Purpose Although surrogate decision-making is prevalent in intensive care units and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. Subjects and methods We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death. We developed and applied a (...) coding framework to identify normative statements by clinicians regarding what considerations should guide surrogates’ decisions, including whether clinicians explained one or more of Buchanan and Brock’s three standard principles of SDM to family members. Results Clinicians made at least one statement about how to perform the surrogate role in 24 conferences ). We observed three general types of normative guidance provided to surrogates, with some conferences containing more than one type of guidance: counselling about one or more standard principles of SDM ; counselling surrogates to make decisions centred on the patient as a person, without specifying how to accomplish that ; and counselling surrogates to make decisions based on the family’s values. Conclusions Clinicians did not provide normative guidance about the surrogate role in two-thirds of family conferences for incapacitated patients at high risk for death. When they did, clinicians’ guidance was often incomplete and sometimes conflicted with standard principles of SDM. Future work is needed to understand whether providing explicit guidance on how to perform the surrogate role improves decision-making or mitigates surrogates’ psychological distress. (shrink)

Purpose Although surrogate decision-making is prevalent in intensive care units and concerns with decision quality are well documented, little is known about how clinicians help family members understand the surrogate role. We investigated whether and how clinicians provide normative guidance to families regarding how to function as a surrogate. Subjects and methods We audiorecorded and transcribed 73 ICU family conferences in which clinicians anticipated discussing goals of care for incapacitated patients at high risk of death. We developed and applied a (...) coding framework to identify normative statements by clinicians regarding what considerations should guide surrogates’ decisions, including whether clinicians explained one or more of Buchanan and Brock’s three standard principles of SDM to family members. Results Clinicians made at least one statement about how to perform the surrogate role in 24 conferences ). We observed three general types of normative guidance provided to surrogates, with some conferences containing more than one type of guidance: counselling about one or more standard principles of SDM ; counselling surrogates to make decisions centred on the patient as a person, without specifying how to accomplish that ; and counselling surrogates to make decisions based on the family’s values. Conclusions Clinicians did not provide normative guidance about the surrogate role in two-thirds of family conferences for incapacitated patients at high risk for death. When they did, clinicians’ guidance was often incomplete and sometimes conflicted with standard principles of SDM. Future work is needed to understand whether providing explicit guidance on how to perform the surrogate role improves decision-making or mitigates surrogates’ psychological distress. (shrink)

First published in 1986. Routledge is an imprint of Taylor & Francis, an informa company.

Did the liberal art disciplines at American universities have the highest failure rate between the 1970s and the early 2000s? Important theoretical traditions indeed believe that the liberal arts are the most threatened disciplines in the academy, while other theories have differing views. This paper reexamines the vulnerability of academic disciplines by assessing new data. It focuses on the closing of academic departments and programs, and it uses event history analysis to show that practical arts departments and programs failed at (...) a much higher rate than liberal arts departments and programs. In doing so, this paper raises important questions about how American universities are changing during a time of budget cuts and retrenchment. (shrink)

First published in 1996. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

The object of this paper is to study the analogy, drawn both positively and negatively, between mathematics and fiction. The analogy is more subtle and interesting than fictionalism, which was discussed in part I. Because analogy is not common coin among philosophers, this particular analogy has been discussed or mentioned for the most part just in terms of specific similarities that writers have noticed and thought worth mentioning without much attention's being paid to the larger picture. I intend with this (...) analogy (looking at others' comparisons) to shed a little light on what is going on in mathematics, how one can understand it a bit other than experientially. This intention is philosophical and the way that I am attempting to accomplish it is also philosophical. I shall conclude my attempt to explain how it is possible and even natural for mathematics and fiction to have the analogy they have, taking it for granted, as argued in part I, that they are not to be identified. To this end I shall discuss philosophers' comparisons, mainly those of Hodes, Resnik, Tharp, and Wagner, who are the writers that seem to me to have written most thoughtfully and sufficiently extensively about fiction in making the comparison and of Körner, whose comparison is different. Whether either of these comparisons or the more general analogy is of permanent philosophical interest will have to be decided by philosophers now that they have had a fuller examination. I shall mention some other writers' reference to fiction, but not all; indeed, I am sure that I have not even found all the comparisons that there are. (shrink)

Menachem Butler. Bibliography: Mark Steiner’s main works, pp. 3–7.

What is implied by "ethics of history"? The authors of this volume, internationally renowned philosophers and intellectual historians, address this question in all its novelty and ambiguity and develop varied perspectives on the place and nature of ethics in the philosophy, enterprise, and practice of history. Is the whole historical process--largely consisting of the actions and sufferings of persons and groups--subject to ethical constraint? And what of the ways in which historians present their subject matter; are these methods subject to (...) moral scrutiny? Although they approach these issues from different directions, the contributors agree in their critique of the correspondence theory of history, tin their acceptance of an unbridgeable gap between the past and the historian's present account, and in their call for a revision of the popular appeal to historical objectivity. (shrink)

Sex and the American Teenager provides an expert's assessment on the controversies over teenagers' sexual development, beliefs, and problems, and schools' methods of coping with such matters. Thomas's book is not only replete with facts about sexual issues in school, it provides case studies that illustrate the specific ways that sex issues arise.

Components from a variety of existing theories combine with insights from the author's research to create an original theory of moral development.

This book presents a new classification system for acts of wrongdoing, sanctions imposed on the people who commit those acts, and the aims these sanctions intend to achieve.

The study that George Lakoff and Rafael Núñez call "idea analysis" and begin in their recent book Where mathematics comes from is intended to dissect mathematical concepts into their metaphorical parts, where metaphor is used in the cognitive-science sense promoted by Lakoff and Mark Johnson in Metaphors we live by and subsequent works by each of them and together. Lakoff and Núñez's analysis of the (modern) algebraic concept of group is based on the attribution to contemporary mathematics of what will (...) be widely recognizable by their name for it, the folk theory of essences. I argue that this philosophical basis for their analysis is spurious and supply an alternative analysis of the same concept within their "metaphorical" paradigm but without essences. This analysis, which I hope is more viable than theirs, is intended to support the general applicability of the paradigm by freeing it from outmoded philosophical baggage. (shrink)

Without wishing to suggest that professional philosophers would regard the book as philosophy, I can report that this book is definitely philosophical. Most of the book pertains to mathematical invention, but not just the psychology thereof, with many examples of the way in which mathematical advances move from two different and incompatible ways of viewing something to a higher viewpoint on it that makes better sense and better mathematics. A simple example of this is the invention of zero, where the (...) two incompatible viewpoints are that numbers are for counting and that there is nothing to count. The number one exemplified almost the same degree of blockage for the ancient Greeks, for whom the least number was two. It is perhaps unfortunate that the word that the author chose to represent the presence of such resolvable cognitive difficulties is ‘ambiguity’. As ambiguity is severely shunned by mathematicians and as there is none of it—as the word is normally used—in such situations as are described either before, when there are the two viewpoints, or later when there is a higher one, the use of ‘ambiguity’ would be misleading if it were not so adequately explained not to mean ambiguity. The excuse for using the word is claimed to be the genuine ambiguity of one of the simplest examples discussed, 3 + 4, with indifferently the meanings ‘add four to three’ and …. (shrink)

Supererogation has gained attention as a means of explaining the voluntary behaviours of individuals and organizations that are done for the benefit of others and which go above what is required of legislation and what may be expected by society. Whilst the emerging literature has made some significant headway in exploring supererogation as an ethical lens for the study of business there remain several important issues that require attention. These comprise, the lack of primary evidence upon which such examinations have (...) been made, attention has been given to only singular pro-social acts of organizations, and the focus has been upon the actions of large organizations. Furthermore, Heyd’s (Supererogation, Cambridge University Press, 1982) original taxonomy of six supererogatory acts, comprising Moral Heroism, Beneficence, Volunteering, Favour, Forgiveness and Forbearance, has been considered to be complete and other forms of supererogatory acts have not yet been explored. In order to address these gaps this study poses the research questions: First, it studies how a single, contemporary SME performs multiple supererogatory acts in its attempts to address its social and environmental goals that go beyond CSR. Second, it seeks to gain a deeper theoretical understanding of Heyd’s (Supererogation, Cambridge University Press, 1982) taxonomy of six forms of supererogation through the capture of primary data. This research makes a three-year case study examination of a single SME that has been formally recognized for its work in addressing social and environmental issues at local, national and global levels. Primary data are acquired of the supererogatory acts that it performs through a three-year participant observation case study, utilizing 61 interviews and 3 focus groups with internal and external stakeholders. In doing so, it addresses the empirical limitations of the extant research, substantiates each of the forms that supererogatory acts may take, and makes a contribution to the theory of supererogation by identifying a further class of act that is ‘Sharing’. (shrink)

The story of this book of 'materials on Ludwik Fleck' is also the story of the reception of Ludwik Fleck. In this volume, some essential materials which have been produced by that reception have been gathered together.

This paper considers the view that medicine is both “science” and “art.” It is argued that on this view certain clinical knowledge – of patients’ histories, values, and preferences, and how to integrate them in decision-making – cannot be scientific knowledge. However, by drawing on recent work in philosophy of science it is argued that progress in gaining such knowledge has been achieved by the accumulation of what should be understood as “scientific” knowledge. I claim there are varying degrees of (...) objectivity pertaining to various aspects of clinical medicine. Hence, what is often understood as constituting the “art” of medicine is amenable to objective methods of inquiry, and so, may be understood as “science”. As a result, I conclude that rather than endorse the popular philosophical distinction between the art and science of medicine, in the future a unified, multifaceted epistemology of medicine should be developed to replace it. (shrink)

There are at least a few plausible grounds for our use of the term Beta in our title, notwithstanding that there is a key departure, in our framework, from classical Beta Existential Graphs. The situation, in brief, is as follows.The reader accustomed to Peirce’s graphical development of quantificational logic may, if desired, continue to think of formulas being written on a “sheet of assertion.” We retain the “cut” notation for negation and continue to represent conjunction simply by juxtaposition of diagrams. (...) However, on the side of departure, we dispense with the sometimes problematic “lines of identity” of classical Beta and instead represent a quantification by a.. (shrink)

This edition of the Handbookfollows the first edition by 10 years.

_An accessible discussion of the thought of key figures of the Kyoto School of Japanese philosophy._.

Three common ethical principles for establishing the limits of parental authority in pediatric treatment decision making are the harm principle, the principle of best interest, and the threshold view. This paper consider how these principles apply to a case of a premature neonate with multiple significant comorbidities whose mother wanted all possible treatments, and whose health care providers wondered whether it would be ethically permissible to allow him to die comfortably despite her wishes. Whether and how these principles help to (...) understand what was morally right for the child is questioned. The paper concludes that the principles were of some value in understanding the moral geography of the case, but that the case reveals common bioethical principles for medical decision making are problematically value-laden because they are inconsistent with the widespread moral value of medical vitalism. (shrink)

No abstract available. First paragraph: In this issue’s target article, Stier and Schoene-Siefert purport to ‘depotentialize’ the argument from potentiality based on their claim that any human cell may be “converted” into a morally significant entity, and consequently, the argument from potentiality finally succumbs to a reductio ad absurdum. I aim to convey two reasons for skepticism about the innocuousness of the notion of cell convertibility, and hence, the cogency of their argument.

This paper explores how current United States policies for funding nonreproductive cloning are justified and argues against that justification. I show that a common conceptual framework underlies the national prohibition on the use of public funds for cloning research, which I call the simple argument. This argument rests on two premises: that research harming human embryos is unethical and that embryos produced via fertilization are identical to those produced via cloning. In response to the simple argument, I challenge the latter (...) premise. I demonstrate there are important ontological differences between human embryos (produced via fertilization) and clone embryos (produced via cloning). After considering the implications my argument has for the morality of publicly funding cloning for potential therapeutic purposes and potential responses to my position, I conclude that such funding is not only ethically permissible, but also humane national policy. (shrink)

The concepts, health and disease, have received considerable attention in philosophy of medicine. The first goal of this paper is to demonstrate that three prominent analyses of health and disease can be synthesized if one assumes that medicine is both theoretical and practical, and, therefore, value-laden. The second goal of this paper is to give an account of one route by which evaluative and factual claims come together in medical knowledge, during medical conversations between clinicians and patients. Accomplishing these two (...) goals together yields an epistemology of medicine that moves past debates about health and disease. On this view the conceptual foundations of medicine rest on subjective and objective claims about health states and their evaluations. By making subjective and objective claims, patients and clinicians negotiate whether patients’ health states are sufficiently dysfunctional to warrant medical intervention, leading to the formation of complementary illness narratives, which are anchored to different degrees in personal experience and medical theory. On this view, health and disease are supplanted as the conceptual foundations of medicine. Rather, medicine is better understood in terms of two basic aims: The first aim of medicine is to fully understand patients in scientific and personal terms; the second aim is to intervene upon patients’ states of illness in ways that are consistent with full understanding. (shrink)

According to standard linguistic theory, the meaning of an utterance is the product of conventional semantic meaning and general pragmatic rules on language use. We investigate how such a division of labor between semantics and pragmatics could evolve under general processes of selection and learning. We present a game‐theoretic model of the competition between types of language users, each endowed with certain lexical representations and a particular pragmatic disposition to act on them. Our model traces two evolutionary forces and their (...) interaction: (i) pressure toward communicative efficiency and (ii) transmission perturbations during the acquisition of linguistic knowledge. We illustrate the model based on a case study on scalar implicatures, which suggests that the relationship between underspecified semantics and pragmatic inference is one of coevolution. (shrink)

Few figures of the Middle Ages command the attention of so many modern disciplines as Robert Grosseteste (c. 1170-1253). Theology, Philosophy, History, and Science are all areas which his life and thought continue to have significance and to inspire re-interpretation. Accompanied by a series of original commentaries, this new edition of Grosseteste's work, with English translation, draws together the perspectives of modern scientists and medieval specialists. Volume I of a six volume series, Knowing and Speaking presents two of the (...) earliest of Grosseteste's works, the treatises On the Liberal Arts and On the Generation of Sounds. These are accompanied by a significant Middle English treatise on the Seven Liberal Arts whose anonymous fifteenth-century author translated and excerpted passages from Grosseteste's treatises in a re-imagining of their structure and function.0Each work is treated separately within the volume, which is constructed in three parts. On the Liberal Arts sets Grosseteste's thoughts on the arts subjects and emphasises moral concerns about the purpose of learning. On the Generation of Sounds builds on the theories and statements of On the Liberal Arts in connection to the production of sound, elaborating the earlier position, relating the generation of sounds to human vocal and speech production. (shrink)

This paper explores how current United States policies for funding nonreproductive cloning are justified and argues against that justification. I show that a common conceptual framework underlies the national prohibition on the use of public funds for cloning research, which I call the simple argument. This argument rests on two premises: that research harming human embryos is unethical and that embryos produced via fertilization are identical to those produced via cloning. In response to the simple argument, I challenge the latter (...) premise. I demonstrate there are important ontological differences between human embryos (produced via fertilization) and clone embryos (produced via cloning). After considering the implications my argument has for the morality of publicly funding cloning for potential therapeutic purposes and potential responses to my position, I conclude that such funding is not only ethically permissible, but also humane national policy. (shrink)

This paper proposes a Rawlsian conception of moral justification as a social activity. Through a close reading, Rawls’ view of ethical justification is shown to be significantly more dialogical and deliberative than is commonly appreciated. The result is a view that emphasizes the social nature of ethical justification and identifies information sharing between persons as the crux of justification in metaethics, in contrast to normative ethics. I call it Rawlsian reflective equilibrium to distinguish it from other varieties.

In previous work we have described the nature of geologic reasoning and the relation between the geological observer and the outcrop which is the object of their study. We now turn to further consideration of the epistemological aspects of geology that have been largely neglected by twentieth century epistemology. Our basic claim is that the experiential facts of geological field work do not fit with a philosophy of science that has evolved out of considerations on the laboratory sciences. Shifting our (...) focus from the lab to the field offers a more embodied, historical, and fallibilistic understanding of geology. (shrink)