Western society today is less unified by a set of core values than ever before. Undoubtedly, the concept of moral consensus is a difficult one in a liberal, democratic and pluralistic society. But it is imperative to avoid a rigid majoritarianism where sensitive personal values are at stake, as in bioethics. Bioethics has become an influential part of public and professional discussions of health care. It has helped frame issues of moral values and medicine as part of a more general (...) effort to find consensus about some of the most perplexing questions of our time. But why is it thought that a moral consensus is important or that it deserves respect? How does moral consensus acquire legitimacy in a society that includes diverse value systems? How is moral consensus possible and how do small groups help create or distort consensus processes? Written by a medical school professor trained in philosophy, this timely work tackles these questions from philosophical, historical, and social scientific standpoints. It begins by describing the traditional ambivalence about consensus in Western culture as well as the uncertain relationship in modernity between consensus and expertise. After outlining the current bioethical consensus, the book gives philosophical and political analyses of the idea of consensus, then assesses the role of consensus in national ethics commissions and in the ethics committee movement. Moreno constructs an original, naturalistic philosophy of moral consensus, referred to as "bioethical naturalism", and then applies sociology and social psychology to actual consensus processes. The book concludes with an account of bioethics as a consensus-oriented social reform movement. This insightful volume will be essential reading for bioethicists, philosophers, physicians, members of ethics committees, and all those concerned with ethical and social issues in health care. (shrink)

I explore two accounts of properties within a dispositional essentialist (or causal powers) framework, the pure powers view and the powerful qualities view. I first attempt to clarify precisely what the pure powers view is, and then raise objections to it. I then present the powerful qualities view and, in order to avoid a common misconception, offer a restatement of it that I shall call the truthmaker view. I end by briefly defending the truthmaker view against objections.

This article is based on a public lecture hosted by the Monash University Centre for Human Bioethics in Melbourne, Australia on 11 April 2013. The lecture recording was transcribed by Vicky Ryan; and, the original transcript has been edited — for clarity and brevity — by Vicky Ryan, Michael Selgelid and Jonathan Moreno.

Children and adults from theus and China heard about people who died in two types of narrative contexts – medical and religious – and judged whether their psychological and biological capacities cease or persist after death. Most 5- to 6-year-olds reported that all capacities would cease. In theus, but not China, there was an increase in persistence judgments at 7–8 years, which decreased thereafter.uschildren’s persistence judgments were influenced by narrative context – occurring more often for religious narratives – and such (...) judgments were made especially for psychological capacities. When participants were simply asked what happens to people following death, in both countries there were age-graded increases in references to burial, religious ritual, and the supernatural. (shrink)

Medical and public health research includes surveys, interviews, and biospecimens — techniques that do not present substantial risks to subjects. Consequently, this research is exempt from regulation under the Federal Common Rule. Nevertheless, at many institutions, exempt research is frequently subject to the same regulatory process that is required for non-exempt research, requiring the consumption of time and resources for review by Institutional Review Board members or staff. The federal government has indicated an intention to reform and centralize this system, (...) but has not yet specified the form that it will use instead. By examining the policies of the top 50 research institutions, this article assesses institutional practices surrounding exempt research, quantifies the extent of exempt-research review requirements, documents a problem of “over-compliance,” and makes recommendations for reform. (shrink)

According to ‘composition as identity’, a composite object is identical to all its parts taken together. Thus, a plurality of composite objects is identical to the plurality of those objects’ parts. This has the consequence that, e.g., the bricks which compose a brick wall are identical to the atoms which compose those bricks, and hence that the plurality of bricks must include each of those atoms. This consequence of CAI is in direct conflict with the standard analysis of plural definite (...) descriptions. According to that analysis, the denotation of ‘the bricks’ can include only bricks. It seems, then, that if CAI is true, ‘the bricks’ doesn’t denote anything; more generally, if CAI is true, there are fewer pluralities than we ordinarily think. I respond to this argument by developing an alternative analysis of plural descriptions which allows the denotation of ‘the bricks’ to include non-bricks. Thus, we can accept CAI, while still believing in all the pluralities we could want. As a bonus, my approach to plural descriptions and plural comprehension blocks recent arguments to the effect that CAI entails compositional nihilism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Notes on Psychodramatic Treatment of a Person with SchizophreniaJonathan D. Moreno, PhD (bio)I have enjoyed reflecting on Mr. Chapy’s account of work in psychodrama with a patient with schizophrenia.Although at one time many years ago I was interested in phenomenological psychiatry, and especially the writings of Ludwig Binswanger and Medard Boss, I am not an authority on dasein-analysis, so I have nothing to add to the discussion. I should (...) say, however, that my father had little interest in this approach, which was far too abstract for his taste. He proceeded from the standpoint of the theater, of action and enactment. He believed that the drama itself provided the insight.For the purposes of this response, I take it as a given that the patient in question has been accurately diagnosed, although in the description of the scene with his father he does not exhibit the usual symptoms, such as auditory hallucinations. People with schizophrenia often find it difficult to manage the voices they are hearing without substantial preparation for a psychodrama. According to psychodramatic method, one way to prepare them is to externalize the voices, allowing a different therapist to take the role of each one as the protagonist instructs them how to play that role. Chair may be set up so that each “voice,” personified by an auxiliary ego, can sit in each chair in an array. This preparation may require a number of sessions. If the scene is to be enacted with a significant other, like the father in this instance, the patient may not be able to warm up to a direct encounter, especially with all the different voices competing for his internal attention. So he may be directed to observe each voice in the encounter with his father, preferably played by a therapist of his choosing and trained for the role, usually by giving the father-player certain lines so that they can learn something about the father and the way he addresses his son.Or consider the patient whose illness manifests itself as delusions, often of a megalomaniac character. They may be a messiah, for example, or the rightful heir of a royal line whose identity is being suppressed by governmental forces. The patient might be invited to choose key therapists to play the roles of key members of their circle, [End Page 225] enacting critical scenes like the sermon on the mount or speeches to their oppressed followers. In this way the patient’s “act hunger” may be to some degree satiated and have a calming effect on their anxiety and irritation with the frustrating world around them that refuses to accept their “authentic” identity and belief system.In these ways, psychodrama therapy can take advantage of one of the remarkable advantages of this method for such patients, who are generally recalcitrant to talk therapy alone and for whom medication is at best modestly effective. Still, these disorders are among the most challenging for psychotherapists. Although the process of treating them may open up insights into the nature of the human mind, as Chapy has pursued in this paper, we await the neuroscience that can affect the kind of long-term remission they and their families so desperately wish. [End Page 226]Jonathan D. MorenoUniversity of Pennsylvania [email protected] D. Moreno Jonathan D. Moreno is a philosopher and historian who specializes in the intersection of bioethics, culture, science, and national security, and has published seminal works on the history, sociology and politics of biology and medicine. He is an elected member of the National Academy of Medicine.submitted on January 27, 2023Accepted on January 30, 2023Copyright © 2023 Johns Hopkins University Press... (shrink)

In 1962, Harvard professor of anesthesiology Henry Beecher wrote to Senator Estes Kefauver about certain additions to the federal Food and Drug Act then being considered. According to The Antibiotic Era, the Maryland congressman Samuel Friedel had introduced language that would require informed consent in clinical research. Beecher joined a number of other distinguished medical scientists warning that such a requirement would “cripple” American medical research. A year before, Beecher had protested the U.S. Army's inclusion of the Nuremberg Code in (...) its contracts. Beecher's commitment to a medical ethics of virtue rather than one of oversight suggests that he was a far more interesting person than the cardboard cutout so often vaguely referenced in bioethics as an icon of the rights of human subjects. His thinking about research ethics was rooted in his post‐World War II laboratory work with LSD. (shrink)

Is human cognition best described by optimal models, or by adaptive but suboptimal heuristic strategies? It is frequently hard to identify which theoretical model is normatively best justified. In the context of information search, naoptimal” models.

Modernism has been a celebration of the present. Why does it need a legacy ? Why should that which was born in the spirit of rebellion perpetuate itself as tomorrow’s past? Modernism has been profoundly reflective of late nineteenth- and twentieth-century cultural values. Is that not enough? It is not that modernism has forgotten the past—an art that rebels against its past must understand its adversary—but rather that it asks us not to forget the present. The revolt of modernism was (...) made possible, if not inevitable, by the rediscovery of the past. In earlier, eras, when the past was less readily accessible, artists worked for their present with little thought about their heritage. Renaissance composers, for example, generally knew little of music even two generations old; much medieval music theory and composition were based on misconceptions of Greek models. Yet by the nineteenth century, works from the past were available and understood. Virtually all composers agreed with Johannes Brahms, who reputedly said of Ludwig van Beethoven, “You have no idea how the likes of us feel when we hear the tramp of a giant like him behind us.” Historical consciousness had entered the arts, and artists were both threatened by competition with the past and seduced by the powerful idea that their works might outlive them. The Romantic artist became a genius speaking to posterity. Gustav Mahler was not the only Romanticist to pin his hopes on the future: “My time will yet come.” Small wonder that, once the future came to be, its artists rebelled against pronouncements from their past—the time rightfully belonged to them and no longer to Mahler’s generation. While many twentieth-century artists continued to create for their future, the most extreme modernists rejected not only their past but also the quest for immortality. They have written of their day and for their day. The real legacy of modernism is that it has no legacy. Jonathan D. Kramer is professor of music theory and composition at the College-Conservatory of Music at the University of Cincinnati and also program annotator and new music advisor of the Cincinnati Symphony Orchestra. He is currently working on Time and the Meanings of Music . His previous contribution to Critical Inquiry, “New Temporalities in Music,” appeared in Spring 1981. (shrink)

Quine says that ontology is about what there is, suggesting that to be ontologically committed to Fs is to be committed to accepting a sentence which existentially quantifies over Fs. Kit Fine argues that this gets the logical form of some ontological theses wrong. Fine is right that some ontological theses cannot be rendered simply as ‘There are Fs’. But the root of the problem has yet to be recognized, either by Fine or by his critics. Sometimes to adopt an (...) ontological thesis is not merely to commit yourself to there being at least one F; it is to take a stand on which Fs there are. Once we recognize the ‘particularity’ of these ontological theses, we can adequately express them within the confines of a Quinean approach to ontology and ontological commitment. (shrink)

I claim that a whole is identical to its parts. Many find this claim incredible: it seems that a whole and its parts must be distinct, for the whole is one thing while its parts are many things. Byeong-uk Yi has developed a version of this argument which exploits the resources of plural logic. Yi provides logical analyses of the predicates ‘one’ and ‘many’ which seem to show that nothing can satisfy them both. But there are two senses of the (...) word ‘one’. One of these senses is not captured by Yi’s analysis, and in this sense of the word, it is logically possible for many things to be one. Moreover, we should only believe that a whole is one thing in this sense, not that it is one thing in the sense Yi has analysed. Thus, we can identify wholes with their parts without contradiction. (shrink)

The cellular processes of transport, division and, possibly, early development all involve microtubule‐based motors. Recent work shows that, unexpectedly, many of these cellular functions are carried out by different types of kinesin and kinesin‐related motor proteins. The kinesin proteins are a large and rapidly growing family of microtubule‐motor proteins that share a 340‐amino‐acid motor domain. Phylogenetic analysis of the conserved motor domains groups the kinesin proteins into a number of subfamilies, the members of which exhibit a common molecular organization and (...) related functions. The kinesin proteins that belong to different subfamilies differ in their rates and polarity of movement along microtubules, and probably in the particles/organelles that they transport. The kinesins arose early in eukaryotic evolution and gene duplication has allowed functional specialization to occur, resulting in a surprisingly large number of different classes of these proteins adapted for intracellular transport of vesicles and organelles, and for assembly and force generation in the meiotic and mitotic spindles. (shrink)

Recent efforts to support state regulation of risky behavior like cigarette smoking, alcohol consumption, driving without seatbelts and riding motorcycles without helmets have focused on economic justifications—the costs to society of the consequences of these activities. However, opponents have successfully argued that the economic burdens of regulation outweigh the social benefits. To reduce the toll on society of these behaviors, we need justification for regulation that asserts the moral primacy of health and the well‐being of the community.

Metaphysicians of various stripes claim that a single object can have more than one exact location in space or time – e.g. endurantists claim that an object persists by being ‘all there’ at different moments in time. Antony Eagle has developed a formal theory of location which is prima facie consistent with multi-location, but Damiano Costa and Claudio Calosi argue that the theory is unattractive to multi-location theorists on other grounds. I examine their charge that Eagle’s theory won’t allow an (...) endurantist to account for certain cases of mereological change. I argue that the charge sticks, but not for the reasons Costa and Calosi think. Along the way, I explore an issue which is underexplored in their paper, namely, how an endurantist might modify Eagle’s theory to incorporate a parthood relation which obtains, not absolutely, but only relative to times. (shrink)

On September 4, 2001, press reports indicated that the Defense Intelligence Agency of the U.S. Department of Defense planned to reproduce a strain of anthrax virus suspected of being held in Russian laboratories. According to the same reports, the Central Intelligence Agency, under the auspices of Project Clear Vision, is engaged in building replicas of bomblets believed to have been developed by the former Soviet Union. These small bombs were designed to disperse biological agents, including anthrax. Government attorneys were said (...) to be confident that, because these projects were designed to develop defensive measures, they were not in violation of the 1972 Biological and Toxin Weapons Convention. (shrink)

One hypothesis concerning the human dorsal anterior cingulate cortex (ACC) is that it functions, in part, to signal the occurrence of conflicts in information processing, thereby triggering compensatory adjustments in cognitive control. Since this idea was first proposed, a great deal of relevant empirical evidence has accrued. This evidence has largely corroborated the conflict-monitoring hypothesis, and some very recent work has provided striking new support for the theory. At the same time, other findings have posed specific challenges, especially concerning the (...) way the theory addresses the processing of errors. Recent research has also begun to shed light on the larger function of the ACC, suggesting some new possibilities concerning how conflict monitoring might fit into the cingulate's overall role in cognition and action. (shrink)

The authors consider the nature of explanatory models in the social sciences in order to suggest ways in which conceptual systems differ. They suggest that, in many cases, theorists, researchers and clinicians can utilize insights from rival models in building their own models, without sacrificing the integrity of their own work.

According to Composition as Identity, a whole is distinct from each of its parts individually, but identical to all of them taken together. It is sometimes claimed that, if you accept CAI, then your belief in a whole is ‘ontologically innocent’ with respect to your belief in its parts. This claim is false. But the defender of CAI can claim a different advantage for her view. Following Agustín Rayo, I distinguish ontology from plethology. I then show that CAI allows us (...) to introduce an interesting notion of ‘plethological innocence’ which would otherwise collapse into the notion of ‘ontological innocence’, and that CAI renders belief in composite objects plethologically innocent. (shrink)

The generality problem is perhaps the most notorious problem for process reliabilism. Several recent responses to the generality problem have claimed that the problem has been unfairly leveled against reliabilists. In particular, these responses have claimed that the generality problem is either (i) just as much of a problem for evidentialists, or (ii) if it is not, then a parallel solution is available to reliabilists. Along these lines, Juan Comesaña has recently proposed solution to the generality problem—well-founded reliabilism. According to (...) Comesaña, the solution to the generality problem lies in solving the basing problem, such that any solution to the basing problem will give a solution to the generality problem. Comesaña utilizes Conee and Feldman’s evidentialist account of basing (Conee and Feldman’s well-foundedness principle) in forming his version of reliabilism. In this paper I show that Comesaña’s proposed solution to the generality problem is inadequate. Well-founded reliabilism both fails to solve the generality problem and subjects reliabilism to new damning verdicts. In addition, I show that evidentialism does not face any parallel problems, so the generality problem remains a reason to prefer evidentialism to reliabilism. (shrink)

Saba Bazargan-Forward (2022, Authority, Cooperation, and Accountability), conceives of agency as divided into two functions: a deliberative function (deciding what to do) and an executive function (acting on that decision). He claims that these two functions can distributed across multiple agents, and that this has important moral consequences: if you outsource the executive function to me, then the practical reasons you take there to be, for A-ing, are relevant to whether I can permissibly A and to how my A-ing reflects (...) on my character. However, the natural way of understanding the 'divided agency' model --- i.e. that in cases of divided agency the executor literally acts on the deliberator's reasons --- is problematic and doesn't seem to reflect Bazargan-Forward's considered view, while his considered view doesn't seem to support his moral judgments, either about the permissibility of the executor's behaviour or of their character. I suggest an alternative to Bazargan-Forward's 'divided agency' model and consider what moral judgments it supports. (shrink)

When asked why he turned from philosophy to the history of ideas, Isaiah Berlin said that he was worried that if he stayed in philosophy he wouldn't know any more at the end of his life than he had at the beginning. Mark Lilla makes the point in a somewhat more constructive way: "His [Berlin's] instinct told him that you learn more about an idea as an idea when you know something about its genesis and understand why certain people found (...) it compelling and were spurred to action by it".It took me decades longer than the brilliant Oxford don to appreciate the point, but when I did it came as a lightning strike of recognition. My brain seems to have been keyed from the beginning in the syntax of... (shrink)

Freedom and moral responsibility have one foot in the practical realm of human affairs and the other in the esoteric realm of fundamental metaphysics—or so we believe. This has been denied, especially in the metaphysics-bashing era occupying the first two-thirds or so of the twentieth century, traces of which linger in the present day. But the reasons for this denial seem to us quite implausible. Certainly, the argument for the general bankruptcy of metaphysics has been soundly discredited. Arguments from Strawson (...) and others that our moral practices are too deeply embedded in human life to rest on anything as tenuous as a metaphysical doctrine far from the thoughts of ordinary people would seem to prove too much: we can easily imagine fantastic scenarios far from the thoughts of ordinary people—involving, say, alien manipulation or massive deception—that, if true, would clearly undermine claims to freedom and responsibility. For still other philosophers, the separation of the moral life from (some) metaphysical issues is prescriptive, not descriptive: it is a recommendation that we revise ordinary moral thought by severing its allegedly problematic links to metaphysics. (Some philosophers appear to hover undecided between such a prescriptive project and a Strawsonian descriptive claim.) We suspect that the prospects of retaining the binding force of ordinary moral thought, were such a reconceived moral practice widely embraced, are bleak. A transition to something closer to moral nihilism seems at least as likely. In any case, our interest here is in descriptive metaphysics, not revisionary. -/- To say as we do that freedom and moral responsibility have a partly metaphysical character is not to suggest that they can be had only if some highly specific version of a particular metaphysical framework is correct. Instead, we suggest in what follows, it is a broadly neo-Humean metaphysics that is not hospitable to freedom (for reasons distinctive to the metaphysics), while a broadly neo-Aristotelian metaphysics is. But we also think (and it is the main aim of our paper to show) that different versions of the neo- Aristotelian metaphysics lead to rather different metaphysical accounts of free and responsible action. Specifically, we will argue that (1) the most satisfactory account of human freedom within the broadly neo-Aristotelian metaphysics is agent-causal, but that (2) two different versions of the general metaphysics will lead to important differences in the agent-causal account of freedom. Adjust the details of your general metaphysics, and the details of your account of freedom are transformed in significant ways. Action theory cannot properly be pursued in isolation from general metaphysics. (shrink)

Understanding how neurons represent, process, and manipulate information is one of the main goals of neuroscience. These issues are fundamentally abstract, and information theory plays a key role in formalizing and addressing them. However, application of information theory to experimental data is fraught with many challenges. Meeting these challenges has led to a variety of innovative analytical techniques, with complementary domains of applicability, assumptions, and goals.

If economics has been the “dismal science” of the past century, health policy promises to be that of the next. Health policy issues evoke far less passion than the emotion-laden immediacies of bedside decision making. Nevertheless, it is patent that “macro” issues in all their obscurity and complexity are unavoidable if the health care delivery system of the future is to be fiscally sound and publicly acceptable. In addition, as Americans are now learning, options for care at the bedside are (...) ineluctably constrained by seemingly distant societal choices. (shrink)

The immune surveillance theory postulates that spontaneous tumors are normally rejected by the immune system and appear only when they override host‐immune recognition and rejection mechanisms. The present mini‐review describes a spontaneous tumor system, the reticulum cell sarcomas (RCS) in SJL/J mice, that is dependent on host tumor‐specific immune lymphocytes for growth. This continuous tumor‐specific response results in tumor progression and death of the host. This tumor system contradicts the basic concept of immune surveillance. We propose as an explanation that (...) some highly antigenic tumors, like the RCS, may have evolved in a non‐autonomous fashion but, nevertheless, have lost regulatory controls of cell proliferation. In the RCS system, the tumor expresses Class II MHC I‐E like specificities that are not expressed on the host cells and which selectively stimulate a subpopulation of I‐E specific T cells, the Vβ17a+ clonotype, leading to their expansion and continuous nurturing of the tumor via secreted lymphokines. This neoantigenic stimulation bypasses the tumor regulatory response that might have resulted if the tumor had not expressed neo‐antigens. Furthermore, passive administration of anti‐clonotypic antibody to tumor‐bearing mice results in tumor regression and long‐term survival through removal of the tumor reactive T cells. Thus, in this tumor system, immunosuppressive treatments are the prescription for tumor rejection. (shrink)

Federal policies on human subjects research have performed a near‐about face. In the 1970s, policies were motivated chiefly by a belief that subjects needed protection from the harms and risks of research. Now the driving concern is that patients, and the populations they represent, need access to the benefits of research.

In Matthew 23:1-3, Jesus commands His disciples and the crowd to listen to the scribes and Pharisees even while not imitating their actions. Many modern interpreters have lessened the force of Matthew 23:1-3 by an assumption of irony on the part of Jesus. We presume that God could never ordain this for His people. However, this easier reading may not be the best reading. A more straightforward interpretation, but one that is difficult to hear, suggests that at times we may (...) need to sit under bad leadership as means of receiving God’s Word. Pre-critical and modern interpreters provide an understanding of the words of Jesus that is consistent with a theology of God’s providence in times of transition and bad leadership. In addition, there are instances of His direction in both the Old and New Testaments that reinforce this challenging path. It is through this more faithful stance that we grow and flourish in difficult times. (shrink)

Bioethics as a field has been fortunate that its values and concerns have mirrored the values and concerns of society. In light of the September 11th attacks, it is possible that we are witnessing the beginning of a transition in American culture, one fraught with implications for bioethics. The emphasis on autonomy and individual rights may come to be tempered by greater concern over the collective good. Increased emphasis on solidarity over autonomy could greatly alter public response to research abuses (...) aimed at defense from bioterrorism, to privacy of genetic information, and to control of private medical resources to protect the public health. (shrink)

it is mandatory that in building up our strength, we enlarge upon our technical superiority by an accelerated exploitation of the scientific potential of the United States and our allies. National Security Council, NSC-G8: United States Objectives and Program for National Security April 14, 1950 Innovation within the armed forces will rest on experimentation with new approaches to warfare, strengthening joint operations, exploiting U.S. intelligence advantages, and takingfull advantage of science and technology. George W Bush, The National Security Strategy of (...) the United States of America, September 17,2002. (shrink)

This study provides an account of Augustine's understanding of prayer and its importance to his theology by drawing on his practices as monk and bishop.