The use of evidence in medicine is something we should continuously seek to improve. This book seeks to develop our understanding of evidence of mechanism in evaluating evidence in medicine, public health, and social care; and also offers tools to help implement improved assessment of evidence of mechanism in practice. In this way, the book offers a bridge between more theoretical and conceptual insights and worries about evidence of mechanism and practical means to fit the results into evidence assessment procedures.

Recent philosophical literature has turned its attention towards assessments of how to judge scientific proposals as worthy of further inquiry. Previous work, as well as papers contained within this special issue, propose criteria for pursuitworthiness (Achinstein, 1993; Whitt, 1992; DiMarco & Khalifa, 2019; Laudan, 1977; Shan, 2020; Šešelja et al., 2012). The purpose of this paper is to assess the grounds on which pursuitworthiness demands can be legitimately made. To do this, I propose a challenge to the possibility of even (...) minimal criteria of pursuitworthiness, inspired by Paul Feyerabend. I go on to provide a framework for identifying the contexts in which pursuitworthiness criteria may promote the efficiency of scientific inquiry. I then spell out some implications this framework has for values and pursuit. (shrink)

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Ethics at the centre of global and local challenges. For much of the history of the Journal of Business Ethics, ethics was seen within the academy as a peripheral aspect of business. However, in (...) recent years, the stakes have risen dramatically, with global and local worlds destabilized by financial crisis, climate change, internet technologies and artificial intelligence, and global health crises. The authors of these commentaries address these grand challenges by placing business ethics at their centre. What if all grand challenges were framed as grand ethical challenges? Tanusree Jain, Arno Kourula and Suhaib Riaz posit that an ethical lens allows for a humble response, in which those with greater capacity take greater responsibility but remain inclusive and cognizant of different voices and experiences. Focussing on business ethics in connection to the grand challenge of environmental emergencies, Steffen Böhm introduces the deceptively simple yet radical position that business is nature, and nature is business. His quick but profound side-step from arguments against human–nature dualism to an ontological undoing of the business–nature dichotomy should have all business ethics scholars rethinking their “business and society” assumptions. Also, singularly concerned with the climate emergency, Boudewijn de Bruin posits a scenario where, 40 years from now, our field will be evaluated by its ability to have helped humanity emerge from this emergency. He contends that Milieudefensie v. Royal Dutch Shell illustrates how human rights take centre stage in climate change litigation, and how business ethics enters the courtroom. From a consumer ethics perspective, Deirdre Shaw, Michal Carrington and Louise Hassan argue that ecologically sustainable and socially just marketplace systems demand cultural change, a reconsideration of future interpretations of “consumer society”, a challenge to the dominant “growth logic” and stimulation of alternative ways to address our consumption needs. Still concerned with global issues, but turning attention to social inequalities, Nelarine Cornelius links the capability approach to global and corporate governance, arguing that CA will continue to lie at the foundation of human development policy, and, increasingly, CSR and corporate governance. Continuing debate on the grand challenges associated with justice and equality, Laurence Romani identifies a significant shift in the centrality of business ethics in debates on managing differences, positing that dialogue between diversity management and international management can ground future debate in business ethics. Finally, the essay concludes with a commentary by Charlotte Karam and Michelle Greenwood on the possibilities of feminist-inspired theories, methods, and positionality for many spheres of business ethics, not least stakeholder theory, to broaden and deepen its capacity for nuance, responsiveness, and transformation. In the words of our commentators, grand challenges must be addressed urgently, and the Journal of Business Ethics should be at the forefront of tackling them. (shrink)

"[This] book guides readers in thinking deeply about important moral issues that frequently arise in business situations and helps them develop the reasoning and analytical skills to resolve those issues. Combining insightful and accessible textbook chapters by the authors, cases that highlight the real-world importance of key ethical concepts, and reading selections from the most influential voices in contemporary ethical debates, this book provides a comprehensive, flexible, and pedagogically proven course of study exploring the intersections of commerce and ethics."--Book cover.

Combining engaging discussions and stimulating new case studies, BUSINESS ETHICS: A TEXTBOOK WITH CASES gives students a comprehensive survey of business ethics that will guide them toward becoming ethical professionals, even if they have never studied philosophy before. Rich with real-world examples, BUSINESS ETHICS: A TEXTBOOK WITH CASES invites students to critically analyze and apply a broad range of philosophical concepts and principles to today's most important issues in business and beyond. BUSINESS ETHICS: A TEXTBOOK WITH CASES is a concise (...) (without readings) and updated version of the eleventh edition of MORAL ISSUES IN BUSINESS. BUSINESS ETHICS: A TEXTBOOK WITH CASES is also available in an eBook format. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

Many philosophers have suggested that claims of need play a special normative role in ethical thought and talk. But what do such claims mean? What does this special role amount to? Progress on these questions can be made by attending to a puzzle concerning some linguistic differences between two types of 'need' sentence: one where 'need' occurs as a verb, and where it occurs as a noun. I argue that the resources developed to solve the puzzle advance our understanding of (...) the metaphysics of need, the meaning of 'need' sentences, and the function of claims of need in ethical discourse. (shrink)

It is often taken for granted that our desires can contribute to what it is rational for us to do. This paper examines an account of desire—the ‘guise of the good’— that promises an explanation of this datum. I argue that extant guise-of-the-good accounts fail to provide an adequate explanation of how a class of desires—basic desires—contributes to practical rationality. I develop an alternative guise-of-the-good account on which basic desires attune us to our reasons for action in virtue of their (...) biological function. This account emphasises the role of desire as part of our competence to recognise and respond to normative reasons. (shrink)

Aimed at undergraduates, _Contemporary Ethics_ presupposes little or no familiarity with ethics and is written in a clear and engaging style. It provides students with a sympathetic but critical guide to utilitarianism, explaining its different forms and exploring the debates it has spawned. The book leads students through a number of current issues in contemporary ethics that are connected to controversies over and within utilitarianism. At the same time, it uses utilitarianism to introduce students to ethics as a subject. In (...) these ways, the book is not only a guide to utilitarianism, but also an introduction to some standard problems of ethics and to several important topics in contemporary ethical theory. (shrink)

Advances in neuroscience might make it possible to develop techniques for directly altering offenders’ brains, in order to make offenders more responsible and law-abiding. The idea of using such techniques within the criminal justice system can seem intuitively troubling, even if they were more effective in preventing crime than traditional methods of rehabilitation. One standard argument against this use of brain interventions is that it would undermine the individual’s free will. This paper maintains that ‘free will’ (at least, as that (...) notion is understood by those who adopt the influential compatibilist approach) is an inadequate basis for explaining what is problematic about some direct brain interventions. This paper then defends an alternative way of objecting to certain kinds of direct brain interventions, focusing on the relationship between the offender and the state rather than the notion of free will. It opposes the use of interventions which aim to enhance ‘virtue responsibility’ (by instilling particular values about what is right and wrong), arguing that this would objectify offenders. In contrast, it argues that it may be acceptable to use direct brain interventions to enhance ‘capacity responsibility’ (i.e. to strengthen the abilities necessary for the exercise of responsible agency, such as self-control). Finally it considers how to distinguish these different kinds of responsibility enhancement. (shrink)

Slurring expressions display puzzling behaviour when embedded, such as under negation and in attitude and speech reports. They frequently appear to retain their characteristic qualities, like offensiveness and propensity to derogate. Yet it is sometimes possible to understand them as lacking these qualities. A theory of slurring expressions should explain this variability. We develop an explanation that deploys the linguistic notion of focus. Our proposal is that a speaker can conversationally implicate metalinguistic claims about the aptness of a focused slurring (...) expression. This explanation of variability relies on independently motivated mechanisms and is compatible with any theory of slurring expressions. (shrink)

Artificial intelligence (AI) based clinical decision support systems (CDSS) are becoming ever more widespread in healthcare and could play an important role in diagnostic and treatment processes. For this reason, AI‐based CDSS has an impact on the doctor–patient relationship, shaping their decisions with its suggestions. We may be on the verge of a paradigm shift, where the doctor–patient relationship is no longer a dual relationship, but a triad. This paper analyses the role of AI‐based CDSS for shared decision‐making to better (...) comprehend its promises and associated ethical issues. Moreover, it investigates how certain AI implementations may instead foster the inappropriate paradigm of paternalism. Understanding how AI relates to doctors and influences doctor–patient communication is essential to promote more ethical medical practice. Both doctors' and patients' autonomy need to be considered in the light of AI. (shrink)

The present studies investigate how the intentions of third parties influence judgments of moral responsibility for other agents who commit immoral acts. Using cases in which an agent acts under some situational constraint brought about by a third party, we ask whether the agent is blamed less for the immoral act when the third party intended for that act to occur. Study 1 demonstrates that third-party intentions do influence judgments of blame. Study 2 finds that third-party intentions only influence moral (...) judgments when the agent's actions precisely match the third party's intention. Study 3 shows that this effect arises from changes in participants' causal perception that the third party was controlling the agent. Studies 4 and 5, respectively, show that the effect cannot be explained by changes in the distribution of blame or perceived differences in situational constraint faced by the agent. (shrink)

The theories of reasoned action and planned behaviour have fundamentally changed the view that attitudes directly translate into behaviour by introducing intentions as a crucial intervening stage. Much research across numerous ethical contexts has drawn on these theories to offer a better understanding of how consumers form intentions to act in an ethical way. Persistently, researchers have suggested and discussed the existence of an intention–behaviour gap in ethical consumption. Yet, the factors that influence the extent of this gap and its (...) magnitude have not been systematically examined. We, therefore, contribute to the debate on the intention–behaviour gap by reviewing the empirical TRA/tpb studies that have assessed both intention and behaviour in ethical contexts. The findings from our review show that few studies assessed the intention–behaviour relationship and as a result, there is limited empirical evidence to date to quantify more accurately the intention–behaviour gap in ethical consumption. Our second contribution aims to provide an empirical case study which assesses the magnitude of the intention–behaviour gap in the context of avoidance of sweatshop clothing and to assess the roles of planning and actual behavioural control in potentially reducing the intention–behaviour gap. The findings of our case study suggest that there is indeed a large gap between intention and behaviour, and we conclude by calling for more empirical longitudinal studies to assess the complex nature of the relationship between intention and behaviour. (shrink)

In this paper we argue that greater attention must be given to peoples’ expression of “care” in relation to consumption. We suggest that “caring about” does not necessarily lead to “care-giving,” as conceptualising an attitude–behaviour gap might imply, but that a closer examination of the intensity, morality, and articulation of care can lead to a greater understanding of consumer narratives and, thus, behaviour. To examine this proposition, a purposive sample of self-identified ethical consumers was interviewed. Care is expressed by the (...) study’s participants in a variety of ways and linked to behaviour through diverse patterns that includes consumption and abstention. We find significant correspondence between the academic literature on the ‘ethics of care’ and our participants’ articulation of their ethical consumption behaviours. We suggest, therefore, that a close understanding of an ethics of care among consumers is important both in providing insight into the attitude–behaviour gap challenge evident in the literature and to the continued development of an ethical consumption discourse. (shrink)

Background Our objective was to evaluate whether the description of a machine learning (ML) app or brain imaging technology to predict the onset of schizophrenia or alcohol use disorder (AUD) influences healthcare professionals’ judgments of stigma, empathy, and compassion. Methods We randomized healthcare professionals (N = 310) to one vignette about a person whose clinician seeks to predict schizophrenia or an AUD, using a ML app, brain imaging, or a psychosocial assessment. Participants used scales to measure their judgments of stigma, (...) empathy, and compassion. Results Participants randomized to the ML vignette endorsed less anger and more fear relative to the psychosocial vignette, and the brain imaging vignette elicited higher pity ratings. The brain imaging and ML vignettes evoked lower personal responsibility judgments compared to the psychosocial vignette. Physicians and nurses reported less empathy than clinical psychologists. Conclusions The use of predictive technologies may reinforce essentialist views about mental health and substance use that may increase specific aspects of stigma and reduce others. (shrink)

Researchers often refer to “research integrity”, “scientific integrity”, “research misconduct”, “scientific misconduct” and “research ethics”. However, they may use some of these terms interchangeably despite conceptual distinctions. The aim of this paper is to clarify what is signified by several key terms related to research integrity, and to suggest clearer conceptual delineation between them. To accomplish this task, it provides a conceptual analysis based upon definitions and general usage of these phrases and categorization of integrity-breaching behaviours in literature and guidelines, (...) including clarification of the different domains and agents involved. In the first part of the analysis, following some initial clarifications, I explore the distinction between internal and external rules of integrity. In the second part, I explore the distinction between integrity and lack of misconduct, before suggesting a recategorisation of different types of integrity breach. I conclude that greater clarity is needed in the debate on research integrity. Distinguishing between scientific and research integrity, reassessing the relative gravity of different misbehaviours in light of this distinction, and recognising all intentional breaches of integrity as misconduct may help to improve guidelines and education. (shrink)

Facts about need play some role in our causal understanding of the world. We understand, for example, that people have basic needs for food, water and shelter, and that people come to be harmed because those needs go unmet. But what are needs? How do explanations in terms of need fit into our broader causal understanding of the world? This paper provides an account of need attribution, their contribution to causal explanations, and their relation to disposition attribution.

The authors argue that corporate philanthropy is far too important as a social instrument for good to depend on ethical egoism for its support. They claim that rule utilitarianism provides a more compelling, though not exclusive, moral foundation. The authors cite empirical and legal evidence as additional support for their claim.

Feyerabend is infamous for his defense of pluralism, which he extends to every topic he discusses. Disagreement, a by-product of this pluralism, becomes a sign of flourishing critical communities. In Feyerabend’s political works, he extends this pluralism from science to democratic societies and incorporates his earlier work on scientific methodology into a procedure for designing just policy. However, a description and analysis of Feyerabend’s conception of disagreement is lacking. In this paper, I reconstruct and assess Feyerabend’s conception of disagreement, with (...) a particular emphasis on the role of experts, and its role in the formation of science policy. I go on to assess this argument in light of recent literature on manufactured disagreement on politically contentious science policy. I conclude by suggesting some prospects and problems for de-idealizing Feyerabend’s position on disagreement to see whether it may be plausibly implemented. (shrink)

To anyone vaguely aware of Feyerabend, the title of this paper would appear as an oxymoron. For Feyerabend, it is often thought, science is an anarchic practice with no discernible structure. Against this trend, I elaborate the groundwork that Feyerabend has provided for the beginnings of an approach to organizing scientific research. Specifically, I argue that Feyerabend’s pluralism, once suitably modified, provides a plausible account of how to organize science. These modifications come from C.S. Peirce’s account of the economics of (...) theory pursuit, which has since been corroborated by empirical findings in the social sciences. I go on to contrast this approach with the conception of a ‘well-ordered science’ as outlined by Kitcher (Science, truth, and democracy, Oxford University Press, New York, 2001), Cartwright (Philos Sci 73(5):981–990, 2006), which rests on the assumption that we can predict the content of future research. I show how Feyerabend has already given us reasons to think that this model is much more limited than it is usually understood. I conclude by showing how models of resource allocation, specifically those of Kitcher (J Philos 87:5–22, 1990), Strevens (J Philos 100(2):55–79, 2003) and Weisberg and Muldoon (Philos Sci 76(2):225–252, 2009), unwittingly make use of this problematic assumption. I conclude by outlining a proposed model of resource allocation where funding is determined by lottery and briefly examining the extent to which it is compatible with the position defended in this paper. (shrink)

The goal of this book is to develop a new approach to reading the rule-following sections guided by a simple idea. The simple idea is that Wittgenstein's remarks on rule-following are split between two distinct but complementary projects. The projects are marked not only by different guiding questions, but different presuppositions and methodologies. There is of course precedent for reading the rule-following remarks as comprising two parts. For example, there is the reading of (S. Kripke 1982) on which Wittgenstein first (...) presents a skeptical challenge before turning to its skeptical solution. And there are readings like (Minar 2011) and (Goldfarb 2012) that likewise treat the sections as roughly divided into two components or "chapters." But even these commentators do not explicitly associate their components with different questions and associated methodologies, and so fall short of attributing to Wittgenstein's text anything quite like the thoroughgoing bipartite structure I will be proposing here. (shrink)

Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

Medical interventions such as methadone treatment for drug addicts or “chemical castration” for sex offenders have been used in several jurisdictions alongside or as an alternative to traditional punishments, such as incarceration. As our understanding of the biological basis for human behaviour develops, our criminal justice system may make increasing use of such medical techniques and may become less reliant on incarceration. Academic debate on this topic has largely focused on whether offenders can validly consent to medical interventions, given the (...) coercive environment of the criminal justice system. Both sides in this debate share the assumption that administering medical interventions to offenders without their valid consent would be unethical. Recently, Thomas Douglas has mounted a formidable challenge to this “consent requirement”. Essentially, his argument rests on a comparison between prison and medical interventions. Douglas asks: if the state is entitled to impose a prison sentence on a criminal without the criminal’s consent, why is consent required for the imposition of a medical intervention? The most obvious way of defending the consent requirement against Douglas’s challenge appeals to the fact that incarceration merely interferes with the right to free movement, but medical interventions interfere with the right to bodily integrity. This argument rests on what Douglas calls the “robustness claim”—the claim that the right to bodily integrity is more robust than the right to freedom of movement. In other words, the right to freedom of movement loses its protective force in a wider range of circumstances than the right to bodily integrity. Douglas’s article seeks to undermine the robustness claim, by arguing that neither case-based intuitions, nor theoretical considerations support this claim. In this article, I will attempt to raise some doubts about Douglas’s challenge to the consent requirement and the robustness claim. (shrink)

Informed consent is at the core of the clinical relationship. With the introduction of machine learning (ML) in healthcare, the role of informed consent is challenged. This paper addresses the issue of whether patients must be informed about medical ML applications and asked for consent. It aims to expose the discrepancy between ethical and practical considerations, while arguing that this polarization is a false dichotomy: in reality, ethics is applied to specific contexts and situations. Bridging this gap and considering the (...) whole picture is essential for advancing the debate. In the light of the possible future developments of the situation and the technologies, as well as the benefits that informed consent for ML can bring to shared decision-making, the present analysis concludes that it is necessary to prepare the ground for a possible future requirement of informed consent for medical ML. (shrink)

Background Structured training in research integrity, research ethics and responsible conduct of research is one strategy to reduce research misconduct and strengthen reliability of and trust in scientific evidence. However, how researchers develop their sense of integrity is not fully understood. We examined the factors and circumstances that shape researchers’ understanding of research integrity. Methods This study draws insights from in-depth, semi-structured interviews with 33 researchers in the life sciences and medicine, representing three seniority levels across five research universities in (...) Switzerland. Results The results of this study indicate that early education, moral values inculcated by the family and participation in team sports were the earliest influences on notions of honesty, integrity and fairness among researchers. Researchers’ personality traits, including degree of ambition and internal moral compass, were perceived as critical in determining the importance they attributed to conducting research with high ethical standards. Positive and negative experiences in early research life also had a significant impact on their views regarding research integrity. Two thirds of the study participants had not received any formal training in research integrity. Their awareness of training opportunities at their institutions was also limited. Conclusion Age-appropriate development of honesty and integrity starts as early as primary education. Research integrity training should be offered from the bachelors level and continue throughout the entire professional life of researchers. Although these courses may not imbue researchers with integrity itself, they are essential to improving the research culture, reinforcing integrity norms, and discouraging researchers who lack personal integrity from engaging in research misconduct. (shrink)

_Theurgy and the Soul_ is a study of Iamblichus of Syria, whose teachings set the final form of pagan spirituality prior to the Christianization of the Roman Empire. Gregory Shaw focuses on the theory and practice of theurgy, the most controversial and significant aspect of Iamblichus's Platonism. Theurgy literally means "divine action." Unlike previous Platonists who stressed the elevated status of the human soul, Iamblichus taught that the soul descended completely into the body and thereby required the performance of theurgic (...) rites—revealed by the gods—to unite the soul with the One. Iamblichus was once considered one of the great philosophers whose views on the soul and the importance of ritual profoundly influenced subsequent Platonists such as Proclus and Damascius. The Emperor Julian followed Iamblichus's teachings to guide the restoration of traditional pagan cults in his campaign against Christianity. Although Julian was unsuccessful, Iamblichus's ideas persisted well into the Middle Ages and beyond. His vision of a hierarchical cosmos united by divine ritual became the dominant world view for the entire medieval world and played an important role in the Renaissance Platonism of Marsilio Ficino. Even Ralph Waldo Emerson wrote that he expected a reading of Iamblichus to cause a "revival in the churches." But modern scholars have dismissed him, seeing theurgy as ritual magic or "manipulation of the gods." Shaw, however, shows that theurgy was a subtle and intellectually sophisticated attempt to apply Platonic and Pythagorean teachings to the full expression of human existence in the material world. (shrink)

From the 1970s onwards, Feyerabend argues against the freedom of science. This will seem strange to some, as his epistemological anarchism is often taken to suggest that scientists should be free of even the most basic and obvious norms of science. His argument against the freedom of science is heavily influenced by his case study of the interference of Chinese communists in mainland China during the 1950s wherein the government forced local universities to continue researching traditional Chinese medicine rather than (...) Western medicine. Feyerabend claims this move was justifiable and, eventually, vindicated by the resulting research which was beneficial for locals and the West at large. The purpose of this paper is to provide a comprehensive overview and analysis on Feyerabend’s views on the freedom of science and his social commentary on US science funding policy that follows therefrom. This proves to be exceedingly difficult because Feyerabend’s writings on the subject are filled with gaps, unnoticed tensions, and cognitive dissonance. Still, I think Feyerabend’s scattered insights and the contradictions that emerge lead to an interesting microcosm of the issues contained in the freedom of science debate. (shrink)

Blackmail raises a pair of parallel legal and moral problems, sometimes referred to as the "paradox of blackmail". It is sometimes legal and morally permissible to ask someone for money, or to threaten to release harmful information about them, while it is illegal and morally impermissible to do these actions jointly. I address the moral version of this paradox by bringing instances of blackmail under a general account of wrongful coercion. According to this account, and contrary to the appearances which (...) give rise to the paradox, threatening the release of harmful information to constrain another's actions is almost never morally impermissible unless it is likewise impermissible to carry out one's threat. To defend this claim I identify a special wrong that arises in the paradoxical cases of threatened information release. The account also resolves a number of other puzzles about blackmail—for example, why profiting from a threat in blackmail can sometimes be impermissible, even though accepting identical payment from an independent offer to retain the same information can be permissible. (shrink)

This article provides a systematic analysis of the proposal to use Covid‐19 vaccination status as a criterion for admission of patients with Covid‐19 to intensive care units (ICUs) under conditions of resource scarcity. The general consensus is that it is inappropriate to use vaccination status as a criterion because doing so would be unjust; many health systems, including the UK National Health Service, are based on the principle of equality of access to care. However, the analysis reveals that there are (...) several unique features of Covid vaccination status in the context of a pandemic that make this issue disanalogous to cases (such as lung cancer caused by smoking) discussed previously. First, there is equality in access to care at the point of vaccination; the unvaccinated refuse the offer of preventive care when they decline vaccination, weakening their claim to ongoing care if they become ill (this is qualitatively different from ‘poor lifestyle choices’ such as smoking). Second, the decision of one person to refuse vaccination substantially increases the risk that they will become seriously ill and need ICU care; the person who chooses not to get vaccinated thus potentially increases the pressure on intensive care bed provision, as well as increasing the risk that he or she will infect others who in turn might end up needing ICU care. Third, justice cuts both ways, and giving unvaccinated patients equal priority may itself be unjust when other patients have reduced their risk of ending up on the ICU by getting vaccinated. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...) can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Desire satisfaction has not received detailed philosophical examination. Yet intuitive judgments about the satisfaction of desires have been used as data points guiding theories of desire, desire content, and the semantics of ‘desire’. This paper examines desire satisfaction and the standard propositional view of desire. Firstly, I argue that there are several distinct concepts of satisfaction. Secondly, I argue that separating them defuses a difficulty for the standard view in accommodating desires that Derek Parfit described as ‘implicitly conditional on their (...) own persistence’, a problem posed by Shieva Kleinschmidt, Kris McDaniel, and Ben Bradley. The solution undercuts a key motivation for rejecting the standard view in favour of more radical accounts proposed in the literature. (shrink)

Applications of artificial intelligence/machine learning in health care are dynamic and rapidly growing. One strategy for anticipating and addressing ethical challenges related to AI/ml for health care is patient and public involvement in the design of those technologies – often referred to as ‘co-design’. Co-design has a diverse intellectual and practical history, however, and has been conceptualized in many different ways. Moreover, AI/ml introduces challenges to co-design that are often underappreciated. Informed by perspectives from critical data studies and critical digital (...) health studies, we review the research literature on involvement in health care, and involvement in design, and examine the extent to which co-design as commonly conceptualized is capable of addressing the range of normative issues raised by AI/ml for health care. We suggest that AI/ml technologies have amplified and modified existing challenges related to patient and public involvement, and created entirely new challenges. We outline three pitfalls associated with co-design for ethical AI/ml for health care and conclude with suggestions for addressing these practical and conceptual challenges. (shrink)

The ethical review of research using methods of artificial intelligence and machine learning in health care contexts has become an important challenge for Research Ethics Boards (also refer...

What determines whether an action is right or wrong? Morality, Rules, and Consequences: A Critical Reader explores for students and researchers the relationship between consequentialist theory and moral rules. Most of the chapters focus on rule consequentialism or on the distinction between act and rule versions of consequentialism. Contributors, among them the leading philosophers in the discipline, suggest ways of assessing whether rule consequentialism could be a satisfactory moral theory. These essays, all of which are previously unpublished, provide students in (...) moral philosophy with essential material and ask key questions on just what the criteria for an adequate moral theory might be. (shrink)

There has been a great deal of skepticism towards the value of the realism/anti-realism debate. More specifically, many have argued that plausible formulations of realism and anti-realism do not differ substantially in any way. In this paper, I argue against this trend by demonstrating how a hypothetical resolution of the debate, through deeper engagement with the historical record, has important implications for our criterion of theory pursuit and science policy. I do this by revisiting Arthur Fine’s ‘small handful’ argument for (...) realism and show how the debate centers on whether continuity should be an indicator for the future fruitfulness of a theory. I then demonstrate how these debates work in practice by considering the case of the Human Brain Project. I close by considering some potential practical considerations of formulating meta-inductions. By doing this, I contribute three insights to the current debate: 1) demonstrate how the realism/anti-realism debate is a substantive debate, 2) connect debates about realism/anti-realism to debates about theory choice and pursuit, and 3) show the practical significance of meta-inductions. (shrink)

This collection of new essays interprets and critically evaluates the philosophy of Paul Feyerabend. It offers innovative historical scholarship on Feyerabend's take on topics such as realism, empiricism, mimesis, voluntarism, pluralism, materialism, and the mind-body problem, as well as certain debates in the philosophy of physics. It also considers the ways in which Feyerabend's thought can contribute to contemporary debates in science and public policy, including questions about the nature of scientific methodology, the role of science in society, citizen science, (...) scientism, and the role of expertise in public policy. The volume will provide readers with a comprehensive overview of the topics which Feyerabend engaged with throughout his career, showing both the breadth and the depth of his thought. (shrink)

Cryonic suspension is a relatively new technology that offers those who can afford it the chance to be 'frozen' for future revival when they reach the ends of their lives. This paper will examine the ethical status of this technology and whether its use can be justified. Among the arguments against using this technology are: it is 'against nature', and would change the very concept of death; no friends or family of the 'freezee' will be left alive when he is (...) revived; the considerable expense involved for the freezee and the future society that will revive him; the environmental cost of maintaining suspension; those who wish to use cryonics might not live life to the full because they would economize in order to afford suspension; and cryonics could lead to premature euthanasia in order to maximize chances of success. Furthermore, science might not advance enough to ever permit revival, and reanimation might not take place due to socio-political or catastrophic reasons. Arguments advanced by proponents of cryonics include: the potential benefit to society; the ability to cheat death for at least a few more years; the prospect of immortality if revival is successful; and all the associated benefits that delaying or avoiding dying would bring. It emerges that it might be imprudent not to use the technology, given the relatively minor expense involved and the potential payoff. An adapted and more persuasive version of Pascal's Wager is presented and offered as a conclusive argument in favour of utilizing cryonic suspension. (shrink)

Philosophy and Phenomenological Research, EarlyView.

In Canada, as in many developed countries, healthcare conscientious objection is growing in visibility, if not in incidence. Yet the country's health professional policies on conscientious objection are in disarray. The article reports the results of a comprehensive review of policies relevant to conscientious objection for four Canadian health professions: medicine, nursing, pharmacy and dentistry. Where relevant policies exist in many Canadian provinces, there is much controversy and potential for confusion, due to policy inconsistencies and terminological vagueness. Meanwhile, in Canada's (...) three most northerly territories with significant Aboriginal populations, whose already precarious health is influenced by funding and practitioner shortages, there are major policy gaps applicable to conscientious objection. In many parts of the country, as a result of health professionals' conscientious refusals, access to some legal health services – including but not limited to reproductive health services such as abortion – has been seriously impeded. Although policy reform on conscientious conflicts may be difficult, and may generate strenuous opposition from some professional groups, for the sake of both patients and providers, such policy change must become an urgent priority. (shrink)

Adults apply ownership not only to objects but also to ideas. But do people come to apply principles of ownership to ideas because of being taught about intellectual property and copyrights? Here, we investigate whether children apply rules from physical property ownership to ideas. Studies 1a and 1b show that children (6–8 years old) determine ownership of both objects and ideas based on who first establishes possession of the object or idea. Study 2 shows that children use another principle of (...) object ownership, control of permission—an ability to restrict others’ access to the entity in question—to determine idea ownership. In Study 3, we replicate these findings with different idea types. In Study 4, we determine that children will not apply ownership to every entity, demonstrating that they do not apply ownership to a common word. Taken together, these results suggest that, like adults, children as young as 6 years old apply rules from ownership not only to objects but to ideas as well. (shrink)

De se exceptionalism is the view, notably championed by Perry (1979) and Lewis (1979), that our characteristically 'first-personal' ways of thinking about ourselves present unique challenges to standard views of propositional attitudes like belief. Though the view has won many adherents, it has recently come under a barrage of deserved criticism. A key claim of detractors is that classic examples used to motivate de se exceptionalism from de se ignorance or misidentification are nothing more than familiar Frege-puzzles, which raise no (...) issues exclusive to self-directed thought. After reviewing how this simple objection has substantial force against the classic defenses of exceptionalism, I provide new arguments based on cases of pure de se ignorance that avoid the criticism. Afterward, I revisit Lewis's defense of exceptionalism, diagnosing how he arrived at roughly the right conclusions on the basis of an argument that begged critical questions and obscured the representationally unique features of the de se. (shrink)

The paper highlights how a popular version of epistemological disjunctivism labors under a kind of 'internalist challenge'—a challenge that seems to have gone largely unacknowledged by disjunctivists. This is the challenge to vindicate the supposed 'internalist insight' that disjunctivists claim their view does well to protect. The paper argues that if we advance disjunctivism within a context that recognizes a distinction between merely functional and judgmental belief, we get a view that easily overcomes the internalist challenge.

This essay situates the major works of W.E.B. Du Bois and some of his minor work between the 1880s and 1940 in the historical context of black people's writing about race since the eighteenth century. In offering examples of the evolution of black thinking and writing on this topic, it views Du Bois's work in the context of Moral and Ethical Philosophy (rather than the more obvious History, Sociology, and Political Economics) in order to reveal his efforts as a disruption, (...) deliberately designed to shift the discussions of race and race relations from defense to offense, which he did most explicitly and profoundly in Dusk of Dawn (1940) but had been doing much more subtly throughout his scholarly career. (shrink)