Institutional review boards and investigators are used to talking about risks of harm. Both low risks of great harm and high risks of small harm must be disclosed to prospective subjects and should be explained and categorized in ways that help potential subjects to understand and weigh them appropriately. Everyone on an IRB has probably spent time at meetings arguing over whether a three-page bulleted list of risk description is helpful or overkill for prospective subjects. Yet only a small fraction (...) of all the time and attention lavished on risk disclosure has been devoted to discussing whether and when potential benefit to subjects can reasonably be claimed and, if so, how it should be described in the consent form and process.Traditionally, IRBs and regulators have worked to ensure that clear lines can be drawn between research that, by definition, carries no potential for direct benefit — because it uses healthy volunteers or because it is not foreseeably focused on the development of treatments — and research that does have the development of effective treatments as its goal. (shrink)

Significantly, Berkeley, in his Essay Towards a New Theory of Vision, leveled a sustained attack on just this geometrical theory of distance perception. At first glance it may seem, as it did to Berkeley, that Descartes’ geometrical theory is produced by a simple error: namely, by the idea that a physiological optics provides an adequate description of the psychological processes of judging distances. In truth, this is the weakest of Berkeley’s objections to Descartes’ theory. Obviously we do not see the (...) angles and lines of convergence when we focus on a distant object, nor are we aware of having used any geometrical rules in judging distance. And Descartes never claimed this. (shrink)

The volume brings together for the first time original essays by leading philosophers working on powers in relation to metaphysics, philosophy of natural and social science, philosophy of mind and action, epistemology, ethics and social and political philosophy. In each area, the concern is to show how a commitment to real causal powers affects discussion at the level in question. In metaphysics, for example, realism about powers is now recognized as providing an alternative to orthodox accounts of causation, modality, properties (...) and laws. Dispositional realist philosophers of science, meanwhile, argue that a powers ontology allows for a proper account of the nature of scientific explanation. In the philosophy of mind there is the suggestion that agency is best understood in terms of the distinctive powers of human beings. Those who take virtue theoretic approaches in epistemology and ethics have long been interested in the powers that allow for knowledge and/or moral excellence. In social and political philosophy, finally, powers theorists are interested in the powers of sociological phenomena such as collectivities, institutions, roles and/or social relations, but also in the conditions of possibility for the cultivation of the powers of individuals. The book will be of interest to philosophers working in any of these areas, as well as to historians of philosophy, political theorists and critical realists. (shrink)

As a response to Le Fils, a film directed by the Dardenne brothers (), we explore the idea of speaking as an invitation and juxtapose it against ideas of speaking as a transactional, calculative, calibrated, activity. Speaking tends to be understood as a relatively straightforward matter: as a means of communication structured by such values as the reciprocal balancing of rights and obligations, of clear communication of information, of the gaining of insight into what is happening. Speaking, then, is a (...) means by which we explain, prove or pass judgement on something. Understood this way, it is easily associated with ideas of empowerment or of the mediation of information: one directs or commits oneself to a (shared) orientation—for example to what Jürgen Habermas refers to as ‘communicative reason’. It presupposes a particular attitude of the subject; speaking that addresses the listener and the speaker herself in the name of an orientation or particular expertise to which access is claimed. In this article, by contrast, we would like to explore a different avenue of thought whereby speaking appears rather as an abandoning or exposing of oneself. It is less an activity than a passivity or passion, through which one becomes present in the present, which is at once also a kind of invitation. In exploring this form of speaking, we take up some ideas of Martin Buber. Our discussion relates speaking to being inspiring and being inspired, revealing in the process the way that to be inspiring is at the same time to be inspired. Speaking as invitation, we conclude, is what education is about. (shrink)

It is widely assumed that informing prospective subjects about the risks and possible benefits of research not only protects their rights as autonomous decisionmakers, but also empowers them to protect their own interests. Yet interviews with patient‐subjects conducted under the auspices of the Advisory Committee on Human Radiation Experiments suggest this is not always the case. Patient‐subjects often trust their physician to guide them through decisions on research participation. Clinicians, investigators, and IRBs must assure that such trust is not misplaced.

People who lack decision‐making capacity may be able to communicate preferences, which can and should inform surrogate decision‐making on their behalf. It is unclear whether making a further distinction about “capacity for preferences,” as Jason Wasserman and Mark Navin propose in this issue of the Hastings Center Report, would improve the process of surrogate decision‐making. Anyone who is regularly involved in surrogate decision‐making or who has worked to articulate decision‐making standards and processes can think of cases in which a patient's (...) voice was ignored or his or her preferences and ability to communicate them overlooked. However, we can also think of cases in which it was unclear whether information provided by a patient, recently or in the past, should have been characterized as a preference relevant to a medical decision that the patient lacked the capacity to make. We should also recognize that clear preferences of a patient who lacks decision‐making capacity may conflict with the limits of another person or of a family's resources such that these preferences cannot guide a surrogate's decision. This patient will not get what he wants. A situation in which preferences are known and make sense but cannot be applied in a feasible way demonstrates the limits of the medical decision‐making framework concerning care that is not covered by medical insurance. (shrink)

This paper raises health equity concerns about the use of passports for domestic and international travel to certify COVID-19 vaccination. Part I argues that for international travel, health equity objections undercut arguments defending vaccine passports, which are based on tholding people responsible, protecting global health, safeguarding individual liberty and continuing current practice. Part II entertains a proposal for a scaled down vaccine passport for domestic use in countries where vaccines are widely and equitably available. It raises health equity concerns related (...) to racial profiling and fairness to people who are vaccine cautious. Part III sets forth a proposal for a flexible pass that certifies people who have been vaccinated, tested, previously infected or granted a conscientious objection. It sets ethical guidelines for the timing and use of flexible passes that promote equity, public health education, antidiscrimination, privacy and flexibility. (shrink)

People are living, breathing creatures. Dominant feminist discourses are situated within hegemonic human exceptionalism which, by framing the body in terms of human forms of meaning-making and social life, eschews first-order embodiment as worthy of inquiry. Here, well-known reasons for avoidance of “the biological” are briefly summarized and an argument is advanced for meta-theoretical centering of creatureliness. A three-pronged agenda is proposed that embraces the creaturely body without the “-isms” and “-izings” that subvert feminist commitments. By unsettling HHE, executing the (...) agenda would promote broader feminist coalitions and new scholarly collaborations aimed at fleshing out gender. (shrink)

Societal aging raises challenging ethical questions regarding the just distribution of health care between young and old. This article considers a proposal for age-based rationing of health care, which is based on the prudential life span account of justice between age groups. While important objections have been raised against the prudential life span account, it continues to dominate scholarly debates. This article introduces a new objection, one that develops out of the well-established disability critique of social contract theories. I show (...) the implications of this critique for the prudential life span account and for the special case of age-group justice. The result is that age-based rationing based on the prudential life span approach is not supported, and that the prudential life span approach itself is not the best way to think about allocating health care between age groups. I propose an alternative approach that avoids the disability objection, and consider its implications for specific proposals for age-based rationing of health care. (shrink)

This response to Richard Lennan’s presentation of Rahner’s call for a new understanding of faith raises questions about 1) the rationale behind Rahner’s “short formulas,” 2) how feminist challenges are understood, and 3) the place of “the ecclesial” in a secular milieu.

Is age discrimination ethically objectionable? One puzzle is that we sometimes assume that the target of both age discrimination and ageism must be older people, yet in poorer nations, older people are generally shown more respect. This article explores the ethical question. It looks first at ethical arguments favoring age discrimination toward younger people in low‐income, less industrialized countries of the global South, using sub‐Saharan Africa as an illustration. It contrasts these with arguments favoring age discrimination toward older people in (...) high‐income, more industrialized countries of the global North, particularly the United States and United Kingdom. Finally, it considers what role, if any, differences in life expectancy, infant and child mortality, and prospects for healthy lives should play in the moral embrace of a particular view by a community. It argues that there can be reasons to favor different types of discrimination in different parts of the world. (shrink)

An advertising firm''s ethical culture (as defined by the firm''s managerial and peer ethical behaviors) may affect the employees'' comfort levels and ethical behaviors. In this research, scenarios were used to describe advertising firms with various ethical cultures. Respondents'' perceived comfort levels in working for the firms described in the scenarios and the respondents'' behavioral intentions when faced with various advertising situations were assessed. Results of the study indicate that peer ethical behavior exerts a strong influence on the comfort or (...) discomfort level and the ethical behavioral intentions of potential advertising employees. Further, the strong influence exerted by peers seems to transcend the ethical behavior of the manager and carry over to the attitude toward the entire corporate advertising environment. This study provides insights for firms and researchers interested in assessing the impact of an advertising firm''s ethical culture on potential employees. (shrink)

This paper explores the relationship between the bonds of practitioner/patient trust and the notion of a justified lie. The intersection of moral theories on lying which prioritize right action with institutional discretionary power allows practitioners to dismiss, or at least not take seriously enough, the harm done when a patient's trust is betrayed. Even when a lie can be shown to be justified, the trustworthiness of the practitioner may be called into question in ways that neither theories of right action (...) nor contemporary discourse in health care attends to adequately. I set out features of full trustworthiness along Aristotelian lines. (shrink)

Baconian science, a tool for plundering nature, has impelled physicians to insist on medical treatment even when it is futile. The Hippocratic tradition of medicine teaches us instead to acknowledge nature's limits.

The non-financial effects (NFE) antitakeover amendment addresses the duties of company directors and management when faced with a possible takeover bid. The NFE amendment either permits or requires managers to consider the interests of the company's stakeholders during takeover bids. Other types of antitakeover devices have been viewed as protecting either stockholder or management interests. The NFE amendment would appear to protect a broad spectrum of interests including those of company employees, creditors, and the community in which the company operates. (...) Positive market returns to the adoption of NFE amendments provide some evidence that investors approve. The percent of both management and institutional ownership are positively related to the market reaction to the NFE amendment adoption. To the extent that institutional ownership proxies for the broad spectrum of stakeholder interest, NFE devices, unlike some other amendments that have been studied, appear to be in the interests of more than a single interest group. (shrink)

The essays can be read separately, but together they amount to the striking vision of a philosopher sensitive to the world of his times and attempting to open ...

Many, if not most, of our highly prized ‘laws’ of physics cannot be adequately rendered as statements of regular association among the values of ‘categorical’ quantities, I have argued.63 This is true even if we do not balk at the concept of natural necessity and are willing to add that the associations hold ‘by law’. They are rather ascriptions of capacities. They tell us what capacities a system will have by virtue of having a given property. The law of gravity (...) is one example. A system of mass M has the capacity of strength GMm/r2 to move another object of mass m a distance r away towards itself. I call this the gravitational capacity. My second thesis is a commonly shared one. Ascriptions of capacities do not reduce to conditionals involving only categorical properties. I shall here discuss two questions about these theses: 1) Why think of capacities as akin to dispositions or powers; and 2) Why allow them in science? Before tackling the first question, I shall first try to figure out what features we expect to be characteristic of dispositions and powers themselves. (shrink)

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.