BackgroundNormally, physicians understand they have a duty to treat patients, and they perform accordingly consistent with codes of medical practice, standards of care, and inner moral motivation. In the case of COVID-19 pandemic in a developing country such as Bangladesh, however, the fact is that some physicians decline either to report for duty or to treat patients presenting with COVID-19 symptoms. At issue ethically is whether such medical practitioners are to be automatically disciplined for dereliction of duty and gross negligence; (...) or, on the contrary, such physicians may legitimately claim a professional right of autonomous judgment, on the basis of which professional right they may justifiably decline to treat patients.MethodsThis ethical issue is examined with a view to providing some guidance and recommendations, insofar as the conditions of medical practice in an under-resourced country such as Bangladesh are vastly different from medical practice in an industrialized nation such as the USA. The concept of moral dilemma as discussed by philosopher Michael Shaw Perry and philosopher Immanuel Kant’s views on moral appeal to “emergency” are considered pertinent to sorting through the moral conundrum of medical care during pandemic.ResultsOur analysis allows for conditional physician discretion in the decision to treat COVID-19 patients, i.e., in the absence of personal protective equipment (PPE) combined with claim of duty to family. Physicians are nonetheless expected to provide a minimum of initial clinical assessment and stabilization of a patient before initiating transfer of a patient to a “designated” COVID-19 hospital. The latter is to be done in coordination with the national center control room that can assure admission of a patient to a referral hospital prior to ambulance transport.ConclusionsThe presence of a moral dilemma (i.e., conflict of obligations) in the pandemic situation of clinical care requires institutional authorities to exercise tolerance of individual physician moral decision about the duty to care. Hospital or government authority should respond to such decisions without introducing immediate sanction, such as suspension from all clinical duties or termination of licensure, and instead arrange for alternative clinical duties consistent with routine medical care. (shrink)

This research explored the feasibility of using multidimensional scaling (MDS) analysis in novel combination with other techniques to study comprehension of epistemic adverbs expressing doubt and certainty (e.g., evidently, obviously, probably ) as they relate to health communication in clinical settings. In Study 1, Australian English speakers performed a dissimilarity-rating task with sentence pairs containing the target stimuli, presented as “doctors' opinions.” Ratings were analyzed using a combination of cultural consensus analysis (factor analysis across participants), weighted-data classical-MDS, and cluster analysis. (...) Analyses revealed strong within-community consistency for a 3-dimensional semantic space solution that took into account individual differences, strong statistical acceptability of the MDS results in terms of stress and explained variance, and semantic configurations that were interpretable in terms of linguistic analyses of the target adverbs. The results confirmed the feasibility of using MDS in this context. Study 2 replicated the results with Canadian English speakers on the same task. Semantic analyses and stress decomposition analysis were performed on the Australian and Canadian data sets, revealing similarities and differences between the two groups. Overall, the results support using MDS to study comprehension of words critical for health communication, including in future studies, for example, second language speaking patients and/or practitioners. More broadly, the results indicate that the techniques described should be promising for comprehension studies in many communicative domains, in both clinical settings and beyond, and including those targeting other aspects of language and focusing on comparisons across different speech communities. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Schopenhauer and the Nature of Philosophy by Jonathan HeadJudith NormanJonathan Head. Schopenhauer and the Nature of Philosophy. Lanham, MD: Lexington Books, 2021. Pp. xviii + 183. Hardback, $95.00.It is a bit strange to read an overview of Schopenhauer's philosophy that does not center on the obvious and attention-grabbing idea of will, but Jonathan Head has brought a fresh and welcome perspective to the topic by focusing instead on (...) Schopenhauer's notion of philosophy itself. This perspective enables Head to paint a more sympathetic picture of Schopenhauer than is often the case—more coherent in his systematic pretensions, more consistent in his philosophical project over the long course of his writings, and (perhaps most surprisingly) more solicitous for the welfare of his readers.Head's thesis is that Schopenhauer analyzed ('diagnosed' might be a better word) the human need for metaphysics and constructed his own philosophy carefully to address this need. "The need for metaphysics," Head explains, "is a natural desire that all human beings have for explanation and consolation, in the face of the recognition of pessimistic truths regarding the world we live in" (xiv), specifically recognition of the "wrongness of the world" (51) and "the illusory nature of the principle of individuation" (70). Several quite specific metaphilosophical insights and methods arise from this seemingly straightforward statement. [End Page 528] For one thing, Head points out that explanation and consolation are rather different goals for philosophy, uniting theoretical and practical concerns in a way that might not be expected from a self-declared Kantian. But he argues for this dual functionality by tracing the notion of "better consciousness" from Schopenhauer's earliest writings to its evolution into a "denial of the will," a form of consciousness with directly salvific consequences (interestingly, according to Head, not just for the individual but intergenerationally), now rooted in a metaphysics of will.The second and more philosophically fruitful peculiarity about Schopenhauer's diagnosis of the human "need for metaphysics" is the manner in which it arises from "the recognition of pessimistic truths" (xiv). There is a lot packed into the notion of recognition here. Schopenhauer has a distinctive philosophical method that grounds philosophical thinking in intuitive apprehension of basic truths. And, as Head argues, while this intuition functions as the ground for truth-seeking, it also hampers philosophy as a discursive discipline, since the concepts in which truth claims are presented cannot capture or communicate the unique proximity to truth characteristic of intuition. Thus, philosophical truths cannot be communicated directly, and the function of philosophical texts is to inspire an intuitive insight on the part of the readers so that they are able to see for themselves what the philosophy purports to say. (Stoicism, for instance, is for Schopenhauer an admirable but ultimately limited philosophical perspective in that it develops a system that relies exclusively on reason without promoting a grounding intuition.) Head argues that insight into the basic nature of the will is the intuition that Schopenhauer spins his philosophy around.This has both metaphysical and metaphilosophical implications. As for the former, it means that metaphysics is possible as a discipline, even in the wake of (and while by and large respecting) the limits Kant imposed on epistemology. Metaphysics has an empirical aspect, relying on empirical cognitive sources to provide a worldview for which it provides a key. Head emphasizes the irreducibility of this "objective" perspective, for offering both understanding as well as consolation (namely, knowledge that we have cognitive resources that other creatures do not). But Head argues that Schopenhauer gives primacy to the (compatible and complementary) subjective standpoint, and in particular our (quasi-speculative) intuition into the thing-in-itself via insight into our own basic essence as will. This peek into a nonrepresentational reality provides the reader with a guiding intuition (and the text with a central thought) that has an "inbuilt [implicitly] inferential structure" (72) from which an extraordinarily fruitful set of implications follows for constructing a metaphysics of will.The implications for metaphilosophy are no less interesting, and the central claim of Head's text is that Schopenhauer carefully constructed his central work, The World as Will and Representation, to guide... (shrink)

We all have beliefs, even strong convictions, about what is just and fair in our social arrangements. How should these beliefs and the theories of justice that incorporate them guide our thinking about practical matters of justice? This wide-ranging collection of essays by one of the foremost medical ethicists in the USA explores the claim that justification in ethics, whether of matters of theory or practice, involves achieving coherence between our moral and non-moral beliefs. Amongst the practical issues addressed in (...) the volume are the design of health-care institutions, the distribution of goods between the old and the young, and fairness in hiring and firing. In combining ethical theory and practical ethics this volume will prove especially valuable to philosophers concerned with ethics and applied ethics, political theorists, bioethicists, and others involved in the study of public policy. (shrink)

Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health (...) and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness.". (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Objective Reality of Ideas in Descartes, Caterus, and Su irez NORMAN j. WELLS IT HAS LONG BEEN ACKNOWLEDGEDthat Francisco Sufirez's distinction between a formal and an objective concept exercised some influence upon Descartes's teaching on 'idea'.' It would appear, however, that not enough attention has been given to that distinction of Sufirez (and especially to another to be mentioned shordy) to aid in dispelling what I take to (...) be a widespread confusion and misunderstanding with regard to 'idea' in Descartes, especially with respect to 'idea' taken 'objectively'. Much, if not all, of the confusion in question has to do with Descartes's admittedly equivocal use of the term 'idea'. For he had allowed that 'idea' could be taken 'materially' (materialiter), on the one hand, for the knowing activity of the intellect. On the other hand, it could be taken 'objectively' (objective) for the thing (res) represented by that knowing activity.' At this point, the contemporary reader can only be brought up short, See E. Gilson, Index scolastico-cart~sien (New York: Burt Franklin Reprint, 1912), 48-49; Discours de la m~thode: Texte et commentazre (Paris: J. Vrin, 1947), 321; G. Rodis-Lewisin her edition of Meditationes de Prima PhRosoph.m (Paris: J. Vrin, 1953), 41 n. 1; L'oeuure de Descartes (Paris: J. Vrin, 1971), 53~ n. 8; J. Collins, Modern European Philosophy (Milwaukee: Bruce, 1954), 165;T.J. Cronin, S.J., Objecttve Being m Descartes and SuArez (Rome: Gregorian University Press, 1966); "Objective Reality of Ideas in Human Thought: Descartes and Su~rez," Wisdom in Depth: Essays in Honor of Henri Renard, SJ., eds. V. F. Daues, S.J., M. R. Holloway, S.J., L. Sweeney, S.J. (Milwaukee : Bruce, 1966), 68-79; L. Gilen, S.J., "Uber die Beziehungen Descartes zur zeitgenossischen Scholastik," Scholastik 32 (1957): 41-66; R. Dalbiez, "Les sources scolastiques de la th~orie cart6sienne de l'&re objectif," Revue d'histoire de la philosophic 3 (1929): 464-72;J. Owens, C.S.S.R., in The Cambridge HtstoU of Later Medu,val Philosophy, eds. N. Kretzmann, A. Kenny, J. Pinborg (Cambridge University Press, 1982), 459; G. Nuchelmans,Judgment and Propositwnfrom Descartesto Kant (Amsterdam: North Holland Publishing Co., 1983), 36-54. " Oeuvres de Descartes, ed. C. Adam et P. Tannery, 11 vols. (Paris: J. Vrin, 1897-19o9; hereafter cited according to volume, page and line), Praefatio ad Lectorem, 7: 8. 19-251 "Sed respondeo hic subesse aequivocationem in voce ideae: sumi enim potest vel materialiter, pro operatione intellectus, quo sensu me perfectior dici nequit, vel objective, pro re per istam operationem repraesentata, quae res, etsi non supponatur extra intellectum existere, potest tamen me esse perfectior ratione suae essentiae." It is clear that two realities are to be causally accounted for. The [33] 34 JOURNAL OF THE HISTORY OF PHILOSOPHY 28"1 JANUARY 1990 conditioned as we are by an appreciation of 'objectivity' altogether extramental! It makes for a considerable wrench of perspective to do justice to Descartes's acknowledged doctrine of intramental objectivity and an intramental 'thing represented' (resrepraesentata). 'Idea', then, in traditional Cartesian fashion, designates the act of representing as well as the 'thing represented '. S Yet, for all this, and despite repeated expressions of the same doctrine, there is a persistent tendency in the history of Cartesianism and its scholarship to interpret 'idea' taken 'objectively' as in some way representative. Contrary to what I take to be Descartes's constant position, such a rendering unwittingly transfers that function which is proper to the cognitive activity, mind is the efficient cause of its cognitive activity. With respect to ideas taken 'objectively', such as the ideas of God and the triangle on the levels of metaphysical and mathematical intelligibility, an efficient cause, extrinsic to the mind, is certainly at issue. For here we are in the presence of what is independent of the mind, however intramental it may be. On the triangle, see Medit. 5; 7: 64. ]4s7 : "...est tamen profecto determinata quaedam ejus natura, sire essentia, sive forma, immutabUis et aeterna, quae a me non efficta est, nec a mente mea dependet." For the idea of God, see Medit. 5; 7: 68. l o-12: "Nam sane multis modis inteUigo illam [ideam... (shrink)

Applied a theory of information integration to decision making with probabilistic events. 10 undergraduates judged the subjective worth of duplex bets that included independent gain and lose components. The worth of each component was assumed to be the product of a subjective weight that reflected the probability of winning or losing, and the subjective worth of the money to be won or lost. The total worth of the bet was the sum of the worths of the 2 components. Thus, each (...) judgment required multiplying and adding operations. The multiplying model worked quite well in 4 experimental conditions. The adding model showed more serious discrepancies, though these were small in magnitude. The theory of functional measurement was applied to scale the subjective values of the probability and money stimuli. Subjective and objective values were nonlinearly related both for probability and for money. (shrink)

Scientific revolution is a widely known concept. But does revolution really occur in science? Change through revolution means that present thinking does not retain anything from the past, because everything is thrown away due to the revolution. Does this pattern of change really correspond to the history of science? There is another pattern which is called evolution. This writing will show that process of evolution rather than revolution presents the real situation of scientific change. According to this concept, science grows (...) as an organic species grows in certain environment. An organism is different from its every former stage, yet it remains the same organism throughout its life. In the same way, we will find both change and continuity in scientific growth. (shrink)

Many societies, and nearly all wealthy, developed countries, provide universal access to a broad range of public health and personal medical services. Is such access to health care a requirement of social justice, or is it simply a matter of social policy that some countries adopt and others do not? If it is a requirement of social justice, we should be clear about what kinds of care we owe people and how we determine what care is owed if we cannot (...) possibly meet every health need, as arguably no society can. We should be clear about what constitutes appropriate access to that care, given that there are diverse barriers to access. We must also be able to say why we owe these things as a matter of justice, and, of course, different accounts of social justice will bake and serve this cake in different ways. (shrink)

How can health plans make fair determinations about when “experimental” (and costly) treatments such as high dose chemotherapy with autologous bone marrow transplantation should be covered despite lack of clear clinical consensus about their benefits? Different models for managing “last chance” therapies evolving in some health plans offer promising examples of how issues of fairness and legitimacy in decisionmaking can be addressed.

Arnauld's criticisms as "a model of confusion confounded.” In a review of Wilson's book, R. McRae refers to "the difficult and not too coherent subject of material falsity. '' J. Cottingham describes the Descartes-Arnauld debate on the material falsity of adventitious ideas as "an involved and rather inconclusive exchange " and claims that the example of the material falsity of such ideas espoused by Descartes in Meditation III is "needlessly complicated. " A. Kenny, in turn, notes that several things are (...) "confusing in Descartes' account of false ideas. " Later reference is made to the fact that "Descartes appears confused. [...] and that "Descartes, it seems, cannot give a consistent answer. '' As will become clear, I take issue with each of these assessments. When Descartes' position on material falsity is understood in the light of late Scholastic sources, especially Suarez, whence it draws its strength and inspiration, the alleged confusion and incoherency vanishes. .. (shrink)

To be Black means to have ancestors whose humanity has been de-nied by slavery, colonialism, neo-colonialism, and segregation, as well as by many theories elaborated in order to justify and intensify these modes of domination. To be Black also means having to face the enduring legacies of these systems and theories, which predomi-nantly manifest through overexposure to violence and death. Today, premature death and habituation to loss remain constitutive fea-tures of Black experience. Dignity, often de????ined as the inherent value of (...) every single human being, has been a core concept in ethics since Kant, at least. But in both philosophy and modern politics, the claim of respect for the dignity of people has coexisted with deep antiblack-ness. However, apart from the Western understanding of dignity stands another tradition. The concept of dignity is pervasive in Black radicalism, Caribbean philosophy, and African thought since the 18th century. This article draws inspiration from the legacy of these thinkers to elaborate an ethics centred on the speci????icities of racial-ized life. (shrink)

James Rachels’ seminal paper “ Why Privacy Is Important ” (1975) remains one of the most influential statements on the topic. It offers a general theory that explains why privacy is important in relation to mundane personal information and situations. According to the theory, privacy is important because it allows us to selectively disclose personal information and to engage in behaviors appropriate to and necessary for creating and maintaining diverse personal relationships. Without this control, it is implied, the diversity of (...) relationships would diminish; relationships would “flatten out”, we might say. The aspect of the paper that addresses information flows (what I refer to as his information privacy theory) has been of particular interest to computer information privacy theorists. Despite its continued importance to computer privacy theorists, however, the information privacy theory appears to be contradicted by recent developments in computing. In particular, since the publication of Rachels’ paper we have seen an extensive amount of personal information collected. Further, recent developments in computing falling under the heading of social computing have brought about a new wave of personal information creation and collection. This paper will reassess and resituate Rachels’ information privacy theory in light of these developments. I will argue that the increasing collection of personal data will not flatten relationships as the information privacy theory predicts because such data lack contextual factors important to Rachels’ general theory. The paper will conclude by pointing to some areas where Rachels’ general theory and where his information privacy theory will continue to be relevant. (shrink)

Book reviewed in this article: Just Doctoring: Medical Ethics in the Liberal State. By Troyen A. Brennan. The Ends of Human Life: Medical Ethics in a Liberal Polity. By Ezekiel J. Emanuel.

There is a hoary tradition in moral philosophy that assumes we cannot determine which moral theory is acceptable or correct unless we have available a correct theory of human nature, or, in its more modern form, of the person. With such a theory of the person, however, we could at least narrow down the choice among competing ethical theories. A more recent tradition, at least in one of its standard interpretations, agrees it would be necessary to have a correct theory (...) of the person before we could determine an acceptable moral theory, but it denies there is a determinate nature of the person to be captured in such a theory. The plasticity of the person, according to this strand of Marxist theory, rules out the possibility of there being universal moral theory at all. In this paper, I would like to explore a view that treads an intermediate path. It agrees with the Marxist denial that there is a determinate nature of the person, a deep fact of the matter, that can be abstracted from the social matrix and made the subject of a theory of the person. And, it agrees with both traditions that moral theory depends on and embodies a theory of the person. But, by making the problem of arriving at an acceptable view of the person itself something that depends on overall theoretical considerations, including moral ones, the intermediary, view may be able to avoid the type of moral relativism associated with the Marxist view. (shrink)

Includes bibliographical references (p. [271]-285) and index.