Ethical foundations of patient safety -- Vigilance -- Mindfulness -- Compliance -- Humility -- Some theoretical aspects of vigilance and risk acceptability -- Fifty shades of error -- The standard care and medical malpractice law as an ethical achievement -- The present and the future.

Various kinds of alcohol and drug testing, such as preemployment, routine, and for-cause testing, are commonly performed by employers. While healthcare organizations usually require preemployment drug testing, they vary on whether personnel will be subjected to further testing. Recently, a call has gone out for postincident testing among physicians who are involved in serious, preventable events, especially ones leading to a patient's death. This article will offer a number of counterarguments to that proposal and discuss an alternate approach: that health (...) institutions can better improve patient safety and employees’ well-being by implementing an organizational policy of “speaking up” when system operators notice work behaviors or environmental factors that threaten harm or peril. The article will conclude with a description of various strategies that facilitate speaking up, and why the practice constitutes a superior alternative to mandatory alcohol and drug testing in the wake of serious, harm-causing m.. (shrink)

Among various kinds of disclosures typically required in research as well as in clinical scenarios, risk information figures prominently. A key question is, what kinds of risk information would the reasonable person want to know? I will argue, however, that the reasonable person construct is and always has been incapable of settling this very question. After parsing the nebulous if not “contentless” character of the reasonable person, I will explain how Western courts have actually adjudicated cases of “negligent nondisclosure,” that (...) is, cases in which patient‐plaintiffs allege that their informed consent rights were violated by the failure of their health providers to inform them of reasonably foreseeable risks that subsequently materialized. To support my argument, I will scrutinize the landmark decision by the United Kingdom's Supreme Court in Montgomery v. Lanarkshire Health Board and, in particular, Justice Brenda Hale's concurrence. (shrink)

Sometimes Blumenthal-Barby et al. (2022) discuss the philosopher’s contribution to bioethics as a largely theoretical or apriori one that arrives from out of the blue—like Parfit’s identity theory—...

A historical investigation of the exclusion of Africa and Asia from modern histories of philosophy.

The use of placebo as a control condition in clinical trials of major depressive disorder and anxiety disorders continues to be an area of ethical concern. Typically, opponents of placebo controls argue that they violate the beneficent-based, “best proven diagnostic and therapeutic method” that the original Helsinki Declaration of 1964 famously asserted participants are owed. A more consequentialist, oppositional argument is that participants receiving placebo might suffer enormously by being deprived of their usual medication(s). Nevertheless, recent findings of potential for (...) suicidality in young people treated with antidepressants, along with meta-analyses suggesting that antidepressants add no significant clinical benefit over placebos, warrant a re-evaluation of the arguments against placebo. Furthermore, the nature of placebo treatment in short-term clinical trials is often not well understood, and lack of understanding can foster opposition to it. This paper will show how scientific justifications for placebo use are morally relevant. The fundamental ethical importance of placebo controls is discussed in relation to several aspects of clinical trials, including detection of adverse events, accurate assessment of clinical benefit, advancing understanding of the heterogeneity of depression and anxiety disorders and respecting informed consent requirements. Prohibiting the use of placebo controls is morally concerning in that such prohibitions allow for the possibility of serious adverse public health consequences. Moral worries that research participants receiving placebo are being unduly jeopardised will be shown to be exaggerated, especially in relation to the net benefits for end-users to be gained from the quality of data resulting from using placebo controls. (shrink)

Professor Jecker (2008) argues that a broader conception of justice in allocating health care resources would focus moral attention on how the determinants of socioeconomic marginalization unfairly...

The impression one derives from the target article on “The Duty to Disclose Adverse Clinical Trials Results” is that Liao and colleagues (2009) envision a research platform consisting only of a tea...

Voluntary, employment‐based insurance is afflicted by a variety of internal imbalances: inequities in the way health insurance is paid for, a conflict of interest in the selection of health insurance, the concentration of the healthy and the sick into separate plans, and free‐ridership. But while all these imbalances generate severe problems, those seeking to reform health insurance in the United States should concentrate on the last two.

In this issue of the Hastings Center Report, Mélanie Terrasse, Moti Gorin, and Dominic Sisti, urge ethicists to devote scholarly attention to a wave of troubling artificial intelligence applications affecting health consumers’ rights and the quality of their care. I very much agree. We already have neuroethicists, business ethicists, and genetics ethicists; AI‐related systems in health care present more than enough warrant to herald the appearance of a new ethics specialist—the “intel‐ethicist,” let’s say. Nonetheless, Terrasse and colleagues may have exaggerated (...) some of the potential moral problems of AI. Examining only social media and e‐health programs, the authors produce an impressive array of questions to consider, but I will argue that two of them are not nearly as worrisome as might be supposed. (shrink)

How (Not) to Be Secular is what Jamie Smith calls "your hitchhiker's guide to the present" -- it is both a reading guide to Charles Taylor's monumental work A Secular Age and philosophical guidance on how we might learn to live in our times. Taylor's landmark book A Secular Age (2007) provides a monumental, incisive analysis of what it means to live in the post-Christian present -- a pluralist world of competing beliefs and growing unbelief. Jamie Smith's book is a (...) compact field guide to Taylor's insightful study of the secular, making that very significant but daunting work accessible to a wide array of readers. Even more, though, Smith's How (Not) to Be Secular is a practical philosophical guidebook, a kind of how-to manual on how to live in our secular age. It ultimately offers us an adventure in self-understanding and maps out a way to get our bearings in today's secular culture, no matter who "we" are -- whether believers or skeptics, devout or doubting, self-assured or puzzled and confused. This is a book for any thinking person to chew on. (shrink)

This chapter provides an introduction to higher-order metaphysics as well as to the contributions to this volume. We discuss five topics, corresponding to the five parts of this volume, and summarize the contributions to each part. First, we motivate the usefulness of higher-order quantification in metaphysics using a number of examples, and discuss the question of how such quantifiers should be interpreted. We provide a brief introduction to the most common forms of higher-order logics used in metaphysics, and indicate a (...) number of questions which can be raised in such systems using logical vocabulary alone. Using a further example, we return to applications of higher-order logics in metaphysics. We also mention key developments in the history of higher-order logic as it pertains to metaphysics. Finally, we mention certain arguments which have been raised against the use of higher-order logic, and some ways of responding to them. (shrink)

Putative counterexamples to the Principle of Identity of Indiscernibles (PII) are notoriously inconclusive. I establish ground rules for debate in this area, offer a new response to such counterexamples for friends of the PII, but then argue that no response is entirely satisfactory. Finally, I undermine some positive arguments for PII.

Practical deliberation often involves conditional judgements about what will (likely) happen if certain alternatives are pursued. It is widely assumed that the conditionals useful in deliberation are counterfactual or subjunctive conditionals. Against this, I argue that the conditionals of deliberation are indicatives. Key to the argument is an account of the relation between 'straightforward' future-directed conditionals like ' If the house is not painted, it will soon look quite shabby' and * "w e r e ' ' e d F (...) D C s like ' If the house were not to be painted, it would soon look quite shabby': an account on which both of these types of FDCs are grouped with the indicatives for semantic treatment and on which, while conditionals of both types are properly used in means/ends deliberations, those of the ' were'ed-up variety are especially well suited for that purpose. (shrink)

In the traditional form of canonical quantization, certain field components (not having “conjugate” momenta) must be regarded as noncanonical. This long-known distinction enters modern gauge theories, when they are canonically quantized as by Kugo and Ojima. We avoid that peculiarity by not using any conjugate “momenta” at all. In our formulation, canonical quantization can be related to Feynman's path integral.

Aggregating individuals’ consistent attitudes might produce inconsistent collective attitudes. Some groups therefore need the capacity to form attitudes that are irreducible to those of their members. Such groups, group-agent realists argue, are agents in control of their own attitude formation. In this paper, however, I show how group-agent realism overlooks the important fact that groups consist of strategically interacting agents. Only by eliminating group agency from our social explanations can we see how individuals vote strategically to gain control of their (...) groups and produce collective attitudes we cannot make sense of if we treat groups as agents. (shrink)

'Pataphysics: The Poetics of an Imaginary Science is a survey that attempts to describe a hypothetic philosophy--the avant-garde pseudo-science imagined by Alfred Jarry. 'Pataphysics is a supplement to metaphysics, accenting it, then replacing it, in order to create a philosophic alternative, whose discipline can study cases, not of conception, but of exception: variance , alliance , and deviance . 'Pataphysics synthesizes the romantic schism between a literal, scientized discourse and a figural, poeticized discourse, and my thesis suggests that this revision (...) of the signifier "science" by 'pataphysics is symptomatic of a postmodern transition in science from a paradigm of absolutism to a paralogy of relativism. Structured as a descriptive explication, which emphasizes a theoretical perspective, this survey is divided into five chapters: the first chapter recounts the history of the conflict between science and poetry ; the second chapter examines the avant-garde pseudo-science of 'pataphysics itself ; and finally, the last three chapters discuss the influence of 'pataphysics upon the poetics of its subsequent successors . While my thesis focuses upon theories of textual poetics rather than poetry itself , my thesis does nevertheless strive to be as conceptually encyclopedic as 'pataphysics itself: instead of normalizing 'pataphysics within one theoretical perspective, this survey alludes intermittently to 'pataphysical enterprises that constitute exceptions to such a genealogy of Jarryites. What is at stake is the status of poetry in a world of science. How might poetry reclaim its own viable truth? How might science benefit from its own poetic irony? For the postmodern condition, such questions have already opened up a novel space for speculative imagination; hence, this survey presents itself as a kind of primer for a future of possible research. (shrink)

In this short but meaty book, Peter Unger questions the objective answers that have been given to central problems in philosophy. As Unger hypothesizes, many of these problems are unanswerable, including the problems of knowledge and scepticism, the problems of free will, and problems of causation and explanation. In each case, he argues, we arrive at one answer only relative to an assumption about the meaning of key terms, terms like "know" and like "cause," even while we arrive at an (...) opposite answer relative to quite different assumptions, but equally arbitrary assumptions, about what the key terms mean. (shrink)