Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...) Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. -/- Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. -/- Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data. (shrink)

Das deutsche Gesundheitswesen steht durch die schnell steigende Anzahl an CO- VID-19-Erkrankten vor erheblichen Herausforderungen. In dieser Krisensituation sind alle Beteiligten mit ethischen Fragen konfrontiert, beispielsweise nach gerech- ten Verteilungskriterien bei begrenzten Ressourcen und dem gesundheitlichen Schutz des Personals angesichts einer bisher nicht therapierbaren Erkrankung. Daher werden schon jetzt klinische und ambulante Ethikberatungsangebote verstärkt mit Anfragen nach Unterstützung konfrontiert. Wie können Ethikberater*innen Entscheidungen in der Krankenversorgung im Rahmen der COVID-19-Pandemie unterstützen? Welche Grenzen von Ethikberatung sind zu beachten? Bislang liegen hierzu (...) noch wenige praktische Erfahrungen vor. Angesichts der dynamischen Entwicklung erscheint es der Akademie für Ethik in der Medizin (AEM) wichtig, einen Diskurs über die angemessene Rolle der Ethikberatung bei der Bewältigung der vielfachen Heraus- forderungen durch die COVID-19-Pandemie zu führen und professionelle Hinweise zu geben. Mit dem vorliegenden Diskussionspapier möchte die AEM einen Beitrag zur Beantwortung wesentlicher Fragen leisten, die sich für die Ethikberatung in den verschiedenen Bereichen des Gesundheitswesens stellen. Sie regt an, diesen Dis- kurs weiter zu führen und hat ein Online-Forum (s. unten) eingerichtet, in dem Ethikberater*innen ihre Erfahrungen teilen und die professionelle Selbstreflexion der Ethikberatung in Pandemiezeiten mit Anregungen fördern können. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted by (...) two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...) were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

This paper develops an account of the meaning of `ought', and the distinction between weak necessity modals (`ought', `should') and strong necessity modals (`must', `have to'). I argue that there is nothing specially ``strong'' about strong necessity modals per se: uses of `Must p' predicate the (deontic/epistemic/etc.) necessity of the prejacent p of the actual world (evaluation world). The apparent ``weakness'' of weak necessity modals derives from their bracketing whether the necessity of the prejacent is verified in the actual world. (...) `Ought p' can be accepted without needing to settle that the relevant considerations (norms, expectations, etc.) that actually apply verify the necessity of p. I call the basic account a modal-past approach to the weak/strong necessity modal distinction (for reasons that become evident). Several ways of implementing the approach in the formal semantics/pragmatics are critically examined. The account systematizes a wide range of linguistic phenomena: it generalizes across flavors of modality; it elucidates a special role that weak necessity modals play in discourse and planning; it captures contrasting logical, expressive, and illocutionary properties of weak and strong necessity modals; and it sheds light on how a notion of `ought' is often expressed in other languages. These phenomena have resisted systematic explanation. In closing I briefly consider how linguistic inquiry into differences among necessity modals may improve theorizing on broader philosophical issues. (shrink)

This paper demarcates a theoretically interesting class of "evaluational adjectives." This class includes predicates expressing various kinds of normative and epistemic evaluation, such as predicates of personal taste, aesthetic adjectives, moral adjectives, and epistemic adjectives, among others. Evaluational adjectives are distinguished, empirically, in exhibiting phenomena such as discourse-oriented use, felicitous embedding under the attitude verb `find', and sorites-susceptibility in the comparative form. A unified degree-based semantics is developed: What distinguishes evaluational adjectives, semantically, is that they denote context-dependent measure functions ("evaluational (...) perspectives")—context-dependent mappings to degrees of taste, beauty, probability, etc., depending on the adjective. This perspective-sensitivity characterizing the class of evaluational adjectives cannot be assimilated to vagueness, sensitivity to an experiencer argument, or multidimensionality; and it cannot be demarcated in terms of pretheoretic notions of subjectivity, common in the literature. I propose that certain diagnostics for "subjective" expressions be analyzed instead in terms of a precisely specified kind of discourse-oriented use of context-sensitive language. I close by applying the account to `find x PRED' ascriptions. (shrink)

This paper investigates how inquiry into normative language can improve substantive normative theorizing. First I examine two dimensions along which normative language differs: “strength” and “subjectivity.” Next I show how greater sensitivity to these features of the meaning and use of normative language can illuminate debates about three issues in ethics: the coherence of moral dilemmas, the possibility of supererogatory acts, and the connection between making a normative judgment and being motivated to act accordingly. The paper concludes with several brief (...) reflections on the theoretical utility of the distinction—at least so-called—between “normative” and “non-normative” language and judgment. Clarifying the language we use in normative conversation and theorizing can help us diagnose problems with bad arguments and formulate better motivated questions. This can lead to clearer answers and bring into relief new theoretical possibilities and avenues to explore. (shrink)

This paper develops an account of mood selection with attitude predicates in French. I start by examining the “contextual commitment” account of mood developed by Portner and Rubinstein Proceedings of SALT 22, CLC Publications, Ithaca, NY, pp 461–487, 2012). A key innovation of Portner and Rubinstein’s account is to treat mood selection as fundamentally depending on a relation between individuals’ attitudes and the predicate’s modal backgrounds. I raise challenges for P&R’s qualitative analysis of contextual commitment and explanations of mood selection. (...) There are indicative-selecting predicates that are felicitous in contexts where there isn’t contextual commitment ; and there are subjunctive-selecting predicates that involve no less contextual commitment than certain indicative-selecting verbs. I develop an alternative account of verbal mood. The general approach, which I call a state-of-mind approach, is to analyze mood in terms of whether the formal relation between the predicate’s modal backgrounds and an overall state of mind represents a relation of commitment. Indicative mood in French presupposes that the informational-evaluative state determined by the predicate’s modal backgrounds is included in the informational-evaluative state characterizing the event described by the predicate. The account provides an improved explanation of core mood-selection puzzles, including subjunctive-selection with emotive factives, indicative-selection with fiction verbs, indicative-selection with espérer ‘hope’ versus subjunctive-selection with vouloir ‘want’, and indicative-selection with commissives versus subjunctive-selection with directives. Subjunctive-selection with modal adjectives is briefly considered. The mood-selection properties of the predicates are derived from the proposed analysis of mood, independently attested features of the predicates’ semantics, and general principles of interpretation. (shrink)

This paper examines distinctive discourse properties of preposed negative 'yes/no' questions (NPQs), such as 'Isn’t Jane coming too?'. Unlike with other 'yes/no' questions, using an NPQ '∼p?' invariably conveys a bias toward a particular answer, where the polarity of the bias is opposite of the polarity of the question: using the negative question '∼p?' invariably expresses that the speaker previously expected the positive answer p to be correct. A prominent approach—what I call the context-management approach, developed most extensively by Romero (...) and Han (2004)—attempts to capture speaker expectation biases by treating NPQs fundamentally as epistemic questions about the proper discourse status of a proposition. I raise challenges for existing context-managing accounts to provide more adequate formalizations of the posited context-managing content, its implementation in the compositional semantics and discourse dynamics, and its role in generating the observed biases. New data regarding discourse differences between NPQs and associated epistemic modal questions are introduced. I argue that we can capture the roles of NPQs in expressing speakers’ states of mind and managing the discourse common ground without positing special context-managing operators or treating NPQs as questions directly about the context. I suggest that we treat the operator introduced with preposed negation as having an ordinary semantics of epistemic necessity, though lexically associated with a general kind of endorsing use observed with modal expressions. The expressive and context-managing roles of NPQs are explained in terms of a general kind of discourse-oriented use of context-sensitive language. The distinctive expectation biases and discourse properties observed with NPQs are derived from the proposed semantics and a general principle of Discourse Relevance. (shrink)

Recent decades have witnessed a flurry of interest in Nietzsche's metaethics — his views, if any, on metaphysical, epistemological, semantic, and psychological issues about normativity and normative language and judgment. Various authors have highlighted a tension between Nietzsche's metaethical views about value and his ardent endorsement of a particular evaluative perspective: Although Nietzsche makes apparently "antirealist" claims to the effect that there are no evaluative facts, he vehemently engages in evaluative discourse and enjoins the "free spirits" to create values. Nearly (...) every major type of metaethical "-ism" has been ascribed to Nietzsche in response. This chapter provides a critical introduction to Nietzsche's metaethics, focusing on matters concerning the nature and grounds of normativity. I begin by examining and raising challenges for Nadeem Hussain's prominent interpretation of Nietzsche as a revolutionary fictionalist. I argue that a constructivist interpretation (developed elsewhere) provides an improved account of the connections, for Nietzsche, between evaluative attitudes and the nature of value, and among practical nihilism, art, and value creation. Values, on this view, are treated as grounded purely in facts about creatures’ evaluative attitudes. The chapter concludes by considering several alternative subjectivist, constitutivist, and non-cognitivist interpretations. A nuanced understanding of the space of metaethical theories brings into relief a plausible normative and metanormative view that we can attribute to Nietzsche. (shrink)

It is common to think that what theory of linguistic vagueness is correct has implications for debates in philosophy of law. I disagree. I argue that the implications of particular theories of vagueness on substantive issues of legal theory and practice are less far-reaching than often thought. I focus on four putative implications discussed in the literature concerning (i) the value of vagueness in the law, (ii) the possibility and value of legal indeterminacy, (iii) the possibility of the rule of (...) law, and (iv) strong discretion. I conclude with some methodological remarks. Delineating questions about conventional meaning, the metaphysics/metasemantics of (legal) content determination, and norms of legal interpretation and judicial practice can motivate clearer answers and a more refined understanding of the space of overall theories of vagueness, interpretation, and law. (shrink)

Review of Paul Katsafanas, Agency and the Foundations of Ethics: Nietzschean Constitutivism.

Currently, there are many advocacy interventions aimed at reducing animal consumption. We report results from a lab (N = 267) and a field experiment (N = 208) exploring whether, and to what extent, some of those educational interventions are effective at shifting attitudes and behavior related to animal consumption. In the lab experiment, participants were randomly assigned to read a philosophical ethics paper, watch an animal advocacy video, read an advocacy pamphlet, or watch a control video. In the field experiment, (...) we measured the impact of college classes with animal ethics content versus college classes without animal ethics content. Using a pretest, post-test matched control group design, humane educational interventions generally made people more knowledgeable about animals used as food and reduced justifications and speciesist attitudes supporting animal consumption. None of the interventions in either experiment had a direct, measurable impact on self-reported animal consumption. These results suggest that while some educational interventions can change beliefs and attitudes about animal consumption, those same interventions have small impacts on animal consumption. (shrink)

Knowledge of human uses of animals is an important, but understudied, aspect of how humans treat animals. We developed a measure of one kind of knowledge of human uses of animals – knowledge of factory farming. Studies 1 (N = 270) and 2 (N = 270) tested an initial battery of objective, true or false statements about factory farming using Item Response Theory. Studies 3 (N = 241) and 4 (N = 278) provided evidence that responses to a 10-item Knowledge (...) of Factory Farming Scale predicted a reduction in consumption of animal products (rs = −.17- −.27) and approval of political actions aimed at factory farming (rs = .2 – .24). Path models from Studies 3 and 4 suggested that different kinds of knowledge uniquely predicted different outcomes. The Knowledge of Factory Farming scale was a unique predictor of approval of political actions concerning factory farmed animals but not animal consumption. Knowledge of Animals Used as Food predicted animal consumption but not political actions concerning farmed animals. These results highlight that different kinds of knowledge can be relevant for different animal related outcomes. (shrink)

Once known as the city of silk, Suzhou 苏州 has become the centre of wedding dress production, selling paradise on earth for one day, including copies of the last royal wedding dress, out of shops at the foot of mythic Tiger Hill. Suzhou is also the host of what is known as the Silicon Valley of the East. It has attracted millions of migrants searching for a better future; millions of tourists visit every year to experience the past, strolling through (...) the gardens and courtyards of its Old Town. The contrasts could hardly be more apparent. Slow time, and fast time, and the time of the in-between, are woven into the city’s complex spatial fabric. This is a conversation by eight authors in eight frames on a city that connects them. (shrink)

Pasteur’s originality in the way he developed pure research is to have understood the importance, for society, of the underlying motivation. Curiosity, of course, is a strong motivation, which explains why we seek to understand the origin of life. But, in front of the immensity of the possible choices, why not, also, choose to start from questions of economic interest (diseases of beer and wine, diseases aVecting the silk industry . . . ) Finally, of course, health is a constant (...) preoccupation, but the diseases, which have no borders, often come from tropical countries and Asia especially. It is therefore necessary to settle there, but not to come and impose one’s point of view, but on the contrary to use the knowledge coming from the local culture in order to open new ways of understanding the reality of the world. (shrink)

Zen and Japanese Culture is one of the twentieth century's leading works on Zen, and a valuable source for those wishing to understand its concepts in the context of Japanese life and art. In simple, often poetic, language, Daisetz Suzuki describes his conception of Zen and its historical evolution. He connects Zen to the philosophy of the samurai, and subtly portrays the relationship between Zen and swordsmanship, haiku, tea ceremonies, and the Japanese love of nature. Suzuki's contemplative work is enhanced (...) by anecdotes, poetry, and illustrations showing silk screens, calligraphy, and examples of architecture. Since its original publication in 1938, this important work has played a major role in shaping conceptions of Zen's influence on Japanese traditional arts. Richard Jaffe's introduction acquaints a new generation of readers with Suzuki's life and career in both Japan and America. Jaffe discusses how Zen and Japanese Culture was received upon its first publication and analyzes the book in light of contemporary criticism, especially by scholars of Japanese Buddhism. (shrink)

This paper puts forth Central Asian AI Ethics Principles and proposes a layered strategy tailored for the development of ethical principles in the field of artificial intelligence (AI) in Central Asian countries. This approach includes the customization of AI ethics principles to resonate with local nuances, the formulation of national and regional-level AI Ethics principles, and the implementation of subject-specific principles. While countering the narrative of ineffectiveness of the AI Ethics principles, this paper underscores the importance of stakeholder collaboration, provides (...) a comprehensive framework, and emphasizes the need for responsible AI practices. By adopting this approach, Central Asian region can contribute towards the regional integration and global discourse on AI ethics while promoting the responsible use of AI technology in their respective countries. (shrink)

Things strike me in a variety ways. F and F# sound slightly different, ripe and unripe tomatoes neither look nor taste nor smell the same, and silk feels smoother than corduroy. In each case, I distinguish an experience of something on the basis of what it is like to be its subject. That is to say, in philosophical parlance, if not quite the vernacular, its “quale,” leads me to categorize it and, thus, respond appropriately to its stimulus. The function of (...) a quale being established, we must define it along with its subject and, as Sartre maintained, their relation. How should we understand the subject and predicate terms and the copula in sentences such as ‘He is listening to Chopin’ or ‘She is seeing the sights of Paris’? Elaborating upon adverbialism, I shall argue that the subject of experiencing is a hylomorphic compound that is temporarily identical to the 'accidental compound' that it forms along with a qualified passion. I begin by explicating the adverbialist’s treatment of qualitative consciousness and defending it against the charge of circularity. (shrink)

Philip Roth’s novel 'The Human Stain' recounts an instance of racial passing: its protagonist, Coleman Silk, is African-American but light-skinned enough to pass as white. Coleman’s decision to pass and his subsequent violent death, I argue, confront us with complex ethical questions regarding unjust social roles, loyalty, and moral luck. I also argue, building on Hegel’s definition of tragedy, that 'The Human Stain' is a particularly modern tragedy. The novel highlights conflicting role obligations, inadequate conceptions of freedom, and the tensions (...) of cultural paradigm shifts—all characteristics typical of modern tragedy. I claim that parsing 'The Human Stain' as a tragedy deepens our understanding of the novel as well as drawing our attention to its philosophical significance. (shrink)

Pakistan and China are friends from very long time. They have trading relations through the Ancient Silk Road. Now both the countries want to increase the volume of their trade. China decided to make large investment in Pakistan under its One Belt One Road vision through CPEC project. The CPEC is a combination of infrastructure development, power generation and research and development project. China and Pakistan are equally going to benefit from the project thus they both are interested in doing (...) the project in time and hence are putting their all efforts to complete the project. Some of the countries are working to stop the project by strong opposition but China and Pakistan are standing erect to complete the project. The study addresses the historical relations between Pakistan and China moreover pointed out the benefits that Pakistan and China are expecting from the project. The study also discusses the external and internal challenges to Pakistan that are creating hindrance in the completion of CPEC. (shrink)