Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

In this new textbook two Catholic ethicists with extensive teaching experience present a moral theology based on vision. David Matzko McCarthy and James M. Donohue draw widely from the Western philosophical tradition while integrating biblical and theological themes in order to explore such fundamental questions as What is good? The fourteen chapters in Moral Vision are short and thematic. Substantive study questions engage with primary texts and encourage students to apply theory to everyday life and common human experiences. The (...) book is accessibly written and flexible enough to fit into any undergraduate or seminary course on ethics. (shrink)

This paper makes the case for a pluralist, contextualist view of nursing ethics. In defending this view, I briefly outline two current perspectives of nursing ethics – the Traditional View and the Theory View. I argue that the Traditional View, which casts nursing ethics as a subcategory of healthcare ethics, is problematic because it (1) fails to sufficiently acknowledge the unique nature of nursing practice; and (2) applies standard ethical frameworks such as principlism to moral problems which tend to alienate (...) or undermine nursing ethical concerns. Alternatively, the Theory View, which aims to build an independent and comprehensive theory of nursing ethics, is also found wanting because it (1) fails to sufficiently acknowledge the heterogeneous nature of nursing practices; (2) overemphasizes the differences and undervalues the similarities between nurses and other health professionals; and (3) assumes that one ethical framework can be meaningfully applied across diverse moral problems and contexts.My alternative, is to argue that nursing ethics inquiry should take a pluralist and critical stance towards available ethical frameworks and the negotiation of the ethical realm. On this view, the search for moral consensus or a unique ethical framework for nursing is replaced by the task of working strategically with multiple frameworks in order to expand the moral agency of nurses and empower them to positively engage with moral uncertainty as an inevitable feature of living a moral life. I conclude by indicating some of the implications that this has for the teaching of nursing ethics. (shrink)

This book proposes a new theory of the origins of human language ability and presents an original account of the early evolution of language. It explains why humans are the only language-using animals, challenges the assumption that language is a consequence of intelligence, and offers a new perspective on human uniqueness. The author draws on evidence from archaeology, linguistics, cognitive science, and evolutionary biology. Making no assumptions about the reader's prior knowledge he first provides an introductory but critical survey of (...) all sources of evidence for language evolution. He then considers what language itself reveals about its own and human origins and evolution. He shows that certain central aspects of language do not, unexpectedly, reflect what they are used for, are maladapted for their function. He considers why this should be, and argues that these odd aspects of language reveal important clues about its evolutionary origin. The Origins of Complex Language fulfils the promise of its title. In doing so it turns upside down conventional theories about the relation between cognition and expression, truth and reference, and the co-evolution of mind and body. Original in conception, brilliantly executed, stylishly written, this book will attract a wide range of readers interested in the evolution and origins of language. (shrink)

In this important volume Habermas outlines the views which form the basis of his critical theory of modern societies. The volume comprises five interlocking essays, which together define the contours of his theory of communication and of his substantive account of social change. ′What is Universal Pragmatics?′ is the best available statement of Habermas′s programme for a theoryof communication based on the analysis of speech acts. In the following two essays Habermas draws on the work of Kohlberg and others to (...) develop a distinctive account of moral consciousness and normative structures. ′Toward a Reconstruction of historical Materialsim′ takes these issues further, offering a wide–ranging reconstruction of Marx′s historical materialsim understood as a theory of social evolution. The final essay focuses on the question of legitimacy and on the legitimation problems faced by modern states. This book is essential reading for anyone concerned with the key questions of social and political theory today. (shrink)

Jurgen Habermas is unquestionably one of the foremost philosophers writing today. His notions of communicative action and rationality have exerted a profound influence within philosophy and the social sciences. This volume examines the historical and intellectual contexts out of which Habermas' work emerged, and offers an overview of his main ideas, including those in his most recent publication. Amongst the topics discussed are his relationship to the Frankfurt School of critical theory and Marx, his unique contributions to the philosophy of (...) the social sciences, the concept of 'communicative ethics', and the critique of post-modernism. New readers and non-specialists will find this the most convenient, accessible guide to Habermas currently available. Advanced students will find a conspectus of recent developments in the interpretation of Habermas. (shrink)

Philosophers often assume that we can somehow quantitatively measure how good things are for people. But what does such talk mean? And what are the measures? In *Weighing Goods* John Broome offers one treatment of these questions. In his later *Weighing Lives* he offers a different treatment. This article discusses both positions but advocates a third. But while the three positions disagree about matters of meaning, they agree about the form of the measures. Roughly speaking, they are such that the (...) goodness of a lottery for an individual is equal to its expected goodness for her. (shrink)

In this unique and comprehensive book, George McCarthy examines the influence of Greek philosophy, literature, arts, and politics on the development of twentieth-century German social thought. McCarthy demonstrates that the classical spirit vitalized thinkers such as Weber, Heidegger, Freud, Marcuse, Arendt, Gadamer, and Habermas. With the romancing of antiquity, they transformed their understanding of the modern self, political community, and Enlightenment rationality. By viewing contemporary social theory from the framework of the classical world, McCarthy argues, we are (...) capable of thinking beyond the limits of modernity to new possibilities of human reason, science, beauty, and social justice. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

We show that without assuming completeness or continuity, a strongly independent preorder on a possibly infinite dimensional convex set can always be given a vector-valued representation that naturally generalizes the standard expected utility representation. More precisely, it can be represented by a mixture-preserving function to a product of lexicographic function spaces.

Symbolic arithmetic is fundamental to science, technology and economics, but its acquisition by children typically requires years of effort, instruction and drill1,2. When adults perform mental arithmetic, they activate nonsymbolic, approximate number representations3,4, and their performance suffers if this nonsymbolic system is impaired5. Nonsymbolic number representations also allow adults, children, and even infants to add or subtract pairs of dot arrays and to compare the resulting sum or difference to a third array, provided that only approximate accuracy is required6–10. Here (...) we report that young children, who have mastered verbal counting and are on the threshold of arithmetic instruction, can build on their nonsymbolic number system to perform symbolic addition and subtraction11–15. Children across a broad socio-economic spectrum solved symbolic problems involving approximate addition or subtraction of large numbers, both in a laboratory test and in a school setting. Aspects of symbolic arithmetic therefore lie within the reach of children who have learned no algorithms for manipulating numerical symbols. Our findings help to delimit the sources of children’s difficulties learning symbolic arithmetic, and they suggest ways to enhance children’s engagement with formal mathematics. We presented children with approximate symbolic arithmetic problems in a format that parallels previous tests of non-symbolic arithmetic in preschool children8,9. In the first experiment, five- to six-year-old children were given problems such as ‘‘If you had twenty-four stickers and I gave you twenty-seven more, would you have more or less than thirty-five stickers?’’. Children performed well above chance (65.0%, t1952.77, P 5 0.012) without resorting to guessing or comparison strategies that could serve as alternatives to arithmetic. Children who have been taught no symbolic arithmetic therefore have some ability to perform symbolic addition problems. The children’s performance nevertheless fell short of performance on non-symbolic arithmetic tasks using equivalent addition problems with numbers presented as arrays of dots and with the addition operation conveyed by successive motions of the dots into a box (71.3% correct, F1,345 4.26, P 5 0.047)8.. (shrink)

Among “continental” philosophers there is general agreement that reason has to be understood as culturally mediated and embodied in social practice, and thus that the critique of reason should be carried out through some form of sociocultural analysis. At the same time, there is very sharp disagreement among them as to just what form the critique should take. In its most general terms, that disagreement has come to be known as the “modernity/postmodernity debate” in philosophy. Stylizing a bit, we might (...) characterize one side as attacking Enlightenment—especially Kantian—conceptions of reason and the rational subject at their very roots, and the other side as wanting to preserve such conceptions by transforming them. It is the merit of Richard Bernstein’s recent book to have reconstructed these abstruse metaphilosophical debates in generally comprehensible prose and to have indicated in the process the relevance of the pragmatist tradition to the issues they raise. (shrink)

The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (...) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described. (shrink)

A mixture preorder is a preorder on a mixture space (such as a convex set) that is compatible with the mixing operation. In decision theoretic terms, it satisfies the central expected utility axiom of strong independence. We consider when a mixture preorder has a multi-representation that consists of real-valued, mixture-preserving functions. If it does, it must satisfy the mixture continuity axiom of Herstein and Milnor (1953). Mixture continuity is sufficient for a mixture-preserving multi-representation when the dimension of the mixture space (...) is countable, but not when it is uncountable. Our strongest positive result is that mixture continuity is sufficient in conjunction with a novel axiom we call countable domination, which constrains the order complexity of the mixture preorder in terms of its Archimedean structure. We also consider what happens when the mixture space is given its natural weak topology. Continuity (having closed upper and lower sets) and closedness (having a closed graph) are stronger than mixture continuity. We show that continuity is necessary but not sufficient for a mixture preorder to have a mixture-preserving multi-representation. Closedness is also necessary; we leave it as an open question whether it is sufficient. We end with results concerning the existence of mixture-preserving multi-representations that consist entirely of strictly increasing functions, and a uniqueness result. (shrink)

This collection of articles and associated discussion papers focuses on a problem that has attracted increasing attention from linguists and psychologists throughout the world during the past several years. Reduced to essentials, the problem is that of discovering the character of the mental capacities that make it possible for human beings to attain knowledge of their language on the basis of fragmentary and haphazard early linguistic experience. A fundamental assumption running through all of these contributions is that people possess strong (...) innate predispositions that are critical for success in this task. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A New Look at Animal-to-Human Organ TransplantationCharles R. McCarthy (bio)The acute shortage of organs available for transplantation into human beings combined with a new scientific understanding of the immune systems of both humans and animals make it probable that animal-to-human solid organ transplants (xenografts) may soon be attempted at a frequency rate unknown in the past. 1 Optimism about successful animal-to-human organ transplantation is greater than at any (...) previous time. The creation of a reliable supply of animal organs appears to be technically feasible. At least five major transplant centers in the United States are currently considering plans to pursue xenotransplantation. Although, at the time of this writing, no federal guidelines prohibit animal-to-human organ transplantation, the institutions considering such programs are awaiting deliberations on the subject by the Institute of Medicine (IOM), the Food and Drug Administration (FDA), and the Department of Health and Human Services (DHHS).The demand for organs suitable for transplantation into human beings greatly exceeds the supply. According to the United Network for Organ Sharing (UNOS 1996a), approximately 44,000 patients in the United states awaited organ transplantation at the end of 1995. In 1994, more than 3,000 patients died while on the transplant waiting list, and the demand for transplantable organs increases annually (UNOS 1996b). The figures do not include the hundreds or perhaps thousands of patients who could profit from a transplant, but who do not meet the requirements of the UNOS waiting list. Even if efforts to persuade persons to donate organs are redoubled, and even if the consent to donate organs should become a legal presumption, there is little prospect of developing a sufficient supply of transplantable human organs to meet the growing demand.As technical and biological barriers to successful animal-to-human xenografts are lowered, the prospect of raising dedicated colonies of animals, genetically altered to reduce the chances that human hosts will reject organs derived from them, is being seriously discussed. 2 Such colonies do not exist at the present time. [End Page 183] However, if new techniques for animal-to-human transplantation prove successful, it is likely that animal colonies will be established to provide a ready and predictable supply of organs for transplantation to humans. Some believe that commercial investment in colonies of purpose-bred animals to serve as a source of transplantable organs is close at hand (Leventhal 1994).New drugs and new combinations of existing drugs have improved the chances of successful medical outcomes for patients who receive solid organ transplants. It is now recognized that serial application of immunosuppressive drugs can reduce the likelihood of both short- and long-term organ rejection (Makowka 1994). Improved understanding of both human and animal immune systems, insights into histocompatibility, new agents to control graft-versus-host disease, animal breeding programs for the production of transgenic animals, and improved surgical techniques have opened, as never before, the possibility of successful transfer of organs from animals to humans. Some rate the chances of good patient outcomes (usually measured in terms of time of patient survival) as high, others make more conservative predictions, but virtually all experts believe that the chances for successful human patient outcomes resulting from xenotransplantation are improved. Because many patients face immanent death unless their organs can be replaced, there can be little doubt that many humans will readily consent to xenotransplantation.History Suggests CautionDespite the advances in immunosuppression, the frequency of failure in past animal-to-human xenograft attempts should temper the optimism of the transplant community. To date, all efforts to prolong human life by implanting solid organs from animals into human recipients have failed. The first attempts at animal-to-human xenotransplantation early in the twentieth century resulted in the early death of all recipients (Neuhof 1923). More sophisticated efforts at xenotransplantation occurred in the late 1960s and early 1970s, a period when anti-rejection drugs began to make allografts more feasible. Although one human recipient of a xenograft survived for nine months (with poor quality of life), most patients died within a matter of minutes, hours, or a few days following the transplantation of organs from chimpanzees or baboons (Starzl... (shrink)

The selectionsfrom the work of fourteen contemporary philosophers not only display the multiplicity of approachesbeing pursued since the breakup of any consensus on what philosophy is, but also help to clarifythis proliferation of views and ...

Business and society researchers, as well as practitioners, have been critiqued for ignoring those with less voice and power often referred to as “fringe stakeholders.” Existing methods used in B&S research often fail to address issues of meaningful participation, voice and power, especially in developing countries. In this article, we stress the utility of visual participatory research methods in B&S research to fill this gap. Through a case study on engaging Ghanaian cocoa farmers on gender inequality issues, we explore how (...) VPR methods may be used by researchers to achieve more inclusive, and thus more credible, stakeholder research that can improve decision making within businesses. Furthermore, we argue that ingrained social and environmental problems tackled by B&S research and the unique context in which they occur may open up new opportunities to develop participatory visual methods for social change. (shrink)

Spatial Representation presents original, specially written essays by leading psychologists and philosophers on a fascinating set of topics at the intersection of these two disciplines. They address such questions as these: Do the extraordinary navigational abilities of birds mean that these birds have the same kind of grip on the idea of a spatial world as we do? Is there a difference between the way sighted and blind subjects represent the world 'out there'? Does the study of brain-injured subjects, such (...) as 'blind seers', tell us anything about the working of normal spatial consciousness? -/- The essays are arranged into five sections, each of which reflects a central area of research into spatial cognition, and opens with a short introduction by the editors, designed to facilitate cross-disciplinary reading. The volume as a whole offers a rich and compelling expression of the view that to advance our understanding of the way we represent the external world it is necessary to draw on both philosophical and psychological approaches. (shrink)

At the beginning of Aeneid 12, a truce is agreed so that Aeneas and Turnus can fight each other in single combat. But this truce is violated through the instigation of Turnus’ sister Juturna, who in turn has been instigated by Juno. The Italian Tolumnius casts a spear that kills an Etruscan warrior. Aeneas pleads for calm and the maintenance of the truce, but he in turn is wounded by an arrow. Turnus, seeing the Trojans in disarray, rushes into battle, (...) and a general engagement ensues. So Turnus, even if he did not instigate the breach, does nothing to heal it, and for that reason alone is a criminal, who deserves his ultimate death at the hands of Aeneas. (shrink)

This paper has both theoretical and practical ambitions. The theoretical ambitions are to explore what would constitute both effective and ethical treatment of Autism Spectrum Disorder.1 However, the practical ambition is perhaps more important: we argue that a dominant form of Applied Behavior Analysis, which is widely taken to be far-and-away the best “treatment”2 for ASD, manifests systematic violations of the fundamental tenets of bioethics. Moreover, the supposed benefits of the treatment not only fail to mitigate these violations, but they (...) often exacerbate them. Warnings of the perils of ABA are not original to us—autism advocates have been ringing this... (shrink)

Corballis's claim that the origin of syntax lies in solely gesture is contested. His scenario does not explain why constraints on syntactic “movement” are apparently part of the human biological endowment for language. It also does not pay enough attention to the internal structure of sentences, and how they contrast with other linguistic units such as noun phrases.

Grodzinsky associates Broca's area with three kinds of deficit, relating to articulation, comprehension (involving trace deletion), and production (involving “tree pruning”). Could these be special cases of one deficit? Evidence from research on language evolution suggests that they may all involve syllable structure or those aspects of syntax that evolved through exploiting the neural mechanisms underlying syllable structure.

In the so-called ‘Iliadic’Aeneid, Dido is scarcely mentioned. At first sight, Aeneas’ dalliance at Carthage is forgotten when he gets down to the serious business of establishing the Trojans in Italy. But the poem's last mention of Dido is enmeshed in a network of parallel passages elsewhere in theAeneidrelating to tunics and adoption. In the light of similarities between Aeneas and the superficially unimportant Trojan warrior Nisus, these passages bear crucially on the contrast between Aeneas’ public and privatepietas: his obedience (...) to imposed commitments and to chosen ones. In this way, Virgil provides guidance on what motivates Aeneas’ fury in Books 10 and 12. (shrink)