Patient autonomy has a critical role in making decisions in medical practice and it is accepted by international conventions on health care and various national medical codes. However, pertaining to terminally ill patients, this right becomes very problematic in regards to end of life decisions. Utilitarian ethicists motivated by materialistic worldview and individualism have made patient autonomy based arguments for the permissibility of active euthanasia. An appraisal of pro-euthanasia arguments that include the best interest, golden rule, and autonomy is made (...) in this paper. The best interest and golden rule arguments are based on subjective moral judgment thus failing the universalization test. The argument from autonomy is unconvincing because of the confounded autonomy of the terminally ill patients. (shrink)

Submission of study protocols to research ethics committees constitutes one of the earliest stages at which planned trials are documented in detail. Previous studies have investigated the amendments requested from researchers by RECs, but the type of issues raised during REC review have not been compared by sponsor type. The objective of this study was to identify recurring shortcomings in protocols of drug trials based on REC comments and to assess whether these were more common among industry-sponsored or non-industry (...) trials. (shrink)

In this paper I argue that the trolley method of moral philosophy has three shortcomings not yet adequately addressed in the literature. First, trolley problems highlight high stakes ethical decisions. These decisions do not represent the majority of ethical decisions made by most people, and thus, the trolley method ignores most of moral life. Second, the trolley method operates by way of a faux-anonymization of moral agents. This process leads to descriptions of moral agents being unwittingly supplied by those (...) to whom the problems are presented and thereby the formation of a paradigmatic moral agent which excludes a considerable number of real world moral persons. Lastly, the trolley method mischaracterizes what most moral decision-making is like by presenting a moral agent's decision as isolated, uninfluenced, and made with full self-awareness. (shrink)

Despite progress, discrimination in public health remains a problem. A significant aspect of this problem relates to how medical resources are allocated. The paradigm of quality-adjusted-life-year (QALY) dictates that medical resources should be allocated on the basis of units measured as length of life and quality of life that are expected after the implementation of a treatment. In this article, I discuss some of the ethical shortcomings of QALY, by focusing on some of its flawed moral aspects, as well (...) as the way it relates to discrimination on the basis of age, race, and disability status. I argue that while this approach seeks to maximize efficiency, it does not place sufficient value on the preservation of life itself. Even more concerning is the fact that the use of QALY disproportionately harms minorities. While QALY is a well-intentioned approach to the allocation of scarce healthcare resources, new alternatives must be sought. (shrink)

Although the principles defining HIT find support within a variety of fields, the framework is currently underspecified in several respects, which prevents it from fully achieving its purpose. We highlight a number of such shortcomings and propose avenues for a resolution of some of these issues.

Simpson and Gangestad's (1991) Sociosexual Orientation Inventory (SOI) is pivotal in Schmitt's cross-national study on sociosexuality. Here I elaborate on psychometric shortcomings of the SOI that are crucial in this research context.

Romanian pedagogical theory rests on the assumption that any educational content can be taught and learned faster and better by recourse to a battery of teaching methods. In the present study we question that assumption and show that the methods generally recommended have no didactic merits when it comes to teaching philosophy and the human sciences. In order to prove that we commence by rendering manifest the origins, the specificity and the presuppositions of the teaching methods described in the literature. (...) Afterwards we determine the specificity of the objects of study of philosophy and the human sciences in general. On these bases we develop a series of three arguments that show why, given the particularity of both, the recourse to methods for teaching philosophy and the human sciences is inadequate. (shrink)

I argue that rights-forfeiture by itself is no path to permissibility at all (even barring special circumstances), neither in the case of self-defense nor in the case of punishment. The limiting conditions of self-defense, for instance – necessity, proportionality (or no gross disproportionality), and the subjective element – are different in the context of forfeiture than in the context of justification (and might even be absent in the former context). In particular, I argue that a culpable aggressor, unlike an innocent (...) aggressor, forfeits rights against proportionate defense, including unnecessary defense (as well as rights against the infliction of proportionate non-defensive harm). Yet, I demonstrate that this stance need not lead to the abandonment of the necessity condition of justified self-defense in the case of a culpable aggressor. Since justification and liability are not the same, there is no reason to assume that the necessity condition of justified self-defense must be explained under an appeal to the aggressor’s rights. Parallel arguments apply to the other limiting conditions of permissible self-defense as well as to the limiting conditions of permissible punishment. Accordingly, I also sketch alternative explanations of the proportionality requirement and the subjective element. All these alternative explanations appeal to a principle of precaution: instead of explaining the unjustifiability of unnecessarily harming a culpable attacker or wrongdoer by an appeal to the rights of the attacker or wrongdoer himself, one can also, and better, explain it by a requirement to take reasonable precautions against violating the rights of innocent people. (shrink)

The success of the stakeholder theory in management literature as well as in current business practices is largely due to the inherent simplicity of the stakeholder model––and to the clarity of Freeman’s powerful synthesised visual conceptualisation. However, over the years, critics have attacked the vagueness and ambiguity of stakeholder theory. In this article, rather than building on the discussion from a theoretical point of view, a radically different and innovative approach is chosen: the graphical framework is used as the central (...) perspective. The major shortcomings of the popular stakeholder framework are systematically confronted with the graphical scheme to illustrate their visual impact. The graphical illustrations of the imperfections help explain the sometimes-oversimplified generalisation inherent to every graphical model. They also make some interrelationships easier to understand. The analysis demonstrates that, with the tacit but implicit acceptance of simplification of the discussed explanatory elements, Freeman’s framework remains a rather good approximation of reality. Only a few minor changes to the stakeholder model are consequently proposed. (shrink)

The success of the stakeholder theory in management literature as well as in current business practices is largely due to the inherent simplicity of the stakeholder model-and to the clarity of Freeman's powerful synthesised visual conceptualisation. However, over the years, critics have attacked the vagueness and ambiguity of stakeholder theory. In this article, rather than building on the discussion from a theoretical point of view, a radically different and innovative approach is chosen: the graphical framework is used as the central (...) perspective. The major shortcomings of the popular stakeholder framework are systematically confronted with the graphical scheme to illustrate their visual impact. The graphical illustrations of the imperfections help explain the sometimes-oversimplified generalisation inherent to every graphical model. They also make some interrelationships easier to understand. The analysis demonstrates that, with the tacit but implicit acceptance of simplification of the discussed explanatory elements, Freeman's framework remains a rather good approximation of reality. Only a few minor changes to the stakeholder model are consequently proposed. (shrink)

Gallagher hardly refers to the central issue of the phenomenological reduction, and he perpetuates the historical blunder of Chisholm, misinterpreting Husserlian intentionality as linguistic intensionality. This misunderstanding opens the way to a “naturalization” of phenomenology, which misses the very method of the phenomenological reduction as well as the essential dimension of subjective lived experience.

In 2002 with the passing of the Euthanasia Law, Belgium became one of the few countries worldwide to legalize euthanasia. In the 18 years since the passing of the law, much has changed. We argue that in Belgium a widening of the use of euthanasia is occurring and that this can be ethically and legally problematic. This is in part related to the fact that several legal requirements intended to operate as safeguards and procedural guarantees in reality often fail to (...) operate as such. We focus on three kinds of safeguards or procedural guarantees: the legally defined due care criteria for eligibility for euthanasia; the consultation of a second physician; and the reporting of euthanasia cases to the Federal Control and Evaluation Commission for Euthanasia. We will show how each of these three safeguards can exhibit shortcomings in theory and practice. (shrink)

I present an argument that for any computer-simulated civilization we design, the mathematical knowledge recorded by that civilization has one of two limitations. It is untrustworthy, or it is weaker than our own mathematical knowledge. This is paradoxical because it seems that nothing prevents us from building in all sorts of advantages for the inhabitants of said simulation.

A widely held picture in political science emphasizes the cognitive shortcomings of us citizens. We’re ignorant. We don’t know much about politics. We’re irrational. We bend the evidence to show our side in the best possible light. And we’re malleable. We let political elites determine our political opinions. This paper is about why these shortcomings matter to democratic values. Some think that democracy’s value consists entirely in its connection to equality. But the import of these shortcomings, I (...) argue, cannot be explained in purely egalitarian terms. To explain it, we must instead think of democracy’s value partly in terms of collective autonomy. Our ignorance and irrationality undermine the epistemic conditions for realizing this kind of autonomy. They stop us knowing the outcomes of our political choices. Our irrationality and malleability undermine the independence conditions for realizing such autonomy. They mean our political choices are subject to problematic kinds of interpersonal influence. Thus, at root, the import of the widely held picture is that, if accurate, it closes off this critical aspect of democracy’s value. (shrink)

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

A familiar form of scepticism supposes that knowledge requires infallibility. Although that requirement plays no role in our ordinary epistemic practices, Barry Stroud has argued that this is not a good reason for rejecting a sceptical argument: our ordinary practices do not correctly reflect the requirements for knowledge because the appropriateness-conditions for knowledge attribution are pragmatic. Recent fashion in contextualist semantics for 'knowledge' agrees with this view of our practice, but incorrectly. Ordinary epistemic evaluations are guided by our conception of (...) a person's standing with regard to the reasons that there are for and against the truth of a belief. Thus the objection from our ordinary practices is sound: fallibility is not an epistemological shortcoming, and a convincing sceptical argument must use only requirements which figure in ordinary epistemic practice. (shrink)

A familiar form of scepticism supposes that knowledge requires infallibility. Although that requirement plays no role in our ordinary epistemic practices, Barry Stroud has argued that this is not a good reason for rejecting a sceptical argument: our ordinary practices do not correctly reflect the requirements for knowledge because the appropriateness-conditions for knowledge attribution are pragmatic. Recent fashion in contextualist semantics for 'knowledge' agrees with this view of our practice, but incorrectly. Ordinary epistemic evaluations are guided by our conception of (...) a person's standing with regard to the reasons that there are for and against the truth of a belief. Thus the objection from our ordinary practices is sound: fallibility is not an epistemological shortcoming, and a convincing sceptical argument must use only requirements which figure in ordinary epistemic practice. (shrink)

This chapter contains sections titled: Epistemic Commitments of Naturalism The Unity of Scientific Explanations The Explanatory Poverty of the Supernatural The Demands of Objectivity Projecting God Nature is Enough Notes.

There is no easy escape from parochialism in its twin forms of insularity and bias. Ronald Green has suggested that the JRE suffers from both, and to the extent that this is true, correction is required. Assessing the truth of the complaint is, however, complicated. While more attention to the methods and findings of other disciplines is desirable, success in this area is best achieved by the appropriation of such work by ethicists. Evidence of engagement with other disciplines may therefore (...) be diffuse, layered, and hard to isolate. Concerning Western bias, it is certainly true that the JRE should publish more historical studies relating to non-Christian religious traditions, but the themes and issues that Green identifies as the indices of Western and theological biases may instead arise indigenously in other religious traditions and may actually express the dominance of certain developments in moral philosophy. (shrink)

Zhuangzi is considered a creative poet-philosopher because of his use of imaginative images. He used the imaginative images of his system to construct the world of the Dao. He left the essence of material things as they are to speak for the mystery of existence itself, and let them express both the state of and the dream for human freedom. Zhuangzi’s way of using images shows his own lack of the understanding about images, and his lack of adequate assessments. He (...) used images in accord with his own personal preferences and fixed characteristics. He also had a tendency to equate the Dao which he experienced in his mind with the Dao itself. These shortcomings limit his improving and understanding of the Dao, so that his Dao failed to become more open to a wider existence. (shrink)

The article examines the resources and the shortcomings of pluralism in today’s Turkey in light of the spring 2013 Gezi protests in İstanbul’s Taksim district. The protests have had ecological and civic as well as political implications and were a turning point in the country’s political life.

ABSTRACTThe prohibition against the first use of force is defeasible, but under what conditions? Proponents of preventive war, both classical and contemporary, suggest that potential threats suffic...

Minimal adversariality consists in the opposition of contradictory conclusions in argumentation, and its usual metaphorical expression as a game between combating arguers has seen it be criticized from a number of perspectives: the language used, whether cooperation best attains the argumentative telos of epistemic betterment, and the ideal nature of the metaphor itself. This paper explores primarily the idealization of deductive argumentation, which is problematic due to its attenuated applicability to a dialectic involving premises and justificatory biases that are left (...) hidden and unelucidated. To clarify the issue and offer up a solution, we consider minimal adversariality as an involuntary state of affairs before relating this interpretation to a link between rational persuasion and the attainment of epistemic betterment. Through this we see how the idealizing tendencies of minimal adversariality can be reduced even in argumentation involving premises whose justifications for any arguer are inaccessible to any other arguer. (shrink)

The core idea of social constructivism in mathematics is that mathematical entities are social constructs that exist in virtue of social practices, similar to more familiar social entities like institutions and money. Julian C. Cole has presented an institutional version of social constructivism about mathematics based on John Searle’s theory of the construction of the social reality. In this paper, I consider what merits social constructivism has and examine how well Cole’s institutional account meets the challenge of accounting for the (...) characteristic features of mathematics, especially objectivity and applicability. I propose that in general social constructivism shows promise as an ontology of mathematics, because the view can agree with mathematical practice and it offers a way of understanding how mathematical entities can be real without conflicting with a scientific picture of reality. However, I argue that Cole’s specific theory does not provide an adequate social constructivist account of mathematics. His institutional account fails to sufficiently explain the objectivity and applicability of mathematics, because the explanations are weakened and limited by the three-level theoretical model underlying Cole’s account of the construction of mathematical reality and by the use of the Searlean institutional framework. The shortcomings of Cole’s theory give reason to suspect that the Searlean framework is not an optimal way to defend the view that mathematical reality is socially constructed. (shrink)

Deep brain stimulation as investigational intervention for symptomatic relief from Alzheimer disease has generated big expectations. Our aim is to discuss the ethical justification of this research agenda by examining the underlying research rationale as well as potential methodological pitfalls. The shortcomings we address are of high ethical importance because only scientifically valid research has the potential to be ethical. We performed a systematic search on MEDLINE and EMBASE. We included 166 publications about DBS for AD into the analysis (...) of research rationale, risks and ethical aspects. Fifty-eight patients were reported in peer-reviewed journals with very mixed results. A grey literature search revealed hints for 75 yet to be published, potentially enrolled patients. The results of our systematic review indicate methodological shortcomings in the literature that are both scientific and ethical in nature. According to our analysis, research with human subjects was performed before decisive preclinical research was published examining the specific research question at stake. We also raise the concern that conclusions on the potential safety and efficacy have been reported in the literature that seem premature given the design of the feasibility studies from which they were drawn. In addition, some publications report that DBS for AD was performed without written informed consent from some patients, but from surrogates only. Furthermore, registered ongoing trials plan to enroll severely demented patients. We provide reasons that this would violate Art. 28 of the Declaration of Helsinki, because DBS for AD involves more than minimal risks and burdens, and because its efficacy and safety are not yet empirically established to be likely. Based on our empirical analysis, we argue that clinical research on interventions of risk class III should not be exploratory but grounded on sound, preclinically tested, and disease-specific a posteriori hypotheses. This also applies to DBS for dementia as long as therapeutic benefits are uncertain, and especially when research subjects with cognitive deficits are involved, who may foreseeably progress to full incapacity to provide informed consent during the required follow-up period. (shrink)

While Superman’s fantastic abilities make him the most powerful being on Earth, his upbringing on the Kents’ farm is what makes him a hero. Unfortunately, moral philosophy often understates the importance of such character. One popular approach to ethics, utilitarianism, asks us to act in ways that maximize the happiness or well‐being of all the people affected. We are not born with virtues (or vices), and this is critical for understanding Superman's heroic personality. The question of how Superman's upbringing would (...) be affected by landing in another nation was explored in Mark Millar's Superman: Red Son (2004). Instead of truth, justice, and the American way, Hitler's Superman would value the totalitarian ideals of propaganda, obedience, and serving the führer. Imagine how some of the major events of World War II may have been different had Superman been involved with Hitler's cause. (shrink)

This paper discusses three shortcomings of the current state of the debate regarding historical evidence against scientific realism. Attending to these issues will direct the debate away from over-generalising wholesale arguments.

Many bioethicists promote and defend the ‘bedside rationing paradigm’; a pertinent example is the recent publication by Morten Magelssen and colleagues, in which they attack my previous criticism in the field. The present response focuses on what I consider to be the main side-effects of the ‘bedside rationing paradigm’: the ignorance towards intentions and societal roles, the crumbling of political practice, and the fiduciary loss in the physician–patient relationship. Further, I claim that these side effects are related to certain underlying (...) presumptions, such as the conception of fairness as equivalent with distributive justice and the belief in the presence of universally valid, context-independent moral principles. These presumptions are characteristics of modernist ethics; thus, the ‘bedside rationing paradigm’ illustrates some fundamental shortcomings of this moral theory. I argue that an ethics of virtue is better suited to the practice of medicine as well as to the rationing dilemmas. (shrink)

Phenomenological sociology was founded at the beginning of 1930s by Alfred Schutz. His mundane phenomenology sought to combine impulses drawn from Husserl's transcendental phenomenology and Weber's action theory. It was made famous at the turn of 1960s and 1970s by Garfinkel's ethnomethodology and Berger & Luckmann's social constructionism. This paper deals with the notable accomplishments of Schutz and his followers and then proceeds to a shared shortcoming, which is that the phenomenological approach is unable to understand meaning in any other (...) way but as actors's knowledge. Therefore, phenomenological sociologists are forced to describe the actor's interpretations of meaning as transparent to the actor him/herself, even if they sometimes make heroic attempts to escape the limitations of the phenomenological conception. The limitation is apparent in Husserl's and Schutz's definition of meaning as a “reflective intentional act”, Garfinkel's use of the term “accounting” to refer to a signifying effect, and the way Berger and Luckmann describe their social theory as “sociology of knowledge”. Today, similar confusions are present in Michael Polanyi's “tacit knowledge”and in Giddens' structuration theory. (shrink)

Deepfakes pose a multi-faceted threat to the acquisition of knowledge. It is widely hoped that technological solutions—in the form of artificially intelligent systems for detecting deepfakes—will help to address this threat. I argue that the prospects for purely technological solutions to the problem of deepfakes are dim. Especially given the evolving nature of the threat, technological solutions cannot be expected to prevent deception at the hands of deepfakes, or to preserve the authority of video footage. Moreover, the success of such (...) technologies depends on institutional trust that is in short supply. Finally, outsourcing the discrimination between the real and the fake to automated, largely opaque systems runs the risk of undermining epistemic autonomy. (shrink)