Clinical geneticists are increasingly confronted with ethical tensions between their responsibilities to individual patients and to other family members. This paper considers the ethical implications of a “familial” conception of the clinical genetics role. It argues that dogmatic adherence to either the familial or to the individualistic conception of clinical genetics has the potential to lead to significant harms and to fail to take important obligations seriously.Geneticists are likely to continue to be required to make moral judgments in the resolution (...) of such tensions and may find it useful to have access to ethics training and support. (shrink)

As the science and technology of the brain and mind develop, so do the ways in which brains and minds may be surveilled and manipulated. Some cognitive libertarians worry that these developments undermine cognitive liberty, or “freedom of thought.” I argue that protecting an individual’s cognitive liberty undermines others’ ability to use their own cognitive liberty. Given that the threatening devices and processes are not relevantly different from ordinary and frequent intrusions upon one’s brain and mind, strong protections of cognitive (...) liberty may proscribe neurotechnological intrusions, but also ordinary intrusions. Thus, the cognitive libertarian position “hog-ties” others’ use of their own liberties. This problem for the cognitive libertarian is the same problem that ordinary libertarianism faces in protecting individual rights to property and person. But the libertarian strategies for resolving the problem don’t work for the cognitive libertarian. I conclude that the right to mental privacy is weaker than what cognitive libertarians want it to be. (shrink)

This volume brings together mostly previously unpublished studies by prominent historians, classicists, and philosophers on the roles and effects of religion in Socratic philosophy and on the trial of Socrates. Among the contributors are Thomas C. Brickhouse, Asli Gocer, Richard Kraut, Mark L. McPherran, Robert C. T. Parker, C. D. C. Reeve, Nicholas D. Smith, Gregory Vlastos, Stephen A. White, and Paul B. Woodruff.

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is obligatory (...) to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

Originally published in 1989 Liberal Neutrality approaches the recommendation of neutrality by confronting the abstract prescription (that we should be neutral) with the implications for particular people and institutions. This not only identifies what neutrality involves logically, but also exposes the practical difficulties that may be encountered in pursuing it. In some cases, such close examination shows that neutrality is not desirable, and in others that it is attainable only within certain limits. Although neutrality has become a fashionable term in (...) political theory, this is the only volume to subject the idea to systematic scrutiny. It will be useful not only to specialists in diverse disciplines - political scientists, philosophers, sociologists, lawyers and educationalists. (shrink)

In After God: Morality and Bioethics in a Secular Age, H. Tristram Engelhardt, Jr. explores the broad implications for moral reasoning once a culture has lost a God’s-eye perspective. In this paper, I focus on the implications of Engelhardt’s views for clinical ethics consultation. I begin by examining the question of whether clinical ethics consultants should advocate a particular viewpoint and/or process during consultations or adopt a neutral stance. I then examine the implications of Engelhardt’s views for this question. Finally, (...) I discuss some of Engelhardt’s foundational ontological, metaphysical, meta-ethical, and epistemological commitments and how these commitments connect to his views on clinical ethics consultation. (shrink)

We live in a death-denying culture where, despite the fact death happens to everyone, individuals prefer to deny death, facing it only when necessary. There exists a myth that death can be delayed, or perhaps redefined, or controlled in some fashion. The stories in this issue serve as examples of how healthcare professionals encounter death and how they learn to cope with it.

Religions often operate as comprehensive worldviews, attempting to answer the deepest existential questions that human beings can ask: Who am I? Where do I come from? Where am I going after I die? How should I live? Often ethical systems are embedded and justified within these broader narratives. Inevitably, the clinical ethics consultant will encounter and engage with religiously based ethical systems. In this issue, the authors reflect seriously and deeply on the implications of such engagement.

Burnout among health professionals is at epidemic proportions. In response, many health institutions have emphasised the importance of self-care, relying particularly on the idea that doctors who are burned out provide worse care for their patients. Although not made explicit, this suggests that doctors might have a responsibility to their patients (and perhaps others) to practice self-care. This chapter explores the potential grounds for such an obligation. We suggest that while there is potential for a limited obligation of self-care, institutional (...) emphasis on this risks instrumentalising doctors' well-being, minimising institutional responsibilities and workers' rights, and being excessively demanding for individuals. (shrink)

The article “Consciousness in a Bioreactor? Science and Ethics of Potentially Conscious Human Cerebral Organoids” (Zillo and Lavazza 2023) presents a thoughtful discussion on the potential ethical...

Since the 1990s there have been a number of government and market led initiatives to improve the welfare of layer hens in the United Kingdom, Australia and the USA. The focus of these regulatory and market initiatives has been a shift away from the dominant battery-cage system to enriched cages, barn/aviary and free-range production systems. Government regulations have played an important role in setting some minimum welfare standards and the banning of battery cages in the UK and in some US (...) states. However the commodification and market segmentation of higher welfare standards has also seen the growth in production and demand of cage-free and free-range eggs in all three countries. This paper maps and compares the developments in government regulation and market segmentation of layer-hen welfare in the UK, Australia and the USA. The role of labelling and certification in facilitating commodification and market segmentation will be examined, including the public controversies and legal conflicts over egg labelling. The key state, market and civil society actors in each country will also be identified, and their role in driving or resisting higher standards examined, including the increasingly influential role of animal welfare organizations and food corporations. (shrink)

A clinical ethics consultant may, at times, be called upon to make independent substantive moral judgments and then offer justifications for those judgments. A CEC does not act unprofessionally by utilizing background beliefs that are religious in nature to justify those judgments. It is important, however, for a CEC to make such judgments authentically and, when asked, to offer up one’s reasons for why one believes the judgment is true in a transparent fashion.

This paper illustrates a role that bioethics should play in developing and criticizing protocols for breast cancer genetic screening. It demonstrates how a critical bioethics, using approaches and reflecting concerns of contemporary philosophy of science and science studies, may critically interrogate the normative and conceptual schemes within which ethical considerations about such screening protocols are framed. By exploring various factors that influence the development of such protocols, including politics, cultural norms, and conceptions of disease, this paper and the critical bioethics' (...) approach it endorses illuminate and critically assess some of the competing worldviews informing protocol development. One of the frequently neglected worldviews in traditional bioethics' treatment of protocols concerning breast care is constituted by women's own views of their breasts and breast cancer, both within the technologically-oriented social practice of American medicine and in light of the social construction of their breasted experience in American society. This paper attempts to redress and critically assess this neglect on the part of traditional bioethics. Finally, in contrast to traditional bioethics, critical bioethics critically interrogates its own normative and conceptual commitments. In this final capacity, a critical bioethics' approach makes a valuable contribution to the evolution of bioethics. (shrink)

Relativism in psychology unravels the truth-claims and oppressive\npractices of the discipline, but simply relativizing psychological knowledge\nhas not been sufficient to comprehend and combat the discipline\nas part of the ‘psy-complex’. For that, a balanced review of the contribution\nand problems of relativism needs to work dialectically, and so\nthis article reviews four problematic rhetorical balancing strategies in\nrelativism before turning to the contribution of critical realism. Critical\nrealism exposes positivist psychology’s pretensions to model itself\non what it imagines the natural sciences to be, and it grounds (...) discursive\naccounts of mentation in social practices. The problem is that those\nsympathetic to mainstream psychology are also appealing to ‘realism’\nto warrant it as a science and to discredit critical research that situates\npsychological phenomena. Our use of critical realism calls for an\naccount of how psychological facts are socially constructed within\npresent social arrangements and for an analysis of the underlying historical\nconditions that gave rise to the ‘psy-complex’. Only by understanding\nhow the discipline of psychology reproduces notions of\nindividuality and human nature, a critical realist endeavour, will it be\npossible to transform it, and to socially construct it as something different. (shrink)

An important role of the philosopher is to critically reflect on what is often taken for granted, using the tools of argument and analysis. This article engages with six different papers that offer critical reflections on conventional concepts and beliefs in bioethics regarding informed consent, continuous deep sedation, traditional moral theories underlying bioethical thinking, the definition of mental disease, and codes of ethics for particular medical specialties.

Despite having paved the way for face, womb and penis transplants, hand transplantation today remains a small hybrid of reconstructive microsurgery and transplant immunology. An exceptionally limited patient population internationally complicates medical researchers’ efforts to parse outcomes “objectively.” Presumed functional and psychosocial benefits of gaining a transplant hand must be weighed in both patient decisions and bioethical discussions against the difficulty of adhering to post-transplant medications, the physical demands of hand transplant recovery on the patient, and the serious long-term health (...) risks of immunosuppressant drugs. This paper relates five narratives of hand transplantation drawn from an oral history project to show how narrative methods can and should inform ethical evaluations and the clinical process of hand transplantation. The interviews with patients and their partners analyzed here lead us to suggest that qualitative accounts of patient experiences should be used to complement clinical case studies reported in medical journals and to help develop instruments to assess outcomes more systematically. (shrink)

As a device used by scientists in the course of performing research, the digital computer might be considered a scientific instrument. But if so, what is it an instrument for? This paper explores a number of answers to this question, focusing on the use of computers in a simulating mode.

The terms “paradigm” and “paradigm shift” originated in “The Structure of Scientific Revolutions” by Thomas Kuhn. A paradigm can be defined as the generally accepted concepts and practices of a field, and a paradigm shift its replacement in a scientific revolution. A paradigm shift results from a crisis caused by anomalies in a paradigm that reduce its usefulness to a field. Claims of paradigm shifts and revolutions are made frequently in the neurosciences. In this article I will consider neuroscience paradigms, (...) and the claim that new tools and techniques rather than crises have driven paradigm shifts. I will argue that tool development has played a minor role in neuroscience revolutions. (shrink)

On the first page of “What is Cantor's Continuum Problem?”, Gödel argues that Cantor's theory of cardinality, where a bijection implies equal number, is in some sense uniquely determined. The argument, involving a thought experiment with sets of physical objects, is initially persuasive, but recent authors have developed alternative theories of cardinality that are consistent with the standard set theory ZFC and have appealing algebraic features that Cantor's powers lack, as well as some promise for applications. Here we diagnose Gödel's (...) argument, showing that it fails in two important ways: Its premises are not sufficiently compelling to discredit countervailing intuitions and pragmatic considerations, nor pluralism, and its final inference, from the superiority of Cantor's theory as applied to sets of changeable physical objects to the unique acceptability of that theory for all sets, is irredeemably invalid. (shrink)

In this first study of the role of scepticism in literature, Fred Parker offers a lively and stimulating introduction to key issues in eighteenth-century literature and philosophy. Parker traces the presence of sceptical thinking in works by Pope, Hume, Sterne, and Johnson, relates it more broadly to the social self-consciousness of eighteenth-century culture, and discusses its source in Locke and its inspiration in Montaigne.

BackgroundThe concept of benefit sharing to enhance the social value of global health research in resource poor settings is now a key strategy for addressing moral issues of relevance to individuals, communities and host countries in resource poor settings when they participate in international collaborative health research.The influence of benefit sharing framework on the conduct of collaborative health research is for instance evidenced by the number of publications and research ethics guidelines that require prior engagement between stakeholders to determine the (...) social value of research to the host communities. While such efforts as the production of international guidance on how to promote the social value of research through such strategies as benefit sharing have been made, the extent to which these ideas and guidelines have been absorbed by those engaged in global health research especially in resource poor settings remains unclear. We examine this awareness among stakeholders involved in health related research in Kenya.MethodsWe conducted in-depth interviews with key informants drawn from within the broader health research system in Kenya including researchers from the mainstream health research institutions, networks and universities, teaching hospitals, policy makers, institutional review boards, civil society organisations and community representative groups.ResultsOur study suggests that although people have a sense of justice and the moral aspects of research, this was not articulated in terms used in the literature and the guidelines on the ethics of global health research.ConclusionThis study demonstrates that while in theory several efforts can be made to address the moral issues of concern to research participants and their communities in resource poor settings, quick fixes such as benefit sharing are not going to be straightforward. We suggest a need to pay closer attention to the processes through which ethical principles are enacted in practice and distil lessons on how best to involve individuals and communities in promoting ethical conduct of global health research in resource poor settings. (shrink)

Healthcare systems need to consider not only how to prevent error, but how to respond to errors when they occur. In the United Kingdom’s National Health Service, one strand of this latter response is the ‘No Blame Culture’, which draws attention from individuals and towards systems in the process of understanding an error. Defences of the No Blame Culture typically fail to distinguish between blaming someone and holding them responsible. This article argues for a ‘responsibility culture’, where healthcare professionals are (...) held responsible in cases of foreseeable and avoidable errors. We demonstrate how healthcare professionals can justifiably be held responsible for their errors even though they work in challenging circumstances. We then review the idea of ‘responsibility without blame’, applying this to cases of error in healthcare. Sensitive to the undesirable effects of blaming healthcare professionals and to the moral significance of holding individuals accountable, we argue that a responsibility culture has significant advantages over a No Blame Culture due to its capacity to enhance patient safety and support medical professionals in learning from their mistakes, while also recognising and validating the legitimate sense of responsibility that many medical professionals feel following avoidable error, and motivating medical professionals to report errors. (shrink)

Autonomy has been the central principle underpinning changes which have affected the practice of medicine in recent years. Medical education is undergoing changes as well, many of which are underpinned, at least implicitly, by increasing concern for autonomy. Some universities have embarked on graduate courses which utilize problem-based learning (PBL) techniques to teach all areas, including medical ethics. I argue that PBL is a desirable method for teaching and learning in medical ethics. It is desirable because the nature of ethical (...) enquiry is highly compatible with the learning processes which characterize PBL. But it is also desirable because it should help keep open the question of what autonomy really is, and how it should operate within the sphere of medical practice and medical education. (shrink)

ABSTRACT Refugees crossing the Mediterranean Sea in small boats has become a common sight in the media, particularly since the so-called ‘refugee crisis’ in 2015. The number of boats crossing the English Channel between the French and UK coasts has been increasing as other migration routes have been closed down. This article reports the findings of a discourse analysis of 96 UK newspaper articles published in December 2018 when the daily crossings were referred to as a ‘major crisis’. Adopting a (...) broadly critical discursive psychology perspective, we identify the use of three main interpretative repertoires used within the media reporting. Firstly, a ‘secure the borders’ repertoire which positions the UK’s borders as porous and easily breached, secondly, a ‘smuggling is immoral’ repertoire which works to position smugglers as to blame for the current ‘crisis’ and removes responsibility for the crisis from the Government, and finally, a ‘desperate people’ repertoire which worked to position the refugees themselves as vulnerable and in need of protection, but also as people who will engage in risky behaviours. We suggest that the use of these repertoires ultimately functions to obscure the need for safe and legal migration routes to the UK. (shrink)

It is not clear whether breast cancer screening is a public health intervention or an individual clinical service. The question is important because the concepts best suited for ethical reasoning in public health might be different to the concepts commonly employed in biomedical ethics. We consider it likely that breast screening has elements of a public health intervention and used an empirical ethics approach to explore this further. If breast screening has public health characteristics, it is probable that policy and (...) practice experts will employ socially embedded concepts when reasoning about it. We gathered data on whether and how these concepts existed in the discussion and reasoning of Australian breast screening experts. We found that experts employed these concepts when talking about the purpose and practices of breast screening, and the behaviour of breast screening professionals and consumers. Experts gave varied judgements about breast screening based on reasoning with these concepts, considering it to be more or less successful in contributing to the public interest and in incorporating socially embedded concepts into its operational agenda. Our findings are compatible with breast screening having public health characteristics. We advocate for the incorporation of socially embedded concepts in breast screening policy and practice. (shrink)

Excerpt from Talks on Wrote This In The discussion of the doctrine of Concentration presented in this book is the outcome of work done in the Cook County Normal School. In 1883 I resigned my position as one of the Supervisors of the Boston schools in order to come into closer range and con tact with children's minds. The work done in Quincy was a slight beginning of something far better. About the Publisher Forgotten Books publishes hundreds of thousands of (...) rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)