Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making.Chong Ming Lim,Michael C.Dunn &Jacqueline J. Chin -2016 -Journal of Medical Ethics 42 (8):542-549.detailsOne recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. (...) In this paper, we discuss the bioethicists’ response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists —elaborative and enumerative—and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. (shrink)
Substitute Decision-Making for Adults with Intellectual Disabilities Living in Residential Care: Learning Through Experience.Michael C.Dunn,Isabel C. H. Clare &Anthony J. Holland -2008 -Health Care Analysis 16 (1):52-64.detailsIn the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this (...) process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, ‘strategic substitute decision-making’, paralleled the MCA’s legal and ethical framework, whilst the second process, ‘relational substitute decision-making’, was markedly different from these statutory procedures. In this setting, ‘relational substitute decision-making’ underpinned everyday personal and social interventions connected with residents’ daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed. (shrink)
Bioethics Casebook 2.0: Using Web‐Based Design and Tools to Promote Ethical Reflection and Practice in Health Care.Jacob Moses,Nancy Berlinger,Michael C.Dunn,Michael K. Gusmano &Jacqueline J. Chin -2015 -Hastings Center Report 45 (6):19-25.detailsThe idea of the Internet as Gutenberg 2.0—a true revolution in disseminating information—is now a routine part of how bioethics education works. The Internet has become indispensable as a channel for sharing teaching materials and connecting learners with a central platform that houses materials to support an online or hybrid curriculum or a traditional course. A newer idea in bioethics education reflects developments in web-based medical education more broadly and draws on design principles developed for the Internet. This approach to (...) online bioethics education requires thinking about web-based learning as an engaging, potentially immersive experience, about learners' expectations concerning web-based learning, and about differences between self-directed learning and teaching to support group learning. In clinician education in bioethics, the interrelated goals of ethical reflection and practice for professionals and of continuous quality improvement in health care are supported by a focus on real-world challenges and by encouraging the habits of self-directed learning. In this paper, we describe how an international, interdisciplinary team used a web-based framework to develop a health care ethics casebook whose content, design, and pedagogy were tailored to the needs and expectations of health care professionals and other audiences in Singapore; we also explain how they used this framework to make the casebook accessible nationwide and to support cross-cultural learning. (shrink)
Motor Imagery and Merleau-Pontyian Accounts of Skilled Action.J. C. Berendzen -2014 -Ergo: An Open Access Journal of Philosophy 1:169-198.detailsMaurice Merleau-Ponty is often interpreted as claiming that opportunities for action are directly present in perceptual experience. However, he does not provide much evidence for how or why this would occur, and one can doubt that this is an appropriate interpretation of his phenomenological descriptions. In particular, it could be argued the Merleau-Pontyian descriptions mistakenly attribute pre-perceptual or post-perceptual elements such as allocation of attention or judgment to the perceptual experience itself. This paper argues for the Merleau-Pontyian idea that opportunities (...) for action are present in perceptual experience. It further argues that the phenomenological descriptions can be supported and explained via reference to contemporary research on motor imagery. In particular, it will be argued that non-conscious, covert motor imagery is used to prepare for and regulate skilled actions, and that it is plausible that this imagery combines with perception (likely vision) to create a single experience of the environment as enabling action. The paper will also show that contemporary views on motor imagery are broadly compatible with Merleau-Ponty’s aims. (shrink)
(1 other version)A solution of the decision problem for the Lewis systems s2 and s4, with an application to topology.J. C. C. McKinsey -1941 -Journal of Symbolic Logic 6 (4):117-134.detailsIn this paper I shall give a solution of the decision problem for the Lewis systems S2 and S4; i.e., I shall establish a constructive method for deciding whether an arbitrary given sentence of one of these systems is provable. The method is laborious to apply, since, in order to decide by means of it whether a given sentence is provable, it is necessary to construct a (usually very large) finite matrix. The argument will perhaps be of general interest, however, (...) because it does not seem to depend too closely on the special features of these particular systems, so that it may be possible to apply it in order to solve the decision problem for other such systems.Section II presents the decision method for S2, and Section III for S4. In Section IV, I shall establish a certain correspondence between S4 and topology, which will provide a solution for a decision problem in topology; this correspondence also enables us to settle a previously unsolved problem with regard to the Lewis systems.In treating of this system, I shall use the notation of Lewis, with the single exception that I shall use the symbol “≣”, instead of Lewis's symbol “=”, for strict equivalence. I shall use the symbol “=” to denote identity. Thus “p≣q” is a formula of S2, while “x=y” is the statement asserting that x and y are identical. I shall refer to the rules, primitive sentences and theorems of S2 by the names and numbers used by Lewis. Whenever a theorem stated by Lewis involves the symbol “=”, I shall of course suppose that this symbol has been replaced throughout by “≣”: thus, for example, I shall take 19.82 to be “(◇p∨◇q) ≣ ◇(p∨q)”, instead of “(◇p∨◇q) ≣ ◇(p∨q)”. (shrink)
Fitch's proof, verificationism, and the knower paradox.J. C. Beall -2000 -Australasian Journal of Philosophy 78 (2):241 – 247.detailsI have argued that without an adequate solution to the knower paradox Fitch's Proof is- or at least ought to be-ineffective against verificationism. Of course, in order to follow my suggestion verificationists must maintain that there is currently no adequate solution to the knower paradox, and that the paradox continues to provide prima facie evidence of inconsistent knowledge. By my lights, any glimpse at the literature on paradoxes offers strong support for the first thesis, and any honest, non-dogmatic reflection on (...) the knower paradox provides strong support for the second. Whether verificationists want to go the route I've suggested is not for me todecide. As in the previous section my aim has been that of defending the mere viability of verificationism in the face of what many, many philosophers have taken to be its death-knell, namely Fitch's Proof. But, as the final objection makes clear, showing that verificationism can live in the face of Fitch's Proof is one thing; showing that it should live is another project. If nothing else, I hope that this papershows that verificationists still have a project to pursue; Fitch's Proof, contrary to popular opinion, need not bury verificationism.13. (shrink)
(1 other version)Wittgenstein and the Problem of Machine Consciousness.J. C. Nyíri -1989 -Grazer Philosophische Studien 33 (1):375-394.detailsFor any given society, its particular technology of communication has far-reaching consequences, not merely as regards social organization, but on the epistemic level as well. Plato's name-theory of meaning represents the transition from the age of primary orality to that of literacy; Wittgenstein's use-theory of meaning stands for the transition from the age of literacy to that of a second orality (audiovisual communication, electronic information processing). On the basis of a use-theory of meaning the problem of machine consciousness, to which (...) the later Wittgenstein again and again returned, is capable of a non-essentialist solution: appropriate changes in our form of life might well entail a radically different psychological language-game. (shrink)
Inner models for set theory—Part I.J. C. Shepherdson -1951 -Journal of Symbolic Logic 16 (3):161-190.detailsOne of the standard ways of proving the consistency of additional hypotheses with the basic axioms of an axiom system is by the construction of what may be described as ‘inner models.’ By starting with a domain of individuals assumed to satisfy the basic axioms an inner model is constructed whose domain of individuals is a certain subset of the original individual domain. If such an inner model can be constructed which satisfies not only the basic axioms but also the (...) particular additional hypothesis under consideration, then this affords a proof that if the basic axiom system is consistent then so is the system obtained by adding to this system the new hypothesis. This method has been applied to axiom systems for set theory by many authors, including v. Neumann, Mostowski, and more recently Gödel, who has shown by this method that if the basic axioms of a certain axiomatic system of set theory are consistent then so is the system obtained by adding to these axioms a strong form of the axiom of choice and the generalised continuum hypothesis. Having been shown in this striking way the power of this method it is natural to inquire whether it has any limitations or whether by the construction of a sufficiently ingenious inner model one might hope to decide other outstanding consistency questions, such as the consistency of the negations of the axiom of choice and continuum hypothesis. In this and two following papers we prove some general theorems concerning inner models for a certain axiomatic system of set theory which lead to the result that as far as a fairly large family of inner models are concerned this method of proving consistency has been exhausted, that no essentially new consistency results can be obtained by the use of this kind of model. (shrink)
Palágyis Kritik an der Gegenstandstheorie.J. C. Nyíri -1995 -Grazer Philosophische Studien 50 (1):603-613.detailsDer ungarische Philosoph Melchior (Menyhert) Palägyi hatte niemals eine unmittelbare Kritik der Meinongschen Philosophie verfaßt; 1902 erwog er sogar die Möglichkeit, sich bei Meinong zu habilitieren. Dennoch ist die Gegenstandstheorie Meinongs durch die von Palägyi aufgebaute, sprachphilosophisch begründete Widerlegung des logischen Objektivismus eines Bolzano oder Husseri an sich zweifellos ebenfalls berührt. Palägyis Kritik an dem modernen Piatonismus, durch Herder, Max Müller und vermutlich Nietzsche beeinflußt, die bezüglichen Argumente des späteren Wittgenstein und von Eric Havelock in gar mancher Hinsicht vorwegnehmend, ist (...) weitgehend unbekannt und unbeachtet geblieben. Indem der Aufsatz die Prinzipien dieser Kritik nun eben auf die Gegenstandstheorie anwendet, sollen gewisse grundsätzliche Züge der Meinongschen Begriffsbildung in einer geschichtlich angemessenen Weise kritisch beleuchtet werden. (shrink)
Student Rights and the Special Characteristics of the School Environment in American Jurisprudence.J. C. Blokhuis -2015 -Journal of Philosophy of Education 49 (1):65-85.detailsIn American jurisprudence, there can be no presumption of constitutional rights coextensive with those of adults for children in any institutional context. This includes public schools, in part because of the legal status of minors and in part because the ‘special characteristics of the school environment’ are predicated on a ‘custodial and tutelary’ relationship between teachers and pupils.