Wexler and Sullivan (2023) recommend integration as a guiding principle for translational neuroethics. We agree that collaboration between neuroethicists and other professionals can advance the fie...

Volume 19, Issue 11, November 2019, Page 42-44.

Shared decision-making is a well-recognized model to guide decision-making in medical care. However, the shared decision-making concept can become exceedingly complex in adolescent patients with varying degrees of autonomy who have most of their medical decisions made by their parents or legal guardians. The complexity increases further in ethically difficult situations such as terminal illness. In contrast to the typical patient-physician dyad, shared decision-making in adolescents requires a decision-making triad that also includes the parents or guardians. The multifactorial nature of (...) these cases can overwhelm treatment teams, with minimal guidance on how to best approach the patient–parents–physician dynamic in an ethically appropriate manner. Estimated time left to live is the paramount ethical consideration for such cases with respect to shared decision-making. This paper offers a sliding scale to serve as a grounding reference for clinicians who care for terminally ill adolescents and hospital ethics committee members for initiating and guiding the ethical discussion for these patients. This paper also elucidates several other ethically salient features inherent to many of these cases, including quality of life, treatability of disease, cultural influences, among others. Yet how each of these variables is weighed is dependent upon the specific circumstances of each individual case. Ultimately, shared decision-making in adolescent patients with terminal illnesses must be a collaborative and ongoing process that thoughtfully weighs the values and ethical responsibilities of the patient, parents, and physician to ideally reconcile differences and come to a consensus on the best management option for each individual patient. (shrink)

Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical (...) cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward. (shrink)

Miller synthesizes Karen Horney's model of submission, aggression and withdrawal, Jean Baker Miller's concept of relational being, Julia Kristeva's idea of psychic space, and Kelly Oliver's notions on social support to advance a penetrating analysis of the fiction of Paule Constant.

Modes-of-being figure centrally in Heidegger's masterwork Being and Time. Testimony to this is Heidegger's characterisation of two of his most celebrated enquiries—the Existential analytic and the Zeug analysis—as investigations into the respective modes-of-being of the entities concerned. Yet despite the importance of this concept, commentators disagree widely about what a mode-of-being is. In this paper, I systematically outline and defend a novel and exegetically grounded interpretation of this concept. Strongly opposed to Kantian readings, such as those advocated by Taylor Carman (...) and Cristina Lafont, I interpret a mode-of-being as a universal that defines a district —that is, a natural class of entities that ought to be conceptualised in a special way. As such, every mode-of-being plays an important metaphysical and epistemic role: serving both to unify a natural class of a high degree of generality and as the interpretandum of an act yielding the basic-concepts pertaining to the entities therein. In explicating and arguing for this interpretation, I attribute a characteristically Aristotelian philosophical position to the early Heidegger, encompassing both metaphysical and epistemological realism and a conceptualist theory of universals. (shrink)

This article surveys recent developments in the epistemology of modality.

It is widely assumed that sense perception cannot deliver knowledge of nonactual (metaphysical) possibilities. We are not supposed to be able to know that a proposition p is necessary or that p is possible (if p is false) by sense perception. This paper aims to establish that the role of sense perception is not so limited. It argues that we can know lots of modal facts by perception. While the most straightforward examples concern possibility and contingency, others concern necessity and (...) impossibility. The possibility of a perceptual route to some modal knowledge is not as radical as it may at first sound. On the contrary, acknowledging it has benefits. (shrink)

Whitehead’s metaphysics provides resources for understanding a world in value-realist terms. Central to this value realism is an aesthetic conception of rationality that sees a hope implicit in our practices—the hope that our linguistic tools are suited to the task of getting things right in our fields of inquiry. This pragmatic hope entails an understanding of individual freedom and responsibility to participate in a patient restructuring of the world toward the highest retention of value. It also enables an understanding of (...) individual freedom as obstructive to this restructuring. One task of this article is to show that attunement in theory to the hope implicit in practice can ameliorate this obstructiveness. A subsequent task is to show that, insofar as this preliminary hope is not a metaphysical premise, but a regulative ideal seeking satisfaction, it can serve as a warrant for an implicit theology in linguistic pragmatism. In this way, I argue that we can come to see pragmatism as a method lending itself to a philosophical theology of the Whiteheadian variety. We can do this precisely insofar as rationalism is seen as predicated on an aesthetic ideal of harmony—a harmony between what is and what ought to be our matters of concern. We can come to see the structure of rationality in terms of an aestheticism corrective of analytic conceptions of meaning and truth. (shrink)

Displays of eye movements may convey information about cognitive processes but require interpretation. We investigated whether participants were able to interpret displays of their own or others' eye movements. In Experiments 1 and 2, participants observed an image under three different viewing instructions. Then they were shown static or dynamic gaze displays and had to judge whether it was their own or someone else's eye movements and what instruction was reflected. Participants were capable of recognizing the instruction reflected in their (...) own and someone else's gaze display. Instruction recognition was better for dynamic displays, and only this condition yielded above chance performance in recognizing the display as one's own or another person's. Experiment 3 revealed that order information in the gaze displays facilitated instruction recognition when transitions between fixated regions distinguish one viewing instruction from another. Implications of these findings are discussed. (shrink)

In biomedicine, practitioners often treat risk of disease as an illness in itself—suitable for monitoring and intervention. In some cases, increased diagnostics improve health outcomes by detecting problems early. Recently, however, science and technology studies scholars and medical practitioners have noted that the treatment of risk can also lead to unnecessary intervention and possible harm. Despite these findings, it is often hard to see changes in practice. Childbirth serves as an illuminating case because two models of health risk operate simultaneously—in (...) addition to the model valuing frequent intervention, there is another that seeks to mitigate risk by refusing medical surveillance. Based on interviews with birth providers and an analysis of professional documents, this article uses the case of fetal heart rate monitoring in American childbirth to demonstrate how some health providers are framing “intentional non-knowing” as a moral imperative to reduce medical risk. Studying the success and limitations of this “risk counterculture” illuminates how risk societies are changing in response to data suggesting that more information can have hurtful effects. This case integrates well-developed theories of knowledge production with less-developed theories of knowledge nonproduction, leading to a more fruitful discussion of the boundaries of responsible knowledge in risk management. (shrink)

The epistemology of modality has focused on metaphysical modality and, more recently, counterfactual conditionals. Knowledge of kinds of modality that are not metaphysical has so far gone largely unexplored. Yet other theoretically interesting kinds of modality, such as nomic, practical, and ‘easy’ possibility, are no less puzzling epistemologically. Could Clinton easily have won the 2016 presidential election—was it an easy possibility? Given that she didn’t in fact win the election, how, if at all, can we know whether she easily could (...) have? This paper investigates the epistemology of the broad category of ‘objective’ modality, of which metaphysical modality is a special, limiting case. It argues that the same cognitive mechanisms that are capable of producing knowledge of metaphysical modality are also capable of producing knowledge of all other objective modalities. This conclusion can be used to explain the roles of counterfactual reasoning and the imagination in the epistemology of objective modality. (shrink)

Challenges to the exercise of the basic socio-economic rights of half the global population give rise to some of the most pressing issues today. This timely book focuses on world poverty, providing a systematic exposition of the evolving legal responsibility of the international community of states to cooperate in addressing the structural obstacles that contribute to this injustice. This book analyzes the approach, contribution, and current limitations of the international law of human rights to the manifestations of world poverty, inviting (...) the reader to rethink human rights, and, in particular, the framing of responsibilities that are essential to their contemporary protection. (shrink)

This paper examines "moderate modal skepticism", a form of skepticism about metaphysical modality defended by Peter van Inwagen in order to blunt the force of certain modal arguments in the philosophy of religion. Van Inwagen’s argument for moderate modal skepticism assumes Yablo's (1993) influential world-based epistemology of possibility. We raise two problems for this epistemology of possibility, which undermine van Inwagen's argument. We then consider how one might motivate moderate modal skepticism by relying on a different epistemology of possibility, which (...) does not face these problems: Williamson’s (2007: ch. 5) counterfactual-based epistemology. Two ways of motivating moderate modal skepticism within that framework are found unpromising. Nevertheless, we also find a way of vindicating an epistemological thesis that, while weaker than moderate modal skepticism, is strong enough to support the methodological moral van Inwagen wishes to draw. (shrink)

For healing the land and human relationships to land are a step toward healing a troubled relationship, borne of a history, which is painful for native people and shameful for settlers. Protection...

The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and ‘anticipatory triage’ likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public’s moral intuitions. Our study aimed to explore general public views in the UK on (...) the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public. Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected ‘fair innings’ and ‘life projects’ principles as justifications for age-based allocation. They were also wary of the ‘maximise life-years’ principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This ‘triad’ of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. (shrink)

Ethical medical care of pregnant women in Australia should include the real provision of information regarding the risks and benefits of vaginal birth. Routinely obtaining consent for the different ways in which childbirth is commonly intervened on and the assistance involved (such as midwife-led care or a planned caesarean section) and providing sufficient information for women to evaluate the harms and benefits of the care on offer, would not only enable the empowerment of women but would align with the current (...) standard of care as established by Rogers v Whittaker. (shrink)

Developing a simple test to identify swiftly neonates with sepsis who carry the genetic variant which means that one dose of the recommended antibiotic, gentamicin, will cause the child to become profoundly deaf looks like an admirable objective. The baby needs antibiotics and needs them within 1 hour of admission to the neonatal intensive care unit. Conventional genetic tests take much longer to yield results. The test being trialled produces results in 25 min; a baby who carries the variant can (...) be treated with a different antibiotic. All the test requires is a gentle swab of the baby’s inner cheek. Babies can be treated for potentially fatal sepsis without the risk that the drugs designed to save their lives will cost them their hearing. Parents and healthcare staff are relieved of worry—a great idea? PALOH is not a trial of the safety or efficacy of the test, only to assess how feasible it will be to carry out this test in a busy NICU, without disrupting the care of the baby. A tiny painless ‘scrape’ will take a sample of DNA—what’s the fuss about? Several other invasive and painful procedures will be carried out without a fuss.1 The problem is DNA. Genetic information must be safeguarded from falling into the wrong hands. In section 45 of Human Tissue Act 2004, Parliament legislated to prohibit non-consensual DNA testing.1 It fits uncomfortably in a statute designed to regulate retention and uses of human material, after revelations that organs and tissue from the …. (shrink)

While best known for the immensely popular and controversial novel Uncle Tom's Cabin, Harriet Beecher Stowe is also the author of an extensive body of additional work on American culture and politics. Playing many roles--journalist, pamphleteer, novelist, preacher, and advisor on domestic affairs--Stowe used the written word as a vehicle for religious, social, and political commentaries, often leavening them with entertainment in order to reach a broad audience. She had a profound effect on American culture, not because her ideas were (...) unique, but because they were common. What made her so radical was that she insisted on putting her ideas into action. The Oxford Harriet Beecher Stowe Reader offers a focused collection of Stowe's writings from the 1830s through the 1860s. Illustrating her broad range, rhetorical strategies, and cultural designs on the world, it is ideal for courses in nineteenth-century American literature, women's literature, and American history. The volume collects those selections best suited for classroom use, reprinting many pieces here for the first time. Editor Joan D. Hedrick provides a substantial introduction that assesses Stowe's vital impact on nineteenth-century American literature, politics, and culture. The readings are divided into three sections: Early Sketches, Antislavery Writings, and Domestic Culture and Politics. Early Sketches presents the finest writing of Stowe's literary apprenticeship. Antislavery Writings includes Uncle Tom's Cabin in its entirety, placing it in the context of Stowe's considerable and often-overlooked body of other antislavery writings. This section also includes a generous selection from A Key To Uncle Tom's Cabin, a companion volume to the novel. Domestic Culture and Politics shows the scope of Stowe's thinking on the Victorian home, for which she was a major propagandist. The inclusion here of "The True Story of Lady Byron's Life," an exposé of male debauchery and incest at the core of a nineteenth-century home, represents Stowe's willingness to tackle the most challenging political and social issues of her time. (shrink)

Editor's suggested further reading in BioEssaysA new paradigm in cell therapy for diabetes: Turning pancreatic α‐cells into β‐cells Abstract.

If reification is the projection of a false, thing-like appearance onto society, what is de-reifying critique supposed to reveal? After distinguishing between versions of reification based on a social ontology of will from those that think of the social as a normatively constituted domain, I argue that Lukács’ work on reification fudges this distinction through his account of class. I then turn to the debate between Schmitt and Kelsen, where the will-versus-norm issue is central. I argue that the consonance between (...) ideas about reification and will-based theories like Schmitt’s is superfcial, as the latter relies on identifcation with authority for its account of normativity, making Kelsen’s ideas about normativity stemming from an orientation toward intersubjective process more convivial. I note, however, that norm-based accounts are less amenable to radical change than will-based ones, making the link between dereification and radical politics less direct than is often thought. (shrink)

Hannah Arendt brings the traditionally ontological practice of phenomenology into social and political philosophy. She does this in two ways: by employing phenomenological methods in her approach to examining the world around her and by showing how phenomenology is related to ethical life through her description of thinking. In this article, I explore the first of these ways by locating Arendt’s methods in relation to Martin Heidegger’s definition of phenomenology, as given in the Being and Time. Arendt’s usage of phenomenological (...) methods is clear in her examinations of banal evil and modern judicial systems. These topics lead to a discussion of how thinking, for Arendt, is a phenomenological activity that has bearing on ethical life. I will turn to Arendt’s essay, “Personal Responsibility Under Dictatorship” to clarify how phenomenology, as characteristic of the thinking Arendt prescribes, is ethically important. (shrink)

Over the past decade, we have witnessed some early signs of progress in the battle against international bribery and corruption, a problem that throughout the history of commerce had previously been ignored. We present a model that we then use to assess progress in reducing bribery. The model components include both hard law and soft law legislation components and enforcement and compliance components. We begin by summarizing the literature that convincingly argues that bribery is an immoral and unethical practice and (...) that the economic harm it causes falls most heavily on those least able to absorb it. The next section summarizes the main provisions of anti-bribery legislation including the Foreign Corrupt Practices Act (FCPA), the Organization for Eco nomic Development's Convention on Combating Bribery of Foreign Officials in International Business Transactions, the United Nations Convention Against Corruption and the laws of selected countries. We conclude this section with a discussion of the "moral imperialism" argument for not imposing Western laws and values on other cultures. The next section focuses on the roles played by NGOs including Transparency International (TI), the World Economic Forum (WEF), and the International Chamber of Commerce. We review trends in enforcement and prosecution, including a review of the United States' enforcement processes, mechanisms for cross-border legal assistance, a discussion of the distinctive nature of FCPA cases, and an assessment of what the future holds for enforcement. The final section focuses on compliance processes for corporations aimed at reducing the risk of FCPA and related violations. This section also addresses the ethics of gift giving and "grease" payments. The article concludes with a summary and suggestions for further research. Throughout the article, we reference important bribery cases and include comments from several authorities who are on the front lines of the battle against international bribery. (shrink)

Discussion of a metaphysical sense of 'inheritance' and cognate notions relevant to fundamentality.

The moral/conventional task has been widely used to study the emergence of moral understanding in children and to explore the deficits in moral understanding in clinical populations. Previous studies have indicated that moral transgressions, particularly those in which a victim is harmed, evoke a signature pattern of responses in the moral/conventional task: they are judged to be serious, generalizable and not authority dependent. Moreover, this signature pattern is held to be pan‐cultural and to emerge early in development. However, almost all (...) the evidence for these claims comes from studies using harmful transgressions of the sort that primary school children might commit in the schoolyard. In a study conducted on the Internet, we used a much wider range of harm transgressions, and found that they do not evoke the signature pattern of responses found in studies using only schoolyard transgressions. Paralleling other recent work, our study provides preliminary grounds for skepticism regarding many conclusions drawn from earlier research using the moral/conventional task. (shrink)

Knowledge closure is the claim that, if an agent S knows P, recognizes that P implies Q, and believes Q because it is implied by P, then S knows Q. Closure is a pivotal epistemological principle that is widely endorsed by contemporary epistemologists. Against Knowledge Closure is the first book-length treatment of the issue and the most sustained argument for closure failure to date. Unlike most prior arguments for closure failure, Marc Alspector-Kelly's critique of closure does not presuppose any (...) particular epistemological theory; his argument is, instead, intuitively compelling and applicable to a wide variety of epistemological views. His discussion ranges over much of the epistemological landscape, including skepticism, warrant, transmission and transmission failure, fallibilism, sensitivity, safety, evidentialism, reliabilism, contextualism, entitlement, circularity and bootstrapping, justification, and justification closure. As a result, the volume will be of interest to any epistemologist or student of epistemology and related subjects. (shrink)

The idea that the epistemology of modality is in some sense a priori is a popular one, but it has turned out to be difficult to precisify in a way that does not expose it to decisive counterexamples. The most common precisifications follow Kripke’s suggestion that cases of necessary a posteriori truth that can be known a priori to be necessary if true ‘may give a clue to a general characterization of a posteriori knowledge of necessary truths’. The idea is (...) that whether it is contingent whether p can be known a priori for at least some broad range of sentences ‘p’. Recently, Al Casullo and Jens Kipper have discussed restrictions of such principles to atomic sentences. We show that decisive counterexamples even to such dramatically restricted Kripke-style principles can be constructed using minimal logical resources. We then consider further restrictions, and show that the counterexamples to the original principles can be turned into counterexamples to the further restricted principles. We conclude that, if there are any true restrictions of Kripke-style principles, then they are so weak as to be of little epistemological interest. (shrink)

There are three primary aims of the book. The first, set out in the book's introduction, is to explain how two fairly recent developments in philosophy, externalism and modalism, provide the basis for a promising account of knowledge - an account that achieves anti-skeptical results and avoids Gettier-style counterexamples that are based on an agent having warranted beliefs that are merely luckily true. Epistemological externalism is the thesis that not all the factors that make a true belief a case of (...) knowledge need to be cognitively accessible or "internal" to the agent. Modalism, as the author construes it, is the use of possible worlds talk in clarifying what would or might be the case and what is necessarily so." "The second objective is to work through the different modalized epistemologies extant in the literature, assessing their strengths and weaknesses, with a view toward constructing a working theory. Finally, the author proposes the theory that knowledge is reliably formed, sensitive true belief, and defends the theory against objections."--Jacket. (shrink)

Thought experiments provide a conspicuous case study for epistemologists of the imagination. Galileo’s famous thought experiment about falling stones is a central example in the debate about how thought experiments in science work. According to a standard interpretation, the thought experiment poses a challenge to an Aristotelian principle about falling bodies that conceives of bodies in an extremely liberal way. This chapter argues that this interpretation is implausible and then shows how the thought experiment might present a challenge to a (...) principle that conceives of bodies in a less permissive, more plausible way. The new interpretation of the thought experiment relies on a distinction between two ways of imagining Galileo’s experiment, one of which requires Aristotelians to temporarily ignore their belief in the principle under challenge. It is suggested that the distinction tracks an increasingly familiar distinction among dual-process theories in psychology: ‘intuitive’ and ‘reflective’ imagination. In order for Aristotelians to appreciate the thought experiment’s challenge to their theory, they are expected to use their intuitive imagination and not just their reflective imagination. (shrink)

Scientific societies can play an important role in promoting ethical research practices among their members, and over the past two decades several studies have addressed how societies perform this role. This survey continues this research by examining current efforts by scientific societies to promote research integrity among their members. The data indicate that although many of the societies are working to promote research integrity through ethics codes and activities, they lack rigorous assessment methods to determine the effectiveness of their efforts.

Examines some of the ethical questions raised by the capabilities of modern medicine.

Argument that full grounds modally entail what they ground.

In this paper, I explore the question of whether the expected consequences of holding a belief can affect the rationality of doing so. Special attention is given to various ways in which one might attempt to exert some measure of control over what one believes and the normative status of the beliefs that result from the successful execution of such projects. I argue that the lessons which emerge from thinking about the case ofbelief have important implications for the way we (...) should think about the rationality of a number of other propositional attitudes,such as regret, desire, and fear. Finally,I suggest that a lack of clarity with respect to the relevant issues has given rise to a number of rather serious philosophical mistakes. (shrink)

It has long been recognized that we have a great deal of freedom to imagine what we choose. This paper explores a thesis—what we call “intentionalism (about the imagination)”—that provides a way of making this evident (if vague) truism precise. According to intentionalism, the contents of your imaginings are simply determined by whatever contents you intend to imagine. Thus, for example, when you visualize a building and intend it to be of King’s College rather than a replica of the college (...) you have imagined the former rather than the latter because you intended to imagine King’s College. This is so even if the visual image you conjure up equally resembles either. This paper proposes two kinds of counterexamples to intentionalism and discusses their significance. In particular, it sketches a positive account of how many sensory imaginings get to be about what they are about, which explains how the causal history of our mental imagery can prevent us from succeeding in imagining what we intended. (shrink)

Using traditional meta-analytic techniques, we compile relevant research to enhance conceptual appreciation of ethical climate theory (ECT) as it has been studied in the descriptive and applied ethics literature. We explore the various treatments of ethical climate to understand how the theoretical framework has developed. Furthermore, we provide a comprehensive picture of how the theory has been extended by describing the individual-level work climate outcomes commonly studied in this theoretical context. Meta-analysis allows us to resolve inconsistencies in previous findings as (...) well as confirm the central tenets of the overall ethical climate framework. In addition, we consider the ethical climate relationships in the larger context of the␣theoretical framework, using path analysis to test the structural relationships. Overall, our results provide evidence of the relationships between ethical climate perceptions and individual-level work outcomes. Based on our analyses, we offer future research directions important for further development of ECT. (shrink)