In a short rejoinder, I thank Macklin and Benatar for their very helpful and thought-provoking comments and at the same time, I want to provide some additional information, which might be of interest to Macklin and our readers.

Feminist bioethicists of a variety of persuasions discuss the 2013 case of Marlise Munoz, a pregnant woman whose medical care was in dispute after she became brain dead.

This book provides an analysis of the debate surrounding cultural diversity, and attempts to reconcile the seemingly opposing views of "ethical imperialism," the belief that each individual is entitled to fundamental human rights, and cultural relativism, the belief that ethics must be relative to particular cultures and societies. The author examines the role of cultural tradition, often used as a defense against critical ethical judgments. Key issues in health and medicine are explored in the context of cultural diversity: the physician-patient (...) relationship, disclosing a diagnosis of a fatal illness, informed consent, brain death and organ transplantation, rituals surrounding birth and death, female genital mutilation, sex selection of offspring, fertility regulation, and biomedical research involving human subjects. Among the conclusions the author reaches are that ethical universals exist, but must not be confused with ethical absolutes. The existence of ethical universals is compatible with a variety of culturally relative interpretations, and some rights related to medicine and health care should be considered human rights. Illustrative examples are drawn from the author's experiences serving on international ethical review committees and her travels to countries in Africa, Asia, and Latin America, where she conducted educational workshops and carried out out her own research. (shrink)

What makes individuals, groups, or even entire countries vulnerable? And why is vulnerability a concern in bioethics? A simple answer to both questions is that vulnerable individuals and groups are subject to exploitation, and exploitation is morally wrong. This analysis is limited to two areas. First is the context of multinational research, in which vulnerable people can be exploited even if they are not harmed, and harmed even if they are not exploited. Second is the situation of women, who are (...) made vulnerable in cultural settings or in entire countries in which they are oppressed and powerless. (edited). (shrink)

ABSTRACTComparative effectiveness studies, referred to here as “usual-care” trials, seek to compare current medical practices for the same medical condition. Such studies are presumed to be safe and involve only minimal risks. However, that presumption may be flawed if the trial design contains “unusual” care, resulting in potential risks to subjects and inaccurately informed consent. Three case studies described here did not rely on clinical evidence to ascertain contemporaneous practice. As a result, the investigators drew inaccurate conclusions, misinformed research participants, (...) and subjects’ safety was compromised. Before approving usual-care protocols, IRBs and scientific review committees should evaluate the quality and completeness of information documenting usual-care practices. Guidance from governmental oversight agencies regarding evidence-based documentation of current clinical practice could prevent similar occurrences in future usual-care trials. Accurate information is necessary to ensure that trials comply with government regulations that require minimizing research risks to subjects and accurate informed consent documents. (shrink)

Intense aesthetic experiences are often described in terms of self-forgetfulness, where the perceiver becomes immersed in the aesthetic phenomenon to the extent of losing consciousness of being the subject of the experience. Although such experiences have been described from the early eighteenth century onwards, there is still a surprising lack of detailed investigation on the precise nature of aesthetic self-forgetfulness. What happens in this experience, and precisely what is the ‘self’ that is forgotten? Building on phenomenological theories of self-consciousness, I (...) argue that aesthetic self-forgetfulness cannot be understood as an absolute eradication of the self, as a pre-reflective self-consciousness stays intact even in deeply immersive aesthetic experiences. Thus, I argue that talk of self-forgetfulness is to some extent misleading, and the changes in the subject’s self-relation during aesthetic experience is better understood in terms of an altered sense of agency. (shrink)

Rhodes seeks to defend her ‘conclusion that everyday ethics and medical ethics [are] incompatible’.1 She challenges ‘views that medical ethics is nothing more than common morality applied to clinical matters’ (Rhodes, p2).1 Beauchamp and Childress explicate the term ‘common morality’ at length.2 Nowhere do they claim that medical ethics is ‘nothing more than common morality applied to clinical matters’. Here is what they do say: “The origin of the norms of the common morality is no different in principle from the (...) origin of the norms of a particular morality for a medical or other profession … The primary difference is that the common morality has authority in all communities, whereas particular moralities are authoritative only for specific groups” (Beauchamp and Childress, p8).2 This critique discusses the seven examples Rhodes uses to illustrate her main point: that common morality and medical ethics are radically different. I contend that common morality accounts for the purported differences she cites. In ordinary life, people can simply mind their own business, whereas physicians have a duty to act in their professional setting. On this view, common morality cannot explain the moral obligation people have to prevent easily avoidable harm to others. A bystander …. (shrink)

Gillon is correct that the four principles provide a sound and useful way of analysing moral dilemmas. As he observes, the approach using these principles does not provide a unique solution to dilemmas. This can be illustrated by alternatives to Gillon’s own analysis of the four case scenarios. In the first scenario, a different set of factual assumptions could yield a different conclusion about what is required by the principle of beneficence. In the second scenario, although Gillon’s conclusion is correct, (...) what is open to question is his claim that what society regards as the child’s best interest determines what really is in the child’s best interest. The third scenario shows how it may be reasonable for the principle of beneficence to take precedence over autonomy in certain circumstances, yet like the first scenario, the ethical conclusion relies on a set of empirical assumptions and predictions of what is likely to occur. The fourth scenario illustrates how one can draw different conclusions based on the importance given to the precautionary principle. (shrink)

In recent years there has been considerable discussion and controversy concerning the concepts of mental health and mental illness. The controversy has centered around the problem of providing criteria for an adequate conception of mental health and illness, as well as difficulties in specifying a clear and workable system for the classification, understanding, and treatment of psychological and emotional disorders. In this paper I shall examine a cluster of these complex and important issues, focusing on attempts to define ‘mental health’ (...) and ‘mental illness’; diverse factors influencing the ascription of the predicates ‘is mentally ill’ and ‘is mentally healthy’; and some specific problems concerning these concepts as they appear in various theories of psychopathology. The approach here will be in the nature of a survey, directed at the specification of a number of problems—conceptual, methodological, and pragmatic—as they arise in various attempts to define and to provide criteria for applying the concepts of mental health and mental illness. (shrink)

: Following a long process of revision, a new version of the Declaration of Helsinki was approved by the World Medical Association in 2000. Two provisions of the Declaration address ongoing international controversies regarding research sponsored by industrialized countries and conducted in developing countries. Despite the issuance of the final version of the Declaration, opponents remain locked in debate. Moreover, the Declaration remained silent on other prominent controversies concerning international research. An analysis of these current controversies reveals reasons why they (...) are not likely to be readily resolved, despite apparent agreement by opponents on overarching ethical principles. (shrink)

Neither the George Washington University embryo splitting experiment nor the technique of embryo splitting itself has ethical flaws. The experiment harmed or wronged no one, and the investigators followed intramural review procedures for the experiment, although some might fault them for failing to seek extramural consultation or for not waiting until national guidelines for research on preembryos were developed. Ethical objections to such cloning on the basis of possible loss of individuality, possible lessening of individual worth, and concern about potential (...) harm to the resulting children are discussed and challenged, as are objections to the creation of embryos for the purpose of genetic diagnosis. Many of the ethical questions raised by the George Washington experiment are similar to those posed by existing reproductive technologies that allow the simultaneous production of several embryos. A multidisciplinary group should consider whether regulation of cloning is needed, and laws should be enacted to prohibit a commercial market for all frozen embryos. (shrink)

Jehovah's Witnesses who refuse blood transfusions on religious grounds have long created ethical dilemmas for those in the medical profession trying to serve them. A bioethicist working in a clinical setting explores how one hospital ethics committee grappled with the additional problem of pregnant Jehovah's Witnesses, including the complex interdependence of maternal and fetal rights.

People often sincerely assert or judge one thing (for example, that all the races are intellectually equal) while at the same time being disposed to act in a way evidently quite contrary to the espoused attitude (for example, in a way that seems to suggest an implicit assumption of the intellectual superiority of their own race). Such cases should be regarded as ‘in-between’ cases of believing, in which it's neither quite right to ascribe the belief in question nor quite right (...) to say that the person lacks the belief. (shrink)

A new political movement has arisen in bioethics, self‐consciously distingushed from the rest of the ield and characterized by a new way of writing and arguing. Unfortunately, that new method is mean‐spirited, mystical, and emotional. It claims insight into ultimate truth yet disavows reason.

Recent years have witnessed a surge of interest in the early phases of the phenomenological movement. However, early phenomenological aesthetics has so far received very little attention in the current “Renaissance” of early phenomenology, albeit that the early phenomenologists made significant contributions to aesthetics and even argued for a special affinity between aesthetics and phenomenology. They also took part in the exceptionally lively debates of early 20th-century German aesthetics, which in general has remained all too underappreciated in today’s research. This (...) special issue of the Journal of Aesthetics and Phenomenology aims to kindle new interest in early phenomenological aesthetics and its wider intellectual contexts. In this introductory article, I will first provide a short overview of early phenomenology and then describe the main topics, proponents, and publications of early phenomenological aesthetics, setting them in the context of early 20th-century German aesthetics. (shrink)

We examined the effects of framing and order of presentation on professional philosophers’ judgments about a moral puzzle case (the “trolley problem”) and a version of the Tversky & Kahneman “Asian disease” scenario. Professional philosophers exhibited substantial framing effects and order effects, and were no less subject to such effects than was a comparison group of non-philosopher academic participants. Framing and order effects were not reduced by a forced delay during which participants were encouraged to consider “different variants of the (...) scenario or different ways of describing the case”. Nor were framing and order effects lower among participants reporting familiarity with the trolley problem or with loss-aversion framing effects, nor among those reporting having had a stable opinion on the issues before participating the experiment, nor among those reporting expertise on the very issues in question. Thus, for these scenario types, neither framing effects nor order effects appear to be reduced even by high levels of academic expertise. (shrink)

Robert Baker and Rosamond Rhodes each argue against the universality “common morality,” the approach to ethics that comprises four fundamental principles and their application in various settings. Baker contends that common morality cannot account for cultural diversity in the world and claims that a human rights approach is superior in the context of global health. Rhodes maintains that bioethics is not reducible to common morality because medical professionals have special privileges and responsibilities that people lack in everyday life. Baker fails (...) to demonstrate how the human rights approach to global ethics is more sensitive to culture than the use of bioethics principles that comprise common morality. Rhodes has a narrow interpretation of “common morality,” which when understood more broadly, accounts for the special privileges and obligation of medical professionals. (shrink)

Finding an effective method that can lower women’s risk of HIV infection is an ethical imperative. A vaginal microbicide is a preventive method that can be controlled by women. Well-designed scientific research has already yielded modest success, yet more research is needed in order to develop an even better product. But just as research must be scientifically sound, it must also be ethically sound. Ethical challenges in HIV microbicide research include issues of safety and level of efficacy, whether pregnant women (...) and adolescents should be included in clinical trials, and whether male partners of women participants should be involved in any way in the process of obtaining informed consent. (shrink)

The study of organizational ethics continues to be the focus of significant academic attention, however it is a discourse that remains largely informed by a form of morality that is perhaps best described as ordered and cognitive. Traditional approaches to questions of organizational ethics emphasize a fundamentally static view of organizations and the people within them, reinforcing notions of mind/body dualism and reifying ethics as an outcome of human agency, choice, and deliberate intention (see MacKay and Chia). We challenge this (...) approach and instead argue in favor of ethics research that adopts an ontology grounded in process metaphysics. Escaping the confines of Cartesian dualism, we reconceptualize organizational ethics as something that is in fact not held constant, is not a static termination point or an outcome of events, but is rather an input into the continually reconstituting context of the organization over time (see Langley, et al.). The process ethics we articulate provides a grounding for moral critique in diverse communities that is not undermined by relativism. Moreover, it provides guidance to managers and employees facing moral problems without forcing them to face a tyranny of principles. We consider how a process ethics would be enacted in organizations through managerial decision-making and in the treatment of employees. (shrink)

What does it mean to say that ethics committees that provide prospective review of research involving human beings should be “independent”? In the United States, IRBs—which are typically located within and review research protocols at the institution for which most of their members work—cannot really be considered independent. Yet separating the IRB from the research institution may in turn mean less independence from a trial’s sponsors, as this kind of IRB is commercially motivated and paid directly by the sponsor. One (...) possible answer is to create independent IRBs that are not for profit, but how this model would attract financial and administrative support is unclear. (shrink)

It is always gratifying when another scholar endorses one's own publicly stated position on a controversial matter. It was therefore with distinct appreciation that I read John Banja's article crit...

A young man, terminally ill and in extreme suffering, asks to be removed from life support, requesting morphine first so he'll be asleep when the machine stops. His physician agrees, but the hospital's chief administrator intervenes, arguing that the morphine might itself cause death, leaving the physician open to criminal indictment for murder. To placate the administrator, the doctor and patient reach a grim compromise: life support will be disconnected first, and only after manifest signs of suffering appear will the (...) physician administer the morphine, to alleviate pain. The patient's request is ultimately respected, but many staff members feel he has been made to suffer needlessly. This is just one of many cases Ruth Macklin discusses in Enemies of Patients, an eye-opening look at the growing number of forces that are hostile to the interests of patients, including hospital administrators, lawyers who represent hospitals, insurance companies, government regulations, and even some well intentioned physicians. Macklin, a highly regarded medical ethicist, the author of Mortal Choices and the subject of a New York Times Magazine cover story, provides a behind-the-scenes look at how the patient's ethical rights are often violated. She describes, for instance, how a new breed of hospital administrator, the risk manager, acts consistently as an enemy of the patient, often urging physicians to continue aggressive, expensive treatments for critically ill patients--even when the patient and doctor agree the treatment should cease--for fear of lawsuits, bad publicity, or criminal indictment. (Macklin points out, for instance, that even though no physician has ever been convicted of a crime for withdrawing treatment from a patient in a permanent vegetative state, hospital lawyers and risk managers regularly assert that there is a danger of criminal liability in such cases.) The government also can become an enemy of patients. The most egregious case, according to Macklin, is the Federal government's "gag rule" which has prohibited health care facilities that receive Title X funds from discussing abortion with pregnant women, violating the patient's right to full information. And physicians themselves can become enemies of patients. Some, seeing themselves as fiscal gatekeepers, ration expensive health care procedures on financial rather than medical grounds. Some physicians refuse to treat patients who don't follow their advice (a cardiologist, for instance, who will not take care of patients who smoke) and others won't treat patients who pose a threat of lawsuit (such as a California woman in need of life-sustaining dialysis, who had previously sued another physician). Packed with numerous case histories drawn from the author's experience in a major urban medical center, Enemies of Patients will give readers a better understanding of their rights as patients and show them how to forge an alliance with their doctors against common enemies. (shrink)

ABSTRACT Fast forward 50 years into the future. A look back at what occurred in the field of bioethics since 2010 reveals that a conference in 2050 commemorated the death of bioethics. In a steady progression over the years, the field became increasingly fragmented and bureaucratized. Disagreement and dissension were rife, and this once flourishing, multidisciplinary field began to splinter in multiple ways. Prominent journals folded, one by one, and were replaced with specialized publications dealing with genethics, reproethics, nanoethics, and (...) necroethics. Mainstream bioethics organizations also collapsed, giving way to new associations along disciplinary and sub‐disciplinary lines. Physicians established their own journals, and specialty groups broke away from more general associations of medical ethics. Lawyers also split into three separate factions, and philosophers rejected all but the most rigorous, analytic articles into their newly established journal. Matters finally came to a head with global warming, the world‐wide spread of malaria and dengue, and the cost of medical treatments out of reach for almost everyone. The result was the need to develop plans for strict rationing of medical care. At the same time, recognition emerged of the importance of the right to health and the need for global justice in health. By 2060, a spark of hope was ignited, opening the door to the resuscitation of bioethics and involvement of the global community. (shrink)

Finding an effective microbicide that could substantially lower women’s risk of acquiring HIV infection is an ethical imperative. Women and girls continue to be disproportionally affected by HIV in sub-Saharan Africa. Ethics guidelines for conducting preventive HIV microbicide trials call for steps that intertwine biomedical research and public health. Ethical considerations include adequate studies of the safety of microbicides, the use of placebo controls in future trials once a microbicide is shown to be effective, whether leftover microbicide from a trial (...) that demonstrated efficacy should be made available to the public or used in the control group of a future trial, what preventive measures and treatment should be provided for trial participants during and after the research, and what constitute ‘fair benefits’ to the community or country when a trial is completed. The Global Campaign for Microbicides conducted a study of the benefits being provided to participants in microbicide trials and others, and found substantial evidence that researchers and sponsors are meeting the obligations stated in ethical guidelines. A cautionary tale of an HIV prevention trial that was prematurely halted demonstrates the need for engagement with the community where trials are carried out. (shrink)

In some recent works, Crupi and Iacona have outlined an analysis of ‘if’ based on Chrysippus’ idea that a conditional holds whenever the negation of its consequent is incompatible with its antecedent. This paper presents a sound and complete system of conditional logic that accommodates their analysis. The soundness and completeness proofs that will be provided rely on a general method elaborated by Raidl, which applies to a wide range of systems of conditional logic.

Over the last several years, there has been an explosion of interest and attention devoted to the problem of Uncertainty Quantification (UQ) in climate science—that is, to giving quantitative estimates of the degree of uncertainty associated with the predictions of global and regional climate models. The technical challenges associated with this project are formidable, and so the statistical community has understandably devoted itself primarily to overcoming them. But even as these technical challenges are being met, a number of persistent conceptual (...) difficulties remain. So why is UQ so important in climate science? UQ, I would like to argue, is first and foremost a tool for communicating knowledge from experts to policy makers in a way that is meant to be free from the influence of social and ethical values. But the standard ways of using probabilities to separate ethical and social values from scientific practice cannot be applied in a great deal of climate modeling, because the roles of values in creating the models cannot be discerned after the fact—the models are too complex and the result of too much distributed epistemic labor. I argue, therefore, that typical approaches for handling ethical/social values in science do not work well here. (shrink)

Preface -- Introduction -- How to value democracy -- Paper stones, the ethics of participation -- Philosophers-citizens -- Superdeliberators -- What is it like to be a citizen? -- Democracy's ethics of belief -- The division of democratic labor -- Representing principles -- Democratic complicity -- Not in my name, macrodemocratic design.

The type of research known as cluster randomized trials raises ethical questions not readily answered within the standard understanding of research ethics. What distinguishes a CRT is that it randomizes at the level of social groups rather than at the level of individual research participants: in a CRT, the regimen under study might be assigned to a village, hospital, or school. The organizational schemes of CRTs raise an assortment of fundamental ethical problems. In certain CRTs, the question of whether it (...) is possible to obtain individual informed consent is central. Also, if the intervention is offered at the level of a sizable social group, there is usually no realistic possibility for individuals to opt out of the trial. Other ethical questions raised by CRTs have to do with identifying the subjects of research, and indeed with whether “research” is occurring at all. (shrink)

Sovereign is he who provides the exception.…The exception is more interesting than the rule. The rule proves nothing; the exception proves everything. In the exception the power of real life breaks through the crust of a mechanism that has become torpid by repetition.In spring 2020, in response to the COVID-19 crisis, world leaders imposed severe restrictions on citizens’ civil, political, and economic liberties. These restrictions went beyond less controversial and less demanding social distancing measures seen in past epidemics. Many states (...) and countries imposed universal lockdowns. Lockdowns, as we define them here, require people to stay home; in some countries and places, citizens must have ad hoc licenses to... (shrink)

It seemed like only minutes after a team of Scottish scientists announced, in late February 1997, that they had successfully cloned a sheep, that governmental officials and private citizens throughout the world called for a ban on cloning human beings. The rush to legislate or issue executive orders was so swift, it is reasonable to wonder why the news that a mammal had been cloned ignited such a stampede to prohibit, even criminalize, attempts to clone humans. These events raise a (...) series of separate, yet related questions. Why does the prospect of cloning human beings incite such strong reactions? What reasons have been proposed for enacting national laws or international conventions to prohibit cloning? Can these prohibitions be justified by sound ethical arguments? Before attempting to answer these questions, let us look first at the responses that called for public policy measures to ban human cloning. (shrink)

Written by one of the instrumental figures in environmental ethics, Nature as Subject traces the development of an ethical policy that is centered not on human beings, but on itself. Katz applies this idea to contemporary environmental problems, introducing themes of justice, domination, imperialism, and the Holocaust. This volume will stand as a foundational work for environmental scholars, government and industry policy makers, activists, and students in advanced philosophy and environmental studies courses.

On an intellectualist approach to belief, the intellectual endorsement of a proposition (such as “The working poor deserve as much respect as the handsomely paid”) is sufficient or nearly sufficient for believing it. On a pragmatic approach to belief, intellectual endorsement is not enough. Belief is behaviorally demanding. To really, fully believe, you must also “walk the walk.” This chapter argues that the pragmatic approach is preferable on pragmatic grounds: It rightly directs our attention to what matters most in thinking (...) about belief. (shrink)

This article focuses on the access of people in developing countries to medications and medical services that are readily available to inhabitants of industrialized countries. There are, of course, other critical dimensions of public health that require action on a global scale. These include relief for large numbers of people who are starving or living at nearly subsistence levels; provision of a supply of clean, potable water for populations deprived of that essential resource; and the consequences for local agricultural production (...) in countries in which globalization has led to deforestation of vast portions of the land. The focus here on access to health services and needed medications is not intended to minimize the importance of these other areas of global health. (shrink)

In computer simulations of physical systems, the construction of models is guided, but not determined, by theory. At the same time simulations models are often constructed precisely because data are sparse. They are meant to replace experiments and observations as sources of data about the world; hence they cannot be evaluated simply by being compared to the world. So what can be the source of credibility for simulation models? I argue that the credibility of a simulation model comes not only (...) from the credentials supplied to it by the governing theory, but also from the antecedently established credentials of the model building techniques employed by the simulationists. In other words, there are certain sorts of model building techniques which are taken, in and of themselves, to be reliable. Some of these model building techniques, moreover, incorporate what are sometimes called “falsifications.” These are contrary-to-fact principles that are included in a simulation model and whose inclusion is taken to increase the reliability of the results. The example of a falsification that I consider, called artificial viscosity, is in widespread use in computational fluid dynamics. Artificial viscosity, I argue, is a principle that is successfully and reliably used across a wide domain of fluid dynamical applications, but it does not offer even an approximately “realistic” or true account of fluids. Artificial viscosity, therefore, is a counter-example to the principle that success implies truth – a principle at the foundation of scientific realism. It is an example of reliability without truth. (shrink)

How do you know what you want? Philosophers have lately developed sophisticated accounts of the practical and doxastic knowledge that are rooted in the point of view of the subject. Our ability to just say what we are doing or what we believe—that is, to say so authoritatively, but not on the basis of observation or evidence—is an aspect of our ability to reason about the good and the true. However, no analogous route to orectic self-knowledge is feasible. Knowledge of (...) desire is distinctive in being a matter of our affective response to imagined prospects. An examination of this idea yields the following thesis: I know what I want just in case the object pursued in anticipation of a certain pleasure actually yields the anticipated pleasure. (shrink)

Four key guidance points in the UNAIDS guidance document, Ethical Considerations in HIV Preventive Vaccine Research, are compared with analogous statements in three other recently issued documents dealing with international research. Those documents are: the Declaration of Helsinki, as revised in 2000; the report of the U.S. National Bioethics Advisory Commission, issued in 2001; and a current (2001) draft revision of the 1993 CIOMS International Ethical Guidelines for Biomedical Research Involving Human Subjects. The four guidance points compared with statements on (...) similar issues in the other three documents are Guidance Point 2, which deals with making available a safe and effective vaccine after trials are completed; the second half of Guidance Point 4, which requires that the desired outcome should potentially benefit the population from which research participants are drawn; Guidance Point 11, which discusses what should be provided to a control group in a vaccine trial; and Guidance Point 16, which addresses the care and treatment to be provided for trial participants who become infected with HIV during the trial. The analysis and comparison concludes that the UNAIDS guidance points are at least as ethically sound as analogous points in these other documents, and for the most part are ethically superior in providing greater benefits to research participants and to others. Nevertheless, they are subject to the criticism that they are too ‘aspirational’ and not sufficiently ‘pragmatic’. (shrink)

It has been argued that 'causes' of action and 'reasons' for acting represent incompatible conceptual categories. This paper examines the alleged incompatibility between these concepts and attempts to show that not only are 'reason' explanations compatible with causal explanations but also that it is plausible to construe the former as a species of the latter. Providing reasons often aids in the search for relevant causal factors, And causal explanations are more systematic than corresponding reason explanations.

Rosamond Rhodes (2005) has provided much food for thought in her interesting and provocative article. Probably the most controversial point is her proposal that participation in a research project...

The variably strict analysis of conditionals does not only largely dominate the philosophical literature, since its invention by Stalnaker and Lewis, it also found its way into linguistics and psychology. Yet, the shortcomings of Lewis–Stalnaker’s account initiated a plethora of modifications, such as non-vacuist conditionals, presuppositional indicatives, perfect conditionals, or other conditional constructions, for example: reason relations, difference-making conditionals, counterfactual dependency, or probabilistic relevance. Many of these new connectives can be treated as strengthened or weakened conditionals. They are definable conditionals. (...) This article develops a technique to infer the logic for such definable conditionals from the known logic of the underlying defining conditional. The technique is applied to central examples. The results show that a large part of the zoo of conditionals arises from a basic conditional—a constant nucleus of the different contextual and conceptual variations of variably strict conditionals. (shrink)

Implementation research is increasingly common in developing countries as a way of studying the introduction to the population of health interventions that have been proven to be effective elsewhere. Implementation studies are often conducted as cluster randomized trials, a design that raises ethical and conceptual questions different from those in conventional randomized controlled trials. It is often unclear who the subjects of the research are, informed consent may be difficult or impossible to obtain and controversy surrounds the use of comparison (...) clusters that provide substandard care to the population where the research is carried out. An examination of protocols for this type of research reveals uncertainty on the part of researchers themselves about whom or what they are studying and from whom (if anyone) informed consent is required. (shrink)

… [T]he question “valuable to what end?” is one of extraordinary complexity. For example, something obviously valuable in terms of the longest possible survival of a race would by no means have the same value if it were a question of developing a more powerful type. The welfare of the many and the welfare of the few are radically opposite ends.There is no question that genetic engineering in many forms… will come about. It is a general rule that whatever is (...) scientifically feasible will be attempted. The application of these technics must, however, be examined from the point of view of ethics, individual freedom and coercion. Both the scientists directly involved and, perhaps more important, the political and social leaders of our civilization must exercise utmost caution in order to prevent genetic, evolutionary and social tragedies. (shrink)

In his recent book, Time and Chance, David Albert claims that by positing that there is a uniform probability distribution defined, on the standard measure, over the space of microscopic states that are compatible with both the current macrocondition of the world, and with what he calls the “past hypothesis”, we can explain the time asymmetry of all of the thermodynamic behavior in the world. The principal purpose of this paper is to dispute this claim. I argue that Albert's proposal (...) fails in his stated goal—to show how to use the time‐reversible dynamics of Newtonian physics to “underwrite the actual content of our thermodynamic experience” (Albert 2000, 159). Albert's proposal can satisfactorily explain why the overall entropy of the universe as a whole is increasing, but it does not and cannot explain the increasing entropy of relatively small, relatively short‐lived systems in energetic isolation without making use of a principle that leads to reversibility objections. (shrink)

This paper investigates the implicative conditional, a connective intended to describe the logical behavior of an empirically defined class of natural language conditionals, also namedimplicative conditionals, which excludes concessive and some other conditionals. The implicative conditional strengthens the strict conditional with the possibility of the antecedent and of the contradictory of the consequent.$${p\Rightarrow q}$$p⇒qis thus defined as$${\lnot } \Diamond {(p \wedge \lnot q) \wedge } \Diamond {p \wedge } \Diamond {\lnot q}$$¬◊(p∧¬q)∧◊p∧◊¬q. We explore the logical properties of this conditional in (...) a reflexive normal Kripke semantics, provide an axiomatic system and prove it to be sound and complete for our semantics. The implicative conditional validates transitivity and contraposition, which we take to be integral parts of reasoning and communication. But it only validates restricted versions of strengthening the antecedent, right weakening, simplification, and rational monotonicity. Apparent counterexamples to some of these properties are explained as due to contextual factors. Finally, the implicative conditional avoids the paradoxes of material and strict implication, and validates some connexive principles such as Aristotle’s theses and weak Boethius’ thesis, as well as some highly entrenched principles of conditionals, such as conjunction of consequents, disjunction of antecedents, modus ponens, cautious monotonicity and cut. (shrink)

The view that we must respect cultural traditions is a welcome change from the past, when colonial powers ridiculed native customs and often sought to eradicate them. Nevertheless, it is reasonable to ask whether there is a limit to tolerance of a ritual that has been designated a “harmful traditional practice” by the United Nations Office of the High Commissioner for Human Rights, the United Nations Population Fund, and the recently created agency, UN Women. The article “Seven Things To Know (...) About Female Genital Surgeries in Africa,” by the Public Policy Advisory Network on Female Genital Surgeries in Africa, contends that a need exists for more balanced critical thinking and open debate about what the authors choose to call “female genital surgery.” No one can reasonably quarrel with the call for accurate information in descriptions of the methods and consequences of female genital cutting. The network's own discussion of the facts is highly questionable, however. (shrink)

The prelims comprise: Introduction Public Policy Actions Strong Reactions to Human Cloning A Rational Approach to Public Policy.

Presidential commissions come and go by design, and it is reasonable to wonder about the impact of their recommendations. I have been involved in the work of two presidential commissions: as a member of the Advisory Committee on Human Radiation Experiments (from 1994 to 1995) and as senior consultant to the National Bioethics Advisory Commission (from 1999 to 2000) for its report on multinational research. I continue to reflect on and look for the impact of both these commissions.ACHRE's charter included (...) the review of experiments with ionizing radiation sponsored or conducted by the United States government since the 1940s. The committee was also charged with investigating specific intentional releases of radiation into the environment. ACHRE had a somewhat unique difficulty built into its work: the need to make retrospective ethical judgments. With the National Bioethics Advisory Commission, my main role as senior consultant consisted of writing chapters of the report on multinational research for the commissioners’ approval. A more important concern for me as a hired consultant was how to maintain intellectual and moral integrity. Unlike when writing scholarly papers, where I can express my own views, when I was drafting text for a presidential commission, the commissioners’ views took precedence over my own when we disagreed. I wondered, how much could I comply with the commissioners’ positions without compromising my own integrity? (shrink)

: The Advisory Committee on Human Radiation Experiments experienced some disagreements among its members in the course of its work. An epistemological controversy over the nature and degree of evidence required to draw ethical conclusions pervaded the committee's deliberations. Other disagreements involved the proper role of a governmental advisory committee and the question of when it is appropriate to notify people that they were unknowing subjects of radiation experiments. In the end, the Committee was able to reach consensus on almost (...) all of its findings and recommendations through a process that preserved the integrity of its members. (shrink)

Empirical evidence confirms the existence of health inequalities between women and men in developing countries, with women experiencing poorer health status than men, as well as less access to vital health services. These disparities have different sources and take different forms, some of which result from cultural factors, others from discriminatory laws and practices, and still others from the biological fact that only women undergo pregnancy and childbirth, a major cause of maternal mortality. The injustice lies in the fact that (...) many of these disparities result from socially controllable factors, while others could be remedied, especially in cases of violations of human rights. Past and recent policies and practices of the United States Government can be faulted for both actions and omissions that have contributed to such inequalities. Different conceptions of global justice are explored, with implications for who owes what to whom regarding these disparities. (shrink)

The AIDS epidemic calls for an ethical analysis of conflicting obligations surrounding HIV-infected psychiatric patients and confidentiality, as well as issues that go beyond confidentiality. Although laws pertaining to HIV infection have been enacted in a number of states, these statutes leave much discretion to health professionals. The ethical principle known as "the harm principle" can permit disclosure of confidential information and detention or isolation of psychiatric patients who pose a threat of infecting other patients. From an ethical point of (...) view, however, the circumstances under which traditional protections may be weakened or abandoned remain limited. (shrink)

This article explores the role of the Britons Society, a small racial nationalist sect founded in 1919, in the propagation of conspiracist antisemitism in the United Kingdom in the aftermath of the First World War. It focuses on its ideological output, aimed at cultivating an antisemitic ‘Jewwise’ mindset that viewed the fight against ‘the Jew’ as an eternal eschatological struggle. During its comparatively long life, the Britons published a voluminous quantity of antisemitic literature, including over eighty editions of _The Protocols (...) of the Elders of Zion_, two during the Second World War, before it finally closed its doors in 1983. The article explores some of the Britons’ trans-national networking and concludes with several thematic case studies (anti-Bolshevism, imperial decline, antisemitic anti-Zionism) to highlight how conspiracist antisemitism formed an analytical lens through which readers could be made to understand the supposed role of the ‘Jewish conspiracy’ in world affairs. (shrink)