In connection with his discussion of the three Ulpian formulae, Kant introduces three “leges,” namely the “lex iusti,” the “lex iuridica,” and the “lex iustitiae,” which he then defines in § 41 of the Doctrine of Right. The three “leges” correspond to the attributes “right,” “juridical,” and “established as right.” These three attributes in turn relate to the possibility, the reality, and the (material) necessity of our rights and juridical duties. The three “leges” and attributes have certain consequences for the (...) division of public justice, public justice being constitutive of the juridical state, into “iustitia tutatrix,” “iustitia commutativa,” and “iustitia distributiva.” This article provides a comprehensive account of all these concepts from § 41 of the Doctrine of Right. It also explains what until now has seemed to be a rather cryptic comment Kant makes at the end of his discussion of the Ulpian formulae regarding internal and external legal duties, and those legal duties that contain the derivation of the external legal duties from the principle of the internal legal duties through subsumption. Indeed the article provides the key to understanding the entire Doctrine of Right from a totally new perspective. (shrink)

Ethics of Everyday Medicine: Explorations of Justice examines and analyses the relatively unexplored domain of ethics involved in the everyday practice of medicine. From the author's clinical experience, virtually every decision made in the day-to-day practice of medicine is fundamentally an ethical question, as virtually every decision hinge on some value judgment that goes beyond the medical facts of the matter. The first part of the book is devoted to medical decision cases in several areas of medicine. These cases highlight (...) elements of the current healthcare ecosystem, involving players other than the physician and patient. Insurers (private, commercial, and governmental), administrators, and regulators' perspectives are surfaced in point of care case analysis. Part two contributes to the development of actionable tools to develop better ethical systems for the everyday practice of medicine by providing a critical analysis of Reflective Equilibrium and ethical induction from the perspective of logic and statistics. The chapter on Justice discusses the neurophysiological representations of just and unjust behaviours. The chapter on Ethical Theories follows, describing the epistemic conundrum, principlism, reproducibility, abstraction, chaos and complexity. The following chapter approaches ethical decisions from the logic and statistic perspectives. The following chapter, The Patient as Parenthetical, the author discusses patient-centric ethics, and the rise of business- and government-cetric ethics. The final chapter, A Framework to Frame the Questions for Explore Further, proposes a working framework to deal with current ethical issues. (shrink)

Despite medicine's achievements, medical errors and the difficulty of reproducing research prove medicine is far from perfect. This book provides a critical and historical analysis of medical reasoning that recognizes the constant need for certainty despite the enormous variety of disease, illness, symptoms, and behavior in patients. According to Erwin Montgomery, Jr., medicine depends on logic, balancing utility with certainty, and anticipating errors in judgment.

Mistrust and fear of research often exist in minority communities because of assumptions, preconceived ideas, and historical abuse and racism that continue to influence research participation. The research establishment is full of well-meaning ‘outsider’ investigators who recognize discrimination, health disparities, and insufficient health care providers in minority communities, but struggle in breaking through this history of mistrust. This article provides ethical insights from one such ‘insider-outsider’, community-based participatory research project implemented via community health advisors in the Mississippi Delta. Both community-based (...) participatory research and community health advisors provide opportunities to address the ethical issues of trust, non-maleficence, and justice in minority communities. Implications for ethics-driven nursing research are discussed. (shrink)

I sketch an explanatory framework that fits a variety of contemporary research programs in cognitive science. I then investigate the scope and the implications of this framework. The framework emphasizes (a) the explanatory role played by the semantic content of cognitive representations, and (b) the important mechanistic, non-intentional dimension of cognitive explanations. I show how both of these features are present simultaneously in certain varieties of cognitive explanation. I also consider the explanatory role played by grounded representational content, that is, (...) content evaluated by appeal to its truth, falsity, accuracy, inaccuracy and other relational properties. (shrink)

Published in 1797, the Doctrine of Right is Kant's most significant contribution to legal and political philosophy. As the first part of the Metaphysics of Morals, it deals with the legal rights which persons have or can acquire, and aims at providing the grounding for lasting international peace through the idea of the juridical state. This commentary analyzes Kant's system of individual rights, starting from the original innate right to external freedom, and ending with the right to own property and (...) to have contractual and family claims. Clear and to the point, it guides readers through the most difficult passages of the Doctrine, explaining Kant's terminology, method and ideas in the light of his intellectual environment. One of the very few commentaries on the Doctrine of Right available in English, this book will be essential for anyone with a strong interest in Kant's moral and political philosophy. (shrink)

Suicide among Veterans experiencing or at risk for homelessness remains a significant public health concern. Conducting research to understand and meet the needs of this at-risk population remains challenging due to myriad factors. To address this challenge, the United States Department of Veterans Affairs convened the Health Services Research and Development Suicide Prevention in Veterans Experiencing Homelessness: Research and Practice Development meeting, bringing together subject-matter experts in the fields of homelessness and suicide prevention, both from within and outside of VA. (...) During the meeting, attendees identified 10 potential research priorities at the intersection of suicide prevention and homelessness. After the meeting, Delphi methodology was used to achieve consensus on the relative importance of the identified research domains. Through this iterative Delphi process, agreement was reached regarding the need to increase understanding of barriers and facilitators to suicide risk assessment and emergency intervention for Veterans experiencing homelessness by examining the perspectives of both Veterans and healthcare providers. Elucidating the complex relationships between risk periods, subgroups, suicide means, and drivers of suicide among Veterans experiencing homelessness was also considered a top priority. This article documents the Delphi process and provides a research agenda for researchers, funding agencies, and policymakers to prioritize the most relevant and potentially impactful research domains aimed at preventing suicide among Veterans experiencing or at risk for homelessness. (shrink)

Unit I. Fundamental characteristics of the common law. The source of law -- The jury -- The adversary system of trial -- Retroactivity: a return to stare decisis -- Unit II. The courts and their jurisdiction. Court systems in the United States -- Court system in England -- Unit III. Constitutional law. Judicial review -- Equal protection -- Freedom of speech -- Appendix I. Constitution of the United States -- Appendix II. Table of Supreme Court cases -- Appendix III. Common (...) case citations. (shrink)

First, this article considers Kant's rather odd requirement that every contract consist of four declarations of will: an offer, an approval of the offer, a promise and an acceptance of this promise. It explains Kant's theory as a stepping stone for Savigny's later development of the principle of abstraction, a principle which separates the contract of obligation from the contract of ownership transfer and makes the validity of each independent of the validity of the other. Second, the article interprets Kant's (...) "Dogmatic Division of All Rights Acquirable through Contracts," contained in section 31 of the Doctrine of Right. It claims that the table consists of aspects of contractual relationships and is dynamic rather than static in that these aspects can be intermingled to produce a wealth of different types of contracts. (shrink)

Kant's theory of punishment is commonly regarded as purely retributive in nature, and indeed much of his discourse seems to support that interpretation. Still, it leaves one with certain misgivings regarding the internal consistency of his position. Perhaps the problem lies not in Kant's inconsistency nor in the senility sometimes claimed to be apparent in the Metaphysic of Morals, but rather in a superimposed, modern yet monistic view of punishment. Historical considerations tend to show that Kant was discussing not one, (...) but rather two facets of punishment, each independent but nevertheless mutually restrictive. Punishment as a threat was intended to deter crime. It was a tool in the hands of civil society to counteract human drives toward violating another's rights. In its execution, however, the state was limited in its reaction by a retributive theory of justice demanding respect for the individual as an end and not as a means to some further social goal. This interpretation of Kant's theory of punishment maintains consistency from the earliest through the latest of his writings on moral, legal, and political philosophy. It provides a good reason for rejecting current economic analyses of crime and punishment. Most important of all, it credits Kant's theory in its clear recognition of the ideals intrinsic to libertarian government. (shrink)

This research investigates the perceptions of five constituent groups of an accredited business school — their perceptions of others'' ethics, of their own ethics and ideal values, and of how business ethics can be improved. Self-described behavior from the constituent groups is quite similar, yet is decidedly different from that which respondents felt others would do. Undergraduate business students tended to have the lowest estimation of others'' ethics in addition to the least ethical self-described behavior compared with other constituent groups. (...) All constituents were solidly in favor of improving ethics by developing principles of business ethics, requiring ethics courses in business schools and introducing industry codes of ethics. People are much more ethical than they are perceived to be. Knowing that others are more ethical may in turn cause other people to act more ethically. Similarly, believing that others are less ethical may encourage less ethical behavior. (shrink)

According to a two-level criterion for combination tests in the field of ordinary language, moral 'ought'-sentences may be taken to imply 'I intend'-sentences partly semantically and partly pragmatically. If so, a trenchant linguistic analysis of the concept of moral obligation cannot do without a non-classical logic which allows to model these important kinds of ordinary-language implications by means of purely syntactical derivations. For this purpose, an integrated logic of conviction and intention has been tentatively devised by way of a doxastically, (...) buletically, and pragmatically extended calculus of natural deduction. This system of buletic logic cannot even be launched without one or two derivation rules of deductive closedness. However, these very closedness rules appear to be responsible for buletic paradoxes which are analogous to paradoxes long since known from other, less exotic branches of logic but at first sight look much more virulent. After having scrutinized two potential strategies for coping with the paradoxes of buletic logic, finally we can convince ourselves that these paradoxes, as well as their familiar non-buletic counterparts, are but apparent paradoxes, provided we consistently lean on C-CT and do not let pragmatical considerations intrude into purely logical ones. (shrink)

Non-invasive prenatal testing is at the forefront of prenatal screening. Current uses for NIPT include fetal sex determination and screening for chromosomal disorders such as trisomy 21. However, NIPT may be expanded to many different future applications. There are a potential host of ethical concerns around the expanding use of NIPT, as examined by the recent Nuffield Council report on the topic. It is important to examine what NIPT might be used for before these possibilities become consumer reality. There is (...) limited research exploring views of women on possible future uses of NIPT, particularly those of women who have undergone NIPT. In this study, we examined the views of women who undertook NIPT previously on the acceptability of and interest levels in using NIPT for a number of current and possible future applications. These included several medical conditions encompassing psychiatric, neurodevelopmental and adult-onset conditions as well as non-medical traits such as intelligence. One thousand women were invited to participate and 235 eligible surveys were received. Women generally reported an interest in using NIPT for medical conditions that severely impacted quality of life and with an onset earlier in life and stressed the importance of the accuracy of the test. Concerns were raised about the use of NIPT for non-medical traits. Respondents indicated that termination of pregnancy was not their only reason for testing, particularly in the case of sex. These results can further inform the ethical debate around the increasing integration of NIPT into healthcare systems. (shrink)

Women’s health activists laid the groundwork for passage of the law that created the U.S. Food and Drug Administration in 1906. The pharmaceutical and food industries fought regulatory reforms then and continue to do so now. We examine public health activism in the Progressive Era, the postwar era and the present day. The women’s health movement began in the 1960s, and criticized both the pharmaceutical industry and the medical establishment. In the 1990s, patient advocacy groups began accepting industry funds; thousands (...) of commercially-funded groups now dominate the advocacy landscape. As pharma funding became normalized, concerns arose regarding a) the lack of transparency and public accountability regarding funding, b) the distortion of groups’ agendas, and c) the ability of pharma-funded groups to dominate the discourse and override less well-resourced patient and health advocacy groups. Although industry-funded groups argue that funding allows them to provide useful services, the trade-off in health risks, exorbitant prices and distorted information is far too high. Sincerity is beside the point; patients and the industry have differing interests when it comes to drug safety and efficacy, drug information and drug prices. A growing resistance movement is asserting the values of its activist predecessors and opposing the prevailing culture of pharma-funded advocacy. (shrink)

ABSTRACT A rereading of the American scientific literature on sex determination from 1902 to 1926 leads to a different understanding of the construction of the Mendelian‐chromosome theory after 1910. There was significant intellectual continuity, which has not been properly appreciated, underlying this scientific “revolution.” After reexamining the relationship between the ideas of key scientists, in particular Edmund B. Wilson and Thomas Hunt Morgan, I argue that, contrary to the historical literature, Wilson and Morgan did not adopt opposing views on Mendelism (...) and sex determination. Rather, each preferred a non‐Mendelian explanation of the determination of sex. Around 1910, both integrated the Mendelian and non‐Mendelian theories to create a synthetic theory. One problem was the need to avoid an overly deterministic view of sex while also accepting the validity of Mendelism. Morgan’s discovery of mutations on the X chromosome takes on different significance when set in the context of the debate about sex determination, and Calvin Bridges’s work on sex determination is better seen as a development of Morgan’s ideas, rather than a departure from them. Conclusions point to the role of synthesis within fields as a way to advance scientific theories and reflect on the relationship between synthesis and explanatory “pluralism” in biology. (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)