to act. This view figures centrally in many philosophical controversies, and while taken for granted by some, it is vigorously disputed by others. In this essay I show that if the disputed position is correctly interpreted, it is well armored against stock objections and implied by a premise that is (...) not only plausible, but generally accepted by the position's critics. (shrink)

The adolescing self -- Imaging and fettered imaging -- Characteristics of the superego God -- Adolescing religion and formal religion -- Images of the superego God -- The adult self -- Unfettered imaging and religious experiencing -- Characteristics of the living God -- Adult religion and integral spirituality -- Images of the living God -- Transformation and why it gets so little attention -- What hinders transformation -- What facilitates transformation -- Images of transformation.

This volume is devoted entirely to exploring the role of animals in the thought of Immanuel Kant. Leading scholars address questions regarding the possibility of objective representation and intentionality in animals, the role of animals in Kant's scientific picture of nature, the status of our moral responsibilities to animals' welfare, and more.

Introduction -- Building blocks -- The old way of thinking -- The new way -- Grammar and philosophy -- The grammar of mathematics -- The grammar of experience -- The grammar of psychology -- Part II -- What does it all mean?

The question "Why should I be moral?," taken as a request for reasons to be moral, strikes many philosophers as silly, confused, or otherwise out of line. Hence we find many attempts to dismiss it as spurious. This paper addresses four such attempts and shows that they fail. It does so partly by discussing various errors about reasons for action, errors that lie at the root of the view that "Why should I be moral?" is ill-conceived. Such errors include the (...) mistake of confusing different uses of "moral reason for A to ø" and the mistake of treating as axiomatic, as in need of no argument, the view that moral considerations furnish every agent with practical reasons. Among the philosophers discussed are John Hospers, Philippa Foot, Stephen Toulmin, H. A. Prichard, and William Frankena. (shrink)

With one exception, the papers in this volume were originally presented to the Boston Area Colloquium in Ancient Philosophy during 2006-7. Five colloquia deal directly with Plato, while another discusses Heidegger's interpretation of Plato. Two colloquia deal with the Epicurean notion of preconception and with the Stoic conception of the good.

This latest BACAP Proceedings covers three key areas in ancient philosophy, ethics, method and physics. Under ethics, there are three papers on Socratic piety, Aristotelian friendship, and Augustinian-Platonic virtue. Under method, Socratic elenchos, Socratic maieutic, and Aristotelian aporematic inquiry. Under physics, life in Plato and mo.

This latest volume of _BACAP Proceedings_ contains some innovative research by international scholars on Plato, Aristotle, and Sophocles. It covers such themes as Plato on the philosopher ruler, and Aristotle on essence and necessity in science._ This publication has also been published in hardback, please click here_ for details.

This volume represents some of the activities of the Boston Area Colloquium in Ancient Philosophy from the academic year 1997-98. It contains nine colloquia that were hosted by eight different colleges and universities in the greater Boston area. Discussions of the works of Plato dominate this volume, with six of the nine colloquia based on Platonic texts. Appropriately, the colloquia begin with an analysis of division in the ancient atomists. Later, a study of truth in Aristotle gives a counterpoint to (...) the Platonic interplay of drama and pedagogy or logic and rhetoric examined in papers about the "Theaetetus" and "Symposium". A presentation of Proclus’s account of evil revisits some of the issues of sophistry and morality discussed in relation to Plato’s "Republic" and "Euthydemus". Finally, the remaining Platonic papers are in a way not about Plato at all, but about Socrates and Xanthippe, supplementing Platonic dialogues with Xenophon and others. Underneath these discussions of ancient texts current modes of philosophy run along, providing a score of alternative interpretative schemes._ This publication has also been published in paperback, please click here_ for details. (shrink)

Most of the colloquia explore important topics such as the notion of self in Plato and the relationship between sense and knowledge in Aristotle. In addition, two colloquia discuss the origins of Pyrrhonic scepticism and the themes of Seneca’s _Natural Questions_._ This publication has also been published in hardback, please click here_ for details.

This latest volume of BACAP Proceedings contains some innovative research by international scholars on Plato and Aristotle. It covers such themes as Plato on recollection and on justice, along with Aristotle on Nous and on law._ This publication has also been published in paperback, please click here_ for details.

This volume of BACAP Proceedings contains recent research by international scholars on Empedocles, Plato, Aristotle, Plotinus and some Hellenistic philosophers. It covers such topics as Epicurean methods of managing mental pain, moral nostalgia in Plato' s Republic, and empty terms in Aristotelian logic._ This publication has also been published in paperback, please click here_ for details.

This volume of the Proceedings continues the success of the Colloquium in providing a venue where a wide range of classical themes and figures is examined from the multiple perspectives of the current philosophical scene. This diversity gives the Proceedings a unique appeal to all those, philosophers and classicists, interested in the long tradition of ancient thought in both Greek and Latin._ This publication has also been published in paperback, please click here_ for details.

This volume of the Proceedings continues the success of the Colloquium in providing a venue where a wide range of classical themes and figures is examined from the multiple perspectives of the current philosophical scene. This diversity gives the Proceedings a unique appeal to all those, philosophers and classicists, interested in the long tradition of ancient thought in both Greek and Latin._ This publication is also available in hardback, please click here_ for details._ Also published as issue 1 of Volume (...) 20 of Brill Academic Publisher's journal _Boston Area Colloquium in Ancient Philosophy_. For more details on this journal, please click here_. (shrink)

This volume contains papers and commentaries originally presented to the Boston Area Colloquium in Ancient Philosophy during the 2004-5 academic year. Of the seven colloquia in the volume, two deal with Plato while the rest are dedicated to Aristotle.

This volume contains papers originally presented to the Boston Area Colloquium in Ancient Philosophy during 2005-6. Of the seven colloquia, two deal with topics in Neoplatonism, four are dedicated to Aristotle’s ethics and metaphysics, and one to Plato’s Republic.

This volume contains papers originally presented to the Boston Area Colloquium in Ancient Philosophy during 2005-6. Of the seven colloquia, two deal with topics in Neoplatonism, four are dedicated to Aristotle’s ethics and metaphysics, and one to Plato’s Republic.

A familiar claim, meant as a challenge to moral knowledge, is that we can credibly accept putative moral facts just in case they explain natural facts. This paper critically addresses Elizabeth Tropman’s response to a version of that claim. Her response has interest partly because it falls within, and extends, an influential philosophical tradition – that of trying to expose (some) skeptical challenges as spurious or ill-conceived. Also, Tropman’s target is not just any version of the claim just mentioned. It (...) is Gilbert Harman’s classic version, according to which putative moral facts must earn credibility by explaining the formation of moral beliefs. This version has wide influence, and variations of it can arise in many areas. Tropman’s response is thus well worth attention. (shrink)

This is a brief reference article on William Wollaston's moral theory, including some influential objections to it.

With one exception, the papers in this volume were originally presented to the Boston Area Colloquium in Ancient Philosophy during 2006-7. Five colloquia deal directly with Plato, while another discusses Heidegger's interpretation of Plato. Two colloquia deal with the Epicurean notion of preconception and with the Stoic conception of the good.

This volume contains papers and commentaries originally presented to the Boston Area Colloquium in Ancient Philosophy during the 2004-5 academic year. Of the seven colloquia in the volume, two deal with Plato while the rest are dedicated to Aristotle.

This latest BACAP Proceedings covers three key areas in ancient philosophy, ethics, method and physics. Under ethics, there are three papers on Socratic piety, Aristotelian friendship, and Augustinian-Platonic virtue. Under method, Socratic elenchos, Socratic maieutic, and Aristotelian aporematic inquiry. Under physics, life in Plato and mo.

This volume represents some of the activities of the Boston Area Colloquium in Ancient Philosophy from the academic year 1997-98. It contains nine colloquia that were hosted by eight different colleges and universities in the greater Boston area. Discussions of the works of Plato dominate this volume, with six of the nine colloquia based on Platonic texts. Appropriately, the colloquia begin with an analysis of division in the ancient atomists. Later, a study of truth in Aristotle gives a counterpoint to (...) the Platonic interplay of drama and pedagogy or logic and rhetoric examined in papers about the "Theaetetus" and "Symposium". A presentation of Proclus’s account of evil revisits some of the issues of sophistry and morality discussed in relation to Plato’s "Republic" and "Euthydemus". Finally, the remaining Platonic papers are in a way not about Plato at all, but about Socrates and Xanthippe, supplementing Platonic dialogues with Xenophon and others. Underneath these discussions of ancient texts current modes of philosophy run along, providing a score of alternative interpretative schemes._ This publication has also been published in paperback, please click here_ for details. (shrink)