Respect for Autonomy has been a mainstay of medical ethics since its enshrinement as one of the four principles of biomedical ethics by Beauchamp and Childress’ in the late 1970s. This paper traces the development of this modern concept from Antiquity to the present day, paying attention to its Enlightenment origins in Kant and Rousseau. The rapid C20th developments of bioethics and RFA are then considered in the context of the post-war period and American socio-political thought. The validity and utility (...) of the RFA are discussed in light of this philosophical-historical account. It is concluded that it is not necessary to embrace an ethic of autonomy in order to guard patients from coercion or paternalism, and that, on the contrary, the dominance of autonomy threatens to undermine those very things which have helped doctors come to view and respect their patients as persons. (shrink)

Florence Ashley has argued that requiring patients with gender dysphoria to undergo an assessment and referral from a mental health professional before undergoing hormone replacement therapy (HRT) is unethical and may represent an unconscious hostility towards transgender people. We respond, first, by showing that Ashley has conflated the self-reporting of symptoms with self-diagnosis, and that this is not consistent with the standard model of informed consent to medical treatment. Second, we note that the model of informed consent involved in cosmetic (...) surgery resembles the model Ashley defends, and that psychological assessment and referral is recognised as an important aspect of such a model. Third, we suggest that the increased prevalence of psychiatric morbidity in the transgender population arguably supports the requirement of assessment and referral from a mental health professional prior to undergoing HRT. (shrink)

In this paper we explore the thesis that the role of argumentation in practical reasoning in general and legal reasoning in particular is to justify the use of defeasible rules to derive a conclusion in preference to the use of other defeasible rules to derive a conflicting conclusion. The defeasibility of rules is expressed by means of non-provability claims as additional conditions of the rules.We outline an abstract approach to defeasible reasoning and argumentation which includes many existing formalisms, including default (...) logic, extended logic programming, non-monotonic modal logic and auto-epistemic logic, as special cases. We show, in particular, that the admissibility semantics for all these formalisms has a natural argumentation-theoretic interpretation and proof procedure, which seem to correspond well with informal argumentation. (shrink)

Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then examine (...) their comments regarding the analogy between abortion and HRT, and the language of informed consent. We also scrutinize the data upon which Ashley relies to defend the claim that informed consent without assessment always yields positive outcomes, finding this conclusion to be overstated. Finally, even if Ashley’s arguments were vindicated, the claim that the gatekeeping of HRT is motivated by hostility towards transgender people remains unsupported. (shrink)

In a recent article in this journal, Abram Brummett argues that new and future assisted reproductive technologies will provide challenging ethical questions relating to lesbian, gay, bisexual and transgender (LGBT) persons. Brummett notes that it is likely that some clinicians may wish to conscientiously object to offering assisted reproductive technologies to LGBT couples on moral or religious grounds, and argues that such appeals to conscience should be constrained. We argue that Brummett's case is unsuccessful because he: does not adequately interact (...) with his opponents’ views; equivocates on the meaning of ‘natural’; fails to show that the practice he opposes is eugenic in any non‐trivial sense; and fails to justify and explicate the relevance of the naturalism he proposes. We do not argue that conscience protections should exist for those objecting to providing LGBT people with artificial reproductive technologies, but only show that Brummett's arguments are insufficient to prove that they should not. (shrink)

Our thesis is that the story of Onan in Genesis chapter 38 offers scriptural and logical grounds for believing that contraceptive acts are sinful. We set out a five-part modus ponens argument which considers the meaning and significance the story of Onan and, by showing that contraceptive acts are substantially similar to the act for which Onan is infamous, conclude that Christians ought not to practise contraception. We then respond to objections to this conclusion before finally and briefly touching upon (...) some of the implications of our thesis for Christian ethics, namely with reference to the perverted faculty argument and natural law. (shrink)

This paper explores the societal and individual acceptance of technologies for the human body, focusing on brain-computer interfaces (BCIs), particularly Elon Musk's Neuralink. BCIs promise a direct connection between the brain and computers. Their acceptance depends on general aspects such as feasibility and usefulness. In the case of brain implants, they should also not jeopardize the user's autonomy or have a dehumanizing effect. In the case of innovative technologies that are still in development, such as BCIs, acceptance depends largely on (...) their public relation presentation. The article uses the case of Neuralink to analyze how new technologies for human bodies, and specifically BCIs, are presented as acceptable technologies. Analyzing Neuralink's public relations communication, the study reveals how the company constructs a vision of a plausible and desirable future, countering skepticism often associated with science fiction tropes. The article emphasizes the relevance of the categorization of BCIs and shows how the presentation of BCI as an autonomy-enhancing therapy product can positively influence the acceptability of the technology. By addressing key topics of ethical discourse, such as autonomy and identity, Neuralink attempts to create social acceptance for its innovative but controversial BCI technology. The results contribute to the understanding of the complicated dynamics between technological development, public relations, and societal values. (shrink)

Self-managing teams have been predicted to break down organizational hierarchies and sex-segregated functional divisions. Based on participant observation and interviews with 39 men and women in service-oriented self-managing teams, the authors found that the metaphor of family emerged in interviews as a popular way to describe teams' interaction and social relations. The ways that team members used the family metaphor revealed that women were often perceived in familial roles that the authors argue encourage emotional labor. Although relational tasks may not (...) directly reproduce traditional gender power relations in teams, women can face difficulties taking on more instrumental team tasks. The authors propose that the persistence of family metaphors sustains the organizational gender categorization that self-managing teams as work-based, cross-functional groups were supposed to help eliminate. To the extent that this is the case, it suggests the importance of exploring the gendered organizational cultures that exist alongside structural arrangements. (shrink)

Introduction The General Medical Council stipulates that doctors must be competent professionals, not merely scholars and practitioners. Medical school curricula should enable students to develop professional values and competencies. Additionally, medical schools are moving towards integrated undergraduate curricula, Cardiff's C21 being one such example. Methods We carried out an audit to determine the extent to which C21 delivers GMC professionalism competencies, and a student questionnaire to explore student perspective on ethics and professionalism. Results and discussion C21 delivers explicit or implicit (...) teaching for all major GMC competencies, though some missed opportunities remain. The questionnaire responses showed that most students value ethics and professionalism teaching, and that it is most well received when delivered in a variety of ways and contexts throughout the curriculum. We also note that some respondents confuse ethics and professionalism with the policing of student behaviour. Conclusions C21 and curricula like it offer many opportunities for nurturing ethically and professionally competent physicians. Students appear to value this, though there remains confusion between medical school discipline and ethics and professionalism which needs further explication. (shrink)

Volume 26, Issue 3, September 2020, Page 284-286.

This paper presents a novel argumentation framework to support Issue-Based Information System style debates on design alternatives, by providing an automatic quantitative evaluation of the positions put forward. It also identifies several formal properties of the proposed quantitative argumentation framework and compares it with existing non-numerical abstract argumentation formalisms. Finally, the paper describes the integration of the proposed approach within the design Visual Understanding Environment software tool along with three case studies in engineering design. The case studies show the potential (...) for a competitive advantage of the proposed approach with respect to state-of-the-art engineering design methods. (shrink)

People are prone to ascribe value to persons they love. However, the relation between love and value is far from straightforward. This is particularly evident given certain views on the nature of love. Setting out from the idea that what causes us to have an attitude towards an object need not be found in the intentional content of the attitude, this paper depicts love as an attitude that takes non‐fungible persons as intentional objects. Taking this view as a starting point, (...) the paper shows why it is difficult to combine with certain views on value. The main challenge comes from the idea that value judgments are universalizable. This view squares badly with the thought that the people whom we love are irreplaceable. Introducing the idea that properties may have different functions in the intentional content of the attitude, this paper determines what precisely it is about love that makes it hard to combine with universalizability. Moreover, it suggests two ways of meeting this challenge. (shrink)

Antonio Negri’s article explores the relationship between the juridical categories of ‘public’ and ‘private’ and the political concept of the common through the theme of the ‘material constitution’ defining actual relations of power which defy the crystallization of ‘formal constitutions’. The financial convention shaping the material constitution of contemporary capitalism refers to the rise of what Foucault called biopower, where value is no longer the expression of a mere quantity of commodities but of a set of activities and services, which (...) are immediately cooperative. In this context, any form of measure cannot but be political and hence it must be established through new forms of economic governance. The social relation of capital becomes immediately political once money displaces labour as rule, norm and measure of value. As a result, processes of political subjectivation within the Eurocrisis combine de-stituent and con-stituent movements: requests for insolvencies, social occupations, commoning and mutualization are the means through which social struggles formulate the multitudes’ demands for ‘equality as a condition of freedom’. (shrink)

In The Value Gap, Toni Rønnow-Rasmussen addresses the distinction between what is finally good and what is finally good-for, two value notions that are central to ethics and practical deliberation. The first part of the book argues against views that claim that one of these notions is either faulty, or at best conceptually dependent on the other notion. Whereas these two views disagree on whether it is good or good-for that is the flawed or dependent concept, it is argued, (...) as against both approaches, that goodness and goodness-for are independent value notions that cannot be fully understood in terms of one another. The second part provides an analysis of good and good-for in terms of a fitting-attitude analysis. By elaborating a more nuanced understanding of the key elements of this analysis—reasons and pro-attitudes—Rønnow-Rasmussen challenges the widespread idea that there are no genuine practical and moral dilemmas. The result is that the gap between favouring for a reason what is good and favouring for a reason what is good for someone appears insurmountable. (shrink)

The much endorsed idea that reasons are facts, gives raise to several issues, not least when it is applied to the distinction between agent-neutral and agent-relative reasons. The paper distinguish in broad terms between two important views on the nature of facts. Given in particular a view that conceives of facts as abstract entities, the dichotomy is not particularly problematic. We might run into problems when it comes to identifying which facts are reasons and which are not, but the very (...) dichotomy itself seems sound. On this, the so-called thin approach, it is at least a possibility that some reasons will be (in some sense of the dichotomy) agent-neutral and some will be agent-relative. The second approach, the thick account, is, much less popular. It is argued that the thin approach trivializes an interesting issue among practical philosophers. The thin account is also in one respect less appealing than its thick cousin. The thick account is not flawless, though. At the end, a couple of objections to it will be considered. (shrink)

Many well-known arguments in the philosophy of mind use thought experiments to elicit intuitions about consciousness. Often, these thought experiments include mechanistic explanations of a systems’ behavior. I argue that when we understand a system as a mechanism, we are not likely to understand it as an agent. According to Arico, Fiala, Goldberg, and Nichols’ (2011) AGENCY Model, understanding a system as an agent is necessary for generating the intuition that it is conscious. Thus, if we are presented with a (...) mechanistic description of a system, we will be very unlikely to understand that system as conscious. Many of the thought experiments in the philosophy of mind describe systems mechanistically. I argue that my account of consciousness attributions is preferable to the “Simplicity Intuition” account proposed by David Barnett (2008) because it is more explanatory and more consistent with our intuitions. Still, the same conclusion follows from Barnett’s “Simplicity” account and from my own account: we should reassess the conclusions that have been drawn from many famous thought experiments. (shrink)

Feminist scholars challenge ahistorical conceptions of the patriarchal state and emphasize the importance of power struggles across class, race, and gender lines in transforming state gender policies. They also unintentionally downplay the ideological power struggles among race- and class-homogeneous patriarchal institutions, especially in relatively monolithic political contexts with little or no independent feminist movement. Our historical case study of the transformations of Polish abortion laws and selected economic policies geared toward women explores how these changing policies were used in, and (...) shaped by, the ideological power struggles between two homogeneous, powerful, male-dominated institutions: the Communist Party and the Catholic Church. We argue that one cannot understand patriarchal state practices without considering the ideological power struggles between patriarchal institutions in homogeneous social contexts as well as in those of a more heterogeneous nature. (shrink)

This study aims to determine possible associations between strength parameters, injury rates, and performance outcomes over six seasons in professional basketball settings. Thirty-six male professional basketball players [mean ± standard deviation : age, 30.5 ± 4.7 years; height, 199.5 ± 9.5 cm; body mass, 97.9 ± 12.9 kg; BMI 24.6 ± 2.5 kg/m2] participated in this retrospective observational study, conducted from the 2008–09 to the 2013–14 season. According to their epidemiological records, each player followed an individual plan designed within different (...) strength training programs: Functional, Eccentric, or Resistance. Seven hundred and fourteen valid records were obtained from 170 individual strength tests during 31 sessions. Tests performed were leg press, squat, and jerk. Parameters recorded were force, power, velocity, peak velocity, and time to peak velocity for strength; time loss injury and muscle injury for injury rate; and games won, games lost, and championships for performance outcomes. All the strength variables and injuries are independent of the strength programs. The correlation analysis showed very significant relationships between muscular injuries and time to peak velocity, significant relationships between force and games lost, and muscular injuries with games lost per season. Mean values per season described a possible association of force, time to peak velocity, and muscular injuries with performance outcomes. In this specific context, strength variables and injury rate data show no association with a single type of strength training program in this cohort of high-performance basketball players. (shrink)

„Ich bin Iron Man.“ Mit diesem Satz bekennt sich Tony Stark, genialer Technik-Erfinder und Leiter von „Stark Industries“, zu seiner neuen High-Tech-Rüstung: ein fliegendes Roboter-Exoskelett, das ihm übernatürliche Fähigkeiten verleiht. Dieses Pressestatement wird zum Auftakt der Iron Man-Identität. Doch was hat es mit Iron Man eigentlich auf sich? Was verraten die Action- und Science-Fiction-Filmreihen „Iron Man“ (2008–2013) und „The Avengers“ (2012–2018) über uns selbst? -/- Puzio, Anna: Die Helden und Monster in uns – ein technikphilosophischer Blick auf "Iron Man" und (...) die "Avengers". Auf: zem::dg. (shrink)

It is argued that the so-called fitting attitude- or buck-passing pattern of analysis may be applied to personal values too if the analysans is fine-tuned in the following way: An object has personal value for a person a, if and only if there is reason to favour it for a’s sake. One benefit with it is its wide range: different kinds of values are analysable by the same general formula. Moreover, by situating the distinguishing quality in the attitude rather than (...) the reason part, the analysis admits that personal value is recognizable as a value not only by the person for whom it has personal value, but for everyone else too. We thereby avoid facing two completely different notions of value, viz., one pertaining to impersonal value, and another to personal value. The analysis also elucidates why we are justified in our concern for objects that are valuable for us; if value just is, as it is suggested, the existence of reasons for such a concern, the justification is immediately forthcoming. (shrink)

This article examines parallels between the increasing mental burnout and environmental overshoot in the organisational context. The article argues that there is a particular philosophy of management that connects these two phenomena of overshoot and burnout, namely productivism. As there are boundaries in all ecological processes and systems, the productivist aim of having ever more output and growth is deemed absurd. It is proposed that productivity as a management philosophy not only leads to mental ill-health in organisations but also to (...) overshoot in the environment. The article concludes that productivism, which denies the limits in utilisation of humans and other natural resources, fits poorly with circular economy and sustainability. Hence, ecological management should be complemented with a more holistic and processual view of organizations, as well as have an aim of peaceful coexistence between all earthbound objects. This signifies acknowledging and caring for human and non-human needs both now and in future by applying the idea of moderation to production of goods and services. (shrink)

Although recent research suggests that women are underrepresented in philosophy after initial philosophy courses, there have been relatively few empirical investigations into the factors that lead to this early drop-off in women’s representation. In this paper, we present the results of empirical investigations at a large American public university that explore various factors contributing to women’s underrepresentation in philosophy at the undergraduate level. We administered climate surveys to hundreds of students completing their Introduction to Philosophy course and examined differences in (...) women’s and men’s feelings of belonging, comfort, and confidence in the philosophy classroom. We present findings suggesting various factors that contribute to women’s lower willingness to continue in philosophy compared to men’s, including perceptions about intuition-based methods in philosophy, the usefulness of the philosophy major, philosophy as a male discipline, and philosophical abilities as innate talents. We conclude by providing some suggestions for improving undergraduate philosophy courses in ways that would increase women’s willingness to continue in philosophy and may improve the courses for all students. (shrink)

This is a stimulating and vivid area of philosophical research, but it has tended to monopolize the notion of 'good-for', linking it necessarily to welfare or ...

Conscientious Objection (CO) has become a highly contested topic in the bioethics literature and public policy. However, when CO is discussed, it is almost universally referred to as a single entity. Reality reveals a more nuanced picture. Healthcare professionals may object to a given action on numerous grounds. They may oppose an action because of its ends, its means, or because of factors that lay outside of both ends and means. Our paper develops a taxonomy of CO, which makes it (...) possible to describe the refusals of healthcare professional with greater finesse. The application of this development will potentially allow for greater subtlety in public policy and academic discussions – some species of CO could be permitted while others could be prohibited. (shrink)

Environmental issues are among the most critical scientific and social problems of today. The human environment is an environment of inequality and crisis, and a platform for debate on the fairness of social order. The crisis is the result of human behaviour, which reflects the failure of development and unjust distribution of consequences. The gap between rich and poor on a global scale is evident in the disproportionate climate change impacts on countries and their ability to cope. In this respect, (...) the economic and political inequalities between First and Third World countries are fortified by ecological ones. The development of international environmental mechanisms such as the Kyoto Agreement is instrumental in this kind of change. The pursuit of tackling and controlling climate change has its unforeseen consequences, whereas in specific communities the existent inequalities are emphasised in new forms. If mechanisms developed for the environment, such as the market of carbon emissions and the carbon balance, lead to environmental injustice and disproportionately affects vulnerable groups, it raises the question of their purpose. On the path of Rawl’s idea on the fairness of social institutions, such system demonstrates itself as contradictory and unjust. (shrink)

Here we respond to Shaw et al., and show why the application of Conscientious Objection cannot be dismissed from cases of organ donation, where the donor is presumed to be dead.

Clinical ethics consultants should show bold moral courage in discharging their duties to patients, families, and healthcare providers. Given the corrosive impact on trust, and on the appropriate d...