This book is the result of an idea launched by the present editors of providing a gift to Dr. Runner in the form of a Festschrift written by former students. The response was overwhelming. Glenn Andreas, one of Dr. Runner's closest friends, and Paul Schrotenboer, secretary of the Reformed Ecumenical Synod, enthusiastically joined us, together with Bernard Zylstra of the Institute for Christian Studies and Harry Van Dyke of the Free University of Amsterdam, to form a committee for (...) this purpose... Upon the appearance of this publication the editors wish to express their sincere thanks to the members of the committee for the advice and encouragement they gave and for the work they have done. (shrink)

Gestures of Grace is a celebration of the life and career of Robert Sweetman, H. Evan Runner Chair in the History of Philosophy at the Institute for Christian Studies (2001–present). These essays, written by students and colleagues, testify to the remarkable breadth and depth of Sweetman’s research and teaching, from his early scholarly career at the Pontifical Institute of Medieval Studies to his time at ICS. Throughout the volume, there is extensive engagement with Sweetman’s influential historical scholarship on (...) topics such as the emergence and development of the Dominican order in the twelfth and thirteenth centuries, medieval women authors, Thomas Aquinas and Duns Scotus, and indeed on Sweetman’s own systematic contribution to the nature and promise of Christian scholarship today. (shrink)

Patients participating in the shared benefits of publicly funded health care enjoy the benefits of treatments tested on previous patients. Future patients similarly depend on treatments tested on present patients. Since properly designed research assumes that the treatments being studied are—so far as is known at the outset—equivalent in therapeutic value, no one is clinically disadvantaged merely by taking part in research, provided the research involves administering active treatments to all participants. This paper argues that, because no other practical or (...) moral considerations count decisively against so doing, we could and should oblige patients to agree to receive indicated treatment within the terms of any concurrent research protocols. This ensures their treatment will benefit not only themselves but also future patients through contributing to new knowledge. By analogy with the paying of income tax, patients should not be allowed to “veto” their social responsibility to take part in clinical research. (shrink)

This chapter discusses the various meanings of the two critical ideas in this book and compares them. These critical ideas are “religion” and “public bioethics”. The chapter focuses most of all not on the different religious roles, but on what we think “public bioethics” is or should be.

While functioning quite well for many years, the bioethics profession is in crisis. John H. Evans closely examines the history of the bioethics profession, and based on the sociological reasons the profession evolved as it did, proposes a radical solution to the crisis.

The notion of patients’ duties has received periodic scholarly attention but remains overwhelmed by attention to the duties of healthcare professionals. In a previous paper the author argued that patients in publicly funded healthcare systems have a duty to participate in clinical research, arising from their debt to previous patients. Here the author proposes a greatly extended range of patients’ duties grounding their moral force distinctively in the interests of contemporary and future patients, since medical treatment offered to one patient (...) is always liable to be an opportunity cost in terms of medical treatment needed by other patients. This generates both negative and positive duties. Ten duties—enjoining obligations ranging from participation in healthcare schemes to promoting one’s own earliest recovery from illness—are proposed. The characteristics of these duties, including their basis, moral force, extent and enforceability, are considered. They are tested against a range of objections—principled, societal, epistemological and practical—and found to survive. Finally, the paper suggests that these duties could be thought to reinforce a regrettably adversarial characteristic, shared with rights-based approaches, and that a preferable alternative might be sought through the notion of a “virtuous patient” contributing to a problem-solving partnership with the clinician. However, in defining and giving content to that partnership, there is a clear role for most, if not all, of the proposed duties; their value thus extends beyond the adversarial context in which they might first be thought to arise. (shrink)

Bioethicists’ attraction to principlism is rooted in a Western view of how matters that affect the public ought to be deliberated and decided: their resolution ought to be so structured and constrained that it can be understood and verified even by those at a remove from the circumstances of the problem. That view of deliberation, itself fostered by the Western view of government, has encouraged principlism to spread from its source in human subjects research into other areas of bioethics discourse.

Truth and Meaning is a classic collection of original essays on fundamental questions in the philosophy of language. It was first published in 1976, and has remained essential reading in this area ever since. The contributors include leading figures in late twentieth-century philosophy, such as Donald Davidson, Saul Kripke, P. F. Strawson, and Michael Dummett.

There is an unspoken distinction in ethical criteria in bioethics. On the one hand, there are criteria that can be used with discretion and judgment by an individual or small group of people like a...

Using a fictional but representative general practice consultation, involving the diagnosis of irritable bowel syndrome in a patient who is anxious for some relief from the discomfort his condition entails, this paper argues that when both a drug fails to out-perform placebo and the condition in question is a functional illness with no demonstrable underlying pathology, then the action of the drug is not only no better than placebo, and it is also no different from it either. The paper also (...) argues that, in the circumstances of the consultation described, it is striking that current governance deems it ethical for a practitioner to prescribe either a drug or a placebo, both of which appear to rely for their effectiveness on a measure of concealment on the part of the doctor, yet deems it unethical for a practitioner openly to prescribe a harmless and enjoyable substance which is likely to be no less effective than either drug or placebo and is also likely to be better-tolerated and cheaper than the drug. (shrink)

Blumenthal-Barby (2024) argues that the concept of personhood should not be used in bioethics, and part of her justification is that personhood is not consistent with the public’s values. In this c...

Anthropologists have long explained social behaviour as if people always do what they think is best. But what if most of these explanations only work because they are premised upon ignoring what philosophers call 'akrasia' - that is, the possibility that people might act against their better judgment? The contributors to this volume turn an ethnographic lens upon situations in which people seem to act out of line with what they judge, desire and intend. The result is a robust examination (...) of how people around the world experience weaknesses of will, which speaks to debates in both the anthropology of ethics and moral philosophy. (shrink)

In this essay I suggest that the bioethics profession’s jurisdiction over healthcare ethics consultation is in need of reinforcement. I argue that as the profession becomes more successful, competitors will challenge the profession to justify its ethical claims and ask whose ethics the profession represents. This challenge will come more quickly as the profession tries to influence the ethics of healthcare organizations. I propose a method of bolstering jurisdiction that will make the profession less vulnerable to challenge in the future.

In response to Flamm and Kodish, I argue that our misunderstanding or disagreement is primarily the result of different definitions of power. I also disagree with them and claim that they are indeed using the public’s ethics. Finally, I argue that there is no reason to think that bioethicists cannot have the same sort of influence in the boardroom that they have in the clinic.

Sawai et al. (2022) provide a good summary of the bioethical debate about brain organoids with an eye toward future directions. Like many contemporary texts in bioethics, they call for engagement w...

I greatly appreciate the opportunity provided by the editor of Zygon to further develop the ideas in my book Morals Not Knowledge: Recasting the Contemporary U.S. Conflict between Religion and Science in conversation with four critical commentaries. It is an honor to have one's work focused upon so intently, and I greatly appreciate the time and effort of the critics. The book was quite intentionally written as a provocation, an attempt at agenda setting, and as a call for changing the (...) thinking of the entire religion and science academic community. In my previous writings I have kept close to the data, allowing myself at best mid‐level conclusions, but this book is a foray into the abstraction and inevitable lack of precision required for high‐level generalization. I hope that it continues to be generative of debate. (shrink)

Professors are increasingly encouraged to adopt multiple role relationships with their students. Regardless of professor intent, these relationships carry risks. Left unexamined is whether student–faculty social multiple relationships impact student in-class behaviors. Provocatively, our exploratory study provides empirical support suggesting that when undergraduate students perceive that their professors engage in the multiple faculty–student relationships of friendships, drinking (alcohol) relationships, and sexual partnerships, students report they are more likely to engage in uncivil behaviors in the professor’s classroom. Accordingly, our study provides (...) a backdrop against which to think more substantively about the professorial role and the boundaries that accompany it. (shrink)

While there may be a place in some contexts for high handed, “blanket” legislative prohibitions on dissenting views of what constitutes death, the paper under consideration does not describe such a contextThis stimulating and provocative paper by Professor Appel, Defining death: when physicians and families differ, asks us to consider “whether patients’ families should be permitted to opt out of widely accepted definitions of death in favour of their own standards”. This is a striking question in many ways. It reminds (...) us that, as a simple description of fact, there are indeed different standards for human death in so far as different groups or communities have accepted and continue to accept varying notions of what constitutes human death. The question’s reference to “opting out” suggests, perhaps reasonably, that it seems prima facie odd to think of adopting a definition of death as being a matter of individual choice. The reference to “permission” invites us to suppose limitations, primarily legal, upon the extent to which such a choice could be tolerated. Also, the question ascribes to certain “definitions of death” the authority of being widely accepted. The definitions thus favoured are, we learn, the various formulations of death referring to the state of the brain, chief among them “whole brain death” although the author is troublingly vague over whether all such formulations are morally, legally, or conceptually equivalent; and the relevant communities of acceptance turn out to consist of many—but, as the author admits, not all—physicians labouring under varying and inconsistent jurisdictions in the United States.My preface to the criticisms that follow is a …. (shrink)

Motor training to improve walking and balance function is a common aspect of rehabilitation following motor-incomplete spinal cord injury. Evidence suggests that moderate- to high-intensity exercise facilitates neuroplastic mechanisms that support motor skill acquisition and learning. Furthermore, enhancing corticospinal drive via transcranial direct current stimulation may augment the effects of motor training. In this pilot study, we investigated whether a brief moderate-intensity locomotor-related motor skill training circuit, with and without tDCS, improved walking and balance outcomes in persons with MISCI. In (...) addition, we examined potential differences between within-day and between-day effects of MST. Twenty-six adults with chronic MISCI, who had some walking ability, were enrolled in a 5-day double-blind, randomized study with a 3-day intervention period. Participants were assigned to an intensive locomotor MST circuit and concurrent application of either sham tDCS or active tDCS. The primary outcome was overground walking speed measured during the 10-meter walk test. Secondary outcomes included spatiotemporal gait characteristics, peak trailing limb angle, intralimb coordination, the Berg Balance Scale, and the Falls Efficacy Scale-International questionnaire. Analyses revealed a significant effect of the MST circuit, with improvements in walking speed, cadence, bilateral stride length, stronger limb TLA, weaker limb ACC, BBS, and FES-I observed in both the MST+tDCSsham and MST+tDCS groups. No differences in outcomes were observed between groups. Between-day change accounted for a greater percentage of the overall change in walking outcomes. In persons with MISCI, brief intensive MST involving a circuit of ballistic, cyclic locomotor-related skill activities improved walking outcomes, and selected strength and balance outcomes; however, concurrent application of tDCS did not further enhance the effects of MST.Clinical Trial Registration[ClinicalTrials.gov], identifier [NCT03237234]. (shrink)

So-called ‘gain-of-function’ (GOF) research is virological research that results in a virus substantially more virulent or transmissible than its wild antecedent. GOF research has been subject to ethical analysis in the past, but the methods of GOF research have to date been underexamined by philosophers in these analyses. Here, we examine the typical animal used in influenza GOF experiments, the ferret, and show how despite its longstanding use, it does not easily satisfy the desirable criteria for ananimal model. We then (...) discuss the limitations of the ferret model, and how those epistemic limitations bear on ethical and policy questions around the risks and benefits of GOF research. We conclude with a reflection on how philosophy of science can contribute to ethical and policy debates around the risks, benefits and relative priority of life sciences research. (shrink)

This paper first distinguishes governance (collective, autonomous self-regulatory processes) from government (externally-imposed mandatory regulation); it proposes that the second of these is essentially incompatible with a conception of the medical humanities that involves imagination and vision on the part of medical practitioners. It next develops that conception of the medical humanities, as having three distinguishable aspects (all of them distinct from the separate phenomena popularly known as “arts-in-health”): first, an intellectual enquiry into the nature of clinical medicine; second, an important (...) dimension of medical education; third, a resource for moral and aesthetic influences upon clinical practice, supporting “humane health care” as the moral inspirations behind organised medicine. Medical humanities sustains these three aspects through paying proper attention to the existential and subjective aspects of medicine. By encouraging authentic imagination among health care practitioners, medical humanities aligns well with both humane health care and governance in the sense of self-regulation. However, it can neither be achieved mechanistically nor well-measured through proxies such as patient satisfaction. Above all, it should not be allowed to supply, through inappropriate qualitative “targets,” new forms of management tyranny. (shrink)

In terms of intervening in embodied experience, medical treatment is wonder-full in its ambition and its metaphysical presumption; yet, wonder’s role in clinical medicine has received little philosophical attention. In this paper, I propose, to doctors and others in routine clinical life, the value of an openness to wonder and to the sense of wonder. Key to this is the identity of the central ethical challenges facing most clinicians, which is not the high-tech drama of the popular conceptions of medical (...) ethics but, rather, the routine of patients’ undramatic but unremitting demands for the clinician’s time and respectful attention. Wonder (conceived as an intense and transfiguring attentiveness) is a ubiquitous ethical source, an alternative to the more familiar respect for rational autonomy, a source of renewal galvanizing diagnostic imagination, and a timely recalling of the embodied agency of both patient and clinician. (shrink)

At the beginning of the 20th century, the shorter Greek version of the book of Tobit, GI, which is included in the Catholic Bible, was thought to be the oldest version. It was defined as ‘a lesson on almsgiving and its redeeming powers’. As the discoveries of the Semitic copies of Tobit at Qumran, GI is recognised to be a reworking of the longer version GII, most probably originally written in Aramaic, between 225 and 175 BCE. In all versions of (...) Tobit, the theme of almsgiving is introduced as specifically directed to Jewish kinsmen, but towards the end, is to be directed to all poor, suggesting that it may have been written by a Hellenistic Jew. Although the surface context of the narrative of Tobit is the Jewish tradition of proper observation of mitzvot and sacrifice and eventual reward, the various versions contain varying degrees of ancient Near Eastern wisdom, and an ironic, subversive reflection of hypocritical righteousness. This article questioned why the endings differ markedly in different versions. To try to find answers, a semantic comparison was made between GI and the most complete Aramaic version 4Q196. Contribution: This article considered the implications of source criticism in the reception of the various versions of Tobit. The possibility was examined that the pre-Christian, Aramaic version 4Q196Tobit does not confirm the excessive focus on almsgiving as righteousness apparent in the GI version of LXX Tobit. (shrink)