Book Reviewed in this article: Israel's Prophetic Tradition: Essays in honour of Peter R. Ackroyd. Edited by Richard Coggins, Anthony Phillips and Michael Knibb, Pp.xxi, 272. Cambridge University Press, 1982, £21.00. Essays on John. By C.K. Barrett. Pp.viii, 167, London, SPCK, 1982, £10.50. The Letter to the Colossians. By Eduard Schweizer, translated by Andrew Chester. Pp.319, London, SPCK, 1982, £12.50. Foundational Theology: Jesus and the Church. By Francis Schüssler Fiorenza. Pp.xix, 326, New York Crossroad, 1984, $22.50. The Darkness of God: (...) Theology after Hiroshima. By Jim Garrison. Pp.x, 238, London, SCM Press, 1982, £5.95. Discerning the Mystery, An Essay on the Nature of neology. By Andrew Louth. Pp.xiv, 150, Oxford, Clarendon Press, 1983, £12.50. The Tao and the Daimon: Segments of a Religious Inquiry. By Robert C. Neville. Pp.xv, 281, Albany, New York, State University of New York Press, 1982, $34.50 ), $11.95. Person and Myth: Maurice Leenhardt in the Melanesian World. By James Clifford. Pp.xi, 270, Berkeley, University of California Press, 1982, £21.50. Transcendence and the Sacred. Edited by A.M. Olson and L.S. Rouner. Pp.xv, 230, University of Notre Dame Press, 1981, £10.75. A History of Religious Ideas. Vol. 2: From Gautama Buddha to the Triumph of Christianity. By Mircea Eliade. Translated by William R. Trask. Pp.xi, 565, Chicago, University of Chicago Press, 1982, £17.50. Ordeal by Labyrinth: Conversations with Claude‐Henri Racquet. By Mircea Eliade. Translated by Derek Coltman. Pp.ix, 225, Chicago, University of Chicago Press, 1982, £12.55. Religious Philosophy of Prince‐Bishop Njegosh of Montenegro. By Zika Rad. Prvulovich. Pp.xviii, 273, Birmingham, The Author, 1984, £12.50, £10.50. The Home of Meaning: The Hermeneutics of the Subject of Paul Ricoeur. By John W. Van Dengel. Pp.xxi, 333, Washington, D.C., University Press of America, 1982, $24.50, $13.25. Life Forms and Meaning Stucture. By Alfred Schutz, translated, introduced and annotated by Helmut Wagner. Pp.vi, 217, London, Routledge & Kegan Paul, 1982, £11.95. The Shaping of Man: Philosophical Aspects of Sociobiology. By Roger Trigg. Pp.xx, 186. Oxford, Basil Blackwell, 1982, £12.50, £5.95. Marx and Marxisms: Royal Institute of Philosophy Lecture Series, 14. Edited by G.H.R. Parkinson. Pp.vi, 268, Cambridge University Press, 1982, £9.95. Marx and Justice: The Radical Critique of Liberalism. By Allen E. Buchanan. Pp.xiv, 206, London, Methuen, 1982, £12.95. Israel Satanter: Text, Structure, Idea. By Hillel Goldberg. Pp.xvii, 358, New York, Ktav, 1981, $17.50. Freud on Femininity and Faith. By Judith Van Herik. Pp.xiii, 216, Berkeley, University of California Press, 1982, £17.50. Women, Reason and Nature. By Carol McMillan. Pp.x, 165, Oxford, Basil Blackwell, 1982, £12.50. Supererogation: Its Status in Ethical Theory. By David Heyd. Pp.vii, 191, Cambridge University Press, 1982, £14.00. The Cambridge History of Later Medieval Philosophy. Edited by Norman Kretzmann, Anthony Kenny and Jan Finborg. Pp.xi, 1035, Cambridge, Cambridge University Press, 1982, £40.00. St Thomas Aquinas. By Ralph McInerny. Pp.197, Notre Dame, University of Notre Dame Press, 1982, £4.50. Yves de Vallone: The Making of an Esprit‐Fort. By James O'Higgins, S.J. Pp.viii, 248, The Hague, Martinus Nijhoff, 1982, $35.00. Religion and National Identity. Edited by Stuart Mews. Pp.xvi, 618, Oxford, Basil Blackwell, 1982, £19.50. Mortmain Legislation and the English Church, 1279–1500. By Sandra Raban. Pp.xii, 215,, Cambridge University Press, 1982, £25.00. John XXIII, Pope of the Council. By Peter Hebblethwaite. Pp.viii, 550, London, Geoffrey Chapman, 1984, £14.95.iCompiled by J.F. Púglisi and S.J. Voicu. Pp.260, Rome, Centro Pro Unione, 1984, $20.00. Ireland: A Bibliography of Material held at St Deiniol's Library. Compiled by Helen C. Price. Pp.iv, 136, Hawarden, St Deiniol's, 1984, £2.50. The Later Poems, 1972–1982. By R.S. Thomas. Pp.224, London, Macmillan, 1984, £4.95. (shrink)

Ethical guidelines for conducting clinical trials have historically been based on a perceived therapeutic obligation to treat and benefit the patient-participants. The origins of this ethical framework can be traced to the Hippocratic oath originally written to guide doctors in caring for their patients, where the overriding moral obligation of doctors is strictly to do what is best for the individual patient, irrespective of other social considerations. In contrast, although medicine focuses on the health of the person, public health is (...) concerned with the health of the entire population, and thus, public health ethics is founded on the societal responsibility to protect and promote the health of the population as a whole. From a public health perspective, research ethics should be guided by giving due consideration to the risks and benefits to society in addition to the individual research participants. On the basis of a duty to protect the population as a whole, a fiduciary obligation to realise the social value of the research and the moral responsibility to distribute the benefits and burdens of research fairly across society, how a public health perspective on research ethics results in fundamental re-assessments of the proper course of action for two salient topical issues in research ethics is shown: stopping trials early for reasons of efficacy and the conduct of research on less expensive yet less effective interventions. (shrink)

I take it as my assignment to criticize the Gauthier enterprise. At the outset, however, I should express my general agreement with David Gauthier's normative vision of a liberal social order, including the place that individual principles of morality hold in such an order. Whether the enterprise is, ultimately, judged to have succeeded or to have failed depends on the standards applied. Considered as a coherent grounding of such a social order in the rational choice behavior of persons, the enterprise (...) fails. Considered as an extended argument implying that persons should adopt the moral stance embodied in the Gauthier structure, the enterprise is, I dunk, largely successful. Considered as a set of empirically falsifiable propositions suggesting that persons do, indeed, choose as the Gauthier precepts dictate, the enterprise offers Humean hope rather than Hobbesian despair. (shrink)

Psychedelic-assisted Psychotherapy combines the use of psychedelic compounds, such as psilocybin, with psychotherapy. PAP has shown some promise as a novel treatment for Major Depressive Disorder, and empirical research suggests that its efficacy turns on the altered states induced by psychedelic compounds. In this paper we draw on the literature of phenomenology to explain the therapeutic potential of psychedelic experiences. Svenaeus characterises mental illness as a form of suffering that entails three distinct but related experiences of alienation or “unhomelike being-in-the-world”: (...) illness suffering, which relates to embodiment; existential suffering, which relates to self-narratives, and political suffering, which relates to social relationships. Ratcliffe further characterises the experience of MDD in phenomenological terms as a loss of pre-intentional possibility that manifests as excessive noematic feeling in the experience of embodiment, restrictive narratives in the construction of self, and disconnectedness in experience of the social world. We contend that PAP ameliorates the suffering associated with MDD by inducing and consolidating a state of broadened pre-intentional possibility—one that entails sudden, profound and enduring changes in embodiment, self-narratives, and social experience. We argue further that this phenomenological account is consistent with a bio-psycho-social model of mental health and illness, and we frame it as an argument supporting the plausibility of recent claims about treatment success. This helps to justify ongoing future empirical research in this setting. (shrink)

While the UK Home Office’s proposals to preventively detain people with what it has called dangerous severe personality disorder have been subjected to debate and criticism the deeply troubling jurisprudential issues in these proposals have not yet entered into public debate in a way that their seriousness deserves.1 It is good that a commentator as well known as Professor Szasz is speaking out on this issue.Professor Szasz focuses upon a crucial question by calling into question the medicalisation of terms like (...) dangerousness and mental illness.2 There is a great temptation for legislators and the public to treat these terms as if they are purely scientific terms and to think of risk assessment as a precise science. I don’t share Professor’s Szasz’s worry about how psychiatry is using these terms but I think there are some important questions about how these concepts function in the public sphere.This issue is important enough to justify the use of some rhetorical claims because such claims can serve to bring out what are neglected and important issues. In raising the following objections I am not attempting to refute the message that is in Szasz’s article or to say that he is not making an important point but rather to attempt to sharpen the issues and to suggest ways that we can respond to Professor Szasz’s challenge.Psychiatry has progressed in a number of ways since Professor Szasz wrote The Myth of Mental Illness.3 The science is much better, we have much better medications, and psychiatrists are acutely aware of the tension between treating their patient and their obligations to the public interest.So when Professor Szasz says: “Psychiatrists offer to relieve the disturbed person of the burden of coping …. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

A report by the Nuffield Council on Bioethics, contrary to the Declaration of Helsinki, permits most important research initiatives in developing countries.The Ethics of Research Related to Health Care in Developing Countries by the Nuffield Council on Bioethics makes a number of innovative recommendations that depart from codes such as the Declaration of Helsinki. It recommends that standards of care might be relativised to the standard of that nation. It recommends that very good reasons need to be given for not (...) giving post-trial access to medications but recognises that there may be justifiable instances of this. It is the view of the authors that these and other recommendations of the report are sensible pieces of advice given the complexities of the developing world. (shrink)

Good theory; bad politics - this is how Zizek's works have been described. Now Chris McMillan argues that Zizek's reading of global capitalism could reinvent political subversion. He highlights the political consequences of Zizek's fundamental concepts, such as the Lacanian Real, universality and the communist hypothesis. He argues that Zizek's turn to Communism represents the ultimate significance of Zizek's work for the 21st century and a marked new direction for Zizekian theory. While Zizek's work attracts a lot of labels, (...) most of them pejorative - communist, conservative, anti-semantic - Chris McMillan identifies Zizek's unique and productive contribution to social and political theory, constructing his work as a response to the difficulties of contemporary social theory and the political deadlock of global capitalism. (shrink)

Employing the techniques of modern economic analysis, Professor Buchanan reveals the conceptual basis of an individual's social rights by examining the ...

If knowledge is socially constructed, then students' discursive attachments should be eminently malleable. Students' radical openness to change, however, is not the defining characteristic of a university classroom. Instead, learners appear to desire coherence of knowledge over revelations of contingency, and pedagogical acts that disrupt existing formations are as likely to produce reactionary responses as revolutionary reorganizations of the self. In this article Chris McMillan argues that neither the constructivist nor the social constructionist readings of critical pedagogy are able (...) to account for this fixity of knowledge. In response he contends that Slavoj Žižek's Lacanian-inspired theory of subjectivity and of the Real can effectively respond to the limitations of these approaches by insisting upon the pedagogical value of the lack within subjectivity. A Žižekian conception of subjectivity is able to respond to this lacuna by positing the negativity of the subject as the agent of transformation and to produce a “pedagogy of the impossible” that evokes the moments of impossibility within discourse embodied by the subject qua the Lacanian Real. (shrink)

This is the first book that explains how you actually go about doing good bioethics. John McMillan develops an account of the nature of bioethics; he reveals how a number of methodological spectres have obstructed bioethics; and then he shows how moral reason can be brought to bear upon practical issues via an 'empirical, Socratic' approach.

The question of whether any of us can truly be held responsible for what we do is an issue that occupied the ancient Greeks and continues to entertain our leading thinkers. Whether we can be held responsible for our health, or lack thereof, has additional layers of complexity because of the way in which what we do over time impacts our health. Those of us who have ever self-deceptively wondered about the apparent shrinking of our belt or at the fact (...) that the stairs seem to have multiplied are familiar with the idea that our health can change gradually over time as a result of successive choices that we have made. While there are one-off behaviours that can have an impact on health, for example, a single exposure to a very high level of radiation, in general, ill health develops over time, within an environment and complex set of interactions with other people. The implications of that complexity are central to this issue’s Feature Article by Brown and Savulescu.1 They note that there is debate over whether responsibility should play a role in the allocation of healthcare, and, rather than taking a view on that issue, make a number of suggestions about how the concept of responsibility used in healthcare can be enriched by attending to the complex relationship between behaviour and health. …. (shrink)

In Better than Human, noted bioethicist Allen Buchanan grapples with the ethical dilemmas of the medical revolution and biomedical enhancements. One problem, he argues, is that the debate over these enhancements has divided into polar extremes--into denunciations of meddling in the natural order, or else a heady optimism that we can cure all that ails humanity. In fact, Buchanan notes, the human genome has always been unstable, and intervention is no offense against nature.

John Rawls begins a Theory of Justice with the observation that "Justice is the first virtue of social institutions, as truth is of systems of thought… Each person possesses an inviolability founded on justice that even the welfare of society as a whole cannot override"1 (p.3). The COVID-19 pandemic has resulted in lock-downs, the restriction of liberties, debate about the right to refuse medical treatment and many other changes to the everyday behaviour of persons. The justice issues it raises are (...) diverse, profound and will demand our attention for some time. How we can respect the Rawlsian commitment to the inviolability of each person, when the welfare of societies as a whole is under threat goes to the heart of some of the difficult ethical issues we face and are discussed in this issue of the Journal of Medical Ethics. The debate about ICU triage and COVID-19 is quite well developed and this journal has published several articles that explore aspects of this issue and how different places approach it.2–5 Newdick et al add to the legal analysis of triage decisions and criticise the calls for respecting a narrow conception of a legal right to treatment and more detailed national guidelines for how triage decisions should be made.6 They consider scoring systems for clinical frailty, organ failure assessment, and raise some doubts about the fairness of their application to COVID-19 triage situations. Their argument seems to highlight instances of what is called the McNamara fallacy. US Secretary of Defense Robert McNamara used enemy body counts as a measure …. (shrink)

Cohen (2023), Rahimzadeh and colleagues (2023), and Porsdam Mann and colleagues (2023) have written thorough and well-canvassed pieces about the ethical and conceptual challenges of large language...

This important study, the first book-length treatment of an increasingly crucial topic, treats the moral issues of secession at two levels. At the practical level, Professor Buchanan develops a coherent theory of the conditions under which secession is morally justifiable. He then applies it to historical and contemporary examples, including the U.S. Civil War and more recent events in Bangladesh, Katanga, and Biafra, the Baltic states, South Africa, and Quebec. This is the first systematic account of the conditions and (...) terms that justify secession from a political union.But Buchanan also locates this account of the right to secede in the broader context of contemporary political thought, introducing readers to influential accounts of political society such as contractarianism and communitarianism, and showing how the possibility of secession fits into a more complete understanding of political community and political obligation.At both levels this is an important book. It will interest not just political and social theorists but any reader concerned with one of the most momentous issues of our day: the future of troubled political federations and other states under conditions of ethnic and cultural pluralism. (shrink)

The recent renaissance in research on psychedelic-assisted psychotherapy is showing great promise for the treatment of many psychiatric conditions. Interestingly, therapeutic outcomes for patients undergoing these treatments are predicted by the occurrence of a mystical experience—an experience characterised in part by a sense of profound meaning. This has led to hypotheses that psychedelic-assisted psychotherapy is therapeutic because it enhances perception of meaning, and consequently leads to a meaning response. The putative mechanism of action of psychedelics as meaning enhancers raises normative (...) ethical questions as to whether it can be justified to pharmacologically increase the perception of meaning in order to heal patients. Using the perspectives of hedonistic moral theories, this paper argues that if psychedelics operate as meaning enhancers, psychedelic-assisted psychotherapy can be ethically justified. An anti-hedonistic objection is presented by applying Robert Nozick’s Experience Machine thought experiment to the case of psychedelic-assisted psychotherapy. However, it is argued that this objection falls short for two reasons. First, even if pleasure and pain are not the only consequences which have moral value they are not morally irrelevant, therefore, therapeutic meaning enhancement can still be justified in cases of extreme suffering. Second, it is possible that psychedelic states of consciousness do not represent a false reality, hence their therapeutic meaning enhancement is not problematic according to Nozick’s standards. (shrink)

Neoliberalism has ushered in a rise in managerialism, technocracy and bureaucratisation in residential child care where economy, efficiency, and effectiveness have been prioritised over the moral imperative to care. One implication has been the commodification of children who are traded in a culture of procurement and commissioning compounded by a climate of austerity, and where moral regulation has been replaced by contractual regulation. The impact of this upon the care that children receive has raised concern. The impact upon frontline carers (...) of intractable moral challenges which this climate presents in their role of caring each day is less well understood. The naming of an experience can provide an important starting place to understanding and challenging it. This article draws upon the phenomenon of ‘moral distress’, which is well documented in the medical field, and considers the transferability of this phenomenon from nursing to residential child care. It proposes that moral distress discourse may provide a language to residential child care workers through which their experience of the betrayal of the moral fabric of their work may be articulated. (shrink)

There’s no doubt that medical ethics should be ‘grounded’, in the sense that it aims to make a practical, normative contribution to significant ethical issues in medicine. There are a number of ways in which ethics can do that, two of which feature in this issue of the Journal of Medical Ethics. One way is by responding to significant new policy or legal developments that will have an impact on clinical practice. This issue discusses two legal developments that matter to (...) patients and healthcare professionals: the sanctions applied to Dr Bawa-Garba and the Supreme Court’s ruling on the withdrawal of artificial nutrition and hydration. A second way of grounding ethical analysis in the reality and complexity of ethical issues is by using empirical methods. There are two papers in this issue from Canada that illustrate how the subtleties of complex ethical issues can be teased out via qualitative methods. Medical tourism is an important and rapidly developing phenomenon that raises a set of interesting and tricky ethical issues.1 It has been discussed in the Journal of Medical Ethics before and its implications for end of life, dentistry and other health interventions have been explored.2 3 Reproductive tourism occurs in many countries and the complications it can create for issues such as the citizenship of resulting children have been discussed at some length in the JME.4 5 Reproductive tourism is a good example of an area where it is particularly important for ethical analysis to be grounded in the facts and reality of a situation and an empirical approach to ethics is therefore a good option for this topic. In this issue, Couture et …. (shrink)

The conviction that Gilles Deleuze is doing something radical in his work has been accompanied by a corresponding anxiety as to how to read it. In this rigorous and lucid work, Ian Buchanan takes up the challenge by answering the following questions: How should we read Deleuze? How should we read _with_ Deleuze? To show us how Deleuze’s philosophy works, Buchanan begins with Melville’s notion that “a great book is always the inverse of another book that could only (...) be written in the soul, with silence and blood.” Buchanan demonstrates that the figure of two books—one written in ink and the other written in blood—lies at the center of Deleuze’s hermeneutics and that a special relation must be established in order to read the second book from the first. This relation is Deleuzism. By explicating elemental concepts in Deleuze—desire, flow, the nomad—Buchanan finds that, despite Deleuze’s self-declared moratorium on dialectics, he was in several important respects a dialectician. In essays that address the “prehistory” of Deleuze’s philosophy, his methodology, and the utopic dimensions of his thought, Buchanan extracts an apparatus of social critique that arises from the philosopher’s utopian impulse. _Deleuzism_ is a work that will engage all those with an interest in the twentieth-century’s most original philosopher. (shrink)

Change is inevitable, and increasingly rapid and continuous in healthcare as organizations strive to adapt, improve and innovate. Organizational change challenges healthcare providers because it restructures how and when patient care delivery is provided, changing ways in which nurses must carry out their work. The aim of this doctoral study was to explore frontline nurses’ experiences of living with rapid and continuous organizational change. A critical hermeneutic approach was utilized. Participants described feeling voiceless, powerless and apolitical amidst rapid and continuous (...) organizational changes which fuelled apathy, cynicism and disengagement from the organization. However, critical analysis of the data showed that nurses actively engaged with power, voice and politics through resistant and transgressive behaviours in micro‐ethical moments of practice. There is a need to reconceptualize the concepts of voice, power and politics in nursing as there is dissonance between nurses’ beliefs about these concepts and what they are enacting in practice. Recognizing their enactment of power, voice and political agency at the micro‐level may empower nurses. Empowerment would mitigate the high levels of reports of powerlessness experienced in practice during organizational changes. (shrink)

This article argues that hope is of value in clinical ethics and that it can be important for clinicians to be sensitive to both the risks of false hope and the importance of retaining hope. However, this sensitivity requires an understanding of the complexity of hope and how it bears on different aspects of a well-functioning doctor-patient relationship. We discuss hopefulness and distinguish it from three different kinds of hope, or ‘hopes for’, and then relate these distinctions back to differing (...) accounts of autonomy. This analysis matters because it shows how an overly narrow view of the ethical obligations of a clinician to their patient, and autonomy, might lead to scenarios where patients regret the choices they make. (shrink)

The book uses evolutionary principles to explain tribalism, a way of thinking and acting that divides the world into Us versus Them and achieves cooperation within a group at the expense of erecting insuperable obstacles to cooperation among groups. Tribalism represents political controversies as supreme emergencies in which ordinary moral constraints do not apply and as zero-sum, winner take all contests. Tribalism not only undermines democracy by ruling out compromise, bargaining, and respect for the Other; it also reverses one of (...) the most important milestones of progress in how we understand morality: the insight that morality is not a list of commands to be unthinkingly followed, but rather that morality centrally involves the giving and taking of reasons among equals. Tribalism rejects this insight by branding the Other as a being who is incapable of reasoning. (shrink)

This article on the potential for patient online records access (ORA) to increase the likelihood of nocebo effects is timely, 1 given the recent introduction of full prospective records access for primary care patients in England. 2 Blease provides a convincing overview of the evidence for the nocebo effect and examines the complex interplay with health inequities. The article proposes two mechanisms for ORA augmenting nocebo effects through: (A) patients reading about possible negative outcomes of treatments and (B) a negative (...) clinician tone or less supportive content in the notes diminishing patient trust and setting up negative expectations. Blease notes a small percentage of those who had used ORA at least once during the previous year in one study reported feeling more worried about their medications, 3 and that those with mental health diagnoses were significantly more prone to this than those without such diagnoses.shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 91-92 [Access article in PDF] Jaspers and Defining Phenomenology John McMillan IT IS POSSIBLE TO DISTINGUISH a number of positions that you might take on the importance of phenomenology for the study of the mind. The strongest position is to think that phenomenology is sufficient for understanding the mind. This is a position that would be very hard to defend and it (...) is unlikely that Gupta and Kay want to endorse such a view. It is clear that Jaspers did not believe this; although he thought that first-person experience was undervalued, his project was an attempt to make sense of different kinds of explanation, all of which contribute to our understanding of the mind.A second position is to deny that phenomenology gives us anything that is of use in understanding the mind and psychopathology. Philosophers have developed a number of such positions, from the eliminativism of Churchland (1981) to the heterophenomenology of Daniel Dennett (1989, 1991).A third position is to hold that phenomenology is one of the methods that are useful for understanding the mind and psychopathology. Along with neuroscience and other more behavioral approaches to behavior, phenomenology is an important component of an adequate understanding of the mind. This position appears to be that endorsed by Jaspers, Gupta, Kay, and the authors they discuss. It is also the position that Grant Gillett and I defend in Consciousness and Intentionality (2001). Gupta and Kay's paper presents an argument about where the boundaries between phenomenology and other approaches to the mind and psychopathology ought to be drawn. Gupta and Kay, following Jaspers, think that the boundaries of the phenomenological ought to be drawn around those approaches that employ empathy and the presuppositionless stance and do not include objective phenomena.Given that the paper is primarily about what phenomenology means and that it endorses the way that Jaspers used the term, it is fairly important that we have a definition from Jaspers. Gupta and Kay give a description of some of Jaspers's methods for getting at subjective phenomena, but do not give an account of what Jaspers thinks the aim of phenomenology is. In other words, one way to classify something as phenomenological is its methods and another is by what the point of the exercise is. In General Psychopathology, Jaspers (1997) says that phenomenology is an empirical method for investigating "individual psychic experience" (p. 55). We can think of this as a claim about the objective of phenomenology and then consider the merits of different phenomenological methodologies in terms of their success in achieving this objective. This opens up the possibility that a theory may be genuinely phenomenological because it has a plausible method for getting at psychic lived experience but does not use all of the methods advocated by Jaspers.Gupta and Kay are correct that Jaspers does stress the importance of the presuppositionless [End Page 91] stance, the importance of empathy and the importance of not simply relying on objective phenomena. However, it is not obvious why an approach to understanding the mind or psycho- pathology must satisfy these conditions to be phenomenological. Imagine the following kind of situation: when I am observed to hit my big toe against a brick and give a yelp, it is possible to infer something about my psychic lived experience. There is not much is room for doubt about my first-person experience and, although you might ask me questions about my pain, they are unlikely to add much to what you can simply read from my behavior. This example may appear a little crude because the first-person experience in this case is not especially complex and is not that interesting as a entrance to the inner workings of an individual's mental life. It is not hard to come up with other examples where we can read the first-person experience from behavior in a fairly accurate and informative way. A father gazing at his young child while she is sleeping in his arms may be having a number of thoughts that we would not know about... (shrink)

Institutionalizing the Just War provides a new approach to theorizing the morality of war and argues that sound moral principles regarding war-making must take into account the fact that the validity of moral principles can depend upon existing institutions and social practices.

Abstract:This report describes the system of ethical review that was adopted in New Zealand based on the findings and recommendations from the Cartwright Inquiry in 1988. It discusses the changes made to this system under recent governmental initiatives enacted by the National Party, and some of the implications of those changes.

The drift toward behavioral accounts of the cluster of psychological and behavioral traits that were interchangeably referred to as psychopathy, sociopathy and anti-social personality is interesting and well worth exploring. Justman's correct that before the work of the Feighner group and the adoption of Antisocial Personality Disorder in the Diagnostic and Statistical Manual of Mental Disorders -III, the choice of concept did not seem to be vital and in the Mask of Sanity, Cleckley mentions all three terms and does not (...) seem to think much hangs on which term we choose.It seems correct that many held the absence of guilt to be the psychological marker of psychopathy... (shrink)

While apparently helpful concepts such as ”best interests“ appear to have the virtue of simplicity, they are really place holders for the communication, time and listening that’s required to understand what truly matters to patients and others involved in healthcare. When we know what matters to a patient, we can have confidence that we have a “legitimate” view of what’s important to them. Two papers in this issue of the Journal of Medical Ethics explore different ways in which values can (...) be legitimised and applied consistently in healthcare. When a patient can no longer say what it is that matters to them and a significant decision needs to be made, the values that will inform what should happen next need to be legitimised in some way. Common ways of doing that include proxy decision makers or advanced directives. In this issue Jacob Appel calls for the ways in which “substituted judgments” are used for patients who have previously expressed a wish to die, to …. (shrink)

The Journal of Medical Ethics has published a few papers over recent years that explore the ethical implications of ectogenesis.1–4 It is an as yet undeveloped but theoretically possible method by which a fetus can be gestated outside of the womb, and while the prospects of ‘full’ ectogenesis seem some way off, there are techniques that suggest ‘partial’ ectogenesis could be closer. This issue’s Feature Article considers two of the principal arguments that have been developed in favour of ectogenesis being (...) permissible and available.5 Cavaliere observes that the equality and freedom promoting aspects of ectogenesis will only benefit a small number of women, and she argues that it’s the broader political perspective ectogenesis advances that’s valuable. By equality she has in mind the workplace, the burdens of bearing, as well as equality among fertile, infertile, trans and lesbian women. In this context, …. (shrink)

What limitations on intervention in support of democratic revolutions does proper regard for the collective right of self-determination impose? Some have held that if intervention in support of democratic revolutions is justified, it must cease once the authoritarian regime has been deposed—that any effort by the intervener to use force to shape the new political order would violate the people’s right of self-determination. This essay argues that proper regard for self-determination is compatible with much more extensive interventions.

This book articulates a systematic vision of an international legal system grounded in the commitment to justice for all persons. It provides a probing exploration of the moral issues involved in disputes about secession, ethno-national conflict, "the right of self-determination of peoples," human rights, and the legitimacy of the international legal system itself. Buchanan advances vigorous criticisms of the central dogmas of international relations and international law, arguing that the international legal system should make justice, not simply peace among (...) states, a primary goal, and rejecting the view that it is permissible for a state to conduct its foreign policies exclusively according to what is in the "national interest." He also shows that the only alternatives are not rigid adherence to existing international law or lawless chaos in which the world's one superpower pursues its own interests without constraints. This book not only criticizes the existing international legal order, but also offers morally defensible and practicable principles for reforming it. Justice, Legitimacy, and Self-Determination will find a broad readership in political science, international law, and political philosophy. (shrink)

The distinctive aim of applied ethics is to provide guidance as to how we ought to act, as individuals and as shapers of social policies. In this essay, I argue that applied ethics as currently practiced is inadequate and ought to be transformed to incorporate what I shall call social moral epistemology. This is a branch of social epistemology, the study of the social practices and institutions that promote the formation, preservation, and transmission of true beliefs. For example, social epistemologists (...) critically evaluate the comparative advantages of adversarial versus inquisitorial criminal proceedings as mechanisms for the discovery of truth. (shrink)

Credences are beliefs about evidential probabilities. We give the view an assessment-sensitive formulation, show how it evades the standard objections, and give several arguments in support.

Steven Pinker has said that one of the most important questions humans can ask of themselves is whether moral progress has occurred or is likely to occur. Buchanan and Powell here address that question, in order to provide the first naturalistic, empirically-informed and analytically sophisticated theory of moral progress--explaining the capacities in the human brain that allow for it, the role of the environment, and how contingent and fragile moral progress can be.

The Nobel prize-winning molecular biologist Walter Gilbert described the mapping and sequencing of the human genome as “the grail of molecular biology.” The implication, endorsed by enthusiasts for the new genetics, is that possessing a comprehensive knowledge of human genetics, like possessing the Holy Grail, will give us miraculous powers to heal the sick, and to reduce human suffering and disabilities. Indeed, the rhetoric invoked to garner public support for the Human Genome Project appears to appeal to the best of (...) the Western tradition's enthusiasm for progress: the idea of improving human lives through the practical application of scientific knowledge. (shrink)

Scholarly inquiry into medical ethics should inform and guide those involved in making challenging ethical decisions.1 It should strive to be integral to the work of health care professionals and health care institutions2 and clinical relevance seems essential for this to happen. To acknowledge the importance of clinical relevance for medical ethics, the Journal of Medical Ethics has introduced a regular Clinical Ethics section at the beginning of each issue. Papers that we think are likely to be of particular interest (...) and relevance to clinicians will be placed in this section of the journal. One way in which a paper can be framed for a more clinical audience is by organising it around a scenario that healthcare professions might face. The paper published in this issue’s Clinical Ethics section considers a dilemma about whether an egg donor should be contacted to help diagnose a condition that the resulting child might have.3 While egg donation has become more common, the complexities presented by this scenario might appear removed from those which most health professionals face. However, the way in which genomics is becoming incorporated into healthcare means that the issues this scenario raises are relevant to all healthcare professionals. The spread of genomics into practice means that the …. (shrink)