This chapter contains sections titled: Life Themes Definite descriptions and reference Truth Logical theory Meaning and related notions Individuals Persons and states of mind Subjects and predicates The bounds of sense Responses to skepticism Freedom and resentment Conclusion.

The book deals with the notion of Downward Causation from a wide array of perspectives, including physics, biology, psychology, social science, communication studies, text theory, and philosophy. The book includes proponents as well as opponents discussing the validity of the notion.

This major study examines the most fundamental categories in terms of which we conceive of ourselves, critically surveying the concepts of substance, causation, agency, teleology, rationality, mind, body and person, and elaborating the conceptual fields in which they are embedded. The culmination of 40 years of thought on the philosophy of mind and the nature of the mankind Written by one of the world’s leading philosophers, the co-author of the monumental 4 volume _Analytical Commentary on the Philosophical Investigations_ Uses broad (...) categories, such as substance, causation, agency and power to examine how we think about ourselves and our nature Platonic and Aristotelian conceptions of human nature are sketched and contrasted Individual chapters clarify and provide an historical overview of a specific concept, then link the concept to ideas contained in other chapters. (shrink)

This new edition offers expanded selections from the works of Kongzi, Mengzi, Zhuangzi, and Xunzi ; two new works, the dialogues _Robber Zhi_ and _White Horse_; a concise general introduction; brief introductions to, and selective bibliographies for, each work; and four appendices that shed light on important figures, periods, texts, and terms in Chinese thought.

Given the fact that many people use Wikipedia, we should ask: Can we trust it? The empirical evidence suggests that Wikipedia articles are sometimes quite good but that they vary a great deal. As such, it is wrong to ask for a monolithic verdict on Wikipedia. Interacting with Wikipedia involves assessing where it is likely to be reliable and where not. I identify five strategies that we use to assess claims from other sources and argue that, to a greater of (...) lesser degree, Wikipedia frustrates all of them. Interacting responsibly with something like Wikipedia requires new epistemic methods and strategies. (shrink)

Many of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an (...) emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics. (shrink)

The underdetermination of theory by evidence is supposed to be a reason to rethink science. It is not. Many authors claim that underdetermination has momentous consequences for the status of scientific claims, but such claims are hidden in an umbra of obscurity and a penumbra of equivocation. So many various phenomena pass for `underdetermination' that it's tempting to think that it is no unified phenomenon at all, so I begin by providing a framework within which all these worries can be (...) seen as species of one genus: A claim of underdetermination involves (at least implicitly) a set of rival theories, a standard of responsible judgment, and a scope of circumstances in which responsible choice between the rivals is impossible. Within this framework, I show that one variety of underdetermination motivated modern scepticism and thus is a familiar problem at the heart of epistemology. I survey arguments that infer from underdetermination to some reëvaluation of science: top-down arguments infer a priori from the ubiquity of underdetermination to some conclusion about science; bottom-up arguments infer from specific instances of underdetermination, to the claim that underdetermination is widespread, and then to some conclusion about science. The top-down arguments either fail to deliver underdetermination of any great significance or (as with modern scepticism) deliver some well-worn epistemic concern. The bottom-up arguments must rely on cases. I consider several promising cases and find them to either be so specialized that they cannot underwrite conclusions about science in general or not be underdetermined at all. Neither top-down nor bottom-up arguments can motivate any deep reconsideration of science. (shrink)

Reflection Principles are commonly thought to produce only strong axioms of infinity consistent with V = L. It would be desirable to have some notion of strong reflection to remedy this, and we have proposed Global Reflection Principles based on a somewhat Cantorian view of the universe. Such principles justify the kind of cardinals needed for, inter alia , Woodin’s Ω-Logic.

This paper briefly reviews highlights from decades of debates in medicine, law, bioethics, psychology and social research about children’s and parents’ views and consent to medical treatment and research. There appears to have been a rise and later a fall in respect for children’s views, illustrated among many examples by a recent book on the zone of parental discretion, which is reviewed. A return to greater respect for children’s views and consent is advocated.

Engineering is 'the people-serving profession'. The work of engineers involves interaction with clients, other engineers, and the public at large. More than any other profession, their work also directly involves and affects the environment. This book makes the case that engineers have special professional obligations to protect and enhance the environment, and the authors - one, an engineer and the other, a philosopher - seek to provide an ethical basis for these obligations. In exploring these ethical issues, the authors aim (...) to show that engineers make a difference. The text opens with a series of case studies in which engineers face complex and challenging decisions about the environment. Succeeding chapters examine different ideas about environmental ethics for engineers, including professional codes and both modern and historical discussions of environmental responsibility. The book concludes with a collection of readings that complement the text. Students, as well as practising engineers, will find much of interest in this well-argued and thought-provoking book. (shrink)

This paper canvasses recent arguments in favor of commercial markets in human transplant kidneys, raising objections to those arguments on grounds of the role of injustice, exploitation, and coercion in compromising the autonomy of those most likely to sell a kidney, namely, the least well off members of society.

Central to Thomas Sprat's History of the Royal Society was the description and justification of the method adopted and advocated by the Fellows of the Society, for it was thought that it was their method which distinguished them from ancients, dogmatists, sceptics, and contemporary natural philosophers such as Descartes. The Fellows saw themselves as furthering primarily a novel method, rather than a system, of philosophy, and the History gave expression to this corporate self-perception. However, the History's description of their method (...) was not necessarily accurate. Rather, as will be argued below, by a combination of subtle misrepresentation and selective exposition, Sprat portrayed a method which would further the aims of social and ecclesiastical stability and material prosperity, essential for the Royal Society since its continued existence depended upon the creation of a social basis for the institutionalized pursuit of natural philosophy. Some link had to be forged between the activities of the Society and the intellectual and social aspirations of the Restoration. To understand the intent and meaning of Sprat's History and the method there portrayed, we must therefore look to the institutional needs which it fulfilled. (shrink)

We locate winning strategies for various ${\mathrm{\Sigma }}_{3}^{0}$ -games in the L-hierarchy in order to prove the following: Theorem 1. KP+Σ₂-Comprehension $\vdash \exists \alpha L_{\alpha}\ models"\Sigma _{2}-{\bf KP}+\Sigma _{3}^{0}-\text{Determinacy}."$ Alternatively: ${\mathrm{\Pi }}_{3}^{1}\text{\hspace{0.17em}}-{\mathrm{C}\mathrm{A}}_{0}\phantom{\rule{0ex}{0ex}}$ "there is a β-model of ${\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}\text{\hspace{0.17em}}\text{\hspace{0.17em}}+\text{\hspace{0.17 em}}{\mathrm{\Sigma }}_{3}^{0}$ -Determinacy." The implication is not reversible. (The antecedent here may be replaced with ${\mathrm{\Pi }}_{3}^{1}\text{\hspace{0.17em}}\text{\hspace{0.17em}}\left({\mathrm{\Pi }}_{3}^{1}\right)-{\mathrm{C}\mathrm{A}}_{0}:\text{\hspace{0.17em}}{\mathrm{\Pi }}_{3}^{1}$ instances of Comprehension with only ${\mathrm{\Pi }}_{3}^{1}$ -lightface definable parameters—or even weaker theories.) Theorem 2. KP +Δ₂-Comprehension +Σ₂-Replacement + ${\mathrm{\Sigma }}_{3}^{0}\phantom{\rule{0ex}{0ex}}$ -Determinacy. (Here AQI (...) is the assertion that every arithmetical quasi-inductive definition converges.) Alternatively: $\Delta _{3}^{1}{\rm CA}_{0}+{\rm AQI}\nvdash \Sigma _{3}^{0}$ -Determinacy. Hence the theories: ${\mathrm{\Pi }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0},\text{\hspace{0.17em}}{\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}+\text{\hspace{0.17em}}{\mathrm{\Sigma }}_{3}^{0}-\mathrm{D}\mathrm{e}\mathrm{t}\phantom{\rule{0ex}{0ex}}$ -Det, ${\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}+\mathrm{A}\mathrm{Q}\mathrm{I}$ , and ${\mathrm{\Delta }}_{3}^{1}-{\mathrm{C}\mathrm{A}}_{0}\phantom{\rule{0ex}{0ex}}$ are in strictly descending order of strength. (shrink)

The present volume is, we believe, the first-ever edited volume devoted to the emotion of disgust. In this chapter we address the following issues: 1. Why was disgust almost completely ignored until about 1990, 2. Why has there been a great increase in attention to disgust since about 1990?, 3. The outline of an integrative, body-to-soul preadaptation theory of disgust, 4. Some specific features of disgust that make it particularly susceptible to laboratory research and particularly appropriate to address some fundamental (...) issues in psychology. In the final section, we outline some new questions that arise from the recent increased interest in disgust in the areas of brain mechanisms, psychopathology, the psychometric approach to the structure of disgust, and disgust and morality. We then indicate some important aspects of disgust that have yet to receive systematic investigation. (shrink)

This paper argues that in modern (agro)biotechnology, (un)naturalness as an argument contributed to a stalemate in public debate about innovative technologies. Naturalness in this is often placed opposite to human disruption. It also often serves as a label that shapes moral acceptance or rejection of agricultural innovative technologies. The cause of this lies in the use of nature as a closed, static reference to naturalness, while in fact “nature” is an open and dynamic concept with many different meanings. We propose (...) an approach for a dynamic framework that permits an integrative use of naturalness in debate, by connecting three sorts of meaning that return regularly in the arguments brought forward in debate; cultural, technological, and ecological. We present these as aspects of nature that are always present in the argument of naturalness. The approach proposes a dynamic relation between these aspects, formed by gradients of naturalness, which in turn are related to ethical concerns. In this way we come to an overview that makes it possible to give individual arguments a relative place and that does justice to the temporality of the concept of nature and the underlying ethical concerns stakeholders have in respect to innovation in agriculture. (shrink)

We look at various notions of a class of definability operations that generalise inductive operations, and are characterised as “revision operations”. More particularly we: (i) characterise the revision theoretically definable subsets of a countable acceptable structure; (ii) show that the categorical truth set of Belnap and Gupta’s theory of truth over arithmetic using \emph{fully varied revision} sequences yields a complete \Pi13 set of integers; (iii) the set of \emph{stably categorical} sentences using their revision operator ψ is similarly \Pi13 and which (...) is complete in Gödel’s universe of constructible sets L; (iv) give an alternative account of a theory of truth—realistic variance that simplifies full variance, whilst at the same time arriving at Kripkean fixed points. (shrink)

This article explores three ways in which a cognitively entrenched mindreading (or 'theory of mind') system may bias our thinking as cognitive scientists. One issues in a form of tacit dualism, impacting scientific debates about phenomenal consciousness. Another leads us to think that our own minds are easier to know than they really are, influencing debates about self-knowledge, and about mindreading itself. And the third results in a bias in favour of empiricist over nativist accounts of cognitive development. The discussion (...) throughout is tentative and speculative, and can be regarded as an appeal for caution, as well as a call for further research. (shrink)

Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing (...) the procurement rate.In this paper, we meet the main objections to mandated choice . We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation. (shrink)

We analyse the extent of possible computations following Hogarth ([2004]) conducted in Malament–Hogarth (MH) spacetimes, and Etesi and Németi ([2002]) in the special subclass containing rotating Kerr black holes. Hogarth ([1994]) had shown that any arithmetic statement could be resolved in a suitable MH spacetime. Etesi and Németi ([2002]) had shown that some relations on natural numbers that are neither universal nor co-universal, can be decided in Kerr spacetimes, and had asked specifically as to the extent of computational limits there. (...) The purpose of this note is to address this question, and further show that MH spacetimes can compute far beyond the arithmetic: effectively Borel statements (so hyperarithmetic in second-order number theory, or the structure of analysis) can likewise be resolved: Theorem A. If H is any hyperarithmetic predicate on integers, then there is an MH spacetime in which any query ? n H ? can be computed. In one sense this is best possible, as there is an upper bound to computational ability in any spacetime, which is thus a universal constant of that spacetime. Theorem C. Assuming the (modest and standard) requirement that spacetime manifolds be paracompact and Hausdorff, for any spacetime there will be a countable ordinal upper bound, , on the complexity of questions in the Borel hierarchy computable in it. Introduction 1.1 History and preliminaries Hyperarithmetic Computations in MH Spacetimes 2.1 Generalising SADn regions 2.2 The complexity of questions decidable in Kerr spacetimes An Upper Bound on Computational Complexity for Each Spacetime CiteULike Connotea Del.icio.us What's this? (shrink)

Sen’s capabilities approach offers a radical generalisation of the conventional approach to welfare economics. It has been highly influential in development and many researchers are now beginning to explore its implications for health care. This paper contributes to the emerging debate by discussing two examples of such applications: first, at the individual decision making level, namely the right to die, and second, at the social choice level. For the first application, which draws on Nussbaum’s list of capabilities, it is argued (...) that many capabilities are ambiguously or indirectly related to the right to die, but the ability to form a concept of the good life and plan one’s own life provides a direct justification for such a right. In the second application, the focus is specifically on healthcare rationing and it is argued that, although not committed to age based rationing, the capabilities approach provides a more natural justification of age related access to health care than the fair innings argument, which is often used to justify the alleged ageism inherent in quality adjusted life years maximisation. (shrink)

In the axiomatic development of the logic of nonrelativistic quantum mechanics it is not difficult to set down certain plausible axioms which ensure that the quantum logic of propositions has the structure of an orthomodular poset. This can be done in a number of ways, for example, as in Gunson [2], Mackey [4], Piron [5], Varadarajan [7] and Zierler [8], and we summarise one of these ways in §2 below.

We show that Leitgeb’s dependence operator of Leitgeb is a \-operator and that this is best possible.

It has been common wisdom for centuries that scientific inference cannot be deductive; if it is inference at all, it must be a distinctive kind of inductive inference. According to demonstrative theories of induction, however, important scientific inferences are not inductive in the sense of requiring ampliative inference rules at all. Rather, they are deductive inferences with sufficiently strong premises. General considerations about inferences suffice to show that there is no difference in justification between an inference construed demonstratively or ampliatively. (...) The inductive risk may be shouldered by premises or rules, but it cannot be shirked. Demonstrative theories of induction might, nevertheless, better describe scientific practice. And there may be good methodological reasons for constructing our inferences one way rather than the other. By exploring the limits of these possible advantages, I argue that scientific inference is neither of essence deductive nor of essence inductive. (shrink)

I argue that quantum optical experiments that purport to refute Bohr’s principle of complementarity fail in their aim. Some of these experiments try to refute complementarity by refuting the so called particle–wave duality relations, which evolved from the Wootters–Zurek reformulation of BPC. I therefore consider it important for my forgoing arguments to first recall the essential tenets of BPC, and to clearly separate BPC from WZPC, which I will argue is a direct contradiction of BPC. This leads to a need (...) to consider the meaning of particle–wave duality relations and to question their fundamental status. I further argue that particle and wave complementary concepts are on a different footing than other pairs of complementary concepts. (shrink)

Objective: To assess whether continuous consent, a process in which information is given to research participants at different stages in a trial, and clinician training in that process were effective when used by clinicians while gaining consent to the Total Body Hypothermia (TOBY) trial. The TOBY trial is a randomised controlled trial (RCT) investigating the use of whole-body cooling for neonates with evidence of perinatal asphyxia. Obtaining valid informed consent for the TOBY trial is difficult, but is a good test (...) of the effectiveness of continuous consent. Methods: Semistructured interviews were conducted with 30 sets of parents who consented to the TOBY trial and with 10 clinicians who sought it by the continuous consent process. Analysis was focused on the validity of parental consent based on the consent components of competence, information, understanding and voluntariness. Results: No marked problems with consent validity at the point of signature were observed in 19 of 27 (70%) couples. Problems were found mainly to lie with the competence and understanding of the parents: mothers, particularly, had problems with competence in the early stages of consent. Problems in understanding were primarily to do with side effects. Problems in both competence and understanding were observed to reduce markedly, particularly for mothers, in the post-signature phase, when further discussion took place. Randomisation was generally understood but unpopular. Information was not always given by clinicians in stages during the short period available before parents gave consent. Most clinicians, however, were able to give follow-up information. Discussion: Consent validity was found to compare favourably with similar trials examined in the Euricon study. Conclusion: Adopting the elements of the continuous consent process and clinician training in RCTs should be considered by researchers, particularly when they have concerns about the quality of consent they are likely to obtain by using a conventional process. (shrink)

Immunisation is offered to all age groups in the UK, but is mainly given to infants and school-age children. Such immunisation is not compulsory, in contrast to other countries, such as the United States. Levels of immunisation are generally very high in the UK, but the rates of immunisation vary with the public perception of the risk of side effects. This article discusses whether compulsory vaccination is acceptable by considering individual cases where parents have failed to give consent or have (...) explicitly refused consent for their children to be immunised. In particular, the rights of: a parent to rear his/her child according to his/her own standards; the child to receive health care, and the community to be protected from vaccine-preventable infectious disease are considered. The conclusion of the article is that compulsory vaccination cannot, with very few exceptions, be justified in the UK, in view of the high levels of population immunity which currently exist. (shrink)

At the very end of Plato's Philebus Socrates and Protarchus place the goods of a human life in a hierarchy (66a-67b). Previous interpretations of this passage have concentrated upon its relevance to the good human life, including the allowance of (true and pure) pleasures. This view picks up Plato's metaphor of a mixture of reason and pleasure, but the ranking of the goods is emphatically a vertical stratification and not a mixture in which all elements are equally fundamental. In this (...) article I argue that each and all of the higher ranked goods are necessary conditions for the goods of the level immediately below. The ranking represents an attempt to identify as far as possible what is responsible for the characteristics of the good in human life, and therefore to narrow down the definition of the good itself. (shrink)

According to the causal interpretation of quantum mechanics, one can precisely define the state of an individual particle in a many-body system by its position, momentum, and spin. It is shown in the EPR spin experiment that the quantum torque brings about an instantaneous change in the state of one of the particles when the other undergoes a local interaction, but that such a transfer of “information” cannot be extracted by any experiment subject to the laws of quantum mechanics.

1. _The project_ Over the last two and a half centuries three main strands of opinion can be discerned in philosophers.

This practical and essential text, co-authored by an engineer and an ethicist, covers ethical dilemmas that any engineer might encounter on the job, emphasizing the responsibility of a practicing engineer to act in an ethical manner. To illustrate the complexities involved, the authors present characters who encounter situations that test the engineering code of ethics. The dialogue between the characters highlights different perspectives of each dilemma. As they proceed through the book, students see how the code of ethics can help (...) in decision making, as well as the implications of various decisions. The philosophical theory that supports the ethical situations encountered is presented as boxed material following each section. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

Randomised controlled trials (RCTs) sometimes recruit participants who are desperate to receive the experimental treatment. This paper defends the practice against three arguements that suggest it is unethical first, desperate volunteers are not in equipoise. Second clinicians, entering patients onto trials are disavowing their therapeutic obligation to deliver the best treatment; they are following trial protocols rather than delivering individualised care. Research is not treatment; its ethical justification is different. Consent is crucial. Third, desperate volunteers do not give proper consent: (...) effectively, they are coerced. This paper responds by advocating a notion of equipoise based on expert knowledge and widely shared values. Where such collective, expert equipoise exists there is a prima facie case for an RCT. Next the paper argues that trial entry does not involve clinicians disavowing their therapeutic obligation; individualised care based on insufficient evidence is not in patients best interest. Finally, it argues that where equipoise exists it is acceptable to limit access to experimental agents; desperate volunteers are not coerced because their desperation does not translate into a right to receive what they desire. (shrink)

Optimization by definition is the action of making most effective or the best use of a resource or situation and that is required almost in every field of engineering. In this work, the optimization of Least Mean square (LMS) algorithm is carried out with the help of Particle Swarm Optimization (PSO) and Ant Colony Optimization (ACO). Efforts have been made to find out the advantages and disadvantages of combining gradient based (LMS) algorithm with Swarm Intelligence SI (ACO, PSO). This optimization (...) of LMS algorithm will help us in further extending the uses of adaptive filtering to the system having multi-model error surface that is still a gray area of adaptive filtering. Because the available version of LMS algorithm that plays an important role in adaptive filtering is a gradient based algorithm, that get stuck at the local minima of system with multi-model error surface considering it global minima, resulting in an non-optimized convergence. By virtue of the proposed method we have got a profound solution for the problem associated with system with multimodal error surface. The results depict significant improvements in the performance and displayed fast convergence rate, rather stucking at local minima. Both the SI techniques displayed their own advantage and can be separately combined with LMS algorithm for adaptive filtering. This optimization of LMS algorithm will further help to resolve serious interference and noise issues and holds a very important application in the field of biomedical science. (shrink)

The principle of excluded middle is the logical interpretation of the law V ≤ A v ヿA in an orthocomplemented lattice and, hence, in the lattice of the subspaces of a Hilbert space which correspond to quantum mechanical propositions. We use the dialogic approach to logic in order to show that, in addition to the already established laws of effective quantum logic, the principle of excluded middle can also be founded. The dialogic approach is based on the very conditions under (...) which propositions can be confirmed by measurements. From the fact that the principle of. excluded middle can be confirmed for elementary propositions which are proved by quantum mechanical measurements, we conclude that this principle is inherited by all finite compound propositions. For this proof it is essential that, in the dialog-game about a connective, a finite confirmation strategy for the mutual commensurability of the subpropositions is used. (shrink)

Recent research governance documents say that the body of research evidence must reflect population diversity. The response to this needs to be more sophisticated than simply ensuring minorities are present in samples. For quantitative research looking primarily at treatment effects of drugs and devices four suggestions are made. First, identify where the representation of minorities in samples matters—for example, where ethnicity may cause different treatment effects. Second, where the representation of a particular group matters then subgroup analysis of the results (...) will usually be necessary. Third, ensuring representation and subgroup analysis will have costs; deciding on whether such representation is worthwhile will involve cost benefit analysis. Fourth, the representation of minorities should not be seen as mainly a locality issue. For qualitative research it is argued that the representation of diversity is often important. Given the small samples of many qualitative projects, however, the best way to ensure representation occurs is to allow a proliferation of such research, not to stipulate such representation in samples. (shrink)

The challenges posed by chronic illness have pointed out to epidemiologists the multifactorial complex nature of disease causality. This notion has been referred to as a web of causality. This web extends theoretically beyond risk markers. It includes determinants of emergence/non-emergence of disease. This web of determinants is a form of complex system. Due to its complexity, the determinants within such system are not linked to each others in a linear, predictable manner only. Predictability is possible only on a short-term (...) basis, and unpredictability sets in over the long run. Understanding such a system of determinants calls for articulation and testing of complex models which synthesize our knowledge of multiple determinants at many scales, both biological and otherwise. Given the complexity of this web and existing knowledge about the nonlinearity of such systems, the following question is posed: Can the challenge of studying causality be adequately addressed if emphasis continues to be placed on using tools and methods that are geared towards looking at such system from a linear paradigm? Or is it time to add to the epidemiologic research agenda the notion of nonlinearity and its relevant form of analytical approaches that are being tested in other disciplines? Furthermore, the question posed here applies as well to the study of determinants of health. Addressing determinants of heath adds further complexity to our task. (shrink)

The terms “competency” and “decision making capacity” are often used interchangeably in the medical setting. Although competency is a legal determination made by judges, “competency” assessments are frequently requested of psychiatrists who are called to consult on hospitalised patients who refuse medical treatment. In these situations, the bioethicist is called to consult frequently as well, sometimes as a second opinion or “tie breaker”. The psychiatric determination of competence, while a clinical phenomenon, is based primarily in legalism and can be quite (...) different from the bioethics approach. This discrepancy highlights the difficulties that arise when a patient is found to be “competent” by psychiatry but lacking in DMC by bioethics. Using a case, this dilemma is explored and guidance for reconciling the opinions of two distinct clinical specialties is offered. (shrink)

Berent (this issue) critiques one of the three main proposals put forward by Carruthers (this issue), who suggests that cognitive scientists are biased against innateness-claims by the tacit assumptions of the mentalizing faculty. Berent proposes, instead, that the bias results from dissonance produced by a conflict between our innate dualism and our innate essentialism. The present response raises a number of difficulties for her argument.

One of the predominant debates in AI Ethics is the worry and necessity to create fair, transparent and accountable algorithms that do not perpetuate current social inequities. I offer a critical analysis of Reuben Binns’s argument in which he suggests using public reason to address the potential bias of the outcomes of machine learning algorithms. In contrast to him, I argue that ultimately what is needed is not public reason per se, but an audit of the implicit moral assumptions of (...) societies within which algorithms are built and applied. Public justification is appealing since it offers us the possibility to align the decision-making outcomes of the algorithm with the core moral values of stakeholders within a constitutional democratic society. My concern is that the common moral principles that form the foundation of public reason are not necessarily neutral, as they still express specific moral ideals and normative standards even if there is moral agreement by society as a whole, or among different stakeholders within society. Appealing to such normative standards may thus still lead to algorithmic outcomes being biased as common moral values may very well still be discriminatory even though they are formed from a consensus, and even if public reason is applied as a kind of filter for potential algorithmic outcomes. Hence, I argue that these implicit moral norms within society that we take as a given in public reasoning, need to be audited from generation to generation in order to effectively mitigate potential algorithmic bias. (shrink)

Introduction to, and overview of, the contents of the Symposium on consent and confidentialityThe papers in this symposium are based on a meeting held by the Academy of Medical Sciences in London on 12 February 2002. The decision to hold this meeting, and to explore in detail these important and contentious issues, arose from a number of concerns that the Academy felt about what may reasonably be called “impediments to medical research”.These include: The regulations arising from the implementation of the (...) European data protection directive and their effect on the gathering and holding of data needed for disease surveillance as well as for research. Phil Boyd, in his paper, presents the views and the work of the Information Commission, the responsible UK body in this area. The “Source Informatics” case where the Department of Health requested a judicial review on the use, by this company, of anonymised prescribing data from general practitioner records for informing the pharmaceutical industry about patterns of drug use. Mr Justice Latham ruled that the use of even this anonymised data for commercial purposes could be a breach of patients' rights to confidentiality. The Court of Appeal, however, emphatically reversed his decision and, no further appeal having been made to the House of Lords, the law of the land is now clear that there is no breach of confidentiality in the use of anonymised data. It did seem to us, …. (shrink)

My original paper suggested that an ethics of care which failed to specify how, and about what, to care would be devoid of normative and descriptive content. Bradshaw's approach provides such a specification and is, therefore, not devoid of such content. However, as all ethical approaches suggest something about the 'what' and 'how' of care, they are all 'ethics of care' in this broader sense. This reinforces rather than undermines my original conclusion. Furthermore, Bradshaw's 'ethics of care' has philosophical and (...) historical problems which I outline. (shrink)

Recently, Alper, Bridger, Earman and Norton have all proposed examples of dynamic systems that, in their view, are incompatible with classical (Newtonian) mechanics. In the first section of the present paper I shall show that their arguments are all undermined by the same fallacy. The second section proves that their conclusions of incompatibility are indeed false, and that what we are really looking at are new forms of indeterminist evolution of the same kind as that found recently in the literature (...) on supertasks. In the third section of the paper, I argue that one of these new forms of evolution is particularly interesting, and that analysis of it leads to a new vision of the relation between interaction by contact and impenetrability. 1. Introduction2. The fallacy3. Understanding some physical supertasks4. A philosophically interesting implication: contact and impenetrability. (shrink)

Background:: Over the past few years, research ethics committees have increasingly demanded explicit consent before archival tissue samples can be used in research projects. Current UK guidance in this area requires an assessment of whether it is “practical” to obtain explicit consent. Ethics committees have little experience or evidence to help them to judge what is “practical” in this context.Methods:: We attempted to obtain general consent for research use of surplus tissue from renal transplant biopsies from the entire patient population (...) of the renal transplant unit in Leicester. The nature of this patient population would be expected to facilitate this task.Results:: A total of 495 letters were sent. Attempts were made to contact non-responders when they attended the outpatient clinic. One year after the initiation of the project, the opinions of 26% of the patients had still not been ascertained.Conclusions:: The results confirm that the vast majority of patients are happy for “surplus” biopsy material to be used for research; the situation does not parallel the use of autopsy tissue. A requirement to obtain explicit consent for the study of archival tissue is likely, however, to block or at least seriously delay research, which is contrary to the public interest and specifically may harm the interests of the patients concerned. In the UK, the problem of tissue being used against the wishes of the donor has now been largely replaced by the problem of prohibition of tissue use against the wishes of the donor. (shrink)