Arguments from disagreement against moral realism begin by calling attention to widespread, fundamental moral disagreement among a certain group of people. Then, some skeptical or anti-realist-friendly conclusion is drawn. Chapter 2 proposes that arguments from disagreement share a structure that makes them vulnerable to a single, powerful objection: they self-undermine. For each formulation of the argument from disagreement, at least one of its premises casts doubt either on itself or on one of the other premises. On reflection, this shouldn’t be (...) surprising. These arguments are intended to support very strong metaphysical or epistemological conclusions about morality. They must therefore employ very strong metaphysical or epistemological premises. But, given the pervasiveness of disagreement in philosophy, especially about metaphysics and epistemology, very strong premises are virtually certain to be the subject of widespread, intractable disagreement—precisely the sort of disagreement that proponents of these arguments think undermine moral claims. Thus, these arguments undermine their own premises. If Chapter 2’s argument is sound, it provides realists with a single, unified strategy for responding to any existing or forthcoming arguments from disagreement. (shrink)

This reflection item provides an edited account of human rights lawyer Harriet Wistrich’s conversation with Manvir Grewal, Visiting Lecturer and Ph.D. student, and Harriet Samuels, Reader in Law at the University of Westminster. It summarises the exchange which focused on Harriet Wistrich’s career trajectory and the many public interest law cases that she has brought on behalf her clients, mainly women, in both domestic and international forums. It also includes a condensed version of the question and answer (...) session with the audience. Questions included the broader issues around domestic violence, rape, coercive control, sex work and the nature of feminism. (shrink)

Moorean arguments are a popular and powerful way to engage highly revisionary philosophical views, such as nihilism about motion, time, truth, consciousness, causation, and various kinds of skepticism (e.g., external world, other minds, inductive, global). They take, as a premise, a highly plausible first-order claim (e.g., cars move, I ate breakfast before lunch, it’s true that some fish have gills) and conclude from it the falsity of the highly revisionary philosophical thesis. Moorean arguments can be used against nihilists in ethics (...) (error theorists), too. Recently, error theorists have recognized Moorean arguments as a powerful challenge and have tried to meet it. They’ve argued that moral Moorean premises seem highly credible to us, but aren’t, by offering various debunking explanations. These explanations all appeal to higher-order evidence—evidence of error in our reasoning. I argue that drawing attention to higher-order evidence is a welcome contribution from error theorists, but that the higher-order evidence actually counts further against error theoretic arguments—including their debunking explanations—and further in favor of Moorean arguments and the commonsense views they support. Along the way I answer a few prominent objections to Moorean arguments: that they are objectionably question-begging, rely on categorizing some facts as “Moorean Facts”, and that reports of one’s credence in a proposition bears no interesting relation to that proposition’s credibility. (shrink)

Defining Mental Disorder: Jerome Wakefield and His Critics, edited by Denis Forest and Luc Faucher, is essential reading for students and researchers in philosophy of medicine whose work is informed by that of Jerome Wakefield, or the disease debate in general. If you are anything like me, this book will open the door to a new depth of understanding of the harmful dysfunction analysis (HDA) and its methodical underpinnings, and an enriched appreciation of what is at stake in defining medical (...) disorder. To those confident that they understand Wakefield’s view and the surrounding debate, thinking perhaps that they do not need a refresher, I would say: perhaps you do not understand it as well as you think. Defining Mental Disorder provides much more than an overview of previously well-trodden ground. The chapters themselves, and Wakefield’s own detailed responses, help to elucidate a number of methodological nuances and peculiarities that have rarely been covered in such depth before. I was startled to learn how philosophically complex Wakefield’s position actually is, and how shallow my own understanding of it has been. It emerges as a far more nuanced and sophisticated account than I had given it credit for, and one that deserves serious reevaluation. (shrink)

One of the deepest and longest-lasting debates in ethics concerns a version of the Euthyphro question: are choiceworthy things choiceworthy because agents have certain attitudes toward them or are they choiceworthy independent of any agents’ attitudes? Reasons internalists, such as Bernard Williams, Michael Smith, Mark Schroeder, Sharon Street, Kate Manne, Julia Markovits, and David Sobel answer in the first way. They think that all of an agent’s normative reasons for action are grounded in facts about that agent’s pro-attitudes (e.g., her (...) desires, valuing states, normative judgments). According to the most popular brand of internalism, idealizing internalism, an agent’s reasons are grounded, not in her actual pro-attitudes, but rather in what her pro-attitudes would be in suitably idealized conditions. Idealizing internalists presuppose that, for any agent with an irrational set of attitudes, there is one uniquely rational set that that agent would have if she were to undergo the relevant idealizing process. I argue that this assumption is false and that it raises two puzzles for idealizing internalism: one about the existence of practical reasons and another about their normative weight. I argue that idealizing internalists have an adequate solution to the first puzzle but not the second. Indeed, when they try to solve the second puzzle, they confront a dilemma. This second puzzle and the associated dilemma thus constitutes a powerful, but so far unnoticed, difficulty for idealizing internalism. (shrink)

This paper presents four arguments in favour of respecting Ulysses Contracts in the case of individuals who suffer with severe chronic episodic mental illnesses, and who have experienced spiralling and relapse before. First, competence comes in degrees. As such, even if a person meets the usual standard for competence at the point when they wish to refuse treatment (time 2), they may still belesscompetent than they were when they signed the Ulysses Contract (time 1). As such, even if competent at (...) time 1andtime 2, there can still be a disparity between thelevelsof competence at each time. Second, Ulysses Contracts are important to protect people’smost meaningfulconcerns. Third, on the approach defended, the restrictions to people’s liberty would be temporary, and would be consistent with soft paternalism, rather than hard paternalism: the contracts would be designed in such a way that individuals would be free to change their minds, and to change or cancel their Ulysses Contracts later. Finally, even if one rejects the equivalence thesis (the claim that allowing harm is as bad as doing harm), this is still consistent with the claim that, inparticular cases, it can be as wrong toallowa harm as to do a harm. Nevertheless, controversies remain. This paper also highlights several safeguards to minimise risks. Ultimately, we argue that people who are vulnerable to spiralling deserve a way to protect their autonomy as far as possible, using Ulysses Contracts when necessary. (shrink)

Abstract: Longtermist Effective Altruists (EAs) aim to mitigate the risk of existential catastrophes. In this paper, I have three goals. First, I identify a catastrophic risk that EAs have completely ignored. I call it religious catastrophe: the threat that (as Christians and Muslims have warned for centuries) billions of people stand in danger of going to hell for all eternity. Second, I argue that, even by secular EA lights, religious catastrophe is at least as bad and at least as probable (...) and, therefore, at least as important as many of the standard EA catastrophic risks (e.g., catastrophic climate change, nuclear winter). Third, I present the following dilemma for secular EAs: either adopt religious catastrophe as an EA cause or ignore religious catastrophe but also ignore catastrophic risks whose mitigation has a similar or lower expected value (i.e., most or all of them). Business as usual—ignoring religious catastrophe while championing the typical EA causes—is not an option consistent with longtermist EA principles. (shrink)

In this thought-provoking work, Tony D. Sampson presents a contagion theory fit for the age of networks. Unlike memes and microbial contagions, _Virality_ does not restrict itself to biological analogies and medical metaphors. It instead points toward a theory of contagious assemblages, events, and affects. For Sampson, contagion is not necessarily a positive or negative force of encounter; it is how society comes together and relates. Sampson argues that a biological knowledge of contagion has been universally distributed (...) by way of the rhetoric of fear used in the antivirus industry and other popular discourses surrounding network culture. This awareness is also detectable in concerns over _too much connectivity_, such as problems of global financial crisis and terrorism. Sampson’s “virality” is as established as that of the biological meme and microbe but is not understood through representational thinking expressed in metaphors and analogies. Rather, Sampson interprets contagion theory through the social relationalities first established in Gabriel Tarde’s microsociology and subsequently recognized in Gilles Deleuze’s ontological worldview. According to Sampson, the reliance on representational thinking to explain the social behavior of networking—including that engaged in by nonhumans such as computers—allows language to overcategorize and limit analysis by imposing identities, oppositions, and resemblances on contagious phenomena. It is the power of these categories that impinges on social and cultural domains. Assemblage theory, on the other hand, is all about relationality and encounter, helping us to understand the viral as a positively sociological event, building from the molecular outward, long before it becomes biological. (shrink)

To mark International Women’s Day the Research Group for Law, Gender and Sexuality at Westminster Law School held an evening conversation on 10 March 2016 on Women and Asylum. Speakers working in different areas of the asylum system shared their insights and experiences with an audience of staff, students, activists and other visitors. Harriet Samuels chaired the conversation and the speakers were Princess Chine Onyeukwu, Debora Singer, Priya Solanki and Zoe Harper. This article is an edited extract from the (...) transcript of the presentations and wide-ranging discussion, including the question and answer session. The discussion focused on the different steps in the refugee determination process and considered, in particular, the gendering of credibility and how women’s perceived lack of credibility has a significant impact on determinations and processes. (shrink)

Utilising empirical ethics analysis, we evaluate the merits of systems proposed to increase deceased organ donation in South Africa. We conclude that SA should maintain its soft opt-in policy, and enhance it with ‘required transplant referral’ in order to maximise donor numbers within an ethically and legally acceptable framework. In SA, as is the case worldwide, the demand for donor organs far exceeds the supply thereof. Currently utilising a soft opt-in system, SA faces the challenge of how to increase donor (...) numbers in a context which is imbued with inequalities in access to healthcare, multiplicitous personal beliefs and practices, distrust of organ transplant and varying levels of education and health literacy. We argue that a hard opt-in, opt-out or mandated consent system would be problematic, and we present empirical data from Gauteng Province illustrating barriers to ethically sound practice in soft consent systems. Ultimately, we argue that in spite of some limitations, a soft opt-in system is most realistic for SA because its implementation does not require extensive public education campaigns at national level, and it does not threaten to further erode trust at a clinical level. However, to circumvent some of the clinical-level barriers identified in our empirical study, we propose a contextually sensitive option for “enabling” soft opt-in through “required transplant referral”. We argue that this system is legally defensible, enhances ethical practice and could also increase donor numbers as it has in many other countries. (shrink)

I was an altar girl at St. Mary the Virgin, New York City–one of the first, in fact. In the mid‑70s, one of my friends approached the Rector and negotiated a deal: we women, who were interested in acolyting, would be allowed to serve at mass during the week, in street clothes, on the condition that we form and staff an altar guild.

Resource constraints in developing countries compel policy makers to ration the provision of healthcare services. This article examines one such set of Guidelines: A patient dialysing in the state sector in South Africa may not refuse renal transplantation when a kidney becomes available. Refusal of transplantation can lead to exclusion from the state-funded dialysis programme. This Guideline is legally acceptable as related to Constitutional stipulations which allow for rationing healthcare resources in South Africa. Evaluating the ethical merit of the Guideline, (...) and exploring the ethical dilemma it poses, proves a more complex task. We examine the actions of healthcare professionals as constrained by the Guideline. From a best interests framework, we argue that in these circumstances directing patient decision making is not necessarily unethical or unacceptably paternalistic. We then scrutinise the guideline itself through several different ethical ‘lenses’. Here, we argue that bioethics does not provide a definitive answer as to the moral merit of rationing dialysis under these circumstances, however it can be considered just in this context. We conclude by examining a potential pitfall of the Guideline: Unwilling transplant recipients may not comply with immunosuppressive medication, which raises questions for policies based on resource management and rationing. (shrink)

Une nouvelle dépendance du palais mycénien de Thèbes, mise au jour en 1980, présentait des traces évidentes de destruction par incendie comme les autres annexes du palais déjà découvertes dans ce secteur. L'abondance des objets en ivoire et des autres trouvailles montre qu'il s'agit d'un atelier d'ivoirier en usage vers le milieu du XIIIe s. La présence d'un squelette féminin dans la couche de destruction, fait jusqu'à présent unique dans la Thèbes mycénienne, prouve la soudaineté de la catastrophe que l'on (...) attribuera avec vraisemblance à un violent séisme. (shrink)

The triumph was the most prestigious accolade a politician and general could receive in republican Rome. After a brief review of the role played by the triumph in republican political culture, this article analyzes the severe limits Augustus placed on triumphal parades after 19 BC, which then became very rare celebrations. It is argued that Augustus aimed at and almost succeeded in eliminating traditional triumphal celebrations completely during his lifetime, by using a combination of refusing them for himself and his (...) relatives and of rewarding his legates who fought under his auspices with ornamenta triumphalia and an honorific statue in the Forum of Augustus. Subsequently, the elimination of the triumph would have been one natural result of the limit placed on further imperial expansion recommended by Augustus in his will, a policy his successors chose not to follow. Tiberius, however, was unwilling to conform to this new order and retired from public life to Rhodes the year after celebrating a triumph in 7 BC, the first such celebration since 19 BC. Tiberius' two triumphs and the senate's repeated offers of further triumphs to Augustus himself represented a different vision of the role triumphal celebration should take in a restored res publica and an ongoing challenge to the princeps. (shrink)

All authors in this symposium use a food regime perspective to ask questions about the present which—as these articles demonstrate—have several possible answers. History suggests a time perspective of 25–40 year cycles so far—a food regime 1870–1914, an experimental and chaotic era 1914–1947, and a food regime 1947–1973. It has been less than 40 years since 1973, when food regime analysts agree that a contested and experimental period began. There is no consensus on whether it has already ended or how (...) it might issue into a new food regime. The conversation is more fruitful than the conclusions. I intend these comments as an invitation to join in. (shrink)

People sometimes knowingly undermine the achievement of their own goals by, e.g., playing the lottery or borrowing from loan sharks. Are these agents acting irrationally? The standard answer is “yes.” But, in a recent award-winning paper, Jennifer Morton argues “no.” On her view, the norms of practical reasoning an agent ought to follow depend on that agent’s resource context (roughly, how rich or poor they are). If Morton is correct, the orthodox view that the same norms of practical rationality apply (...) to all agents needs revision. I argue that Morton’s arguments fail on empirical and philosophical grounds. What’s at stake? If Morton is correct, poverty relief agencies ought to re-design their incentives so resource-scarce agents can rationally respond to them. If I’m correct, resource-scarce agents do act irrationally in the cases under discussion, and we shouldn’t be shy about saying so. Instead of declaring them rational, we should try to understand the causes of their irrational behavior and help them better succeed by their own lights. (shrink)

A different picture of learning is suggested by Karl Popper's account of knowledge growing through 'conjectures and refutations'. The facts of human language are best explained by taking language acquisition to be a case of Popperian learning.

According to the Argument for Autonomous Mental Disorder, mental disorder can occur in the absence of brain disorder, just as software problems can occur in the absence of hardware problems in a computer. This article argues that the AAMD is unsound. I begin by introducing the “natural dysfunction analysis” of disorder, before outlining the AAMD. I then analyze the necessary conditions for realizer autonomous dysfunction. Building on this, I show that software functions disassociate from hardware functions in a way that (...) mental functions do not disassociate from brain functions. It follows that mental disorders are brain disorders necessarily. (shrink)

We often say that one reason is stronger, or weightier, than another. These are metaphors. What does normative strength or weight really consist in? Scanlon (2014) offers a novel answer to this question. His answer appeals to counterfactuals of various kinds. I argue that appealing to counterfactuals leads to deep problems for his view.

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to those (...) with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

The predominant contemporary concept of time is arguably measurable time, promoted as being in accordance with science. This is commonly understood as the time of physics, as, for instance, E. A. Milne claims in an article from 1950 on the modern conception of time, contrasting this with Plato's description of time as the “moving image of eternity”. The prevalence of an emphasis on measurability within such a conception of time is hard to avoid, although this can be nuanced somewhat. In (...) this article I turn to the ancient Greek notion of kairos in order to find another approach to the question of conceptions of temporality. A main objective is to indicate what this concept signifies in terms of adjusting to circumstances, catching the right moment and paying attention to due measure. I also briefly consider Baltasar Gracián's notions of festina lente and détencion in an attempt to show how this suggests a way in which we may be able to develop the ability to do the right thing at the right moment. (shrink)