In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

The aim of the paper is to prove the consistency of libertarianism. We examine the example of Jane, who deliberates at length over whether to vacation in Colorado (C) or Hawaii (H), weighing the costs and benefits, consulting travel brochures, etc. Underlying phenomenological deliberation is an indeterministic neural process in which nonactual motor neural states n(C) and n(H) corresponding to alternatives C and H remain physically possible up until the moment of decision. The neurophysiological probabilities pr(n(C)) and pr(n(H)) evolve continuously (...) according to the different weights Jane's judgement attaches to C and H at different times during the deliberation. The overall process is indeterministic, since Jane's exact judgemental weighting would vary slightly were the process to be repeated from the same initial conditions. The weighting is however rational, and entirely under Jane's control. This controlled, rational, indeterministic process shows that libertarianism is a consistent philosophical thesis. (shrink)

Classical Christian orthodoxy insists that God is Triune: there is only one God, but there are three divine Persons — Father, Son, and Holy Spirit — who are somehow of one substance with one another. But what does this doctrine mean? How can we coherently believe that there is only one God if we also believe that there are three divine Persons? This problem, sometimes called the ‘threeness-oneness problem’ or the ‘logical problem of the Trinity’, is the focus of this (...) interdisciplinary volume. It includes a selection of recent philosophical work on this topic, accompanied by a variety of essays by philosophers and theologians to further the discussion. The book is divided into four parts, the first three dealing in turn with the three most prominent models for understanding the relations between the Persons of the Trinity: Social Trinitarianism, Latin Trinitarianism, and Relative Trinitarianism. Each section includes essays by both proponents and critics of the relevant model. The volume concludes with a section containing essays by theologians reflecting on the current state of the debate. (shrink)

The fundamental problem of Christology is the apparent contradiction of Christ as recorded at Chalcedon. Christ is human and Christ is divine. Being divine entails being immutable. Being human entails being mutable. Were Christ two different persons there’d be no apparent contradiction. But Chalcedon rules as much out. Were Christ only partly human or only partly divine there’d be no apparent contradiction. But Chalcedon rules as much out. Were the very meaning of ‘mutable’ and/or ‘immutable’ other than what they are, (...) there’d be no apparent contradiction. But the meaning is what it is, and changing the meaning of our terms to avoid the apparent contradiction of Christ is an apparent flight from reality. What, in the end, is the explanation of the apparent contradiction of Christ? Theologians and philosophers have long advanced many consistency-seeking answers, all of which increase the metaphysical or semantical complexity of the otherwise strikingly simple but radical core of Christianity’s GodMan. In this paper, I put the simplest explanation on the theological table: namely, Christ appears to be contradictory because Christ is contradictory. This explanation may sound complicated to the many who are steeped in the mainstream account of logic according to which logic precludes the possibility of true contradictions. But the mainstream account of logic can and should be rejected. Ridding theology of the dogma of mainstream logic illuminates the simple though striking explanation of the apparent contradiction of Christ — namely, that Christ is a contradictory being. Just as the simplest explanation to the apparent roundness of the earth has earned due acceptance, so too should the simplest explanation of the apparent contradiction of Christ. (shrink)

This article argues the following points. The Hobbesian hypothesis, which we define as the claim that all people are better off under state authority than they would be outside of it, is an empirical claim about all stateless societies. It is an essential premise in most contractarian justifications of government sovereignty. Many small-scale societies are stateless. Anthropological evidence from them provides sufficient reason to doubt the truth of the hypothesis, if not to reject it entirely. Therefore, contractarian theory has not (...) done what it claims to do: it has not justified state sovereignty to each person subject to it by demonstrating that they benefit from that authority. To be justified in contractarian terms, states have to do something to improve the living standards of disadvantaged people under their rule. (shrink)

Recent trends in business ethics along with growing attacks upon unions, suggest that employee rights will be a major social concern for business managers during the next decade. However, in most of the discussions of employee rights to date, the very meaning and legitimacy of such rights are often uncritically taken for granted. In this paper, we develop an account of employee rights and defend this conception against what we take to be the strongest in-principle objections to it.

The title alone of McCall’s book reveals its ambitious enterprise. The book’s structure is a long inference to the best explanation: chapters present problems that are solved by a single, ontological model. Problems as diverse as time flow, quantum measurement, counterfactual semantics, and free will are discussed. McCall’s style of writing is lucid and pointed—in general, very pleasant to read.

Storrs McCall presents an original philosophical theory of the nature of the universe based on a striking new model of its space- time structure. He shows how his model illuminates a broad range of subjects, including causation, probability, quantum mechanics, identity, and free will, and argues that the fact that the model throws light on such a large number of problems constitutes strong evidence that the universe is as the model portrays it.

Untoward injuries are unacceptably common in medical treatment, at times with tragic consequences for patients. The phrases 'an epidemic of error' and 'the medical toll' have been coined to describe this problem of 'iatrogenic harm', which it has been suggested may have contributed to 98,000 deaths per year in the US. Some of these incidents are the result of negligence on the part of doctors, but more usually they are no more than inevitable concomitants of the complexity of modern healthcare. (...) This book is fundamentally about distinguishing the former from the latter. Although medicine is used as the book's primary example, the points made apply equally to aviation, industrial activities, and many other fields of human endeavour. The book advocates a more informed alternative to the blaming culture which has increasingly come to dominate our response to accidents, whether in the medical field or elsewhere. (shrink)

A number of theologians engaged in the theology and science dialogue—particularly Pentecostal theologian Amos Yong—employ emergence as a framework to discuss special divine action as well as causation initiated by other spiritual realities, such as angels and demons. Mikael and Joanna Leidenhag, however, have issued concerns about its application. They argue that Yong employs supernaturalistic themes with implications that render the concept of emergence obsolete. Further, they claim that Yong's use of emergence theory is inconsistent because he highlights the ontological (...) independence of various spirits in the world concurrently with his advocation of supervenience theory. In view of these concerns, Leidenhag and Leidenhag urge Yong to depart from his application of emergence theory. In what follows, we plan to address each of these criticisms and demonstrate that they are tenuous, if not unwarranted, especially in light of a kenotic-relational pneumatology. (shrink)

The origins and development of community of philosophical inquiry -- The theoretical landscape -- Philosophising with five year olds -- Creating a community of philosophical inquiry (CoPI) with all ages -- Different methods of group philosophical discussion -- What you need to know to chair a CoPI with six to sixteen year olds -- Implementing CoPI in primary and secondary schools -- CoPI, citizenship, moral virtue, and academic performance with primary and secondary children.

A theory of temporal passage is put forward which is "objective" in the sense that time flow characterizes the universe independently of the existence of conscious beings. The theory differs from Grunbaum's "mind-dependence" theory, and is designed to avoid Grunbaum's criticisms of an earlier theory of Reichenbach's. The representation of temporal becoming is accomplished by the introduction of indeterministic universe-models; each model representing the universe at a time. The models depict the past as a single four-dimensional manifold, and the future (...) as a branched structure of such manifolds. Time flow is relativistic in that it manifests itself in a frame-dependent (but not observer-dependent) way. The indeterministic character of the universe-models is mirrored in a "temporal" theory of truth which rejects the principle of bivalence, and suitable semantics are provided for this theory. Finally, an account of physical law is given which defines it in terms of physical possibility, rather than vice versa. (shrink)

The thesis of 3D/4D equivalence states that every three-dimensional description of the world is translatable without remainder into a four-dimensional description, and vice versa. In representing an object in 3D or in 4D terms we are giving alternative descriptions of one and the same thing, and debates over whether the ontology of the physical world is "really" 3D or 4D are pointless. The twins paradox is shown to rest, in relativistic 4D geometry, on a reversed law of triangle inequality. But (...) considering the twins as 3D beings who age through time, the paradox implies that time passes at different rates in different reference frames, and therefore that the concept of a single global or Absolute time is unsustainable. (shrink)

Summary 1. Ecologists and conservation biologists consider many issues when designing a field study, such as the expected value of the data, the interests of the study species, the welfare of individual organisms and the cost of the project. These different issues or values often conflict; however, neither animal ethics nor environmental ethics provides practical guidance on how to assess trade-offs between them. -/- 2. We developed a decision framework for considering trade-offs between values in ecological research, drawing on the (...) field of ecological ethics. We used a case study of the population genetics of three frog species, in which a researcher must choose between four methods of sampling DNA from the study animals. We measured species welfare as the reduction in population growth rate following sampling, and assessed individual welfare using two different definitions: (i) the level of suffering experienced by an animal, and (ii) the level of suffering combined with loss of future life. -/- 3. Tipping the tails of tadpoles ranked as the best sampling method for species welfare, while collecting whole tadpoles and buccal swabbing of adult frogs ranked best for the first and second definitions of individual welfare, respectively. Toe clipping of adult frogs ranked as the worst sampling method for species welfare and the first definition of individual welfare, and equal worst for the second definition of individual welfare. -/- 4. When considering species and individual welfare simultaneously, toe clipping was clearly inferior to the other sampling methods, but no single sampling method was clearly superior to the other three. Buccal swabbing, collecting tadpoles and tail tipping were all preferred options, depending on the definition of individual welfare and the level of precision with which we assessed species welfare. -/- 5.Synthesis and applications. The decision framework we present can be used by ecologists to assess ethical and other trade-offs when planning field studies. A formal decision analysis makes transparent how a researcher might negotiate competing ethical, financial and practical objectives. Defining the components of the decision in this way can help avoid errors associated with human judgement and linguistic uncertainty. (shrink)

This article surveys arguments for the claim that employees have a right to strong forms of decision-making participation. Itconsiders objections to employee participation based on shareholders' property rights and it claims that those objections are flawed. In particular, it argues the employee participation rights are grounded on the same values as are property rights. The articlesuggests that the conflict between these two competing rights claims is best resolved by limiting the scope of corporate property rightsand by recognizing a strong employee (...) right to co-determine corporate decisions. (shrink)

Which Trinity? : the doctrine of the Trinity -- In contemporary philosophical theology -- Whose monotheism? : Jesus and his Abba -- Doctrine and analysis -- "Whoever raised Jesus from the dead" : Robert Jenson on the identity of the Triune God -- Moltmann's perichoresis : either too much or not enough -- "Eternal functional subordination" : considering a recent evangelical proposal -- Holy love and divine aseity in the theology of John Zizioulas -- Moving forward : theses on the (...) future of Trinitarian theology. (shrink)