Building a high school philosophy program from scratch requires vision, creativity, determination, and patience. I recount the steps my colleagues and I took to implement philosophy courses at The Stony Brook School and discuss the challenges that arose along the way. I also offer general outlines of the three courses we have implemented (Critical Reading and Reasoning, History of Philosophy, and Ethics and Politics), discuss pedagogical approaches that we have found to work with high school students, and share feedback on (...) the courses from my students. (shrink)
Population health has recently grown from a series of loosely connected critiques of twentieth-century public health and medicine into a theoretical framework with a corresponding field of research—population health science. Its approach is to promote the public’s health through improving everyday human life: affordable nutritious food, clean air, safe places where children can play, living wages, etc. It recognizes that addressing contemporary health challenges such as the prevalence of type 2 diabetes will take much more than good hospitals and public (...) health departments. -/- Blending philosophy of science/medicine, public health ethics and history, this book offers a framework that explains, analyses and largely endorses the features that define this relatively new field. Presenting a philosophical perspective, Valles helps to clarify what these features are and why they matter, including: searching for health’s “upstream” causes in social life, embracing a professional commitment to studying and ameliorating the staggering health inequities in and between populations; and reforming scientific practices to foster humility and respect among the many scientists and non- scientists who must work collaboratively to promote health. -/- Featuring illustrative case studies from around the globe at the end of all main chapters, this radical monograph is written to be accessible to all scholars and advanced students who have an interest in health—from public health students to professional philosophers. (shrink)
This essay explores how the experience of National Socialism provoked German intellectuals to rethink elitist conventions in politics. It focuses on three figures in the town of Heidelberg—Alexander Mitscherlich, Dolf Sternberger, and Alfred Weber—as well as on a journal and a discussion forum that they established after 1945. Breaking with both mandarin and vanguardist traditions, they conceived a politics that neither transpired over the masses’ heads nor sought to organize them from above but rested on the people's participation from below. (...) Moreover, a correspondence existed between their thinking on democracy and the grassroots, extra-institutional activities they pursued in an attempt to realize what they called “publicness”. Finally, the essay relates such immediate postwar ideas and practices to these intellectuals’ stances toward West Germany after 1949 as well as to the discussion on “publicness” that unfolded there, as exemplified in Jürgen Habermas's early work. (shrink)
Philosophy of epidemiology has recently emerged as a distinct branch of philosophy. The field will surely benefit from pluralism, reflected in the broad range of topics and perspectives in this special issue. Here, I argue that a healthy pluralistic field of philosophy of epidemiology has social responsibilities that require the field as a whole to engage actively with research on social determinants of health and health disparities. Practicing epidemiologists and the broader community of public health scientists have gradually acknowledged that (...) much of their attention ought to be paid to these, i.e. inequitable between-population health variations that largely reflect the world’s inequitable distribution of resources and social conditions. The paper illustrates how and why health disparities and social determinants of health, through no ill will, become de facto secondary concerns in Alex Broadbent’s field-defining Philosophy of Epidemiology, showing the ease with which these topics can be incidentally sidelined. As means for philosophy of epidemiology to meet its social responsibility obligations, I suggest philosophy of epidemiology expand its attention to two particular lines research. First, the paper discusses Geoffrey Rose’s concept of “causes of incidence”—causes of disparities between populations—and argues for the importance of engaging with these causes. Second, the paper argues for the value of engaging with Bruce Link and Jo Phelan’s “fundamental causes” model of how flexible social resources serve as buffers from harms, generating a plethora of shifting and locally-contingent health effects. (shrink)
In this paper we examine the functional anatomy of volition, as revealed by modern brain imaging techniques, in conjunction with neuropsychological data derived from human and non-human primates using other methodologies. A number of brain regions contribute to the performance of consciously chosen, or ‘willed', actions. Of particular importance is dorsolateral prefrontal cortex , together with those brain regions with which it is connected, via cortico-subcortical and cortico-cortical circuits. That aspect of free will which is concerned with the voluntary selection (...) of one action rather than another critically depends upon the normal functioning of DLPFC and associated brain regions. Disease, or dysfunction, of these circuits may be associated with a variety of disorders of volition: Parkinson's disease, ‘utilization’ behaviour, ‘alien’ and ‘phantom’ limbs, and delusions of ‘alien control’ . Brain imaging has allowed us to gain some access to the pathophysiology of these conditions in living patients. At a philosophical level, the distinction between ‘intentions to act', and ‘intentions in action’ may prove particularly helpful when addressing these complex disturbances of human cognition and conscious experience. The exercise and experience of free will depends upon neural mechanisms located in prefrontal cortex and associated brain systems. (shrink)
This paper presents a new model for how to jointly analyze the ethical and evidentiary dimensions of environmental science cases, with an eye toward making science more participatory and publically...
If the notion of free will is to be retained by philosophers, psychiatrists and psychologists, then it will be a free will which is essentially non-conscious. The purpose of this paper is to demonstrate that a conscious free will (in the sense of consciousness initiating action) is incompatible with the evidence of neuroscience, and the phenomenology described in the literature of normal creativity, psychotic passivity, and the neurological syndrome of the alien limb or hand. In particular the work of Libet (...) and others who have directly stimulated the brain and measured activity from its surface leads to the conclusion that subjective states (be they sensory or intentional) are preceded by predictive neural activity. Subjective phenomenology is temporally distinct from the initiation of “voluntary” action. In addition it will be argued that free will is more than a belief and that it comprises a perceptual sensorimotor component. Free will is conceptualized as a three component phenomenon consisting of a perceptual, non-linguistic experience of freedom, an experiential belief which is linguistic, and related to a specified action in time, and an abstract belief which is linguistic but remote from any particular action and akin to philosophical discourse (the abstract belief or otherwise, in free will). A theoretical explanation of some of the pathological phenomenology of possession of action is offered in terms of temporal considerations. The direction of action within mental/virtual space is hypothesized to be a function of the temporal sequence of its initiation and awareness of the latter “reaching” consciousness. It is suggested that perturbation of this temporal sequence may lead to the misattribution of host-as-alien-initiated action. Work of this kind, which is beyond subjective introspection, is necessary if we are to develop adequate models to use in conjunction with modern investigation techniques. (shrink)
Targeting high-risk populations for public health interventions is a classic tool of public health promotion programs. This practice becomes thornier when racial groups are identified as the at-risk populations. I present the particular ethical and epistemic challenges that arise when there are low-risk subpopulations within racial groups that have been identified as high-risk for a particular health concern. I focus on two examples. The black immigrant population does not have the same hypertension risk as US-born African Americans. Similarly, Finnish descendants (...) have a far lower rate of cystic fibrosis than other Caucasians. In both cases the exceptional nature of these subpopulations has been largely ignored by the designers of important public health efforts, including the recent US government dietary recommendations. I argue that amending the publicly-disseminated risk information to acknowledge these exceptions would be desirable for several reasons. First, recognizing low-risk subpopulations would allow more efficient use of limited resources. Communicating this valuable information to the subpopulations would also promote truth-telling. Finally, presenting a more nuanced empirically-supported representation of which groups are at known risk of diseases (not focusing on mere racial categories) would combat harmful biological race essentialist views held by the public. (shrink)
People experiencing alien control report that their thoughts, movements, actions, and emotions have been replaced by those of an "other." The latter is commonly a perceived persecutor of the patient. Here I describe the clinical phenomenology of alien control, mechanistic models that have been used to explain it, problems inherent in these models, the brain deficits and functional abnormalities associated with this symptom, and the means by which disordered agency may be examined in this perplexing condition. Our current state of (...) knowledge implicates potentially reversible dysfunction in certain key brain regions (especially the right parietal cortex), which is temporally related to the presence of symptoms. Alien control is quintessentially a disorder of agency. (shrink)
Two decades ago, the eminent evolutionary biologist George C. Williams and his physician coauthor, Randolph Nesse, formulated the evolutionary medicine research program. Williams and Nesse explicitly made adaptationism a core component of the new program, which has served to undermine the program ever since, distorting its practitioners’ perceptions of evidentiary burdens and in extreme cases has served to warp practitioner’s understandings of the relationship between evolutionary benefits/detriments and medical ones. I show that the Williams and Nesse program more particularly embraces (...) the panselectionist variety of adaptationism (the empirical assumption that non-adaptive evolutionary processes are causally unimportant compared to natural selection), and argue that this has harmed the field. Panselectionism serves to conceal the enormous evidentiary hurdles that evolutionary medicine hypotheses face, making them appear stronger than they are. I use two examples of evolutionary medicine texts, on neonatal jaundice and on asthma, to show that some evolutionary medicine practitioners have allowed their fervent panselectionism to directly shape their recommendations for clinical practice. I argue that this escalation of panselectionism’s influence is inappropriate under Williams’ and Nesse original stated standards, despite being inspired by their program. I also show that the examples’ conflation of clinical and evolutionary considerations is inappropriate even under Christopher Boorse’s controversial evolution-rooted concepts of disease and health. (shrink)
Direct-to-consumer personalized genomic medicine has recently grown into a small industry that sells mail-order DNA sample kits and then provides disease risk assessments, typically based upon results from genome-trait association studies. The companies selling these services have been largely exempted from FDA regulation in the United States. Testing kit companies and their supporters have defended the industry's unregulated status using two arguments. First, defenders have argued that mere absence of harm is all that must be proved for mail-order tests to (...) be acceptable. Second, defenders of mail-order testing have argued that there is an individual right to the tests' information. This article rebuts these arguments. The article demonstrates that the direct-to-consumer market has resulted in the sidelining of clinical utility (medical value to patients), leading to the development of certain mail-order tests that do not promote customers' interests and to defenders' downplaying of a potentially damaging empirical study of mail-order genomic testing's effects on consumers. The article also shows that the notion of an individual right to these tests rests on a flawed reading of the key service provided by mail-order companies, which is the provision of medical interpretations, not simply genetic information. Absent these two justifications, there is no reason to exempt direct-to-consumer personalized genomic medicine from stringent federal oversight. (shrink)
“Nobody had ever seen anything like this before.”“Nobody would have ever thought a thing like this could have happened.”There is a lot at stake in the current and forthcoming debates over what/why/how the COVID-19 pandemic’s effects on the US were unpredictable. These debates are crucial to both our assessments of backward-looking culpability and in the related but even more socially important task of guiding decisions about how to rebuild society after the pandemic subsides. The more we treat the harm as (...) unexpected—a fluke—the more we bolster the argument that no major structural changes need to be made to the US health system. I come to this question as one of... (shrink)
We present an annotated bibliography of peer reviewed scientific research highlighting the human health, animal welfare, and environmental risks associated with genetic modification. Risks associated with the expression of the transgenic material include concerns over resistance and non-target effects of crops expressing Bt toxins, consequences of herbicide use associated with genetically modified herbicide-tolerant plants, and transfer of gene expression from genetically modified crops through vertical and horizontal gene transfer. These risks are not connected to the technique of genetic modification as (...) such, but would be present for any conventionally produced crops with the same heritable traits. In contrast, other risks are a direct consequence of the method used in gene manipulation. These come about because of the unstable nature of the transgene and vectors used to insert it, and because of unpredictable interactions between the transgene and the host genome. The debate over the release of genetically modified organisms is not merely a scientific one; it encompasses economics, law, ethics, and policy. Any discussion on these levels does, however, need to be informed by sound science. We hope that the scientific references provided here will provide a useful starting point for further debate. (shrink)
Sodium monofluoroacetate (1080) is a mammalian pesticide used in different parts of the world for the control of mammalian pest species. In New Zealand it is used extensively and very successfully as a conservation management tool for the control of brushtail possums (Trichosurus vulpecula) – an introduced marsupial that has become a substantial agricultural and conservation management pest. Possums pose a threat to cattle farming in New Zealand as they are a vector for bovine tuberculosis. In protected natural areas, possum (...) browsing is responsible for large scale defoliation of native vegetation. As with many other pesticides, there has been some degree of popular concern about the use of this toxin and its safety, with particular reference to non-target effects. These concerns have been associated with potential non-target effects on human health, and the health of animals of recreational value (e.g., hunting dogs and game animals). This has led to the development of a strong “anti-1080” lobby in New Zealand. In contrast, this study encompasses a science-based risk analysis focusing on the potential risks to non-target native wildlife with a particular focus on chronic toxicity. It finds that there is evidence that 1080 may have endocrine disrupting capabilities (with potential relevance for non-target wildlife) but that this still needs more detailed investigation. This can be clarified by further targeted research. Further research is also needed to test the degradation rates of 1080 and its breakdown products at ecologically-relevant temperatures (i.e., winter stream temperatures – below 11 °C). Such research may demonstrate that some adjustment to 1080 risk management is warranted in New Zealand, or it may help to put to rest the current controversy over the use of this cost effective conservation management tool. (shrink)
Cheryl Cox MacPherson recently argued, in an article for this journal, that ‘Climate Change is a Bioethics Problem’. This article elaborates on that position, particularly highlighting bioethicists' potential ability to help reframe the current climate change discourse to give more attention to its health risks. This reframing process is especially important because of the looming problem of climate change skepticism. Recent empirical evidence from science framing experiments indicates that the public reacts especially positively to climate change messages framed in public (...) health terms, and bioethicists are particularly well positioned to contribute their expertise to the process of carefully developing and communicating such messages. Additionally, as climate framing research and practice continue, it will be important for bioethicists to contribute to the creation of that project's nascent ethical standards. The discourse surrounding antibiotic resistance is posited as an example that can lend insight into how communicating a public health-framed message, including the participation of bioethicists, can help to override public skepticism about the findings of politically contentious scientific fields. (shrink)
We propose that middle managers’ perceived organizational support enhances their performance through the sequential mediation of their behavioral integrity and follower organizational citizenship behaviors. We test our model with data collected from middle managers, their direct subordinates, and their direct superiors at 18 hotel properties in China. The current study’s findings contribute to the existing literature on perceived organizational support and behavioral integrity. They also add a practical self-interest argument for middle managers’ efforts to maintain their word-action alignment by demonstrating (...) that middle manager behavioral integrity positively affects middle managers’ own task performance ratings, both directly and via its positive effect on subordinates’ organizational citizenship behaviors. (shrink)
As the emphasis in the title of his article indicates, Garry Young (2006) wishes to retain a role for conscious intention in the initiation of intentional acts, a proposal he contrasts with the findings and writings of Benjamin Libet, and also my own comments upon the latter (Libet et al., 1983; Spence, 1996). While Libet's classic series of experiments (and their replication by others) established that the conscious intention to act is itself preceded by predictive trains of electrical activity in (...) the brain, Young wishes to attribute a meaningful role to intention even though it arises relatively 'late' in the stream of causation. He believes intention makes a contribution. The question here, or at least the source of perceived disagreement, seems to be: what is the nature of this contribution? Also, are we talking about a single act or the context within which it (action) occurs? (shrink)
Common monogenic genetic diseases, ones that have unexpectedly high frequencies in certain populations, have attracted a great number of conflicting evolutionary explanations. This paper will attempt to explain the mystery of why two particularly extensively studied common genetic diseases, Tay Sachs disease and cystic fibrosis, remain evolutionary mysteries despite decades of research. I review the most commonly cited evolutionary processes used to explain common genetic diseases: reproductive compensation, random genetic drift (in the context of founder effect), and especially heterozygote advantage. (...) The latter process has drawn a particularly large amount of attention, having so successfully explained the elevated frequency of sickle cell anemia in malaria-endemic areas. However, the empirical evidence for heterozygote advantage in other common genetic diseases is quite weak. I introduce and illustrate the significance of a hierarchy of genetic disease phenomena found within the genetic disease explanations, which include the phenomena: single mutation variants of a common genetic disease, single genetic diseases, and classes of diseases with related phenotypic effects. I demonstrate that some of the confusion over the explanations of common genetic diseases can be traced back to confusions over which phenomena are being explained. I proceed to briefly evaluate the existing evidence for two common human genetic diseases: Tay Sachs disease and cystic fibrosis. The above considerations will ultimately shed light on why these diseases’ evolutionary explanations remain so deeply unresolved after so such a great volume of research. (shrink)
Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love. Health is created by caring for oneself and others, by being able to take decisions and have control over one's life circumstances, and by ensuring that the society one lives in creates conditions that allow the attainment of health by all its members.To begin, I largely agree with Doan and Harbin's argument in "Public Health and Precarity," and by extension (...) I largely agree with Sherwin's relational approach to public health. Since this is a commentary on Doan and Harbin's piece, I will keep this relatively short work focused on their paper, rather than... (shrink)
Lionel Penrose (1898–1972) was an important leader during the mid-20th century decline of eugenics and the development of modern medical genetics. However, historians have paid little attention to his radical theoretical challenges to mainline eugenic concepts of mental disease. Working from a classification system developed with his colleague, E. O. Lewis, Penrose developed a statistically sophisticated and clinically grounded refutation of the popular position that low intelligence is inherently a disease state. In the early 1930s, Penrose advocated dividing “mental defect” (...) (low intelligence) into two categories: “pathological mental defect,” which is a disease state that can be traced to a distinct genetic or environmental cause, and “subcultural mental defect,” which is not an inherent disease state, but rather a statistically necessary manifestation of human variation in intelligence. I explore the historical context and theoretical import of this contribution, discussing its rejection of typological thinking and noting that it preceded Theodosius Dobzhansky’s better-known defense of human diversity. I illustrate the importance of Penrose’s contribution with a discussion of an analogous situation in contemporary medicine, the controversial practice of using human growth hormone injections to treat “idiopathic short stature” (mere diminutive height, with no distinct cause). I show how Penrose’s contributions to understanding human variation make such treatments appear quite misguided. (shrink)
A method is described for inducing a type-logical grammar from a sample of bare sentence trees which are annotated by lambda terms, called term-labelled trees . Any type logic from a permitted class of multimodal logics may be specified for use with the procedure, which induces the lexicon of the grammar including the grammatical categories. A first stage of semantic bootstrapping is performed, which induces a general form lexicon from the sample of term-labelled trees using Fulop’s (J Log Lang Inf (...) 14(1):49–86, 2005) procedure. Next we present a two-stage procedure for performing distributional learning by unifying the lexical types that are initially discovered. The first structural unification algorithm in essence unifies the initial family of sets of types so that the resulting grammar will generate all term-labelled trees that follow the usage patterns evident from the learning sample. Further altering the lexical categories to generate a recursively extended language can be accomplished by a second unification. The combined unification algorithm is shown to yield a new type-logical lexicon that extends the learning sample to a possibly infinite (and possibly context-sensitive) language in a principled fashion. Finally, the complete learning strategy is analyzed from the perspective of algorithmic learning theory; the range of the procedure is shown to be a class of term-labelled tree languages which is finitely learnable from good examples (Lange et al in Algorithmic learning theory, Vol 872 of lecture notes in artificial intelligence, Springer, Berlin, pp 423–437), and so is identifiable in the limit as a corollary. (shrink)
A two-stage procedure is described which induces type-logical grammar lexicons from sentences annotated with skeletal terms of the simply typed lambda calculus. First, a generalized formulae-as-types correspondence is exploited to obtain all the type-logical proofs of the sample sentences from their lambda terms. The resulting lexicons are then optimally unified. The first stage constitutes the semantic bootstrapping (Pinker, Language Learnability and Language Development, Harvard University Press, 1984), while the unification procedure of Buszkowski and Penn represents a first attempt at structure-dependent (...) distributional learning of the syntactic and semantic categories. This effort extends earlier induction procedures (Buszkowski and Penn, 1990, Studia Logica 49, 431–454; Kanazawa, 1998, CSLI Publications and the European Association for Logic, Language and Information) for classical categorial grammar to at first the non-associative Lambek calculus, and then to a large class of type logics enriched by modal operators and structural rules. (shrink)
A two-stage procedure is described which induces type-logical grammar lexicons from sentences annotated with skeletal terms of the simply typed lambda calculus. First, a generalized formulae-as-types correspondence is exploited to obtain all the type-logical proofs of the sample sentences from their lambda terms. The resulting lexicons are then optimally unified. The first stage constitutes the semantic bootstrapping, while the unification procedure of Buszkowski and Penn represents a first attempt at structure-dependent distributional learning of the syntactic and semantic categories. This effort (...) extends earlier induction procedures for classical categorial grammar to at first the non-associative Lambek calculus, and then to a large class of type logics enriched by modal operators and structural rules. (shrink)
“Trait” is a ubiquitous term in biology, but its precise meaning and theoretical foundations remain opaque. After distinguishing between “trait” and “character,” I argue for the value of adopting Theodosius Dobzhansky’s 1956 definition and framework for understanding “trait,” which holds that traits are just “semantic devices” that artificially impose order on continuous biological phenomena. I elaborate on this definition to distinguish between trait validity (compliance with Dobzhansky’s trait definition) and trait utility (usefulness of a trait). As a consequence of this (...) elaboration of the meaning of “trait,” it becomes clear that considerations of adaptation, function, homogeneity and natural kinds have clouded discussions of the meaning of “trait” per se. Combining this account with work by David Hull and examples from contemporary biology, I demonstrate that even broad or heterogeneous traits (including multiple sub-traits) can qualify as valid and useful. As a test case for this understanding of trait, I show how it can help resolve critiques of schizophrenia’s status as a single trait, highlighting the recent advances made within schizophrenia research. (shrink)
This article is an introduction to the Synthese Special Issue, Philosophy of Epidemiology. The overall goals of the issue are to revisit the state of philosophy of epidemiology and to provide a forum for new voices, approaches, and perspectives in the philosophy of epidemiology literature. The introduction begins by drawing on Geoffrey Rose’s work on how to conceptualize and design interventions for populations, rather than individuals. It then goes on to highlight some themes that emerged in the articles that make (...) up the issue: philosophy of epidemiology and epidemiological theory—what they are and what they ought to be, pluralism in measurement and causal attribution, epistemic and non-epistemic values in disputes epidemiological practices, decentering philosophy of epidemiology’s Eurocentrism, letting pragmatism guide uses of big data in epidemiology, and revisiting the lessons of classic texts in epidemiological causal inference. The introduction concludes with comments on a philosophy of epidemiology debate we see on, regarding the politics of philosophy of epidemiology. (shrink)
REMARKS ON EVOLUTION AND TIME-SCALES, Graham Cairns-Smith; HODGSON'S BLACK BOX, Thomas Clark; DO HODGSON'S PROPOSITIONS UNIQUELY CHARACTERIZE FREE WILL?, Ravi Gomatam; WHAT SHOULD WE RETAIN FROM A PLAIN PERSON'S CONCEPT OF FREE WILL?, Gilberto Gomes; ISOLATING DISPARATE CHALLENGES TO HODGSON'S ACCOUNT OF FREE WILL, Liberty Jaswal; FREE AGENCY AND LAWS OF NATURE, Robert Kane; SCIENCE VERSUS REALIZATION OF VALUE, NOT DETERMINISM VERSUS CHOICE, Nicholas Maxwell; COMMENTS ON HODGSON, J.J.C. Smart; THE VIEW FROM WITHIN, Sean Spence; COMMENTARY ON HODGSON, Henry (...) Stapp. (shrink)
In some areas of cognitive science we are confronted with ultrafast cognition, exquisite context sensitivity, and scale-free variation in measured cognitive activities. To move forward, we suggest a need to embrace this complexity, equipping cognitive science with tools and concepts used in the study of complex dynamical systems. The science of movement coordination has benefited already from this change, successfully circumventing analogous paradoxes by treating human activities as phenomena of self-organization. Therein, action and cognition are seen to be emergent in (...) ultrafast symmetry breaking across the brain and body; exquisitely constituted of the otherwise trivial details of history, context, and environment; and exhibiting the characteristic scale-free signature of self-organization. (shrink)
Pest control operations andexperimentation on sentient animals such as thebrushtail possum can cause unnecessary andavoidable suffering in the animal subjects.Minimizing animal suffering is an animalwelfare goal and can be used as a guide in thedesign and execution of animal experimentationand pest control operations.The public has little sympathy for the possum,which can cause widespread environmentaldamage, but does believe that control should beas painless as possible. Trapping and poisoningprovide only short-term solutions to the possumproblem and often involve methods that causesuffering. Intrusive experiments (...) connected withthese methods of control and published in thelast 6 years are reviewed. Many of theexperiments do not attain the welfare standardsrequired by members of the public. (shrink)
Training in the responsible conduct of research (RCR) is required for many research trainees nationwide, but little is known about its effectiveness. For a preliminary assessment of the effectiveness of a short-term course in RCR, medical students participating in an NIH-funded summer research program at the University of California, San Diego (UCSD) were surveyed using an instrument developed through focus group discussions. In the summer of 2003, surveys were administered before and after a short-term RCR course, as well as to (...) alumni of the courses given in the summers of 2002 and 2001. Survey responses were analyzed in the areas of knowledge, ethical decision-making skills, attitudes about responsible conduct of research, and frequency of discussions about RCR outside of class. The only statistically significant improvement associated with the course was an increase in knowledge, while there was a non-significant tendency toward improvements in ethical decision-making skills and attitudes about the importance of RCR training. The nominal impact of a short-term training course should not be surprising, but it does raise the possibility that other options for delivering information only, such as an Internet-based tutorial, might be considered as comparable alternatives when longer courses are not possible. (shrink)
Not all actions that are legal are necessarily morally correct. However, there are few protections for providers who are pressured to comply with actions and procedures that infringe on their religious beliefs regarding human dignity. The right of health care providers to freely act on religious convictions and refrain from cooperating with morally reprehensible tasks is often eschewed in favor of political correctness or is branded as discrimination. Adequate safeguards are urgently needed for health care workers at all levels to (...) ensure that they can continue to care for the sick and most vulnerable members of the community without violating the dictates of their conscience. This article examines the free exercise of religion as it pertains to medical provider conscience protections. The author argues for conscience protection legislation with a right of action. (shrink)
In a democracy, citizens should have some control over how they are governed. If they do not participate directly in making policy, they ought to maintain control over the public officials who design policy on their behalf. Rule by Multiple Majorities develops a novel theory of popular control: an account of what it is, why democracy's promise of popular control is compatible with what we know about actual democracies, and why it matters. While social choice theory suggests there is no (...) such thing as a 'popular will' in societies with at least minimal diversity of opinion, the author argues that multiple, overlapping majorities can nonetheless have control, at the same time. After resolving this conceptual puzzle, the author explains why popular control is a realistic and compelling ideal for democracies, notwithstanding voters' low levels of information and other shortcomings. (shrink)