While protection of autonomy is crucial to the practice of medicine, there is the persistent risk of a disconnect between the notion of self-determination and the need for a socially responsible medical system. An example of unbridled autonomy is the preferential use of costly medications without an appreciation of the impact of using these more expensive drugs on the resource pool of others. In the USA, costly medications of questionable incremental benefit are frequently prescribed with the complicity of both doctors (...) and patients. Limiting self-determination in medication choices via an appreciation of the principle of justice reaches a better moral balance, while at the same time acknowledging the goals of doing good and avoiding harm in patient care. (shrink)

Explanation is the name for both the process we use to answer questions raised by observed ambiguities and for the conclusion we offer others. This divergence hints at the many conflicting approaches used to create our contemporary understanding of explanation. Modes of Explanation is the first book in decades to attempt to bring these conflicting approaches together and to offer a compelling narrative to explore how those conflicts can converge. In May 2013, fifty philosophers of science, cognitive scientists, systems scientists, (...) cyberneticists, semioticians, and humanities scholars gathered for three full days of debate. These scholars - including the contributors to this volume - compared insights into a variety of conceptions of explanation and their associated worldviews. Through examples such as the creationism/evolution debate, this volume illustrates the major issues regarding explanation through the dual lenses of scientific realism and pragmatic constructivism. Modes of Explanation is about how we make sense of, and create results in, our world. (shrink)

The present debate on constitutional rights aims to protect the individual against the intrusive power of the state. Analysing the precarious relationship between art and money, the authors argue that constitutional rights need to be extended into the regimes of private governance. This requires four fundamental changes. (1) Constitutional rights can no longer be limited to the protection of individual actors. Instead, they need to be extended to guarantees of freedom of discourses. (2) The new experience of the twentieth century (...) is that totalizing tendencies have their origin not only in politics, but also in other fields of action, especially in technology, science, and the economy. Thus, a discursive concept of constitutional rights should be directed against any social system with totalizing tendencies. (3) Instead of concentrating on centres of economic and social power, constitutional rights in the private sphere should focus on the specific communicative medium of the expansionist social system involved. (4) This excludes the direct analogy of a ‘right’ as a quasispatial exclusion zone. More significant guarantees of discursive autonomy could be found in a ‘proceduralization’ of constitutional rights. (shrink)

The emphasis on duly in Kant's ethics is widely held to constitute a defect. Marcia W. Baron develops and assesses the criticism, which she sees as comprising two objections: that duty plays too large a role, leaving no room for the supererogatory, and that Kant places too much value on acting from duty. Clearly written and cogently argued, Kantian Ethics Almost without Apology takes on the most philosophically intriguing objections to Kant's ethics and subjects them to a rigorous yet (...) sympathetic assessment. (shrink)

When successful and ethical managers are alerted to possible organizational wrongdoing, they take corrective action before the problems become crises. However, recent research [e.g., Rynes et al. (2007, Academy of Management Journal50(5), 987–1008)] indicates that many organizations fail to implement evidence-based practices (i.e., practices that are consistent with research findings), in many aspects of human resource management. In this paper, we draw from years of research on whistle-blowing by social scientists and legal scholars and offer concrete suggestions to managers who (...) are interested in encouraging internal reporting of problems requiring attention, and to observers of questionable activity who are considering reporting it. We also identify ways that research suggests policy-makers can have a more positive influence. We hope that these suggestions will help foster evidence-based practice regarding whistle-blowing. (shrink)

Pretende-se discutir a produção da história especializada, da história midiatizada e da história ensinada na interlocução com a matriz disciplinar de Jörn Rüsen. Defende-se que deve haver a fundamentação científica também na construção do conhecimento histórico escolar, para que o senso comum se torne senso crítico. Contrapõe-se aos revisionismos que negam, silenciam, deturpam a história considerada “sobrecarregada” em relação aos indígenas, ao escravismo e à Ditadura Civil-Militar brasileira. Toma como exemplo de história midiática/pública os Guias Politicamente Incorretos, principalmente da História (...) do Brasil, escrito por Leandro Narloch. Conclui que apenas a história construída com base científica pode refletir sobre o presente vivido para interpretar o passado com vistas ao futuro transformado no sentido de afirmar uma sociedade democrática. (shrink)

American doctors in the 1990s are being asked to serve as "double agents," weighing competing allegiances to patients' medical needs against the monetary costs to society. This situation is a reaction to rapid cost increases for medical services, themselves the result of the haphazard development since the 1920s of an inherently inflationary, open-ended system for funding and delivering health care. The answer to an inefficient system, however, is not to stint on care, but rather to restructure the system to remove (...) the inflationary pressures. As long as we are spending enormous resources on an inherently inefficient and inflationary system we cannot justify asking doctors to withhold beneficial care to save money for third-party payers. Doing so serves a largely political agenda and endangers the patient-centered ethic that is central to medicine. (shrink)

This book is a philosophical reflection on the experience of time from within exile. Its focus on temporality is unique, as most literature on exile focuses on the experience of space, as exile involves dislocation, and moods of nostalgia and utopia. Marcia Sá Cavalcante Schuback proposes that in exile, time is experienced neither as longing back to the lost past nor as wanting a future to come but rather as a present without anchors or supports. She articulates this present (...) as a "gerundive" mode, in which the one who is in exile discovers herself simply being, exposed to the uncanny experience of having lost the past and not having a future. To explore this, she establishes a conversation among three authors whose work has exemplified this sense of gerundive time: the German philosopher Martin Heidegger, the French writer and essayist Maurice Blanchot, and the Brazilian writer Clarice Lispector. The book does not aim to discuss how these authors understand the relation between time and exile, but presents a conversation with them in relation to this question that reflects new aspects in their work. Attempting to think and express this difficult sense of time from within exile, Time in Exile engages with the relation between thought and language, and between philosophy and literature. Departing from concrete existential questions, Sá Cavalcante Schuback reveals new philosophical and theoretical modes to understand what it means to be present in times of exile. (shrink)

This book is a philosophical reflection on the experience of time from within exile. Its focus on temporality is unique, as most literature on exile focuses on the experience of space, as exile involves dislocation, and moods of nostalgia and utopia. Marcia Sá Cavalcante Schuback proposes that in exile, time is experienced neither as longing back to the lost past nor as wanting a future to come but rather as a present without anchors or supports. She articulates this present (...) as a "gerundive" mode, in which the one who is in exile discovers herself simply being, exposed to the uncanny experience of having lost the past and not having a future. To investigate this, the book establishes a conversation among three authors whose work has exemplified this sense of gerundive time: the German philosopher Martin Heidegger, the French writer and essayist Maurice Blanchot, and the Brazilian writer Clarice Lispector. The book does not aim to discuss how these authors understand the relation between time and exile but enters in conversation with them in relation to this question. Attempting to think and express this difficult sense of time from within exile, the book engages with the relation between thought and language, and between philosophy and literature. Departing from concrete existential questions, it opens new philosophical and theoretical modes through which to understand what it means to be present in times of exile. (shrink)

While Plantinga has famously argued that acceptance of neo-Darwinian theory commits one to the rejection of naturalism, Plantinga’s argument is vulnerable to an objection developed by Evan Fales. Not only does Fales’ objection undermine Plantinga’s original argument, it establishes a general challenge which any attempt to revitalize Plantinga’s argument must overcome. After briefly laying out the contours of this challenge, we attempt to meet it by arguing that because a purely naturalistic account of our etiology cannot explain the correlation between (...) our preference for simplicity and simplicity’s ability to serve as a veridical method of theory selection, the scientific realist is committed to the rejection of naturalism. (shrink)

Gideon Rosen (2014) has drawn our attention to cases of duress of a particularly interesting sort: the person's ‘mind is not flooded with pain or fear’, she knows exactly what she is doing, and she makes a clear-headed choice to act in, as Rosen says, ‘awful ways’. The explanation of why we excuse such actions cannot be that the action was not voluntary. In addition, although some duress cases could also be viewed as necessity cases and thus as justified, Rosen (...) wisely sets aside that complicating factor by zeroing in on those cases where the action clearly is not justified. So why do we excuse in these cases, where the action is not justified and the agent acted voluntarily?Rosen thinks the key lies in the ‘ill will’ condition, ‘the idea that an act is blameworthy only if it manifests insufficient concern or regard for those affected’. He says this is relatively uncontroversial; much of my paper is taken up with calling the ‘ill will’ condition into question. I also take issue with Rosen on just how justifications and excuses differ. I argue in favour of understanding justifications (in a context where we are asking how justifications and excuses differ) as not requiring truth, but only reasonable belief. (shrink)

During the past decade ethical theory has been in a lively state of development, and three basic approaches to ethics - Kantian ethics, consequentialism, and virtue ethics - have assumed positions of particular prominence.

This paper focuses on a hypothetical case that represents an intervention request familiar to those who work with individuals with intellectual disability. Stacy has autism and moderate intellectual disability. Her parents have requested treatment for her hand flapping. Stacy is not competent to make her own treatment decisions; proxy consent is required. There are three primary justifications for proxy consent: the right to an open future, substituted judgment, and the best interest standard. The right to an open future justifies proxy (...) consent on the assumption of future autonomy whereas substituted judgment justifies proxy consent via reference to past autonomy. Neither applies. Stacy has not been, nor will she be, competent to make her own treatment decisions. The best interest standard justifies proxy consent on the grounds of beneficence. It is unlikely that hand flapping harms Stacy. None of the three primary means of justifying proxy consent apply to Stacy’s case. (shrink)

Recent studies show that returning global health trainees often report having felt inadequately prepared to deal with ethical dilemmas they encountered during outreach clinical work. While global health training guidelines emphasize the importance of developing ethical and cultural competencies before embarking on fieldwork, their practical implementation is often lacking and consists mainly of recommendations regarding professional behavior and discussions of case studies. Evidence suggests that one of the most effective ways to teach certain skills in global health, including ethical and (...) cultural competencies, is through service learning. This approach combines community service with experiential learning. Unfortunately, this approach to global health ethics training is often unattainable due to a lack of supervision and resources available at host locations. This often means that trainees enter global health initiatives unprepared to deal with ethical dilemmas, which has the potential for adverse consequences for patients and host institutions, thus contributing to growing concerns about exploitation and “medical tourism.” From an educational perspective, exposure alone to such ethical dilemmas does not contribute to learning, due to lack of proper guidance. We propose that the tension between the benefits of service learning on the one hand and the respect for patients’ rights and well-being on the other could be resolved by the application of a simulation-based approach to global health ethics education. (shrink)

Anniversaries and funding crises prompt periodic calls to reevaluate the mission and public perceptions of the U.S. Land-Grant University system. One such call was issued by the Kellogg Commission on the Future of State Colleges and Land Grant Universities in their 1999 report, “Returning to Our Roots: the Engaged Institution.” Written by leaders of state universities and land-grant colleges, this report urges these institutions to engage more authentically and equitably in two-way relationships with their local constituents. Twenty years later, Land-Grant (...) Universities continue to struggle with building widespread public support for their missions and equitable involvement in research, teaching, and extension functions across diverse constituencies. While largely discounted by the Kellogg Commission, a fresh look at the role originally envisioned for the extension arm of the trifold land-grant mandate suggests that we may be conceiving of this system too narrowly. The establishment of statewide extension systems was once seen as a way to ensure that Land-Grant Universities would be accessible and responsive to all of a state’s residents. Extension systems continue to offer a front-door to a major public university in almost every county of the United States, but they tend to be viewed primarily as a way to translate science or distribute information from the university to the public. This discussion uses a historical and modern lens to reimagine the role that Extension could potentially play in catalyzing reciprocal, co-learning relationships between Land-Grant Universities and their diverse local constituencies. (shrink)

In this article, we describe the social and economic changes that have contributed to contemporary problems of work—family conflict, gender inequality, and risks to children's healthy development. We draw on feminist welfare state scholarship to outline an institutional arrangement that would support an earner—carer society—a social arrangement in which women and men engage symmetrically in paid work and unpaid caregiving and where young children have ample time with their parents. We present a blueprint for work—family reconciliation policies in three areas—paid (...) family-leave provisions, working-time regulations, and early childhood education and care—and we identify key policy design principles. We describe and assess these work—family reconciliation policies as they operate in six European countries widely considered to be policy exemplars: Denmark, Finland, Norway, Sweden, Belgium, and France. We close with an analysis of potential objections to these policies. (shrink)

Roche, Marcia Sectarianism has been defined as 'adherence or excessive devotion to a particular religious denomination or sect'.1 However, as Kildea notes, dictionary definitions of the term fail to square with its 'distinctive' meaning in the Australian context.2A more accurate representation of the Australian connotation is conveyed by Hogan, who says that it refers to 'the hostility between different churches or "sects" which has manifested itself in the wider arena of social and political conflict'.3 The social, political and economic (...) discrimination and exclusion that has existed in Australia between Catholics and Protestants was most intense from the beginning of European settlement until the 1960s, when the Catholic Church's endorsement of ecumenism offered a means of positive engagement with members of other Christian denominations. (shrink)

Cavell elaborates the view, traceable from Wittgenstein to Davidson, that there is no thought, and thus no meaning, without language, and shows how this concurs ...

Purpose: To determine the relative value that patients place on consent for procedures in the emergency department (ED) and to define a set of procedures that fall in the realm of implied consent. Methods: A questionnaire was administered to a convenience sample 134 of 174 patients who were seen in the ED of a Midwestern teaching hospital. The questionnaire asked how much time they believed was necessary to give consent for various procedures. Procedures ranged from simple (venipuncture) to complex (procedural (...) sedation). Results: Participants valued a simple blood draw at a low mean of 1.02 minutes of extra time and a lumbar puncture at a high mean of 7.78 minutes. Of all participants 52% and 48% noted a time-value of ?0? time on blood draw and intravenous line starts, respectively, indicating that they desire no additional consent for these procedures. Conclusion: Defining a set of ED procedures covered under implied consent will be difficult because many patients value formal consent for even the simplest procedure. (shrink)

This paper outlines the development and implementation of a new course in Engineering Ethics at the University of Tennessee. This is a three-semester-hour course and is jointly taught by an engineering professor and a philosophy professor. While traditional pedagogical techniques such as case studies, position papers, and classroom discussions are used, additional activities such as developing a code of ethics and student-developed scenarios are employed to encourage critical thinking. Among the topics addressed in the course are engineering as a profession (...) and its role in society; ethical successes and failures; risk, safety, and the environment; professional responsibilities; credit and intellectual property; and international concerns. (shrink)

Uma investigação sobre o risível, a manipulação da imagem e o esteticamente correto. DA autora de Como conversar com o fascista. As cenas ridículas – e os personagens já muito conhecidos – traduzem o sentido da política em nossos dias, mas não apenas como uma bagunça feita por pessoas despreparadas para os cargos que ocupam. A Deturpação serve a uma nova política, em um sentido altamente problemático: o poder é transformado em violência, e a seriedade de certos assuntos dá lugar (...) ao cinismo. ABusadores do poder seguem sempre mais poderosos como engraçadinhos ou bufões inofensivos, muitas vezes até confiáveis, enquanto a população paga preço altíssimo por uma despolitização apresentada como o melhor dos mundos. SOltos em escala social, o fascismo, o machismo e o racismo dão o ritmo e o tom da política em nossos dias sem que pareça que algo possa ser feito. Ao introduzir a noção de “ridículo político” no debate sobre estética e política, os ensaios deste livro são uma contribuição original – e fundamental – de Marcia Tiburi para que pensemos sobre quão grave é o hábito de não tratar com seriedade as coisas políticas. (shrink)

This paper examines two realisations of the television talk show in North America: The Oprah Winfrey Show and Dr. Phil, looking specifically at how they function within the sub-genre of ‘therapeutic talk show’ in keeping with Livingstone and Lunt’s (1994) classification of talk shows. Talk shows are defined by Ilie (2001) as “semi-institutional discourse” having features of a given setting (TV studio), topic- and goal-oriented talk, high degree of topic control, as well as restrictions on time and turn-taking. Theorists examining (...) this sub-genre of therapeutic talk show have argued that it provides a valuable means by which stories otherwise unrecognized have a forum, or that values of truth and honesty can be conveyed (Livingstone & Lunt 1994; Masciarotte 1991; Carbaugh 1988). However, theorists such as Abt and Seesholtz (1994) view therapeutic talk shows as potentially demeaning to guests who appear on them as well as a means by which suffering can be trivialized. Through an examination and analysis of requests for information, both direct and indirect, which are the principal features of all interviews, I look at how Oprah Winfrey and Dr. Phil problematize the narratives told by their guests. Both hosts rely heavily on one type of request, B-Event assertions functioning as indirect requests for information, to provoke specific response. My findings indicate that these talk shows do not in fact provide a forum for talk that would otherwise not be considered as suggested by Livingstone and Lunt (1994). Both Oprah Winfrey and Dr. Phil appropriate the stories provided by their guests; they also participate in their own overarching meta-narrative whereby as ‘heroes’ they solve their guests’ problems within a given time frame. Guests’ narrative responses share more with the speech act of confession than with free self-expression. The speech act of confession encouraged by these therapeutic talk shows serves in turn to reinforce conservatively-held values on the part of the at-home audience for whom such confession is also entertainment. (shrink)

Este artigo pretende analisar a impossibilidade do conhecimento do infinito e, conseqüentemente, a impossibilidade do conhecimento de Deus na filosofia hobbesiana. Ao contrário de Descartes, que prova a existência de Deus pelos efeitos, na assim chamada prova ontológica, Hobbes não admite qualquer prova da existência de Deus, além de recusar-se a atribuir-lhe qualquer funcão política ou epistemológica. Deste modo, Deus será objeto de crença e não de ciência na filosofia hobbesiana.

1. Stoicism in classical Latin literature -- 2. Stoicism in Christian Latin thought through the sixth century.