This article argues that, given the current pervasive uncertainty about the reliability of jury deliberation, we ought to treat it with epistemic humility. I further argue that epistemic humility should be expressed and enforced by turning jury deliberation from a mandatory rule of the jury trial to a waivable right of the defendant. I consider two main objections to my argument: the first one concerns the putative self-defeatingness of humility attitudes; the second objection points to the burdensomeness of granting an (...) unconditional jury deliberation waiver to the defendant. (shrink)

Hedonism claims that all and only pleasure is intrinsically good. One worry about Hedonism focuses on the “only” part: Are there not things other than pleasure, such as personal projects and relationships, that are intrinsically good? If so, it can be objected that Hedonism is incomplete. In this paper, I defend Hedonism against this objection by arguing for a distinction between goodness and desirability that understands “desirability” as a deontic concept, in terms of “reason to desire”, but goodness as an (...) evaluative concept. Based on this distinction, I attempt to show that Hedonists should accept that things other than pleasure, such as personal projects and relationships, are desirable for their own sakes but deny that these things are intrinsically good. (shrink)

The medical ethicist is a fairly recent addition to the clinical setting. The following four potential roles of the clinical ethicist are identified and discussed: consultant in difficult cases, educator of health care providers, counselor for health care providers and finally patient advocate to protect the interests of patients. While the various roles may sometimes overlap, the roles of educator and counselor are viewed as being more congruent with the education and training of medical ethicists than are the roles of (...) consultant and patient advocate. (shrink)

This reissued work, originally published in 1985, is a uniquely broad and original survey of theories and beliefs about the growth, behaviour, performance and reform of the governments of modern Western democracies. After analysing the external pressures which have shaped modern governments, the author examines four different schools of political thought which seek to explain the behaviour and performance of governments, and which offer different remedies for the pluralism, corporatism and bureaucracy. To examine and test these general theories, the author (...) looks closely at how governments actually work. The book is illustrated with examples drawn from various Western societies. The final chapters present the author’s own conclusion about the future role of government, the limits of market philosophy, the future of politics, and the principles and problems of institutional reform. (shrink)

Hate speech is one of the most important conceptual categories in anti‐oppression politics today; a great deal of energy and political will is devoted to identifying, characterizing, contesting, and penalizing hate speech. However, despite the increasing inclusion of gender identity as a socially salient trait, antipatriarchal politics has largely been absent within this body of scholarship. Figuring out how to properly situate patriarchy‐enforcing speech within the category of hate speech is therefore an important politico‐philosophical project. My aim in this article (...) is twofold: first, I argue that sexist speech, though oppressive, is not hate speech. Second, I argue that misogynistic speech is hate speech, even when it is intradivisional. This is important because recognizing that the concepthate speechapplies to certain forms of patriarchy‐enforcing speech is another step in clarifying what is wrong with the practice, and how bad it is in relation to other abuses. Consequently, this article provides a more nuanced account of the kinds of expressions that can and should count as instances of hate speech. (shrink)

The Norman Rockwell image of the American physician who fixed the broken arm of a child, treated the father for hypertension, and brought an unborn child into this world is now almost nonexistent. Since the time of the Rockwell portrait, a highly technical medical industry has evolved. Now two-thirds of physicians are board certified in subspecialties, and patients visit an average of 3–4 different physicians per year. Today's physicians see themselves less as “benevolent and wise counselors overseeing the patient's welfare (...) and more as objective scientists applying the latest technical methods to bring about the desired end.” The intimate patient-physician relationship that was once the norm in our society is rapidly disappearing. (shrink)

The authors address problems with “compulsory” arbitration clauses in contracts. Specifically, they note that consumers are misguided about their rights in such cases. In addition, arbitration clauses do not allow the press to cover any proceedings that may result. The arbitration clauses in contracts are written in legalese that consumers do not understand. The authors found that even university students had difficulty understanding the information in such clauses. An example of an actual case is included.

Increasing use is made of techniques which are supposed to make policy decisions more ‘rational’. Rather little attention, however, has been paid to the relation between these techniques and the logic of choice, the political process, value judgements and assumptions. This short paper will investigate these questions in relation to a particularly fashionable technique, that of cost-benefit analysis.

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that value (...) judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

The enormous growth in medical humanities programs during the past decade has resulted in an extensive literature concerning the content of the discipline and the issues that have been addressed. Comparatively little attention, however, has been devoted to the structure of the discipline of medical humanities concerning the process or the theoretical aspects of the pedagogy of teaching the discipline. This report explicitly addresses the pedagogical aspects of the discipline by comparing and contrasting two different basic approaches to the discipline (...) referred to as the classical humanities approach and the humanistic psychology approach which roughly approximate the cognitive and affective approaches respectively. These two approaches are compared and contrasted in terms of their goals, objectives, methods of implementation, philosophical assumptions and evaluational techniques. (shrink)

After noting why the issue of the use of animals in medical education and research needs to be addressed, this article briefly reviews the historical positions on the role of animals in society and describes in more detail the current positions in the wide spectrum of positions regarding the role of animals in society. The spectrum ranges from the extremes of the animal exploitation position to the animal liberation position with several more moderate positions in between these two extremes. Then (...) the philosophical issue of the moral agency of animals is discussed in terms of an explication of the concept of rights and the concept of personhood. Further research is suggested concerning institutional policies regarding medical students who refuse to do physiology dog labs or other assignments which involve the suffering and/or death of animals. (shrink)

On May 11th a round table discussion was held on the subject "The Interactions of Science and Art under the Conditions of the Revolution in Science and Technology ," organized by the editorial boards of the journals Voprosy filosofii and Voprosy literatury.

In recent years, the theoretical work of Gilligan in women's psychological development has led to the development of the concept of moral orientation or moral voice in contrast to the concept of moral reasoning or moral judgment developed by Kohlberg. These concepts have been of particular interest in gender studies, especially as applied to adolescence. These concepts of moral orientation and moral reasoning are being increasingly employed in healthcare ethics studies in a wide variety of settings. The recent work has (...) included studies of physicians, nurses, dentists, veterinarians, social workers, teachers of medical ethics, and hospital ethics committees. However, the study of moral development in healthcare providers has been hampered because collecting the necessary data from healthcare workers has been labor intensive and extremely time consuming. More efficient methods are needed. (shrink)

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

This study investigates the three major educational philosophies behind the medical humanities programs in the United States. It summarizes the characteristics of the Cultural Transmission Approach, the Affective Developmental Approach, and the Cognitive Developmental Approach. A questionnaire was sent to 415 teachers of medical humanities asking for their perceptions of the amount of time and effort devoted by their programs to these three philosophical approaches. The 234 responses constituted a 54.6% return. The approximately 80:20 gender ratio of males to females (...) and other demographic data on age and educational background were consistent with other studies of the field of medical humanities.Reflections on the results in Table II indicate that some changes need to take place in the teaching of the medical humanities if the perceived ideal is to be achieved. In order for the current teachers of the medical humanities to think that the appropriate philosophies behind the teaching of the medical humanities are being implemented as they should be, much less time and effort need to be devoted to the Cultural Transmission Approach. With no other published reports on the educational philosophies behind the medical humanities programs, this study created a new knowledge base about this relatively young and rapidly emerging field. (shrink)

A study of physicians and medical students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in medicine and their epistemological presuppositions in relationship to the subjective-objective controversy in value theory. The study revealed that most physicians and medical students tend to be objectivists in value theory, i.e., believe that value judgements are knowledge claims capable of being true or false and are expressions of moral requirements and normative imperatives emanating from an external value (...) structure or moral order in the world, but that most physicians and medical students are inconsistent in the philosophical foundations of their medical ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. The study also revealed that most physicians and medical students think more emphasis should be placed upon medical ethics in medical education. (shrink)

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while (...) nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists. (shrink)

High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

The prominent call to legalise same-sex marriage in Australia raises questions concerning whether its achievement will result in amplified societal acceptance of lesbian, gay, bisexual, and transgender (LGBT) people, and on what grounds this acceptance will take place. Same-sex marriage may not challenge heteronormative and patriarchal features typically associated with marriage, and may serve to reinforce a hierarchy that promotes traditional marriage as the ideal relationship structure. This may result in only assimilationist acceptance of LGBT people. However, the consequence of (...) inclusion to marriage ought to reflect social acceptance of LGBTs as people worthy of equal treatment in dignity and in rights, regardless of perceived differences or similarities to a supposed majority standard. This article argues that justice would be best served by introducing and promoting a variety of State-sanctioned unions whilst simultaneously introducing same-sex marriage. This ‘pluralisation strategy’ would increase awareness and legitimacy of other relationship-recognition options, promoting respectful acceptance of LGBT and heterosexual people alike. (shrink)

Following a brief consideration of two contrasting purposes for teaching the medical humanities, a description is given of a film discussion elective course. In contrast to the usual teaching of medical ethics which is primarily a cognitive activity emphasizing the development of a code of principles such as justice, autonomy, and beneficence, the film discussion elective was primarily an affective activity emphasizing the development of an ethical ideal of caring, relatedness, and sensitivity to others. The pass/fail elective, offered for one (...) credit each quarter for two quarters, met once a week for one hour for twenty-four weeks. Each week a film was shown followed by a group discussion. A wide variety of social issues were covered. The objective of the course was to increase the ethical sensitivity of the medical students through promotion of introspection and reflection on social issues. A brief discussion is given of the importance and appropriateness of using film to promote the affective focus of medicine on the relief of suffering. Examples are given of how the course achieved its objective. A detailed description of the resource materials is provided. (shrink)

The most important distinction in value theory is the subjective-objective distinction which determines the epistemological status of value judgments about medical intervention. Ethical decisions in medical intervention presuppose one of three structures of justification — namely, an inductive approach, a deductive approach which can be either consequentialist or non-consequentialist, and a uniquely ethical approach. Inductivism and deductivism have been discussed extensively in the literature and are only briefly described here. The uniquely ethical approach which presupposes value objectivism is analyzed in (...) detail. This method involves a purely ethical inference which moves from facts to values directly with an emphasis on reason which involves a non-logical justification (as opposed to illogical). It involves the use of natural practical arguments which have an imperative conclusion but no imperative premise and exhibit a value-requiredness between two states of affairs. (shrink)

Abstract:Self-ownership has fallen out of favor as a core moral and political concept. I argue that this is because the most popular conception of self-ownership, what I call the property conception, is typically linked to a libertarian (of the left or right) political program. Seeing self-ownership and libertarianism as being necessarily linked leads those who are not inclined toward libertarianism to reject the idea of self-ownership altogether. This, I argue, is a mistake. Self-ownership is a crucial moral and political concept (...) that can earn its keep if we understand it not as type of property right in the self, but rather as a set of territorial rights one has over one’s body. This territorial conception of self-ownership, which I call the sovereignty conception of self-ownership, avoids the traditional arguments raised against the property conception of self-ownership and has other benefits besides. Accepting this conception of self-ownership, I argue, has considerable moral and political benefits without taking on the costs associated with other forms of self-ownership. (shrink)

In this article I analyse two complaints of white vilification, which are increasingly occurring in Australia. I argue that, though the complainants (and white people generally) are not harmed by such racialized speech, the complainants in fact harm Australians of colour through these utterances. These complaints can both cause and constitute at least two forms of epistemic injustice (willful hermeneutical ignorance and comparative credibility excess). Further, I argue that the complaints are grounded in a dual misrecognition: the complainants misrecognize themselves (...) in their own privileged racial specificity, and they misrecognize others in their own marginal racial specificity. Such misrecognition preserves the cultural imperialism of Australia’s dominant social imaginary—a means of oppression that perpetuates epistemic insensitivity.Bringing this dual misrecognition to light best captures the indignity that is suffered by the victims of the aforementioned epistemic injustices. I argue that it is only when we truly recognize difference in its own terms, shifting the dominant social imaginary, that “mainstream Australians”can do their part in bringing about a just society. (shrink)

Only recently have ethicists been invited into the clinical setting to offer recommendations about patient care decisions. This paper discusses this new role for ethicists from the perspective of content and process issues. Among content issues are the usual ethical dilemmas such as the aggressiveness of treatment, questions about consent, and alternative treatment options. Among process issues are those that relate to communication with the patient. The formal ethics consult is discussed, the steps taken in such a consult, and whether (...) there should be a fee charged. We conclude with an examination of the risks and benefits of formal ethics consults. (shrink)

Socialism grew up in opposition to capitalism, just as liberalism developed in reaction to feudalism. Both liberalism and socialism combined potent critiques of the existing socio‐economic order with blueprints for a desirable future society. However, liberalism provides a rather more coherent body of thought than does socialism, and its theories are linked with the emergence of a dominant system combining capitalism and liberal democracy. By contrast, no widespread socio‐economic order has as yet emerged which can be confidently or closely associated (...) with the ideas of socialism. In both cases the relationship between theories and actual systems is a contestable one, but it has been particularly problematic in the history of socialism. (shrink)

Some normative theories are self-defeating. They tell us to respond to our situations in ways that bring about outcomes that are bad, given the aims of the theories, and which could have been avoided. Across a wide range of debates in ethics, decision theory, political philosophy, and formal epistemology, many philosophers treat the fact that a normative theory is self-defeating as sufficient grounds for rejecting it. I argue that this widespread and consequential assumption is false. In particular, I argue that (...) a theory can be self-defeating and still internally consistent, action-guiding, and suitable as a standard for criticism. (shrink)

The growth of autistic self-advocacy and the neurodiversity movement has brought about new ethical, theoretical and ideological debates within autism theory, research and practice. These debates have had genuine impact within some areas of autism research but their influence is less evident within early intervention research. In this paper, we argue that all autism intervention stakeholders need to understand and actively engage with the views of autistic people and with neurodiversity as a concept and movement. In so doing, intervention researchers (...) and practitioners are required to move away from a normative agenda and pay diligence to environmental goodness-of-fit, autistic developmental trajectories, internal drivers and experiences, and autistic prioritized intervention targets. Autism intervention researchers must respond to these debates by reframing effectiveness, developing tools to measure autistic prioritized outcomes, and forming partnerships with autistic people. There is a pressing need for increased reflection and articulation around how intervention practices align with a neurodiversity framework and greater emphasis within intervention programmes on natural developmental processes, coping strategies, autonomy, and well-being. (shrink)