Untoward injuries are unacceptably common in medical treatment, at times with tragic consequences for patients. The phrases 'an epidemic of error' and 'the medical toll' have been coined to describe this problem of 'iatrogenic harm', which it has been suggested may have contributed to 98,000 deaths per year in the US. Some of these incidents are the result of negligence on the part of doctors, but more usually they are no more than inevitable concomitants of the complexity of modern healthcare. (...) This book is fundamentally about distinguishing the former from the latter. Although medicine is used as the book's primary example, the points made apply equally to aviation, industrial activities, and many other fields of human endeavour. The book advocates a more informed alternative to the blaming culture which has increasingly come to dominate our response to accidents, whether in the medical field or elsewhere. (shrink)

There can be no disputing the proposition that doctors and nurses should be held accountable for their professional activities. In most circumstances this accountability should be achieved through appropriate and effective complaints and disciplinary procedures, but there will be cases where the criminal law should become involved. The criminal law, however, is a serious weapon, and should only be used to punish those whose conduct is truly criminal; it should not be used against those who have merely made a human (...) error. The task of the law should therefore be to identify those situations where a doctor or nurse has behaved in a way which demonstrates a criminally culpable state of mind. In NZ recently the law has failed to do this and has been used as a weapon against those who may be in no sense morally blameworthy. -/- In New Zealand recently the law has failed to do this and has been used as a weapon against those who may be in no sense morally blameworthy. In this respect, NZ has been out of step with other comparable jurisdictions and has demonstrably failed to distinguish between cases where death is caused accidentally (through the making of an ordinary human error) and cases where it is caused criminally (through recklessness or culpable negligence). This is a surprising situation in a jurisdiction which has prided itself on its willingness to adopt a reformist legal agenda. (shrink)

In Republic II, after Socrates has constructed the smallest city answering the demands of Necessity, Glaucon dismisses it as unfit for human habitation. The lack of relishes makes life there unpalatable. Without further ado, this “healthy” and “true” city is abandoned, and Socrates spends the rest of the Republic on the etiology, diagnosis, and possible treatment of the chronic “fever” afflicting the city of luxury. Prominent commentators see nothing strange in his brisk turn away from the “true” city, taking the (...) Kallipolis as a hardheaded alternative to Socratic pie in the sky. By contrast, I take seriously Socrates’ claim that the CP is the true city. I analyze its political-economic structure; show how this reappears in the Kallipolis; and explain the CP’s hidden role as a quasi-medical model of equilibrium, an ideal the Kallipolis never achieves, yet to which its rulers must look in exercising their craft. (shrink)

My talk today will be about Newton’s avowed methodology, and specifically the place of experiment in his conception of science, and how his ideas changed significantly over the course of his career. I also want to look at his actual scientific practice and see how this influenced his views on the nature of the experimental sciences.

The precautionary principle (PP) is fundamentally a claim that acting to avoid and/or mitigate threats of serious harm should be accorded high priority in public policy. Over the last three decades, governments and international bodies have endorsed it in principle, and some of them have incorporated it into some areas of policy practice. Yet, PP is controversial in policy circles, public discussion and scholarly discourse. Here the PP literature is reviewed from the perspective of economics, where the tendency is to (...) see theory and methods for rational decision-making under risk and uncertainty as well-established and risk management tools as well developed, and to view the PP with some circumspection. Following a brief introduction to PP concepts, history, applications, and controversies, I review and critique the standard economic approach to decision-making and risk management (here labeled ordinary risk management, ORM), identifying areas of incompleteness especially in the treatment of disproportionate and asymmetric threats. After reviewing some of the more prominent PP controversies in the scholarly literature, I suggest a conceptual framework for a PP that may withstand the major criticisms levied against the PP and make a unique and valid contribution to a decision and risk management arsenal that includes ORM. The framework relates the nature of the threat, the evidence, and the remedy indicated; and each of these elements is discussed in some detail. The scope of this PP is identified in general terms and distinguished from the quantity restrictions and regulatory safety margins that often serve as practical heuristics when ORM-based policies are implemented. Because the PP is clearly identified as a principle, I discuss the role of principles in policy design and implementation, and conclude with some suggestions as to how this PP could guide policy and management. (shrink)

This chapter is a philosophical survey of some leading approaches in formal epistemology in the so-called ‘Bayesian’ tradition. According to them, a rational agent’s degrees of belief—credences—at a time are representable with probability functions. We also canvas various further putative ‘synchronic’ rationality norms on credences. We then consider ‘diachronic’ norms that are thought to constrain how credences should respond to evidence. We discuss some of the main lines of recent debate, and conclude with some prospects for future research.

Socrates -- Plato, The Republic -- Aristotle -- What happened next? -- Hobbes goes to Paris -- Hobbes: raising the great Leviathan -- Locke and the modern order -- Locke: the property argument -- Rousseau -- After the flood -- John Stuart Mill: utilitarianism and liberalism -- Marx -- Rawls: through reason to justice -- In "theory"'s wake -- Rawls: constructing a "political" liberalism -- Concluding reflections.

The Groningen Protocol allows active euthanasia of severely ill newborns with unbearable suffering. Defenders of the protocol insist that the protocol refers to terminally ill infants and that quality of life should not be a factor in the decision to euthanize an infant. They also argue that there should be no ethical difference between active and passive euthanasia of these infants. However, nowhere in the protocol does it refer to terminally ill infants; on the contrary, the developers of the protocol (...) take into account the future quality of life of the infant. We also note how the Nazi Euthanasie Programm started with the premise that there is some life not worthy of living. Therefore, in our opinion, the protocol violates the traditional ethical codes of physicians and the moral values of the overwhelming majority of the citizens of the world. (shrink)

Much of the discussion on business ethics is philosophical in nature. There is no lack of theories and ideals on moral reasoning. What is missing is translating these moral theories and principles into specific, operational procedures that can indicate a proper course of action. Although most business actions are routine and do not raise serious ethical questions, many people experience difficulty in applying their personal moral principles to specific business decisions in ethically-dilemmatic situations.This study seeks to develop a framework that (...) can be utilized to implement personal moral reasoning based on the teleological theory of Utilitarianism and the deontological theory of Ross''s Prima Facie Duties in the business decision-making process. The central feature in the framework is a point-system that quantities the ethical worth of a proposed business action and determines whether the action would be ethically desirable if taken. It provides an objective element in an otherwise qualitative ethical inquiry process. This study also illustrates practical applications of the system by analyzing the ethical implications of a proposed action where foreign bribery is involved. (shrink)

It has often been thought, and has recently been argued, that one of the most profound impacts of Darwin's theory of evolution is the threat that it poses to the very possibility of living a meaningful, and therefore worthwhile, life. Three attempts to ground the possibility of a meaningful life are considered. The first two are compatible with an exclusively Darwinian worldview. One is based on the belief that Darwinian evolution is, in some sense, progressive; the other is based on (...) the belief that the natural world is a thing of value and hence, that our lives are lived in the presence of value. The third is based on a belief in providence, and holds that we must transcend the exclusively Darwinian worldview if we are to find meaning. All three are, for different reasons, rejected. The conclusion reached is that, contrary to what has often been thought and recently argued, the impact of Darwin's theory is precisely to liberate us to lead the most meaningful of lives. (shrink)

Foucault's work has had a profound impact on the medical humanities over the last decade or so. However, most work to date has focused on Foucault's earlier writings rather than his later contributions on the self and governmentality. This article assesses the significance of the concept of governmentality for critical scholarship in the medical humanities, particularly in creating ethical awareness in the field of health care. It examines the context for Foucault's later work, and contributions arising from scholarship building on (...) this work. The governmentality literature, it is argued, raises novel questions about the ways we have come to think about health care in late modern societies. However, there are some limitations with this body of work which have not been fully acknowledged by scholars. The article discusses some of these limitations and offers some suggestions for a fruitful way forward. (shrink)

Este artículo es un estudio acerca de la elaboración de la teoría de la empatía de Edmund Husserl. Procura reconstruir dos de los hitos principales de las reflexiones sobre la empatía en cuanto que vivencia intencional aprehensora de una subjetividad ajena, a partir de una interpretación de textos póstumos sobre la intersubjetividad editados por Iso Kern en 1973 en los volúmenes XIII, XIV y XV de _Husserliana_. El primer hito es la discusión que a comienzos del 1900 Husserl entabla con, (...) por un lado, la teoría de la inferencia por analogía de Benno Erdmann –formulada originalmente por John Stuart Mill– y, por el otro, la teoría de la empatía como instinto de imitación y expresión de Theodor Lipps. El segundo es la reelaboración del concepto de empatía a partir de la fenomenología genética y el descubrimiento de síntesis pasivas a la base de los actos cogitativos del ego. Sostengo en este trabajo que estos dos jalones del pensamiento husserliano sobre la intersubjetividad no están completamente desvinculados: las nociones de analogía y de operaciones no-yoicias, tan importantes en el segundo período, estaban ya presentes a su manera en la interpretación crítica de las teorías de Erdmann/Mill y Lipps. (shrink)

This affair has brought up an incredible number of issues, and I can't dream of addressing them all in 10 minutes, so let me start by circumscribing my talk. I don't want to belabor Social Text 's failings either before or after the publication of my parody: Social Text is not my enemy, nor is it my main intellectual target. I won't go here into the ethical issues related to the propriety of hoaxing. I won't address the obscurantist prose and (...) the uncritical celebrity-worship that have infected certain trendy sectors of the American academic humanities. I won't enter into technical issues of the philosophy of science. I won't discuss the social role of science and technology. Indeed, I want to emphasize that this affair is in my view not primarily about science -- though that was the excuse that I used in constructing my parody -- nor is it a disciplinary conflict between scientists and humanists, who are in fact represented on all sides of the debate. What I believe this debate. (shrink)

We propose that the ontic understanding of quantum mechanics can be extended to a fully realistic theory that describes the evolution of the wavefunction at all times, including during a measurement. In such an approach the wave equation should reduce to the standard wave equation when there is no measurement, and describe state reduction when the system is measured. The general wave equation must be nonlinear and nonlocal, and we require it to be time-symmetric; consequently, this approach is not a (...) new interpretation but a new theory. The wave equation is an integrodifferential equation (IDE). The time symmetry requirement leads to a retrocausal approach, in which the wave equation is solved subject to initial and final conditions to determine history at intermediate times. We propose that different outcomes from (apparently) identically prepared experiments may result from uncontrolled parameters; both the nonlocality and the retrocausality of the theory imply that Bell’s Theorem cannot rule out such “hidden variables.” Beginning with Hamilton’s principle, we demonstrate the construction of such a theory by replacing the action with a functional designed to give rise to a nonlinear, nonlocal IDE as the wave equation. This IDE reduces to the standard wave equation (a differential equation) in the absence of a measurement, but exhibits state reduction to a single eigenvalue when the system interacts with another system with the properties of a measurement apparatus. We demonstrate several desirable features of this theory; for other properties we indicate their plausibility and possible avenues to a proof. (shrink)

Millar, A. 2017. Berkeley's Puzzle. Analysis 77: 232–242.

Informed consent is central to the bioethical principle of respect for persons, a process that involves a discussion between the physician and patient with disclosure of information sufficient to allow the patient to make an informed decision about her or his care. However, despite the importance of informed consent in clinical practice, the process is often ritualized, perfunctory, and performed by individuals with little or no training in the consent process. This article discusses the lack of medical students’ and residents’ (...) training in informed consent and questions the practice of allowing untrained residents and surrogates to obtain consent from patients. (shrink)

Mr. T. H. Mcpherson has given, in a recent article in PHILOSOPHY , various reasons for supposing that there was a development in Butler's ethics from the Sermons to the Analogy . He argues that Butler was in the Sermons a “rational egoist” or “Ethical Eudaemonist,” and in the Analogy an Intuitionist. By “Ethical Eudaemonism” he seems1 to mean that “the ground or criterion of rightness is conduciveness to the agent's interest” or that “it is the happiness-producing character of acts (...) that makes them right” . I shall use the phrase “McPherson's view” to denote the theory that this was Butler's view in the Sermons. (shrink)

Building on research regarding the influence of national identity salience on attitudes towards international institutions and the impact of nationalism on foreign policy preferences, in a case study of America, I explore the role of chauvinistic nationalism to understand its impact on attitudes towards international jurisdiction of punishment for alleged human rights violations by members of the American military. Using binomial regression of survey responses from the 2014 Cooperative Congressional Election Study, I find that respondents with higher levels of chauvinistic (...) nationalist sentiment also have higher levels of opposition to the jurisdiction of international legal institutions to prosecute members of a nation’s military. This study is the first of its kind to offer a systematic and multivariate explanation for public opinion towards the jurisdiction of international human rights institutions over a nation’s armed forces using national survey data. (shrink)

The rapid development of biobanks internationally reflects the considerable expectations attached to the exploitation of genetics knowledge. However, establishing consent and legitimacy for the new generation of biobanks is not without its challenges because they tend to be prospective in nature, involving the collection of DNA, personal medical and lifestyle data generally held over a very long period of time for unspecified research purposes. Thus far, biobanks have tended to be established ahead of wide-ranging debate about their broad implications. Making (...) specific reference to the 'engagement' processes employed by UK Biobank during its establishment phase, this article focuses on the politics of 'public engagement'. It examines the context of arguments for 'public engagement', drawing attention to how particular approaches to 'engagement' within biobank projects may serve to limit debate on substantive questions arising from their development. Unless biobanks' 'engagements' substantially involve publics in deliberations about their development, it is argued, publics are likely to become distrustful of projects and perhaps resist other similar population-based health initiatives in the future. (shrink)

This paper examines moral problems that arise when assigning liability in causally problematic mass exposure tort cases. It examines the relevance of different conceptions of corrective justice for such assignments of liability. It explores an analogy between the expressive role of punishment and the expressive role of tort, and argues that the imposition of liability in causally problematic mass exposure cases can be justified by appeal to expressive considerations.