In a free society, it is common to hear the request that one â ~keep an open mind.â Just what exactly is it, however, to keep an open-mind? How does open-mindedness function? How does it square with important personal commitments? These issues are particularly acute when it comes to matters of religious belief in which open-mindedness can sound to the pious a bit too much like doubt. Certainly, in a discipline whose discourse remains rational dialogue, effort should be spent discerning (...) the contours of this virtue, especially in light of its formal role in establishing responsiveness to new inquiries in matters philosophical and religious. This book provides a collection of essays serving to promote conversation about open-mindedness, its virtue, and its role and application in problems in the philosophy of religion in particular. (shrink)

John DePoe takes issue with Christians who accept Berkeleyan idealism, essentially arguing that there is a special problem from evil for the Christian idealist. While DePoe’s treatment of idealism is commendable, his argument ultimately fails in one of two ways. It either (1) turns on common misunderstandings of idealism or (2) results in consequences unacceptable to Christians. In our article, we respond to DePoe’s argument by remotivating idealism, pointing out ways in which DePoe misunderstands idealists’ responses to the charge of (...) a special problem of evil, and pointing out problems with DePoe’s proposals of materialist solutions to the problem of evil. (shrink)

Many scientific discoveries have depended on external diagrams or visualizations. Many scientists also report to use an internal mental representation or mental imagery to help them solve problems and reason. How do scientists connect these internal and external representations? We examined working scientists as they worked on external scientific visualizations. We coded the number and type of spatial transformations (mental operations that scientists used on internal or external representations or images) and found that there were a very large number of (...) comparisons, either between different visualizations or between a visualization and the scientists’ internal mental representation. We found that when scientists compared visualization to visualization, the comparisons were based primarily on features. However, when scientists compared a visualization to their mental representation, they were attempting to align the two representations. We suggest that this alignment process is how scientists connect internal and external representations. (shrink)

In How to Build a Better Human, prominent bioethicist Gregory E. Pence argues if, we are careful and ethical, we can use genetics, biotechnology, and medicine in safe ethical ways for human enhancement. He looks at the innovations and challenges that have occurred since the birth of bioethics almost 50 years ago and considers the ethical implications of the technological advances that are just around the corner.

Should there be limits to the human alteration of the natural world? Through a study of debates about the environment, agricultural biotechnology, synthetic biology, and human enhancement, Gregory E. Kaebnick argues that such moral concerns about nature can be legitimate but are also complex, contestable, and politically limited.

This essay contends that God created humanity as His co-creators to bring Him glory with one’s entire being, including imagination and creativity. Throughout Scripture, YHWH is depicted as the artistic Creator of all that is beautiful, true, and transcendent. The Bible attests the creation of humanity in the imago Dei--sharing God’s innate creativity--and divine gifting of Spirit-inspired artisans utilizing their talents for God’s glory. Yet, over the centuries, “art” was oft misunderstood and grossly neglected in Christ’s church. Philip Ryken explains (...) how medieval skeptics began removing and destroying art believed to violate the Decalogue. Imbalanced suspicions toward art in Christendom still persist, despite the positive, inspirational effects of icons in Catholic and Orthodox traditions and scientific research that shows the therapeutic value of art across a broad spectrum of mental and physical challenges, including isolation and depression. Makoto Fujimura posits that Christian creatives possess a common faith as “border-walkers,” and can affect phoenix-like positive cultural and ecclesial change by reintroducing beauty as a visible “sermon” into a fragmented, post-pandemic world. (shrink)

Much work in bioethics tries to sidestep bedrock questions about moral values. This is fine if we agree on our values; arguments about human enhancement suggest we do not. One bedrock question underlying these arguments concerns the role of emotion in morality: worries about enhancement are derided as emotional and thus irrational. In fact, both emotion and reason are integral to all moral judgment.

In a recent issue of this journal, Kevin Corcoran has argued that the metaphysical theory one holds to about the nature of human persons is irrelevant to the sort of ethical questions that occupy bioethicists as well as the general public. Specifically, he argues that whether one holds a constitution view of human persons, an animalist view, or a substance dualist view, the real work in one’s ethical reasoning is done by certain moral principles rather than by metaphysical ones. I (...) raise objections to his analysis and propose that it is a combination of ethical principles and metaphysical principles that does the work in our judgements about the morality of abortion and other actions. (shrink)

What is God like? What can God do? What can God know? How does God communicate? Philosopher Gregory E. Ganssle appeals to philosophy for some answers to these questions in this introduction to thinking clearly and carefully about God.

Much work in bioethics tries to sidestep bedrock questions about moral values. This is fine if we agree on our values; arguments about human enhancement suggest we do not. One bedrock question underlying these arguments concerns the role of emotion in morality: worries about enhancement are derided as emotional and thus irrational. In fact, both emotion and reason are integral to all moral judgment.

There is widespread agreement that medical care offered at the end of a life ought to accord with the preferences of the person whose life it is, at least if the care requested would not be futile. There is considerable evidence, too, that making care more “patient‐centered” in this way would tend to lower the cost of care, for the simple reason that people in those straits often prefer to avoid the most intrusive and therefore most expensive care. So patient‐centered (...) care could be a win‐win of sorts: there could be a collective benefit of lowering costs along with the individual benefit of conforming care better to what the patient wants. But to what degree should the collective benefit be an express goal of health reform, in light of the fact that a given patient might want whatever intrusive, aggressive interventions stand a chance of prolonging life? This question animates several items in this issue of the Report. (shrink)

In the current issue of The New Atlantis, Daniel Sarewitz, professor of science and society at Arizona State University, argues that science is broken because it is managed and judged by scientists themselves, operating under Vannevar Bush's famous 1945 declaration that scientific progress depends on the “free play of free intellects … dictated by their curiosity.” With that scientific agenda, society ends up with a lot of unnecessary, uncoordinated, and unproductive research. To save science, holds Sarewitz, we need to put (...) it in the hands of people who are looking for practical solutions to specific problems. In one article in this issue of the Hastings Center Report, Kirstin Borgerson poses a question in this same conceptual space: are there too many clinical trials? Other pieces in the issue cover a mix of topics: the lead article addresses some of the challenges that will have to be faced as “artificial organs” become available, a third article looks at how crowdfunding sites like GoFundMe can be used to make public appeals for medical funding, and a special report found in a supplement to the issue offers a round of analysis and recommendations about the provision of medical care to professional football players. (shrink)

The lead article in this issue of the Report proposes an innovative explanation for why the subjects of medical research often seem to have great difficulty accurately gauging whether the research will be medically beneficial for them. The first commentary lauds the paper and examines its implications in greater detail; the second lauds the effort to rethink subjects' capacities for assessing the therapeutic benefit of research but raises questions about the paper's conceptual framework. The article is about how subjects think (...) about the research they're in. The nature of thought is also the subject of the special report, published as a supplement to the issue, on the uses of stories in bioethics. Essays contributed by some of the scholars who have been prominent in narrative ethics try to articulate why and how thinking in terms of stories can be valuable in the midst of a clinical bioethics consultation.. (shrink)

This issue of the Report is bookended by two pieces that take contrasting although perhaps compatible positions on medical care for those in dire straits. At the end of the issue is an article that considers whether patients may be denied admission to intensive care units on grounds that they are too sick to benefit. We think of ICUs as reserved for the sickest of the sick, notes author Andrew Courtwright, but in fact, “too sick to benefit” is an increasingly (...) common reason given for not putting a patient in the ICU. Meanwhile, the first essay in the book tells the story of a man whose physician more or less told him he was too sick to benefit (under some understanding of the idea) and should opt for death. (shrink)

Can we make wise policy decisions about still‐emerging technologies—decisions that are grounded in facts yet anticipate unknowns and promote the public's preferences and values? There is a widespread feeling that we should try. There also seems to be widespread agreement that the central element in wise decisions is the assessment of benefits and costs, understood as a process that consists, at least in part, in measuring, tallying, and comparing how different outcomes would affect the public interest. But how benefits and (...) costs are best weighed when making decisions about whether to move forward with an emerging technology is not clear. Many commentators feel that the weighing is often inadequate or inappropriate. Those who argue for a “precautionary” approach to the weighing do so precisely because they feel the need for a restraint on the dominant decision‐making tools and processes for assessing outcomes.This Hastings Center special report examines those tools and processes, taking the method known as cost‐benefit analysis as a starting point. In U.S. governance, CBA, sometimes informed by risk assessment, is the most widely used and extensively studied method, and authoritative reports on genetic and reproductive technologies often use language suggestive of cost‐benefit analysis. There is also a long‐running debate about the role of values in CBA and other formal impact assessment mechanisms—and about how those mechanisms compare to the precautionary principle. The guiding idea in the report is to engage in a close examination of the strengths and limits of CBA for ensuring that emerging technologies are used in ways that square with the public's values, drawing on applications of synthetic biology to illustrate and sharpen the analysis and then considering corrections to CBA and some alternative methodologies that handle values differently. (shrink)

: A comparison of casuistry with the strain of particularism developed by John McDowell and David Wiggins suggests that casuistry is susceptible to two very different mistakes. First, as sometimes developed, casuistry tends toward an implausible rigidity and systematization of moral knowledge. Particularism offers a corrective to this error. Second, however, casuistry tends sometimes to present moral knowledge as insufficiently systematized: It often appears to hold that moral deliberation is merely a kind of perception. Such a perceptual model of deliberation (...) cannot offer a convincing account of the possibility of moral progress. This second problem is one to which particularism is itself prone. To redress it, other aspects of casuistry must be exploited: Casuistry contains an account of presumptive generalizations that explains how moral deliberation might be structured by rules while also depending at critical junctures on perception. (shrink)

In this important new book Gregory E. Pence looks at issues on the frontiers of medicine including gene therapy to produce 'brave new babies,' cloning, human eggs and embryos for sale, and experiments on human embryos. Pence argues that the conservatism of the medical establishment, the bioethics community, and the public at large has created shibboleths that impede improvements in our quality of life.

The March–April issue of the Hastings Center Report offers another in a series of articles over the last few years on the structure and the ethics of surrogate decision‐making. Here, Daniel Brudney addresses how to help the surrogate deal with a treatment decision. A core insight he offers is that the structure of the surrogate’s decision has been misunderstood and the misunderstanding makes the task yet harder. As usually understood, the surrogate is supposed to be guided by the question, what (...) would the patient choose, if the patient were making the choice herself? Brudney argues that this conception is impossible, and that the surrogate’s task is instead to consider the patient’s best interests, as illuminated in part by the patient’s expressed values and past choices. This understanding leads, he argues, to a different guiding question: what could the patient choose, given her values? (shrink)

One of the themes running through this issue of the Hastings Center Report is the complexity of how private moral commitments cash out in the public sphere. It's a theme I find both fascinating and important.The lead article is about how hospices in Oregon have dealt with the state's law permitting physician-assisted death. Most patients who have sought physician-assisted death in Oregon did so while in hospice, suggesting to some people that hospices are centrally involved in physician-assisted death—both in patients' (...) decision-making and in administering the medications. In fact, their involvement is much more limited and circumspect, as authors Courtney Campbell and Jessica Cox document.The focus of the article .. (shrink)

One of the foundational thoughts in bioethics is that professional roles can generate special ethical obligations. Bioethics first emerged as an effort to understand the special ethical obligations of physicians and researchers. But bioethics now finds itself subject to a converse thought. Bioethicists engaged in clinical ethics consultations‐discussing patient care and decision‐making with physicians and others‐have a special ethical obligation toward patients and coworkers, and that obligation has generated a professional role, as it were. Clinical ethicists bear the obligation of (...) ensuring that ethical standards for patient care are upheld, and since this work requires special skills and knowledge, clinical ethicists can be asked to demonstrate that they have what it takes and can bring it effectively to bear in consultations. The evolution of clinical ethical consultation is the topic of the lead article in this issue of the Report. The second article in this issue returns to that ur‐topic‐the ethical obligations of physicians and researchers. (shrink)

For the last couple of years, The Hastings Center has been running a research project titled “The Ethical Issues of Synthetic Biology” (funded by the Alfred P. Sloan Foundation) that is focused primarily on whether the prospect of altering microorganisms to meet human ends is intrinsically troubling. “Synthetic biology” is not necessarily limited to the alteration of microorganisms, but the applications now under development—such as yeast that produce a precursor of the antimalarial drug artemisinin or blue-green algae that produce fuel—are (...) certainly limited to that. A set of essays in this issue of the Report features a variety of different takes on the field. For the last six months of the project .. (shrink)

This issue of the Hastings Center Report features three articles exploring aspects of decision-making for others. In the first two, the focus is on the limits of surrogate decision-makers’ authority when the surrogates’ judgments about a patient's treatment conflict with the physicians’. If a physician decides that a patient will not benefit from CPR, for example, but the patient's surrogate insists on it, is the physician obliged to proceed with the procedure? Or can the physician, pointing to a duty to (...) provide good care to the patient and not to cause the patient to suffer, get a do-not-resuscitate order for the patient—even in the face of the surrogate's objections? These are the questions that animate the first article, in which a group of authors report on a policy implemented at Massachusetts General Hospital to help doctors who face this dilemma. The second article, by physician Jeffrey Berger, flips the questions. If a physician decides that a patient's intractable suffering requires palliative sedation, may the surrogate prevent it anyway? Or can the physician, pointing to a duty to alleviate the suffering, administer palliative sedation even in the face of the surrogate's objections? Such circumstances, says Berger, show the need for conceptual work delineating the limits of surrogates’ authority and practical work on mechanisms for doing so—protecting patients and giving physicians a clear route to follow. (shrink)

As described by Lori Gruen in the Perspective column at the back of this issue, federally supported biomedical research conducted on chimpanzees has now come to an end in the United States, although the wind-down has taken longer than expected. The process began with a 2011 Institute of Medicine report that set up several stringent criteria that sharply limited biomedical research. The National Institutes of Health accepted the recommendations and formed a committee to determine how best to implement them. The (...) immediate question raised by this transition was whether the IOM restrictions should be extended in some form to other nonhuman primates—and beyond them to other kinds of animals. In the lead article in this issue, Anne Barnhill, Steven Joffe, and Franklin Miller consider the status of other nonhuman primates. (shrink)