In an article in this journal, Christopher Cowley argues that we have ‘misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors’. We have not. It is Cowley who has misunderstood the role of personal values in the profession of medicine. We argue that there should be better protections for patients from doctors' personal values and there should be more severe restrictions on the right to conscientious objection, particularly in relation to assisted dying. We argue (...) that eligible patients could be guaranteed access to medical services that are subject to conscientious objections by: removing a right to conscientious objection; selecting candidates into relevant medical specialities or general practice who do not have objections; demonopolizing the provision of these services away from the medical profession. (shrink)

If a doctor is trying to decide whether or not to provide a medical treatment, does it matter ethically whether that treatment has already been started? Health professionals sometimes find it harder to stop a treatment (withdraw) than to refrain from starting the treatment (withhold). But does that feeling correspond to an ethical difference? In this article, we defend equivalence—the view that withholding and withdrawal of treatment are ethically equivalent when all other factors are equal. We argue that preference for (...) withholding over withdrawal could represent a form of cognitive bias—withdrawal aversion. Nevertheless, we consider whether there could be circumstances in which there is a moral difference. We identify four examples of conditional nonequivalence. Finally, we reflect on the moral significance of diverging intuitions and the implications for policy. We propose a set of practical strategies for helping to reduce bias in end-of-life decision making, including the equivalence test. (shrink)

According to the free energy principle all living systems aim to minimise free energy in their sensory exchanges with the environment. Processes of free energy minimisation are thus ubiquitous in the biological world. Indeed it has been argued that even plants engage in free energy minimisation. Not all living things however feel alive. How then did the feeling of being alive get started? In line with the arguments of the phenomenologists, I will claim that every feeling must be felt by (...) someone. It must have mineness built into it if it is to feel a particular way. The question I take up in this paper asks how mineness might have arisen out of processes of free energy minimisation, given that many systems that keep themselves alive lack mineness. The hypothesis I develop in this paper is that the life of an organism can be seen as an inferential process. Every living system embodies a probability distribution conditioned on a model of the sensory, physiological, and morphological states that are highly probably given the life it leads and the niche it inhabits. I argue for an ecological and enactive interpretation of free energy. I show how once the life of an organism reaches a certain level of complexity mineness emerges as an intrinsic part of the process of life itself. (shrink)

Julian Wuerth offers a radically new interpretation of major themes in Kant's philosophy. He explores Kant's ontology of the mind, his transcendental idealism, his account of the mind's powers, and his theory of action, and goes on to develop an original, moral realist account of Kant's ethics.

In this paper, we investigate how data about public preferences may be used to inform policy around the use of controversial novel technologies, using public preferences about autonomous vehicles (AVs) as a case study. We first summarize the recent ‘Moral Machine’ study, which generated preference data from millions of people regarding how they think AVs should respond to emergency situations. We argue that while such preferences cannot be used to directly inform policy, they should not be disregarded. We defend an (...) approach that we call ‘Collective Reflective Equilibrium in Practice’ (CREP). In CREP, data on public attitudes function as an input into a deliberative process that looks for coherence between attitudes, behaviours and competing ethical principles. We argue that in cases of reasonable moral disagreement, data on public attitudes should play a much greater role in shaping policies than in areas of ethical consensus. We apply CREP to some of the global preferences about AVs uncovered by the Moral Machines study. We intend this discussion both as a substantive contribution to the debate about the programming of ethical AVs, and as an illustration of how CREP works. We argue that CREP provides a principled way of using some public preferences as an input for policy, while justifiably disregarding others. (shrink)

AI researchers have developed sophisticated language models capable of generating paragraphs of 'synthetic text' on topics specified by the user. While AI text generation has legitimate benefits, it could also be misused, potentially to grave effect. For example, AI text generators could be used to automate the production of convincing fake news, or to inundate social media platforms with machine-generated disinformation. This paper argues that AI text generators should be conceptualised as a dual-use technology, outlines some relevant lessons from earlier (...) debates on dual-use life sciences research, and calls for closer collaboration between ethicists and the machine learning community to address AI language models’ dual-use implications. (shrink)

Cognition has traditionally been understood in terms of internal mental representations, and computational operations carried out on internal mental representations. Radical approaches propose to reconceive cognition in terms of agent-environment dynamics. An outstanding challenge for such a philosophical project is how to scale-up from perception and action to cases of what is typically called ‘higher-order’ cognition such as linguistic thought, the case we focus on in this paper. Perception and action are naturally described in terms of agent-environment dynamics, but can (...) a person’s thoughts about absent, abstract or counterfactual states of affairs also be accounted for in such terms? We argue such a question will seem pressing so long as one fails to appreciate how richly resourceful the human ecological niche is in terms of the affordances it provides. The explanatory work that is supposedly done by mental representations in a philosophical analysis of cognition, can instead be done by looking outside of the head to the environment structured by sociomaterial practices, and the affordances it makes available. Once one recognizes how much of the human ecological niche has become structured by activities of talking and writing, this should take away at least some of the motivation for understanding linguistic thinking in terms of content-bearing internal representations. We’ll argue that people can think about absent, abstract or counterfactual because of their skills for engaging with what we will call “enlanguaged affordances”. We make use of the phenomenological analysis of speech in Merleau-Ponty to show how the multiple affordances an individual is ready to engage with in a particular situation will typically include enlanguaged affordances. (shrink)

The recent tragic and widely publicised death of Jesse Gelsinger in a gene therapy trial has many important lessons for those engaged in the ethical review of research. One of the most important lessons is that ethics committees can give too much weight to ensuring informed consent and not enough attention to minimising the harm associated with participation in research. The first responsibility of ethics committees should be to ensure that the expected harm associated with participation is reasonable. Jesse was (...) an 18-year-old man with a mild form of ornithine transcarbamylase (OTC) deficiency, a disorder of nitrogen metabolism. His form of the disease could be controlled by diet and drug treatment. On September 13 1999 a team of researchers lead by James Wilson at the University of Pennsylvania's Institute for Human Gene Therapy (IHGT) injected 3.8 X 1013 adenovirus vector particles containing a gene to correct the genetic defect. He was the eighteenth and final patient in the trial. The virus particles were injected directly into the liver. He received the largest number of virus particles in a gene therapy trial.1 Four days later he was dead from what was probably an immune reaction to the virus vector. This was the first death directly attributed to gene therapy. It resulted in worldwide publicity, an independent investigation, the Federal Drug Administration (FDA) suspending all trials at the IHGT, an FDA, and a senate subcommittee investigation. At a special public meeting at the National Institutes of Health (NIH) in December 1999, James Wilson, also the director of the IHGT, said they still did not understand fully what had gone wrong.2 Even though a massive dose had been used, only 1% of transferred genes reached the target cells. (None of the patients in the trial showed significant gene expression. Art …. (shrink)

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight general problems (...) with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers to choose the policy supported by the best reasons. (shrink)

In this paper I consider, in connection with dementia, two views of the person. One view of the person is derived from Locke and Parfit. This tends to regard the person solely in terms of psychological states and his/her connections. The second view of the person is derived from a variety of thinkers. I have called it the situated-embodied-agent view of the person. This view, I suggest, more readily squares with the reality of clinical experience. It regards the person as (...) embedded in a history and culture. The human person is also an embodied agent. I contend that this view encourages a more appropriate approach towards the ethical issues that arise in dementia and towards people with dementia. (shrink)

The prelims comprise: Introduction Controversial Choices Kinds of Normative Reasons for Action Limits on Respect for Autonomy Children and Controversial Choice Controversial Choices and the Duty to Strive Toward Perfection and Full Autonomy Acknowledgments Notes References.

Wellbeing is classically considered a bi-product or externality of economic activity, which can either be positively or negatively influenced. This conventional view is returning to the fore in the face of renewed criticisms of ESG reporting standards as leading business astray from its core financial purpose. However, such reactivism overlooks the fact that wellbeing is the functional and overarching aim of human activity, which Aristotle defines as self-actualization. As such, any sound economic system must, in a fundamental way, enhance individual (...) and collective wellbeing. This essay calls for reinforcing social purpose commitments through a capitalism rooted in moral self-awareness in which the common good displaces profit as the sole function of business. According to this picture, profit maintains its proper place as the means of economic transactions, allowing social purpose to take up its proper place as business' central aim. (shrink)

Should people be assisted to die or be given euthanasia when they are suffering from terminal medical conditions? Should they be assisted to die when they are suffering but do not have a ‘diagnosable medical illness?’ What about assisted dying for psychiatric conditions? And is there a difference morally between assisted suicide, voluntary active euthanasia and voluntary passive euthanasia?These are deep questions directly addressed or in the background of the productive discussion between Varelius and Young.1 ,2 Their focus is whether (...) doctors should assist people to die who are ‘tired of life’ and experiencing ‘existential suffering’. An example was Edward Brongersma, an 86-year-old man, who was tired of life but with no serious medical condition, who was assisted by Dr Philip Sutorius to commit suicide in 1998. In the Netherlands, where euthanasia is legal, the Dutch Supreme Court ruled in 2002 that this was wrong because "edical expertise, by its nature, does not extend to questions and complaints that do not have a sick- ness or ailment—mental or physical—as their source.3"Sutorius was convicted, but not punished.Robert Young, considering this case, concurs, concluding, "a physician may justifiably consider that an individual who is ‘tired of life’ should consult a non-medical, professional counsellor, and if that produces no change in outlook, choose suicide. Outside Switzerland, an individual who makes that choice has to then be determined enough to do so unassisted .2"I will argue that there is, within current medical ethics and human rights, a method of assisted suicide which could fall within the limits of the law. But first I will review some recent cases involving requests for dying. I will then discuss an alternative which some may argue addresses these cases, and those of …. (shrink)

Are hierarchical arrangements in the workplace, including the employer-employee relationship, consistent with the ideal of relating to one another as moral equals? With this question at its core, this volume of essays by leading moral and political philosophers explores ideas about justice in the workplace, contributing to both political philosophy and business ethics. Relational egalitarians propose that the ideal of equality is primarily an ideal of social relationships and view the equality of social relationships as having priority over the distributive (...) arrangements. Yet contemporary workplaces are characterized by hierarchical employer-employee relationships. The essays push discussions of the relational egalitarian tradition in new directions, helping to show its promise and its limits. They address pressing concerns at a time of widening inequality and rapid changes in the nature of work. (shrink)

I contrast Robert Veatch's recent liberal vision of medical decision‐making with a more rationalist liberal model. According to Veatch, physicians are biased in their determination of what is in their patient's overall interests in favour of their medical interests. Because of the extent of this bias, we should abandon the practice of physicians offering what they guess to be the best treatment option. Patients should buddy up with physicians who share the same values —‘deep value pairing’. The goal of choice (...) is maximal promotion of patient values. I argue that if subjectivism about value and valuing is true, this move is plausible. However, if objectivism about value is true — that there really are states which are good for people regardless of whether they desire to be in them — then we should accept a more rationalist liberal alternative. According to this alternative, what is required to decide which course is best is rational dialogue between physicians and patients, both about the patient's circumstances and her values, and not the seeking out of people, physicians or others, who share the same values. Rational discussion requires that physicians be reasonable and empathic. I describe one possible account of a reasonable physician. (shrink)

Corruption in higher education has raised concern among governments, citizens, and the education community worldwide. However, few papers have sought to explore the students’ willingness to engage in corrupt practices at the university level. The present study aimed to examine the influence of different corrupt behaviours and perceived corruption among peers on the corrupt intention of university students. 120 undergraduate students participated in a quasi-experimental design divided in 3 treatments to rate their willingness to engage in favouritism and embezzlement behaviours. (...) Results pointed out that students were more prone to committing a non-monetary behaviour favouritism– than a monetary behaviour –embezzlement–. Furthermore, there were not significant differences between the groups of control and high-corruption acceptance; while only the group of low-corruption acceptance showed significant lower rates when compared to the control and the high-corruption acceptance’s group. Practical recommendations need to address students’ perceptions of different corrupt practices, focusing on designing ethical training programmes aimed to raise awareness on the negative consequences of non-monetary activities. Future research directions could generate empirical support to prove if students are able to recognize the underlying mechanisms of subtle corrupt practices. (shrink)

There is a plurality of good reasons for action. An adequate theory of practical rationality has to be compatible with it even if it requires certain modifications of our everyday practices of reasoning. Usual theories of practical rationality do not pass this test. It is envisaged how to revise adequately our understanding of practical rationality.

Discrimination is typically understood to be a comparative phenomenon: S is discriminated against on the basis of trait T if she would not have been treated in the same way if she did not possess T. But the comparative test for discrimination may hide from view some important cases: associational discrimination and stereotype policing. These cases show more clearly what is true of discrimination in general: that it involves a vicarious wrong, that is, an action which wrongs someone other than (...) the primary object of disregard. This suggests why philosophers disagree whether discrimination is wrong because it causes harm or because it expresses disrespect. Paradigmatic cases of discrimination involve both harm and disrespect, but direct the harm and the disrespect towards different targets by treating the harmed individual as a mere representative of the targeted group. Discrimination is dehumanizing, and morally distinctive, precisely because of this fact. (shrink)

The idea that humans are by nature social and political animals can be traced back to Aristotle. More recently, it has also generated great interest and controversy in related disciplines such as anthropology, biology, psychology, neuroscience and even economics. What is it about humans that enabled them to construct a social reality of unrivalled complexity? Is there something distinctive about the human mind that explains how social lives are organised around conventions, norms, and institutions? The Routledge Handbook of Philosophy of (...) the Social Mind is an outstanding reference source to the key topics and debates in this exciting subject and is the first collection of its kind. An international team of contributors present perspectives from diverse areas of research in philosophy, drawing on comparative and developmental psychology, evolutionary anthropology, cognitive neuroscience, and behavioural economics. The thirty-two original chapters are divided into five parts: _The Evolution of Social Mind_: including the social intelligence hypothesis, co- evolution of culture and cognition, ethnic cognition, cooperation; _Developmental and Comparative Perspectives_: including primate and infant understanding of mind, shared intentionality, and moral cognition; _Mechanisms of the Moral Mind:_ including norm compliance, social emotion, and implicit attitudes; _Naturalistic Approaches to Shared and Collective Intentionality_: including joint action, team reasoning and group thinking, and social kinds; _Social Forms of Selfhood and Mindedness_: including moral identity, empathy and shared emotion, normativity and intentionality. Essential reading for students and researchers in philosophy of mind and psychology, _The Routledge Handbook of Philosophy of the Social Mind _is also suitable for those in related disciplines such as social psychology, cognitive neuroscience, economics and sociology. (shrink)

We spend much of our adult lives thinking and reminiscing about particular events of the past, which, by their very nature, can never be repeated. What is involved in a capacity to think thoughts of this kind? In this paper, I propose that such thoughts are essentially connected with a capacity to communicate about past events, and specifically in the special way in which events of the past are valued and shared in our relationships with one another. I motivate this (...) proposal by way of the claim that such thoughts are practically useless: there are no practical, forward-looking tasks that require information which is specific to particular past events. Thus I suggest that thoughts of this specific kind have a home only in the cognitive economy of a creature who finds past events to be of interest for their own sake, and that this interest in the past is a peculiar feature of human social life. (shrink)

Predicates like _knowable_, _believable_ or _evincible_ each are associated with Fitch-like paradoxes. Given some plausible assumptions, the _prima facie_ reasonable hypotheses that _what is true is knowable/believable/evincible_ entail, respectively, the decidedly unreasonable conclusions that _what is true is known/believed/evinced_. I argue that all Fitch-like paradoxes admit of a common diagnosis and give a uniform semantics for predicates like _knowable_ that avoids the paradoxes while accounting for the intuitive meaning of these predicates. Moreover, I argue that a semantics of the same (...) shape is to be given to similar predicates like _erasable_ or _legible_, whose simple analyses likewise face broadly Fitch-like problems. This semantics also highlights and explains the context-sensitive nature of such predicates. (shrink)

A crucially important part of the biosphere – the virosphere – is too often overlooked. Inclusion of the virosphere into the global picture of protein structure space reveals that 63 protein domain superfamilies in viruses do not have any structural and evolutionary relatives in modern cellular organisms. More than half of these have functions which are not virus‐specific and thus might be a source of new folds and functions for cellular life. The number of viruses on the planet exceeds that (...) of cells by an order of magnitude and viruses evolve up to six orders of magnitude faster. As a result, cellular species are subject to a constitutive ‘flow‐through’ of new viral genetic material. Due to this and the relaxed evolutionary constraints in viruses, the transfer of domains between host‐to‐virus could be a mechanism for accelerated protein evolution. The virosphere could be an engine for the genesis of protein structures, and may even have been so before the last universal common ancestor of cellular life. (shrink)

The notion of objectivity in science has come under critique of feminist writers. The scientific ideal of a detached, neutral observer, who has no race, no gender, no cultural identity, no class, and views the world “from nowhere,” has been challenged, and patterns of domination explored. Feminists argue that objectivity is a tacit generalization from the subjectivity of a small, privileged social group “of educated, usually prosperous, white men.” Hence, it is a result of the denial of the subjectivity of (...) women and other marginalized people. The task which I set before myself is to inquire into the problem of objectivity in science and to explore the relationship between objectivity and subjectivity. I argue that, although the feminists’ critique of objectivity contributes to a greater awareness of the problem of objectivity in science and indeed subjectivity matters, their critique is ill founded. It is an example of one of many stereotypes and simplifications that we can find in today’s feminist thought. The affective engagement with the world, the approach that I propose, leads us to knowledge beyond objectivity. It is a prerequisite of knowing persons as persons and things as they are. (shrink)

The notion of “event” is often used, in contemporary philosophy, as a way to overcome the end of metaphysics since it challenges both the metaphysical conditions of appearing and knowing. Thanks to a comparative analysis of the works of Hannah Arendt and Jean-Luc Marion, the authors show that even though the event appears as a questioning of the modern concept of history in the texts of the former, and as a modality of saturated phenomena in the Marion’s phenomenology of givenness, (...) its use allows us to re-evaluate the relationship of both philosophers with metaphysics. After pointing out a fundamental difference of the conception of the event in Arendt and Marion, it is then possible to reveal their position regarding the possibility of thinking after the end of metaphysics. (shrink)

Katerina Jennings and Esther Braun identify an important problem with the current approach to defining categories of competitors in sport (Jennings and Braun 2024). They make a significant contribu...

The death of Socrates is often taken as the starting point for reflection on the relationship between the philosopher and established power. In the Apology, Plato gives an account of Socrates’s own...

In lieu of an abstract, here is a brief excerpt of the content:Autonomy, Well-Being, Disease, and DisabilityJulian Savulescu (bio)Keywordsautonomy, well-being, mental disorder, psychiatric disease, disability, welfare, body integrity identity disorderVarelius seeks to redefine what constitutes mental disorder or mental illness. (I use these terms interchangeably.) "According to this account, 'a person is mentally disordered when her psychological capacity for autonomy is diminished as compared with that of a typical member of our species of her age-group" (Varelius 2009). This is a (...) stimulating and important paper. Varelius describes fruitfully the relationship between mental illness and autonomy, specifically the ways in which mental disorder can undermine autonomy. This is valuable in understanding the impact of mental illness on the lives of people who suffer from it, which is a serious issue in practical ethics. But is it what constitutes mental disorder or illness? There are logical, conceptual reasons why we should not redefine mental illness in this way.Incomplete Account of Mental DisorderThere are a family of related concepts: disease, injury, disorder, illness, disability. There are old and entrenched disputes about how we should define these concepts. Varelius' paper is a contribution to the definition of mental disorder and illness.The primary classificatory category that defines medical practice is that of health and disease. Disease, broadly construed, involves the presence of pathology. Pathology can result from processes primarily or predominantly internal to the organism, such as genetic disease (although external factors affect their expression), or from processes primarily or predominantly external to the organism, such as injuries.The concepts of disorder and illness relate to the concept of disease. Disorder could be defined in terms of the functional effect of pathology. Illness could be defined in terms of the experiential impact of disease.1 How these terms are precisely defined and related need not concern us at the present. What matters is that the primary category is disease.Psychiatry has evolved in its use of terminology. What used to be called psychiatric diseases are now often called mental disorders. I now claim, for the purposes of illustration of the argument (though it does not require this claim), that the dominant category is disease. Indeed, what are called mental disorders appear in the International Classification of Diseases.Disease can be divided into the mental and physical. I believe that the mental will one day be [End Page 59] shown to be shown to be entirely a subset of the physical. That is, that brain pathology will be a cause, if not the only cause, of mental disease. But others may believe the sets of mental and physical disease are intersecting but not coextensive.What matters is that mental disease is a subcategory of the more general category of disease. It must have the same definitional features as "disease" plus some extra ones specific to the "mental," or mind. (The same points apply if you use "disorder" as the dominant category rather than "disease.")One problem for Varelius is this: how does this autonomy account of "mental disease" relate to an account of "physical disease," and "disease" in general? If mental disease is defined in terms of its impact on the psychological capacities necessary for autonomy, how is "disease" in general, or physical disease, to be defined? One obvious response is to define these related concepts in a similar way:Disease: "a person is diseased when her capacity for autonomy is diminished as compared to that of a typical member of our species of her age-group." Physical disease: "a person is physically disordered when her physical capacity for autonomy is diminished as compared to that of a typical member of our species of her age-group."This interpretation is suggested by the following passage from Varelius:As contrasted with the actual condition of being autonomous, as a capacity of an individual autonomy means that a person has the psychological and bodily abilities that being autonomous... requires.(2009)It would be radical to define disease in general in terms of capacity for autonomy. There is no doubt that disease affects our autonomy, and that is morally significant, but these seem clearly separable concepts. Varelius could respond that he is not defining mental disease but rather the mental component... (shrink)

This article provides a narrative review on the concept of dialogue within STS and Deliberative Democracy academic literature. Through this review I find that dialogue has been used in unsystematic, conflicting and sometimes even misleading ways that conflate dialogue and deliberation. Dialogue is used flexibly as an epistemological standpoint, an interactional format, a tradition and format of public engagement, an interactional phenomenon and an idealised moment. I provide a characterisation and theorisation of dialogue that seeks to integrate critical and historical (...) accounts of dialogue, while introducing analytical dimensions that can be leveraged for further research. By bridging STS and Deliberative Democracy, I advance a definition of dialogue as a public technology. (shrink)

The predictive processing theory refers to a family of theories that take the brain and body of an organism to implement a hierarchically organized predictive model of its environment that works in the service of prediction-error minimization. Several philosophers have wondered how belief-like states of prediction account for the conative role desire plays in motivating a person to act. A compelling response to this challenge has begun to take shape that starts from the idea that certain predictions are prioritized in (...) the predictive processing hierarchy. We use the term “first priors” to refer to such predictions. We will argue that agents use first priors to engage in affective sense-making. What has been missing in the literature that seeks to understand desire in terms of predictive processing is a recognition of the role of affective sense-making in motivating action. We go on to describe how affective sense-making can play a role in the context-sensitive shifting assignments of precision to predictions. Precision expectations refer to estimates of the reliability of predictions of the sensory states that are the consequences of acting. Given the role of affect in modulating precision-estimation, we argue that agents will tend to experience their environment through the lens of their desires as a field of inviting affordances. We will show how PP provides a neurocomputational framework that can bridge between first-person phenomenological descriptions of what it is to be a desiring creature, and a third-person, ecological-enactive analysis of desire. (shrink)