Naturalism as a guiding philosophy for modern science both disavows any appeal to the supernatural or anything else transcendent to nature, and repudiates any philosophical or religious authority over the workings and conclusions of the sciences. A longstanding paradox within naturalism, however, has been the status of scientific knowledge itself, which seems, at first glance, to be something that transcends and is therefore impossible to conceptualize within scientific naturalism itself. In Articulating the World, Joseph Rouse argues that the most (...) pressing challenge for advocates of naturalism today is precisely this: to understand how to make sense of a scientific conception of nature as itself part of nature, scientifically understood. Drawing upon recent developments in evolutionary biology and the philosophy of science, Rouse defends naturalism in response to this challenge by revising both how we understand our scientific conception of the world and how we situate ourselves within it. (shrink)

A good therapeutic relationship in mental health services is a predictor of positive clinical outcomes for people who seek help for distressing experiences, such as voice hearing and paranoia. One factor that may affect the quality of the therapeutic relationship and raises further ethical issues is the impact of the clinical encounter on users’ sense of self, and in particular on their sense of agency. In the paper, we discuss some of the reasons why the sense of epistemic agency may (...) be especially fragile in young people with unusual experiences and beliefs. We argue that it is important to identify and avoid behaviours that can undermine young people’s contributions as epistemic agents in the clinical encounter. (shrink)

Both mainstream and disability bioethics sometimes contend that the self-assessment of disabled people about their own well-being is distorted by adaptive preferences that are only held because other, better options are unavailable. I will argue that both of the most common ways of understanding adaptive preferences—the autonomy-based account and the well-being account—would reject blanket claims that disabled people’s QOL self-assessment has been distorted, whether those claims come from mainstream bioethicists or from disability bioethicists. However, rejecting these generalizations for a more (...) nuanced view still has dramatic implications for the status quo in both health policy and clinical ethics. (shrink)

The deeply entrenched, sometimes heated conflict between the disability movement and the profession of bioethics is well known and well documented. Critiques of prenatal diagnosis and selective abortion are probably the most salient and most sophisticated of disability studies scholars’ engagements with bioethics, but there are many other topics over which disability activists and scholars have encountered the field of bioethics in an adversarial way, including health care rationing, growth-attenuation interventions, assisted reproduction technology, and physician-assisted suicide. The tension between the (...) analyses of the disabilities studies scholars and mainstream bioethics is not merely a conflict between two insular political groups, however; it is, rather, also an encounter between those who have experienced disability and those who have not. This paper explores that idea. I maintain that it is a mistake to think of this conflict as arising just from a difference in ideology or political commitments because it represents a much deeper difference—one rooted in variations in how human beings perceive and reason about moral problems. These are what I will refer to as variations of moral psychology. The lived experiences of disability produce variations in moral psychology that are at the heart of the moral conflict between the disability movement and mainstream bioethics. I will illustrate this point by exploring how the disability movement and mainstream bioethics come into conflict when perceiving and analyzing the moral problem of physician-assisted suicide via the lens of the principle of respect for autonomy. To reconcile its contemporary and historical conflict with the disability movement, the field of bioethics must engage with and fully consider the two groups’ differences in moral perception and reasoning, not just the explicit moral and political arguments of the disability movement. (shrink)

If ever I summon before me my highest ideals of men and medicine, I find them sprung from the spirit of Osler. —Wilder Penfield, M.D. Neuroethics is a recently coined term that is shaping our cultu...

Volume 20, Issue 3, March 2020, Page 44-46.

Modernism in the philosophy of science demands a unified story about what makes an inquiry scientific (or a successful science). Fine's "natural ontological attitude" (NOA) is "postmodern" in joining trust in local scientific practice with suspicion toward any global interpretation of science to legitimate or undercut that trust. I consider four readings of this combination of trust and suspicion and their consequences for the autonomy and cultural credibility of the sciences. Three readings take respectively Fine's trusting attitude, his emphasis upon (...) local practice, and his antiessentialism about science as most fundamental to NOA. A fourth, more adequate reading, prompted by recent feminist interpretations of science, offers less restrictive readings of both Fine's trust and his suspicion toward approaching science with "ready-made philosophical engines" (Fine 1986b, 177). (shrink)

Moral responsibility requires that we are in control of what we do. Many contemporary accounts of responsibility cash out this control in terms of abilities and hold that the relevant abilities are strong abilities, like general abilities. This paper raises a problem for strong abilities views: an agent can plausibly be morally responsible for an action or omission, despite lacking any strong abilities to do the relevant thing. It then offers a way forward for ability‐based views, arguing that very weak (...) abilities can form the basis of moral responsibility for both actions and omissions. (shrink)

Few issues in business ethics are as polarizing as the practice of risk classification and underwrit­ ing in the insurance industry. Theorists who approach the issue from a background in economics often start from the assumption that policy-holders should be charged a rate that reflects the ex­ pected loss that they bring to the insurance scheme. Yet theorists who approach the question from a background in philosophy or civil rights law often begin with a presumption against socalled “actuarially fair” premiums (...) and in favor of “community rating,” in which everyone is charged the same price. This paper begins by examining and rejecting the three primary argu­ ments that have been given to show that actuarially fair premiums are unjust. It then considers the two primary arguments that have been offered by those who wish to defend the practice of risk classification. These arguments overshoot their target, by requiring a “freedom to under­ write” that is much greater than the level of freedom enjoyed in most other commercial transac­ tions. The paper concludes by presenting a defense of a more limited right to underwrite, one that grants the legitimacy of the central principle of risk classification, but permits specific deviations from that ideal when other important social goods are at stake. (shrink)

Does the Second Amendment protect those who threaten others by negligently or recklessly wielding firearms? What line separates constitutionally legitimate gun displays from threatening activities that can be legally proscribed? This article finds guidance in the First Amendment doctrine of true threats, which permits punishment of “statements where the speaker means to communicate a serious expression of an intent to commit an act of unlawful violence to a particular individual or group of individual.” The Second Amendment, like the First, should (...) not be read to protect those who threaten unlawful violence. And to the degree that the constitution requires a culpable mental state in such circumstances, the appropriate standard should be recklessness. (shrink)

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

The field of “business for peace” recognizes the role that businesses can play in peacebuilding. However, like much of the discussion concerning business in conflict zones, it has prioritized the view of multinationals, often overlooking the role of indigenous local firms. The economic, social, and intergroup dynamics experienced by local businesses in conflict zones are understudied, with the current paper beginning by positioning micro- and small enterprises in the peacebuilding debate, then engaging with multidisciplinary works to understand how they foster (...) peace. Through a case study set in north Lebanon, we conducted semi-structured interviews with twenty-three MSE owners in one industry who operate across sectarian divisions and with recently displaced Syrian refugees. Our findings indicate that local business activity can simultaneously promote peace and foster conflict, with peacebuilding improved when intergroup differences are reduced within the operating environment. Furthermore, the importance of economic development was elevated for local businesses, suggesting that peace through mechanisms such as social development, the rule of law, and training, is only achieved if economic needs are alleviated through these measures. We conclude by citing how contextual factors in conflict zones can enhance intergroup differences, and how resolving such factors can promote peacebuilding, with further empirical work needed in this area. (shrink)

The transcendental expectation of string theory is that the nature of the fundamental forces, particle spectra and masses, together with coupling constants, is uniquely determined by mathematical and logical consistency, non-empirically, that is by pure reason. However pluralism triumphed with the explosive emergence of the multiverse. String theorists have extended a long-sought dream to a landscape or a happy caparnaum. Proponents of string theory try to qualify their arguments via swampland conjectures while cosmologists retreat to their telescopes. We review the (...) current status of the string theory swampland. (shrink)

Without exaggeration, it could be said that we are entering a golden age of neuroscience. Informed by recent developments in neuroimaging that allow us to peer into the working brain at both a structural and functional level, neuroscientists are beginning to untangle mechanisms of recovery after brain injury and grapple with age-old questions about brain and mind and their correlates neural mechanisms and consciousness. Neuroimaging, coupled with new diagnostic categories and assessment scales are helping us develop a new diagnostic nosology (...) about disorders of consciousness which will likely improve prognostication and suggest therapeutic advances. Historically such diagnostic refinement has yield therapeutic advances in medicine and there is no reason to doubt that this will be the case for disorders of consciousness, perhaps bringing relief to a marginalized population now on the periphery of the therapeutic agenda. In spite of this promise, the translation of research findings into the clinical context will be difficult. As we move from descriptive categories about disorders of consciousness, like the vegetative or minimally conscious states, to ones further specified by integrating behavioral and neuroimaging findings, humility not hubris should be the virtue that guides the ethical conduct of research and practice. (shrink)

If ever I summon before me my highest ideals of men and medicine, I find them sprung from the spirit of Osler. —Wilder Penfield, M.D. Neuroethics is a recently coined term that is shaping our cultu...

The fruit borne of the debate concerning the economy of the gift carried out between Jacques Derrida and Jean-Luc Marion in the 1990s continues to ripen into the present with publications like Anthony Steinbock’s lucid It’s not about the Gift: From Givenness to Loving. I challenge and qualify the fundamental argument of this book in dialogue with two principal French proponents of givenness, Michel Henry and Jean-Luc Marion, against whom Steinbock promotes his strategy of the gift. While Steinbock wishes to (...) displace our relation to the other from giving to loving, I suggest that the discourse of givenness remains the very movement of loving as such. Steinbock occupies a position reminiscent of, but not reducible to, gift-exchange theory, rooted in reciprocity between lover and beloved, whereas I am inclined to move near to the terrain of the unconditioned gift in which loving need not entail reciprocity. My position is not so much a counterclaim as it is a clarification of the inextricable unity between giving and loving. The final section contends that the I enlarge my horizon when I give myself because I do not grasp the other, nor do I expect or obligate the other’s givenness in return; rather in my growth beyond my own self-interest, I allow the other to be given just as the other likes to be given. (shrink)

Locke has been accused of endorsing a theory of kinds that is inconsistent with his theory of individuation. This purported inconsistency comes to the fore in Locke’s treatment of cases involving organisms and the masses of matter that constitute them, for example, the case of a mass constituting an oak tree. In this essay, I argue that this purported problem, known as ‘The Kinds Problem’, can be solved. The Kinds Problem depends on the faulty assumption that nominal essences include only (...) features observable at a time t. Once this assumption is rejected, new candidates open up for the relevant difference in the world that is included in the nominal essence of e.g. mass but not oak tree. And I argue that there is at least one good candidate for the extrinsic feature observable only over time in which the mass differs from the oak it constitutes, namely its persistence conditions. The Kinds Problem can be solved. (shrink)

Toward a Metaphysics of Culture provides an initial, minimal, and original analysis of the concept of uniquely enlanguaged cultures of the human world and of the distinctive metaphysical features of whatever belongs to the things of that world: preeminently, persons, language, actions, artworks, products, history, practices, institutions, and norms. Emphasis is placed on the artifactual and hybrid nature of persons, naturalistic and post-Darwinian evolutionary considerations, and the bearing of the account on a range of disputed inquiries largely centered on the (...) relationship between physical nature and human culture and between the natural and human sciences. The schema offered lays a foundation for a closer analysis of the human mind, cognition, interpretation, nomologicality, normativity, intentionality, realism, and related matters. The central thesis advances the heterodox notion, congruent with post-Darwinian studies in paleoanthropology, that the human person is a natural artifact, a functional transform of the primate members of Homo sapiens, by way of a complexly intertwined biological and encultured evolution, primarily dependent on the invention, transmission, and mastery of true language and the novel hybrid abilities that that makes possible. The emergence of persons is taken to be the obverse side of the mastery of language itself. (shrink)

It is argued that current attempts to model human learning behavior commonly fail on one of two counts: either the model assumptions are artificially restricted so as to permit the application of mathematical techniques in deriving their consequences, or else the required complex assumptions are imbedded in computer programs whose technical details obscure the theoretical content of the model. The first failing is characteristic of so-called mathematical models of learning, while the second is characteristic of computer simulation models. An approach (...) to model building which avoids both these failings is presented under the title of a black-box theory of learning. This method permits the statement of assumptions of any desired complexity in a language which clearly exhibits their theoretical content.Section II of the paper is devoted to the problem of testing and comparing alternative learning theories. The policy advocated is to abandon attempts at hypothesis testing. It is argued that, in general, we not only lack sufficient data and sufficiently powerful techniques to test hypotheses, but that the truth of a model is not really the issue of basic interest. A given model may be true in the sense that on the basis of available evidence we cannot statistically reject it, but not interesting in the sense that it provides little information about the processes underlying behavior. Rather, we should accept or reject models on the basis of how much information they provide about the way in which subjects respond to environmental structure. This attitude toward model testing is made precise by introducing a formal measure of the information content of a model. Finally, it is argued that the statistical concept of degrees-of-freedom is misleading when used in the context of model testing and should be replaced by a measure of the information absorbed from the data in estimating parameters. (shrink)

David Gauthier tries to defend morality by showing that rational agents would choose to adopt a fundamental choice disposition that permits them to cooperate in prisoner's dilemmas. In this paper, I argue that Gauthier, rather than trying to work out a prudential justification for his favored choice disposition, should opt for a transcendental justification. I argue that the disposition in question is the product of socialization, not rational choice. However, only agents who are socialized in such a way that they (...) acquire a disposition of this type could acquire the capacity to use language. Given the internal connection between language and thought, this means that no agent endowed with such a disposition could rationally choose to adopt another. Thus rational reflection by moral agents upon their own fundamental choice disposition will have no tendency to destabilize it. (shrink)

The Johns Hopkins‐Fogarty African Bioethics Training Program (FABTP) has offered a fully‐funded, one‐year, non‐degree training opportunity in research ethics to health professionals, ethics committee members, scholars, journalists and scientists from countries across sub‐Saharan Africa. In the first 9 years of operation, 28 trainees from 13 African countries have trained with FABTP. Any capacity building investment requires periodic critical evaluation of the impact that training dollars produce. In this paper we describe and evaluate FABTP and the efforts of its trainees.Our data (...) show that since 2001, the 28 former FABTP trainees have authored or co‐authored 105 new bioethics‐related publications; were awarded 33 bioethics‐related grants; played key roles on 78 bioethics‐related research studies; and participated in 198 bioethics workshops or conferences. Over the past nine years, trainees have collectively taught 48 separate courses related to bioethics and have given 170 presentations on various topics in the field. Many former trainees have pursued and completed doctoral degrees in bioethics; some have become editorial board members for bioethics journals. Female trainees were, on average, less experienced at matriculation and produced fewer post‐training outputs than their male counterparts. More comprehensive studies are needed to determine the relationships between age, sex, previous experience and training program outputs. (shrink)

We propose a novel reading of Descartes' views on the nature of pain, thirst, and hunger: imperativism. According to imperativism, rather than (exclusively) having intentional contents individuated by a set of correctness conditions specifying the way the world is, pain thirst, and hunger have contents individuated by satisfaction conditions, which specify the way the world ought to be. Unlike representationalist treatments, the imperativist reading satisfies the unique health-preserving role Descartes sets out for pain, thirst, and hunger, without inflating his austere (...) metaphysics of res extensa. (shrink)