Standardizing consultation processes is increasingly important as clinical ethics consultation becomes more utilized in and vital to medical practice. Solid organ transplant represents a relatively nascent field replete with complex ethical issues that, while explored, have not been systematically classified. In this paper, we offer a proposed taxonomy that divides issues of resource allocation from viable solutions to the issue of organ shortage in transplant and then further distinguishes between policy and bedside level issues. We then identify all transplant related (...) ethics consults performed at the Cleveland Clinic between 2008 and 2013 in order to identify how consultants conceptually framed their consultations by the domains they ascribe to the case. We code the CC domains to those in the Core Competencies for Healthcare Consultation Ethics in order to initiate a broader conversation regarding best practices in these highly complex cases. A discussion of the ethical issues underlying living donor and recipient related consults ensues. Finally, we suggest that the ethical domains prescribed in the Core Competencies provide a strong starting ground for a common intra-disciplinary language in the realm of formal CEC. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Lermontov And The Omniscience Of NarratorsDavid A. GoldfarbGod and fictional narrators are the only beings who are sometimes considered omniscient. God, who is sometimes regarded as not fictional, is frequently also regarded as omnipotent. Narrators, who normally seem to have no sphere of action save for conveying information to readers, particularly when they speak omnisciently in the third person, are not considered to have “power” in any way, because (...) they are supposed to function outside the story. God always speaks in the first person, and is regarded as an all-powerful agent.But what happens when the narrator gets in on the action? First-person narrators can enter the plot, speaking in the voice of personal narrative, and sometimes “know” as much or more than some third-person narrators who are supposedly “omniscient.” The positivistic “third-person omniscient” narrator of Turgenev’s Fathers and Sons, for instance, knows only what he sees, and though his omnipresence allows him to see quite a bit, he has virtually no access to the minds of the characters, as do the psychologically omniscient third-person narrators of Tolstoy or Henry James. If knowledge were thus limited in the context of a novel to observables, a first-person narrator who gets around enough could appear much like an omniscient narrator, while also appearing to present a particular point of view. Conversely, the third-person narrator’s seeming objectivity is similarly illusory. Any narrator “chooses” what information to relay, and when and how to relay it. In a sense, third-person omniscient narrators fictionally determine what counts as “the story,” creating the fictional world with their godlike voice. Some overbearing narrators, like Nikolai Chernyshevsky’s anonymous first-person narrator in What Is To Be Done, adopt not only an omniscient and objective standpoint with regard to the actions and [End Page 61] thoughts of the characters, but even presume to tell readers how to interpret the events in the novel. Therefore, all narrators have varying amounts of both knowledge and power, and in some cases they may approach, within variously circumscribed spheres of knowledge and agency, omniscience and omnipotence.In this essay, I would like to explore the range of constraints and effects of the narrator’s fictional power and knowledge. As a test case, I have chosen Mikhail Lermontov’s novel, A Hero of Our Time (Geroi nashego vremeni). Writing between 1837 and 1840, Lermontov was one of the first Russian writers to experiment with the form of the novel, influenced primarily by contemporary English, French, and German examples, as well as the classical epic, making this work, like many of the early Russian novels of the 1820s and 1830s, a jumble of narrative styles interestingly layered on each other. It is a particularly fecund work for studies of narrative subjectivity, because characters shift from narrator to narratee across a variety of genres, all in one text.A Hero of Our Time is composed of five major chapters: “Bela,” “Maksim Maksimich,” “Taman,” “Princess Mary,” and “The Fatalist,” the last three of which comprise the journal of the main character, the officer Grigory Pechorin. The “journal” chapters are preceded by a brief section, set in 1838 or 1839, sometime after Pechorin’s death, called the “Introduction to Pechorin’s Journal.” In “Bela” an unnamed traveler gathering stories in the Caucasus during the year 1837 meets an older officer, Maksim Maksimich, who tells a yarn about the Byronic adventures of Pechorin in the spring of 1833 involving his abduction of a Circassian woman after whom the chapter is named. The second chapter is an interlude, which takes place in 1837, where Maksim and the first narrator actually meet Pechorin, whom Maksim has not seen for about five years, and Pechorin gives his diaries to the first narrator. “Taman” recounts, in the form of a diary, a strange incident in which Pechorin, around 1830, meets smugglers while stranded in the Crimea and is nearly drowned by a young girl. “Princess Mary,” the longest tale, takes place in May 1832—a love story modeled after Aleksander Pushkin’s Eugene Onegin, culminating in a duel in which Pechorin prevails over a certain Grushnitskij, his friend earlier in the... (shrink)

Oxford Philosophical Texts Series Editor: John Cottingham The Oxford Philosophical Texts series consists of authoritative teaching editions of canonical texts in the history of philosophy from the ancient world down to modern times. Each volume provides a clear, well laid out text together with a comprehensive introduction by a leading specialist, giving the student detailed critical guidance on the intellectual context of the work and the structure and philosophical importance of the main arguments. Endnotes are supplied which provide further commentary (...) on the arguments and explain unfamiliar references and terminology, and a full bibliography and index are also included. The series aims to build up a definitive corpus of key texts in the Western philosophical tradition, which will form a reliable and enduring resource for students and teachers alike. David Hume's aim in writing An Enquiry concerning Human Understanding was to introduce his philosophy to a European culture in which many educated people read original works of philosophy. He gives an elegant and accessible presentation of strikingly original and challenging views about the limited powers of human understanding, the attractions of scepticism, the compatibility of free will and determinism, and weaknesses in the foundations of religion. Hume's philosophy was highly controversial in the eighteenth century and remains so today. The text printed in this edition is that of the Clarendon critical edition of Hume's works. A substantial introduction by the editor explains the intellectual background to the work and surveys its main themes. The volume also includes detailed explanatory notes on the text, a glossary of terms, a full list of references, and a section of supplementary readings. (shrink)

Gottlob Frege (1848–1925) was unquestionably one of the most important philosophers of all time. He trained as a mathematician, and his work in philosophy started as an attempt to provide an explanation of the truths of arithmetic, but in the course of this attempt he not only founded modern logic but also had to address fundamental questions in the philosophy of language and philosophical logic. Frege is generally seen (along with Russell and Wittgenstein) as one of the fathers of the (...) analytic method, which dominated philosophy in English-speaking countries for most of the twentieth century. His work is studied today not just for its historical importance but also because many of his ideas are still seen as relevant to current debates in the philosophies of logic, language, mathematics and the mind. The Cambridge Companion to Frege provides a route into this lively area of research. (shrink)

From religion to philosophy to science, all human systems of definition are formed by human brains. The nature and limits of the human brain are the nature and limits of those systems. This essay shows how the human brain works normally then unusually, and what this reveals about the limits of human knowledge. There are many conditions and instances where the brain processes information unusually, including mental disorders, physical events, and drug use. This essay focuses on the neurological events called (...) mystical experiences. (shrink)

This short peer-reviewed text is a concise look at the psychology of how human beings make decisions, including how they form their worldviews and make arguments.

This paper aims to provide two abductive considerations adducing in favor of the thesis of Necessitism in modal ontology. I demonstrate how instances of the Barcan formula can be witnessed, when the modal operators are interpreted 'naturally' -- i.e., as including geometric possibilities -- and the quantifiers in the formula range over a domain of natural, or concrete, entities and their contingently non-concrete analogues. I argue that, because there are considerations within physics and metaphysical inquiry which corroborate modal relationalist claims (...) concerning the possible geometric structures of spacetime, and dispositional properties are actual possible entities, the condition of being grounded in the concrete is consistent with the Barcan formula; and thus -- in the geometric setting -- merits adoption by the Necessitist. (shrink)

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy (...) choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. (shrink)

Part of the appeal of the biological approach to personal identity is that it does not have to countenance spatially coincident entities. But if the termination thesis is correct and the organism ceases to exist at death, then it appears that the corpse is a dead body that earlier was a living body and distinct from but spatially coincident with the organism. If the organism is identified with the body, then the unwelcome spatial coincidence could perhaps be avoided. It is (...) argued that such an identification would be a mistake. A living organism has a different part/whole relationship and persistence conditions than the alleged body. A case will be made that the concept ‘human body’ is a conceptual mess, vague in an unprincipled manner, and that an eliminativist stance towards dead bodies is the appropriate response. CiteULike Connotea Del.icio.us What's this? (shrink)

This book is a defense of modal realism; the thesis that our world is but one of a plurality of worlds, and that the individuals that inhabit our world are only a few out of all the inhabitants of all the worlds. Lewis argues that the philosophical utility of modal realism is a good reason for believing that it is true.

As grandes epidemias de peste que atingiram ao longo de muitos séculos os ingleses, refletiram mudanças importantes para os conhecimentos de cada período histórico. Esse artigo busca unir duas extremidades de um decorrer de grandes catástrofes epidemiológicas na Inglaterra, com um olhar especial à populosa Londres, começando com a primeira entrada da peste bubônica na cidade, em 1348, e seu provável último grande surto, em 1665. Os dois episódios tocados aqui são apresentados sob a perspectiva das novidades, semelhanças e diferenças (...) entre essas duas pontas da história, passando pelas novas respostas da medicina no século XIV e os princípios de uma ‘aritmética política’ no século XVII. Para esse fim, são de extrema importância diferentes fontes, como as inúmeras cópias do tratado médico de John de Burdeaux, escritos a partir de 1390, e o Observations de John Graunt, publicado a partir de 1662. (shrink)

Estudos recentes vêm revisando a composição da literatura que, ao longo do século XVIII serviu como base às ciências em território britânico. Segundo esses estudos, os seiscentistas de fala inglesa dedicaram-se a duas linhagens de texto, originadas em concepções de ciência muito distintas. Uma dessas linhagens tinha como fonte principal a antiga “literatura do segredo” que incluía desde velhos e sigilosos manuais de ofício até os milenares e proibidos tratados de hermética, literatura antes reservada a poucos. Diferente dessa, a outra (...) ]inhagem de textos surgia como um direto da proposta baconiana para a nova ciência: um saber elaborado por muitos e ao alcance de todos. Exemplos conhecidos dessa linhagem são os livros de divulgação utilizados pelos comenianos ingleses ou mesmo os relatórios, atas e memórias das sociedades científicas, geradores dos primeiros embriões de periódicos dedicados às ciências. Todavia, sob essa aparente contraposição das duas linhagens, há indícios de um profícuo diálogo - expresso sobretudo na correspondência e diários pensadores da época. (shrink)

Originally published: Oxford: Clarendon Press, 1932.

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

The singularity hypothesis is a radical hypothesis about the future of artificial intelligence on which self-improving artificial agents will quickly become orders of magnitude more intelligent than the average human. Despite the ambitiousness of its claims, the singularity hypothesis has been defended at length by leading philosophers and artificial intelligence researchers. In this paper, I argue that the singularity hypothesis rests on scientifically implausible growth assumptions. I show how leading philosophical defenses of the singularity hypothesis (Chalmers 2010, Bostrom 2014) fail (...) to overcome the case for skepticism. I conclude by drawing out philosophical implications of this discussion for our understanding of consciousness, personal identity, digital minds, existential risk, and ethical longtermism. GPI Working Paper No . 19-2022. (shrink)

In the Garden of Eden, we had unmediated contact with the world. We were directly acquainted with objects in the world and with their properties. Objects were simply presented to us without causal mediation, and properties were revealed to us in their true intrinsic glory.

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

What happens when machines become more intelligent than humans? One view is that this event will be followed by an explosion to ever-greater levels of intelligence, as each generation of machines creates more intelligent machines in turn. This intelligence explosion is now often known as the “singularity”. The basic argument here was set out by the statistician I.J. Good in his 1965 article “Speculations Concerning the First Ultraintelligent Machine”: Let an ultraintelligent machine be defined as a machine that can far (...) surpass all the intellectual activities of any man however clever. Since the design of machines is one of these intellectual activities, an ultraintelligent machine could design even better machines; there would then unquestionably be an “intelligence explosion”, and the intelligence of man would be left far behind. Thus the first ultraintelligent machine is the last invention that man need ever make. The key idea is that a machine that is more intelligent than humans will be better than humans at designing machines. So it will be capable of designing a machine more intelligent than the most intelligent machine that humans can design. So if it is itself designed by humans, it will be capable of designing a machine more intelligent than itself. By similar reasoning, this next machine will also be capable of designing a machine more intelligent than itself. If every machine in turn does what it is capable of, we should expect a sequence of ever more intelligent machines. This intelligence explosion is sometimes combined with another idea, which we might call the “speed explosion”. The argument for a speed explosion starts from the familiar observation that computer processing speed doubles at regular intervals. Suppose that speed doubles every two years and will do so indefinitely. Now suppose that we have human-level artificial intelligence 1 designing new processors. Then faster processing will lead to faster designers and an ever-faster design cycle, leading to a limit point soon afterwards. The argument for a speed explosion was set out by the artificial intelligence researcher Ray Solomonoff in his 1985 article “The Time Scale of Artificial Intelligence”.1 Eliezer Yudkowsky gives a succinct version of the argument in his 1996 article “Staring at the Singularity”: “Computing speed doubles every two subjective years of work.. (shrink)

This volume is devoted to Lewis's work in metaphysics and epistemology. Topics covered include properties, ontology, possibility, truthmaking, probability, the mind-body problem, vision, belief, and knowledge. The purpose of this collection, and the volumes that precede and follow it, is to disseminate more widely the work of an eminent and influential contemporary philosopher. The volume will serve as a useful work of reference for teachers and students of philosophy.

Religion, science, and naturalism -- Perception and religious experience -- Panexperientialism, freedom, and the mind-body relation -- Naturalistic, dipolar theism -- Natural theology based on naturalistic theism -- Evolution, evil, and eschatology -- The two ultimates and the religions -- Religion, morality, and civilization -- Religious language and truth -- Religious knowledge and common sense.

David Heyd's study will stimulate philosophers to recognise the importance of the rather neglected topic of the distinctiveness of supererogation and the ...

A number of philosophers endorse, without argument, the view that there’s something it’s like consciously to think that p, which is distinct from what it’s like consciously to think that q. This thesis, if true, would have important consequences for philosophy of mind and cognitive science. In this paper I offer an argument for it, and attempt to induce examples of it in the reader. The argument claims it would be impossible introspectively to distinguish conscious thoughts with respect to their (...) content if there weren’t something it’s like to think them. This argument is defended against several objections. Then I use what I call “minimal pair” experiences—sentences read without and with understanding—to induce in the reader an experience of the kind I claim exists. Further objections are considered and rebutted. (shrink)

According to the grounding theory of powers, fundamental physical properties should be thought of as qualities that ground dispositions. Although this view has recently been defended by many different philosophers, there is no consensus for how the view should be developed within a broader metaphysics of properties. Recently, Tugby has argued that the view should be developed in the context of a Platonic theory of properties, where properties are abstract universals. I will argue that the view should not be developed (...) within such a framework. Either the view should be developed with an ontology of Aristotelian properties, or it should be developed in a Nominalist framework that contains no properties at all. (shrink)

Conceptual engineering is the design, implementation, and evaluation of concepts. Conceptual engineering includes or should include de novo conceptual engineering (designing a new concept) as well as conceptual re-engineering (fixing an old concept). It should also include heteronymous (different-word) as well as homonymous (same-word) conceptual engineering. I discuss the importance and the difficulty of these sorts of conceptual engineering in philosophy and elsewhere.

"My work has had nothing to do with gay liberation," Michel Foucault reportedly told an admirer in 1975. And indeed there is scarcely more than a passing mention of homosexuality in Foucault's scholarly writings. So why has Foucault, who died of AIDS in 1984, become a powerful source of both personal and political inspiration to an entire generation of gay activists? And why have his political philosophy and his personal life recently come under such withering, normalizing scrutiny by commentators as (...) diverse as Camille Paglia, Richard Mohr, Bruce Bawer, Roger Kimball, and biographer James Miller? David M. Halperin's Saint Foucault is an uncompromising and impassioned defense of the late French philosopher and historian as a galvanizing thinker whose career as a theorist and activist will continue to serve as a model for other gay intellectuals, activists, and scholars. A close reading of both Foucault and the increasing attacks on his life and work, it explains why straight liberals so often find in Foucault only counsels of despair on the subject of politics, whereas gay activists look to him not only for intellectual inspiration but also for a compelling example of political resistance. Halperin rescues Foucault from the endless nature-versus-nurture debate over the origins of homosexuality ("On this question I have absolutely nothing to say," Foucault himself once remarked) and argues that Foucault's decision to treat sexuality not as a biological or psychological drive but as an effect of discourse, as the product of modern systems of knowledge and power, represents a crucial political breakthrough for lesbians and gay men. Halperin explains how Foucault's radical vision of homosexuality as a strategic opportunity for self-transformation anticipated the new anti-assimilationist, anti-essentialist brand of sexual identity politics practiced by contemporary direct-action groups such as ACT UP. Halperin also offers the first synthetic account of Foucault's thinking about gay sex and the future of the lesbian and gay movement, as well as an up-to-the-minute summary of the most recent work in queer theory. "Where there is power, there is resistance," Michel Foucault wrote in The History of Sexuality, Volume I. Erudite, biting, and surprisingly moving, Saint Foucault represents Halperin's own resistance to what he views as the blatant and systematic misrepresentation of a crucial intellectual figure, a misrepresentation he sees as dramatic evidence of the continuing personal, professional, and scholarly vulnerability of all gay activists and intellectuals in the age of AIDS. (shrink)

An ethnographer's account of his study of jazz-piano playing, which led to discoveries concerning the ways his hands learned about the keyboard and improvisation, sheds light on the nature and range of improvised conduct.