Abstract:Therapeutic misconception (TM)—when clinical research participants fail to adequately grasp the difference between participating in a clinical trial and receiving ordinary clinical care—has long been recognized as a significant problem in consent to clinical trials. We suggest that TM does not primarily reflect inadequate disclosure or participants’ incompetence. Instead, TM arises from divergent primary cognitive frames. The researchers’ frame places the clinical trial in the context of scientific designs for assessing intervention efficacy. In contrast, most participants have a cognitive frame (...) that is personal and focused primarily on their medical problems. To illustrate this, we draw on interview material from both clinical researchers and participants in clinical trials. We suggest that reducing TM requires encouraging subjects to adjust their frame, not just add information to their existing frame. What is necessary is ascientific reframingof participation in a clinical trial. (shrink)

Focusing democratic theory on the pressing issue of punishment, Punishment, Participatory Democracy, and the Jury argues for participatory institutional designs as antidotes to the American penal state. Citizen action in institutions like the jury and restorative justice programs can foster the attunement, reflectiveness, and full-bodied communication needed as foundations for widespread civic responsibility for criminal justice.

: In a 2004 article, we argued that bioethics commissions should be assessed in terms of their usefulness as public forums. A 2006 article by Summer Johnson argued that our perspective was not supported by the existing literature on presidential commissions, which had not previously identified commissions as public forums and that we did not properly account for the political functions of commissions as instruments of presidential power. Johnson also argued that there was nothing sufficiently unique about bioethics commissions to (...) make the public forum perspective particularly applicable. We respond by arguing that analysis of commissions' work as public forums fits well within the literature on commissions, especially on their agenda-setting functions, and that the political functions of commissions are often compatible with their functioning as public forums. We also demonstrate how the origins and concerns of bioethics make public forum analysis particularly applicable to bioethics commissions. (shrink)

Philosophy and Kafka is a collection of original essays interrogating the relationship of literature and philosophy. The essays either discuss specific philosophical commentaries on Kafka’s work, consider the possible relevance of certain philosophical outlooks for examining Kafka’s writings, or examine Kafka’s writings in terms of a specific philosophical theme, such as communication and subjectivity, language and meaning, knowledge and truth, the human/animal divide, justice, and freedom.

This essay discusses the jury 's value in American democracy by examining Alexis de Tocqueville 's analysis of the jury as a free school for the public. His account of jury socialization, which stressed lay deference to judges and trust in professional knowledge, was one side of a complex set of ideas about trust and authority in American political thought. Tocqueville 's contemporary Francis Lieber held juries to have important competencies and to be ambivalent rather than deferential regarding court professionals. (...) The nineteenth-century courtroom exhibited such ambivalence and was marked by institutional conflict involving increasing professional authority demanded by the bench and populist counter-pressures. Assessing the value of the jury today may require some of the conceptual tools Tocqueville offers, but must also renew an appreciation of the jury as a site that utilizes already existing juridical capabilities of lay people and thus re-conceive the relationship between lay people and court professionals. (shrink)

In the Netherlands, the policy of supporting the efforts of ethnic-cultural minorities to express and preserve their cultural distinctiveness, is nowadays considered as problematic because it might interfere with their integration into the wider society. The primary aim is now to reduce these groups' unemployment rate and to stimulate their participation in the wider society. In this article I consider how the notion of the intrinsic value of cultures, if sensible, might affect the policy regarding ethnic-cultural minorities. I develop a (...) theory of intrinsic value of culture, as an analogy of the theory of intrinsic value of non-human natural entities. My conclusion is that the dominant cultural group in the Netherlands should preserve clearly deviant minority cultures which have considerable intrinsic value. (shrink)

Albert Dzur proposes an approach he calls "democratic professionalism" to build bridges between specialists in domains like law, medicine, and journalism and the lay public in such a way as to enable and enhance broader public engagement ...

The United States leads the world in incarceration, and the United Kingdom is persistently one of the European countries with the highest per capita rates of imprisonment. Yet despite its increasing visibility as a social issue, mass incarceration - and its inconsistency with core democratic ideals - rarely surfaces in contemporary Anglo-American political theory. Democratic Theory and Mass Incarceration seeks to overcome this puzzling disconnect by deepening the dialogue between democratic theory and punishment policy. This collection of original essays initiates (...) a multi-disciplinary discussion among philosophers, political theorists, and criminologists regarding ways in which contemporary democratic theory might begin to think beyond mass incarceration. Rather than viewing punishment as a natural reaction to crime and imprisonment as a sensible outgrowth of this reaction, the volume argues that crime and punishment are institutions that reveal unmet demands for public oversight and democratic influence. Chapters explore theoretical paths towards de-carceration and alternatives to prison, suggest ways in which democratic theory can strengthen recent reform movements, and offer creative alternatives to mass incarceration. Democratic Theory and Mass Incarceration offers guideposts for critical thinking about incarceration, examining ways to rebuild crime control institutions and create a healthier, more just society. (shrink)

This paper challenges the traditional assumption that descriptive and prescriptive sciences are essentially distinct by presenting a study on the implicit normativity of the production and presentation of biomedical scientific facts within evidence-based medicine. This interdisciplinary study serves as an illustration of the potential worth of the concept of implicit normativity for bioethics in general and for integrated empirical ethics research in particular. It demonstrates how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions (...) and values, which pre-structure the moral environment of the clinical process of decision-making. As a consequence, the evidence-based decision support did not only support the clinical decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy that information disclosure is a conditional requirement before patient autonomy even starts; patient autonomy is already influenced during the production and presentation of information. These results imply an increased responsibility of those who produce and present evidence-based facts(i.e. scientists in general and physicians in particular). The insights of this study not only involve a different focus on both theory and practice of patient autonomy and informed consent, but they also call for a broader scope of morality than does traditional empirical research in bioethics. The concept of implicit normativity within integrated empirical ethics research calls for a strong cooperation between bioethicists and descriptive scientists, i.e., a cooperation that goes beyond the discipline-specific epistemic values and that takes place during all phases of the research process. (shrink)

This topically organized, interdisciplinary anthology provides competing perspective on the claim that western culture faces a moral crisis. Using clearly written, accessible essays by well-known authors in philosophy, the social sciences, and the humanities, the book introduces students to a variety of perspectives on the current cultural debate about values that percolates beneath the surface of most of our social and political controversies.

A response to Roberto Gargarella’s review of Punishment, Participatory Democracy, and the Jury, by Albert W. Dzur.

Albert Musschenga | : The central question of this article is, Are animals morally responsible for what they do? Answering this question requires a careful, step-by-step argument. In sections 1 and 2, I explain what morality is, and that having a morality means following moral rules or norms. In sections 3 and 4, I argue that some animals show not just regularities in their social behaviour, but can be rightly said to follow social norms. But are the norms they follow (...) also moral norms? In section 5, I contend, referring to the work of Shaun Nichols, that the basic moral competences or capacities are already present in nonhuman primates. Following moral rules or norms is more than just acting in accordance to these norms; it requires being motivated by moral rules. I explain, in section 6, referring to Mark Rowlands, that being capable of moral motivation does not require agency; being a moral subject is sufficient. Contrary to moral agents, moral subjects are not responsible for their behaviour. Stating that there are important similarities between animal moral behaviour and human, unconscious, automatic, habitual behaviour, I examine in section 7 whether humans are responsible for their habitual moral behaviour, and if they are, what then the grounds are for denying that moral animals are responsible for their behaviour. The answer is that humans are responsible for their habitual behaviour if they have the capacity for deliberate intervention. Although animals are capable of intervention in their habitual behaviour, they are not capable of deliberate intervention. | : La question centrale dans cet article est celle de savoir si les animaux sont moralement responsables de ce qu’ils font. Répondre à cette question nécessite une argumentation minutieuse et progressive. Dans les sections 1 et 2, j’explique ce qu’est la moralité, et qu’être doté de moralité signifie de se conformer à des règles ou à des normes morales. Dans les sections 3 et 4, je pose que certains animaux ne se contentent pas de montrer des régularités dans leur comportement social, mais qu’ils suivent aussi véritablement des normes sociales. Toutefois, les normes qu’ils suivent sont-elles morales? Dans la section 5, je prétends, en me référant aux travaux de Shaun Nichols, que les compétences ou capacités morales de base sont déjà présentes chez les primates non humains. Respecter des règles ou des normes morales est bien plus que d’agir conformément à ces normes; cela requiert d’être motivé par des règles morales. Dans la section 6, me référant à Mark Rowlands, j’explique que d’être capable de motivation morale ne nécessite pas d’être un agent moral; le fait d’être un sujet moral suffit. Contrairement aux agents moraux, les sujets moraux ne sont pas responsables de leur comportement. Affirmant qu’il y a de grandes similitudes entre le comportement moral d’un animal et le comportement inconscient, automatique et habituel d’un humain, je me penche, dans la section 7, sur la question de savoir si les humains sont responsables de leur comportement moral habituel, et si tel est le cas, sur quelle base on peut alors nier le fait que les animaux sont eux aussi responsables de leur comportement. La réponse à cette question est que les humains sont responsables de leur comportement habituel s’ils disposent d’une capacité d’intervention réfléchie, délibérée. Bien que les animaux soient capables d’intervenir dans leurs comportements habituels, ils ne peuvent le faire de manière réfléchie, délibérée. (shrink)

In this article I examine the consequences of the dominance of intuitive thinking in moral judging and deciding for the role of moral reasoning in moral education. I argue that evidence for the reliability of moral intuitions is lacking. We cannot determine when we can trust our intuitive moral judgements. Deliberate and critical reasoning is needed, but it cannot replace intuitive thinking. Following Robin Hogarth, I argue that intuitive judgements can be improved. The expertise model for moral development, proposed by (...) Hubert and Stuart Dreyfus, not only teaches us how we acquire intuitive moral judgements, it also shows the interconnectedness of intuitive thinking and deliberate reasoning. Analysing the expertise model in more detail, I show that it cannot do justice to the importance of reasoning skills. Reasoning skills are needed because we expect people to be able to argue for their standpoints. I conclude that moral education should not only aim at improving intuitive moral judgements, but also at acquiring reasoning skills. (shrink)

This paper focuses on coherence and consistency as elements of moral integrity, arguing that several kinds of—mostly second-order—virtues contribute to establishing coherence and consistency in a person's judgements and behaviour. The virtues relevant for integrity always accompany other, substantive virtues, and their associated values, principles and rules. In moral education we teach children all kinds of substantive virtues with integrity as our goal. Nevertheless, many adults do not attain moral integrity, although they are clearly not immoral. What precisely are they (...) lacking? Education for moral integrity should focus on strengthening motivational self-sufficiency, furthering critical and imaginative thinking and promoting moral unity. (shrink)

There is an ongoing debate in animalethics on the meaning and scope of animalwelfare. In certain broader views, leading anatural life through the development of naturalcapabilities is also headed under the conceptof animal welfare. I argue that a concern forthe development of natural capabilities of ananimal such as expressed when living freelyshould be distinguished from the preservationof the naturalness of its behavior andappearance. However, it is not always clearwhere a plea for natural living changes overinto a plea for the preservation (...) of theirnaturalness or wildness. In the first part ofthis article, I examine to what extent theconcerns for natural living meet ``theexperience requirement.'' I conclude that someof these concerns go beyond welfare. In thesecond part of the article. I ask whether wehave moral reasons to respect concernsfor the naturalness of an animal's living thattranscend its welfare. I argue that the moralrelevance of such considerations can be graspedwhen we see animals as entities bearingnon-moral intrinsic values. In my view the``natural'' appearance and behavior of an animalmay embody intrinsic values. Caring for ananimal's naturalness should then be understoodas caring for such intrinsic values. Intrinsicvalues provide moral reasons for action iffthey are seen as constitutive of the good lifefor humans. I conclude by reinterpreting,within the framework of a perfectionist ethicaltheory, the notion of indirect dutiesregarding animals, which go beyond andsupplement the direct duties towardsanimals. (shrink)

This book focuses on terrorism which is usually described as violence or the perception or threat of imminent violence. Terrorism has been used by a broad array of political organisations in furthering their objectives; both right-wing and left-wing political parties, nationalistic, and religious groups, revolutionaries and ruling governments. Those labelled 'terrorists' rarely identify themselves as such, and typically use other generic terms or terms specific to their situation, such as: separatist, freedom fighter, liberator, revolutionary, vigilante, militant, paramilitary, guerrilla, rebel, jihadi (...) or mujaheddin, or fedayeen, or any similar-meaning word in other languages. Sadly is has become a global profession which has come to colour all aspects of life from travel, to office locations to pervasive fear. (shrink)

: As the fifth national bioethics commission has concluded its work and a sixth is currently underway, it is time to step back and consider appropriate measures of success. This paper argues that standard measures of commissions' influence fail to fully assess their role as public forums. From the perspective of democratic theory, a critical dimension of this role is public engagement: the ability of a commission to address the concerns of the general public, to learn how average citizens resolve (...) moral issues in healthcare, and to monitor public opinion on the topics addressed in the commission. Such a public forum role is supported by the critical literature within bioethics, which has deemed some commissions successful, supported more generally by the history of bioethics as a reform discourse that has brought socially important values into the medical domain, and supported more generally still by the example of the great social issues commissions of the 1960s. (shrink)

Environmental ethicists will often say that in dealing with natural entities we need the guidance of an ethic rooted in 'the intrinsic value of nature'. They will add that subjectivist value theories are unable to account for the normativity of intrinsic value discourse. This preoccupation with normativity explains why many environmental ethicists favour value objectivism. As I see it, value theories must address not only the problem of normativity but also the problem of motivation. In fact, my approach to the (...) question as to which type of value theory does most justice to our intuition regarding the value of nature is primarily in terms of the motivational perspective. I argue that neither the usual objectivist theories nor their subjectivist counterparts can accommodate and explain the fact that those who agree that nature has intrinsic value may well differ in motivation to support its preservation. I suggest that such difference in kinds of motivation is related to distinct kinds of value judgement in which belief in the intrinsic value of nature is expressed. To clarify my view I discuss the subjectivist value theory of Gerald Gaus [1]. Gaus regards the distinction between personal and impersonal value judgements to be deeply embedded in his theory. His internalism about the relation between reason and motivation however, leads him to the mistaken conclusion that independent impersonal value judgements do not provide reasons for action. Next, I introduce the distinction between identity-neutral and identity-constitutive reasons. This distinction allows me to formulate more clearly the differences between the kinds of reasons provided by personal and impersonal value judgements. The resulting theory explains how it is that people who do not (personally) value nature may still be motivated to support nature preservation. It also explains why not everyone who endorses natural values will join movements for the preservation of nature. (shrink)

In this article, I discuss whether intuitive moral judgements have epistemic value. Are they mere expressions of irrational feelings that should be disregarded or should they be taken seriously? In section 2, I discuss the view of some social psychologists that moral intuitions are, like other social intuitions, under certain conditions more reliable than conscious deliberative judgements. In sections 3 and 4, I examine whether intuitive moral judgements can be said not to need inferential justification. I outline a concept of (...) moral intuition as a seeming whose seemingness resides in special, phenomenological features such as a felt veridicality, appropriateness, familiarity, or confidence, and whose justificatory force is influenced by the reliability of the belief-producing procedures and by a subject's competence in applying moral concepts. I argue that subjects can come to realise that the beliefs expressed in their intuitive judgements evoke a sense of non-inferential credibility. In section 5, I first discuss the contribution of moral expertise to the non-inferential credibility of a person's intuitions. Subsequently, I discuss whether Walter Sinnott-Armstrong is right in saying that we can never claim non-inferential justification for our intuitions because they are subject to all kinds of distorting influences. (shrink)

Criticism may degenerate into quibbling or nitpicking. How can discussants keep quibblers under control? In the paper we investigate cases in which a battle about words replaces a discussion of the matters that are actually at issue as well as cases in which a battle about minor objections replaces a discussion of the major issues. We survey some lines of discussion dealing with these situations in profiles of dialogue.

According to some proponents of an empirical medical ethics, medical ethics should take the experience, insights, and arguments of doctors and other medical practitioners as their point of departure. Medical practitioners are supposed to have ‘moral wisdom.’ In this view, the moral beliefs of medical practitioners have a special status. In sections I-IV, I discuss two possible defences of such a status. The first defence is based on the special status of the moral beliefs of the health professional as an (...) expert in medical ethics, and the second defence on the special status of the health professional’s moral beliefs as a practitioner. The first defence is built up around the opposition between experts and laypersons, while the second defence rests on the opposition between practitioners and theorists. In sections V and VI, I examine the interrelations between empirical ethics and anti-theory in ethics. Some regard empirical ethics as a laudable alternative to theory-driven normative ethics. I explore their objections against ethical theory and ethical theorising, and conclude that they are not valid. In the last section, VII, I discuss the role of ethicists in medical practice. (shrink)