In this paper, an argument of Alvin Plantinga's for the existence of abstract possible worlds is shown to be unsound. The argument is based on a principle Plantinga calls "Quasicompactness", due to its structural similarity to the notion of compactness in first-order logic. The principle is shown to be false.

Most economists and some philosophers distinguish individual utilities from interpersonal social values. Even if challenges to that conceptual distinction can be met, further philosophically interesting questions arise. I pursue three in this paper, using, as context for the discussion, health economics and its attempt to discern empirically a social welfare function to help guide rationing decisions. (1) To discern these utilities and values in a manner that is morally appropriate if they are to influence rationing decisions, who should be queried? (...) To discern individual health state utilities, persons in precisely those states should be asked (generically, "patients"), but for social values, representatives of the general public should be. (2) To discern social values, what should representatives of the public be asked? They should be asked "person trade-off" (PTO) questions that encompass their own self-interest, not PTO questions that focus only on others. (3) What must public representatives understand before they respond to such questions? Despite the philosophically complex problem of patient adaptation, they should understand (among other things) the health state utilities elicited from actual patients with the conditions at issue. (shrink)

Adolf Menzel was one of the most important German artists of the 19th century, yet he is scarcely known outside his native land. In this study a leading art historian argues that Menzel deserves to be recognized not only as one of the greatest painters and draftsmen of his century but also as a master realist whose work engages profoundly with an extraordinary range of issues - artistic, scientific, philosophical and socio-political. Michael Fried explores Menzel's large and (...) fascinating oeuvre, and in so doing seeks to make the artist's achievement accessible to a wide audience. (shrink)

The authors provide an object-theoretic analysis of two paradoxes in the theory of possible worlds and propositions stemming from Russell and Kaplan. After laying out the paradoxes, the authors provide a brief overview of object theory and point out how syntactic restrictions that prevent object-theoretic versions of the classical paradoxes are justified philosophically. The authors then trace the origins of the Russell paradox to a problematic application of set theory in the definition of worlds. Next the authors show that an (...) object-theoretic analysis of the Kaplan paradox reveals that there is no genuine paradox at all, as the central premise of the paradox is simply a logical falsehood and hence can be rejected on the strongest possible grounds—not only in object theory but for the very framework of propositional modal logic in which Kaplan frames his argument. The authors close by fending off a possible objection that object theory avoids the Russell paradox only by refusing to incorporate set theory and, hence, that the object-theoretic solution is only a consequence of the theory’s weakness. (shrink)

Epistemologists often offer theories of justification without paying much attention to the variety and diversity of locutions in which the notion of justification appears. For example, consider the following claims which contain some notion of justification: B is a justified belief, S's belief that p is justified, p is justified for S, S is justified in believing that p, S justifiably believes that p, S's believing p is justified, there is justification for S to believe that p, there is justification (...) for S's believing p, and S has a justification for believing that p. In addition to these passive uses of the notion of justification, there are active uses as well: S justified his belief in p, believing e justifies believing p, etc. The syntactic variety involves semantic difference as well. For example, the proposition S has a justification for believing that p does not entail that S believes p, whereas the proposition S justifiably believes that p does entail that S believes p. Our ultimate goal is to show that this diversity is only superficial by arguing that there is a basic kind of justification. On the way, however, we shall argue that there are three central uses of a notion of justifica- tion in the above list: propositional justification (as in p is justified for S), personal justification (as in S is justified in believing that p) and doxastic justification (as in S's believing p is justified). Our preliminary argument will be that the multiplicity above can be explained in terms of these three locutions, and the substance of our argument will be to show that one of these three is the basic kind of justification. Success in this task will thereby justify, at least in part, the practice of contem- porary epistemologists. Our conclusions, however, shall not be of much comfort to contemporary epistemology, for the way in which the apparent diversity in the uses of the notion of justification is eliminated undermines much of recent epistemology. (shrink)

The issues and problems of mandatory vaccination policy and roll out in First Nations communities are unique and do not concern the safety and effectiveness of vaccines. These issues are also independent of more specific arguments of mandatory vaccination of healthcare workers as a condition of employment. As important as these issues are, they do not consider the complex politics of ongoing settler colonialism and First Nations community relations. In this paper, we also set aside the very real problems of (...) disinformation, hesitancy, scientific and health illiteracy, and other concerns that drive vaccine hesitancy and refusal. These affect all communities, including First Nations communities. We, instead describe the dominant arguments in favour of mandatory vaccination and critique them in terms of the disputed legitimacy of Settler-Colonial decision-making as it impacts First Nations communities. We contend cultural responsiveness and safety—not state compulsion—must remain the first principles of any engagement—including vaccination—with First Nations Peoples, families, and communities. (shrink)

Contains the following contributions: -/- Ingvar Johansson: Ontologies and Concepts. Two Proposals -/- Christopher Menzel: Reference Ontologies - Application Ontologies: Either/Or or Both/And? -/- Luc Schneider: Foundational Ontologies and the Realist Bias -/- Guenther Goerz, Kerstin Buecher, Bernd Ludwig, Frank-Peter Schweinberger, and Iman Thabet: Combining a Lexical Taxonomy with Domain Ontology in the Erlangen Dialogue System -/- Vim Vandenberghe, Burkhard Schafer, John Kingston: Ontology Modelling in the Legal Domain - Realism Without Revisionism -/- A Proposed Methodology for the Development (...) of Application-Based Formal Ontologies Eric Little . (shrink)

Aid‐in‐dying laws in the United States have two important restrictions. First, only patients who are terminally ill, defined as having a prognosis of six months or less to live, qualify. Second, at the time the patients take the lethal medication, they must be competent to make medical decisions. This means that an advance directive requesting aid in dying for a later time when the patient lacks decision‐making capacity would be invalid. However, many people are more concerned about avoiding living into (...) severe dementia for years—a time when they will lack decision‐making capacity—than they are about preventing suffering or the loss of dignity or autonomy for a few months at the end of life.Gillian Bennett is an example of someone determined not to live into severe dementia. She opted for preemptive suicide in 2014, explaining why in a letter she posted online: “Every day I lose bits of myself, and it’s obvious that I am heading toward the state that all dementia patients eventually get to: not knowing who I am and requiring full‐time care.”A major problem with Bennett’s solution, however, is that the individual is likely thereby to be giving up some “good time.” A legal alternative to preemptive suicide is to create an advance directive stating the circumstances under which one wants not to receive any lifesaving or life‐sustaining treatment, even the most basic and noninvasive. This option is our focus in this paper: how to create effective advance directives to avoid living into severe dementia. To be relevant to progressive dementia, the directive would need to state what kinds of care should be withheld and when. At the same time, advance directives for severe dementia face serious challenges. Before addressing these, we review the normative force of directives themselves. (shrink)

The Process Specification Language (PSL) has been designed to facilitate correct and complete exchange of process information among manufacturing systems, such as scheduling, process modeling, process planning, production planning, simulation, project management, work flow, and business process reengineering. We given an overview of the theories with the PSL ontology, discuss some of the design principles for the ontology, and finish with examples of process specifications that are based on the ontology.

Actualism is the doctrine that the only things there are, that have being in any sense, are the things that actually exist. In particular, actualism eschews possibilism, the doctrine that there are merely possible objects. It is widely held that one cannot both be an actualist and at the same time take possible world semantics seriously — that is, take it as the basis for a genuine theory of truth for modal languages, or look to it for insight into the (...) modal structure of reality. For possible world semantics, it is supposed, commits one to possibilism. In this paper I take issue with this view. To the contrary, I argue that one can take possible world semantics seriously without any commitment to possible worlds or possibilism and hence remain in full compliance with actualist scruples. Moreover, one can do so without without invoking either "ersatz" worlds or haecceities. (shrink)

Physician-assisted suicide laws in Oregon and Washington require the person's current competency and a prognosis of terminal illness. In The Netherlands voluntariness and unbearable suffering are required for euthanasia. Many people are more concerned about the loss of autonomy and independence in years of severe dementia than about pain and suffering in their last months. To address this concern, people could write advance directives for physician-assisted death in dementia. Should such directives be implemented even though, at the time, the person (...) is no longer competent and would not be either terminally ill or suffering unbearably? We argue that in many cases they should be, and that a sliding scale which considers both autonomy and the capacity for enjoyment provides the best justification for determining when: when written by a previously well-informed and competent person, such a directive gains in authority as the later person's capacities to generate new critical interests and to enjoy life decrease. Such an extension of legalized death assistance is grounded in the same central value of voluntariness that undergirds the current more limited legalization. (shrink)

Almost all jurisdictions where physician-assisted death is legal require that the requesting individual be competent to make medical decisions at time of assistance. The requirement of contemporary competence is intended to ensure that PAD is limited to people who really want to die and have the cognitive ability to make a final choice of such enormous import. Along with terminal illness, defined as prognosis of death within six months, contemporary competence is regarded as an important safeguard against mistake and abuse, (...) arguably the strongest objections to legalizing PAD.The insistence on contemporary competence is problematic. It means that someone who has dementia is ruled out as a candidate for PAD, even if she is terminally ill and suffering terrible and unrelievable pain. It also rules out individuals with strong and unwavering desires not to end their life in dementia. (shrink)

W. V. Quine famously defended two theses that have fallen rather dramatically out of fashion. The first is that intensions are “creatures of darkness” that ultimately have no place in respectable philosophical circles, owing primarily to their lack of rigorous identity conditions. However, although he was thoroughly familiar with Carnap’s foundational studies in what would become known as possible world semantics, it likely wouldn’t yet have been apparent to Quine that he was fighting a losing battle against intensions, due in (...) large measure to developments stemming from Carnap’s studies and culminating in the work of Kripke, Hintikka, and Bayart. These developments undermined Quine’s crusade against intensions on two fronts. First, in the context of possible world semantics, intensions could after all be given rigorous identity conditions by defining them (in the simplest case) as functions from worlds to appropriate extensions, a fact exploited to powerful and influential effect in logic and linguistics by the likes of Kaplan, Montague, Lewis, and Cresswell. Second, the rise of possible world semantics fueled a strong resurgence of metaphysics in contemporary analytic philosophy that saw properties and propositions widely, fruitfully, and unabashedly adopted as ontological primitives in their own right. This resurgence — happily, in my view — continues into the present day. -/- For a time, at any rate, Quine experienced somewhat better success with his second thesis: that higher-order logic is, at worst, confused and, at best, a quirky notational alternative to standard first-order logic. However, Quine notwithstanding, a great deal of recent work in formal metaphysics transpires in a higher-order logical framework in which properties and propositions fall into an infinite hierarchy of types of (at least) every finite order. Initially, the most philosophically compelling reason for embracing such a framework since Russell first proposed his simple theory of types was simply that it provides a relatively natural explanation of the paradoxes. However, since the seminal work of Prior there has been a growing trend to consider higher-order logic to be the most philosophically natural framework for metaphysical inquiry, many of the contributors to this volume being among the most important and influential advocates of this view. Indeed, this is now quite arguably the dominant view among formal metaphysicians. -/- In this paper, and against the current tide, I will argue in §1 that there are still good reasons to think that Quine’s second battle is not yet lost and that the correct framework for logic is first-order and type-free — properties and propositions, logically speaking, are just individuals among others in a single domain of quantification — and that it arises naturally out of our most basic logical and semantical intuitions. The data I will draw upon are not new and are well-known to contemporary higher-order metaphysicians. However, I will try to defend my thesis in what I believe is a novel way by suggesting that these basic intuitions ground a reasonable distinction between “pure” logic and non-logical theory, and that Russell-style semantic paradoxes of truth and exemplification arise only when we move beyond the purely logical and, hence, do not of themselves provide any strong objection to a type-free conception of properties and propositions. -/- Most of my arguments in §1 are largely independent of any specific account of the nature of properties and propositions beyond their type-freedom. However, I will in addition argue that there are good reasons to take propositions, at least, to be very fine-grained. My arguments are thus bolstered significantly if it can be shown that there are in fact well-defined examples of logics that are not only type-free but which comport with such a conception of propositions. It is the purpose of §2 to lay out a logic of this sort in some detail, drawing especially upon work by George Bealer and related work of my own. With the logic in place, it will be possible to generalize the line of argument noted above regarding Russell-style paradoxes and, in §3, apply it to two propositional paradoxes — the Prior-Kaplan paradox and the Russell-Myhill paradox — that are often taken to threaten the sort of account developed here. (shrink)

In Modal Logic as Metaphysics, Timothy Williamson claims that the possibilism-actualism (P-A) distinction is badly muddled. In its place, he introduces a necessitism-contingentism (N-C) distinction that he claims is free of the confusions that purportedly plague the P-A distinction. In this paper I argue first that the P-A distinction, properly understood, is historically well-grounded and entirely coherent. I then look at the two arguments Williamson levels at the P-A distinction and find them wanting and show, moreover, that, when the N-C (...) distinction is broadened (as per Williamson himself) so as to enable necessitists to fend off contingentist objections, the P-A distinction can be faithfully reconstructed in terms of the N-C distinction. However, Williamson’s critique does point to a genuine shortcoming in the common formulation of the P-A distinction. I propose a new definition of the distinction in terms of essential properties that avoids this shortcoming. (shrink)

To understand the thesis of actualism, consider the following example. Imagine a race of beings — call them ‘Aliens’ — that is very different from any life-form that exists anywhere in the universe; different enough, in fact, that no actually existing thing could have been an Alien, any more than a given gorilla could have been a fruitfly. Now, even though there are no Aliens, it seems intuitively the case that there could have been such things. After all, life might (...) have evolved very differently than the way it did in fact. So in virtue of what is it true that there could have been Aliens when in fact there are none, and when, moreover, nothing that exists in fact could have been an Alien? So-called "possibilists" offer the following answer: ‘It is possible that there are Aliens’ is true because there are in fact individuals that could have been Aliens. At first blush, this might appear directly to contradict the premise that no existing thing could possibly have been an Alien. The possibilist's thesis, however, is that existence, or actuality, encompasses only a subset of the things that, in the broadest sense, are. So for the possibilist, ‘It is possible that there are Aliens’ is true simply in virtue of the fact that there are possible-but-nonactual Aliens, i.e., things that could have existed (but do not) and which would have been Aliens if they had. Actualists reject this answer; they deny that there are any nonactual individuals. Thus, actualism is the philosophical position that everything there is — everything that can in any sense be said to be — exists, or is actual. (shrink)

Bringsjord (1985) argues that the definition W of possible worlds as maximal possible sets of propositions is incoherent. Menzel (1986a) notes that Bringsjord’s argument depends on the Powerset axiom and that the axiom can be reasonably denied. Grim (1986) counters that W can be proved to be incoherent without Powerset. Grim was right. However, the argument he provided is deeply flawed. The purpose of this note is to detail the problems with Grim’s argument and to present a sound alternative (...) argument for his conclusion – basically the argument Russell gave to establish a well-known paradox in The Principles of Mathematics. (shrink)

This article includes a basic overview of possible world semantics and a relatively comprehensive overview of three central philosophical conceptions of possible worlds: Concretism (represented chiefly by Lewis), Abstractionism (represented chiefly by Plantinga), and Combinatorialism (represented chiefly by Armstrong).

Competent patients have considerable legal authority to control life‐and‐death care. They may refuse medical life support, including medically delivered food and fluids. Even when they are not in need of any life‐saving care, they may expedite death by refusing food and water by mouth—voluntarily stopping eating and drinking, or VSED. Neither right is limited to terminal illness. In addition, in four U.S. states, competent patients, if terminally ill, may obtain lethal drugs for aid‐in‐dying.For people who have dementia and are no (...) longer competent, however, control over the end of life is much less extensive. They may have written a clear advance directive for refusing life‐saving care in specified circumstances yet subsequently find themselves living for years in severe dementia with no need for life‐saving care that could be refused. Chronic progressive dementia is not itself life threatening until its very final stage. Even in jurisdictions that permit active aid‐in‐dying, individuals with advanced dementia are not eligible; they lack the required current competence, and they are seldom deemed terminally ill. As for the right to VSED, its very name—voluntarily stopping eating and drinking—is seen as excluding noncompetent persons.One option for ensuring that one does not live years in severe dementia is to use advance directives to withhold food and water by mouth. The driving element behind VSED is that forcing people to ingest food is as objectionable an intrusion on bodily integrity, privacy, and liberty as imposing unwanted medical treatment. Thus, if incompetent people do not lose their rights to refuse life‐saving treatment, and if people when competent have just as strong a right to VSED as they do to refuse life‐saving treatment, then people do not lose their right to VSED when incompetent either. They only have to exercise it by AD. (shrink)

The iterative conception of set is typically considered to provide the intuitive underpinnings for ZFCU (ZFC+Urelements). It is an easy theorem of ZFCU that all sets have a definite cardinality. But the iterative conception seems to be entirely consistent with the existence of “wide” sets, sets (of, in particular, urelements) that are larger than any cardinal. This paper diagnoses the source of the apparent disconnect here and proposes modifications of the Replacement and Powerset axioms so as to allow for the (...) existence of wide sets. Drawing upon Cantor’s notion of the absolute infinite, the paper argues that the modifications are warranted and preserve a robust iterative conception of set. The resulting theory is proved consistent relative to ZFC + “there exists an inaccessible cardinal number.”. (shrink)

By registering different health benefits on a common scale, CEA allows us to assess the relative social importance of different health care interventions and opens the way for the allocation decisions of health care policy. If it is really to be effective, however, CEA must be recalibrated so that it better reflects some of our widely held beliefs about the merits of different kinds of treatment.

In his paper "Are There Set Theoretic Possible Worlds?", Selmer Bringsjord argued that the set theoretic definition of possible worlds proffered by, among others, Robert Adams and Alvin Plantinga is incoherent. It is the purpose of this note to evaluate that argument. The upshot: these set theoretic accounts can be preserved, but only by abandoning the power set axiom.

This paper traces the course of Prior’s struggles with the concepts and phenomena of modality, and the reasoning that led him to his own rather peculiar modal logic Q. I find myself in almost complete agreement with Prior’s intuitions and the arguments that rest upon them. However, I argue that those intuitions do not of themselves lead to Q, but that one must also accept a certain picture of what it is for a proposition to be possible. That picture. though, (...) is not inevitable. Rather, implicit in Prior’s own account is an alternative picture that has already appeared in various guises, most prominently in the work of Adams, Fine, Deutsch, and Almog. I, too, will opt for this alternative, though I will spell it out rather differently than these philosophers. I will then show that, starting with the alternative picture, Prior’s intuitions can lead instead to a much happier and more standard quantified modal logic than Q. The last section of the paper is devoted to the formal development of the logic and its metatheory. (shrink)

As the story goes, the source of the paradoxes of naive set theory lies in a conflation of two distinct conceptions of set: the so-called iterative, or mathematical, conception, and the Fregean, or logical, conception. While the latter conception is provably inconsistent, the former, as Godel notes, "has never led to any antinomy whatsoever". More important, the iterative conception explains the paradoxes by showing precisely where the Fregean conception goes wrong by enabling us to distinguish between sets and proper classes, (...) collections that are "too big" to be sets. While I agree wholeheartedly with this distinction, in this paper I argue first that the iterative conception does not provide an explanation of all of the set theoretic paradoxes. I then argue that we need to reconsider the distinction between sets and proper classes rather more carefully. The result will be that ZFC does not capture the iterative conception in its full generality. I close by offering a more general theory that, arguably, does. (shrink)

By registering different health benefits on a common scale, CEA allows us to assess the relative social importance of different health care interventions and opens the way for the allocation decisions of health care policy. If it is really to be effective, however, CEA must be recalibrated so that it better reflects some of our widely held beliefs about the merits of different kinds of treatment.

According to many actualists, propositions, singular propositions in particular, are structurally complex, that is, roughly, (i) they have, in some sense, an internal structure that corresponds rather directly to the syntactic structure of the sentences that express them, and (ii) the metaphysical components, or constituents, of that structure are the semantic values — the meanings — of the corresponding syntactic components of those sentences. Given that reference is "direct", i.e., that the meaning of a name is its denotation, an apparent (...) consequence of this view is that any proposition expressed by a sentence containing a name that denotes a contingent being S is itself contingent — notably, the proposition [S does not exist]. Assuming that an entity must exist to have a property, necessarily, [S does not exist] must exist in order to be true. It seems to follow that, necessarily, [S does not exist] is not true and, hence, that S is not contingent after all. Past approaches to the problem — notably, those of Prior and Adams — lead to highly undesirable consequences for quantified modal logic. In this paper, several solutions to this puzzle are developed that preserve actualism, the structured view of propositions, the direct theory of reference, and the intuition that [S does not exist] is indeed possible without the adverse consequences for QML of previous solutions. (shrink)

In this report I motivate and develop a type-free logic with predicate quantifiers within the general ontological framework of properties, relations, and propositions. In Part I, I present the major ideas of the system informally and discuss its philosophical significance, especially with regard to Russell's paradox. In Part II, I prove the soundness, consistency, and completeness of the logic.

In the United States, amid the fractious politics of attempting to achieve something close to universal access to basic health care, two impressions are likely to feed skepticism about the status of a right to universal access: the moral principles that underlie any right to universal access may seem incredibly "ideal," not well rooted in the society's actual fabric, and the necessary practical and political attempts to limit the scope of universally accessible care to make its achievement realistic may seem (...) marked less by moral rhyme and reason than by the pull of conflicting interests. I try to directly dispel the first of these impressions and to obliquely question the second. The immense political barriers to .. (shrink)

In this paper I rehearse two central failings of traditional possible world semantics. I then present a much more robust framework for intensional logic and semantics based liberally on the work of George Bealer in his book Quality and Concept. Certain expressive limitations of Bealer's approach, however, lead me to extend the framework in a particularly natural and useful way. This extension, in turn, brings to light associated limitations of Bealer's account of predication. In response, I develop a more general (...) and intuitively more adequate account of the logical form of predication. (shrink)

Very broadly, an argument from collections is an argument that purports to show that our beliefs about sets imply — in some sense — the existence of God. Plantinga (2007) first sketched such an argument in “Two Dozen” and filled it out somewhat in his 2011 monograph Where the Conflict Really Lies: Religion, Science, and Naturalism. In this paper I reconstruct what strikes me as the most plausible version of Plantinga’s argument. While it is a good argument in at least (...) a fairly weak sense, it doesn’t initially appear to have any explanatory advantages over a non-theistic understanding of sets — what I call set theoretic realism. However, I go on to argue that the theist can avoid an important dilemma faced by the realist and, hence, that Plantinga’s argument from collections has explanatory advantages that realism does not have. (shrink)

The case of Mrs A is a provocative example of euthanasia by advance directive to avoid increasingly severe dementia. It is also a ‘perfect storm’ of a disturbing case, revealing both the challenges that can arise with advance euthanasia directives generally and particular issues in the Dutch procedures. Kim, Miller and Dresser have done a distinct service to bioethics in detailing the case, in explaining the basis of the regional euthanasia review committee reprimand of the administering geriatrician and in highlighting (...) some significant deficiencies in Dutch procedures.1 Many readers, after encountering the case, may find themselves sceptical that AEDs can be an ethically viable vehicle for avoiding living into severe dementia. I will argue that caution and care, not resistance to AEDs for dementia, is in order. Real dilemmas of implementation are inherent in advance directives, to be sure, dilemmas that can be aggravated by a patient’s dementia. Yet much can be done in writing an AED to make its implementation in dementia less problematic, and the Dutch emphasis on intolerable suffering as a necessary condition for euthanasia is not the appropriate legal framework. The difficulties in the case begin with the directive itself. Any advance directive, whether for refusing lifesaving treatment or for physician-assisted death, needs to be clear about what is and is not to happen and when. At first Mrs A’s directive seems to provide a trigger point: ‘I want to make use of the legal right to … euthanasia when I am still at all mentally competent and am no longer able to live at home with my husband. I absolutely do not want to be placed in an institution for elderly dementia patients’. In a revision added a year before her death, the time had become ‘whenever I think the time …. (shrink)

According to traditional theism, God alone exists a se, independent of all other things, and all other things exist ab alio, i.e., God both creates them and sustains them in existence. On the face of it, divine "aseity" is inconsistent with classical Platonism, i.e., the view that there are objectively existing, abstract objects. For according to the classical Platonist, at least some abstract entities are wholly uncreated, necessary beings and, hence, as such, they also exist a se. The thesis of (...) theistic activism purports to reconcile divine aseity with a robust Platonism. Specifically, the activist holds that God creates the abstract objects no less than the contingent concrete objects of the physical universe and hence that, like all created things, they exist ab alio after all, their necessity notwithstanding. But many philosophers believe a severe roadblock for activism remains — a problem known as the bootstrapping objection. Despite widespread faith in the deliverances of this argument, in this paper I show that the bootstrapping objection is open to significant objections on several fronts. (shrink)

In using quality of life as a guide to rationing health services, Oregon laid itself open to charges of bias against the disabled—charges that cannot be dismissed out of hand.

In using quality of life as a guide to rationing health services, Oregon laid itself open to charges of bias against the disabled—charges that cannot be dismissed out of hand.

In a recent paper in JME, Shelton and Geppert use an approach by Menzel and Chandler-Cramer to sort out ethical dilemmas about the oral feeding of patients in advanced dementia, ultimately arguing that the usefulness of advance directives about such feeding is highly limited. They misunderstand central aspects of Menzel’s and Chandler-Cramer’s approach, and in making their larger claim that such directives are much less useful than typically presumed, they fail to account for five important elements in writing (...) good directives for dementia and implementing them properly: (1) Directives should be paired with appointment of trusted agents. (2) Appointed agents’ authority can be greatly weakened without advance directives to guide them. (3) Directives’ implementation does not require clinically precise assessment of dementia’s stage. (4) Palliative support is typically required for withholding of oral feeding to be compassionate. (5) The central purpose of stopping feeding is often not the avoidance of suffering but not prolonging unwanted life. (shrink)

Suppose we believe that God created the world. Then surely we want it to be the case that he intended, in some sense at least, to create THIS world. Moreover, most theists want to hold that God didn't just guess or hope that the world would take one course or another; rather, he KNEW precisely what was going to take place in the world he planned to create. In particular, of each person P, God knew that P was to exist. (...) Call this the "standard" conception. Most theists find the standard conception appealing. Unfortunately, the view seems to conflict with the equally appealing idea — call it "temporal actualism" — that there are no "future" individuals beyond those that already exist in the present moment. For, on this view, for any historical person P, prior to creation, there was no such person as P and hence nothing about P for God to know. Hence, in particular, God couldn't have known that P was to exist. This is of course not a new problem. But past solutions to it are highly problematic. In this paper, after canvassing previous approaches, I will propose a solution that seems to preserve both temporal actualism and a suitably robust form of the standard conception while avoiding the pitfalls of the past. (shrink)