Today's medicine is spiritually deflated and morally adrift; this book explains why and offers an ethical framework to renew and guide practitioners in fulfilling their profession to heal. What is medicine and what is it for? What does it mean to be a good doctor? Answers to these questions are essential both to the practice of medicine and to understanding the moral norms that shape that practice. The Way of Medicine articulates and defends an account of medicine and medical ethics (...) meant to challenge the reigning provider of services model, in which clinicians eschew any claim to know what is good for a patient and instead offer an array of "health care services" for the sake of the patient's subjective well-being. Against this trend, Farr Curlin and Christopher Tollefsen call for practitioners to recover what they call the Way of Medicine, which offers physicians both a path out of the provider of services model and also the moral resources necessary to resist the various political, institutional, and cultural forces that constantly push practitioners and patients into thinking of their relationship in terms of economic exchange. Curlin and Tollefsen offer an accessible account of the ancient ethical tradition from which contemporary medicine and bioethics has departed. Their investigation, drawing on the scholarship of Leon Kass, Alasdair MacIntyre, and John Finnis, leads them to explore the nature of medicine as a practice, health as the end of medicine, the doctor-patient relationship, the rule of double effect in medical practice, and a number of clinical ethical issues from the beginning of life to its end. In the final chapter, the authors take up debates about conscience in medicine, arguing that rather than pretending to not know what is good for patients, physicians should contend conscientiously for the patient's health and, in so doing, contend conscientiously for good medicine. The Way of Medicine is an intellectually serious yet accessible exploration of medical practice written for medical students, health care professionals, and students and scholars of bioethics and medical ethics. (shrink)

While science is taken to differ from non-scientific activities in virtue of its methodology, metaphysics is usually defined in terms of its subject matter. However, many traditional questions of metaphysics are addressed in a variety of ways by science, making it difficult to demarcate metaphysics from science solely in terms of their subject matter. Are the methodologies of science and metaphysics sufficiently distinct to act as criteria of demarcation between the two? In this chapter we focus on several important overlaps (...) in the methodologies used within science and metaphysics in order to argue that focusing solely on methodology is insufficient to offer a sharp demarcation between metaphysics and science, and consider the consequences of this for the wider relationship between science and metaphysics. (shrink)

Recently a number of writers have argued that a new form of relativism involves a form of semantic context-dependence which helps it escape the perhaps most common objection to ordinary contextualism; that it cannot accommodate our intuitions about disagreement. I argue: (i) In order to evaluate this claim we have to pay closer attention to the nature of our intuitions about disagreement. (ii) We have different such intuitions concerning different questions: we have more stable disagreement intuitions about moral disputes than (...) about, say, disputes about matters of taste. (iii) The new form of relativism does not vindicate the stable intuitions about disagreement. (iv) It does a better job explaining the unstable intuitions than contextualism. But, pace some relativists, it is not clear that assertion-truth rather than just proposition-truth has to be relativized to accomplish this. (shrink)

According to moral non-naturalism, the kind of genuine or robust normativity that is characteristic of moral requirements cannot be accounted for within a wholly naturalistic worldview, but requires us to posit a domain of non-natural properties and facts. The main argument for this core non-naturalist claim appeals to what David Enoch calls the 'just-too-different intuition'. According to Enoch, robust normativity cannot be natural, since it is just too different from anything natural. Derek Parfit makes essentially the same claim under the (...) heading of 'the normativity objection', and several other non-naturalists have said similar things. While some naturalists may be tempted to reject this argument as methodologically or dialectically illegitimate, we argue instead that there are important limits to what the just-too-different intuition can show, even setting all other worries aside. More specifically, we argue that the just-too-different argument will backfire on any positive, independent specification of the distinction between the natural and the non-natural. The upshot is that the just-too-different argument can show significantly less than non-naturalists have suggested. (shrink)

It is common wisdom that today’s medicine focuses too much on treating those who are sick and too little on preventing the sickness in the first place. This essay proposes that Jesus’ teaching in the Sermon on the Mount challenges that assumption and the preventive medicine to which it has given rise. In light of Jesus’ teaching, the essay identifies four apparent problems with much of preventive medicine. It then offers four heuristics that might form a basic Christian logic for (...) medicalizing risk—for discerning when and why it would be fitting, wise, and faithful for Christians to make use of medicine to avoid future illness and death. (shrink)

Motivational externalists and internalists of various sorts disagree about the circumstances under which it is conceptually possible to have moral opinions but lack moral motivation. Typically, the evidence referred to are intuitions about whether people in certain scenarios who lack moral motivation count as having moral opinions. People’s intuitions about such scenarios diverge, however. I argue that the nature of this diversity is such that, for each of the internalist and externalist theses, there is a strong prima facie reason to (...) reject it. That much might not be very controversial. But I argue further, that it also gives us a strong prima facie reason to reject all of these theses. This is possible since there is an overlooked alternative option to accepting any of them: moral motivation pluralism , the view that different internalist and externalist theses correctly accounts for different people’s concepts of moral opinions, respectively. I end the paper with a discussion of methodological issues relevant to the argument for moral motivation pluralism and of the consequences of this view for theories about the nature of moral opinions, such as cognitivism and non-cognitivism. (shrink)

Uncivil behavior by leaders may be viewed as an effective way to motivate employees. However, supervisor incivility, as a form of unethical supervision, may be undercutting employees’ ability to do their jobs. We investigate linkages between workplace incivility and perceived work ability, a variable that captures employees’ appraisals of their ability to continue working in their jobs. We draw upon the appraisal theory of stress and social identity theory to examine incivility from supervisors as an antecedent to PWA, and to (...) investigate job involvement and grit as joint moderators of this association. Results from data collected in two samples of working adults provided evidence for three-way interactions in relation to PWA. Among employees with high levels of grit, there was no significant relation between supervisor incivility and PWA, regardless of employee job involvement. However, we found some evidence that for those low in grit, having high job involvement was associated with a stronger relationship between supervisor incivility and PWA. Findings attest to the importance of unethical supervisor behavior, showing the potential for supervisor incivility to erode PWA, as well as the importance of grit as a potential buffer. (shrink)

In the two feature articles for this volume, Gruber et al and Buonomano & Rovelli focus on what the former call the 'two-times problem', in short, the apparent lack of fit between time as described by physical science and our own temporal experience, where 'experience' involves things like memory, anticipation, and perception of change and motion. In this short note I'll make the case that the twotimes problem is less serious than it is often made out to be in the (...) specific case of features like 'passage ' and 'presentness' that are central to the 'A-theory' of time ---the theory that holds time to be composed of dynamic regions of 'past', 'present' and future', and for time to genuinely flow or pass.My contention is three-fold: (1) the two-times problem is better understood as a three-times problem: rather than a conflict between 'physical' and 'manifest' time, what we have in the case of time is differences between the time of physics, the time of experience, and the 'folk' concept of time. (2) Understanding the problem in this way helps deflate certain problems about the relationship of these three pictures; the time of experience and the time of physics are less obviously in a problematic conflict than often supposed; and the folk concept of time is what brings in problematic features of time hard to fit with either the time of physics of experience. (3) Understanding the time of experience as independent from the folk concept of time better fits the actual aims of the... (shrink)

It is often said that the world is explained by laws of nature together with initial conditions. But does that mean initial conditions don’t require further explanation? And does the explanatory role played by initial conditions entail or require that time has a preferred direction? This chapter looks at the use of the ‘initialness defence’ in physics, the idea that initial conditions are intrinsically special in that they don’t require further explanation, unlike the state of the world at other times. (...) Such defences commonly assume a primitive directionality of time to distinguish between initial and final conditions. Using the case study of the time-asymmetry of thermodynamics and the so-called ‘past hypothesis’ — the hypothesis that the early universe was in a state of very low entropy —, I outline and support a deflationary account of the initialness defence that does not pre- suppose a basic directionality of time, and argue that there is a relevant explanatory asymmetry between initial conditions and the state of systems at other times only if certain causal conditions are satisfied. Hence, the initialness defence is available to those who reject a fundamental direction of time. (shrink)

Abordaré la crítica de Axel Honneth a la primera Escuela de Frankfurt y su aparente omisión de Herbert Marcuse. Defenderé a Marcuse contra algunas de las críticas hechas por Honneth a la teoría crítica temprana de la Escuela de Frankfurt. Luego argumentaré que Marcuse siempre estuvo en busca de una subjetividad radical, incluso cuando advirtió contra los mecanismos unidimensionales en curso de producción de sujetos. Finalmente, mostraré que Honneth también construye su proyecto en torno a la búsqueda de una subjetividad (...) radical, pero aborda el problema a través de una teoría de la intersubjetividad que complementa el proyecto de Marcuse. (shrink)

The medical profession’s increasing acceptance of “physician aid-in-dying” indicates the ascendancy of what we call the provider-of-services model for medicine, in which medical “providers” offer services to help patients maximize their “well-being” according to the wishes of the patient. This model contrasts with and contradicts what we call the Way of Medicine, in which medicine is a moral practice oriented to the patient’s health. A steadfast refusal intentionally to harm or kill is a touchstone of the Way of Medicine, one (...) unambiguously affirmed by Christians through the centuries. Moreover, physician aid-in-dying contradicts one of the distinctive contributions that the Christian era brought to medicine, namely, a taken-for-granted solidarity between medical practitioners and those suffering illness and disability. Insofar as medical practitioners cooperate in aid-in-dying, they contradict this solidarity and undermine the trust that patients need to allow themselves to be cared for by physicians when they are sick and debilitated. (shrink)

Moral error-theorists and relativists agree that there are no absolute moral facts, but disagree whether that makes all moral judgments false. Who is right? This paper examines a type of objection used by moral error-theorists against relativists, and vice versa: objections from implausible ascriptions of mistakes. Relativists (and others) object to error-theory that it implausibly implies that people, in having moral beliefs, are systematically mistaken about what exists. Error-theorists (and others) object to relativism that it implausibly implies that people are (...) systematically mistaken about the content of their own moral beliefs. The paper argues that such arguments cannot settle between the two theories since, contrary to first appearance, both theories face the very same challenges of explaining mistaken beliefs. (shrink)

The most basic argument for moral relativism is that different people are (fundamentally) disposed to apply moral terms, such as ‘morally right’ and ‘morally wrong’, and the corresponding concepts, to different (types of) acts. In this paper, I argue that the standard forms of moral relativism fail to account for certain instances of fundamental variation, namely, variation in metaethical intuitions, and I develop a form of relativism—pluralism—that does account for them. I identify two challenges that pluralism faces. To answer the (...) challenges, I first argue that, due to fundamental conceptual variations in ordinary descriptive (nonmoral) discourse, a form of pluralism holds there as well and that this pluralism can answer the corresponding challenges. I then argue that the answers transfer to moral discourse, since the phenomenon of moral variation is structurally identical to that of descriptive variation. (shrink)

According to doxastic normativism, part of what makes an attitude a belief rather than another type of attitude is that it is governed by a truth-norm. It has been objected that this view fails since there are true propositions such that if you believed them they would not be true, and thus the obligation to believe true propositions cannot hold for these. I argue that the solution for doxastic normativists is to find a norm that draws the right distinction between (...) those true propositions we are obliged to believe (“ordinary non-tricky propositions”) and those we are not (“tricky propositions”). I develop a norm which I argue does exactly this, and further argue that it can be used to salvage the idea that belief is constitutively normative. (shrink)

This dissertation investigates the plausibility of metaethical relativism, or more specifically, what I call “moral truth-value relativism”: the idea that the truth of a moral statement or belief depends on who utters or has it, or who assesses it. According to the most prevalent variants of this view in philosophical literature – “standard relativism” – the truth-values are relative to people’s moralities, often understood as some subset of their affective or desirelike attitudes. Standard relativism has two main contenders: absolutism – (...) the view that the truth-values of moral statements and beliefs do not vary in that way – and non-cognitivism – the view that moral judgements do not have truth-values, since they express affective or desire-like attitudes rather than beliefs. Almost the entire dissertation concerns the plausibility of standard relativism in contrast to absolutism. Part 1 examines first the two main arguments for standard relativism: that it accounts for the connection between moral judgements and motivation (chapter 2), and for the prevalence of diversity of moral opinion (chapter 3). Then the most common objection is considered: that it is inconsistent with the existence of genuine moral disagreements (chapter 4). I argue that these arguments are inconclusive. Both relativism and absolutism can account for the features discussed. Part 2 focuses on the fact that different people have different strongly held intuitions about the relative or absolute nature of morality. I argue that given a common methodological approach in philosophy and metaethics, which takes such intuitions as evidence of correct analyses, this difference in intuitions suggests that neither a relativist nor absolutist analysis can be correct for everyone’s moral judgements. I argue that this result holds both given semantic internalism (chapter 6) and given semantic externalism (chapter 7). To get one single analysis of everyone’s moral judgements we would have to abandon the intuitionbased methodology. In chapter 8, however, I argue that we can maintain this methodology if we accept analysis pluralism, the view that different analyses hold for different people’s moral judgements. (shrink)

ABSTRACTIt has been objected to moral non-cognitivism that it cannot account for fundamental moral uncertainty. A person is derivatively uncertain about whether an act is, say, morally wrong, when her certainty is at bottom due to uncertainty about whether the act has certain non-moral, descriptive, properties, which she takes to be wrong-making. She is fundamentally morally uncertain when her uncertainty directly concerns whether the properties of the act are wrong-making. In this paper we advance a new reply to the objection (...) to non-cognitivism, immune to the problems afflicting earlier replies. First, we argue that fundamental moral uncertainty is best understood as classificatory uncertainty, since the psychological factors behind fundamental moral uncertainty are analogous to the factors behind fundamental uncertainty regarding descriptive, non-moral, matters, and fundamental descriptive uncertainty is naturally understood as classificatory uncertainty. We call this the classification account... (shrink)

If man has no nature - if our intellect and understanding are products of our own activities - do we possess a key to self-modification? Are we free to re-make mankind? Sartre champions the romantic idea that we can - by sheer determination - begin afresh. Oakeshott is struck by the vandalism of such a project - he seeks to defend political culture from degradation by meddling academics. The Radical and Conservative understanding of social order and the human self are (...) compared in this in-depth analysis of two contrasting philosophies. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

A survey of a wide range of social?scientific disciplines reveals a definite convergence of theoretical interest in human cognition and communication as situated, concerned, and embedded in social commitment. Recent contributions within situation semantics and cognitive science explicitly reject some of the constraints inherent in their shared philosophical heritage and prepare novel ground for dialogues between fields as far apart as formal semantics and ?dialogical? text theory. Issues such as purely cognitive versus motivational aspects of human situatedness, and the relationship (...) between models of individual information processing, on the one hand, and hermeneutic?dialectic assumptions about social and collective features of meaning and mind, on the other, are thus made topics of cross?disciplinary discussions. These are some of the many problems in need of further clarification if we want to explore the possibility of bridging and/or transcending the gulf between analytic?rationalist and hermeneutic?dialectic contributions to our insight into human cognition and communication. (shrink)

Some alethic pluralists maintain that there are two kinds of truths operant in our alethic discourse: a realist kind and an anti-realist kind. In this paper, we argue that such a binary conception cannot accommodate certain social truths, specifically truths about race. Most alethic pluralists surprisingly overlook the status of racial truths. Douglas Edwards is, however, an exception. In his version of alethic pluralism—Determination Pluralism—racial truths are superassertible (anti-realist) true rather than correspondence (realist) true. We argue that racial truths exhibit (...) features of both superassertibility (anti-realism) and correspondence (realism). This suggests a fuzzy boundary between realist and anti-realist kinds of truth. There may be a continuum rather than a dichotomy of truths. We conclude by sketching one way for alethic pluralists to accommodate such a notion. (shrink)

This article concerns the nature of reason in the work of the Twentieth Century Catholic theologian Erich Przywara and Georg Wilhelm Friedrich Hegel. The discussion centers on three interlocking issues: the question whether proper thinking submits to or transgresses the principle of non-contradiction; the relationship between reason and history; the theological concern with distinguishing the “history of reason” and the divine life. It is argued that both Hegel and Przywara give an account of reason where there are moments of contradiction, (...) and that this is a necessary feature of historical existence. Further, while Przywara and others are concerned with Hegel’s making reason’s reconciliation of contradiction in history identical with the divine life, I argue that although this is a real concern, Hegel’s account is more equivocal than normally admitted. Finally, I argue that the distinguishing feature between Przywara and Hegel is what happens after the moment of contradiction; that is where we see the most important difference between an analogical and a dialectical account of reason. (shrink)

Cognitive science has recently made some startling discoveries about temporal experience, and these discoveries have been drafted into philosophical service. We survey recent appeals to cognitive science in the philosophical debate over whether time objectively passes. Since this research is currently in its infancy, we identify some directions for future research.

Whenever A judges that x-ing is morally wrong and B judges that x-ing is not morally wrong, we think that they disagree. The two standard types of accounts of such moral disagreements both presuppose that the class of moral wrong-judgments is uniform, though in different ways. According to the belief account, the disagreement is doxastic: A and B have beliefs with conflicting cognitive contents. This presupposes “belief-uniformity”: that the content of moral concepts is invariant in such a way that, whenever (...) A believes that x-ing is morally wrong and B believes that x-ing is not morally wrong, their beliefs have mutually inconsistent contents. According to the attitude account, moral disagreements are non-doxastic: A and B have clashing practical attitudes. This presupposes “attitude-uniformity”: that moral judgments are always accompanied by, or consist of, desire-like attitudes. Consequently, neither account is available if both uniformity-claims are rejected – as e.g., various forms of content-relativism do. This paper presents a new non-doxastic account of deontic moral disagreement, consistent with the rejection of both uniformity-claims. I argue first, that even if deontic moral judgments are not desires, and are not always accompanied by desires, they have practical direction in the same sense as desires: they are attitudes that one can act in accordance or discordance with. Second: deontic moral disagreement can be understood as clashes in practical direction: roughly, A and B morally disagree if, and only if, some way of acting is in accordance with A’s judgment but in discordance with B’s. (shrink)

On a simple and neat view, sometimes called the Relational Analysis of Attitude Ascriptions, a belief ascription on the form ‘S believes that x is F’ is correct if, and only if, S stands in the belief-relation to the proposition designated by ‘that x is F’, i.e., the proposition that x is F. It follows from this view that, for a person to believe, say, that x is a boat, there is one unique proposition that she has to believe. This (...) paper argues against this view. It fails, I contend, to make sense of peripheral concept variation. As we attribute and individuate concepts, two people’s concepts C1 and C2 count as e.g., concepts of boats even if their concepts have different extensions in peripheral, or borderline, cases of boats. Thus, A and B can believe that x is a boat through believing peripherally different propositions. It follows that there is no unique proposition that a person has to believe in order to believe e.g., that x is a boat. (shrink)

It is sometimes observed that the debate between internalists and externalists about moral motivation seems to have reached a deadlock. There are those who do, and those who don’t, recognize the intuitive possibility of amoralists: i.e. people having moral opinions without being motivated to act accordingly. This makes Sigrun Svavarsdóttir’s methodological objection to internalism especially interesting, since it promises to break the deadlock through building a case against internalism (construed as a conceptual thesis), not on such intuitions, but on a (...) methodological principle for empirical investigations. According to the objection, internalists incur the burden of argument, since they have to exclude certain explanations of the (verbal and non-verbal) behavior of apparent amoralists, while externalists don’t. In this paper I argue that the objection fails: the principle for empirical investigations is plausible, but Svavarsdóttir’s application of it to internalism is not. Once we clearly distinguish between the conceptual and the empirical aspects of the internalist and externalist explanations of apparent amoralists, we see that these views incur an equal burden of explanation. I end the paper with a positive suggestion to the effect that there is a third alternative, a view that involves accepting neither internalism nor externalism, which does not incur an explanatory burden of the relevant sort. (shrink)