Specialists and primary care physicians play an integral role in treating the twin epidemics of pain and addiction. But inadequate access to specialists causes much of the treatment burden to fall on primary physicians. This article chronicles the differences between treatment contexts for both pain and addiction — in the specialty and primary care contexts — and derives a series of reforms that would empower primary care physicians and better leverage specialists.

Theories of discourse bring to realism new ideas about how knowledge develops and how representations of reality are influenced. We gain an understanding of the conceptual aspect of social life and the processes by which meaning is produced. This collection reflects the growing interest realist critics have shown towards forms of discourse theory and deconstruction. The diverse range of contributions address such issues as the work of Derrida and deconstruction, discourse theory, Eurocentrism and poststructuralism. What unites all of the contributions (...) is a sense that it is essential to provide a realist alternative to the hitherto dominance of social constructionism, hermeneutics and postmodernism, over many of the issues discussed. By developing a realist perspective the different authors attempt to embed discourse within the structured nature of the reality of the world. Realism can situate language, discourse and ideology within context specific, or 'causally efficacious' circumstances. Realism can help to uncover issues of power, representation, and subjectivity and how discursive and other social practices produce real effects. This can help us understand the manner in which social structures are reproduced through various forms of ideology and discourse. And by knowing this, we can start to address questions concerning human emancipation and how the world is to be transformed. (shrink)

From Information to Transformation is about remembering what matters in education and in life. In many ways, it concerns who we are and how we know. Drawing from the wisdom traditions, transpersonal psychology, consciousness studies, and pedagogy, a map of the depths of knowing and learning is constructed that unfolds through six interrelated layers: information, knowledge, intelligence, understanding, wisdom, and transformation. This provides both a process and a direction for education that can prepare students for the extraordinary demands of the (...) twenty-first century. Entering into these depths offers an education that is both practical and remarkable, one that replaces radical disconnection with radical amazement. This integrated approach includes the education of the mind and the heart, balances intuition with the analytic, mastery with mystery, and emphasizes developing wisdom over the mere accumulation of facts. (shrink)

This thesis examines the claim that the sciences are disunified. Chapter 1 outlines and introduces different accounts of the stratification of the sciences in the literature, in particular, Unificationism, Disunificationism, Eliminativism and Human Science Disunificationism. I argue that all of these competing views are informed by an ideal model for successful science. In particular, all of the views discussed are committed to the claim that a science requires laws to be considered scientifically legitimate. At the end of this chapter, the (...) narrower topic of the thesis is revealed: do the special sciences have real legitimate ceteris paribus laws? (shrink)

The companion piece to this article, “Situating Moral Justification,” challenges the idea that moral epistemology's mission is to establish a single, all-purpose reasoning strategy for moral justification because no reasoning practice can be expected to deliver authoritative moral conclusions in all social contexts. The present article argues that rethinking the mission of moral epistemology requires rethinking its method as well. Philosophers cannot learn which reasoning practices are suitable to use in particular contexts exclusively by exploring logical relations among concepts. Instead, (...) in order to understand which reasoning practices are capable of justifying moral claims in different types of contexts, we need to study empirically the relationships between reasoning practices and the contexts in which they are used. The article proposes that philosophers investigate case studies of real-world moral disputes in which people lack shared cultural assumptions and/or are unequal in social power. It motivates and explains the proposed case study method and illustrates the philosophical value of this method through a case study. (shrink)

Topics covered in Discrete Mathematics have become essential tools in many areas of studies in recent years. This is primarily due to the revolution in technology, communications, and cyber security. The book treats major themes in a typical introductory modern Discrete Mathematics course: Propositional and predicate logic, proof techniques, set theory (including Boolean algebra, functions and relations), introduction to number theory, combinatorics and graph theory. An accessible, precise, and comprehensive approach is adopted in the treatment of each topic. The ability (...) of abstract thinking and the art of writing valid arguments are emphasized through detailed proof of (almost) every result. Developing the ability to think abstractly and roguishly is key in any areas of science, information technology and engineering. Every result presented in the book is followed by examples and applications to consolidate its comprehension. The hope is that the reader ends up developing both the abstract reasoning as well as acquiring practical skills. All efforts are made to write the book at a level accessible to first-year students and to present each topic in a way that facilitates self-directed learning. Each chapter starts with basic concepts of the subject at hand and progresses gradually to cover more ground on the subject. Chapters are divided into sections and subsections to facilitate readings. Each section ends with its own carefully chosen set of practice exercises to reenforce comprehension and to challenge and stimulate readers. As an introduction to Discrete Mathematics, the book is written with the smallest set of prerequisites possible. Familiarity with basic mathematical concepts (usually acquired in high school) is sufficient for most chapters. However, some mathematical maturity comes in handy to grasp some harder concepts presented in the book. (shrink)

8.3 The consistency proof -- 8.4 Applications of the consistency proof -- 8.5 Second-order arithmetic -- Problems -- Chapter 9: Set Theory -- 9.1 Axioms for sets -- 9.2 Development of set theory -- 9.3 Ordinals -- 9.4 Cardinals -- 9.5 Interpretations of set theory -- 9.6 Constructible sets -- 9.7 The axiom of constructibility -- 9.8 Forcing -- 9.9 The independence proofs -- 9.10 Large cardinals -- Problems -- Appendix The Word Problem -- Index.

Ranging over central issues of morals and politics and the nature of freedom and authority, this study examines the role of value-neutrality, rights, equality, ...

This lucidly written book examines the social and political significance of the natural sciences through a detailed and original account of science as an interpretive social practice.

Even though sign-systems are a crucial part of society, critical realism, as developed by Roy Bhaskar, does not yet have an adequate theory of signs and semiosis. The few suggestions that Bhaskar offers can be advanced through the semiotics of C.S. Peirce. In doing so, however, it becomes necessary to reconsider Bhaskar's ontological domains of the real, the actual, and the subjective, and expand the last domain into one of semiosis. This new understanding of ontological domains, incorporating Peirceian semiotics, provides (...) the basis for rethinking the ontology of society: the customary dyad structures/agents becomes the triad structures/agents/discourses, each of which possesses material, sociological, and meaningful aspects. (shrink)

The thesis of the present volume is critical and dual. (1) Present day philosophy of man and sciences of man suffer from the Greek mis taken polarization of everything human into nature and convention which is (allegedly) good and evil, which is (allegedly) truth and fal sity, which is (allegedly) rationality and irrationality, to wit, the polar ization of all fields of inquiry, the natural and social sciences, as well as ethics and all technology, whether natural or social, into the (...) totally positive and the totally negative. (2) Almost all philosophy and sci ences of man share the erroneous work ethic which is the myth of man's evil nature - the myth of the beast in man, the doctrine of original sin. To mediate or to compromise between the first view of human nature as good with the second view of it as evil, sociologists have devised a modified utilitarianism with deferred gratification so called, and the theory of the evil of artificial competition (capitalist and socialist alike) and of keeping up with the Joneses. Now, the mediation is not necessary. For, the polarization makes for abstract errors which are simplistic views of rationality, such as reductionism and positivism of all sorts, as well as for concrete errors, such as the disposition to condemn repeatedly those human weaknesses which are inevitable, namely man's inability to be perfectly rational, avoid all error, etc. , thus setting man against himself as all too wicked. (shrink)

Medical Officers serving with their national contingents in peacekeeping operations are faced with difficult ethical decisions in regard to their obligations to the local civilian population. Such populations may be under-resourced in regard to medical care, and vulnerable to abuse and exploitation. Though the medical officer may support the local medical services, he/she should never undermine these resources. Adopting a human rights approach and observing the requirements of ethical medicine, aids the doctor in prioritising his/her duties. At times there may (...) be conflict with one’s own military superiors. It is wise to discuss potential difficulties prior to setting out on the mission. Human rights abuses cannot be ignored. The medical officer has a duty to do his/her best to report their observations so as to prevent abuse or to bring it to an end. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 347-350 [Access article in PDF] Book Review The Sin of Knowledge: Ancient Themes and Modern Variations, The Sin of Knowledge: Ancient Themes and Modern Variations, by Theodore Ziolkowski; xvi & 222 pp. Princeton: Princeton University Press, $29.95. After thirty-five years of teaching and administrating at Princeton University, dozens of books, and innumerable articles, the eminent Germanist Theodore Ziolkowski has turned his attention to a (...) theme appropriate for someone so immersed in the intellectual life: the sorrow and grief that accompany human knowledge. Although Ziolkowski has made great contributions in standard studies of genre (notably the elegy and the twentieth-century novel) and authors (Mann, Hesse, and Broch), he became especially well known for his theorization and implementation of thematic studies, ranging from the sublime--fictionalizations of the life of Jesus--to the humorous--talking animals in literature. The figures whom Ziolkowski has selected for analysis of the sin of knowledge are Adam, Prometheus, and Faust, each of whom he views through both an ancient and a modern lens.All three of these mythic heroes violate "divine prohibitions against the new knowledge" (p. 69). Less heroically, all of these myths treat women misogynistically. Generally, Ziolkowski sees each of these stories as having emerged in a time of crisis, when new opportunities presented humanity with knowledge both alluring and disruptive. Because these are highly elastic myths, able to provide meaning in a variety of contexts, they have all mutated in modern times. Adam's Fall comes to represent the human transition from innocence to consciousness, Prometheus becomes a symbol for socialism's promise, and Faust turns into a representative of the American way of life.Looking at the ancient legend of Adam, Ziolkowski notes that sexuality and wisdom are linked in many of the oldest texts in humanity's recorded history. The emphasis on knowledge, however, is especially strong in the Hebrew myth. While many Near Eastern traditions have stories with similarities to the Biblical account of Adam and Eve, only Hebrew mythology has the Tree of Knowledge. For Ziolkowski, the fact that this story was probably set down during the reign of King Solomon explains this emphasis on knowledge. Because the Age of Solomon was a time of unparalleled wealth and power for the Hebrews, [End Page 347] Ziolkowski argues that the tale of Adam and Eve is the kind of myth "produced by cultures that have reached a certain level of sophistication... and look back with a degree of nostalgia at an imagined simpler, happier existence" (p. 23). According to Ziolkowski, knowledge becomes a sin for the Hebrews as they come to terms with the limitations of everything that their knowledge has brought them even at the height of their power and glory.In the modern era, Ziolkowski continues, the story of Adam has become secularized, representing the transition of humanity from a state of innocence to one of consciousness. He finds references to the Fall in Voltaire's Candide, Kleist's The Broken Pitcher, E. T. A. Hoffmann's The Golden Pot, Melville's Billy Budd, and Hesse's Demian. The overall trend of these representations of the rise of consciousness has been increasingly negative, culminating in sentiments like those expressed by the East German author Günter Kunter, who argues that "our whole present misery and all the problems of industrial civilization" can be linked to "the moment when man used the first firestone as a tool, the Fall" (p. 107). As Ziolkowski concludes: "Two centuries of secularization have brought the modern Adam to a depressing end" (p. 108).Citing Nietzsche, who compared Prometheus to Adam (and Pandora to Eve), Ziolkowski looks first at Hesiod's depiction of Prometheus as a trickster and then to Aeschylus' hero. Unlike the authors of the story of Adam and Eve, though, Aeschylus depicts Prometheus' claim to divine knowledge in a positive light: "Rather than a humankind declining from a glorious golden age to the present deplorable iron age, Aeschylus sees humanity progressing by means of knowledge--the crafts, arts, and sciences--from blindness and ignorance... (shrink)

Jennifer Hornsby has defended the Reasons-Knowledge Thesis : the claim that \-ing because p requires knowing that p, where the ‘because’ at issue is a rationalising ‘because’. She defends by appeal to the thought that it provides the best explanation of why the subject in a certain sort of Gettier case fails to be in a position to \ because p. Dustin Locke and, separately, Nick Hughes, present some modified barn-façade cases which seem to constitute counterexamples to and undermine Hornsby’s (...) way of motivating it by rendering their alternative Reasons-Explanation Thesis a better explanation of Hornsby’s datum. This paper defends and Hornsby’s argument for it against those objections. First, I point out that their supposedly intuitive verdict about the relevant barn-façade cases is not as intuitive as they think. Second, I point out that even if we share the intuition: we have strong reason to doubt the verdict anyway. And finally, I point out that since is independently implausible, the two problems can be tackled anyway. (shrink)

According to standard comparativist views, death is bad insofar as it deprives someone of goods she would otherwise have had. In The Ethics of Killing, Jeff McMahan argues against such views and in favor of a gradualist account according to which how bad it is to die is a function of both the future goods of which the decedent is deprived and her cognitive development when she dies. Comparativists and gradualists therefore disagree about how bad it is to die at (...) different ages. In this paper I examine two prominent criticisms of gradualism and show that both misconstrue McMahan. I develop a related criticism that seems to show that a gradualist cannot coherently relate morbidity and mortality. This criticism also fails, but has an instructive implication for how policy-makers setting priorities for health care investments should regard choices between life-saving interventions and interventions against non-fatal diseases in the very young. (shrink)

Offering the perspectives of some of the most respected thinkers in transpersonal psychology and consciousness studies, this book explores the farther reaches ...

Applications of artificial intelligence/machine learning in health care are dynamic and rapidly growing. One strategy for anticipating and addressing ethical challenges related to AI/ml for health care is patient and public involvement in the design of those technologies – often referred to as ‘co-design’. Co-design has a diverse intellectual and practical history, however, and has been conceptualized in many different ways. Moreover, AI/ml introduces challenges to co-design that are often underappreciated. Informed by perspectives from critical data studies and critical digital (...) health studies, we review the research literature on involvement in health care, and involvement in design, and examine the extent to which co-design as commonly conceptualized is capable of addressing the range of normative issues raised by AI/ml for health care. We suggest that AI/ml technologies have amplified and modified existing challenges related to patient and public involvement, and created entirely new challenges. We outline three pitfalls associated with co-design for ethical AI/ml for health care and conclude with suggestions for addressing these practical and conceptual challenges. (shrink)

Over the last few decades, multiple studies have examined the understanding of participants in clinical research. They show variable and often poor understanding of key elements of disclosure, such as expected risks and the experimental nature of treatments. Did the participants in these studies give valid consent? According to the standard view of informed consent they did not. The standard view holds that the recipient of consent has a duty to disclose certain information to the profferer of consent because valid (...) consent requires that information to be understood. The contents of the understanding and disclosure requirements are therefore conceptually linked. In this paper, we argue that the standard view is mistaken. The disclosure and understanding requirements have distinct grounds tied to two different ways in which a token of consent can be rendered invalid. Analysis of these grounds allows us to derive the contents of the two requirements. It also implies that it is sometimes permissible to enroll willing participants who have not understood everything that they ought to be told about their clinical trials. (shrink)

Most work on reflexivity has focused on individuals exercising their reflexivity through discourse. However, agents have three major aspects (intentionality, causal efficacy and embodiment) and they are fundamentally social. This article examines the possibility of collective reflexivity conducted not just by saying, but also by doing—that is, through their embodiment. By expanding the concept of ‘performatives’ to encompass not just speech acts but also acts that speak (i.e. embodied activities as socially meaningful) and applying the work of Charles S. Peirce (...) in order to develop an ontology of embodied reflexivity, it becomes possible to determine several criteria defining embodied collective reflexivity. Assessing possibilities such as legislative debate, political demonstrations, religious ritual and dramatic performance reveals that a certain set of practices does in fact meet those criteria and discloses additional aspects of what constitutes embodied collective reflexivity. (shrink)

To attribute confusion to someone is to take up a paternalistic stance in evaluating his reasoning.

From oral culture, through the advent of literacy, to the introduction of printing, to the development of electronic media, communication structures have radically altered culture in profound ways. As the first book to take a critical realist approach to culture, Theatre, Communication, Critical Realism examines theatre and its history through the interaction of society’s structures, agents, and discourses. Tobin Nellhaus shows that communication structure—a culture’s use and development of speech, handwriting, printing, and electronics—explains much about why, when, and how (...) theatre has transformed. (shrink)

The Practice of Value explores the nature of value and its relation to the social and historical conditions under which human agents live. At the core of the book are the Tanner Lectures delivered at Berkeley in 2001 by Joseph Raz, who has been one of the leading figures in moral and legal philosophy since the 1970's. Raz argues that values depend importantly on social practices, but that we can make sense of this dependence without falling back on cultural (...) relativism. In response, three eminent philosophers, Christine Korsgaard, Robert Pippin, and Bernard Williams, offer their own distinctive reflections on the connections between value and practice. The book begins with an introduction by Jay Wallace, setting the scene for what follows, and ends with a response from Raz to his commentators. The result is a fascinating debate, accessible to readers throughout and beyond philosophy, about the relations between human values and human life. (shrink)

Introduction -- Instrumental rationality -- Social order -- Deontic constraint -- Intentional states -- Preference noncognitivism -- A naturalistic perspective -- Transcendental necessity -- Weakness of will -- Normative ethics.

Institutional review boards distinguish health care quality improvement and health care quality improvement research based primarily on the rigor of the methods used and the purported generalizability of the knowledge gained. Neither of these criteria holds up upon scrutiny. Rather, this apparently false dichotomy may foster under-protection of participants in QI projects and over-protection of participants within QIR.

We argue that there is a conflict among classical theism's commitments to divine simplicity, divine creative freedom, and omniscience. We start by defining key terms for the debate related to classical theism. Then we articulate a new argument, the Aloneness Argument, aiming to establish a conflict among these attributes. In broad outline, the argument proceeds as follows. Under classical theism, it's possible that God exists without anything apart from Him. Any knowledge God has in such a world would be wholly (...) intrinsic. But there are contingent truths in every world, including the world in which God exists alone. So, it's possible that God contingently has wholly intrinsic knowledge. But whatever is contingent and wholly intrinsic is an accident. So, God possibly has an accident. This is incompatible with classical theism. Finally, we consider and rebut several objections. (shrink)

This article discusses how advocacy can be taught to both law and public health students, as well as the role that public health law faculty can play in advocating for public health. Despite the central role that advocacy plans in translating public health research into law, policy advocacy skills are rarely explicitly taught in either law schools or schools of public health, leaving those engaged in public health practice unclear about whether and how to advocate for effective policies. The article (...) explains how courses in public health law and health justice provide ideal opportunities to teach advocacy skills, and it discusses the work of the George Consortium, which seeks to engage public health law faculty in advocacy efforts. (shrink)

This is a new edition of Joseph Fletcher's 1966 work that ignited a firestorm of controversy at the time of its publication.