Many research ethics guidelines now oblige researchers to offer research participants the results of research in which they participated. This practice is intended to uphold respect for persons and ensure that participants are not treated as mere means to an end. Yet some scholars have begun to question a generalised duty to disclose research results, highlighting the potential harms arising from disclosure and questioning the ethical justification for a duty to disclose, especially with respect to individual results. In support of (...) this view, we argue that current rationales for a duty of disclosure do not form an adequate basis for an ethical imperative. We review policy guidance and scholarly commentary regarding the duty to communicate the results of biomedical, epidemiological and genetic research to research participants and show that there is wide variation in opinion regarding what should be disclosed and under what circumstance. Moreover, we argue that there is fundamental confusion about the notion of “research results,” specifically regarding three core concepts: the distinction between aggregate and individual results, amongst different types of research, and across different degrees of result veracity. Even where policy guidance and scholarly commentary have been most forceful in support of an ethical imperative to disclose research results, ambiguity regarding what is to be disclosed confounds ethical action. (shrink)

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

Quattrocki and Friston (2014) argued that abnormalities in interoception—the process of representing one’s internal physiological states—could lie at the heart of autism, because of the critical role interoception plays in the ontogeny of social-affective processes. This proposal drew criticism from proponents of the alexithymia hypothesis, who argue that social-affective and underlying interoceptive impairments are not a feature of autism per se, but of alexithymia (a condition characterized by difficulties describing and identifying one’s own emotions), which commonly co-occurs with autism. Despite (...) the importance of this debate for our understanding of autism spectrum disorder (ASD), and of the role of interoceptive impairments in psychopathology, more generally, direct empirical evidence is scarce and inconsistent. Experiment 1 examined in a sample of 137 neurotypical (NT) individuals the association among autistic traits, alexithymia, and interoceptive accuracy (IA) on a standard heartbeat-tracking measure of IA. In Experiment 2, IA was assessed in 46 adults with ASD (27 of whom had clinically significant alexithymia) and 48 NT adults. Experiment 1 confirmed strong associations between autistic traits and alexithymia, but yielded no evidence to suggest that either was associated with interoceptive difficulties. Similarly, Experiment 2 provided no evidence for interoceptive impairments in autistic adults, irrespective of any co-occurring alexithymia. Bayesian analyses consistently supported the null hypothesis. The observations pose a significant challenge to notions that interoceptive impairments constitute a core feature of either ASD or alexithymia, at least as far as the direct perception of interoceptive signals is concerned. (shrink)

Debate continues to rage among philosophers of religion over Anthony Flew's famous little paper ‘Theology and Falsification’ and the responses it provoked, most notably R. M. Hare's response that religious claims are in no way like scientific hypotheses. For now, twenty years later, we still find many theists taking a similar tack to Hare's. A particularly interesting example is J. F. Miller in Religious Studies, 1969, who replies to Flew that propositions like ‘God loves mankind’ cannot be subject to falsifiability (...) conditions because they are used as claims expressing ‘religious first-order principles of the Judaeo-Christian Weltanschauung and as such are not amenable to falsification’ (p. 50). Miller seems to put his faith in some kind of great gulf fixed between what he would consider decently falsifiable scientific hypotheses and what he takes to be unfalsifiable first-order principles both of theology and of contemporary science. In what follows we will try to sketch a more rational strategy for modern believers of a liberal empiricist type, for those whose interest in appealing and deferring to experience includes but is not restricted to so-called ‘sense experience’. This will involve accepting analogies between theological statements and so-called hypotheses, insofar as the latter are propositions held and put forward in a somewhat tentative spirit with a view to explaining what we experience. (shrink)

We present a synthetic theory of skilled action which proposes that cognitive processes make an important contribution to almost all skilled action, contrary to influential views that many skills are performed largely automatically. Cognitive control is focused on strategic aspects of performance, and plays a greater role as difficulty increases. We offer an analysis of various forms of skill experience and show that the theory provides a better explanation for the full set of these experiences than automatic theories. We further (...) show that the theory can explain experimental evidence for skill automaticity, including evidence that secondary tasks do not interfere with expert performance, and evidence that experts have reduced memory for performance of sensorimotor skills. (shrink)

Bioethical Prescriptions collects F.M. Kamm's articles on bioethics -- revised for publication in book form -- which have appeared over the last 25 years and which have made her among the most widely-respected philosophers working in this field.

We propose a revised set of moral dilemmas for studies on moral judgment. We selected a total of 46 moral dilemmas available in the literature and fine-tuned them in terms of four conceptual factors (Personal Force, Benefit Recipient, Evitability and Intention) and methodological aspects of the dilemma formulation (word count, expression style, question formats) that have been shown to influence moral judgment. Second, we obtained normative codings of arousal and valence for each dilemma showing that emotional arousal in response to (...) moral dilemmas depends crucially on the factors Personal Force, Benefit Recipient, and Intentionality. Third, we validated the dilemma set confirming that people's moral judgment is sensitive to all four conceptual factors, and to their interactions. Results are discussed in the context of this field of research, outlining also the relevance of our RT effects for the Dual Process account of moral judgment. Finally, we suggest tentative theoretical avenues for future testing, particularly stressing the importance of the factor Intentionality in moral judgment. Additionally, due to the importance of cross-cultural studies in the quest for universals in human moral cognition, we provide the new set dilemmas in six languages (English, French, German, Spanish, Catalan and Danish). The norming values provided here refer to the Spanish dilemma set. (shrink)

I begin by reconsidering the arguments of John Taurek and Elizabeth Anscombe on whether the number of people we can help counts morally. I then consider arguments that numbers should count given by F. M. Kamm and Thomas Scanlon, and criticism of them by Michael Otsuka. I examine how different conceptions of the moral method known as pairwise comparison are at work in these different arguments and what the ideas of balancing and tie-breaking signify for decision-making in various types of (...) cases. I conclude by considering how another moral method that I call virtual divisibility functions and what it helps reveal about an argument by Otsuka against those who do not think numbers count. (shrink)

Ethics for Enemies comprises three original philosophical essays on torture, terrorism, and war. F. M. Kamm deploys ethical theory in her challenging new treatments of these most controversial practical issues. First she considers the nature of torture and the various occasions on which it could occur, in order to determine why it might be wrong to torture a wrongdoer held captive, even if this were necessary to save his victims. In the second essay she considers what makes terrorism wrong--whether it (...) is the intention to harm civilians, rather than harm to them being 'collateral damage,' or something else--and whether terrorism is always wrong. The third essay discusses whether having a right reason, in the sense of a right intention, is necessary in order for a war to be just. Kamm then examines ways in which the harms of war can be proportional to the achievement of the just cause and other goods that war can bring about, so as to make the declaration of war permissible. (shrink)

In this volume, F.M. Kamm explores how theories as well as hypothetical and practical cases help us understand rights and their limits. The book begins by considering moral status and its relation to having rights (including whether non-human animals have rights and what rights future persons have). The author then considers whether rights are grounded in duties to oneself, which duties are correlative to rights, and whether neuroscientific and psychological studies can help determine what rights we have. Kamm next investigates (...) the contours of the right not to be harmed by considering critiques of deontological distinctions, the costs that must be undertaken to avoid harming, and a proposal for permissibly harming someone (that allows for resisting the harm) in the Trolley Problem. Additional chapters cover possible implications of the Trolley Problem for such practical issues as correctly programming self-driving cars, providing medical treatments, and enacting redistributive economic policy. Kamm concludes the book by comparing the use of case-based judgments about extreme cases in moral versus aesthetic theory, and by exploring the significance of the right not to be harmed for morally correct policies in the extreme cases of torture and a pandemic. Where pertinent, Kamm considers the views of Derek Parfit, Tom Regan, Christine Korsgaard, Shelly Kagan, Ronald Dworkin, Amartya Sen, Allan Gibbard, Joshua Greene, Arthur Danto, and Judith Thomson, among others."--Provided by publisher. (shrink)

This article considers the possible relation between the idea of parity and some past work on the allocation of scarce resources. Parity of value is first connected with the idea of some goods being irrelevant in interpersonal comparisons. The notion of moral parity is introduced to describe the recognition that people who are moral equals (even when they are not on a par in terms of value) as not substitutable. The relation between a Separability Test and nonsubstitutability of persons is (...) considered. These ideas are then used to discuss various cases in which one must choose to whom to provide medical assistance, including whether and when to distinguish morally between a disabled and a nondisabled person. (shrink)

Lecture I begins with a brief history of changing views on what the Trolley Problem is and attempts to solve it. The lecture then critically examines Judith Thomson’s recent view that a moral distinction between killing and letting die, and between what a conductor of the trolley or a mere bystander may do to save people from the trolley, eliminates what she now thinks of as the Trolley Problem. The last part considers a different argument for the conclusion that Thomson (...) now favors, but ultimately attempts to resurrect the Trolley Problem, suggesting that it is not who turns the trolley that makes the turning permissible. (shrink)

This book is a philosophical discussion of moral, legal, and medical issues related to aging, dying, and death. One of its aims is to decide whether and when it might make sense to not resist or bring about the end of one's life. To answer this question it considers views about meaning in life and what makes life worth living. It also evaluates recent attempts to help the general public plan in advance for the end of life. It also considers (...) whether or not physician-assisted suicide is morally permissible and if it should be legalized. (shrink)

The object of this paper is to show that, in the sixth and fifth centuries B.C., two different and radically opposed systems of thought were elaborated within the Pythagorean school. They may be called respectively the mystical system and the scientific. All current accounts of Pythagoreanism known to me attempt to combine the traits of both systems in one composite picture, which naturally fails to hold together. The confusion goes back to Aristotle, who usually speaks indiscriminately of ‘the Pythagoreans,’ though (...) now and then the phrase ‘some Pythagoreans’ indicates that he was aware of different currents within the school. (shrink)

Bioethics committees have issued guidelines that medical interventions should be permissible only in cases of clinically verifiable disease, deformity, or injury. Furthermore, once the existence of one or more of these requirements has been proven, the proposed therapeutic procedure must reasonably be expected to result in a net benefit to the patient. As an exception to this rule, some prophylactic interventions might be performed on individuals “in their best interests” or with the aim of averting an urgent and potentially calamitous (...) public health danger. In order to invoke these exceptions, a stringent set of criteria must first be satisfied. Additionally, where the proposed prophylactic intervention is intended for children, who are unlikely to be able to provide a meaningfully informed consent, a heightened scrutiny of any such measures is required. We argue that children should not be subjected to prophylactic interventions “in their best interests” or for public health reasons when there exist effective and conservative alternative interventions, such as behavioural modification, that individuals could employ as competent adolescents or adults to avoid adverse health outcomes. Applying these criteria, we consider the specific examples of prophylactic mastectomy, immunisations, cosmetic ear surgery, and circumcision. (shrink)

This chapter considers the relation between supererogation and duties (also here referred to as obligations) from a nonconsequentialist point of view. It first considers whether supererogation may sometimes take precedence over positive and negative duties and how this relates to personal costs (including efforts) required to perform one’s duty. It then considers how acquiescence to having large costs imposed on one (even permissibly) can be supererogatory. Finally, it considers how what are usually duties can become supererogatory and how what is (...) usually supererogatory can become a duty. The relation between these topics and the trolley problem, the so-called ‘all or nothing problem,’ and the issue of abortion are examined. (shrink)

This response to a commentary on “Allocation of scarce resources, disability, and parity” considers whether a difference that would be morally relevant when choosing which of two people to save retains its relevance if this would affect other people’s chances of being saved.

Zeller argued that the ‘innumerable worlds’ mentioned in accounts of Anaximander's system must be an endless succession of single worlds, not an unlimited number of coexistent worlds scattered through infinite space, some always coming into being while others are passing away. Zeller pointed out that a succession of single worlds is grounded in the principles of the system. ‘Things perish into that from which they had their birth… according to the order of Time,’ a cycle of birth, existence, and destruction. (...) A world ends, and the living divine stuff begets a new world to take its place. On the other hand, there is much in the system to contradict the idea of coexistent worlds. Anaximander's successors, Anaximenes, Anaxagoras, and Diogenes, show that this idea is not a necessary consequence of the unlimitedness of the original world-stuff. Nothing in the appearances of Nature suggests it. Anaximander is a monistic hylozoist, whereas Democritus is a pluralist with his innumerable independent atoms producing, by similar processes, independent world-systems in different parts of an infinite void. (shrink)

The Moral Target: Aiming at Right Conduct in War and Other Conflicts comprises essays that discuss aspects of war and other conflicts in the light of nonconsequentialist ethical theory. Topics include the relation between conditions that justify starting war and those that justify stopping it, the treatment of combatants and noncombatants in war, collaboration, justice after war and other conflicts, terrorism, resistance to communal injustice, and nuclear deterrence.

This article begins by comparing terror and death and then focuses on whether killing combatants and noncombatants as a mere means to create terror, that is in turn a means to winning a war, is ever permissible. The role of intentions and alternative acts one might have done is examined in this regard. The second part of the article begins by criticizing a standard justification for causing collateral (side effect) deaths in war and offers an alternative justification that makes use (...) of the idea of group liability. (shrink)

In this article, I first compare positions I have taken in the past and those taken by Peter Singer on how the allocation of life-saving resources should be affected by the aggregation of expected quality of life, quantity of life, and need, both within the life of a person and across persons . I then reexamine the specific issue of whether and why differences in expected years of life and quality of life that a scarce resource can provide a disabled (...) and a nondisabled person should affect our allocation decisions. I attend to how the use of the veil of ignorance bears on this issue and also how the conclusions I reach differ in certain ways from my past positions. (shrink)

In this article, I shall present three arguments for thc pcrmissibility 0f physician-assisted suicide (PAS), and then examine several objections 0f 21 "K21nti2m" and non-Kantian nature against them. These are really 0bjcctions against certain types of suicide. I shall focus 0n active PAS (eg., when 21 patient takes 21 lethal drug given by E1 physician, in which case both thc physician and patient are active). I shall assume the patient is 21 competent, responsible, rational agent, who gives his being in (...) physical discomfort (pain, nausea, ctc.) as thc reason for intending his death. I am assuming, therefore, thc pain while 21 sourcc of suffering docs not undermine his rational agency in 21 way that threatens responsibility for choice.] Current legal proposals for permitting PAS focus 0n procedures.. (shrink)

A detailed attempt to ground the topological properties of time in the laws of micro- and macro-physical processes. The reversible processes of mechanics are used to define an order among temporally separated events, which is invariant under reversals of time direction. So long as consideration is limited to a single isolated system, a time ensemble, the transfer of the reversibility of the constituent processes of such a system to the system as a whole makes it impossible to define time direction (...) by means of the entropy curve. The directionality of time, accordingly, can only be defined as the direction of the entropy increase of multiple systems, of a space ensemble. A macrostatistical definition of time direction is then based upon the causal relation. The author's view of causation is non-deterministic: the conjunction of two events is caused if they occur together more frequently than can be expected from their chance coincidence. Reichenbach's analyses and arguments are careful and thorough; the book as a whole is a solid achievement. -- M. F. (shrink)

The object of this paper is to determine the relations between the two parts of Parmenides' poem: the Way of Truth, which deduces the necessary properties of a One Being, and the False Way, which contains a cosmogony based on ‘what seems to mortals, in which there is no true belief.’.