Joseph C. Pitt, based on his understanding of trust and of technology, makes the provocative argument that trusting technology is actually a matter of trusting people. I agree with Pitt’s conclusion but differ with him on the nature of trust. I contend, nonetheless, that my understanding of trust actually reinforces Pitt’s characterization of technology as “humanity at work.”.

While there is significant consensus that undergraduate medical education should include bioethics training, there is widespread debate about how to teach bioethics to medical students. Educators disagree about course methods and approaches, the topics that should be covered, and the effectiveness and metrics for UME ethics training. One issue that has received scant attention is the timing of bioethics education during medical training. The existing literature suggests that most medical ethics education occurs in the pre-clinical years. Follow-up studies indicate that (...) medical students in their clinical rotations have little recall or ability to apply ethics concepts that were learned in their pre-clinical training. Trainees also report a desire for medical ethics to be taught in the context of practical application, which would suggest that the timing of pre-clinical ethics education is flawed. However, moving bioethics training to the clinical years should not be assumed to be the solution to the problems of recall and theory application. We argue that the effectiveness of timing bioethics education will depend on when medical students witness or experience particular categories of ethical dilemmas during their training. Our overarching hypothesis is that ethics education will be most effective when the bioethics training on a particular topic correlates to experiential exposure to that ethical issue. The purpose of our current study was to describe medical students exposure to particular categories of ethical conflicts, dilemmas, or issues. Our results may help bioethics educators better strategize about the most effective timing of medical ethics training in UME. (shrink)

The practice of prenatal screening for disability is sometimes objected to because of the hurt and offence such practices may cause to people currently living with disabilities. This objection is commonly termed “the expressivist objection”. In response to the objection it is standardly claimed that disabilities are analogous to illnesses. And just as it would be implausible to suppose reduction of the incidence of illnesses such as flu sends a negative message to ill people, so it is not plausible to (...) suppose prevention of disability sends a negative message to disabled people. The expressivist objection hinges, however, upon a view of the relationship between disability and self identity which sees disability as part of the identity of the disabled person, in a way in which illnesses such as flu cannot be. This possibility is generally not considered in critiques of the expressivist objection. In this paper, an “identity claim” to the effect that disabilities can be identity constituting is accepted and the force of the expressivist argument is reconsidered in the light of its acceptance. It is concluded that even when such an identity claim is accepted, the expressivist objection is still not morally compelling. (shrink)

This article begins from the assumption that what was once an integral dimension of progress—the development of literature and of art more generally—now lies outside its scope. The essay falls into three parts that juxtapose French with German intellectual history. The first part examines the notion of literary progress developed by Charles Perrault and Fontenelle, as well as the opposition to it by Boileau and other antiquarians, during the querelle des Anciens et des Modernes in the later seventeenth century. The (...) second part treats the reception of those arguments during the eighteenth century by J. C. Gottsched, J. J. Bodmer, and J. J. Breitinger. Special attention is given to the paradox that Gottsched, the leader of the German antiquarians, and Bodmer, the leader of the German progressives, were equally devoted to the Leibnizian-Wolffian philosophical system and thus that German Romanticism, heavily indebted to Bodmer's poetics, had roots in rationalist philosophy. The essay's third part discusses ideas of literary progress in the writings of the early Romantics J. G. Herder and Friedrich Schlegel. As these discussions show, the conception of general progress was formed in a field that has since dissociated itself from progress's march. (shrink)

In my previous article I argued that certain of the later MSS. of the Metamorphoses of Apuleius, and especially those which I call Class I., are to a large extent descended from a lost copy of F, made before the rent was torn in Book VIII., and therefore before the writing of ; and I inferred that it was likely that the evidence of these MSS. would prove a valuable addition to that of in places where F is now illegible. (...) In the following pages I shall prove that this hope has been fulfilled. (shrink)

A recent exchange on Benatar’s book Better never to have been between Doyal and Benatar discusses Benatar’s bold claim that people should not be brought into existence. Here, I expand the discussion of original position that the exchange focused on. I also discuss the asymmetries, between benefit and harm and between existence and non-existence, upon which Benatar’s bold claim rests. In both discussions, I show how Benatar’s bold claim can be rejected.

In this paper the coherence of the precautionary principle as a guide to public health policy is considered. Two conditions that any account of the principle must meet are outlined, a condition of practicality and a condition of publicity. The principle is interpreted in terms of a tripartite division of the outcomes of action . Such a division of outcomes can be justified on either “consequentialist” or “deontological” grounds. In the second half of the paper, it is argued that the (...) precautionary principle is not necessarily opposed to risk–cost–benefit analysis, but, rather, should be interpreted as suggesting a lowering of our epistemic standards for assessing evidence that there is a link between some policy and “special bad” outcomes. This suggestion is defended against the claim that it mistakes the nature of statistical testing and against the charge that it is unscientific or antiscientific, and therefore irrational. (shrink)

Tom Shakespeare’s important new book includes, among other topics, a persuasive critique of the social model of disability. A key component in his case against that model consists in an argument against the impairment/disability distinction as this is understood within the social model. The present paper focuses on the case Shakespeare makes against that distinction. Three arguments mounted by Shakespeare are summarised and responded to. It is argued that the responses adequately rebut Shakespeare’s case on this specific issue. Moreover, as (...) the engagement with Shakespeare’s argument illustrates, his claim to employ a critical realist perspective appears to be in considerable tension with the case he offers against the impairment/disability distinction. (shrink)

Published within weeks of Charles Darwin's Origin of Species, Isabelle Duncan's Pre-Adamite Man (1860) is the first full-length treatment of preadamism by an evangelical. Intended as a reconciliation of Genesis and geology, Duncan's work gained immediacy when it was published shortly after the September 1859 revelations that men had walked among the mammoths. Written in the tradition of evangelical 'Christian philosophy', Pre-Adamite Man deploys innovative biblical hermeneutics and recent trends in geology to set out both a biblical preadamite theory, and (...) an unorthodox angelology. Duncan responded to contemporary secular interpretations of geology by pushing evangelical concordist strategies to new frontiers, filling out an acceptance of an ancient earth with new biblically informed catastrophist proposals and extensions of salvation history, while simultaneously retaining a firm commitment to plenary inspiration. The product is a highly readable book that operates both as an accessible treatment of geology and a theological discourse. Running through six printings between 1860 and 1866, the book was reviewed by many of the period's leading journals and created a minor controversy among evangelicals. This study both brings to life this previously neglected episode in scriptural geology, and adds to recent work on Victorian popular science writing. (shrink)

Objective: The objectives of this study are to understand the current functions, structure and operation of hospital ethics committees (HECs) in Shanghai and to facilitate their improvement. Methods: (1) A questionnaire survey, (2) interviews with secretaries and (3) on-site document reviews of HECs in Shanghai were used in the study, which surveyed 33 hospitals. Results: In Shanghai, 57.56% of the surveyed hospitals established HECs from 1998 to 2005. Most HECs used bioethical review of research involving human subjects as well as (...) bioethical review or consultation regarding medical care services and administrative decision- making. Of the surveyed HECs, 14.3% did not provide any formal bioethical training to the HECs’ members and many HECs had no standard operating procedures. Some HECs had no clear definition of what was “conflict of interest” that should be considered by the HECs, while 44.4% of the HECs did not perform continuing review. Discussion: After the issues of related national regulations, more and more hospitals established HECs in Shanghai, but the functions of HECs need to be further developed and formal training on bioethics should be provided to HEC members. To assure the independence and good performance of HECs, the conflict of interest procedure, the standard operating procedures and bioethical review should be improved. Conclusion: HECs in Shanghai had developed in the preceding 10 years and they played great roles in protecting the rights and welfare of human subjects and patients; some areas need improvement. (shrink)

Geoffrey Rose’s prevention paradox points to a tension between two prima facie plausible moral principles: that we should save the greater number and that weshould save the most at risk. This paper argues that a novel moral theory, ex-ante contractualism, captures our intuitions in many prevention paradox cases, regardless of our interpretation of probability claims. However, it goes on to show that it might be impossible to square ex-ante contractualism with all of our moral intuitions. It concludes that even if (...) ex-ante contractualism cannot furnish an entire ethics of risk, it does identify important considerations for any such theory. (shrink)

The current Medicare prospective payment system has many positive incentives for hospitals to control costs. Hospitals are increasing outpatient surgery, decreasing admissions, decreasing length of stay, and decreasing use of ancillary services. These are just the effects that Congress and the Health Care Financing Administration hoped for to save the Medicare trust fund. However, there has been evidence of some adverse outcomes including premature discharge, “dumping” sicker patients and patients without insurance, and adverse impact on hospitals with specialty centers. We (...) examine these issues and present a possible solution based on a new Computerized Severity Index. (shrink)

The moral status accorded to an individual (or class of individuals) helps to account for the weight of the moral obligations considered due to an individual (or class of individuals). Strong arguments can be given to indicate that the moral status accorded, justly or unjustly, to individuals with intellectual disabilities is less than that accorded to those considered intellectually able. This paper suggests that such a view of the moral status of intellectually disabled individuals derives from individualism. Ontological and normative (...) components of individualism are identified. It is shown that individualistic, ontological criteria for personhood compromise the integrity of “dependent” individuals. And it is shown that the normative component of individualism further compromises the integrity of intellectually disabled individuals. An alternative view of the self is outlined in which dependence features centrally. It is tentatively suggested that such a view of the self may prove more congenial to enhancing the moral status of individuals with intellectual disabilities. (shrink)