Specialists and primary care physicians play an integral role in treating the twin epidemics of pain and addiction. But inadequate access to specialists causes much of the treatment burden to fall on primary physicians. This article chronicles the differences between treatment contexts for both pain and addiction — in the specialty and primary care contexts — and derives a series of reforms that would empower primary care physicians and better leverage specialists.
LetCbe an axiom system formalized within the first order functional calculus, and letC′ be related toCas the Bernays-Gödel set theory is related to the Zermelo-Fraenkel set theory. Ilse Novak  and Mostowski  have shown that, ifCis consistent, thenC′ is consistent. Mostowski has also proved the stronger result that any theorem ofC′ which can be formalized inCis a theorem ofC.The proofs of Novak and Mostowski do not provide a direct method for obtaining a contradiction inCfrom a contradiction inC′. We could, (...) of course, obtain such a contradiction by proving the theorems ofCone by one; the above result assures us that we must eventually obtain a contradiction. A similar process is necessary to obtain the proof of a theorem inCfrom its proof inC′. The purpose of this paper is to give a new proof of these theorems which provides a direct method of obtaining the desired contradiction or proof.The advantage of the proof may be stated more specifically by arithmetizing the syntax ofCandC′. (shrink)
Engineering ethics entails three frames of reference: individual, professional, and social. “Microethics” considers individuals and internal relations of the engineering profession; “macroethics” applies to the collective social responsibility of the profession and to societal decisions about technology. Most research and teaching in engineering ethics, including online resources, has had a “micro” focus. Mechanisms for incorporating macroethical perspectives include: integrating engineering ethics and science, technology and society (STS); closer integration of engineering ethics and computer ethics; and consideration of the influence of (...) professional engineering societies and corporate social responsiblity programs on ethical engineering practice. Integrating macroethical issues and concerns in engineering ethics involves broadening the context of ethical problem solving. This in turn implies: developing courses emphasizing both micro and macro perspectives, providing faculty development that includes training in both STS and practical ethics; and revision of curriculum materials, including online resources. Multidisciplinary collaboration is recommended 1) to create online case studies emphasizing ethical decision making in individual, professional, and societal contexts; 2) to leverage existing online computer ethics resources with relevance to engineering education and practice; and 3) to create transparent linkages between public policy positions advocated by professional societies and codes of ethics. (shrink)
Three frames of reference for engineering ethics are discussed—individual, professional and social—which can be further broken down into “microethics” concerned with individuals and the internal relations of the engineering profession and “macroethics” referring to the collective social responsibility of the engineering profession and to societal decisions about technology. Few attempts have been made at integrating microethical and macroethical approaches to engineering ethics. The approach suggested here is to focus on the role of professional engineering societies in linking individual and professional (...) ethics and in linking professional and social ethics. A research program is outlined using ethics support as an example of the former, and the issuance of position statements on product liability as an example of the latter. (shrink)
Sustainability informs the framework for a seminar that we teach for junior and senior undergraduates entitled "The Ethics and Economics of Sustainable Societies." One of the class requirements has each student research and write a life-cycle case study, an exercise in which they trace the full, or partial, life-cycle of some product with which they are familiar. Students are expected to examine the economic, ethical, and ecological implications along each step in the life-cycle of the product. We believe that life-cycle (...) cases in general are very helpful in revealing the full economic, ethical, and ecological consequences of product development, marketing, use, and disposal. We also believe that asking students to research the product themselves provides additional pedagogical benefits. After a brief review of the philosophical case for our alternative view of corporate social responsibility, we will describe the life-cycle case method, offer several examples from our own classes, and make the case for the pedagogical benefits of this approach. (shrink)
What knowledge enables Cyrus to rule easily over multitudes? Why does Xenophon convey it in a novel? Cyrus possesses knowledge of ambition’s effects in the honour-loving soul. He perceives that honour-loving men can be ensnared into abject dependence if they can be made to accept any one individual’s will as the sole source of honour; easier still is the task of ruling those far more numerous men whose love of honour is infused with or subordinated to the love of the (...) material rewards that accompany victory. Cyrus creates a hierarchy of dependence, with himself at the apex, and he rules his honour-loving followers easily, creating the institutions of an empire that endured to Xenophon’s own day. Xenophon depicts this arrangement in a historical romance, rather than describe it in a treatise, in ordermore effectively to inspire the love of virtue in his readers. (shrink)
This paper discusses collaborative learning and its use in an elective course on ethics in engineering. Collaborative learning is a form of active learning in which students learn with and from one another in small groups. The benefits of collaborative learning include improved student performance and enthusiasm for learning, development of communication skills, and greater student appreciation of the importance of judgment and collaboration in solving real-world problems such as those encountered in engineering ethics. Collaborative learning strategies employed in the (...) course include informal small group discussions/problem solving, role-playing exercises, and cooperative student group projects, including peer grading. Student response to these techniques has been highly favorable. Realizing the benefits of collaborative learning is a challenge to both teachers, who must give up some control in the classroom, and students, who must be willing to take greater responsibility for their learning. (shrink)
The literature on self-driving cars and ethics continues to grow. Yet much of it focuses on ethical complexities emerging from an individual vehicle. That is an important but insufficient step towards determining how the technology will impact human lives and society more generally. What must complement ongoing discussions is a broader, system level of analysis that engages with the interactions and effects that these cars will have on one another and on the socio-technical systems in which they are embedded. To (...) bring the conversation of self-driving cars to the system level, we make use of two traffic scenarios which highlight some of the complexities that designers, policymakers, and others should consider related to the technology. We then describe three approaches that could be used to address such complexities and their associated shortcomings. We conclude by bringing attention to the “Moral Responsibility for Computing Artifacts: The Rules”, a framework that can provide insight into how to approach ethical issues related to self-driving cars. (shrink)
Trials with highly unfavourable risk–benefit ratios for participants, like HIV cure trials, raise questions about the quality of the consent of research participants. Why, it may be asked, would a person with HIV who is doing well on antiretroviral therapy be willing to jeopardise his health by enrolling in such a trial? We distinguish three concerns: first, how information is communicated to potential participants; second, participants’ motivations for enrolling in potentially high risk research with no prospect of direct benefit; and (...) third, participants’ understanding of the details of the trials in which they enrol. We argue that the communication concern is relevant to the validity of informed consent and the quality of decision making, that the motivation concern does not identify a genuine problem with either the validity of consent or the quality of decision making and that the understanding concern may not be relevant to the validity of consent but is relevant to the quality of decision making. In doing so, we derive guidance points for researchers recruiting and enrolling participants into their HIV cure trials, as well as the research ethics committees reviewing proposed studies. (shrink)
This paper explores the concept of sustainable development and its ethical and public policy implications for engineering and multinational corporations. Sustainable development involves achieving objectives in three realms: ecological (sustainable scale), economic (efficient allocation) and social (just distribution). While movement toward a sustainable society is dependent upon satisfying all three objectives, questions of just distribution and other questions of equity are often left off the table or downplayed when engineers and corporate leaders consider sustainable development issues. Indeed, almost all the (...) effort of engineers and engineering organizations on the issue of sustainable development has been focused on striking a balance between economic development and environmental protection. Similarly, corporate approaches rely on technological fixes to the challenges posed by sustainable development. While there have been some efforts aimed at incorporating environmental and social equity concepts into engineering codes of ethics, social concerns have been secondary to environmental issues. The incongruity between the ideal of sustainable development and the way in which it is typically characterized by the engineering and business communities has significant implications for engineering and public policy, engineering ethics, and the potential roles of engineers and multinational corporations as facilitators of a transition to a sustainable society. (shrink)
The Rainbow Ramsey Theorem is essentially an "anti-Ramsey" theorem which states that certain types of colorings must be injective on a large subset (rather than constant on a large subset). Surprisingly, this version follows easily from Ramsey's Theorem, even in the weak system RCA₀ of reverse mathematics. We answer the question of the converse implication for pairs, showing that the Rainbow Ramsey Theorem for pairs is in fact strictly weaker than Ramsey's Theorem for pairs over RCA₀. The separation involves techniques (...) from the theory of randomness by showing that every 2-random bounds an ω-model of the Rainbow Ramsey Theorem for pairs. These results also provide as a corollary a new proof of Martin's theorem that the hyperimmune degrees have measure one. (shrink)
Recent trends in business ethics along with growing attacks upon unions, suggest that employee rights will be a major social concern for business managers during the next decade. However, in most of the discussions of employee rights to date, the very meaning and legitimacy of such rights are often uncritically taken for granted. In this paper, we develop an account of employee rights and defend this conception against what we take to be the strongest in-principle objections to it.