Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions.Design: Prospective clinical interventional study.Setting: Internal medicine department of the hospital of La Chaux-de-Fonds, Switzerland.Participants: Nine junior physicians in postgraduate training.Intervention: Information on the ethics of DNR and implementation of new DNR orders.Measurements and main results: Accurate understanding, interpretation, and use of DNR orders, especially with respect to the (...) patients’ involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% after the intervention and the patients’ involvement went from 17% to 48% . Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision.Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

Objective: To evaluate the effect of an intervention on the understanding and use of DNR orders by physicians; to assess the impact of understanding the importance of involving competent patients in DNR decisions. Design: Prospective clinical interventional study. Setting: Internal medicine department (70 beds) of the hospital of La Chaux-de-Fonds, Switzerland. Participants: Nine junior physicians in postgraduate training. Intervention: Information on the ethics of DNR and implementation of new DNR orders. Measurements and main results: Accurate understanding, interpretation, and use of (...) DNR orders, especially with respect to the patients’ involvement in the decision were measured. Junior doctors writing DNR orders had an extremely poor understanding of what DNR orders mean. The correct understanding of the definition of a DNR order increased from 31 to 93% (p<0.01) after the intervention and the patients’ involvement went from 17% to 48% (p<0.01). Physicians estimated that 75% of their DNR patients were mentally competent at the time of the decision. Conclusion: An intervention aimed at explaining the ethical principles and the definition of DNR orders improves understanding of them, and their implementation, as well as patient participation. Specific efforts are needed to increase the involvement of mentally competent patients in the decision. (shrink)

Proponents of the higher‐order (HO) theory of consciousness (e.g., Lau and Rosenthal) have recently appealed to brain lesion evidence to support their thesis that mental states are conscious when and only when represented by other mental states. This article argues that this evidence fails to support HO theory, doing this by first determining what kinds of conscious deficit should result when HO state‐producing areas are damaged, then arguing that these kinds of deficit do not occur in the studies to (...) which HO theorists appeal. The article also develops an apparatus that can be used to evaluate whether other lesion evidence confirms or disconfirms HO theory. (shrink)

Kwaku Marfo, Danielle Garcia, Saira Khalique, Karen Berger, Amy LuMontefiore Medical Center, Bronx, NY, USABackground: Medication errors are a prime concern for all in healthcare. As such the use of information technologies in drug prescribing and administration has received considerable attention in recent years, with the hope of improving patient safety. Because of the complexity of drug regimens in renal transplant patients, occurrence of medication errors is inevitable even with a well adopted computerized physician order entering system. Our objective (...) was to quantify medication error type and frequency in an inpatient renal transplant unit.Methods: Systemic evaluation of all medication errors during an initial 10-day audit and a 28-day follow-up audit in an inpatient renal transplant unit. Each error was concurrently evaluated for potential to result in adverse patient consequences, error type and associated medication class.Results: A total of 103 clinically significant medication errors were detected during the 10-day and 28-day audit time periods. The most common errors were wrong medication dose ordered and wrong time of drug administration. Thirty-six out of 66 prescribing/ordering errors reached the patient.Conclusions: Even with utilization of computerized physician order entry system in an inpatient renal transplant unit, post-kidney transplant patients are at risk for adverse outcomes due to medication errors. The risk factors may be multifactorial and will require both organizational and technical approaches to resolve.Keywords: medication errors, CPOE, inpatient, renal transplant patients. (shrink)

This paper examines a small-scale attempt to support collective evaluation of a transgenic potato variety. By mobilizing Laurent Thevénot’s ideas on the connectedness of the ontological and normative, it investigates how the controversial object was associated with coordinating perspectives or orders of worth in two focus groups. In these groups, the GM potato qualified for evaluation in relation to deterministic market forces. However, it was unclear whether the potato would operate as a beneficial market asset or merely as (...) an accelerator of ever tougher competition. The innovation also had a tendency to disappear out of sight or to receive capacities as a transgenic application of whatever kind. Hence, it was only with effort that the discussions delved into the specific realities and circumstances of the Finnish potato production. When they did, some particular demands posed by the blight resistant potato became visible and discussable. These scripts concerned the counterparts of contract production, possibly favoring the reorganization of producers into larger associations of highly specialized professionals. However, since practical implications and possibilities received little attention, the paper suggests that more attention needs to be put into organization and preparation of multi-stakeholder evaluations. The emergence of learning potential greatly depends on the abilities and willingness of the participants to engage with speculative experiments or reality tests. This is a risky strategy for anyone who hopes that a meeting will remain within a particular scope or that it will reach a particular conclusion. (shrink)

Increasingly, the high throughput technologies used by biomedical researchers are bringing about a situation in which large bodies of data are being described using controlled structured vocabularies—also known as ontologies—in order to support the integration and analysis of this data. Annotation of data by means of ontologies is already contributing in significant ways to the cumulation of scientific knowledge and, prospectively, to the applicability of cross-domain algorithmic reasoning in support of scientific advance. This very success, however, has led to (...) a proliferation of ontologies of varying scope and quality. We define one strategy for achieving quality assurance of ontologies—a plan of action already adopted by a large community of collaborating ontologists—which consists in subjecting ontologies to a process of peer review analogous to that which is applied to scientific journal articles. (shrink)

Prof. Dr. Mustafa Demirci's monograph "Black Rage: The Rebellion of Negro Slaves in the Medieval Islamic World (869-883)" on the 'Zanj rebellion' that took place between 869-883 A.D., during the Abbasid period, and was led by the Ali b. Muhammad, is one of the most important studies both in terms of its subject matter and the author's approach and perspective on the subject. The study, which was prepared with a rich academic literature using basic sources and modern research on the (...) subject, deals with issues such as the geography of the event, the causes and spread of the rebellion, the wars and warfare techniques to suppress the rebellion, the short and long-term effects of the damage left behind by the rebellion from an academic perspective in chronological order. The Zanj revolt started in the marshes of Basra in 869 as a result of Ali b. Muhammad (d. 883), who was originally white and claimed to be a descendant of Ali, organizing black slaves working under difficult conditions in the large farms in and around Basra, and the rebellion grew and spread in a short time. Muwaffak Billāh (843-891), the brother of the Abbasid Caliph Mu’temid Alallâh (843-892), who was assigned to suppress the revolt, was victorious against the rebels after tough struggles, and the revolt ended with the killing of the leader of the rebellion, Ali b. Muhammad, in 883. (shrink)

In the contemporary epistemological literature, peer disagreement is often taken to be an instance of a more general phenomenon of “higher-order evidence.” Correspondingly, its epistemic significance is often thought to turn on the epistemic significance of higher-order evidence in general. This chapter attempts to evaluate this claim, and in doing so to clarify some points of unclarity in the current literature – both about what it is for evidence to be “higher-order,” and about the relationship between disagreement (...) and higher-order evidence. We will begin by considering some candidate definitions of “higher-order evidence,” and offering our own definition that attempts to capture the phenomenon of interest. We will then consider, in light of this definition, whether disagreement and its epistemic significance are best-understood as a kind of higher-order evidence. We’ll argue that although peer disagreement can be epistemically significant qua higher-order evidence, this role doesn’t exhaust its significance, and that it can also serve as straightforward first-order evidence. Finally, we’ll suggest that inattention to this latter point has made broadly conciliatory views about peer disagreement seem somewhat easier to resist than they in fact are. (shrink)

Subjects who retain their beliefs in the face of higher-order evidence that those very beliefs are outputs of flawed cognitive processes are at least very often criticisable. Many think that this is because such higher-order evidence defeats various epistemic statuses such as justification and knowledge, but it is notoriously difficult to give an account of such defeat. This paper outlines an alternative explanation, stemming from some of my earlier work, for why subjects are criticisable for retaining beliefs in (...) the face of paradigm kinds of putatively defeating higher-order evidence: they manifest dispositions that are bad relative to a range of candidate epistemic successes such as true belief and knowledge. In particular, giving up belief in response to higher-order evidence only when that evidence is not misleading would require subjects to have dispositions that discriminate between cases in which their original cognitive processes is fine, and cases in which they merely seemed to be fine. But, I argue, such dispositions are not normally humanly feasible. I show that retaining belief in putative cases of defeat by higher-order evidence is problematic irrespective of whether veritism or some form of gnosticism is true. In the end I contrast my account of dispositional evaluations with similar-sounding ideas that have been put forth in the literature, such as consequentialist views that focus on instrumental means to success. (shrink)

“Local food” is gaining in popularity, particularly within a rising alternative food movement, yet it remains an ambiguous term. We use an illustrative example—the case of “local milk” in Hawai‘i—to demonstrate this point. We evaluate "localness" by measuring the origins of production inputs by economic value and physical mass–an approach that is akin to the Made in America standard. The innovative method we propose is easily replicable to other food products or locations worldwide. We find that most first order (...) production related inputs are obtained from non-local sources. Our findings are significant to the local food debate because a focus beyond the point of production to upstream inputs in the life cycle of a food item can push towards a re-framing what local means both in Hawai‘i and beyond. In particular, our findings suggest that production system type, as opposed to location of production end-point, might have a greater impact on the degree of localness of a product. Looking forward, a shift in focus towards production system characteristics may help researchers make headway in exploring the environmental and economic effects of local food. (shrink)

A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased (...) insight into moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded ‘grey zone articles’, in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients’ and caregivers’ views on ethical challenges, is presented. (shrink)

Clinical Ethics Committees (CECs), as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases (PubMed, (...) Ovid MEDLINE, Scopus, Philosopher’s Index, Embase and Web of Science), following PRISMA guidelines. We included only articles specifically addressing CECs and providing any form of CECs performance assessment. Twenty-nine articles were included. Ethics consultation was the most evaluated of CECs’ functions. We did not find standardized tools for measuring CECs’ efficacy, but 33% of studies considered “user satisfaction” as an indicator, with 94% of them reporting an average positive perception of CECs’ impact. Changes in patient treatment and a decrease of moral distress in health personnel were reported as additional outcomes of ethics consultation. The highly diverse ways by which CECs carry out their activities make CECs’ evaluation difficult. The adoption of shared criteria would be desirable to provide a reliable answer to the question about their effectiveness. Nonetheless, in general both users and providers consider CECs as helpful, relevant to their work, able to improve the quality of care. Their main function is ethics consultation, while less attention seems to be devoted to bioethics education and policy formation. (shrink)

The conceptual ethics of normativity involves normative reflection on normative thought and talk. One motive for engaging in this project is to seek to either vindicate or improve one’s existing normative concepts. This paper clarifies and addresses a deep challenge to the conceptual ethics of normativity, when it is motivated in this way. The challenge arises from the fact that we need to use some of our own normative concepts in order to evaluate our normative concepts. This might seem (...) objectionably circular, akin to trying to verify the accuracy of a ruler by checking it against itself. We dub this the vindicatory circularity challenge. If the challenge cannot be met, it would suggest that all normative inquiry (not just the conceptual ethics of normativity) rests on worryingly arbitrary foundations. We defend a way of answering the challenge that adapts anti-skeptical resources from epistemology. Along the way, we reject several alternative replies to the challenge. These include dismissing the challenge because it cannot be formulated with our concepts, answering it by appeal to a distinctive normative concept, and answers that appeal to certain metaphysical or metasemantic resources. (shrink)

What does evaluation mean? This article examines the evaluative process as a practical judgment that links a situation to a set of values in order to decide upon a course of action. It starts by discussing A. Sen’s “relational” and “comparative” account of evaluation, built in critical dialogue with J. Rawls’ deductive theory. Comparison, incompleteness, reality, and deliberation are the key principles of Sen’s approach, which, in some respects, echoes that of J. Dewey. The second part shows (...) the relevance of completing Sen’s approach with Dewey’s pragmatism, since Dewey’s emphasis on practical judgment is a useful counterbalance to Sen’s focus on evaluation as a cognitive process. Dewey introduces a shift from values to valuation and draws a distinction between prizing and appraising, which makes the logic of inquiry and the search for consistency between means and ends in a given situation the fulcrum of evaluation. The third part of this paper addresses the relationship between values and norms in evaluative processes. Neither Sen nor Dewey deals with this question in a systematic way, although norms, which are both similar and different from values, contribute to frame evaluations in different ways: as horizons, resources, or constrains. Bringing norms into the picture means completing the pragmatist account with an institutionalist perspective, as we suggest through the example of the evaluation of work. (shrink)

The Jinn, which is regarded as the third kind of entity apart from the angel and the human being, has been the subject matter of several separate works written by both Muslims and non-Muslims in the past and present. In short, such works deal with the nature of jinns and their characteristics, and they cover matters such as the beliefs about jinns in several religions and cultures and their relationship with human beings. Apart from the fact that the primary source (...) of Islam, namely, the Quran, has a separate chapter called al-Jinn (The Jinn) /72, it provides information about jinns in many verses in several other chapters. Traditions also provide plenty of information about jinns. One example of such information is on the question whether the Holy Prophet have met with jinns. A study of the traditions on this matter reveals the fact that there are ṣaḥīḥ (authentic) traditions that appear to be in conflict with each other and/or with some of the verses in the Quran. In this paper, we have analyzed and evaluated the relevant traditions in order to reconcile these contradictions, thus we aimed to clarify the matter. The question on whether the Holy Prophet met with jinns is often discussed within the context of narrations coming from Ibn al-Masʿūd and Ibn ʿAbbās. While the traditions coming from Ibn al-Masʿūd indicate that the Prophet met with jinns, a tradition narrated by Ibn ʿAbbās says the opposite. In the present work, we have analyzed the outwardly conflicting traditions narrated by both companions along with traditions narrated by other companions on this matter in the light of the chronology of the revelation of the Quran. As a result, we have concluded that the Holy Prophet have met with jinns as narrated by Ibn al-Masʿūd and that the report narrated by Ibn ʿAbbās was about the first years of Islam. (shrink)

How do we prevent the next pandemic? Will governments successfully tackle climate change? Will they find ways to close the gap between the haves and have-nots and to eliminate poverty? Which solution - democratic or authoritarian - will determine the global governance of a flawed nation-state system? This unique contribution to global studies advances a multidisciplinary theory that the governments of all human societies are the tenuous outcome of the competing solutions to the Imperatives of Order, Welfare, and Legitimacy (...) (OWL). The OWL paradigm provides a common framework to evaluate the contrasting responses of the liberal democratic, Chinese, and Russian solutions to global governance. Underscored is the volume's contention that global governance is the overriding issue confronting nation-states and the diverse and divided peoples of what is now a global society for the first time in the evolution of the species. The volume addresses a wide spectrum of audiences, united in their shared resolve that the democracies prevail in a projected century-long struggle between democratic and authoritarian regimes to determine global governance. Scholars, teachers, students, elected officials, policy analysts, media professionals, and engaged citizens who make self-government work will profit from this visionary and provocative study. (shrink)

Consider what the brain-state theorist has to do to make good his claims. He has to specify a physical–chemical state such that any organism (not just a mammal) is in pain if and only if (a) it possesses a brain of suitable physical–chemical structure; and (b) its brain is in that physical–chemical state. This means that the physical–chemical state in question must be a possible state of a mammalian brain, a reptilian brain, a mollusc’s brain (octopuses are mollusca, and certainly (...) feel pain), etc. At the same time, it must not be a possible (physically possible) state of the brain of any physically possible creature that cannot feel pain. Even if such a state can be found, it must be nomologically certain that it will also be a state of the brain of any extraterrestrial life that may be found that will be capable of feeling pain before we can even entertain the supposition that it may be pain. It is not altogether impossible that such a state will be found... . But this is certainly an ambitious hypothesis. (Putnam 1967/1975, p. 436) The belief that mental states are multiply realized is now nearly universal among philosophers, as is the belief that this fact decisively refutes the identity theory. I argue that the empirical support for multiple realization does not justify the confidence that has been placed in it. In order for multiple realization of mental states to be an objection to the identity theory, the neurological differences among pains, for example, must be such as to guarantee that they are of distinct neurological kinds. But the phenomena traditionally cited do not provide evidence of that sort of variation. In particular, examples of neural plasticity do not provide such evidence. (shrink)

First-order Gödel logics are a family of finite- or infinite-valued logics where the sets of truth values V are closed subsets of [0,1] containing both 0 and 1. Different such sets V in general determine different Gödel logics GV (sets of those formulas which evaluate to 1 in every interpretation into V). It is shown that GV is axiomatizable iff V is finite, V is uncountable with 0 isolated in V, or every neighborhood of 0 in V is uncountable. (...) Complete axiomatizations for each of these cases are given. The r.e. prenex, negation-free, and existential fragments of all first-order Gödel logics are also characterized. (shrink)

This article evaluates the oversight of drugs and medical devices by the U.S. Food and Drug Administration using an integration of public policy, law, and bioethics approaches and employing multiple assessment criteria, including economic, social, safety, and technological. Criteria assessment and expert elicitation are combined with existing literature, case law, and regulations in an integrative historical case studies approach. We then use our findings as a tool to explore possibilities for effective oversight and regulatory mechanisms for nanobiotechnology. Section I describes (...) oversight mechanisms for human drugs and medical devices and presents current nanotechnology products. Section II describes the results of expert elicitation research. Section III highlights key criteria and relates them to the literature and larger debate. We conclude with broad lessons for the oversight of nanobiotechnology informed by Sections I-III in order to provide useful analysis from multiple disciplines and perspectives to guide discussions regarding appropriate FDA oversight. (shrink)

Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate ethics consultation.Objective: To (...) provide an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)

Existing ethical frameworks for public health provide insufficient guidance on how to evaluate the risks of public health programs that compromise the best clinical interests of present patients for the benefit of others. Given the relevant similarity of such programs to clinical research, we suggest that insights from the long‐standing debate about acceptable risk in clinical research can helpfully inform and guide the evaluation of risks posed by public health programs that compromise patients’ best clinical interests. We discuss how (...) lessons learned regarding the ethics of risk in one context can be fruitfully transferred to the other, using the example of a so‐called ‘rational antibiotic use’ guideline that limits antimicrobial prescribing in order to curb antimicrobial resistance. (shrink)

Expressivism - the sophisticated contemporary incarnation of the noncognitivist research program of Ayer, Stevenson, and Hare - is no longer the province of metaethicists alone. Its comprehensive view about the nature of both normative language and normative thought has also recently been applied to many topics elsewhere in philosophy - including logic, probability, mental and linguistic content, knowledge, epistemic modals, belief, the a priori, and even quantifiers. Yet the semantic commitments of expressivism are still poorly understood and have not been (...) very far developed. As argued within, expressivists have not yet even managed to solve the "negation problem" - to explain why atomic normative sentences are inconsistent with their negations. As a result, it is far from clear that expressivism even could be true, let alone whether it is. Being For seeks to evaluate the semantic commitments of expressivism, by showing how an expressivist semantics would work, what it can do, and what kind of assumptions would be required, in order for it to do it. Building on a highly general understanding of the basic ideas of expressivism, it argues that expressivists can solve the negation problem - but only in one kind of way. It shows how this insight paves the way for an explanatorily powerful, constructive expressivist semantics, which solves many of what have been taken to be the deepest problems for expressivism. But it also argues that no account with these advantages can be generalized to deal with constructions like tense, modals, or binary quantifiers. Expressivism, the book argues, is coherent and interesting, but false. (shrink)

Background and aim: Surgical intensive care nurses should have ethical sensitivity allowing them to identify ethical issues in order that they can recognize them and make the right decisions. This descriptive study was conducted with the aim of evaluating the ethical sensitivity of surgical intensive care nurses. Materials and methods: The research was carried out with the participation of 160 nurses in six Turkish hospitals, four state, one university, and one private. The data were collected using the “Nurse Description (...) Form” developed by the researcher and the “Ethical Sensitivity Questionnaire.” The percent, mean, standard deviation, median, minimum and maximum values, significance test for the difference between two means, variance analysis, Mann–Whitney U test, and Kruskal–Wallis Variance Analysis test were used to evaluate the data. Ethical considerations: Ethical commission permission and the corporate permission of the hospitals were received before conducting the research. Results: It was determined that the ethical sensitivities of surgical intensive care nurses were moderate based on the Ethical Sensitivity Questionnaire total score and subdimension score averages. A statistical difference was determined between the Ethical Sensitivity Questionnaire total score of surgical intensive care nurses and the institution where they worked, the period of working in the occupation, and the period of working in the intensive care unit. Conclusion: Based on the results of the research, the organization of training and studies devoted to the elimination of ethical sensitivity differences between institutions and workers is suggested. (shrink)

According to the KK-principle, knowledge iterates freely. It has been argued, notably in Greco, that accounts of knowledge which involve essential appeal to normality are particularly conducive to defence of the KK-principle. The present article evaluates the prospects for employing normality in this role. First, it is argued that the defence of the KK-principle depends upon an implausible assumption about the logical principles governing iterated normality claims. Once this assumption is dropped, counter-instances to the principle can be expected to arise. (...) Second, it is argued that even if the assumption is maintained, there are other logical properties of normality which can be expected to lead to failures of KK. Such failures are noteworthy, since they do not depend on either a margins-for-error principle or safety condition of the kinds Williamson appeals to in motivating rejection KK. “Introduction: KK and Being in a Position to Know” Section formulates two versions of the KK-Principle; “Inexact Knowledge and Margins for Error” Section presents a version of Williamson’s margins-for-error argument against it; “Knowledge and Normality” and “Iterated Normality” Sections discuss the defence of the KK-Principle due to Greco and show that it is dependent upon the implausible assumption that the logic of normality ascriptions is at least as strong as K4; finally, “Knowledge in Abnormal Conditions” and “Higher-Order Ignorance Inside the Margins” Sections argue that a weakened version of Greco’s constraint on knowledge is plausible and demonstrate that this weakened constraint will, given uncontentious assumptions, systematically generate counter-instances to the KK-principle of a novel kind. (shrink)

Whenever we communicate, we inevitably have to say one thing before another. This means introducing particularly subtle patterns of salience into our language. In this paper, I introduce ‘order-based salience patterns’, referring to the ordering of syntactic contents where that ordering, pretheoretically, does not appear to be of consequence. For instance, if one is to describe a colourful scarf, it wouldn’t seem to matter if one were to say it is ‘orange and blue’ or ‘blue and orange’. Despite their (...) apparent triviality, I argue that order-based salience patterns tend to make the content positioned first more salient – in the sense of attention-grabbing – in a way that can have surprising normative implications. Giving relative salience to gender differences over similarities, for instance, can result in the activation of cognitively accessible beliefs about gender differences. Where those beliefs are epistemically and/or ethically flawed, we can critique the salience pattern that led to them, providing an instrumental way of evaluating those patterns. I suggest that order-based salience patterns can also be evaluated on constitutive grounds; talking about gender differences before similarities might constitute a subtle form of bias. Finally, I reflect on how the apparent triviality of order-based salience patterns in language gives them an insidious strength. (shrink)

Among those enthused by Pascal’s pithy remark that “the heart has its reasons of which reason knows nothing” are phenomenological value-theorists. What makes Pascal particularly attractive to these phenomenologists is the suggestion that the heart has reasons, and reasons of its own, which resonates with the quasi-cognitive function that they ascribe to feeling. Feelings apprehend values, which are genuine objects that display an essential order and a rank distinct from the objects of reason. In this paper, I introduce and (...) evaluate Pascal’s reception in phenomenological axiology. I begin by reviewing the philosophical position that for the phenomenological value-theorists corresponds to the Pascalian notion of the order of the heart (I). I then turn to Pascal and explore the notion of the order of the heart, especially in relation to the order of reason, in his thought (II). Finally, I evaluate the legitimacy of the attribution of the phenomenological position to Pascal, arguing that, while there is not a perfect correspondence, there is an affinity that warrants the phenomenologists’ allusions to Pascal (III). (shrink)

Moral Case Deliberation is an up and coming form of ethics support wherein clinical professionals deliberate about moral questions they face in their work. So far, it has been unclear what quality of deliberation in MCD is entailed and how to evaluate this quality. This article proposes a coding scheme that fits the theoretical background of MCD and allows researchers to evaluate the quality of the deliberation in MCDs. We consider deliberation in MCD to be of good quality when participants (...) enrich their own understanding of a case by being exposed to the viewpoints of others. In order to have such an enriching effect, the deliberation in an MCD ought to involve different kinds of arguments from the perspectives of different stakeholders and in favour of different resolutions to the case; and the process of deliberation ought to be critical but constructive. (shrink)

In this paper the language of first-order modal logic is enriched with an operator @ ('actually') such that, in any model, the evaluation of a formula @A at a possible world depends on the evaluation of A at the actual world. The models have world-variable domains. All the logics that are discussed extend the classical predicate calculus, with or without identity, and conform to the philosophical principle known as serious actualism. The basic logic relies on the system (...) K, whereas others correspond to various properties that the actual world may have. All the logics are axiomatized. (shrink)

Contrary to the widespread concern about over-treatment at the end of life, today, patient preferences for palliative care at the end of life are frequently respected. However, ethically challenging situations in the current healthcare climate are, instead, situations in which a competent patient requests active treatment with the goal of life-prolongation while the physician suggests best supportive care only. The argument of futility has often been used to justify unilateral decisions made by physicians to withhold or withdraw life-sustaining treatment. However, (...) we argue that neither the concept of futility nor that of patient autonomy alone is apt for resolving situations in which physicians are confronted with patients' requests for active treatment. Instead, we integrate the relevant arguments that have been put forward in the academic discussion about ‘futile’ treatment into an ethical algorithm with five guiding questions: (1) Is there a chance that medical intervention will be effective in achieving the patient's treatment goal? (2) How does the physician evaluate the expected benefit and the potential harm of the treatment? (3) Does the patient understand his or her medical situation? (4) Does the patient prefer receiving treatment after evaluating the benefit-harm ratio and the costs? (5) Does the treatment require many resources? This algorithm shall facilitate approaching patients' requests for treatments deemed futile by the physician in a systematic way, and responding to these requests in an ethically appropriate manner. It thereby adds substantive considerations to the current procedural approaches of conflict resolution in order to improve decision making among physicians, patients and families. (shrink)

Despite the fact that ethics consultations are an accepted practice in most healthcare organizations, many clinical ethicists continue to feel marginalized by their institutions. They are often not paid for their time, their programs often have no budget, and institutional leaders are frequently unaware of their activities. One consequence has been their search for concrete ways to evaluate their work in order to prove the importance of their activities to their institutions through demonstrating their efficiency and effectiveness.

There is a disparity between the multitude of apparently successful expert system prototypes and the scarcity of expert systems in real everyday use. Modern tools make it deceptively easy to make reasonable prototypes, but these prototypes are seldom made subject to serious evaluation. Instead the development team confronts their product with a set of cases, and the primary evaluation criterion is the percentage of correct answers: we are faced with a “95% syndrome”. Other aspects related to the use (...) of the system are almost ignored. There is still a long way to go from a promising prototype to a final system.It is maintained in the article that a useful test must be performed by future users in a situation that is as realistic as possible. If this is not done claims of usefulness cannot be justified. It is also stated that prototyping does not make “traditional” analysis and design obsolete, although the contents of these activities will change.In order to discuss the effects of using the systems a distinction between expert systems as media, tools and experts is proposed. (shrink)

Kuhn claimed that several algorithms can be defended to select the best theory based on epistemic values such as simplicity, accuracy, and fruitfulness. In a recent paper, Okasha :83–115, 2011) argued that no theory choice algorithm exists which satisfies a set of intuitively compelling conditions that Arrow had proposed for a consistent aggregation of individual preference orderings. In this paper, we put forward a solution to avoid this impossibility result. Based on previous work by Gaertner and Xu, we suggest to (...) view the theory choice problem in a cardinal context and to use a general scoring function defined over a set of qualitative verdicts for every epistemic value. This aggregation method yields a complete and transitive ranking and the rule satisfies all Arrovian conditions appropriately reformulated within a cardinal setting. We also propose methods that capture the aggregation across different scientists. (shrink)

In order to better improve the teaching quality of university teachers, an effective method should be adopted for evaluation and analysis. This work studied the machine learning algorithms and selected the support vector machine (SVM) algorithm to evaluate teaching quality. First, the principles of selecting evaluation indexes were briefly introduced, and 16 evaluation indexes were selected from different aspects. Then, the SVM algorithm was used for evaluation. A genetic algorithm (GA)-SVM algorithm was designed and experimentally (...) analyzed. It was found that the training time and testing time of the GA-SVM algorithm were 23.21 and 7.25 ms, both of which were shorter than the SVM algorithm. In the evaluation of teaching quality, the evaluation value of the GA-SVM algorithm was closer to the actual value, indicating that the evaluation result was more accurate. The average accuracy of the GA-SVM algorithm was 11.64% higher than that of the SVM algorithm (98.36 vs 86.72%). The experimental results verify that the GA-SVM algorithm can have a good application in evaluating and analyzing teaching quality in universities with its advantages in efficiency and accuracy. (shrink)

I argue that teaching evaluation tools may function as ethical codes, and answer certain demands that ECs cannot sufficiently fulfill. In order to be viable, an EC related to the teaching profession must assume a different form, and such a form is already present in several of the contemporary TETs. The TET matrix form allows for certain features that are incompatible with the EC form. The TET’s benchmark scale – ranging from below the acceptable to the ideal level (...) across the dimensions of teachers’ competence – allows it to answer the demands upon ECs, raised by the EC critics. TETs embrace both minimal requirements and lofty ideals, while ECs of different types have a hard time combining these two features. TETs relate to different dimensions of teacher competence, connecting ethical and professional components with didactical, managerial and cognitive components, without lumping them together. (shrink)

Despite the growing autonomy of schools in the school systems of developed countries and the increase in the educational prerogatives of head teachers, the latter, particularly in France, have a relatively weak legitimacy to regulate and transform the teaching practices of teachers. Faced with this difficulty, they are regularly obliged to implement detour strategies in order to create the conditions for pedagogical change within the institution. In this article, we will show, through a qualitative study carried out in a (...) French secondary school, how the management team took advantage of the margin of maneuver left by the institution to experiment an innovative evaluation device without note. This experiment gave the school principal the opportunity to enroll, interest and temporarily stabilize a network of school actors (teachers and other staff) around local issues and mobilize them Transform teaching practices. The data collected were analyzed from the characteristics of the translation process theorized by Callon (1986). (shrink)

A one-stop resource on the current developments in word order research, this comprehensive survey provides an up-to-date, critical overview of this widely debated topic, exploring and evaluating research carried out in four major ...

The transition semantics presented in Rumberg (J Log Lang Inf 25(1):77–108, 2016a) constitutes a fine-grained framework for modeling the interrelation of modality and time in branching time structures. In that framework, sentences of the transition language L_t are evaluated on transition structures at pairs consisting of a moment and a set of transitions. In this paper, we provide a class of first-order definable Kripke structures that preserves L_t-validity w.r.t. transition structures. As a consequence, for a certain fragment of L_t, (...) validity w.r.t. transition structures turns out to be axiomatizable. The result is then extended to the entire language L_t by means of a quite natural ‘Henkin move’, i.e. by relaxing the notion of validity to bundled structures. (shrink)

A second-order preference is a preference over preferences. This paper addresses the role that second-order preferences play in a theory of instrumental rationality. I argue that second-order preferences have no role to play in the prescription or evaluation of actions aimed at ordinary ends. Instead, second-order preferences are relevant to prescribing or evaluating actions only insofar as those actions have a role in changing or maintaining first-order preferences. I establish these claims by examining and (...) rejecting the view that second-order preferences trump first-order preferences. I also examine and reject the view that second-order preferences give additional normative force to an agent’s preferred first-order preferences. I conclude by arguing that second-order preferences should be integrated into an agent’s object-level preference ordering, and by explaining how best to make sense of this integration. (shrink)