Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 16 Heft: 1 Seiten: 179-214.

Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals disagree with the conclusions of ethical analysis. Resource allocation is considered by clinicians to be a legitimate reason to withhold but not to withdraw intensive care treatment. We analyse five arguments in favour of non-equivalence, and find only relatively (...) weak reasons to restrict rationing to withholding treatment. On the contrary, resource allocation provides a strong argument in favour of equivalence: non-equivalence causes preventable death in critically ill patients. We outline two proposals for increasing equivalence in practice: (1) reduction of the mortality threshold for treatment withdrawal, (2) time-limited trials of intensive care. These strategies would help to move practice towards more rational treatment limitation decisions. (shrink)

What role should legislation or policy play in avoiding the complications of in-vitro fertilization? In this article, we focus on single versus double embryo transfer, and assess three arguments in favour of mandatory single embryo transfer: risks to the mother, risks to resultant children, and costs to society. We highlight significant ethical concerns about each of these. Reproductive autonomy and non-paternalism are strong enough to outweigh the health concerns for the woman. Complications due to non-identity cast doubt on the extent (...) to which children are harmed. Twinning may offer an overall benefit rather than burden to society. Finally, including the future health costs for children in reproductive policy is inconsistent with other decisions. We conclude that mandatory single embryo transfer is not justified and that a number of countries should reconsider their current embryo transfer policy. (shrink)

Are there some newborn infants whose short- and long-term care costs are so great that treatment should not be provided and they should be allowed to die? Public discourse and academic debate about the ethics of newborn intensive care has often shied away from this question. There has been enough ink spilt over whether or when for the infant's sake it might be better not to provide life-saving treatment. The further question of not saving infants because of inadequate resources has (...) seemed too difficult, too controversial, or perhaps too outrageous to even consider. However, Roman Catholic ethicist Charles Camosy has recently challenged this, arguing that costs should be a primary consideration in decision-making in neonatal intensive care. In the first part of this paper I will outline and critique Camosy's central argument, which he calls the ‘social quality of life (sQOL)’ model. Although there are some conceptual problems with the way the argument is presented, even those who do not share Camosy's Catholic background have good reason to accept his key point that resources should be considered in intensive care treatment decisions for all patients. In the second part of the paper, I explore the ways in which we might identify which infants are too expensive to treat. I argue that both traditional personal ‘quality of life’ and Camosy's ‘sQOL’ should factor into these decisions, and I outline two practical proposals. (shrink)

COVID-19 vaccine requirements have generated significant debate. Here, we argue that, on the evidence available, such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. We begin by distinguishing our argument from two implausible claims about natural immunity: natural immunity is superior to ‘artificial’ vaccine-induced immunity simply because it is ‘natural’ and it is better to acquire immunity through natural infection than via vaccination. We then briefly survey the evidence base for (...) the comparison between naturally acquired immunity and vaccine-induced immunity. While we clearly cannot settle the scientific debates on this point, we suggest that we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity. Subjecting them to vaccine mandates is therefore not justified. We conclude by defending the standard of proof that this argument from necessity invokes, and address other pragmatic and practical considerations that may speak against natural immunity exemptions. There are no data in this work. (shrink)

Recent International Relations scholarship has identified ‘societal multiplicity’ as the ontological concept that gives IR its identity as an academic discipline. My article, by contrast, addresses the question: What are the consequences, that is, the positive potential and the necessary costs, of understanding multiplicity as a moral-political value in world politics? The question is important because, in contrast to the focus on multiplicity as the ontology of IR, it allows us to develop a more radically democratic idea of multiplicity as (...) a value in world politics. To address this question, I will bring Rosenberg’s conception of societal multiplicity into conversation with the radically democratic idea of Tully’s ‘strange multiplicity’ and draw out the consequences of such a normative turn. My argument is that while Rosenberg does not frame multiplicity as a value, Tully’s normative understanding of the concept harbours enormous potential to transform oppressive and dominating practices in world politics. However, I will also show that Tully’s general rejection of all forms of domination comes at a price that must not be underestimated. It is of crucial importance to get a clear picture of these consequences as we must decide whether or not this price is, ultimately, worth paying. (shrink)

This chapter contains sections titled: The Inversion Argument The Costs‐of‐Dominance Argument The Distraction Argument Defining Discrimination.

The environmental costs and energy constraints have become emerging issues for the future development of Machine Learning (ML) and Artificial Intelligence (AI). So far, the discussion on environmental impacts of ML/AI lacks a perspective reaching beyond quantitative measurements of the energy-related research costs. Building on the foundations laid down by Schwartz et al., 2019 in the GreenAI initiative, our argument considers two interlinked phenomena, the gratuitous generalisation capability and the future where ML/AI performs the majority of quantifiable inductive inferences. (...) The gratuitous generalisation capability refers to a discrepancy between the cognitive demands of a task to be accomplished and the performance (accuracy) of a used ML/AI model. If the latter exceeds the former because the model was optimised to achieve the best possible accuracy, it becomes inefficient and its operation harmful to the environment. The future dominated by the non-anthropic induction describes a use of ML/AI so all-pervasive that most of the inductive inferences become furnished by ML/AI generalisations. The paper argues that the present debate deserves an expansion connecting the environmental costs of research and ineffective ML/AI uses (the issue of gratuitous generalisation capability) with the (near) future marked by the all-pervasive Human-Artificial Intelligence Nexus. (shrink)

In a recent essay in this journal, Tom O’Shea defends socialist republicanism, marrying the value of freedom as nondomination to public ownership of the means of production. In this reply, I argue that the efficiency costs that often attach to public ownership may undercut the ability of the socialist republic to combat domination by public agents. I provide two reasons in support of this claim. First, the economic gains provided by efficiency can insulate individuals from the discretionary power of other (...) agents. Put briefly, the more wealth you have, the less the discretionary power threatens your basic interests. Second, the efficiency costs of public ownership also make it more difficult to hold accountable the managers of economic organizations. This shortcoming of O’Shea’s argument reveals a point hitherto neglected in the republican literature—caring about nondomination implies caring about efficiency. (shrink)

Political writings of eighteenth-century France have been so far mostly overlooked as a source of republican thought. Philosophers such as Condorcet actively promoted the ideal of republicanism in ways that can shed light on current debates. In this paper, I look at one particular source: Le Republicain, published in the summer 1791, focusing on previously unattributed articles by Condorcet’s wife and collaborator, Sophie de Grouchy. Grouchy, a philosopher in her own right, is beginning to be known for her Letters on (...) Sympathy, a response to Adam Smith’s Theory of Moral Sentiment, which she published at the same time as her translation of that text into French. I argue, further, that in the texts, which I attribute to Grouchy, we can find the early development of a commercial republican theory, a belief, which is reflected in her discussion of the ‘cost’ of tyranny. (shrink)

This chapter contains sections titled: Does Feminism Discriminate against Men? Are Men Worse off than Women? Taking the Second Sexism Seriously Conclusion.

We discuss whether and under what conditions people should be allowed to choose which COVID-19 vaccine to receive on the basis of personal ethical views. The problem arises primarily with regard to some religious groups’ concerns about the connection between certain COVID-19 vaccines and abortion. Vaccines currently approved in Western countries make use of foetal cell lines obtained from aborted foetuses either at the testing stage or at the development stage. The Catholic Church’s position is that, if there are alternatives, (...) Catholic people have a moral obligation to request the vaccine whose link with abortion is more remote, which at present means that they should refuse the Oxford/AstraZeneca vaccine. We argue that any consideration regarding free choice of the vaccine should apply to religious and non-religious claims alike, in order to avoid religion-based discrimination. However, we also argue that, in a context of limited availability, considering the significant differences in costs and effectiveness profile of the vaccines available, people should only be allowed to choose the preferred vaccine if: 1) this does not risk compromising vaccination strategies; and 2) they internalize any additional cost that their choice might entail. The State should only subsidize the vaccine that is more cost-effective for any demographic group from the point of view of public health strategies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.3 (2000) 433-452 [Access article in PDF] When Ideas Matter: The Moral Philosophy of Fontenelle Gregory Matthew Adkins Introduction There has been a recent trend in the historiography of seventeenth- and eighteenth-century intellectual culture to analyze that culture from a sociological perspective. This perspective, a necessary corrective to a pure history of ideas, takes knowledge as a socially constructed phenomenon and thus subject (...) to sociological analysis. The point of the sociology of knowledge, however, is not to re-hash and bolster old externalist arguments but to do away with the whole debate over whether ideas or social conditions are more important in intellectual history and the history of science. A focus on sociology does not mean that ideas do not matter. This becomes apparent when analyzing the ethics of early modern intellectuals.For example, Anne Goldgar's recent work, Impolite Learning: Conduct and Community in the Republic of Letters, 1680-1750 (1995), gives much attention to the sociology of the seventeenth- and eighteenth-century Republic of Letters--but at the cost of relegating the role of ideas to the sidelines. According to Goldgar, if one wants to understand early modern intellectuals as a community, including their ethics and sense of morality, one should focus on forms of sociability rather than the ideas and philosophies they put forth in their writings. An aristocratic ethic dominated early modern scholarship, she argues, and even took precedence over knowledge claims: "[i]n striving to make its inner workings acceptable to the outside community the Republic of Letters chose, like the aristocracy, to empty its internal relationships of content, choosing instead to concentrate on form.... [A]rguments were often judged on the politeness with which they were presented, rather than on their intrinsic merit." 1 Men of [End Page 433] letters, although often of humble origin, cultivated nobility by emulating aristocratic modes of decorum and noble interests in status and reputation. One way they promoted these ideas was through a literary genre adopted from classical antiquity, the éloge (eulogy), which presented exemplary modes of behavior by praising the lives of the "heroes" of the Republic of Letters. Interestingly, the years on which Goldgar focuses her analysis almost precisely encompass the period of Bernard le Bouyer de Fontenelle's mature intellectual production. Yet Fontenelle (1657-1757), widely hailed during his lifetime as having perfected the art of the éloge, plays no role in her argument.From 1699 to 1740 Fontenelle, as secrétaire perpétuel of the Académie Royale des Sciences, composed some sixty-nine éloges in honor of recently deceased members of the academy and of other notable savants. Even a brief glance at Fontenelle's eulogies reveals an intimate link between philosophy and morality. A more careful examination of them in the context of his life and works shows that this link was logically commensurate with his genuinely held notions of human nature, happiness, reason, and the good. In fact the relationship in the eulogies between notions of nobility and the virtues proper to the savant or philosopher is highly intellectualized. Fontenelle was not as concerned with status and reputation or with self-fashioning as one might think. 2 We can only assimilate his ethics to those of the court aristocracy if we ignore what he actually wrote.Through his eulogies and other writings, Fontenelle's thoughts on philosophy and morality have had a lasting impact on western culture. He presented an image of what would come to characterize the proper, objective, modern scientist and thinker. 3 In order to understand the éloge as an institution in the Republic of Letters (and by extension the early modern intellectual ethic) it is therefore important to examine Fontenelle's moral philosophy more carefully. It is a philosophy expressed in his eulogies but understood clearly only in the context of his life and works. On the ÉlogesAs noted above, one way to contextualize the institution of the éloge is to place it within a Republic of Letters concerned with adopting the manners of the nobility: the éloges... (shrink)

Dominic Scott compares the Republic and Nicomachean Ethics from a methodological perspective. He argues that Plato and Aristotle distinguish similar levels of argument in the defence of justice, and that they both follow the same approach: Plato because he thinks it will suffice, Aristotle because he thinks there is no need to go beyond it.

abstract Much of the literature on torture in recent years takes the position of denouncing the barbarity of torture, while allowing for exceptions to this veto in extreme circumstances. The ticking‐bomb argument, where a terrorist is tortured in order to extract information of a primed bomb located in a civilian area, is often invoked as one of those extreme circumstances where torture becomes justified. As the War on Terrorism intensifies, the ticking‐bomb argument has become the dominant line of (...) reasoning used by both academics and policy advisers to justify a legalized, state‐sponsored program of torture. This paper argues for the unconditional refutation of any attempt to justify torture, without exceptions. We argue against the consequentialist reasoning of the ticking‐bomb argument not from a deontological position, but on consequentialist grounds. Empirical evidence suggests that the institutionalization of torture practices creates serious problems. Torture interrogation fails to fulfil its initial purpose as a low‐cost life saver, while its long‐term potential is the devastation of democratic institutions. (shrink)

Independence is the condition that, if X is preferred to Y, then a lottery between X and Z is preferred to a lottery between Y and Z given the same probability of Z. Is it rationally required that one’s preferences conform to Independence? The main objection to this requirement is that it would rule out the alleged rationality of Allais and Ellsberg Preferences. In this paper, I put forward a sequential dominance argument with fairly weak assumptions for a variant (...) of Independence (called Independence for Constant Prospects), which shows that Allais and Ellsberg Preferences are irrational. Hence this influential objection (that is, the alleged rationality of Allais and Ellsberg Preferences) can be rebutted. I also put forward a number of sequential dominance arguments that various versions of Independence are requirements of rationality. One of these arguments is based on very minimal assumptions, but the arguments for the versions of Independence which are strong enough to serve in the standard axiomatization of Expected Utility Theory need notably stronger assumptions. (shrink)

Clinical guidelines summarise available evidence on medical treatment, and provide recommendations about the most effective and cost-effective options for patients with a given condition. However, sometimes patients do not desire the best available treatment. Should doctors in a publicly-funded healthcare system ever provide sub-optimal medical treatment? On one view, it would be wrong to do so, since this would violate the ethical principle of beneficence, and predictably lead to harm for patients. It would also, potentially, be a misuse of finite (...) health resources. In this paper, we argue in favour of permitting sub-optimal choices on the basis of value pluralism, uncertainty, patient autonomy and responsibility. There are diverse views about how to evaluate treatment options, and patients’ right to self-determination and taking responsibility for their own lives should be respected. We introduce the concept of cost-equivalence, as a way of defining the boundaries of permissible pluralism in publicly-funded healthcare systems. As well as providing the most effective, available treatment for a given condition, publicly-funded healthcare systems should provide reasonable suboptimal medical treatments that are equivalent in cost to the optimal treatment. We identify four forms of cost-equivalence, and assess the implications of CE for decision-making. We evaluate and reject counterarguments to CE. Finally, we assess the relevance of CE for other treatment decisions including requests for potentially superior treatment. (shrink)

I take up the challenge of whyfalsebeliefs are better than “cautious actionpolicies” (target article, sect. 9) in navigating adaptive problems with asymmetric errors. I then suggest that there areinteractionsbetween supernatural beliefs, self-deception, and positive illusions, rendering elements of all such misbeliefs adaptive. Finally, I argue that supernatural beliefs cannot be rejected as adaptive simply because recent experiments are inconclusive. The great costs of religion betray its even greater adaptive benefits – we just have not yet nailed down exactly what they (...) are. (shrink)

ABSTRACT I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments. INTRODUCTION In contrast to the classic model of randomized-control trials, often with a large number of (...) subjects enrolled, precision medicine attempts to optimize therapeutic outcomes by focusing on the individual.[i] A recent publication highlights the strengths and weakness of both traditional evidence-based medicine and precision medicine.[ii] Plus, it outlines a tension in the shift from evidence-based medicine’s inductive reasoning style (the collection of data to postulate general theories) to precision medicine’s abductive reasoning style (the generation of an idea from the limited data available).[iii] The paper’s main example is the application of precision medicine for the treatment of cancer.[iv] I argue that this examination and appreciation for the shift to abductive reasoning should be extended to the intersection of neuroscience and novel brain-computer interfaces too. As the name suggests, brain-computer interfaces are a significant advancement in neurotechnology that directly connects someone’s brain to external or implanted devices.[v] Among the various kinds of brain-computer interfaces, adaptive deep brain stimulation devices require numerous personalized adjustments to their settings during the implantation and computation stages in order to provide adequate relief to patients with treatment-resistant disorders. What makes these devices unique is how adaptive deep brain stimulation integrates a sensory component to initiate the stimulation. While not commonly at the level of sophistication as self-supervising or generative large language models,[vi] they currently allow for a semi-autonomous form of neuromodulation. This paper highlights the implications of applying abductive reasoning to personalized implantable neurotechnologies. Then, it explores whether abductive reasoning is sufficient to justify insurance coverage for devices absent widespread clinical trials, which are better applied to one-size-fits-all treatments.[vii] ANALYSIS I. The State of Precision Medicine in Oncology and the Epistemological Shift While a thorough overview of precision medicine for the treatment of cancer is beyond the scope of this article, its practice can be roughly summarized as identifying clinically significant characteristics a patient possesses (e.g., genetic traits) to land on a specialized treatment option that, theoretically, should benefit the patient the most.[viii] However, in such a practice of stratification patients fall into smaller and smaller populations and the quality of evidence that can be applied to anyone outside these decreases in turn.[ix] As inductive logic helps to articulate, the greater the number of patients that respond to a particular therapy the higher the probability of its efficacy. By straying from this logical framework, precision medicine opens the treatment of cancer to more uncertainty about the validity of these approaches to the resulting disease subcategories.[x] Thus, while contemporary medical practices explicitly describe some treatments as “personalized”, they ought not be viewed as inherently better founded than other therapies.[xi] A relevant contemporary case of precision medicine out of Norway focuses on the care of a patient with cancer between the ventricles of the heart and esophagus, which had failed to respond to the standard regimen of therapies over four years.[xii] In a last-ditch effort, the patient elected to pay out-of-pocket for an experimental immunotherapy (nivolumab) at a private hospital. He experienced marked improvements and a reduction in the size of the tumor. Understandably, the patient tried to pursue further rounds of nivolumab at a public hospital. However, the hospital initially declined to pay for it given the “lack of evidence from randomised clinical trials for this drug relating to this [patient’s] condition.”[xiii] In rebuttal to this claim, the patient countered that he was actually similar to a subpopulation of patients who responded in “open‐label, single arm, phase 2 studies on another immune therapy drug” (pembrolizumab).[xiv] Given this interpretation of the prior studies and the patient’s response, further rounds of nivolumab were approved. Had the patient not had improvements in the tumor’s size following a round of nivolumab, then pembrolizumab’s prior empirical evidence in isolation would have been insufficient, inductively speaking, to justify his continued use of nivolumab.[xv] The case demonstrates a shift in reasoning from the traditional induction to abduction. The phenomenon of ‘cancer improvement’ is considered causally linked to nivolumab and its underlying physiological mechanisms.[xvi] However, “the weakness of abductions is that there may always be some other better, unknown explanation for an effect. The patient may for example belong to a special subgroup that spontaneously improves, or the change may be a placebo effect. This does not mean, however, that abductive inferences cannot be strong or reasonable, in the sense that they can make a conclusion probable.”[xvii] To demonstrate the limitations of relying on the abductive standard in isolation, commentators have pointed out that side effects in precision medicine are hard to rule out as being related to the initial intervention itself unless trends from a group of patients are taken into consideration.[xviii] As artificial intelligence (AI) assists the development of precision medicine for oncology, this uncertainty ought to be taken into consideration. The implementation of AI has been crucial to the development of precision medicine by providing a way to combine large patient datasets or a single patient with a large number of unique variables with machine learning to recommend matches based on statistics and probability of success upon which practitioners can base medical recommendations.[xix] The AI is usually not establishing a causal relationship[xx] – it is predicting. So, as AI bleeds into medical devices, like brain-computer interfaces, the same cautions about using abductive reasoning alone should be carried over. II. Responsive Neurostimulation, AI, and Personalized Medicine Like precision medicine in cancer treatment, computer-brain interface technology similarly focuses on the individual patient through personalized settings. In order to properly expose the intersection of AI, precision medicine, abductive reasoning, and implantable neurotechnologies, the descriptions of adaptive deep brain stimulation systems need to deepen.[xxi] As a broad summary of adaptive deep brain stimulation, to provide a patient with the therapeutic stimulation, a neural signal, typically referred to as a local field potential,[xxii] must first be detected and then interpreted by the device. The main adaptive deep brain stimulation device with premarket approval, the NeuroPace Responsive Neurostimulation system, is used to treat epilepsy by detecting and storing “programmer-defined phenomena.”[xxiii] Providers can optimize the detection settings of the device to align with the patient’s unique electrographic seizures as well as personalize the reacting stimulation’s parameters.[xxiv] The provider adjusts the technology based on trial and error. One day machine learning algorithms will be able to regularly aid this process in myriad ways, such as by identifying the specific stimulation settings a patient may respond to ahead of time based on their electrophysiological signatures.[xxv] Either way, with AI or programmers, adaptive neurostimulation technologies are individualized and therefore operate in line with precision medicine rather than standard treatments based on large clinical trials. Contemporary neurostimulation devices are not usually sophisticated enough to be prominent in AI discussions where the topics of neural networks, deep learning, generative models, and self-attention dominate the conversation. However, implantable high-density electrocorticography arrays (a much more sensitive version than adaptive deep brain stimulation systems use) have been used in combination with neural networks to help patients with neurologic deficits from a prior stroke “speak” through a virtual avatar.[xxvi] In some experimental situations, algorithms are optimizing stimulation parameters with increasing levels of independence.[xxvii] An example of neurostimulation that is analogous to the use of nivolumab in Norway surrounds a patient in the United States who was experiencing both treatment-resistant OCD and temporal lobe epilepsy.[xxviii]Given the refractory nature of her epilepsy, implantation of an adaptive deep brain stimulation system was indicated. As a form of experimental therapy, her treatment-resistant OCD was also indicated for the off-label use of an adaptive deep brain stimulation set-up. Another deep brain stimulation lead, other than the one implanted for epilepsy, was placed in the patient’s right nucleus accumbens and ventral pallidum region given the correlation these nuclei had with OCD symptoms in prior research. Following this, the patient underwent “1) ambulatory, patient-initiated magnet-swipe storage of data during moments of obsessive thoughts; (2) lab-based, naturalistic provocation of OCD-related distress (naturalistic provocation task); and (3) lab-based, VR [virtual reality] provocation of OCD-related distress (VR provocation task).”[xxix] Such signals were used to identify when to deliver the therapeutic stimulation in order to counter the OCD symptoms. Thankfully, following the procedure and calibration the patient exhibited marked improvements in their OCD symptoms and recently shared her results publicly.[xxx] In both cases, there is a similar level of abductive justification for the efficacy of the delivered therapy. In the case study in which the patient was treated with adaptive deep brain stimulation, they at least had their neural activity tested in various settings to determine the optimum parameters for treatment to avoid them being based on guesswork. Additionally, the adaptive deep brain stimulation lead was already placed before the calibration trials were conducted, meaning that the patient had already taken on the bulk of the procedural risk before the efficacy could be determined. Such an efficacy test could have been replicated in the first patient’s cancer treatment, had it been biopsied and tested against the remaining immunotherapies in vitro. Yet, in the case of cancer with few options, one previous dose of a drug that appeared to work on the patient may justify further doses. However, as the Norwegian case presents, corroboration with known responses to a similar drug (from a clinical trial) could be helpful to validate the treatment strategy. (It should be noted that both patients were resigned to these last resort options regardless of the efficacy of treatment.) There are some elements of inductive logic seen with adaptive deep brain stimulation research in general. For example, abductively the focus could be that patient X’s stimulation parameters are different from patient Y’s and patient Z’s. In contrast, when grouped as subjects who obtained personalized stimulation, patients X, Y, and Z demonstrate an inductive aspect to this approach’s safety and/or efficacy. The OCD case holds plenty of abductive characteristics in line with precision medicine’s approach to treating cancer and as more individuals try the method, there will be additional data. With the gradual integration of AI into brain-computer interfaces in the name of efficacy, this reliance on abduction will continue, if not grow, over time. Moving forward, if a responsive deep brain stimulation treatment is novel and individualized (like the dose of nivolumab) and there is some other suggestion of efficacy (like clinical similarities to other patients in the literature), then it may justify insurance coverage for the investigative intervention, absent other unrelated reasons to deny it. III. Ethical Implications and Next Steps While AI’s use in oncology and neurology is not yet as prominent as its use in other fields (e.g., radiology), it appears to be on the horizon for both.[xxxi] AI can be found in both the functioning of the neurotechnologies as well as the implementation of precision medicine. The increasing use of AI may serve to further individualize both oncologic and neurological therapies. Given these implications and the handful of publications cited in this article, it is important to have a nuanced evaluation of how these treatments, which heavily rely on abductive justification, ought to be managed. The just use an abductive approach may be difficult as AI infused precision medicine is further pursued. At baseline, such technology relies on a level of advanced technology literacy among the general public and could exclude populations who lack access to basic technological infrastructure or know-how from participation.[xxxii] Even among nations with adequate infrastructure, as more patients seek out implantable neurotechnologies, which require robust healthcare resources, the market will favor patient populations that can afford this complex care.[xxxiii] If patients already have the means to pay for an initial dose/use of a precision medicine product out of pocket, should insurance providers be required to cover subsequent treatments?[xxxiv] That is, if a first dose of a cancer drug or a deep brain stimulator over its initial battery life is successful, patients may feel justified in having the costs of further treatments covered. The Norwegian patient’s experience implies there is a precedent for the idea that some public insurance companies ought to cover successful cancer therapies, however, insurance companies may not all see themselves as obligated to cover neurotechnologies that rely on personalized settings or that are based on precision/abductive research more than on clinical trials. CONCLUSION The fact that the cases outlined above rely on abductive style of reasoning implies that there may not be as strong a justification for coverage by insurance, as they are both experimental and individualized, when compared to the more traditional large clinical trials in which groups have the same or a standardized protocol (settings/doses). If a study is examining the efficacy of a treatment with a large cohort of patients or with different experimental groups/phases, insurance companies may conclude that the resulting symptom improvements are more likely to be coming from the devices themselves. A preference for inductive justification may take priority when ruling in favor of funding someone’s continued use of an implantable neurostimulator. There are further nuances to this discussion surrounding the classifications of these interventions as research versus clinical care that warrant future exploration, since such a distinction is more of a scale[xxxv] than binary and could have significant impacts on the “right-to-try” approach to experimental therapies in the United States.[xxxvi] Namely, given the inherent limitations of conducting large cohort trials for deep brain stimulation interventions on patients with neuropsychiatric disorders, surgically innovative frameworks that blend abductive and inductive methodologies, like with sham stimulation phases, have traditionally been used.[xxxvii] Similarly, for adaptive brain-computer interface systems, if there are no large clinical trials and instead only publications that demonstrate that something similar worked for someone else, then, in addition to the evidence that the first treatment/dose worked for the patient in question, the balance of reasoning would be valid and arguably justify insurance coverage. As precision approaches to neurotechnology become more common, frameworks for evaluating efficacy will be crucial both for insurance coverage and for clinical decision making. ACKNOWLEDGEMENT This article was originally written as an assignment for Dr. Francis Shen’s “Bioethics & AI” course at Harvard’s Center for Bioethics. I would like to thank Dr. Shen for his comments as well as my colleagues in the Lázaro-Muñoz Lab for their feedback. - [i] Jonathan Kimmelman and Ian Tannock, “The Paradox of Precision Medicine,” Nature Reviews. Clinical Oncology 15, no. 6 (June 2018): 341–42, https://doi.org/10.1038/s41571-018-0016-0. [ii] Henrik Vogt and Bjørn Hofmann, “How Precision Medicine Changes Medical Epistemology: A Formative Case from Norway,” Journal of Evaluation in Clinical Practice 28, no. 6 (December 2022): 1205–12, https://doi.org/10.1111/jep.13649. [iii] David Barrett and Ahtisham Younas, “Induction, Deduction and Abduction,” Evidence-Based Nursing 27, no. 1 (January 1, 2024): 6–7, https://doi.org/10.1136/ebnurs-2023-103873. [iv] Vogt and Hofmann, “How Precision Medicine Changes Medical Epistemology,” 1208. [v] Wireko Andrew Awuah et al., “Bridging Minds and Machines: The Recent Advances of Brain-Computer Interfaces in Neurological and Neurosurgical Applications,” World Neurosurgery, May 22, 2024, S1878-8750(24)00867-2, https://doi.org/10.1016/j.wneu.2024.05.104. [vi] Mark Riedl, “A Very Gentle Introduction to Large Language Models without the Hype,” Medium (blog), May 25, 2023, https://mark-riedl.medium.com/a-very-gentle-introduction-to-large-language-models-without-the-hype-5 f67941fa59e. [vii] David E. Burdette and Barbara E. Swartz, “Chapter 4 - Responsive Neurostimulation,” in Neurostimulation for Epilepsy, ed. Vikram R. Rao (Academic Press, 2023), 97–132, https://doi.org/10.1016/B978-0-323-91702-5.00002-5. [viii] Kimmelman and Tannock, 2018. [ix] Kimmelman and Tannock, 2018. [x] Simon Lohse, “Mapping Uncertainty in Precision Medicine: A Systematic Scoping Review,” Journal of Evaluation in Clinical Practice 29, no. 3 (April 2023): 554–64, https://doi.org/10.1111/jep.13789. [xi] Kimmelman and Tannock, “The Paradox of Precision Medicine.” [xii] Vogt and Hofmann, 1206. [xiii] Vogt and Hofmann, 1206. [xiv] Vogt and Hofmann, 1206. [xv] Vogt and Hofmann, 1207. [xvi] Vogt and Hofmann, 1207. [xvii] Vogt and Hofmann, 1207. [xviii] Vogt and Hofmann, 1210. [xix] Mehar Sahu et al., “Chapter Three - Artificial Intelligence and Machine Learning in Precision Medicine: A Paradigm Shift in Big Data Analysis,” in Progress in Molecular Biology and Translational Science, ed. David B. Teplow, vol. 190, 1 vols., Precision Medicine (Academic Press, 2022), 57–100, https://doi.org/10.1016/bs.pmbts.2022.03.002. [xx] Stefan Feuerriegel et al., “Causal Machine Learning for Predicting Treatment Outcomes,” Nature Medicine 30, no. 4 (April 2024): 958–68, https://doi.org/10.1038/s41591-024-02902-1. [xxi] Sunderland Baker et al., “Ethical Considerations in Closed Loop Deep Brain Stimulation,” Deep Brain Stimulation 3 (October 1, 2023): 8–15, https://doi.org/10.1016/j.jdbs.2023.11.001. [xxii] David Haslacher et al., “AI for Brain-Computer Interfaces,” 2024, 7, https://doi.org/10.1016/bs.dnb.2024.02.003. [xxiii] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 103–4; “Premarket Approval (PMA),” https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P100026. [xxiv] Burdette and Swartz, “Chapter 4 - Responsive Neurostimulation,” 104. [xxv] Burdette and Swartz, 126. [xxvi] Sean L. Metzger et al., “A High-Performance Neuroprosthesis for Speech Decoding and Avatar Control,” Nature 620, no. 7976 (August 2023): 1037–46, https://doi.org/10.1038/s41586-023-06443-4. [xxvii] Hao Fang and Yuxiao Yang, “Predictive Neuromodulation of Cingulo-Frontal Neural Dynamics in Major Depressive Disorder Using a Brain-Computer Interface System: A Simulation Study,” Frontiers in Computational Neuroscience 17 (March 6, 2023), https://doi.org/10.3389/fncom.2023.1119685; Mahsa Malekmohammadi et al., “Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson’s Disease,” Movement Disorders 31, no. 3 (2016): 426–28, https://doi.org/10.1002/mds.26482. [xxviii] Young-Hoon Nho et al., “Responsive Deep Brain Stimulation Guided by Ventral Striatal Electrophysiology of Obsession Durably Ameliorates Compulsion,” Neuron 0, no. 0 (October 20, 2023), https://doi.org/10.1016/j.neuron.2023.09.034. [xxix] Nho et al. [xxx] Nho et al.; Erik Robinson, “Brain Implant at OHSU Successfully Controls Both Seizures and OCD,” OHSU News, accessed March 3, 2024, https://news.ohsu.edu/2023/10/25/brain-implant-at-ohsu-successfully-controls-both-seizures-and-ocd. [xxxi] Awuah et al., “Bridging Minds and Machines”; Haslacher et al., “AI for Brain-Computer Interfaces.” [xxxii] Awuah et al., “Bridging Minds and Machines.” [xxxiii] Sara Green, Barbara Prainsack, and Maya Sabatello, “The Roots of (in)Equity in Precision Medicine: Gaps in the Discourse,” Personalized Medicine 21, no. 1 (January 2024): 5–9, https://doi.org/10.2217/pme-2023-0097. [xxxiv] Green, Prainsack, and Sabatello, 7. [xxxv] Robyn Bluhm and Kirstin Borgerson, “An Epistemic Argument for Research-Practice Integration in Medicine,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 43, no. 4 (July 9, 2018): 469–84, https://doi.org/10.1093/jmp/jhy009. [xxxvi] Vijay Mahant, “‘Right-to-Try’ Experimental Drugs: An Overview,” Journal of Translational Medicine 18 (June 23, 2020): 253, https://doi.org/10.1186/s12967-020-02427-4. [xxxvii] Michael S. Okun et al., “Deep Brain Stimulation in the Internal Capsule and Nucleus Accumbens Region: Responses Observed during Active and Sham Programming,” Journal of Neurology, Neurosurgery & Psychiatry 78, no. 3 (March 1, 2007): 310–14, https://doi.org/10.1136/jnnp.2006.095315. (shrink)

The authors use empirical research into the environmental practices of 31 manufacturing small and medium-sized enterprises (SMEs) to show that ‚business performance’ and ‚regulation’ considerations drive behaviour. They suggest that this is inevitable, given the market-based decision-making frames that permeate and dominate the industry in which manufacturing SMEs operate. Since the environment is a pillar of corporate social responsibility (CSR), the findings have important implications for CSR policy, which promotes voluntary actions predicated on a business case. It is argued that (...) this approach will not alter the behaviour of manufacturing SMEs significantly because CSR practice will be regarded as an optional and costly ‚extra’ affecting core business activity. Consequently, the use and development of existing regulatory structures, providing minimum standards for many activities covered by CSR, remains the most effective means through which the behaviour of manufacturing SMEs will be changed in the short to medium-term. Another feature of the paper is the distinction made between ‚business performance’ and the ‚business case’ argument. Business performance emphasises cost reductions and efficiency whereas the business case accentuates the benefits to shareholders of good practices as their firms become more attractive to stakeholders and society. Manufacturing SMEs␣try to improve business performance because of the pressures placed on them by market-dominated decision-making frames. These frames do not encourage manufacturing SMEs to undertake voluntary actions for the benefit of wider stakeholders and society. (shrink)

Is it OK to lie to Siri? Is it bad to mistreat a robot for our own pleasure? Under what condition should we grant a moral status to an artificial intelligence system? This paper looks at different arguments for granting moral status to an AI system: the idea of indirect duties, the relational argument, the argument from intelligence, the arguments from life and information, and the argument from sentience. In each but the last case, we find unresolved (...) issues with the particular argument, which leads us to move to a different one. We leave the idea of indirect duties aside since these duties do not imply considering an AI system for its own sake. The paper rejects the relational argument and the argument from intelligence. The argument from life may lead us to grant a moral status to an AI system, but only in a weak sense. Sentience, by contrast, is a strong argument for the moral status of an AI system—based, among other things, on the Aristotelian principle of equality: that same cases should be treated in the same way. The paper points out, however, that no AI system is sentient given the current level of technological development. (shrink)

Land-based climate mitigation schemes such as REDD+ imply the creation of ‘rights to carbon’ for actions that enhance carbon sinks. In many cases, the legal and normative foundations of such rights are unclear. This article focuses on special rights on the basis of improvement. Considering improvement in relation to carbon sinks requires asking what it means to ‘improve’ an environmental resource. Our answer departs in two significant respects from the standard conception of improvement, namely by reconceiving action in relation to (...) ecosystem services, and accordingly, making the case for a counterfactual baseline to be used to compare an improved and unimproved state. Our modifications potentially allow for a variety of agents to claim special carbon rights on the basis of beneficial interactions with land-based carbon sinks. We give three archetypical examples of agents who may claim pro tanto special rights to carbon based on their interaction with carbon sinks. (shrink)

There is a popular conception among many Zeitgeist watchers, especially in places like the US, Western Europe and Australia, of the urbanized East as existing somehow further into the future. As William Gibson once stated: `The future is here; it just isn't equally distributed yet.' This kind of cultural fetishism extends to not only technolust, but the practices that new gadgets and electronics encourage. The specific phenomenon explored in this article is that of virtual girlfriends and boyfriends: whether in the (...) form of avatars or automated SMS text messages. This particularly Japanese `craze', if we can call it that, fascinates and appals people who still hold P2P romance IRL in high-esteem. It seems like an insult to the intrinsically human and humanist discourse of courtship; and indeed it is. How does this perspective change, however, if we consider `love' as a technology? That is, as both a code with its own algorithmic parameters, and a discourse that also challenges the hyper-rational assumptions of the `merely machinic'. Extending the argument articulated in my book, Love and Other Technologies, this article asks how the emergence of virtual dating and other techno-inflected treatments of romance are working to undo our jealously held notions of intimacy and identity. It concludes that all sex can be considered cybersex, given the communication flows that occur both before, during and after the act. For, as we continue to enframe the discourse of intimacy via new and mobile media, we find it increasingly difficult to deny that intensified inter-subjectivity is always already a matter of technics. Indeed, what Heidegger says of modern technology can effectively be applied to modern love: that it embodies an `unreasonable demand' of nature (and thus has the capacity to reveal something essential about the posthuman condition). (shrink)

This project tackles the problem of analyzing a specific form of reasoning called ‘sunk costs’ in economics and ‘argument from waste’ in argumentation theory. The project is to build a normative structure representing the form of the argument, and then to apply this normative structure to actual cases in which the sunk costs argument has been used. The method is partly structural and partly empirical. The empirical part is carried out through the analysis of case studies of (...) the sunk costs argument found in business decision-making, as well as other areas like medical decision-making and everyday conversational argumentation. The structural part is carried out by using existing methods and techniques from argumentation theory, like argumentation schemes. The project has three especially significant findings. First, the sunk costs argument is not always fallacious, and in many cases it can be seen to be a rational precommitment strategy. Second, a formal model of argumentation, called practical reasoning, can be constructed that helps a rational critic to judge which sunk costs arguments are fallacious and which are not. Third, this formal model represents an alternative model of rationality to the cost-benefit model based on Bayesian calculation of probabilities. This alternative model is called the argumentation model, and it is based on interpersonal reasoning in dialogue as the model of rational thinking. This model in turn is based on the underlying notion of commitment in dialogue. (shrink)

Feminists have argued that oppressive socialization undermines the liberal model of autonomy. We contend that this argument can also be employed effectively as a challenge to the standard bioethical model of informed consent. We claim that the standard model is inadequate because it relies on presumptions of procedural autonomy and rational choice that overlook the problem of how agents are often socialized so that they adopt and internalize oppressive norms as part of their motivational structure. The argument that (...) oppressive socialization undermines liberalism’s view of autonomy is most relevant to what Beauchamp and Childress call the threshold elements of informed consent—competence and voluntariness. We show how these elements fail to account for morally relevant factors such as oppressive socialization. (shrink)

The idea of ‘community’ dominates politics in Northern Ireland in both popular and political discourse and in academic writing, policy and legislation. Depending upon particular understandings of the notion of community different arguments are made about the policies that need to be implemented to develop the peace process. This has had a fundamental impact on areas such as legislation over parades and the development of a Bill of Rights for Northern Ireland. This essay critically looks at understandings of ‘community’; how (...) it becomes used in political discourse and in policy development and the character of its relationship with ideas about safety and security. (shrink)

We present two prudent semantics within Dung's theory of argumentation. They are based on two new notions of extension, referred to as p-extension and c-extension. Two arguments cannot belong to the same p-extension whenever one of them attacks indirectly the other one. Two arguments cannot belong to the same c-extension whenever one of them indirectly attacks a third argument while the other one indirectly defends the third. We argue that our semantics lead to a better handling of controversial arguments (...) than Dung's ones. We compare the prudent inference relations induced by our semantics w.r.t. cautiousness; we also compare them with the inference relations induced by Dung's semantics. (shrink)

(1) In the first part of this paper, I review Chomsky's meandering journey from the formalism/mentalism of Syntactic Structures, through several methodological positions, to the minimalist theory of his latest work. Infected with mentalism from first to last, each and every position vitiates Chomsky's repeated claims that his theories will provide useful guidance to later theories in such fields as cognitive psychology and cognitive neuroscience. With the guidance of his insights, he claims, psychologists and neuroscientists will be able to avoid (...) costly dead-end lines of research. -/- (2) This never happened. As I have shown, this never could have happened. (See Johnston, 2018). What has happened, instead, is that current neurolinguistic research (with the arguable exception of the now-dated Lemma Model of Willem Levelt) proceeds without reference to Chomsky. It also wholeheartedly rejects the mentalism of the associated Language of Thought theory of Jerry Fodor. (See Johnston, 2018). -/- (3) I make this argument in the first part of this paper. I would also like to point out that most of my argument was developed in 1972, when I was a graduate student. I know of no other sustained criticisms of Chomsky at that time, and certainly none along the lines I had developed back then. -/- (4) In the second part of this paper, I present my own account of the methodology of science. When I was a graduate student, philosophy of science was dominated by an attempt to describe a methodology common to all the specific sciences, i.e. Hempel’s deductive-nomological model. These days, Hempel’s emphasis on the methodological unity of science has been rejected by such “dis-unity” philosophers of science as Ian Hacking, Patrick Suppes and Nancy Cartwright (see Cat, 2021). -/- (5) I view this change as the swing of a pendulum or, to change the metaphor, a journey from one end point of a continuum to another. As the level of abstraction at which one tries to describe scientific method is raised, the descriptions become increasingly general. Whether or not unity-of-science theories become so general as to be vacuous, is ultimately a subjective judgment. And so I expect that philosophers will eventually become tired of increasingly specific “close to the workbench” descriptions of how scientists work, and begin to turn back to methodological “big pictures”, finding in them powerful abstractions rather than empty irrelevancies. -/- (6) In the second part of this paper, I present my own account of the methodology of science, which I would situate somewhere between the “unity” and “dis-unity” accounts. However, I am not a scientist. My own views about scientific method have three origins: -/- (6a) my work as a graduate student from 1966 until I passed my comprehensive exams in 1973 (at a different university); -/- (6b) reading every issue of Scientific American from 1972 until nearly 2000, (at which point I continued to read it only sporadically, since I concluded that, around that time, it had evolved from a serious science magazine to a popular science magazine); and -/- (6c) my three-year immersion in the cognitive neuroscience of language after I retired, based on repeated study of and note-taking for (Banesh & Compton, 2018), (Kemmerer, 2015), several other books and, finally, numerous articles not hidden behind a paywall. -/- So, as always with my writings: caveat emptor. (shrink)

The author of the Summa Halensis claims that the human body is maximally composite and argues for this using a proof strategy that intends to deduce the body’s composition from the human soul’s immateriality. This study examines that claim and argument, which is given both in a shorter and a longer form. The core of the article consists in a careful reconstruction of both forms, along with an enquiry into its Jewish Neoplatonic sources (first and foremost the Fons vitae) (...) and its appearance in zoological commentaries contemporary to the Summa written by Peter of Spain and Albert the Great. It emerges that the argument brings into play various features of the Summist’s hylomorphic theory, especially a pluralism about substantial forms. (shrink)

I present an immanent, and explanatory, critique of reflections on the nature of politics and of power within political science. I argue that these reflections are problematic, to the extent that they presuppose an actualist conception of the political, and that this is generated by an empiricist way of thinking on the one hand and a constructivist way of thinking on the other. I show how re-defining politics, power, and the political on the basis of a dialectical critical realist ontology (...) resolves these problems and, thereby, allows us to understand the conditions for social change and the relationship between the political and the economic. My argument has two, important implications: first, that the proposal that those who study politics professionally should celebrate philosophical diversity is dangerous–at least if it makes it difficult to sustain a distinct, emancipatory form of political inquiry; and, second, that the nature of social reality justifies the need both for specialized forms of inquiry, such as politics and economics, and integrative forms of inquiry, such as political economy. (shrink)

[Comment] Donald Trump’s executive order on energy limits the costs and benefits of carbon to domestic sources. The argument for this executive order is that carbon policies should not be singled out from other policies as globally inclusive. Two independent arguments are offered for adopting a global social cost of carbon. The first is based on reinforcing norms in the face of commons tragedies. The second is based on the limitations of consequentialist analyses. We can distinguish consequences for which (...) probabilistic indifference is appropriate. The mechanisms for global effects for carbon are well-understood, whereas most policy effects are primarily domestic. [Open access]. (shrink)

This article is the first in a series of four articles that engage critically with the arguments of two recent and significant additions to the literature on critical realism, namely Bhaskar’s ‘Enlightened Common Sense: The Philosophy of Critical Realism’, and Bhaskar et al.’s ‘Interdisciplinarity and Wellbeing: A Critical Realist General Theory of Interdisciplinarity’. Using the method of immanent critique and focusing mainly, but not exclusively, on the arguments of Enlightened Common Sense, I identify, and propose solutions to, a range of (...) problems pertaining to the concepts of depth, emergence and transfactuality. In identifying and resolving these problems, my aim is to clarify and develop the categories of original critical realism and thereby ensure that critical realism as a whole is as effective an underlabourer for science as it can be. (shrink)

I criticize the particular argument for evolutionary progressivism which is based on the concept of a series of "dominant life forms." My procedure is to show that there is no rigorous definition for the concept of "dominant life form." I examine several attempts to define this concept by Julian Huxley and a new formulation of the concept by G. G. Simpson and show that none of the criteria either of these men develop for determining which groups of organisms can (...) be classified as dominant are adequate to exclude any groups of organisms from the classification. The concept proves so broad as to be meaningless. Since it is a key concept in the particular argument for progressivism that I discuss, the criticism of the concept demonstrates the argument to be invalid. (shrink)

The purpose of this paper is to review the rising influence of commercialism in American medicine and to examine some of the consequences of this trend. Increased competition subverts physician collegiality, draws hospitals into for-profit ownership and behavior, and leads clinical investigators into secrecy and possibly into bias and abuse. Medicine faces a deprofessionalization evidenced in loss of control over the clinical setting and over self-regulation. Health care becomes a commodity relying on cultivation of desires instead of satisfaction of needs, (...) even as many basic needs go unmet. Patients become consumers empowered with lawsuits and the connection of medicine to the relief of suffering is attenuated. Medical encounters are increasingly impersonal, dominated by specialization, technology, and bureaucracy. Patients are losing their physician-advocates to new conflicts of interests, physicians are losing their impulse to charity, and trust in the doctor-patient relationship and in medicine generally is eroding. (shrink)

At least from the standpoint of contemporary cultural and ethical resources, physicians have argued eloquently and exhaustively both for and against physician-assisted suicide. If one avoids the temptation to ruthlessly simplify either position to immorality or error, then a strange dilemma arises. How is it that well educated and intelligent physicians, committed strongly and compassionately to the care of their patients, argue adamantly for opposing positions? Thus rather than simply rehashing old arguments, this essay attempts to rethink the nature of (...) human morality as both a source and a fracturing of human rationality – and with morality, the question of human nature in the context of violence, oppression, service, and obligation. This interpretation of moral life is laid out roughly along the lines of the Jewish philosopher Emmanuel Levinas, and further clarified through a discussion of the Hippocratic Oath. These resources are then brought to bear on the specific arguments and recommendations concerning physician-assisted suicide. (shrink)

In Gaudium et Spes and Dignitatis Humanae the Second Vatican Council not only presents the dignity of the human person as the parting point for its moral teaching but also grounds human dignity in natural teleology. Natural teleology is the view that the good of any thing corresponds to, and so can be discerned from, the ends to which it is directed by its nature, both that end which is proper to it and those ends that it has as part (...) of a wider order. As official Church teachings, these documents refrain from providing a philosophical justification of their account of human dignity. The existence of natural teleology, however, is generally contested in modern philosophy. For this reason, grounding human dignity in natural teleology constitutes a questionable approach to the issue. Of all major Catholic theologians, Thomas Aquinas is arguably the one who provides the most developed philosophical resources for articulating these views on natural teleology and its connection with human dignity. This paper examines and assesses the way in which he grounds human dignity in natural teleology. In his view, we see that human beings are the principle part of the universe and that the other parts of the universe are ordered towards the good of human beings. After surveying his general justification of how a thing is ordered to particular ends in virtue of its nature, the paper considers his explanation of how each part of the universe assumes further ends within the universe as a whole, and his main set of arguments on how we perceive human dignity against the backdrop of the natural teleology of the universe. (shrink)

This article provides a map of the UBI debate, structured into the main themes that guide and group the arguments on both sides. It finds that UBI’s supporters and opponents both draw on core principles of justice and freedom, focusing on need and poverty, discrimination and inequality, growth, social opportunity, individuality, and self-development. From an economic perspective, they both appeal to business concerns about efficiency, risk, flexibility, and consumption, as well as labour interests on work fulfilment, working conditions, remuneration, and (...) bargaining. Likewise, they focus on political questions around welfare state reforms, redistribution, taxation and funding sources, democratic citizenship, and the prospects for cross-party policy coalitions. By providing an overview of the thematic pillars of the UBI debate, this article helps researchers and activists locate and orient themselves within the wider spectrum of opinion on UBI. (shrink)

Our long-standing hypothesis has been that feedforward information flow is sufficient for speech perception, reading, and sentence (syntactic and semantic) processing more generally. We are encouraged by the target article's argument for the same hypothesis, but caution that more precise quantitative predictions will be necessary to advance the field.

According to the Samaritan principle, we have a duty to rescue others from perils when we can do so at no unreasonable cost to ourself or others. Candice Delmas has argued that this principle generates a duty to engage in civil disobedience, when laws and practices expose people to ‘persistent Samaritan perils’: by engaging in this form of protest, she claims, citizens can contribute to the rescue of the victims of serious injustice. In this article, I contend that her (...) class='Hi'>argument confuses duties of rescue with duties of justice. Furthermore, I point out that two central features of civil disobedience, namely, communicativeness and conscientiousness, make it unsuitable as a strategy for ‘rescue operations’. On the one hand, communicative constraints make civil disobedience time-consuming, and dependent on others’ willingness to engage in the communicative exchange. On the other, conscientiousness often requires agents to accept costs well beyond the threshold warranted by the Samaritan principle. Treating civil disobedients akin to ‘good Samaritans’ trivialises the selflessness of their sacrifices. (shrink)

Belgium's policy of not permitting Catholic hospitals to refuse euthanasia services rests on ethical presuppositions concerning the secular justification of political power which reveal the paradoxical character of European liberalism: In endorsing freedom as a value (rather than as a side constraint), liberalism prioritizes first-order intentions, thus discouraging lasting moral commitments and the authority of moral communities in supporting such commitments. The state itself is thus transformed into a moral community of its own. Alternative policies (such as an explicit moral (...) diversification of public healthcare or the greater tolerance for Christian institutions in the Netherlands) are shown to be incompatible with Europe's liberal concern with securing social and material freedom resources, as well as the concern with equality of opportunity, as embodied in the European Union's anti-discrimination labor law. The essay's argument for the preferability of a libertarian solution closes with the challenge that only if the provision of public healthcare can be shown to be rationally indispensable for a morally justified polity, could the exposed incoherence of modern European liberalism be generously discounted. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Everyday Utopia: What 2,000 Years of Wild Experiments Can Teach Us About the Good Life by Kristen R. GhodseeMark A. AllisonKristen R. Ghodsee. Everyday Utopia: What 2,000 Years of Wild Experiments Can Teach Us About the Good Life. New York: Simon & Schuster, 2023. 352 pp., hardcover, $29.99. ISBN 9781982190217.Kristen R. Ghodsee has written a wide-ranging, highly readable, and commendably radical vindication of utopian thought and experimentation. Everyday (...) Utopia is aimed at the educated lay reader—itself, perhaps, a utopian projection—rather than specialists. Nevertheless, all but the most erudite and cosmopolitan of scholars will encounter unfamiliar and compelling utopiana within its pages. While her earlier book, Why Women Have Better Sex Under Socialism: And Other Arguments for Economic Independence (2018), concentrated on "state-sponsored solutions" to the deprivations of capitalism and patriarchy, the present volume sets its sights squarely on the private sphere, and utopian visions "for rearranging our domestic lives" (17).Ghodsee situates this turn to the domestic in two contexts. The first is the COVID-19 pandemic, which revealed the frangibility of the international commitment to gender equality. "Women around the globe woke up and realized that decades of feminism had done little to reverse the social expectation that mothers, sisters, wives, and daughters should provide care for young children, elderly parents, and sick relatives, as well as perform the emotional labors that hold families together in times of crisis," she laments (xii). Everyday Utopia's second context is the spate of recent works of "popular neo-utopianism," including Rutger Bregman's Utopia for Realists (2017), Aaron Bastani's Fully Automated Luxury Communism (2019), and Peter Diamandis and Steven Kotler's Abundance: The Future is Better Than You Think (2012) (14). What Ghodsee finds wanting in this discourse is its myopic focus on the public sphere, and its unspoken presupposition that our private and domestic lives have no such need of utopian renovation. But it is just this presupposition [End Page 285] that the COVID-19 lockdown discredited, although many other indicators (runaway housing and childcare costs, the environmental crisis, the epidemic of loneliness) already suggested as much. Ghodsee rightly insists that "where we reside, how we raise and educate our children, our personal relationship to things, and the quality of our connections to friends, families, and partners impact us as much as tax policies, the price of energy, or the way we organize formal employment" (14). As utopian thinkers from Plato forward have understood, moreover, it is short-sighted to suppose that sweeping economic and political transformations are possible without a concomitant rethinking of the "intimate worlds" that subtend these public domains (15).Accordingly, Everyday Utopia devotes its succeeding chapters to examining alternatives to the dominant institutions of the contemporary private sphere, including the single-family household, the monogamous couple paradigm of childrearing and mating, and the institution of private property. In each case, Ghodsee plumbs the past and limns the present to highlight utopian alternatives to contemporary norms. Among this book's greatest strengths is its consistently international range of examples and admirably sustained commitment to feature "experiments that have received relatively less attention" in the extant literature (xv).Take, for example, the chapter on communal alternatives to single-family homes. Ghodsee includes many of the usual (and eminently worthy) suspects: Buddhist and Christian cenobite monasteries, Fourierist phalansteries, Israeli kibbutzim, and the Corbusier-inspired "microdistricts" of the former Eastern bloc (47). But we also learn of less canonical phenomena, such as the Neolithic proto-city of Çatalhöyük, "one of the first major settlements in the world," where as many as eight thousand people lived in an essentially contiguous structure, in highly egalitarian and likely non-consanguineous households (32). Or consider the Beguine nuns, a lay order founded in 1190 that survived, albeit in attenuated form, into the twentieth century. The Beguine lived communally in urban areas, enjoying liberties unthinkable not only to their cloistered counterparts, but to virtually all their female contemporaries: they brewed beer, made lace, taught school—and traversed the streets unchaperoned. The chapter concludes with a discussion of contemporary cohousing. In Denmark, roughly one percent of the population was living in co... (shrink)

Jerry Fodor has argued that a modular mind must include central systems responsible for updating beliefs, and has defended this position by appealing to shared properties of belief fixation and scientific confirmation. Peter Carruthers and Stephen Pinker have attacked this analogy between science and ordinary inference. I examine their arguments and show that they fail. This does not show that Fodor’s more general position is correct.

In this paper, we explore a popular flexible work arrangement, home-based telework, in the Indian IT industry. We show how IT managers used the dominant meanings of telework to portray telework as an employee benefit that outweighed the attendant cost—intensified work. While using their discretion to grant telework, the managers drew on this portrayal to orchestrate a negotiated exchange with their subordinates. Consequently, the employees consented to accomplish the intensified work at home in exchange of telework despite their opposition to (...) the intensified work in the office. Thus, whereas the extant studies consider work intensification as an unanticipated outcome of using FWAs, we show how firms may use FWAs strategically to get office-based intensified work accomplished at home. While the dominant argument is that employees reciprocate the opportunity to telework with intensified work, we show a discursively orchestrated negotiation that favors management. A corrective policy measure is to frame telework as an employee right. (shrink)

There are not enough solid organs available to meet the needs of patients with organ failure. Thousands of patients every year die on the waiting lists for transplantation. Yet there is one currently available, underutilized, potential source of organs. Many patients die in intensive care following withdrawal of life-sustaining treatment whose organs could be used to save the lives of others. At present the majority of these organs go to waste.In this paper we consider and evaluate a range of ways (...) to improve the number and quality of organs available from this group of patients. Changes to consent arrangements (for example conscription of organs after death) or changes to organ donation practice could dramatically increase the numbers of organs available, though they would conflict with currently accepted norms governing transplantation.We argue that one alternative, Organ Donation Euthanasia, would be a rational improvement over current practice regarding withdrawal of life support. It would give individuals the greatest chance of being able to help others with their organs after death. It would increase patient autonomy. It would reduce the chance of suffering during the dying process. We argue that patients should be given the choice of whether and how they would like to donate their organs in the event of withdrawal of life support in intensive care.Continuing current transplantation practice comes at the cost of death and prolonged organ failure. We should seriously consider all of the alternatives. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Saving Honor:The Ideology of Equal Esteem and the Good of Honor, Friendship, and Glory according to St. ThomasDominic Verner O.P.In his book Natural Law and Human Rights, Pierre Manent assesses and critiques a practical ideology that he finds pervasive within the European academy and sees increasingly informing the practical sensibilities of much of the Western world. "Our governing doctrine," as Manent calls it, is chiefly characterized by the primacy (...) of right over law and the rejection of any objective principle by which actions and persons might be judged.1 It is "the plasticity of the human form" itself which demands respect.2 The only non-constructed and thus normative characteristic of equal human nature is the power of being an "individval-conatus," the power to be one's own rule and reason for acting.3 And the only generally recognized purpose of this "individual-conatus" is to satisfy the desire for power, which is the sole universal motive of human action.4 Such an individual can be legitimately ruled and governed only by himself, a claim reflected in the ideal of the autonomous subject and representative government.5 In sum, Manent characterizes this ideology in terms of a thoroughgoing [End Page 335] rejection of any objective rule, "any law of God or of nature," according to which man is defined and judged.6Manent warns that this ideology is opposed to the very wellsprings of action, since an operation is rightly called an action only when it is performed according to some deliberate choice, which requires some rule and reason. If all rules and reasons are entirely self-generated, then there is no principle according to which deliberation might occur. Such a so-called autonomous subject purports to command himself, but in fact he is more patient than agent: the subject is moved by desires and preferences which cannot be weighed according to any discriminatory rule or principle, since the desires and preferences themselves are the only rule the subject acknowledges. Aside from submitting to the movement of the inexplicably strongest preference, the only positive reason for acting that remains is to destroy any vestiges of objective rules or reasons for acting—that is, the law—that might hinder the realization of individual preference: "The acting animal is now the prisoner of the very audacious and ingenious arrangement that he once devised to escape the urgency and to avoid the difficulty of the practical question. Caught in the realm of inaction, he seeks out, in a kind of terminal fever, the last corners of social existence that still escape the laissez-faire idea and where the very idea of the law might suffer its final defeat."7What is a Christian to make of this practical ideology? What natural inclinations does it privilege and how might the goods it seeks be sought rightly? Manent argues that the sole universal motive for action explicitly recognized by this practical ideology is a certain kind of power: the power of self-determination. According to the governing doctrine, this power is the only universal human motive that can be relied upon to construct common life and political order. Manent's response to this ideology is therefore to propose a recovery of a natural law account of the heterogeneity of universal human motivations to include useful, pleasing, and honorable goods. In this article, I will argue that Manent's own account of the ideology he critiques suggests a more fundamental motive driving the ideology, namely, a desire for an unassailable esteem. And since it is a desire for esteem that best explains the attractiveness of the ideology of modern freedom, an alternative vision of practical life will need to address the desire for esteem and articulate its proper bases. In advancing this argument, I will first show that Manent's own analysis highlights the importance of the desire for esteem in motivating the ideology of modern freedom. I will then turn to the anthropology of Thomas [End Page 336] Aquinas to show that the desire for esteem is manifested in the desire for honor and for friendship and is rooted in a fundamental inclination to have certain knowledge of one's... (shrink)

Die Behandlung von einwilligungsunfähigen psychisch kranken Menschen mit neuen Therapiemethoden ist insbesondere im Kontext des „individuellen Heilversuchs“, der als Anwendung wenig erprobter Therapieansätze im Rahmen von „ultima ratio“-Entscheidungen charakterisiert ist, mit ethischen Abwägungsproblemen verbunden. Diese bestehen aufgrund von Einschränkungen in der Handlungs- und Entscheidungsautonomie der betroffenen Patienten und, aufgrund eigen- oder fremdgefährdender Symptome der psychischen Krankheit selbst, insbesondere in der praktischen Umsetzung ethisch akzeptierter Modelle stellvertretender Entscheidung sowie in der Wahl des Bezugspunkts der Nutzen-Risiko-Analyse des intendierten Therapieverfahrens. Der Artikel untersucht (...) den ethischen Konflikt zwischen gerechtfertigter Hilfeleistung und Instrumentalisierungsrisiko psychisch kranker Menschen zu Fremdzwecken am historischen Beispiel der „Rindenexcisionen“ des Psychiaters Gottlieb Burckhardt (1836–1907). Als Lösungsmöglichkeit dieses ethischen Konflikts wird das „Konzept des kontrollierten individuellen Heilversuchs“ diskutiert. (shrink)