Parents and physicians often grapple with the agonizing decision of whether to continue life-sustaining treatment for critically ill infants. In this paper, we introduce a novel framework called the Fundamental Conditions Approach (FCA) to guide these difficult choices. Building on S. Matthew Liao’s work, the FCA evaluates whether an infant possesses or can develop the fundamental capacities necessary for engaging in basic activities that constitute a good life. These capacities include the ability to think, respond to facts, develop interpersonal relationships, (...) and interact with one’ environment. We argue that if an infant lacks nearly all of these fundamental capacities and medical interventions cannot restore them, there are stronger ethical grounds for withdrawing life-sustaining treatment. Conversely, if an infant retains some fundamental capacities or could develop them with treatment, there are compelling reasons to continue care. To illustrate its practical and ethical implications, we apply the FCA to complex cases such as Tinslee Lewis and other infants with severe congenital conditions. We also compare the FCA with other prevailing models, including the best interest standard, the Life Worth Living Approach, the relational potential standard, and medical vitalism. We contend that the FCA offers more concrete guidance while avoiding some of the limitations inherent in these alternatives. While the FCA cannot eliminate all uncertainty in these challenging situations, we conclude that it provides a substantive and intuitively plausible approach to decision-making about life sustaining treatment for critically ill infants. (shrink)

1. Sexual Brains and Body Politics 2. Hormones and Hardwiring 3. Making Sense of Brain Organization Studies 4. Thirteen Ways of Looking at Brain Organization 5. Working Backward from “Distinct‘ Groups 6. Masculine and Feminine Sexuality 7. Sexual Orienteering 8. Sex-Typed Interests 9. Taking Context Seriously 10. Trading Essence for Potential.

In ‘Rethinking Disease’, Powell and Scarffe1 propose what in effect is a modification of Jerome Wakefield’s2 3 harmful dysfunction analysis (HDA) of medical (including mental) disorder. The HDA maintains that ‘disorder’ (or ‘disease’ in Powell and Scarffe’s terminology) is a hybrid factual and value concept requiring that a biological dysfunction, understood as a failure of some feature to perform a naturally selected function, causes harm to the individual as evaluated by social values. Powell and Scarffe accept both the HDA’s evolutionary (...) biological function component and its incorporation of a value component. Their proposed ‘new twist’ is to revise the value component: ‘Our proposed definition of disease is as follows: a biomedical state is a disease only if it implicates a biological dysfunction that is, or would be, properly disvalued’. So, they propose that a disorder is a ‘properly disvalued dysfunction’ rather than a ‘harmful dysfunction’, an approach they term ‘thickly normative’ in contrast to the thin normative approach of the HDA. There has been a surge of interest recently in better understanding the ‘harm’ component of the HDA. Powell and Scarffe’s analysis is a helpful contribution to this discussion. We focus here exclusively on their proposal regarding the analysis of the concept of disorder and ignore many important related issues that the authors address, ranging from prioritising resource allocation between disorders and non-disorders to whether the concept of disorder should be replaced by a generic welfarist concept. The resolution of these additional issues depends on first understanding ‘disorder’. The authors’ proposed changes to the HDA also deserve evaluation because the HDA, which has been endorsed by leading nosologists,4 plays an influential role in nosological debate across categories of disorder ranging, for example, from sexual paraphilias5 to psychopathy.6 A basic problem is that Powell and Scarffe misinterpret …. (shrink)

In “Genetic Privacy, Disease Prevention, and the Principle of Rescue,” Madison Kilbride argues that patients have a duty to warn biological family members about clinically actionable adverse genetic findings. The duty does not stem from the special obligations that we may have to family members, she argues, but rather follows from the principle of rescue, which she understands as the idea that one ought to prevent, reduce, or mitigate the risk of harm to another person when the expected harm is (...) serious and the cost or risk to oneself is sufficiently moderate. We doubt, however, whether the principle of rescue can ground a duty to warn in the cases Kilbride envisages, and we suggest that Kilbride may have underappreciated the role that special obligations could play in generating a duty to warn family members. (shrink)

High temporal resolution event-related brain potential and electroencephalographic coherence studies of the neural substrate of short-term storage in working memory indicate that the sustained coactivation of both prefrontal cortex and the posterior cortical systems that participate in the initial perception and comprehension of the retained information are involved in its storage. These studies further show that short-term storage mechanisms involve an increase in neural synchrony between prefrontal cortex and posterior cortex and the enhanced activation of long-term memory representations of material (...) held in short-term memory. This activation begins during the encoding/comprehension phase and evidently is prolonged into the retention phase by attentional drive from prefrontal cortex control systems. A parsimonious interpretation of these findings is that the long-term memory systems associated with the posterior cortical processors provide the necessary representational basis for working memory, with the property of short-term memory decay being primarily due to the posterior system. In this view, there is no reason to posit specialized neural systems whose functions are limited to those of short-term storage buffers. Prefrontal cortex provides the attentional pointer system for maintaining activation in the appropriate posterior processing systems. Short-term memory capacity and phenomena such as displacement of information in short-term memory are determined by limitations on the number of pointers that can be sustained by the prefrontal control systems. Key Words: coherence; event-related potentials; imaging; long-term memory; memory; short-term memory; working memory. (shrink)

This collection of essays is dedicated to William Rowe, with great affection, respect, and admiration. The philosophy of religion, once considered a deviation from an otherwise analytically rigorous discipline, has flourished over the past two decades. This collection of new essays by twelve distinguished philosophers of religion explores three broad themes: religious attitudes of faith, belief, acceptance, and love; human and divine freedom; and the rationality of religious belief. Contributors include: William Alston, Robert Audi, Jan Cover, Martin Curd, Peter van (...) Inwagen, Norman Kretzmann, George Nakhnikian, John Hawthorne, Philip Quinn, James Ross, Eleonore Stump, and William Wainwright. (shrink)

While much of the social and political attention surrounding the nationwide opioid epidemic has focused on the dramatic increase in overdose deaths among white, middle-class, suburban and rural users, the impact of the epidemic in Black communities has largely been unrecognized. Though rates of opioid use at the national scale are higher for whites than they are for Blacks, rates of increase in opioid deaths have been rising more steeply among Blacks than whites over the last five years. Moreover, the (...) rate of opioid overdose deaths among Blacks already exceeds that of whites in several states. The lack of discussion of Black overdose deaths in the national opioid discourse further marginalizes Black people, and is highly consistent with a history of framing the addictions of people of color as deserving of criminal punishment, rather than worthy of medical treatment. This article argues that, because racial inequalities are embedded in American popular and political cultures as well as in medicine, the federal and state governments should develop more culturally targeted programs to benefit Black communities in the opioid crisis. Such programs include the use of faith-based organizations to deliver substance use prevention and treatment services, the inclusion of racial impact assessments in the implementation of drug policy proposals, and the formal consideration of Black people's interaction with the criminal justice system in designing treatment options. (shrink)

The term "human dignity" is the source of considerable confusion in contemporary bioethics. It has been used by Kantians to refer to autonomy, by others to refer to the sanctity of life, and by still others to refer—albeit obliquely—to an important but infrequently discussed set of human goods. In the first part of this article, I seek to disambiguate the notion of human dignity. The second part is a defense of the philosophical utility of such a notion; I argue that (...) there is nothing implausible about appealing to a deontological "principle of dignity" to solve bioethical problems, especially those concerning the development of new biotechnologies. There may, however, be problems associated with any attempt to use dignity as a basis for public policy. This sort of worry is explained and briefly addressed in the final section. (shrink)

Direct-to-consumer genetic testing is a growing phenomenon, fuelled by the notion that knowledge equals control. One ethical question that arises concerns the proband’s duty to share information indicating genetic risks in their relatives. However, such duties are unenforceable and may result in the realisation of anticipated harm to relatives. We argue for a shift in responsibility from proband to provider, placing a duty on test providers in the event of identified actionable risks to relatives. Starting from Parker and Lucassen’s 'joint (...) account model', we adapt Kilbride’s application of the rule of rescue and balance it against the relative’s right not to know, placing responsibility on the providers of direct-to-consumer genetic testing. Where the risk of disease to a relative is actionable, we argue providers ought to share results even in the face of the proband’s objections. Confidentiality issues are navigated by a pre-emptive consent model, whereby consumers agree to the sharing of certain information with their relatives ahead of testing and as a condition of testing. When a relative is informed, the proband’s privacy is protected by maximal deidentification, and the rights of the relative are met by a stepwise approach to informing that allows them to decide how much information they receive. (shrink)

Shamik Dasgupta (2016) proposes to tame the Principle of Sufficient Reason (PSR) to apply to only non-autonomous facts, which are facts that are apt for explanation. Call this strategy to tame the PSR the taming strategy. In a recent paper, Della Rocca (2020a) argues that proponents of the taming strategy, in attempting to formulate a restricted version of the PSR, nevertheless find themselves committed to endorsing a form of radical monism, which, in turn, leads right back to an untamed-PSR. Suppose, (...) for the sake of argument, that Della Rocca is right. My question is this: Is there reason to believe the principle of sufficient reason (in its untamed version)? In this paper, I argue that it is impossible for there to be a reason to believe the untamed-PSR. (shrink)

Phenomenology of practice is a useful, rigorous way of deeply understanding human phenomena. Therefore, it allows research to be conducted into nursing's most sensitive and decisive aspects. While it is a widely used research approach and methodology in nursing, it is seldom addressed and made use of in its practical and applied value. This article aimed to approach the global outlook of van Manen's hermeneutic‐phenomenological method to better understand its theoretical background and to address and support the contribution this method (...) can make to nursing, if rigorously applied. For a professional discipline like nursing, van Manen's approach is especially interesting because, in addition to contributing to the body of knowledge of nursing, it provides a special kind of knowledge that allows nurses to act in a more reflective manner, and with tact and skill, in certain situations and relationships that arise in their daily practice. A more in‐depth understanding of this research methodology may help nurse‐researchers make good use of it and also harness knowledge derived from this type of research. This comes as a result of assuming that phenomenological texts, the final product of the research, have tremendous educational potential for people who read them carefully. (shrink)

In this essay, I draw on Kant’s legal philosophy in order to defend the right to voluntary motherhood by way of abortion at any stage of pregnancy as an essential feature of women’s basic rights. By developing the distinction between innate and acquired right in Kant’s legal philosophy, I argue that the viability standard in US law (as established in Planned Parenthood v. Casey) misunderstands the nature of embodied right. Our body is the site of innate right; it is the (...) means through which we can set and pursue ends in the world. The law, therefore, cannot adjudicate the relationship between the will and the body: it cannot require us to allow our bodies to be used against our will. By comparing unwanted pregnancy to sexual assault, I problematize the notion that consent to pregnancy, like consent to sex, can ever be conclusive. I examine Kant’s own account of unwanted pregnancy, in which he describes mother and child finding themselves “in a state of nature” in order to rethink the status of the fetus in law, and I argue that we should understand the fetus’s right to life as provisional, rather than as enforceable by law. (shrink)

What is the relationship between war propaganda and nationalism, and what are the effects of each on support for, or participation in, violent acts? This is an important question for international criminal law and ongoing speech crime trials, where prosecutors and judges continue to assert that there is a clear causal link between war propaganda, nationalism, and mass violence. Although most legal judgments hinge on the criminal intent of propagandists, the question of whether and to what extent propaganda and nationalism (...) interact to cause support for violence or participation remains unanswered. Our goal here is to contribute to research on propaganda and nationalism by bridging international criminal law and the behavioral and brain sciences. We develop an experiment conducted with Serbian participants that examines the effects of propaganda as identified in the latest international speech crime trial as causing mass violence, and thereby test hypotheses of expert witness Anthony Oberschall’s theory of mass manipulation. Using principal components analysis and Bayesian regression, we examine the effects of propaganda exposure and prior levels of nationalism as well as other demographics on support for violence, ingroup empathy, and outgroup empathy. Results show that while exposure to war propaganda does not increase justifications of violence, specific types of war propaganda increase ingroup empathy and decrease outgroup empathy. Further, although nationalism by itself is not significant for justifying violence, the interaction of increased nationalism and exposure to violent media is significant for altering group empathies. The implications of these findings are discussed with respect to international criminal law and the cognitive science of nationalism. (shrink)

Although COVID-19 vaccines are free and readily available in the United States, many healthcare workers remain unvaccinated, potentially exposing their patients to a life-threatening pathogen. This paper reviews the ethical and legal factors surrounding patient requests to limit their care teams exclusively to vaccinated providers. Key factors that shape policy in this area include patient autonomy, the rights of healthcare workers, and the duties of healthcare institutions. Hospitals must also balance the rights of interested parties in the context of logistical (...) constraints, equity, and public health considerations. (shrink)

When causal decision theory was created in the 1970s, access to Howard Sobel’s contribution was available only in a narrowly circulated mimeographed manuscript. After some time, he allowed his ideas to appear in the form of articles. Here we finally have a book length exposition on Sobel’s causal Bayesian point of view consisting of collected, revised, and amplified papers spanning a period of twenty years.

This article develops a model of relational happiness that challenges popular individualized definitions and emphasizes how it can enhance the sociological analysis of inequality. Many studies of happiness suggest that social inequalities are closely associated with distributions of happiness at the national level, but happiness research continues to favour individual-level analyses. Limited attention has been given to the intersubjective aspects of happiness and the correlations between it and higher social equality. Conversely, key theoretical debates about inequalities, such as Axel Honneth (...) and Nancy Fraser’s exchanges, have only indirectly touched on happiness. A relational approach to happiness is not new, but what this article offers is a new combination of a relational understanding of happiness as an intersubjectively, culturally experienced complex of emotions with discussions about recognition of marginalized groups and redistribution of material resources. This combined approach can further debates about understanding and remedying social inequalities. It argues that theories and measurements of happiness must consider how it can be achieved collectively through working at mutual respect as well as greater material equality. (shrink)

This paper explores Kant's account of marriage and its relevance to contemporary debates over same-sex marriage. Kant's defense of marriage is read against debates unfolding in Prussia in the 1790s, when the question of whether marriage was a "universal estate" was a central point of debate surrounding the Prussian Legal Code of 1794. By reading Kant's arguments in light of this historical context, and in comparison with those offered by his contemporaries, Fichte and von Hippel, this article shows both that (...) the debates about marriage in the 1790s mirror contemporary tensions, and that Kant took a "middle path" that innovatively defended marriage as a basic feature of the state. (shrink)

This interdisciplinary, empirical and theoretical approach to forgiveness and revenge considers the roles of truth, restitution and ritual in the promotion of forgiveness and deterrence of revenge in multiple contexts.

Terror management theory and research can rectify shortcomings in Atran & Norenzayan's (A&N's) analysis of religion. (1) Religious and secular worldviews are much more similar than the target article supposes; (2) a propensity for embracing supernatural beliefs is likely to have conferred an adaptive advantage over the course of evolution; and (3) the claim that supernatural agent beliefs serve a terror management function independent of worldview bolstering is not empirically supported.

A text for normal schools and teachers' colleges.

Very little research has attempted to describe normal human variation in female genitalia, and no studies have compared the visual images that women might use in constructing their ideas of average and acceptable genital morphology to see if there are any systematic differences. The objective of the present work was to determine if visual depictions of the vulva differed according to their source so as to alert medical professionals and their patients to how these depictions might capture variation and thus (...) influence perceptions of ‘normality’. A comparative analysis was conducted by measuring (a) published visual materials from human anatomy textbooks in a university library, (b) feminist publications (print and online) depicting vulval morphology and (c) online pornography, focusing on the most visited and freely accessible sites in the UK. Post hoc tests showed that labial protuberance was significantly less (p<0.001, equivalent to approximately 7 mm) in images from online pornography compared to feminist publications. All five measures taken of vulval features were significantly correlated (p<0.001) in the online pornography sample, indicating a less varied range of differences in organ proportions than the other sources where not all measures were correlated. Women and health professionals should be aware that specific sources of imagery may depict different types of genital morphology and may not accurately reflect true variation in the population, and consultations for genital surgeries should include discussion about the actual and perceived range of variation in female genital morphology. (shrink)

SummaryBorn to a noble family in the Italian Trentino, Prati studied philosophy in Austria and Germany. Returning to Italy, he joined the carbonari, a network of revolutionary secret societies. Forced into exile in Switzerland, he worked as an educator alongside Pestalozzi. Following his expulsion from Switzerland, Prati sought refuge in Britain, becoming acquainted with Coleridge, the Benthamite utilitarians, and the Owenites. Following the July Revolution, Prati went to Paris, where he became a Saint-Simonian. Returning to Britain, he sought to convert (...) the British to Saint-Simonism, before undertaking a series of other literary projects. He eventually returned to Italy, where he entered into correspondence with the Roman Catholic philosopher Antonio Rosmini. Prati left behind him a trail of letters, newspaper articles, pamphlets, and books, written in four different European languages. These have been hitherto neglected by scholars, and constitute the basis of the current article. (shrink)

The prospect of including artificial intelligence (AI) in clinical decision-making is an exciting next step for some areas of healthcare. This article provides an analysis of the available kinds of AI systems, focusing on macro-level characteristics. This includes examining the strengths and weaknesses of opaque systems and fully explainable systems. Ultimately, the article argues that “grey box” systems, which include some combination of opacity and transparency, ought to be used in healthcare settings.

Book reviewed in this article: Public Duties: The Moral Obligations of Government Officials. Edited by Joel L. Fleishman, Lance Liebman, and Mark H. Moore.

The thesis that humanity progresses in a lawlike manner from inferior states (of wellbeing, cognitive skills, culture, etc.) to superior ones dominated eighteenth- and nineteenth- century thought, including authors otherwise as diverse as Kant and Ernst Haeckel. Positioning himself against this philosophically and scientifically popular view, Nietzsche suggests that humanity is in a prolonged state of decline. I argue that Nietzsche’s rejection of the thesis that progress is inevitable is a product of his acceptance of Lamarck’s use-and-disuse theory of evolution (...) and his belief that society selects for traits beneficial to society and negatively selects for traits that promote individual flourishing. This explains Nietzsche’s emphasis on self-development as cultivating traits that Nietzsche views as valuable and that would, by Lamarck’s theory of evolution, become heritable and so help steer our evolutionary trajectory, correcting our decline. (shrink)

Language for Learning in the Primary School is the long awaited second edition of _Language for Learning_, first published in 2004 and winner of the NASEN/TES Book Award for Teaching and Learning in 2005. This handbook has become an indispensable resource, packed full of practical suggestions on how to support 5-11 year old children with speech, language and communication difficulties. Colour coded throughout for easy referencing, this unique book supports inclusive practice by helping teachers to: Identify children with speech, language (...) and communication needs Understand speech, language and communication skills Consider roles and responsibilities at primary school Plan a differentiated and adapted curriculum Consider the language demands across subjects Adopt a whole school approach Make use of a wide range of positive strategies Empower children to access the curriculum Language for Learning in the Primary School comes complete with a wealth of photocopiable resources, giving teachers and teaching assistants the confidence to help children with SLCN more effectively in mainstream settings. It will also be an extremely useful resource for speech and language therapists, specialist teachers and educational psychologists. (shrink)

Most countries compile evidence from witnesses and victims manually, whereby the interviewer assimilates what the interviewee says during the course of an interview to produce an evidential statement. This exploratory research examined the quality of evidential statements generated in real world investigations. Transcribed witness/victim interviews were compared to the resultant written statements produced by the interviewing officer and signed as an accurate record by the interviewee. A coding protocol was devised to assess the consistency of information between what was said (...) by the interviewee in the verbal interview and what was reported in the written statement. Statements contained numerous errors including omissions, distortions, and the inclusion of information not mentioned in the verbal interview. This exploratory work highlights an important area for future research focus. (shrink)