Addressing Consent Issues in Donation After Circulatory Determination of Death

Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients.     

A Logical Transmission Principle for Conclusive Reasons

Dretske's conclusive reasons account of knowledge is designed to explain how epistemic closure can fail when the evidence for a belief does not transmit to some of that belief's logical consequences. Critics of Dretske dispute the argument against closure while joining Dretske in writing off transmission. This paper shows that, in the most widely accepted system for counterfactual logic (David Lewis's system VC), conclusive reasons are governed by an informative, non-trivial, logical transmission principle. If r is a conclusive reason for believing p in Dretske's sense, and if p logically implies q, and if p and q satisfy one additional condition, it follows that r is a conclusive reason for believing q. After introducing this additional condition, I explain its intuitive import and use the condition to shed new light on Dretske's response to scepticism, as well as on his distinction between the so-called ‘lightweight’ and ‘heavyweight’ implications of a piece of perceptual knowledge.     

Disagreement and Intellectual Scepticism

Several philosophers have recently argued that disagreement with others undermines or precludes epistemic justification for our opinions about controversial issues (e.g. political, religious, and philosophical issues). This amounts to a fascinating and disturbing kind of intellectual scepticism. A crucial piece of the sceptical argument, however, is that our opponents on such topics are epistemic peers. In this paper, I examine the reasons for why we might think that our opponents really are such peers, and I argue that those reasons are either (a) too weak or (b) too strong, implying absurd conclusions. Thus, there is not a compelling case for disagreement-based intellectual scepticism.     

Assertion,Complexity, and Sincerity

The target of this paper is the ‘simple’ knowledge account of assertion, according to which assertion is constituted by a single epistemic rule of the form ‘One must: assert p only if one knows p’ (where p is a proposition). My aim is to argue that those who are attracted to a knowledge account of assertion should prefer what I call the ‘complex’ knowledge account, according to which assertion is constituted by a system of rules all of which are, taken together, constitutive of assertion. One of those rules—which, following John Searle, I call the ‘preparatory condition’—is of the form ‘One must: assert p only if one knows p.’ All else being equal, simple accounts are preferable to complex accounts. I argue in this paper that all else isn't equal. While the simple knowledge account provides an elegant explanation of certain data, it is hard to see how to integrate the simple knowledge account into a more general theory of illocutionary acts. Because the complex knowledge account avoids this objection while explaining the same data as the simple knowledge account does, I conclude that the complex knowledge account is superior to the simple knowledge account.     

Peer Disagreement and Two Principles of Rational Belief

This paper presents a new solution to the problem of peer disagreement that distinguishes two principles of rational belief, here called probability and autonomy. When we discover that we disagree with peers, there is one sense in which we rationally ought to suspend belief, and another in which we rationally ought to retain our original belief. In the first sense, we aim to believe what is most probably true according to our total evidence, including testimony from peers and authorities. In the second, we aim to base our beliefs only on objective evidence and argumentation, even if that lowers the probability of their being true. The first principle of rational belief tends to serve the short-term epistemic interests of individuals, while the second tends to serve the long-term epistemic interests of both individuals and groups. The best way to reconcile these principles in cases of peer disagreement is to associate them with two corresponding species of belief, here called perception and opinion.     

Unique Best Deserver Theory and Arguments From Misclassification

It is a core commitment of Epistemic Two-Dimensionalism (E2D) that an utterance is 1-necessary iff it is a priori. But Jeff Speaks's Argument from Misclassification proves that, on a natural interpretation, E2D assigns necessary 1-intensions to many utterances that speakers deem a posteriori. Given that 1-intensions are meant to formalize a speaker's own understanding of the words she utters, this proof raises serious difficulties for E2D. In response, Elliott, McQueen, and Weber point out that the Argument from Misclassification presupposes a controversial theory of reference-fixation for proper names and argue that E2Dists ought to reject this theory. They discuss three alternatives to the theory that render E2D immune to the Argument from Misclassification. I demonstrate here that each of these alternatives either (i) replicates the faults of the original theory by assigning necessary 1-intensions to a posteriori utterances, or (ii) makes 1-intensions creatures of darkness. I argue that, although the Argument from Misclassification does indeed rely on a controversial theory of reference-fixation, Elliott, McQueen, and Weber have indicated no promising alternative to this theory.     

前瞻记忆年老化研究的自然情境和实验室情境比较

年龄—前瞻记忆矛盾现象在实验室情境和自然情境研究中普遍存在。当任务设置为日常情境时, 前瞻记忆不受年龄影响或随年龄增长而促进, 前瞻记忆成绩可能受人格、生活方式、任务材料、提示等因素的影响; 当任务是实验室情境设置时, 与年轻被试相比, 老年被试前瞻记忆成绩一般都较差, 前瞻记忆成绩可能受回溯记忆负载、线索类型和策略控制加工的需求等因素的影响。年龄-前瞻记忆矛盾现象可能来自于环境与意向的社会性特征、认知资源分配策略等方面的原因。最后, 从被试控制、任务材料的设置、动机因素的探索等方面对今后的研究提出建议和展望。     

On Wittgenstein's Kantian solution of the problem of philosophy

In 1931 Wittgenstein wrote: ‘the limit of language manifests itself in the impossibility of describing the fact that corresponds to (is the translation of) a sentence without simply repeating the sentence’. Here, Wittgenstein claims, ‘we are involved?…?with the Kantian solution of the problem of philosophy’. This paper shows how this remark fits with Wittgenstein's early account of the substance of the world, his account of logic, and ultimately his view of philosophy. By contrast to the currently influential resolute reading of the Tractatus, the paper argues that the early Wittgenstein did not aim at destroying the idea of a limit of language, but that the notion lies at the very heart of Wittgenstein's early view. In doing so, the paper employs and defends the Kantian interpretation of Wittgenstein's early philosophy.     

Psychological availability and work engagement: The moderating role of sex and race

This study sought to determine the relationship of sex and race as moderators of psychological availability on work engagement in various South African organisations. Participants were 1 059 employees predominantly from the corporate sector in Gauteng province (females = 61%, blacks = 36%). Cross-sectional survey data were collected from the employees using the Psychological Conditions Scale and the Utrecht Work Engagement Scale (UWES). Moderated hierarchical regression analyses tested the prediction of work engagement from psychological availability, while controlling for the sex and race of employees. Psychological availability increased the level of work engagement for both men and women, the relationship, however, was stronger for women as compared to men. White employees were less work engaged compared to other race group members. Psychological availability was higher for the black, Indian, and coloured employees compared to white employees. The results confirmed the positive relationship of psychological availability on work engagement, and that sex and race differences exist for employees in a developing country.