Ethical dilemmas in prioritizing patients for scarce radiotherapy resources.Cyprien Shyirambere,Vincent K. Cubaka,Scott A. Triedman,Lawrence N. Shulman,Katherine Van Loon,Nicaise Nsabimana,Jean Bosco Bigirimana,Grace Umutesi,Cam Nguyen,Espérance Mutoniwase,Anita Ho &Rebecca J. DeBoer -2024 -BMC Medical Ethics 25 (1):1-11.detailsBackgroundRadiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve all patients who would benefit from it. Allocation systems are needed to guide patient prioritization for radiotherapy in resource-limited contexts. These systems should be informed by allocation principles deemed relevant to stakeholders. This study explores the ethical dilemmas and views of decision-makers engaged in real-world prioritization of scarce radiotherapy resources at a cancer center in Rwanda in order to identify relevant principles.MethodsSemi-structured interviews (...) were conducted with a purposive sample of 22 oncology clinicians, program leaders, and clinical advisors. Interviews explored the factors considered by decision-makers when prioritizing patients for radiotherapy. The framework method of thematic analysis was used to characterize these factors. Bioethical analysis was then applied to determine their underlying normative principles.ResultsParticipants considered both clinical and non-clinical factors relevant to patient prioritization for radiotherapy. They widely agreed that disease curability should be the primary overarching driver of prioritization, with the goal of saving the most lives. However, they described tension between curability and competing factors including age, palliative benefit, and waiting time. They were divided about the role that non-clinical factors such as social value should play, and agreed that poverty should not be a barrier.ConclusionsMultiple competing principles create tension with the agreed upon overarching goal of maximizing lives saved, including another utilitarian approach of maximizing life-years saved as well as non-utilitarian principles, such as egalitarianism, prioritarianism, and deontology. Clinical guidelines for patient prioritization for radiotherapy can combine multiple principles into a single allocation system to a significant extent. However, conflicting views about the role that social factors should play, and the dynamic nature of resource availability, highlight the need for ongoing work to evaluate and refine priority setting systems based on stakeholder views. (shrink)
In Gods We Trust: The Evolutionary Landscape of Religion.Scott Atran -2002 - New York, US: Oup Usa.detailsThis ambitious, interdisciplinary book seeks to explain the origins of religion using our knowledge of the evolution of cognition. A cognitive anthropologist and psychologist,Scott Atran argues that religion is a by-product of human evolution just as the cognitive intervention, cultural selection, and historical survival of religion is an accommodation of certain existential and moral elements that have evolved in the human condition.
Giving Way on One's Desire: Response to Fuller.Scott Welsh -2013 -Philosophy and Rhetoric 46 (1):114-121.detailsIn my article, “Coming to Terms with the Antagonism Between Rhetorical Reflection and Political Agency,” I argue that academic desire is inherently frustrated by motives in tension with each other (2012). As rhetoric scholars, we are supposed to explore what we find politically interesting or important by isolating a chosen element of the political in order to perform a systematic study of that element and generate some insight about it. Yet graduate students quickly learn that moral fervor and political commitment (...) are not the same thing as studying something that they care about. And this moment of revelation is no less true for a partisan in the throws of a political campaign than it is for an academic shut away .. (shrink)
Metaphorical Transcendence: Notes on Levinas's Unpublished Lecture on Metaphor.Scott Davidson -2015 -Journal of Speculative Philosophy 29 (3):366-375.detailsABSTRACT In his published work, Levinas only mentions metaphor for the sake of dismissing its relevance to his ethics of transcendence. Metaphor is aligned with the poetic imagery and the rhetorical devices that weave together an ontology of immanence, whereas transcendence is said to occur through an immediate encounter with the other. But Levinas's unpublished lecture “La Métaphore” is of interest precisely because it troubles this distinction through the notion of a “metaphorical transcendence.” Although Levinas abandons this terminology after his (...) lecture, this article suggests that an implicit, but unavowed, operation of metaphor persists in the guise of his ethics of substitution. (shrink)
Correction to: The Hidden Dimensions of Human–Technology Relations.Scott T. Luan -2019 -Philosophy and Technology 32 (4):771-771.detailsThe original version of this article unfortunately contains an incorrect sentence.
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Finding the History and Philosophy of Science.Scott B. Weingart -2015 -Erkenntnis 80 (1):201-213.detailsHistory of science and philosophy of science have experienced a somewhat turbulent relationship over the last century. At times it has been said that philosophy needs history, or that history needs philosophy. Very occasionally, something entirely new is said to need them both. Often, however, their relationship is seen as little more than a marriage of convenience. This article explores that marriage by analyzing the citations of over 7,000 historians, philosophers, and sociologists of science. The data reveal that a small (...) but tightly-knit bridge does exist between the disciplines, and raises suggestions about how to understand that bridge in a more nuanced fashion. (shrink)
Conversation, Individuals and Concepts: Some Key Concepts in Gordon Pask's Interaction of Actors and Conversation Theories.B.Scott -2009 -Constructivist Foundations 4 (3):151 - 158.detailsPurpose: Gordon Pask has left behind a voluminous scientific oeuvre in which he frequently uses technical language and a detail of argument that makes his work difficult to access except by the most dedicated of students. His ideas have also evolved over a long period. This paper provides introductions to three of Pask's key concepts: "conversations," "individuals," and "concepts." Method: Based on the author's close knowledge of Pask's work, as his collaborator for ten years and as someone who has had (...) access to and is familiar with almost all of his published work, the paper selects three of Pask's key concepts for elucidation in order to motivate the interested reader to explore Pask's work in the original. Results: Pask's key concepts, "conversations," "individuals," and "concepts," which are central in his conversation theory and his later elaborations in "interaction of actors theory," are shown to be grounded in fundamental principles from cybernetics. Furthermore, the form of Pask's theorising is that of second order (reflexive) metatheorising, developing theories of theorising that explain their own form and genesis. (shrink)
A God for This World.Scott Cowdell -2000 - Mowbray.detailsThis lively study examines how God became remote from the world, the consequences for belief, and how God is today being re-imagined as being at home in the world and at work in natural and human events. Beyond classical theism and modern atheism, traditions of God at home in the world are recovered and holistic images of God explored -- old and new. Incorporating insights from quantum physics, postmodern theory, chaos theory and evolutionary biology, the book recaptures the sense of (...) God as the "soul" of the world, commending a secular mysticism of God "in, with and under" all the struggles of matter, life and consciousness. This reinvigorated tradition of divine action is brought into respectful dialogue with the undeniable challenges to faith which evil and suffering pose. (shrink)
Ethical Properties and Divine Commands.Scott Davis -1983 -Journal of Religious Ethics 11 (2):280 - 300.detailsIn a recent essay Robert Adams attempted to define a form of divine command ethics that would meet the typical philosophical criticisms of such an ethics. More recently, responding to new criticisms of the theory of meaning assumed in this essay and some details of the system he described there, Adams has redefined his position using the causal theory of meaning. The present essay examines Adam's fundamental position and the main lines of Jeffrey Stout's critique of it, then attempts to (...) assess the success of Adams' latest redefinition of divine command ethics. (shrink)
Posttraumatic stress in organizations: Types, antecedents, and consequences.Scott David Williams &Jonathan Williams -2020 -Business and Society Review 125 (1):23-40.detailsResearch indicates that the well‐being and productivity of over 100 million people in the global workforce may be compromised by posttraumatic stress (PTS). Given that work‐related experiences are often the source of the trauma that leads to PTS, and that PTS due to any cause can interfere with employees’ job performance, organizations would do well to consider the antecedents and consequences of PTS. This review of research—primarily within fields adjacent to business—on the types, antecedents, consequences, and organizational implications of PTS (...) is presented to advance inquiry within the field of business. The definition of PTS requires attention to the new classification of complex posttraumatic stress disorder that can result from threats that are not life‐threatening such as bullying and sexual harassment. PTS antecedents include organizational and extraorganizational traumas, and risk and resilience factors. Absenteeism, impaired cognitive functioning, strained relationships, and growth are among the consequences of PTS. Organizations can assist through disaster planning, empathetic leaders, mental health literacy initiatives, and employee assistance programs. Many research questions arise that, when answered, will allow organizations to better understand how they can improve employee productivity and well‐being by attending to PTS. (shrink)
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Neuroscience, power and culture: an introduction.Scott Vrecko -2010 -History of the Human Sciences 23 (1):1-10.detailsIn line with their vast expansion over the last few decades, the brain sciences — including neurobiology, psychopharmacology, biological psychiatry, and brain imaging — are becoming increasingly prominent in a variety of cultural formations, from self-help guides and the arts to advertising and public health programmes. This article, which introduces the special issue of History of the Human Science on ‘Neuroscience, Power and Culture’, considers the ways that social and historical research can, through empirical investigations grounded in the observation of (...) what is actually happening and has already happened in the sciences of mind and brain, complement speculative discussions of the possible social implications of neuroscience that now appear regularly in the media and in philosophical bioethics. It suggests that the neurosciences are best understood in terms of their lineage within the ‘psy’-disciplines, and that, accordingly, our analyses of them will be strengthened by drawing on existing literatures on the history and politics of psychology — particularly those that analyze formations of knowledge, power and subjectivity associated with the discipline and its practical applications. Additionally, it argues against taking today’s neuroscientific facts and brain-targetting technologies as starting points for analysis, and for greater recognition of the ways that these are shaped by historical, cultural and political-economic forces. (shrink)
Transparency and Two-Factor Photographic Appreciation.Scott Walden -2016 -British Journal of Aesthetics 56 (1):33-51.detailsIn his classic paper ‘Transparent Pictures: On the Nature of Photographic Realism’, Kendall Walton highlights the special sense of contact with their subjects that photographs typically engender and argues that we must postulate photographic transparency in order to explain their capacity to do so. He also downplays the epistemic advantages historically associated with the medium and instead finds the source of our medium-specific appreciation of photographs largely in their transparency. I argue that Walton errs in both these respects. I offer (...) a simpler, deflationary means of explaining the contact phenomenon, one that does not mandate that we see through photographs, and I show how an epistemic advantage associated with the medium can be brought together with this deflationary understanding to yield a two-factor analysis of our experiences in looking at photographs. I conclude with an application of this two-factor approach to an iconic photograph from the modernist canon. (shrink)
Health and the Governance of Security: A Tale of Two Systems.Sevgi Aral,Scott Burris &Clifford Shearing -2002 -Journal of Law, Medicine and Ethics 30 (4):632-643.detailsThe provision of police services and the suppression of crime is one of the first functions of civil government. Article 3 of the Universal Declaration of Human Rights speaks of a right to “security of person.” “The term ‘police’ traditionally connoted social organization, civil authority, or formation of a political community—the control and regulation of affairs affecting the general order and welfare of society,” including the protection of public health. Civil dispute resolution is also an important part of a system (...) that moves people away from self-help and toward reliance on collectively constituted, peaceful channels for working out problems.A safe and secure environment is tied to health. Research in social epidemiology suggests that a shared sense of security from physical violence and interference with property can contribute to better community health. (shrink)
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After the MDGs: Citizen Deliberation and the Post-2015 Development Framework.Scott Wisor -2012 -Ethics and International Affairs 26 (1):113-133.detailsThe Millennium Development Goals (MDGs), an unprecedented set of global commitments to reduce various forms of human deprivation and promote human development, are set to expire in 2015. Despite their promise, the MDGs are flawed in a variety of ways. The development community is already discussing what improved development framework should replace the MDGs. I argue that global justice advocates should focus first on the procedure for developing the post-2015 development framework. Specifically, they should create spaces for citizens, especially the (...) most marginalized and oppressed, to actively deliberate about the form and content of a future global development framework, and ensure that this deliberation receives political uptake in formal intergovernmental processes for deciding the post-2015 framework. (shrink)
How should INGOs allocate resources?Scott Wisor -2012 -Ethics and Global Politics 5 (1):27-48.detailsInternational Non-governmental Organizations (INGOs) face difficult choices when choosing to allocate resources. Given that the resources made available to INGOs fall far short of what is needed to reduce massive human rights deficits, any chosen scheme of resource allocation requires failing to reach other individuals in great need. Facing these moral opportunity costs, what moral reasons should guide INGO resource allocation? Two reasons that clearly matter, and are recognized by philosophers and development practitioners, are the consequences (or benefit or harm (...) reduction) of any given resource allocation and the need (or priority) of individual beneficiaries. If accepted, these reasons should lead INGOs to allocate resources to a limited number of countries where the most prioritarian weighted harm reduction will be achieved. I make three critiques against this view. First, on grounds the consequentialist accepts, I argue that INGOs ought to maintain a reasonably wide distribution of resources. Second, I argue that even if one is a consequentialist, consequentialism ought not act as an action guiding principle for INGOs. Third, I argue that additional moral reasons should influence decision making about INGO resource allocation. Namely, INGO decision making should attend to relational reasons, desert, respect for agency, concern for equity, and the importance of expressing a view of moral wrongs. (shrink)
Collected Works of Robert Burns.WilliamScott Douglas (ed.) -1879 - Routledge.detailsWilliamScott Douglas's six volume edition of Burns's work is the most oustanding of all the nineteenth century editions in terms of completeness and scholarship. The first three volumes contain Burn's poetry, and the prose works in the final volumes include some sixty-eight previously unpublished letters or parts of letters.