Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

This chapter presents an overview of the life, work, and philosophical contributions of Śāntarakṣita (c. 725–788), who is known for his synthesis of Nāgārjuna’s Madhyamaka with elements of the Dignāga-Dharmakīrti tradition of logic and epistemology. His two most important independent treatises, the Compendium of True Principles (Tattvasaṃgraha) and the Ornament of the Middle Way (Madhyamakālaṃkāra), are characterized by an emphasis on the indispensable role of rational analysis on the Buddhist path as well as serious and systematic engagement with competing Buddhist (...) and non-Buddhist schools of thought. Śāntarakṣita employs a pedagogical-rhetorical device of provisionally adopting what he deems to be successively more rational views to reject less rational ones. Using this approach, in the Ornament of the Middle Way, he recommends a gradual path to arrive at an understanding of the Madhyamaka ultimate truth by incorporating Yogācāra idealist ontology into his presentation of conventional truth. In this same text, he presents an influential iteration of the neither-one-nor-many argument for the Madhyamaka ultimate truth, the emptiness of intrinsic nature—i.e., the universal negation of ontologically independent being—leaving a lasting and significant impact on both Indian and Tibetan Madhyamaka Buddhist philosophy. (shrink)

Dharmakīrti’s (c. seventh century) Examination of Relations (Sambandhaparīkṣā) is unique in the Indian Buddhist canon for its being the only extant root text devoted entirely to the topic of the ontological status of relations. But the core thesis of this treatise—that relations are only nominally real—is in prima facie tension with another claim that is central to Dharmakīrti’s epistemology: that there exists some kind of “natural relation” (svabhāvapratibandha) that reliably underwrites inferences. Understanding how Dharmakīrti can consistently rely on natural relations (...) to prop up his presentation of inferential reasoning while at the same time advancing an anti-realist account of relations is critical for making sense of his system of logic and epistemology, which came to be nearly universally adopted in Tibetan Buddhism cutting across traditions. Chomden Rikpé Reldri (1227–1305), who was perhaps the most prolific commentator on logic and epistemology in the history of Tibetan philosophy, composed two texts commenting on the Examination of Relations, neither of which have received any scholarly attention to date. In this paper, I provide an introduction to Chomden Reldri’s two commentaries and consider how they may illuminate Dharmakīrti’s text and also what they reveal about the understanding of Dharmakīrti’s account of relations in early Tibetan scholasticism. I then present a translation of Dharmakīrti’s Examination of Relations together with Chomden Reldri’s commentary, Annotations and Topical Outline of the Examination of Relations (’Brel pa brtag pa’i mchan dang sa bcad gnyis). (shrink)

Against the standard view that the Republic’s division of goods distinguishes between intrinsic and instrumental value, a growing number of scholars have correctly argued that goods possess value δι᾽ αὑτό in virtue of some of their causal effects. However, these scholars have not yet given a convincing and principled account of what it means to be valuable διὰ τὰ γιγνόμενα ἀπ’ αὐτοῦ such that some effects can contribute to the value a good has δι᾽ αὑτό. In this paper I offer (...) such an account. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

In the 5th century a number of sophists challenged the orthodox understanding of morality and claimed that practicing injustice was the best and most profitable way for an individual to live. Although a number of responses to sophistic immoralism were made, one argument, in fact coming from a pair of sophists, has not received the attention it deserves. According to the argument I call Immortal Repute, self-interested individuals should reject immorality and cultivate virtue instead, for only a virtuous agent can (...) win the sort of everlasting reputation that makes a life truly admirable and successful. (shrink)

A growing number of scholars have seen that the Republic’s division of goods includes goods which possess value δι᾽ αὑτό in virtue of some of their causal effects. Building on this, I argue that goods, including justice, which are valuable διὰ τὰ γιγνόµενα ἀπ’ αὐτοῦ (and whose effects can contribute to the value a good has δι᾽ αὑτό) are so in virtue of a limited class of beneficial effects: those that depend on the recognition of other agents. This way of (...) dividing goods explains why Socrates legitimately invokes some effects of justice in his demonstration that justice is valuable δι᾽ αὑτό. (shrink)

The U.S. Supreme Court's majority opinion in Vacco v. Quill assumes that the principle of double effect explains the permissibility of hastening death in the context of ordinary palliative care and in extraordinary cases in which painkilling drugs have failed to relieve especially intractable suffering and terminal sedation has been adopted as a last resort. The traditional doctrine of double effect, understood as providing a prohibition on instrumental harming as opposed to incidental harming or harming asa side effect, must be (...) distinguished from other ways in which the claim that a result is notintended might be offered as part of ajustification for it. Although double effectmight appropriately be invoked as a constrainton ordinary palliative care, it is not clearthat it can be coherently extended to justifysuch practices as terminal sedation. A betterapproach would reconsider double effect'straditional prohibition on hastening death as ameans to relieve suffering in the context ofacute palliative care. (shrink)

Making decisions with an, often significant, element of risk seems to be an integral part of many of the projects of the diverse profession of engineering. Whether it be decisions about the design of products, manufacturing processes, public works, or developing technological solutions to environmental, social and global problems, risk taking seems inherent to the profession. Despite this, little attention has been paid to the topic and specifically to how our understanding of engineering as a distinctive profession might affect how (...) we should make decisions under risk. This paper seeks to remedy this, firstly by offering a nuanced account of risk and then by considering how specific claims about our understanding of engineering as a social profession, with corresponding social values and obligations, should inform how we make decisions about risk in this context. (shrink)

In the 5th century a number of sophists challenged the orthodox understanding of morality and claimed that practicing injustice was the best and most profitable way for an individual to live. Although a number of responses to sophistic immoralism were made, one argument, in fact coming from a pair of sophists, has not received the attention it deserves. According to the argument I call Immortal Repute, self-interested individuals should reject immorality and cultivate virtue instead, for only a virtuous agent can (...) win the sort everlasting reputation that makes a life truly admirable and successful. (shrink)

Most medical research and a substantial amount of non-medical research, especially that involving human participants, is governed by some kind of research ethics committee (REC) following the recommendations of the Declaration of Helsinki for the protection of human participants. The role of RECs is usually seen as twofold: firstly, to make some kind of calculation of the risks and benefits of the proposed research, and secondly, to ensure that participants give informed consent. The extent to which the role of the (...) REC includes the former is not uncontroversial. Indeed, the most prevalent debate on the role of RECs sees liberals and strong paternalists arguing over the importance of informed consent given by competent agents versus the significance of making benevolent decisions on behalf of others. On the one hand, liberals argue for the rights of competent adults to decide for themselves the kinds and extents of risks to which they wish to expose themselves. On the other hand, proponents of strong paternalism raise concerns about the likelihood of participants being able to truly understand the complex data involved in research. They support a role for RECs in which they exercise duties of benevolence towards patients and participants by limiting the extent to which they can be exposed to significant, permanent and irreversible harms. In this paper, we will argue that when it comes to decisions about risk it is neither possible nor desirable for RECs to adopt either role. (shrink)

Schopenhauer’s pessimistic philosophy is a depressing read. He writes many pages about how suffering is the norm, and any happiness we feel is merely a temporary alleviation of suffering. Even so, his account of suffering rings true to many readers. What are we to do with our lives if Schopenhauer is right, and we are doomed to suffer? In this paper, I use William James’ pragmatic method to find practical implications of Schopenhauer’s pessimism. I provide a model for how we (...) are to live our lives in a suffering world, a model that provides means to reduce suffering. (shrink)

The 2005 International Consensus Conference on Intersex resulted in a substantive revision of the lexicon and guidelines for treating intersex conditions. The speed with which the new treatment protocol has been adopted by healthcare practitioners and providers is considered unprecedented. However, a number of intersex people and advocacy groups have complained that the recommended revisions are inadequately informed by the testimony of intersex people. In this paper, I argue that such complaints are valid and that, despite the conference conveners stated (...) intention, the revisions perpetuate the epistemic injustice long endured by intersex people. By analyzing the Consensus Conference and its results as a failed attempt to redress the epistemic marginalization of intersex patients and advocacy groups, I am able to identify lingering institutional hurdles to cultivating the virtue of epistemic justice in biomedical practice. (shrink)

This paper argues that Frege's notoriously long commitment to Kant's thesis that Euclidean geometry is synthetic _a priori_ is best explained by realizing that Frege uses ‘intuition’ in two senses. Frege sometimes adopts the usage presented in Hermann Helmholtz's sign theory of perception. However, when using ‘intuition’ to denote the source of geometric knowledge, he is appealing to Hermann Cohen's use of Kantian terminology. We will see that Cohen reinterpreted Kantian notions, stripping them of any psychological connotation. Cohen's defense of (...) his modified Kantian thesis on the unique status of the Euclidean axioms presents Frege's own views in a much more favorable light. (shrink)

Replies for a symposium on Propositions.

There’s a common line of reasoning which supposes that the phenomenal unity of conscious experience is grounded in a mind-like simple subject. To the contrary, Mādhyamika Buddhist philosophers like Śrīgupta (seventh–eighth century) argue that any kind of mental simple is incoherent and thus metaphysically impossible. Lacking any unifying principle, the phenomenal unity of conscious experience is instead an unfounded illusion. In this paper, I present an analysis of Śrīgupta’s "neither-one-nor-many argument" against mental simples and show how his line of reasoning (...) is driven by a set of implicit questions concerning the nature of and relation between consciousness and its intentional object. These questions not only set the agenda for centuries of intra-Buddhist debate on the topic, but they are also questions to which any defender of unified consciousness or a simple subject of experience arguably owes responses. (shrink)

The claim that all vagueness must be a feature of language or thought is the current orthodoxy. This is a claim about the “location” of vagueness. “Locating Vagueness” argues that this claim is false, largely by defending the possibility of borderline cases in the absence of language and thought. If the orthodoxy about the location of vagueness is false, then so too is any account of the “nature” of vagueness that implies that orthodoxy. So this paper concludes that various accounts (...) of the nature of vagueness are false. Among such accounts, so this paper argues, are the standard versions of supervaluationism and the standard versions of epistemicism. So I conclude that those accounts are false. Along the way, I present, and uncover ways to motivate, several heretical accounts of the nature of vagueness, including nonstandard versions of both supervaluationism and epistemicism. (shrink)

Many of us share a strong intuition that fictional literature possesses cognitive value in the sense that it has the capacity to expand and/or clarify our knowledge or understanding of the world. If we agree that we learn something when we read and discuss certain texts, we may nevertheless find the form this learning takes to be anything but obvious.

Canonical defenders of the principle of sufficient reason (PSR), such as Leibniz and Spinoza, are metaphysical foundationalists of one stripe or another. This is curious since the PSR—which says that everything has a ground, cause, or explanation—in effect, denies fundamental entities. In this paper, I explore the apparent inconsistency between metaphysical foundationalism and approaches to metaphysical system building that are driven by a commitment to the PSR. I do so by analyzing how Indian Buddhist philosophers arrive at foundationalist and anti-foundationalist (...) positions motivated by implicit commitments to different versions of the PSR. I begin by introducing the Buddhist principle of dependent origination (pratītyasamutpāda) as a proto-PSR that is restricted to causal explanation. Next, I show how Vasubandhu’s Sautrāntika Abhidharma metaphysics is shaped by a qualified commitment to both causal and metaphysical grounding versions of the PSR. I then reveal how Nāgārjuna’s Madhyamaka metaphysics is driven by an unrestricted and exceptionless commitment to causal and metaphysical grounding versions of the PSR. Finally, I consider how Nāgārjuna’s account may put him in a unique position to respond to a common contemporary objection to the PSR from necessitarianism. I conclude by addressing a competing interpretation on which Nāgārjuna is best understood as an anti-rationalist rather than an uber-rationalist, as I characterize him. (shrink)

The contents of our conscious mind can seem unpredictable, whimsical, and free from external control. When instructed to attend to a stimulus in a work setting, for example, one might find oneself thinking about household chores. Conscious content thus appears different in nature from reflex action. Under the appropriate conditions, reflexes occur predictably, reliably, and via external control. Despite these intuitions, theorists have proposed that, under certain conditions, conscious content resembles reflexes and arises reliably via external control. We introduce the (...) Reflexive Imagery Task, a paradigm in which, as a function of external control, conscious content is triggered reliably and unintentionally: When instructed to not subvocalize the name of a stimulus object, participants reliably failed to suppress the set-related imagery. This stimulus-elicited content is considered ‘high-level’ content and, in terms of stages of processing, occurs late in the processing stream. We discuss the implications of this paradigm for consciousness research. (shrink)

According to Madhyamaka Buddhist philosophers, everything depends for its existence on something else. But what would a world devoid of fundamentalia look like? In this paper, I argue that the anti-foundationalist “neither-one-nor-many argument” of the Indian Mādhyamika Śrīgupta commits him to a position I call “metaphysical indefinitism.” I demonstrate how this view follows from Śrīgupta’s rejection of mereological simples and ontologically independent being, when understood in light of his account of conventional reality. Contra recent claims in the secondary literature, I (...) clarify how the Madhyamaka metaphysical dependence structure is not a straightforward infinitism since it does not honor strict asymmetry or transitivity. Instead, its dependence relations are irreflexive and extendable, admitting of dependence chains of indefinite (though not actually infinite) length and dependence loops of non-zero length. Yet, the flexible ontology of Śrīgupta's Madhyamaka can accommodate a contextualist account of asymmetry and support a revisable theory of conventional truth, delivering significant payoffs for the view, including the capacity to accommodate developments in scientific explanation. (shrink)

According to a dominant view of stigma, a person is stigmatized within a community if sufficiently many people within that community hold a bad view of her. I call this the 'Bad View Model'. In this paper, I argue against the Bad View Model on the grounds that such beliefs are neither necessary nor sufficient for stigma, and that the account cannot explain the distinctive phenomenology of stigma, including certain vulnerabilities to shame. I then develop an alternative that explains these (...) features of stigma, which I call the 'Shaming Model'. On this view, a person is stigmatized within a community if she is shamed by members of that community, and this is explained by their belief that she has deviated from some social norm and/or standard. (shrink)

How should we interpret the popular objection that stigmatised subjects are not treated as individuals? The Eidelson View claims that stigma, because of its connection to stereotypes, violates an instance of the general requirement to respect autonomy. The Self-Presentation View claims that stigma inhibits the functioning of certain morally important capacities, notably the capacity for self-presentation. I argue that even if we are right to think that stigma violates a requirement to respect autonomy, this is insufficient to account for the (...) full weight of the charge that stigmatised subjects are not treated as individuals. We need the Self-Presentation View to explain a special threat to agency. I then address the worry that focusing on a concern with being treated as individuals opens the door to the suggestion that treating as superior can be just as morally troubling as stigma. This objection is fatal for the Eidelson View. But the Self-Presentation View has a number of resources for deflating the worry. We should not exclude the possibility of a moral symmetry between some cases of stigma and some cases of treating as superior. Rather, we should provide a nuanced account of the circumstances in which either phenomenon is detrimental for self-presentation. (shrink)

"I would like to address the nature of transgression and its logic or itinerary in Sade's work. If this task is somewhat speculative and incomplete, it perhaps mirrors the foundational incompleteness of the more than sixteen extant volumes of Sade's writings. For a more exhaustive, if not definitive, resolution of the very issue of transgression, the analysis would have to continue the debate between Derrida and Foucault over the validity of Bataille's celebrated account of transgression, which in turn draws upon (...) the earlier work of Roger Caillois." (opening paragraph of the article). (shrink)

Jan Westerhoff defends an account of thoroughgoing non-foundationalism that he calls “irrealism,” which is implicitly modeled on a Madhyamaka Buddhist view. In this paper, I begin by raising worries about the irrealist’s account of human cognition as taking place in a brain-based representational interface. Next, I pose first-order and higher-order challenges to how the irrealist—who defends a kind of global error theory—can sensibly accommodate an unlocalized appearance-reality distinction, both metaphysically and epistemologically. Finally, although Westerhoff insists that irrealism itself is not (...) an ontological theory and that the irrealist’s rejection of absolutely general quantification precludes his commitment to any ultimately true theories, I propose strategies inspired by the Svātantrika commentarial tradition of Madhyamaka for how the irrealist might develop a lightweight account of unrestricted quantification that could be used to advance a lightweight ultimately true theory. This, I suggest, may allow the irrealist to (i) preserve a commitment to an unlocalized appearance-reality distinction, (ii) underwrite a distinction between ordinary veridical states and metaphysically accurate epistemic states, and (iii) provide an explanation for the massive error that he claims characterizes ordinary cognition. (shrink)

Longchen Rabjampa (1308–64), scholar of the Tibetan Buddhist Nyingma tradition, presents a novel doxographical taxonomy of the so-called Svātantrika branch of Madhyamaka Buddhist philosophy, designating the Indian Mādhyamika Śrīgupta (c. 7th/8th century) as the exemplar of a Svātantrika sub-school which maintains that appearance and emptiness are metaphysically distinct. This paper compares Longchenpa’s characterization of this “distinct-appearance-and-emptiness” view with Śrīgupta’s own account of the two truths. I expose a significant disconnect between Longchenpa’s Śrīgupta and Śrīgupta himself and argue that the impetus (...) for Longchenpa’s doxographical innovation originates not in Buddhist India, but within his own Tibetan intellectual milieu, tracing back to his twelfth-century Sangpu Monastery predecessors, Gyamarwa and Chapa. (shrink)

This paper aims to provide a roadmap to AI governance. In contrast to the reigning paradigms, we argue that AI governance should not be merely a reactive, punitive, status-quo-defending enterprise, but rather the expression of an expansive, proactive vision for technology—to advance human flourishing. Advancing human flourishing in turn requires democratic/political stability and economic empowerment. Our overarching point is that answering questions of how we should govern this emerging technology is a chance not merely to categorize and manage narrow risk (...) but also to construe the risks and opportunities much more broadly, and to make correspondingly large investments in public goods, personnel, and democracy itself. To lay out this vision, we take four steps. First, we define some central concepts in the field, disambiguating between forms of technological harms and risks. Second, we review normative frameworks governing emerging technology that are currently in use around the globe. Third, we outline an alternative normative framework based in power-sharing liberalism. Fourth, we walk through a series of governance tasks that ought to be accomplished by any policy framework guided by our model of power-sharing liberalism. We follow these with proposals for implementation vehicles. (shrink)

Trenton Merricks argues for and defends a novel version of primitivism about truth : being true is a primitive monadic but non-intrinsic property. This examination consists of the following triad: a critical discussion of Merricks’ argument for his view, a rejection of his objection against Paul Horwich’s minimalist theory of truth, and a direct objection against his view on the grounds that it entails being true is a mysterious and suspicious property. The conclusion is that Merricks’ primitivism should be rejected.

Critical Notice of Kant's Transcendental Deduction, by Henry Allison. Oxford: Oxford University Press, 2015. Pp. Xv + 477.

In a recent discussion, Trenton Merricks concludes that we cannot understand how God might miraculously bring it about that there will be the resurrection of the body. It is contended to the contrary, that it is not utterly mysterious how God might give us our bodies back.

It is difficult to overstate the importance of freedom in Kant's critical philosophy, and there are few scholars whose expertise on this subject could rival Henry E. Allison's. In this magisterial commentary, Allison meticulously chronicles the development of Kant's theory of freedom from his earliest pre-critical works all the way through the Metaphysics of Morals. Great care is taken to explain how and why Kant's views changed over time, and Allison provides compelling, sympathetic interpretations at every turn. (...) The first four chapters deal with Kant's pre-critical writings and his lectures on metaphysics and ethics from the 1760s. The general narrative here is likely to be a familiar one for the target audience... (shrink)

In this paper I offer a counterexample to the so called vagueness argument against restricted composition. This will be done in the lines of a recent suggestion by Trenton Merricks, namely by challenging the claim that there cannot be a sharp cut-off point in a composition sequence. It will be suggested that causal powers which emerge when composition occurs can serve as an indicator of such sharp cut-off points. The main example will be the case of a heap. It seems (...) that heaps might provide a very plausible counterexample to the vagueness argument if we accept the idea that four grains of sand is the least number required to compose a heap—the case has been supported by W. D. Hart. My purpose here is not to put forward a new theory of composition, I only wish to refute the vagueness argument and point out that we should be wary of arguments of its form. (shrink)

The Doctrine of Microphysical Supervenience states that microphysical duplicates cannot differ in their intrinsic properties. According to Merricks :59–71, 1998a, Objects and persons, Oxford University Press, 2001), however, this thesis is false, since microphysical duplicates can differ with respect to the intrinsic property of consciousness. In my view, Merricks’ argument is plausible, and extant attempts to reject it are problematic. However, the argument also threatens to make consciousness appear mysterious, by implying that consciousness facts fail to be microphysically determined and (...) that there can be brute and inexplicable differences in consciousness between material things. The paper therefore develops an account that can respect the soundness of Merricks’ argument while avoiding these problematic consequences. At the heart of the proposal is the idea that consciousness can be microphysically grounded despite failing to microphysical supervene. The proposed view also has the interesting consequence that consciousness is an intrinsic property despite depending on extrinsic factors for its instantiation. (shrink)

Ted Sider argues that nihilism about objects is incompatible with the metaphysical possibility of gunk and takes this point to show that nihilism is flawed. I shall describe one kind of nihilism able to answer this objection. I believe that most of the things we usually encounter do not exist. That is, I take talk of macroscopic objects and macroscopic properties to refer to sets of fundamental properties, which are invoked as a matter of linguistic convention. This view is a (...) kind of nihilism : it rules out the existence of objects; that is, from an ontological point of view, there are no objects. But unlike the moderate nihilism of Mark Heller, Peter van Inwagen and Trenton Merricks that claims that most objects do not exist, I endorse a radical nihilism according to which there are no objects in the world, but only properties instantiated in spacetime. As I will show, radical nihilism is perfectly compatible with the metaphysical possibility of gunk. It is also compatible with the epistemic possibility that we actually live in a gunk world. The objection raised by Ted Sider only applies to moderate nihilism that admits some objects in its ontology. (shrink)