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.

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)

Context: The dominant approach to the study of perception is representational/computational, with an emphasis on the achievements of the brain and the nervous system, which are taken to construct internal models of the world. Alternatives include ecological, embedded, embodied, and enactivist approaches, all of which emphasize the centrality of action in understanding perception. Problem: Despite sharing many theoretical commitments that lead to a rejection of the classical approach, the alternatives are characterized by important contrasts and points of divergence. Here we (...) focus on the enactive and ecological approaches, in particular, on how they construe the status of the environment and the content of perception. Method: We begin with a review of James Gibson’s ecological psychology, highlighting it as a psychology for all organisms not just humans. Against this backdrop, we consider enactivist arguments against direct perception - a central assertion of the ecological approach - and in favor of interpreting the activity of perceptual agents as a kind of construction of a perceptually meaningful world. Results: We assess the merits of this interpretation and we conclude that it cannot be grounded on fundamental principles such as thermodynamics and organism-environment mutuality. Implications: As a consequence, enactivism remains close to representationalism and entails a form of dualism. Constructivist content: We advance a criticism of the constructivist foundations of the enactive approach to perception. Perception-action mutuality at the heart of enactivism does not require mental construction; indeed, perception-action mutuality obviates construction. (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)

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)

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)

In the past decades, an enormous amount of precious information has been collected about molecular and genetic characteristics of cancer. This knowledge is mainly based on a reductionistic approach, meanwhile cancer is widely recognized to be a ‘system biology disease’. The behavior of complex physiological processes cannot be understood simply by knowing how the parts work in isolation. There is not solely a matter how to integrate all available knowledge in such a way that we can still deal with complexity, (...) but we must be aware that a deeply transformation of the currently accepted oncologic paradigm is urgently needed. We have to think in terms of biological networks: understanding of complex functions may in fact be impossible without taking into consideration influences outside of the genome. Systems Biology involves connecting experimental unsupervised multivariate data to mathematical and computational approach than can simulate biologic systems for hypothesis testing or that can account for what it is not known from high-throughput data sets. Metabolomics could establish the requested link between genotype and phenotype, providing informations that ensure an integrated understanding of pathogenic mechanisms and metabolic phenotypes and provide a screening tool for new targeted drug. (shrink)

In this paper, I consider the idea of meaning in life as I believe it has arisen in some discussions of ageing and death. I critically examine and compare the views of Atul Gawande and Ezekiel Emanuel, connecting their views to the idea of meaning in life. I further consider the relation of meaning in life to both the dignity of the person and the reasonableness of continuing or not continuing to live. In considering these issues, I evaluate and draw (...) on Bernard Williams’ distinction between categorical and conditional desires, Susan Wolf's work on meaning in life, and Jeremy Waldron's views on dignity in old age. (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 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)

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 article considers how legislators should respond to evidence that identifies a common and widely accepted parental practice as a potential source of harm to children, using domestic exposure to environmental tobacco smoke as a test case. It is claimed that children are parties to the Harm Principle, and that the State has an obligation to protect children from exposure to harm. Parental prerogative is limited by the need to avoid harming children. That said, there is considerable uncertainty about what (...) is harmful to children. Several sources of uncertainty, both empirical and conceptual, are explored, in order to demonstrate the complexity of the task legislators face. Seven considerations that are relevant to decisions about legislation of harmful parental practices are outlined, and these considerations are then employed to assess the case in favour of legislating to prohibit the exposure of children to environmental tobacco smoke in domestic settings. (shrink)

This essay considers how the fact that some morally innocent person is nevertheless a threat to others can bear on the permissibility of health policies that harm some to protect others. Two types of innocent threats are distinguished. In the case of abortion, it is argued that even if the embryo/fetus were a person, abortion could be permissible to protect a woman’s life, health, or bodily autonomy. Whether there nevertheless should be time limits on abortions and what surprising form such (...) limits might take are also considered. In the case of pandemics, it is suggested that discussions of health policies should, but often do not, distinguish morally between innocent threats and their potential victims as well as between providing benefits to people and preventing harms to them. The essay also examines discussions of pandemics by health professionals that make use of the trolley problem, the doctrine of double effect, and related philosophical distinctions. (shrink)

The data produced by the scientific community impacts on academia, clinicians, and the general public; therefore, the scientific community and other regulatory bodies have been focussing on ethical codes of conduct. Despite the measures taken by several research councils, unethical research, publishing and/or reviewing behaviours still take place. This exploratory study considers some of the current unethical practices and the reasons behind them and explores the ways to discourage these within research and other professional disciplinary bodies. These interviews/discussions with PhD (...) students, technicians, and academics/principal investigators were conducted mostly in European higher education institutions including UK, Italy, Ireland, Portugal, Czech Republic and Netherlands.Through collegiate discussions, sharing experiences and by examining previously published/reported information, authors have identified several less reported behaviours. Some of these practices are mainly influenced either by the undue institutional expectations of research esteem or by changes in the journal review process. These malpractices can be divided in two categories relating to methodological malpractices including data management, and those that contravene publishing ethics. The former is mostly related to “committed bias”, by which the author selectively uses the data to suit their own hypothesis, methodological malpractice relates to selection of out-dated protocols that are not suited to the intended work. Although these are usually unintentional, incidences of intentional manipulations have been reported to authors of this study. For example, carrying out investigations without positive controls; but including these from a previous study. Other methodological malpractices include unfair repetitions to gain statistical significance, or retrospective ethical approvals. In contrast, the publication related malpractices such as authorship malpractices, ethical clearance irregularities have also been reported. The findings also suggest a globalised approach with clear punitive measures for offenders is needed to tackle this problem. (shrink)

Purpose: In the educational field a lack of focus on the process of arriving at a level of profound understanding of a phenomenon can be observed. While classical approaches in education focus on "downloading," repeating, or sometimes optimizing relatively stable chunks of knowledge (both facts and procedural knowledge), this paper proposes to shift the center of attention towards a more dynamic and constructivist perspective: learning as a process of individual and collective knowledge creation and knowledge construction. The goal of this (...) process is to profoundly understand a phenomenon in its multi-dimensionality and complexity and to reflect on the processes that have lead to this understanding. The issue we want to tackle in this paper is how this profound understanding can be brought about in a technology-enhanced learning environment. Method: Part 1 of this paper explores strategies of technology-enhanced knowledge sharing/creation in the field of higher education. Part 2 presents a successful blended learning scenario that illustrates the implementation of these learning strategies in a concrete course design. In this case study students are involved in active theory construction processes by conducting virtual experiments with a virtual organism. Part 3 elaborates on the epistemological implications of this case study. Findings: A constructivist framework for modes of knowing and modes of coming to know is developed. It is shown that -- in order to reach a profound understanding of a phenomenon -- it is essential to take into account the multi-facetted character of knowledge and to use the strategy of double-loop learning. Conclusion: This leads to an understanding of learning/teaching as a process of socio-epistemological engineering. Furthermore, the role of the teacher changes in such a constructivist setting of learning/teaching: Their primary task is to provide a "pedagogically (and technologically) augmented environment." They are responsible for creating an atmosphere of collective knowledge construction and reflection. Beyond the role of a coach and moderator the teacher has to act as a facilitator or "enabler" for the (individual and collective) processes of double-loop learning. (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.