In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 16.4 (2006) 379-396MuseSearchJournalsThis JournalContents[Access article in PDF]Pharmacists and Conscientious Objection *In March 2005, a Wisconsin pharmacist's act of conscience garnered headlines across the United States. After a married woman with four children submitted a prescription for the morning-after pill, the pharmacist, Neil Noesen, not only refused to fill it, but also refused to transfer the prescription to another pharmacist or to return the prescription (...) to the customer. As more such incidents occurred, many states "... decided to consider and enact laws setting the bounds of pharmacists' and other health care workers' professional obligations" (III, Grady 2006, p. 327). Discussions of objector legislation, also referred to as "conscience clauses," "refusal clauses," and "abandonment laws" (III, Appel 2005, p. 279), are not limited to professional ethics, but also draw from philosophical, theological, and legal perspectives. The purpose of this Scope Note is to present a wide variety of viewpoints on the health provider's right to conscience.More than 40 years ago the development of "The Pill" as the first reliable method of birth control not only ushered in a feminist revolution, but also provided a new focus for concerns of conscience for those who were part of the anti-abortion movement based on religious belief in the sanctity of life. Similarly, in the past ten years, worldwide, and seven years (1999) since the emergency contraception "morning after" pill first became available as a prescription item, there has been an upsurge in the number of medical personnel who refuse to prescribe or dispense it on grounds of personal conscience, whether for religious reasons or not. Their actions bring into play issues of power and control for health care personnel and for patients—in this case women, which also raises women's rights issues. Ironically, studies in France, Sweden, and the United Kingdom have shown that emergency contraception does not reduce the abortion rate—it is too infrequently used (II, Glasier 2006).It is important to underline the difference between the "morning-after" pill or "Plan B," which is made up of two progestin pills containing levonorgestrel (a synthetic derivative of the female hormone progesterone), and RU-486 (Mifiprex [End Page 379] or mifipristone with misoprostol). Plan B, if taken within 72 hours post-coitus prevents implantation, and therefore pregnancy, by suppressing the output of luteinizing hormone, the hormone that triggers the ovulation process. Scientists have been unable to determine whether this action could destroy already fertilized eggs, but even if it does, it uses the same mechanism as occurs with the birth-control pill, that was developed some 45 years ago. By contrast, RU-486 acts up to 49 days after implantation by blocking the action of progesterone in order to terminate the pregnancy and as such is an abortifacient (II, US FDA 1).On 24 August 2006, the U.S. Food and Drug Administration announced approval of the Plan B pill for over-the-counter (OTC ) sales (II, US FDA 2). Although this action makes the drug more widely available, it remains to be seen whether pharmacists who are conscientious objectors and who refuse to dispense it also will refuse to provide it OTC.A survey article by Rebecca Dresser (II, 2005, p. 9) succinctly sums up the problem for conscientious objectors: "Because emergency contraception can act to block implantation of a fertilized egg, people who believe in protection of human life after conception find it morally objectionable."When conscientious objections are raised over abortion or birth control services performed, prescribed, or dispensed, they affect not only the health professionals—physicians, pharmacists, nurses, and health technicians—who may object, as well as their colleagues and/or managers, but also the consumers: the female patients who are then forced to reconsider or to seek an alternative supplier, as well as their spouses or partners. Alta Charo (II, 2005, p. 2473) makes the point that the patient needs to have access to a system of counseling and referral "so... (shrink)

A neurally plausible model of how the process of visually perceiving a letter in the context of a word is learned, and how such processing occurs in adults is proposed. The model consists of a collection of abstract letter feature detector neurons and their interconnections. The model also includes a learning rule that specifies how these interconnections evolve with experience. The interconnections between neurons can be interpreted as representing the spatially redundant, sequentially redundant, and transgraphemic information in letter string displays. (...) Anderson, Silverstein, Ritz, and Jones's (1977) “Brain‐State‐in‐a‐Box” (BSB) neural mechanism is then used to implement the proposed model. The resulting system makes explicit qualitative predictions using both letter recognition accuracy and reaction time as dependent measures. In particular, the model offers an integrated explanation of some experiments involving manipulations of orthographic regularity, masking, case alternations, and experience with words. The similarities and differences between the model and models proposed by Adams (1979) and McClelland and Rumelhart (1981) are also discussed. (shrink)

Participants were asked to draw inferences about correlation from single x,y observations. In Experiment 1 statistically sophisticated participants were given the univariate characteristics of distributions of x and y and asked to infer whether a single x, y observation came from a correlated or an uncorrelated population. In Experiment 2, students with a variety of statistical backgrounds assigned posterior probabilities to five possible populations based on single x, y observations, again given knowledge of the univariate statistics. In Experiment 3, statistically (...) naïve participants were given a problem analogous to that given in Experiment 1, framed verbally. Experiment 4 replicated Experiment 3 but added an “impossible to determine” response option. Models that rely on computing sample correlations make no predictions about these investigations. From a Bayesian perspective, participants’ inferences in all four experiments tended to make probabilistically valid inferences as long as the single datum was directional. The results are discussed in light of the Brunswikian notion of vicarious functioning. (shrink)

The collection presents a variety of promising new directions in Royce scholarship from an international group of scholars, including historical reinterpretations, explorations of Royce's ethics of loyalty and religious philosophy, and contemporary applications of his ideas in psychology, the problem of reference, neo-pragmatism, and literary aesthetics.

This collection of essays is dedicated to the prolific career of Paul Ricoeur. Honoring his work, this anthology addresses questions and concerns that defined Ricoeur’s.

Metaphysics and language: Quine, W. V. O. On the individuation of attributes. Körner, S. On some relations between logic and metaphysics. Marcus, R. B. Does the principle of substitutivity rest on a mistake? Van Fraassen, B. C. Platonism's pyrrhic victory. Martin, R. M. On some prepositional relations. Kearns, J. T. Sentences and propositions.--Basic and combinatorial logic: Orgass, R. J. Extended basic logic and ordinal numbers. Curry, H. B. Representation of Markov algorithms by combinators.--Implication and consistency: Anderson, A. R. Fitch (...) on consistency. Belnap, N. D., Jr. Grammatical propaedeutic. Thomason, R. H. Decidability in the logic of conditionals. Myhill, J. Levels of implication.--Deontic, epistemic, and erotetic logic: Bacon, J. Belief as relative knowledge. Wu, K. J. Believing and disbelieving. Kordig, C. R. Relativized deontic modalities. Harrah, D. A system for erotetic sentences. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

Sinking organic particles transfer ∼10 gigatonnes of carbon into the deep ocean each year, keeping the atmospheric CO2 concentration significantly lower than would otherwise be the case. The exact size of this effect is strongly influenced by biological activity in the ocean's twilight zone (∼50–1,000 m beneath the surface). Recent work suggests that the resident zooplankton fragment, rather than ingest, the majority of encountered organic particles, thereby stimulating bacterial proliferation and the deep‐ocean microbial food web. Here we speculate that this (...) apparently counterintuitive behaviour is an example of ‘microbial gardening’, a strategy that exploits the enzymatic and biosynthetic capabilities of microorganisms to facilitate the ‘gardener's’ access to a suite of otherwise unavailable compounds that are essential for metazoan life. We demonstrate the potential gains that zooplankton stand to make from microbial gardening using a simple steady state model, and we suggest avenues for future research. (shrink)

This book is a critical examination of certain basic issues and themes crucial to understanding how ethics currently interfaces with health care and biomedical research. Beginning with an overview of the field, it proceeds through a delineation of such key notions as trust and uncertainty, dialogue involving talk and listening, the vulnerability of the patient against the asymmetric power of the health professional, along with professional and individual responsibility. It emphasizes several themes fundamental to ethics and health care: (1) the (...) work of ethics requires strict focus on the specific situational understanding of each involved person. (2) Moral issues, at least those intrinsic to each clinical encounter, are presented solely within the contexts of their actual occurrence; therefore, ethics must not only be practical but empirical in its approach. (3) Each particular situation is in its own way imprecise and uncertain, and the different types and dimensions of imprecision and uncertainty are critical for everyone involved. (4) Finally, medicine and health care more broadly are governed by the effort to make sense of the healer's experiences with the patient, whose own experiences and interpretations are ingredient to what the healer seeks to understand and eventually treat. In addition to providing a way to develop ethical considerations in clinical life and research projects, the book proposes that narratives provide the finest way to state and grapple with these themes and issues, whether in classrooms or real-life situations. It concludes with a prospective analysis of newly emerging issues presented by and within the new genetics, which, together within a focus on the phenomenon of birth, leads to an clearer understanding of human life. (shrink)

The measurement of sensory intensity has had a long history, attracting the attention of investigators from many disciplines including physiology, psychology, physics, mathematics, philosophy, and even chemistry. While there has been a continuing doubt by some that sensation has the properties necessary for measurement, experiments designed to obtain estimates of sensory intensity have found that a general rule applies: Equal stimulus ratios produce equal sensory ratios. Theories concerning the basis for this simple psychophysical rule are discussed, with emphasis given to (...) the physical correlate theory, which considers judgments of subjective magnitudes to be based upon estimates of physical dimensions that vary regularly with changes in degree of stimulation. For the most thoroughly investigated sensory scales, brightness and loudness, the physical correlate is considered to be distance. Our “tacit knowledge” of the sensory effects of changing distance plays an essential role in matching motor activities to environmental conditions and in ensuring accurate perceptual evaluations through brightness and loudness constancies. In psychophysical experiments, subjects apparently use this same tacit knowledge when required to estimate relative subjective magnitudes. The evidence related to the physical correlate theory is summarized, and it is concluded that, while under appropriate conditions we demonstrate considerable skill in evaluating environmental relationships, we are quite unable to estimate the neurophysiological nature or quantity of sensory response. A psychophysics devoted to studying conditions required for accuracy and conditions producing errors in the perception of environmental relationships would seem to be more valuable than one devoted to subjective magnitudes. (shrink)

Ethics and the Clinical Encounter explores the moral dimensions of clinical medicine and the phenomenon of illness, to determine what ethics must be in order to be fully responsive to clinical encounters. Written in a lively and conversational style with minimal technical terminology, and enhanced by actual experience or real clinical situations, this volume lays out a clinical ethics methodology both in practical and theoretical terms. Here's what the experts had to say: Professor Zaner has provided us with a remarkably (...) lucid and trenchant discussion of the interface of philosophy and the field of medicine. He brings into play an extraordinary range of historial knowledge, extensive observations based on firsthand experience with medical practices, and an acute sense of philosophical argumentation. This is a work that will be an exemplary and indispensable text in the philosophy of medicine for years to come. -- Calvin Schrag... it is a highly original contribution usable in a number of fields.... It really has no competition.... The genius of Zaner's approach is to ground ethics from the 'bottom up' and to direct us to the concrete particulars of therapeutic encounters wherein lie moral and ethical matters... meaty, challenging, and ultimately rewarding.... -- Paul R. Dokecki Richard M. Zaner founded the Center for Clinical and Research Ethics at Vanderbilt University Medical Center. Having established Vanderbilt's first Hospital Ethics Committee (1985), he served as co-chair of VUMC's Ethics Committee since its inception in 1990. Zaner has published five original books, edited ten, and translated four more, and has published more than 100 sections of books and professional journals. (shrink)

Tested the 2-process theory of detection, search, and attention presented by the current authors in a series of experiments. The studies demonstrate the qualitative difference between 2 modes of information processing: automatic detection and controlled search; trace the course of the learning of automatic detection, of categories, and of automatic-attention responses; and show the dependence of automatic detection on attending responses and demonstrate how such responses interrupt controlled processing and interfere with the focusing of attention. The learning of categories is (...) shown to improve controlled search performance. A general framework for human information processing is proposed. The framework emphasizes the roles of automatic and controlled processing. The theory is compared to and contrasted with extant models of search and attention. (shrink)

Early in the first volume of his Ideen zu einer reinen Phiinomeno logie und phiinomenologischen Philosophie, Edmund Husserl stated concisely the significance and scope of the problem with which this present study is concerned. When we reflect on how it is that consciousness, which is itself absolute in relation to the world, can yet take on the character of transcendence, how it can become mundanized, We see straightaway that it can do that only by means of a certain participation in (...) transcendence in the first, originary sense, which is manifestly the transcendence of material Nature. Only by means of the experiential relation to the animate organism does consciousness become really human and animal (tierischen), and only thereby does it achieve a place in the space and in the time of Nature. l Consciousness can become "worldly" only by being embodied within the world as part of it. In so far as the world is material Nature, consciousness must partake of the transcendence of material Nature. That is to say, its transcendence is manifestly an embodiment in a material, corporeal body. Consciousness, thus, takes on the characteristic of being "here and now" (ecceity) by means of experiential (or, more accurately, its intentive) relation to that corporeal being which embodies it. Accordingly, that there is a world for consciousness is a conse quence in the first instance of its embodiment by 2 that corporeal body which is for it its own animate organism. (shrink)

Early in the first volume of his Ideen zu einer reinen Phiinomeno logie und phiinomenologischen Philosophie, Edmund Husserl stated concisely the significance and scope of the problem with which this present study is concerned. When we reflect on how it is that consciousness, which is itself absolute in relation to the world, can yet take on the character of transcendence, how it can become mundanized, We see straightaway that it can do that only by means of a certain participation in (...) transcendence in the first, originary sense, which is manifestly the transcendence of material Nature. Only by means of the experiential relation to the animate organism does consciousness become really human and animal (tierischen), and only thereby does it achieve a place in the space and in the time of Nature. l Consciousness can become "worldly" only by being embodied within the world as part of it. In so far as the world is material Nature, consciousness must partake of the transcendence of material Nature. That is to say, its transcendence is manifestly an embodiment in a material, corporeal body. Consciousness, thus, takes on the characteristic of being "here and now" (ecceity) by means of experiential (or, more accurately, its intentive) relation to that corporeal being which embodies it. Accordingly, that there is a world for consciousness is a conse quence in the first instance of its embodiment by 2 that corporeal body which is for it its own animate organism. (shrink)

This honest, forthright, and beautifully-written book introduces readers to the human variations on medical topics spoken of in abstract in the daily news--euthanasia, assisted suicide, abortion, "extreme procedures", genetic testing, experimental surgeries--and to the people who must agonize over those decisions regarding themselves and their loved ones.

Four prominent views of the nature and methods of clinical ethics (especially in consultation forums) are reviewed; each is then submitted to a criticism intended to show both weaknesses and strengths. It is argued that clinical ethics needs to be responsive to the specific complexities of clinical situations. For this, the need for an expanded notion of practical reason within unique situations is emphasized, one whose aim is to facilitate decision-making on the part of those directly responsible for them and (...) consonant with their own respective moral frameworks and conceptions of what is most worthwhile. Keywords: Casuistry, clinical ethics, consultation, decision-making, dialogue, facilitator, practical reason, relationships CiteULike Connotea Del.icio.us What's this? (shrink)

This article reviews the historical and current controversies about the nature of clinical ethics consultation, as a way to focus on the place and responsibility of ethics consultants within the context of clinical conversation — interpreted as a form of dialogue. These matters are approached through a particularly compelling instance of the controversy that involves several major figures in the field. The analysis serves to highlight very significant questions of the nature and constraints of clinical situations, and the moral responsibility (...) and legal accountability that are especially important for clinical ethics consultants. (shrink)

Many of the errors that occur in children' subtraction are due to the use of incorrect strategies rather than to the incorrect recall of number facts. A production system is presented for performing written subtraction which is consistent with an earlier analysis of the nature of such a cognitive skill. Most of the incorrect strategies used by schoolchildren can be accounted for in a principled way by simple changes in the production system, such as the omission of individual rules or (...) the inclusion of rules appropriate to other arithmetical tasks. The production system model is evaluated against a corpus of over 1500 subtraction problems done by 10‐year olds and is shown to account for about two‐thirds of the (nonnumber fact) errors. It also provides an alternative, simpler interpretation of the subtraction errors analysed by Brown and Burton (1978). Some implications for teaching are discussed. (shrink)

Physicians have for some time been questioning the prevailing view of medicine as applied biology. It is urged that medicine needs to be reconceived so as to provide appropriate emphasis on the patient's experience and understanding of illness. After reviewing these arguments and the scientific paradigm underlying the received view in light of certain themes in medicine's history and of current thinking, Pellegrino's thesis is analyzed: medicine should be understood as an inherently moral enterprise, a form of praxis focused on (...) "the healing relationship". Understanding the illness experience and the professed healer's "compassion" supports Pellegrino's view, and suggests that the healing relationship is perhaps best conceived as a form of dialogue. Keywords: compassion, dialogue, healing relationship, illness experience, interpretation CiteULike Connotea Del.icio.us What's this? (shrink)

This book addresses fundamental issues in linguistic theory, including the relation between formal and cognitive approaches, the autonomy of syntax, the content of universal grammar, and the value of generative and functional approaches to grammar. It focuses on the grammar of case relations, signalled by morphological case, prepositions, and word order. Part I offers a critical history of modern grammars of case, focussing on the last four decades and setting this in the context of earlier, including ancient, developments. The subjects (...) considered include the evolution of ideas concerning deep structure and semantic and grammatical relations, and arguments for the maintenance of the traditional central position of case in the grammar. In parts II and III Professor Anderson examines the category of case and central unresolved issues in the grammar of case. The latter include questions relating to the idea of an ontologically-based grammar, particularly the degree to which syntactic categories and relationships are grounded in meaning, and the notion of linguistic creativity. This involves a consideration of the way in which cases may be identified and whether their distribution is determined through semantics. The book sheds new light on the interactions between meaning and grammar and on the structure and development of lexical and grammatical systems. The argument and its far-reaching consequences will be of wide interest to linguists, philosophers and others seeking to understand the workings of language. (shrink)

This book is the first systematic account of the syntax and semantics of names. Drawing on work in onomastics, philosophy, and linguistics John Anderson examines the distribution and subcategorization of names within a framework of syntactic categories, and considers how the morphosyntactic behaviour of names connects to their semantic roles. He argues that names occur in two basic circumstances: one involving vocatives and their use in naming predications, where they are not definite; the other their use as arguments of (...) predicators, where they are definite. This division is discussed in relation to English, French, Greek, and Seri, and a range of other languages. Professor Anderson reveals that the semantic status of names, including prototypicality, is crucial to understanding their morphosyntax and role in derivational relationships. He shows that semantically coherent subsets of names, such as those referring to people and places, are characterized by morphosyntactic properties which may vary from language to language. His original and important investigation will appeal to scholars and advanced students of linguistics and philosophy. (shrink)

This textbook offers a unique and accessible approach to ethical decision-making for practicing pharmacists and student pharmacists. Unlike other texts, it gives clear guidance based on the fundamental principles of moral philosophy, explaining them in simple language and illustrating them with abundant clinical examples and case studies. The strength of this text is in its emphasis on normative ethics and critical thinking, and that there is truly a best answer in the vast majority of cases, no matter how complex. The (...) authors place high trust in a pharmacist’s moral judgment. This teaches the reader how to think, based on ethical principles, not necessarily what to think. This means navigating between the two extremes of overly theoretical and excessively prescriptive. The cogent framework given in this text uses the language of competing duties, identifying the moral principles at stake that create duties for the pharmacist. This is the balancing act of normative ethics, and of deciding which duties should prevail in a given clinical situation. This work presents a clear-cut pathway for resolving ethical dilemmas encountered by pharmacists, based on foundational principles and critical thinking. Presents a clear-cut pathway for resolving the ethical dilemmas encountered by pharmacists, based on foundational principles and critical thinking. Jon E. Sprague, RPh, PhD, Director of Science and Research for the Ohio Attorney General. (shrink)

After a brief, personal reflection on Aron Gurwitsch’s life and his many influences on my career, I devote this lecture to some of the central themes of a phenomenology of medicine. Its core is the clinical encounter, which displays a certain structure I term the asymmetry of power (physician) and vulnerability (patient, family)—a complex contextual imbalance characterized by multiple points of view, hence points for reflective entrance. These are then interpreted phenomenologically in terms of epoché and reduction (practical distantiation), evidence, (...) reflection, and other related themes. I conclude with a suggestion about “the fundamental method” of phenomenology, free fantasy variation. (shrink)

After a brief, personal reflection on Aron Gurwitsch's life and his many influences on my career, I devote this lecture to some of the central themes of a phenomenology of medicine. Its core is the clinical encounter, which displays a certain structure I term the asymmetry of power and vulnerability —a complex contextual imbalance characterized by multiple points of view, hence points for reflective entrance. These are then interpreted phenomenologically in terms of epoché and reduction, evidence, reflection, and other related (...) themes. I conclude with a suggestion about "the fundamental method" of phenomenology, free fantasy variation. (shrink)