Australia and Thailand have made great progress in partnering with NGOs to respond to HIV/AIDS through the protection of human rights. Unquestionably, the Australian experience is more advanced. However, it is important to note that Australia’s political institutions and traditions were able to empower and accept an NGO movement of this nature almost from the start of disease identification.Thailand did not have this advantage, having only moved toward political institutions that are open to public opinion and civil society’s input within (...) the last 15 years.In spite of their varied histories, both countries eventually traveled down similar paths. In Australia, HIV/AIDS NGOs moved rapidly forward from being standard-setting, fact-finding, and advocacy organizations to becoming capable of creating new HIV/AIDS umbrella organizations and influencing existing governmental organizations on HIV/AIDS human rights issues. Indeed, by the close of the 1980s, NGOs had established themselves firmly in all of these roles. The fact that Australia still struggles with addressing an emerging epidemic among indigenous people is more a sign that the movement has thus far been incomplete than that it is faltering or ineffective. Additionally, now that NGOs are actively working through AFAO on behalf of indigenous peoples, it is likely that there will finally be more movement on human rights and H1V/AIDS issues for this group. However, sex tourism and the illegal trafficking of women and children for purposes of prostitution continue to require ongoing proactive management by the partnership before they become a serious epidemic threat.Thailand’s situation is somewhat different from that of Australia. The HIV/AIDS NGO community has grown since the epidemic exploded in the 1990s, but the organizations themselves continue to have limited power, While they have been an important voice in human rights standard-setting, fact-finding and advocacy regarding HIV/AIDS, they remain unable to fully influence the governmental organizations that ultimately make and implement human rights policies in these areas. As the NGO experience in general is new to Thai politics, continuing human rights abuses are a sign of the miles left to travel on this road rather than an indicator that the road needs to be abandoned.Regardless of their differing experiences with creating HIV/AIDS partnerships, it is impossible to say that either effort has failed to use this mechanism successfully to at least begin seriously addressing HIV/AIDS human rights issues. What can be said is that each partnership can be placed at a differing point on a continuum of effectiveness that ultimately concludes with a fully integrated partnership capable of fundamentally influencing a country’s HIV/AIDS human rights policies on an ongoing basis. (shrink)

In this paper I sketch an account of moral blame and blameworthiness. I begin by clarifying what I take blame to be and explaining how blameworthiness is to be analyzed in terms of it. I then consider different accounts of the conditions of blameworthiness and, in the end, settle on one according to which a person is blameworthy for φ-ing just in case, in φ-ing, she violates one of a particular class of moral requirements governing the attitudes we bear, and (...) our mental orientation, toward people and other objects of significant moral worth. These requirements embody the moral stricture that we accord to these others a sufficient level of respect, one that their moral worth demands. This is a familiar theme which has its roots in P. F. Strawson’s pioneering views on moral responsibility. My development of it leads me to the conclusion that acting wrongly is not a condition of blameworthiness: violating a moral requirement to perform, or refrain from performing, an action is neither necessary nor sufficient for being blameworthy. All we are ever blameworthy for, I will argue, are certain aspects of our mental bearing toward others. We can be said to be blameworthy for our actions only derivatively, in the sense that those actions are the natural manifestations of the things for which we are strictly speaking blameworthy. (shrink)

Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of (...) medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals. (shrink)

It was a little over ten years ago, 1967–8, that H. D. Lewis delivered the first series of Gifford lectures, The Elusive Mind, in the University of Edinburgh. It was my privilege that year to be an auditor in the Seminar at King's College that Professor Lewis was conducting with his students in the area of this topic. I had already read the works in which, in the midst of neo-orthodox and existentialist religious movements, he had devoted himself to critical (...) valuation of those doctrines - witness his Morals and the New Theology, and Morals and Revelation. This earlier work prepared for a comprehensive interpretation of religious experience in his book in 1960: Our Experience of God. (shrink)

When people make judgments about the effects of a perturbation on populations of species in a food web, their judgments exhibit the dissipation effect: a tendency to judge that effects of the perturbation weaken or dissipate as they spread out through the food web from the locus of the perturbation. In the present research evidence for two more phenomena is reported. Terminal locations are points in the food web with just a single connection to the rest of the web. Judged (...) changes tended to be higher for species at terminal locations than for species the same distance from the perturbation but at nonterminal locations. Branches are points in the web where a route splits into two or more routes. Judged changes tended to be lower for species following branching points than for species the same distance from the perturbation but not following branching points. It is proposed that the findings can be explained as effects of a mental model employing concepts of influence and resistance. Under this model a perturbation is a change in energy level at a point in the system that acts as an influence affecting the rest of the system. The basic concepts in this model are domain‐general and on that basis it is predicted that the dissipation effect should be found in judgments of any physical system to which notions of influence and resistance can be applied. (shrink)

It is argued that causal understanding originates in experiences of acting on objects. Such experiences have consistent features that can be used as clues to causal identification and judgment. These are singular clues, meaning that they can be detected in single instances. A catalog of 14 singular clues is proposed. The clues function as heuristics for generating causal judgments under uncertainty and are a pervasive source of bias in causal judgment. More sophisticated clues such as mechanism clues and repeated interventions (...) are derived from the 14. Research on the use of empirical information and conditional probabilities to identify causes has used scenarios in which several of the clues are present, and the use of empirical association information for causal judgment depends on the presence of singular clues. It is the singular clues and their origin that are basic to causal understanding, not multiple instance clues such as empirical association, contingency, and conditional probabilities. (shrink)

In this paper, we move beyond the typical focus on the role of individuals in leading social change to examine "collective social entrepreneurship", the role multiple actors collaboratively play to address social problems, create new institutions, and dismantle outdated institutional arrangements. Specifically, we examine collective social entrepreneurship across a diverse range of collaborative activities including movements, alliances and markets for social good. We identify resource utilization approaches and three associated sets of activities that illustrate the work of collective social entrepreneurs—framing, (...) convening, and multivocality. Using illustrative case studies to examine the phenomenon, we highlight the capacity of collective action across sectors to create markets, institutions and organizations and, to derive success by resonating through embeddedness in broader social movements. (shrink)

In the last few years, the U.S. health care system has seemingly been gripped by “back to the nineties” fever. But there is a notable change in professional debates about how to better control health care costs. Discussion of health care rationing, which was hotly debated in the nineties, has become much more muted.Is health care rationing passé? I contend that debates about health care rationing have waned not because the need to ration has dwindled nor because ethical debates about (...) how or whether to ration have been resolved. They have declined because the word “rationing,” and unrelated concepts such as cost‐effectiveness analysis, have been replaced by terms—“parsimony,” “value,” and “CER”—that are not burdened by emotional and historical baggage.Sometimes the best way to promote healthy moral debate is to turn to new words that don't carry the burden of past debates. (shrink)

There is a debate in normative ethics about whether or not our moral obligations depend solely on either our evidence concerning, or our beliefs about, the world. Subjectivists maintain that they do and objectivists maintain that they do not. I shall offer some arguments in support of objectivism and respond to the strongest argument for subjectivism. I shall also briefly consider the significance of my discussion to the debate over whether one’s future voluntary actions are relevant to one’s current moral (...) obligations. (shrink)

In this lucid and penetrating book, Peter A. Schouls considers Locke's major writings in terms of the closely related ideas of freedom, progress, mastery, reason, and education.

David Lewis has offered a reply to the standard argument for the claim that the truth of determinism is incompatible with anyone’s being able to do otherwise than she in fact does. Helen Beebee has argued that Lewis’s compatibilist strategy is untenable. In this paper I show that one recent attempt to defend Lewis’s view against this argument fails and then go on to offer my own defense of Lewis’s view.

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

Peter A Joy reviews Assessing Lawyer's Ethics: A Practitioner's Guide by Adrian Evans.

Background: Some members of the general public feel that patients who cause their own organ failure through smoking, alcohol use, or drug use should not receive equal priority for scarce transplantable organs. This may reflect a belief that these patients (1) cause their own illness, (2) have poor transplant prognoses or, (3) are simply unworthy. We explore the role that social acceptability, personal responsibility, and prognosis play in people's judgments about transplant allocation. Methods: By random allocation, we presented 283 prospective (...) jurors in Philadelphia county with one of five questionnaire versions. In all questionnaires, subjects were asked to distribute transplantable hearts between patients with and without a history of three controversial behaviors (eating high fat diets against doctors’ advice, cigarette smoking, or intravenous drug use). Across the five questionnaire versions, we varied the relative prognosis of the transplant candidates and whether their behavior caused their primary organ Results: Subjects were significantly less willing to distribute organs to intravenous drug users than to cigarette smokers or people eating high fat diets (p le; 0.0005), even when intravenous drug users had better transplant outcomes than other patients. Subjects’ allocation decisions were influenced by transplant prognosis, but not by whether the behavior in question was causally responsible for the patients’ organ failure. Conclusion: People's unwillingness to give scarce transplantable organs to patients with controversial behaviors cannot be explained totally on the basis of those behaviors either causing their primary organ failure or making them have worse transplant prognoses. Instead, many people believe that such patients are simply less worthy of scarce transplantable organs. (shrink)

We study the proof-theoretic strength and effective content of the infinite form of Ramsey's theorem for pairs. Let RT n k denote Ramsey's theorem for k-colorings of n-element sets, and let RT $^n_{ denote (∀ k)RT n k . Our main result on computability is: For any n ≥ 2 and any computable (recursive) k-coloring of the n-element sets of natural numbers, there is an infinite homogeneous set X with X'' ≤ T 0 (n) . Let IΣ n and BΣ (...) n denote the Σ n induction and bounding schemes, respectively. Adapting the case n = 2 of the above result (where X is low 2 ) to models of arithmetic enables us to show that RCA 0 + IΣ 2 + RT 2 2 is conservative over RCA 0 + IΣ 2 for Π 1 1 statements and that $RCA_0 + I\Sigma_3 + RT^2_{ , is Π 1 1 -conservative over RCA 0 + IΣ 3 . It follows that RCA 0 + RT 2 2 does not imply BΣ 3 . In contrast, J. Hirst showed that $RCA_0 + RT^2_{ does imply BΣ 3 , and we include a proof of a slightly strengthened version of this result. It follows that $RT^2_{ is strictly stronger than RT 2 2 over RCA 0. (shrink)

In physics, the temporal dimension has units of infinitesimally brief duration. Given this, how is it possible to perceive things, such as motion, music, and vibrotactile stimulation, that involve extension across many units of time? To address this problem, it is proposed that there is what is termed an “information construct of happening” (ICOH), a simultaneous representation of recent, temporally differentiated perceptual information on the millisecond time scale. The main features of the ICOH are (i) time marking, semantic labeling of (...) all information in the ICOH with ordinal temporal information and distance from what is informationally identified as the present moment, (ii) vector informational features that specify kind, direction, and rate of change for every feature in a percept, and (iii) connectives, information relating vector informational features at adjacent temporal locations in the ICOH. The ICOH integrates products of perceptual processing with recent historical information in sensory memory on the subsecond time scale. Perceptual information about happening in informational sensory memory is encoded in semantic form that preserves connected semantic trails of vector and timing information. The basic properties of the ICOH must be supported by a general and widespread timing mechanism that generates ordinal and interval timing information and it is suggested that state‐dependent networks may suffice for that purpose. Happening, therefore, is perceived at a moment and is constituted by an information structure of connected recent historical information. (shrink)

A decade ago, we reviewed the field of clinical ethics; assessed its progress in research, education, and ethics committees and consultation; and made predictions about the future of the field. In this article, we revisit clinical ethics to examine our earlier observations, highlight key developments, and discuss remaining challenges for clinical ethics, including the need to develop a global perspective on clinical ethics problems.

In their article, “Supported Decision Making with People at the Margins of Autonomy,” Peterson, Karlawish, and Largent point to the fact that the concept of ‘supported decision-making’ has recently...

Medicine and health care generate many bioethical problems and dilemmas that are of great academic, professional and public interest. This comprehensive resource is designed as a succinct yet authoritative text and reference for clinicians, bioethicists, and advanced students seeking a better understanding of ethics problems in the clinical setting. Each chapter illustrates an ethical problem that might be encountered in everyday practice; defines the concepts at issue; examines their implications from the perspectives of ethics, law and policy; and then provides (...) a practical resolution. There are 10 key sections presenting the most vital topics and clinically relevant areas of modern bioethics. International, interdisciplinary authorship and cross-cultural orientation ensure suitability for a worldwide audience. This book will assist all clinicians in making well-reasoned and defensible decisions by developing their awareness of ethical considerations and teaching the analytical skills to deal with them effectively. (shrink)

Theorists have hypothesized that skill in critical thinking is positively correlated with the consistent internal motivation to think and that specific critical thinking skills are matched with specific critical thinking dispositions. If true, these assumptions suggest that a skill-focused curriculum would lead persons to be both willing and able to think. This essay presents a researchbased expert consensus definition of critical thinking, argues that human dispositions are neither hidden nor unknowable, describes a scientific process of developing conventional testing tools to (...) measure cognitive skills and human dispositions, and summarizes recent empirical research findings that explore the possible relationship of critical thinking skill and the consistent internal motivation, or disposition, to use that skill. Empirical studies indicate that for all practical purposes the hypothesized correlations are not evident. It would appear that effective teaching must include strategies for building intellectual character rather than relying exclusively on strengthening cognitive skills. (shrink)

Since the appearance of Plato’s Dialogues, philosophers have been preoccupied with the identity of Socrates and have maintained that successful interpretation of the work hinges upon a clear understanding of what thoughts and ideas can be attributed to him. In Descent of Socrates, Peter Warnek offers a new interpretation of Plato by considering the appearance of Socrates within Plato’s work as a philosophical question. Warnek reads the Dialogues as an inquiry into the nature of Socrates and in doing so (...) opens up the relationship between humankind and the natural world. Here, Socrates appears as a demonic and tragic figure whose obsession with the task of self-knowledge transforms the history of philosophy. In this uncompromising work, Warnek reveals the importance of the concept of nature in the Platonic Dialogues in light of Socratic practice and the Ancient ideas that inspire contemporary philosophy. (shrink)

It would be useful to have a category of extensive-form games whose isomorphisms specify equivalences between games. Since working with entire games is too large a project for a single paper, I begin here with preforms, where a “preform” is a rooted tree together with choices and information sets. In particular, this paper first defines the category \, whose objects are “functioned trees”, which are specially designed to be incorporated into preforms. I show that \ is isomorphic to the full (...) subcategory of \ whose objects are converging arborescences. Then the paper defines the category \, whose objects are “node-and-choice preforms”, each of which consists of a node set, a choice set, and an operator mapping node-choice pairs to nodes. I characterize the \ isomorphisms, define a forgetful functor from \ to \, and show that \ is equivalent to the full subcategory of \ whose objects are perfect-information preforms. The paper also shows that many game-theoretic entities can be derived from preforms, and that these entities are well-behaved with respect to \ morphisms and isomorphisms. (shrink)

This volume, an expanded edition of the philosophy of language issue of the journal Midwest Studies in Philosophy (1977), includes essays by some of the ...

Peter A. Bertocci; XI—Descartes and Marcel on the Person and his Body: A Critique, Proceedings of the Aristotelian Society, Volume 68, Issue 1, 1 June 1968, Pag.

The comparative utility argument holds that the descendants of African slaves in America are not owed any compensation because they have not been harmed by slavery. Rather, slavery in America was beneficial to the descendants of slaves because they are now able to live in a country that is considerably richer today than any of the African countries from which slaves were taken. In this paper, I show that the comparative utility argument is a red herring with no bearing whatsoever (...) on the question of slave reparations because it conflates two separate wrongs: slavery and forced immigration. The fact that the descendants of slaves now live in America is a consequence of the latter, but not the former. As such, it has no bearing on the legitimacy reparations for slavery. (shrink)

ABSTRACTMother‐to‐child transmission of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age infected with (...) HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)

This volume of the classic series is devoted to the claims, arguments, and perspectives of the New Atheists. The volume collects original work on these topics of leading thinkers in the philosophy of religion, epistemology, and metaphysics, and philosophy of science. These studies are punctuated by an original short story by a leading novelist.