Editorial introduction to series of papers resulting from a European Commission Project on mental capacity.

Definition of the problem: The development and use of drugs aimed at a positive influence on the cognitive decline in patients suffering from Alzheimer's disease raises a number of ethical issues. Arguments: Among other things, these issues are concerned with the significance of these drugs for the patient's subjective well-being and quality of life and with aspects of informed consent to the use of these drugs, particularly in connection with their use in scientific medical research. Conclusion: The value and significance (...) of antidementia drugs depends not only on their effect on cognitive decline, but also on their wider significance for patients' quality of life and their primary carers. The subjective experience of those directly involved deserves more attention in research and practice. (shrink)

Since the introduction of Prozac (fluoxetine), a number of so‐called selective serotonin reuptake inhibitors (SSRIs) have been developed and introduced. These mood enhancers are being presently prescribed for people whose problems are not recognized mental illnesses. It is probable that in the near future the combination of data from advanced biochips and brain imaging will accelerate the development of neurotechnology. So‐called neuroceuticals, used for therapy and enhancement, and to improve different aspects of mental health, will be efficient neuromodulators. The scientific, (...) ethical, and social issues raised by mood enhancement and alteration of personal resilience require further exploration. The chapter talks about the notion of personal autonomy, cosmetic psychopharmacology, power for autonomous, and moral accountability in this context. It suggests that empirical research should also cover psychological and sociological research into perceptions and experiences of individuals who have used these drugs. (shrink)

The American Journal of Bioethics, Volume 11, Issue 8, Page 23-24, August 2011.

Mackenzie and Watts (2011) discuss the role of emotions in decision-making capacity (DMC) for medical treatment decisions. They are concerned that “the rights of the neurodiverse are at risk as the...

Zusammenfassung. Die Entwicklung und die Verwendung von Antidementiva, die die Verzögerung des kognitiven Abbaus bei Alzheimer Patienten zum Ziel haben, werfen eine Reihe ethischer Fragen auf. Diese beziehen sich, neben anderen, auf die Bedeutung dieser Medikamente für das subjektive Wohlbefinden und die Lebensqualität des Patienten und auf Aspekte der Zustimmung zur Verwendung dieser Mittel nach Information, insbesondere im Rahmen der medizinisch-wissenschaftlichen Forschung. Der Wert und die Bedeutung der Antidementiva hängt nicht nur vom Effekt auf den kognitiven Abbau ab, sondern auch (...) im weitesten Sinne von der Auswirkung auf die Lebensqualität der Patienten und ihrer primären Versorger. Die subjektiven Erfahrungen der unmittelbar Betroffenen bedürfen daher mehr Aufmerksamkeit als bisher, sowohl in der Forschung als auch in der Praxis. (shrink)

The shift in the prevailing view of alcoholism from a moral paradigm towards a biomedical paradigm is often characterized as a form of biomedicalization. We will examine and critique three reasons offered for the claim that viewing alcoholism as a disease is morally problematic. The first is that the new conceptualization of alcoholism as a chronic brain disease will lead to individualization, e.g., a too narrow focus on the individual person, excluding cultural and social dimensions of alcoholism. The second claim (...) is that biomedicalization will lead to stigmatization and discrimination for both alcoholics and people who are at risk of becoming alcoholics. The third claim is that as a result of the biomedical point of view, the autonomy and responsibility of alcoholics and possibly even persons at risk may be unjustly restricted. Our conclusion is that the claims against the biomedical conceptualization of alcoholism as a chronic brain disease are neither specific nor convincing. Not only do some of these concerns also apply to the traditional moral model; above that they are not strong enough to justify the rejection of the new biomedical model altogether. The focus in the scientific and public debate should not be on some massive “biomedicalization objection” but on the various concerns underlying what is framed in terms of the biomedicalization of alcoholism. (shrink)

The shift in the prevailing view of alcoholism from a moral paradigm towards a biomedical paradigm is often characterized as a form of biomedicalization. We will examine and critique three reasons offered for the claim that viewing alcoholism as a disease is morally problematic. The first is that the new conceptualization of alcoholism as a chronic brain disease will lead to individualization, e.g., a too narrow focus on the individual person, excluding cultural and social dimensions of alcoholism. The second claim (...) is that biomedicalization will lead to stigmatization and discrimination for both alcoholics and people who are at risk of becoming alcoholics. The third claim is that as a result of the biomedical point of view, the autonomy and responsibility of alcoholics and possibly even persons at risk may be unjustly restricted. Our conclusion is that the claims against the biomedical conceptualization of alcoholism as a chronic brain disease are neither specific nor convincing. Not only do some of these concerns also apply to the traditional moral model; above that they are not strong enough to justify the rejection of the new biomedical model altogether. The focus in the scientific and public debate should not be on some massive “biomedicalization objection” but on the various concerns underlying what is framed in terms of the biomedicalization of alcoholism. (shrink)

Genomic and neuro-scientific research into the causes and course of antisocial behaviour triggers bioethical debate. Often, these new developments are met with reservation, and possible drawbacks and negative side-effects are pointed out. This article reflects on these scientific developments and the bioethical debate by means of an exploration of the perspectives of one important stakeholder group: juveniles convicted of a serious crime who stay in a juvenile justice institution. The views of juveniles are particularly interesting, as possible applications of current (...) and future scientific findings are considered to be most effective if applied early in life. Based on their statements we come to the following provisional conclusions. Concerns about labelling and stigmatization are recognized and widely shared. Possible effects on one's identity are acknowledged too. Yet, a possible biological underpinning of one's antisocial behaviour is not considered to result in the development of a criminal identity. Nonetheless, psychopharmacological interventions are experienced as endangering one's current self. Concerns regarding the refusal of responsibility and the blaming of one's genes or brain can be put into perspective. Instead, participants emphasize the motive of own choice as underlying their criminal behaviour. Moreover, bioethical debate should pay attention to the role of parents of children at risk and the parent-child relationship in families at-risk. We argue that the short-term and long-term interests of children at risk, as well as their interests and those of society at large, may conflict. In order to deal appropriately with newly arising dilemmas, a normative framework needs to be developed. (shrink)

The issue of benefits in international clinical research is highly controversial. Against the background of wide recognition of the need to share benefits of research, the nature of benefits remains strongly contested. Little is known about the perspectives of research populations on this issue and the extent to which research ethics discourses and guidelines are salient to the expectations and aspirations existing on the ground. This exploratory study contributes to filling this void by examining perspectives of people in low-income South (...) African communities on benefits in international clinical research. Twenty-four individuals with and without experience of being involved in clinical research participated in in-depth interviews. Respondents felt that ancillary care should be provided to clinical research participants, while a clinical study conducted in particular community should bring better health to its members through post-trial benefits. Respondents' perspectives were grounded in the perception that the ultimate goal of international clinical research is to improve local health. We argue that perspectives and understandings of the respondents are shaped by local moral traditions rather than clinical research specificities and require attention as valid moral claims. It is necessary to acknowledge such claims and cultural worlds from which they emerge, thus building the foundation for equal and embracing dialogue to bridge different perspectives and handle contradicting expectations. (shrink)

From the Disney 'Teacher of the Year' and New York Times bestselling author comes a road map to enrich students' learning experiences, revised and updated for today's teachers and parents. After publishing the New York Times bestseller The Essential 55 (over 1 million copies sold), award-winning teacher Ron Clark took his rules on the road and traveled to schools and districts in 50 states. He met amazing teachers, administrators, students, parents, and all kinds of people involved in bringing up great (...) kids. These are the eleven qualities he describes in The Excellent 11: Enthusiasm, Adventure, Creativity, Reflection, Balance, Compassion, Confidence, Humor, Common Sense, Appreciation, and Resilience. Ron has filled this book with hundreds of suggestions, stories, and wonderfully funny anecdotes. You'll be smiling as you read--and finding the inspiration to change lives, one student at a time"--Back cover. (shrink)

This article discusses ethical issues which are raised as a result of the introduction of economic evidence in mental health care in order to rationalise clinical practice. Cost effectiveness studies and guidelines based on such studies are often seen as impartial, neutral instruments which try to reduce the influence of non-scientific factors. However, such rationalising instruments often hide normative assumptions about the goals of treatment, the selection of treatments, the role of the patient, and the just distribution of scarce resources. (...) These issues are dealt with in the context of increased control over clinical practice by third parties. In particular, health insurers have a great interest in economic evidence in clinical care settings in order to control access to and quality of health care. The authors conclude that guideline setting and cost effectiveness analysis may be seen as important instruments for making choices in health care, including mental health care, but that such an approach should always go hand in hand with a social and political debate about the goals of medicine and health care. This article is partly based on the results of a research project on the normative aspects of guideline setting in psychiatry and cardiology which was conducted under the guidance of the Royal Dutch Medical Association. (shrink)

In this book Ron Amundson examines two hundred years of scientific views on the evolution-development relationship from the perspective of evolutionary developmental biology. This perspective challenges several popular views about the history of evolutionary thought by claiming that many earlier authors had made history come out right for the Evolutionary Synthesis. The book starts with a revised history of nineteenth-century evolutionary thought. It then investigates how development became irrelevant with the Evolutionary Synthesis. It concludes with an examination of the contrasts (...) that persist between mainstream evolutionary theory and evo-devo. This book will appeal to students and professionals in the philosophy and history of science, and biology. (shrink)

Since the publication of Alasdair MacIntyre’s After Virtue in 1981, tensions inherent to the relationship between morally educative practices and the institutions that house them have been widely noted. We propose a taxonomy of the ways in which the pursuit of external goods by institutions undermines the pursuit of the internal goods of practices. These comprise substitution, where the institution replaces the pursuit of one type of good by another; frustration, where opportunities for practitioners to discover goods or develop new (...) standards of excellence are frustrated by institutional priorities and resource allocation; and injustice, which undermines the integrity of relationships within the organization and/or with partners. These threats, though analytically distinct, are often mutually reinforcing. This conceptual contribution is illustrated both by the extant literature and by a novel context, the three-ring circus. (shrink)

This paper considers discussions of the work of Alasdair MacIntyre in management literature. It argues that management scholars who have attempted to appropriate his After Virtue as a supportive text for conventional business ethics do so only by misreading or by ignoring his other work. It shows that MacIntyre does not argue for a reformed capitalism in which individual virtue overcomes institutional vice. Rather he argues that capitalist businesses are inherently vicious and that therefore individual virtue cannot be realised within (...) them. The job of the virtuous is to resist them.2. The paper first presents an account of MacIntyre’s position on management and introduces some of the critical and supportive uses of his work in management scholarship. It focuses on two papers3 typical of the approach taken by conventional business ethicists to his work. These have attempted to deploy concepts developed by MacIntyre while denying the account of management and organisation of which they form a part. The paper provides some tentative hypotheses as to why management scholars have approached MacIntyre in this way. It argues that these attempted appropriations not only have failed but also must fail as conceptual coherence is sacrificed when the account within which those concepts make sense is denied.4. (shrink)

In a series of papers Geoff Moore has applied Alasdair MacIntyre’s much cited work to generate a virtue-based business ethics. Central to this project is Moore’s argument that business falls under MacIntyre’s concept of ‘practice’. This move attempts to overcome MacIntyre’s reputation for being ‘anti-business’ while maintaining his framework for evaluating social action and replaces MacIntyre’s hostility to management with a conception of managers as institutional practitioners (craftsmen). I argue however that this move has not been justified. Given the importance (...) MacIntyre places on the protection of practices, the result is that much of Moore’s contribution is misplaced. Business cannot name a practice but business institutions certainly do house practices. The task then is to try to understand the circumstances under which practices might flourish and those under which they might founder in a business context. This is not aided by Moore’s redescription of all businesses as practices. (shrink)

This paper introduces ‘Virtue and Virtuousness: When will the twain ever meet?’ a special edition of Business Ethics: A European Review. The Call for Papers invited contributions that could inform the relationship between organisational virtuousness, as conceptualised by positive organisation studies, and the classical conception of virtues pertaining to individual women and men. While the resources of particular virtue traditions – Aristotelian, Catholic, Confucian, and the like – could inform their own debates as to whether virtue extends beyond individuals, the (...) debate between virtue traditions and positive organisation studies has a different dimension. The question is whether the claims of positive social sciences as such are compatible with those of any virtue tradition. We argue that positive social science and virtue traditions are indeed rivals such that adherence to the claims of the one precludes adherence to the other. Resolution to such conflicts requires that one tradition is able to resolve questions that exhaust the resources of the other. This paper suggests that at least one area of incoherence in the findings of positive social sciences can be resolved by virtue traditions, and introduces the remaining papers in the special edition. (shrink)

Philosophers of evolutionary biology favor the so-called etiological concept of function according to which the function of a trait is its evolutionary purpose, defined as the effect for which that trait was favored by natural selection. We term this the selected effect (SE) analysis of function. An alternative account of function was introduced by Robert Cummins in a non-evolutionary and non-purposive context. Cummins''s account has received attention but little support from philosophers of biology. This paper will show that a similar (...) non-purposive concept of function, which we term causal role (CR) function, is crucial to certain research programs in evolutionary biology, and that philosophical criticisms of Cummins''s concept are ineffective in this scientific context. Specifically, we demonstrate that CR functions are a vital and ineliminable part of research in comparative and functional anatomy, and that biological categories used by anatomists are not defined by the application of SE functional analysis. Causal role functions are non-historically defined, but may themselves be used in an historical analysis. Furthermore, we show that a philosophical insistence on the primary of SE functions places practicing biologists in an untenable position, as such functions can rarely be demonstrated (in contrast to CR functions). Biologists who study the form and function of organismal design recognize that it is virtually impossible to identify the past action of selection on any particular structure retrospectively, a requirement for recognizing SE functions. (shrink)

This paper explores the use of advance directives in clinical dementia research. The focus is on advance consent to participation of demented patients in non-therapeutic research involving more than minimal risks and/or burdens. First, morally relevant differences between advance directives for treatment and care, and advance directives for dementia research are discussed. Then attention is paid to the philosophical issue of dementia and personal identity, and the implications for the moral authority of research advance directives. Thirdly, a number of practical (...) shortcomings of advance directives for non-therapeutic dementia research are explored and attention is paid to the role of proxies. It is concluded that upon a closer look the initial attractiveness of advance directives for dementia research is lessened, and that it is doubtful whether these instruments can compensate for the lack of subject consent in case of non-therapeutic dementia research involving more than minimal risks and/or burdens for the incompetent demented subject. (shrink)

This exploratory study examines how managers and professionals regard the ethical and social responsibility reputations of 60 well-known Australian and International companies, and how this in turn influences their attitudes and behaviour towards these organisations. More than 350 MBA, other postgraduate business students, and participants in Australian Institute of Management (Western Australia) management education programmes were surveyed to evaluate how ethical and socially responsible they believed the 60 organisations to be. The survey sought to determine what these participants considered ‘ethical’ (...) and ‘socially responsible’ behaviour in organisations to be. The survey also examined how the participants’ beliefs influenced their attitudes and intended behaviours towards these organisations. The results of this survey indicate that many managers and professionals have clear views about the ethical and social responsibility reputations of companies. This affects their attitudes towards these organisations which in turn has an impact on their intended behaviour towards them. These findings support the view in other research studies that well-educated managers and professionals are, to some extent, taking into account the ethical and social responsibility reputations of companies when deciding whether to work for them, use their services or buy shares in their companies. (shrink)

The so-called "adaptationism" of mainstream evolutionary biology has been criticized from a variety of sources. One, which has received relatively little philosophical attention, is developmental biology. Developmental constraints are said to be neglected by adaptationists. This paper explores the divergent methodological and explanatory interests that separate mainstream evolutionary biology from its embryological and developmental critics. It will focus on the concept of constraint itself; even this central concept is understood differently by the two sides of the dispute.

This exploratory study examines how managers and professionals regard the ethical and social responsibility reputations of 60 well-known Australian and International companies, and how this in turn influences their attitudes and behaviour towards these organisations. More than 350 MBA, other postgraduate business students, and participants in Australian Institute of Management management education programmes were surveyed to evaluate how ethical and socially responsible they believed the 60 organisations to be. The survey sought to determine what these participants considered 'ethical' and 'socially (...) responsible' behaviour in organisations to be. The survey also examined how the participants' beliefs influenced their attitudes and intended behaviours towards these organisations. The results of this survey indicate that many managers and professionals have clear views about the ethical and social responsibility reputations of companies. This affects their attitudes towards these organisations which in turn has an impact on their intended behaviour towards them. These findings support the view in other research studies that well-educated managers and professionals are, to some extent, taking into account the ethical and social responsibility reputations of companies when deciding whether to work for them, use their services or buy shares in their companies. (shrink)

Ron Mallon explores how thinking and talking about kinds of person can bring those kinds into being. He considers what normative implications this social constructionism has for our understanding of our practices of representing human kinds, like race, gender, and sexual orientation, and for our own agency.

In this book Ron Amundson examines 200 years of scientific views on the evolution-development relationship from the perspective of evolutionary developmental biology (evo-devo). This new perspective challenges several popular views about the history of evolutionary thought by claiming that many earlier authors made history come out right for the Evolutionary Synthesis. The book starts with a revised history of nineteenth-century evolutionary thought. It then investigates how development became irrelevant to evolution with the Evolutionary Synthesis. It concludes with an examination of (...) the contrasts that persist between mainstream evolutionary theory and evo-devo. (shrink)

De dicto moral motivation is typically characterized by the agent’s conceiving of her goal in thin normative terms such as to do what is right. I argue that lacking an effective de dicto moral motivation would put the agent in a bad position for responding in the morally-best manner in a certain type of situations. Two central features of the relevant type of situations are the appropriateness of the agent’s uncertainty concerning her underived moral values, and the practical, moral importance (...) of resolving this uncertainty. I argue that in some situations that are marked by these two features the most virtuous response is deciding to conduct a deep moral inquiry for a de dicto moral purpose. In such situations lacking an effective de dicto moral motivation would amount to a moral shortcoming. I show the implications for Michael Smith’s argument against Motivational Judgment Externalism and for Brian Weatherson’s argument against avoiding moral recklessness: both arguments rely on a depreciating view of de dicto moral motivation, and both fail; or so I argue. (shrink)

Recent historiography of 19th century biology supports the revision of two traditional doctrines about the history of biology. First, the most important and widespread biological debate around the time of Darwin was not evolution versus creation, but biological functionalism versus structuralism. Second, the idealist and typological structuralist theories of the time were not particularly anti-evolutionary. Typological theories provided argumentation and evidence that was crucial to the refutation of Natural Theological creationism. The contrast between functionalist and structuralist approaches to biology continues (...) today, and the historical misunderstanding of 19th century typological biology may be one of its effects. This historical case can shed light on current controversies regarding the relevance of developmental biology to evolution. (shrink)

It is common in various quarters of philosophy to derive philosophically significant conclusions from theories of reference. In this paper, we argue that philosophers should give up on such 'arguments from reference.' Intuitions play a central role in establishing theories of reference, and recent cross-cultural work suggests that intuitions about reference vary across cultures and between individuals within a culture (Machery et al. 2004). We argue that accommodating this variation within a theory of reference undermines arguments from reference.

William Whewell tried to explain how scientific knowledge of necessary and certain truth was possible by tracing it to ideas that arose not out of experience but had an independent origin in the mind. Although Whewell has generally been regarded as an a priorist in some sense and as a proponent of hypothetico-deductivism, Snyder tries to show that he can be assimilated to the twentieth-century inductivist mainstream. She fails to make her case, however, in part because she fails to pay (...) sufficient attention to Whewell’s insistence that scientific discovery is beyond the reach of method and always involves happy guesses. (shrink)

What can be learned from a small scale study of managerial work in a highly marginal and under-researched working community? This article uses the ‘goods–virtues–practices–institutions’ framework to examine the managerial work of owner–directors of traditional circuses. Inspired by MacIntyre’s arguments for the necessity of a narrative understanding of the virtues, interviews explored how British and Irish circus directors accounted for their working lives. A purposive sample was used to select subjects who had owned and managed traditional touring circuses for at (...) least 15 years, a period in which the economic and reputational fortunes of traditional circuses have suffered badly. This sample enabled the research to examine the self-understanding of people who had, at least on the face of it, exhibited the virtue of constancy. The research contributes to our understanding of the role of the virtues in organizations by presenting evidence of an intimate relationship between the virtue of constancy and a ‘calling’ work orientation. This enhances our understanding of the virtues that are required if management is exercised as a domain-related practice. (shrink)

Corporate management is torn between either focusing solely on the interests of stockholders or taking into account the interests of a wide spectrum of stakeholders. Of course, there need be no conflict where taking the wider view is also consistent with maximising stockholder wealth. In this paper, we examine the extent to which a conflict actually exists by examining the relationship between a company's positive and negative corporate social responsibility activities and equity performance. In general, we find little evidence to (...) suggest that managers taking a wider stakeholder perspective will jeopardise the interest of its stockholders. However, our findings do suggest that the market is not only influenced by the independent CSR activities, but also the totality of these activities and that the facets that they value do vary over time. It seems that most recently, the market has valued most firms that satisfied minimum requirements in the areas of diversity and environmental protection but were most proactive in the area of employee-relations. (shrink)

Jennifer Rose Carr’s (2020) article “Normative Uncertainty Without Theories” proposes a method to maximize expected value under normative uncertainty without Intertheoretic Value Comparison (hereafter IVC). Carr argues that this method avoids IVC because it avoids theories: the agent’s credence is distributed among normative hypotheses of a particular type, which don’t constitute theories. However, I argue that Carr’s method doesn’t avoid or help to solve what I consider as the justificatory problem of IVC, which isn’t specific to comparing theories as such. (...) This threatens the implementability of Carr’s method. Fortunately, I also show how Carr’s method can nevertheless be implemented. I identify a type of epistemic states where the justificatory problem of IVC is not a necessary obstacle to maximizing expected value. In such states, the uncertainty stems from indecisive normative intuitions, and the agent justifiably constructs each normative hypothesis on the basis of a consistent subset of her intuitions by reference to the same unit of value. This part of my argument complements not only Carr’s (2020) argument, but also some moderate defenses of IVC. The combination of Carr’s paper and mine helps to illuminate the conditions for maximizing expected value under normative uncertainty without unjustified value comparison. (shrink)

The Nature of Dignity argues that, given what evolutionary biology tells us about human nature, we need a new understanding of what is involved in the exhibition of personal dignity, since Kant and other Enlightenment figures whose ideas of dignity have shaped our own were wrong in several of their key assumptions. The required new conception of dignity is then developed on the basis of insights gleaned from history, political-economics, literature, film, hermeneutical ethics, and evolutionary biology.

Coercion and pressure in mental healthcare raise moral questions. This article focuses on moral questions raised by the everyday practice of pressure and coercion in the care for the mentally ill. In view of an example from literature—the story of Ulysses and the Sirens—several ethical issues surrounding this practice of care are discussed. Care giver and patient should be able to express feelings such as frustration, fear and powerlessness, and attention must be paid to those feelings. In order to be (...) able to evaluate the intervention, one has to be aware of the variety of goals the intervention can aim at. One also has to be aware of the variety of methods of intervention, each with its own benefits and drawbacks. Finally, an intervention requires a context of care and responsibility, along with good communication and fair treatment before, during and after the use of coercion and pressure. (shrink)