There has been no informed or honest debate in North America over the issue of liberalized euthanasia. Despite thousands of newspaper stories, scores of learned academic articles, a handful of closely analyzed legal decisions, and hours of broadcast news and talk show imagery, a full discussion is yet to begin.

A personable teenager with Down's syndrome became a Canadian cause célèbre a few months ago when University Hospital in Edmonton, Alberta, denied him a position on the organ transplantation waiting list. Terry Urquart lacked “reasonable” intelligence, hospital officials said, a criterion for all transplant candidates at that hospital. Protests by the boy's family, and by groups active in the cause of those with developmental disabilities, became well-photographed stories on the nightly television news and in the nation's newspapers. It did not (...) hurt the Urquart cause one bit that the 17-year-old teenager had won a gold medal in skiing at the International Special Olympics. (shrink)

Healthcare Providers advising patient surrogates on the appropriateness of continued care for comatose patients have often been sharply criticized for coercive behavior toward patient surrogates; with failing to provide them with adequate information; and for a general failure to adequately cinsider the cimplex needs and hopes of patients, their surrogates, and caregivers. Because decisions on the continuation or withdrawal of care often need the legal approval of surrogates the failure of both medical personnel and patient families to understand each other's (...) priorities may lead to ethical and interpersonal conflict. (shrink)

Bioethics claimed to offer a set of generally applicable, universally accepted guidelines that would simplify complex situations. In Thieves of Virtue, Tom Koch argues that bioethics has failed to deliver on its promises.

To those defining euthanasia as a battle for the principle of self-determination, persons seeking physician assisted death (PAD) are soldiers in the fight for patient autonomy. The reasons they seek it, or the potential of other, non-life-threatening interventions is less important than this principle: individuals have the right not only to choose death (suicide), but to be assisted in dying. They should not be second guessed or denied on the basis of another's distaste for that decision. This paper offers a (...) general review of deaths attributed to Dr. Jack Kevorkian's PAD practice in an attempt to answer two questions: Why do persons seek physician assisted death, and, to what extent does induced death seem, in retrospect, a reasonable and perhaps necessary medical response to specific patient complaints? (shrink)

No single principle is more critical to our ethical stance than the one asserting the sanctity of human life. In debates ranging from the care of anencephalic infants to the maintenance of fragile seniors, the question is, Where are the boundaries of sanctified human life? The generally accepted assumption is that a once firm set of principles and definitions is now eroding in the face of There is no doubt,that the miracles of medical technology have brought up ethical issues not (...) contemplated by us until the very recent past.”. (shrink)

The critical role of surrogates—commonly if erroneously called “Informal caregivers”—has been generally ignored by clinical and bioethical literatures. While assumed to provide no more than ancillary support, these patient representatives directly or indirectly affect patient care to the extent they inhibit or facilitate both home-based care and patient decisions regarding treatment alternatives. Members of this group include relatives and neighbors who may or may not act in consort as advisors, assistants, care providers, and surrogate decisionmakers acting on the patient's behalf (...) with members of the medical community. Not only do they often possess a critical voice strongly influencing both patient care decisions and, after discharge, home care and rehabilitation, this paper argues they do so from a perspective that is often radically different from one endorsed by medical professionals. (shrink)

Although space limitations do not permit including all the responses received after the passing of David Thomasma, some representative expressions are included below. As these remembrances attest, Edmund Pellegrino spoke for all of us when he said at David's memorial service, “It has been said that we die only when forgotten; if so, David will live a long time. He remains a presence for his family, friends, collaborators, and all who met him.”.

In a special issue of this journal, a range of authors addressed the critical problem of difference in bioethics. To what extent do class, culture, ethnicity, and race affect the ethical decisions that patients and professionals must make in a medical context? Those arguing for an understanding of cultural influences in bioethical decisionmakingtypically argue from the perspective of individual case studies to demonstrate the importance of these social constructs. Others, like Erika Blacksher, however, worry that this approach will obscure the (...) uniqueness of individual decisionmakng patterns, allowing all persons of a single group to be aggregated as if their class, cultural construct, or religious affiliation were the single motive element in their medicolegal decisionmaking. There is, she cautions, a risk of misuse if a professional care provider reflexively assumes individual patient or surrogate reactions on the basis of ethnicity or culture. (shrink)

A recent issue of CambridgeQuarterlyofHealthcareEthics provides a fascinating look into the uncertainties surrounding the subject of human cloning. As Nelkin and Lindee point out, for example, the popular assumption is that this technology will lead to individual immortality. life everlasting for the deserving.considers the use of cloning for the replication of human individuals to be ethically unacceptable.”.

For all its apparent debate bioethical discourse is in fact very narrow. The discussion that occurs is typically within limited parameters, rarely fundamental. Nor does it accommodate divergent perspectives with ease. The reason lies in its ideology and the political and economic perspectives that ideology promotes. Here the ideology of bioethics' fundamental axioms is critiqued as arbitrary and exclusive rather than necessary and inclusive. The result unpacks the ideological and political underpinnings of bioethical thinking and suggests new avenues for a (...) broader debate over fundamentals, and a different approach to bioethical debate. (shrink)

Canadian ethicists Jocelyn Downie and Udo Schuklenk seek to assess the effect of Canada’s decriminalisation of ‘medical assistance in dying’ ‘to inform Canada’s ongoing discussions and because other countries will confront the same questions if they contemplate changing their assisted dying law.’1 Their assessment focuses on two arguments earlier levied against expansion of these procedures. The first is that of a ‘slippery slope’ and the second is what they disingenuously call, ‘social determinants of health’. They conclude that, in both cases, (...) the effect of legislation permitting first limited and then expanded options for medical termination has been benign. The argument in this brief commentary is that the ‘slippery slope’ is clearly evident and support for those with chronic, progressive diagnoses a clear contributor to the ever increasing number of persons seeking MAID. Downie and Schuklenk first review the legal and legislative history of MAID. In Carter v Canada, the courts found …. (shrink)

Two rival paradigms permeate bioethics. One generally favors eugenics, euthanasia, assisted suicide and other methods for those with severely restricting physical and cognitive attributes. The other typically opposes these and favors instead ample support for "persons of difference" and their caring families or loved ones. In an attempt to understand the relation between these two paradigms, this article analyzes a publicly reported debate between proponents of both paradigms, bioethicist Peter Singer and lawyer Harriet McBryde Johnson. At issue, the article concludes, (...) are two distinct axiomatic sets of values resulting in not simply different styles of rhetoric but different vocabularies, in effect two different languages of ethics. (shrink)

For more than two decades, classes on “professionalism” have been the dominant platform for the non-technical socialization of medical students. It thus subsumes elements of previous foundation courses in bioethics and “medicine and society” in defining the appropriate relation between practitioners, patients, and society-at-large. Despite its importance, there is, however, no clear definition of what “professionalism” entails or the manner in which it serves various purported goals. This essay reviews, first, the historical role of the vocational practitioner in society, and (...) second, the introduction of “professionalism” as a newly constituted, core value in teaching. The structure of the paper is as an archaeology, a Foucauldian term for an investigation of seemingly separate but related antecedent contexts and ideas whose result is a perspective or point of view. The goal thus is an attempt to precisely locate “professionalism” within the greater history of medicine and its contemporary role in medical socialization. (shrink)

Offers possible solutions to such medical dilemmas as who should receive organ transplants.

Transhumanism advances an ideology promising a positive human advance through the application of new and as yet unrealized technologies. Underlying the whole is a libertarian ethos married to a very Christian eschatology promising a miraculous transformation that will answer human needs and redress human failings. In this paper, the supposedly scientific basis on which transhumanist promises are built is critiqued as futurist imaginings with little likelihood of actualization. Transhumanists themselves are likened to the affable con man Professor Harold Hill who, (...) in The Music Man, describes as dire social problems whose solution is a youth band he seeks to sell but has no intention of building. Even were some of the transhumanist imaginings to be realized, I argue, the result would be a dystopia in which the few received benefits denied to the many. In advancing imaginary technologies as a solution to human needs, transhumanists and their bioethical fellow travelers handily avoid discussion of or advocacy for the kind of pedestrian social actions that demonstrably could achieve many of their purported goals. So their enthusiasms, I conclude, are not merely fanciful but damaging to the humanist goals they pretend to advance. (shrink)

This paper critiques current arguments advancing the potential for transhumanism and a range of biological and pharmacological enhancements to better human flourishing. It does so from a historical perspective weighing the individualistic and competitive evolutionary theories of Darwin with the cooperative and communal theories of Prince Peter Kropotkin a generation later. In doing so it proposes the transhumanist and enhancement enthusiasts operate within a paradigm similar to Darwin’s, one that is atomist and individualistic. The critique, which considers the status of (...) those with cognitive, sensory and physical limits, advances a vision of society as a cooperative and communal rather than individualistic and competitive. Within this framework the argument is not one of either/or but on the lexicographical superiority of the communal and social over the individualistic and competitive ethos underlying both Darwin and most contemporary transhumanist literature. This reordering of priorities, it is argued, reflects advances in contemporary biology and evolutionary thinking. (shrink)

Normative criteria adopted to assure just, equitable, and efficient allocation of donor organs to potential recipients has been widely praised as a model for the allocation of scarce medical resources. Because the organ transplantation program relies upon voluntary participation by potential donors, all such programs necessarily rely upon public confidence in allocation decision making protocols. Several well publicized cases have raised questions in North America about the efficacy of allocation procedures. An analysis of those cases, and the relevant technical literature, (...) suggest consistent structural deficits exist in the organ allocation process as it is applied by many individual transplantation centres. These irregularities are based upon both the failure of rank waiting as a method to guarantee just treatment and a general failure to recognize the extent to which prescriptive criteria — social values — are commonly used to screen potential organ transplant candidates. Resulting idiosyncratic determinations, and a devaluation of rank waiting as a criterion, raise fundamental questions regarding justice, fairness, and equability in the application procedure at large. To correct these structural problems in organ allocation procedures, a multicriterion model defining prescriptive criteria through the Analytic Hierarchy Process (AHP) is proposed. (shrink)

There are in two assumptions inherent in this issue's theme, both inimical to the traditional goals of medicine and to the standards of care it proposed. First, the idea that treatment must be limited for some (but not others) on the basis of cost was born in the early literature of bioethics. Second, that there is a quantifiable and diagnostically predictable period at the “end-of-life” where treatment is “futile,” and therefore not worth supporting in a context of scarcity grew out (...) of bioethics's construction of allocative protocols in the 1990s. This paper traces the history of these ideas as constructs grounded in neither natural scarcity nor in firm diagnostic categories. Their relation to issues of care is therefore suspect. (shrink)

Early announcements of this special journal issue solicited authors interested in contributing articles on the subject of “costs at the end of life.” Those who replied were then informed the title was being changed, on the basis of early subscriber interest, in “rational end-of-life treatment.” Because that seemed a still inadequate reflection of the authorial concerns of responding potential contributors, the editors again changed the title, two months later, to “Making Treatments More Rational and Compassionate for the Chronically Critically Ill.” (...) At that point the editors gave up and decided this issue’s final title would be determined only after the papers were submitted and reviewed. (shrink)

In recent years geographic interest has focused increasingly on the moral and ethical dimensions of social constructions. Much of this work has followed the direction taken by moral philosophers whose principled approach has been applied to a range of ethically or morally problematic contexts. The challenge has been to apply a geographic perspective to an ethical dilemma that seems intractable at the level of ethical principle. This paper uses a geographic perspective to consider in a concrete fashion a current bioethical (...) concern: defining who will or will not be eligible for an organ transplant. Methodologically, it uses the analytic hierarchy process, a multicriterion decision making approach, and Q-analysis to analyze the resulting data. Long known by geographers, Q-analysis presents a methodology for the analysis of relations between two sets of criteria, in this case focus groups and their responses to a hierarchy of criteria. The result is a topology that not only presents but also explains the moral reasoning of members of a diverse set of focus groups constituted at a Canadian hospital to consider the question of organ transplant eligibility. (shrink)

In recent years geographic interest has focused increasingly on the moral and ethical dimensions of social constructions. Much of this work has followed the direction taken by moral philosophers whose principled approach has been applied to a range of ethically or morally problematic contexts. The challenge has been to apply a geographic perspective to an ethical dilemma that seems intractable at the level of ethical principle. This paper uses a geographic perspective to consider in a concrete fashion a current bioethical (...) concern: defining who will or will not be eligible for an organ transplant. Methodologically, it uses the analytic hierarchy process, a multicriterion decision making approach, and Q-analysis to analyze the resulting data. Long known by geographers, Q-analysis presents a methodology for the analysis of relations between two sets of criteria, in this case focus groups and their responses to a hierarchy of criteria. The result is a topology that not only presents but also explains the moral reasoning of members of a diverse set of focus groups constituted at a Canadian hospital to consider the question of organ transplant eligibility. (shrink)

Cultural realities: ethics, values and morals -- Moral stress, distress, and injury -- An ethnography of ethics -- Ethics, geography, and mapping: the failure of the simple -- The tobacco problem -- The morals in the map: stress and distress -- Moral communities and their members -- Mapping poverty: ethics and morals -- An educational example -- Mapping justice as transportation -- Ethics and transplantation -- The ethics of scale, the scale of distress -- It's ... complex.

There is at present a divide in the geographical literature between those interested in distributive justice as a social value and those who seek to implement distributive plans on the basis of efficiency of resource use. The former are 'social geographers' interested in equity as a social value, and the latter are 'practical' economic and locational geographers. This divide mirrors one existing elsewhere in social science between Rawlsian liberalism and utilitarian planners. Here we argue that equality and efficiency are related (...) values that cannot be separated easily in the analysis of practical problems. Data on the distribution of transplantable human organs are considered in a practical consideration of this approach. The case-study suggests that inequality of distribution appears to effect adversely the general organ supply. Stated positively, the data suggest that, to the extent that equality of service is an objective, that goal may positively impact on organ supply. More generally, the conclusion argues for a conjoining of theoretical and practical geographical approaches where a scarce resource must be allocated across a dispersed population. (shrink)

Public opinion surveys and polls have a long history as tools for the reportage of public sentiment. Born in the “straw polls” of nineteenth century politics, their use expanded in the last century to include a range of commercial and social subjects. In recent decades, these have included issues of medico-legal uncertainty including, in a partial list, abortion, fetal tissue research, and the propriety of medical termination. Because public opinion surveys are assumed to be “scientific,” and thus unbiased, there has (...) been little discussion of either their suitability in areas of complex, medico-legal uncertainty or the ethics of their use in these areas. This paper reviews their general history and then their use in the debate over medical termination, often called “medical aid in dying.” In this review, two problems are highlighted. First, there is the ambiguous nature of polls and the manner of their construction. Second, there is the manner in which they are deployed as simple and definitive statements in areas of complex medico-legal debate. The result calls for caution in their use by ethicists and a clear duty by both academics and journalists to understand the limits of the medium in areas of medico-legal debate and discussion. (shrink)

Consensus is the holy grail of bioethics, the lynch pin of the assumption that well informed, well intentioned people may reach generally acceptable positions on ethically contentious issues. It has been especially important in bioethics, where advancing technology has assured an increasing field of complex medical dilemmas. This paper results on the use of a multicriterion decision making system (MCDM) analyzing group process in an attempt to better define hospital policy. In a pilot program at The Hospital for Sick Children, (...) Toronto, a series of small scale focus groups was constituted to examine criteria defining organ transplant eligibility. Criteria were organized hierarchically using the Analytic Hierarchy Process, an MCDM approach, and the resulting data was analyzed using Expert Choice 9.0, software designed to facilitate AHP analysis. Qualitative and quantitative analysis map barriers to practical consensus in a way not previously possible. (shrink)

Medical practice has always involved at least three roles, three complimentary identities. Practitioners have been at once clinicians dedicated to a patient’s care, members of a professional organization promoting medicine, and informed citizens engaged in public debates on health issues. Beginning in the 1970s, a series of social and technological changes affected, and in many cases restricted, the practitioner’s ability to function equally in these three identities. While others have discussed the changing realities of medical practice in recent decades, none (...) have commented on their effect on their effect on rights of practitioners as citizens. Here several cases begin an analysis of the manner in which those changes have limited the physician’s right to act conscientiously and speak publicly in the face of organizational agendas and political priorities. (shrink)

US court decisions guaranteeing life-sustaining care to anencephalic infants have been viewed with disfavor, and sometimes disbelief, by some ethicists who do not believe in the necessity of life-sustaining support for those without cognitive abilities or an independently sustainable future. The distance between these two views – one legal and inclusive, the other medical and specific – seems unbridgeable. This paper reports on a program using multicriterion decision making to define and describe persons in a way which both acknowledges the (...) differences perceived by many as well as those commonalities insisted on in U.S. court decisions. It does this through application of the Analytic Hierarchy Process to a hierarchy of humanness criteria, and secondarily through reference to that concept''s subset, personhood. (shrink)

This article seeks to assess the results of legislation legalizing medical termination, known in Canada as "medical aide in dying" in 2016. Its focus, like that of previous authors, is to ask if the concerns of skeptics opposed to legalization have been realized or were they unfounded. These include the likelihood of a “slippery slope” with an expanding definition of eligibility and of MAiD deaths. Of similar concern at least since 1995 was the likelihood that, in the absence of the (...) provision of palliative, rehabilitative, psychological and social services that medical termination would be a substitute for good medical care. These and other concerns are the basis for the review of MAiD in Canada clinically, legally and as an ethical construct. (shrink)

Bioethics promises a considered, unprejudicial approach to areas of medical decision-making. It does this, in theory, from the perspective of moral philosophy. But the promise of fairly considered, insightful commentary fails when word choices used in ethical arguments are prejudicial, foreclosing rather than opening an area of moral discourse. The problem is illustrated through an analysis of the language of The Royal Society Expert Panel Report: End of Life Decision Making advocating medical termination.

The principal thesis in this book is that bioethics emerged—in the 1960s through the 1980s—under the influence of philosophers who claimed to have universally valid principles that could steer medicine and research to the solution of ethical problems, including even those arising at the bedside of patients. Tom Koch contends that these philosophers and their allied bioethicists “stole medicine” and its traditional values, substituting a philosophical discourse generally inaccessible to the average person. Philosophers thereby refashioned medical ethics in accordance (...) with their vision of a morally and intellectually robust new field. Koch maintains that philosophers have failed to deliver on their promises and that .. (shrink)

Is Tom Shakespeare disabled, or simply distinct in stature? And if the latter, what makes that distinction important?For more than a decade, the British sociologist has been a critical voice in the sociology of difference. The son of a physician with achondroplasia “widely admired as a doctor and as a disabled role model” ,1 Shakespeare fils also has achondroplasia, is the father of children with the condition and, like his father, is professionally successful. As his book’s back cover announces, Shakespeare (...) has “taught and researched sociology at the Universities of Cambridge, Sunderland, Leeds, and Newcastle. He has written and broadcast extensively about disability and genetics, and his co-authored books include The Sexual Politics of Disability, Exploring Disability, and Genetic Politics.”This volume brings together a decade of papers that, Shakespeare says, “draws on my experience of being a disabled person, and the son, father, husband and friend of disabled people”1 to argue the following thesis: “Disability results from the interplay of individual and contextual factors. In other words, people are disabled by society and by their bodies.”1 That argument, he suggests, has resulted in the “breakdown of my relationship with the mainstream of the UK disabled people’s movement”, whose members advance a model of disability based wholly on social construction. Shakespeare sees that as simplistic and no longer viable despite of the extraordinary gains made by those seeking parity through advancement of the social construction thesis.1According to Shakespeare, his former confrères in the British disability movement see as a betrayal his rejection of their argument, one he formerly endorsed, and thus perhaps a repudiation of a generation of admittedly successful activism. To them, in other words, Shakespeare is no longer disabled but disabling, and that judgment must …. (shrink)

This paper responds to the reviews by Edwards, Holm, Koch, Thomas and Vehmas of Disability Rights and Wrongs . After summarising the recent history of disability studies as a discipline, it explores: the political nature of disability research, questions of ontology and definition, and the uses and abuses of the expressivist argument. Disability is an emerging field of enquiry and constructive debate is to be welcomed.

Ten years ago, Megan Shinal sought the care of neurosurgeon Steven Toms for the surgical treatment of a recurrent nonmalignant tumor in the pituitary region of her brain. In their twenty-minute meeting, Shinal did not make a final decision about which surgical approach she wished to pursue. Subsequently, she spoke with Tom's physician assistant once by phone and once in person, when she signed the consent form, which did not appear to designate which surgical approach she had chosen. During the (...) operation—a total resection—Toms perforated Shinal's carotid artery, resulting in hemorrhage, stroke, brain injury, and partial blindness. The jury found that Toms had fulfilled his informed-consent obligations prior to performing the resection; however, in June 2017, the Supreme Court of Pennsylvania overturned the decision, relying on the Pennsylvania Medical Care Availability and Reduction of Error Act. The court found that the language of the act is unambiguous in its requirement that “a physician's duty to provide information to a patient sufficient to obtain her informed consent is non-delegable.” Presumably, this rule of nondelegation applies beyond the surgical theater to other major treatment decisions. And it is unclear whether it applies to other professionals in a subordinate position to the treating physician, such as residents and fellows. (shrink)

Tom Koch's review of Jack Kevorkian's is a valuable look at this one (in)famous crusader's practices. The immediate question raised, and to which Koch provides his own perspectives, is what practical conclusions might be drawn from the final experiences and actions of this cohort of suffering individuals. My briefest and perhaps flippant answer is —including, unfortunately, those derived or hinted at by Koch himself.

Mainstream bioethics takes after a competitive, individualistic understanding of biology and is ultimately rooted in libertarian 19th-century values. These in turn drive much of the enthusiasm for transhumanism and explain why disability in bioethics is often characterised as a lamentable deficiency. That, at least, is the concern raised by Tom Koch in his paper Disabling disability amid competing ideologies.1 He contrasts this paradigm with a cooperative, communal understanding of biology, and in turn, of bioethics—one which entails generally prioritising a (...) socially cooperative and accommodating response to the fact that different humans have different capacities. It is tempting to defensively nit-pick Koch’s criticisms; to conservatively argue that bioethics is fine as it is, thank you very much. That would be the wrong response, I think. His paper raises a crucial and often neglected issue, which is how the notion of human flourishing is implicitly characterised in these discussions. Nevertheless, I think there is a false dichotomy at the heart of this paper—one between the individualistic/competitive and the communal/cooperative—which overestimates the level of disagreement in bioethics. Koch argues that at least some of the elements of a Darwinian competition have been smuggled into bioethics as unquestioned suppositions that inform much of the domain’s …. (shrink)

Preface : consciousness redux -- What is consciousness? -- Who is conscious? -- Animal consciousness -- Consciousness and the rest -- Consciousness and the brain -- Tracking the footprints of consciousness -- Why we need a theory of consciousness -- Of wholes -- Tools to measure consciousness -- The uber-mind and pure consciousness -- Does consciousness have a function? -- Computationalism and experience -- Computers can't simulate experience -- Consciousness : here, there but not everywhere -- Coda : why this (...) matters -- References -- Notes. (shrink)

A philosopher argues that state-sponsored cyberattacks against central military or civilian targets are always acts of war. What is this philosopher doing? According to conceptual analysts, the philosopher is making a claim about our concept of war. According to philosophical realists, the philosopher is making a claim about war per se. In a quickly developing literature, a third option is being explored: the philosopher is engineering the concept of war. On this view, the philosopher is making a proposal about which (...) concept we should have – even if it deviates from the extant concept, and even if it does not capture ‘what war really is’. The activity or method of proposing such revisionary definitions, as well as the metaphilosophical reflection on it, has become known as conceptual engineering. (shrink)

More than twenty years after its original publication, The Case for Animal Rights is an acknowledged classic of moral philosophy, and its author is recognized as the intellectual leader of the animal rights movement. In a new and fully considered preface, Regan responds to his critics and defends the book's revolutionary position.

Conceptual engineering concerns the assessment and improvement of our concepts. But how can proposals to engineer concepts be implemented in the real world? This is known as the implementation challenge to conceptual engineering. In this paper, I am concerned with the meta-philosophical implications of the implementation challenge. Specifically, must we overcome the implementation challenge prior to undertaking conceptual engineering? Some critics have recently answered this question affirmatively. I intend to show that they are mistaken. I argue as follows. First, successful (...) implementation is not an integral part of conceptual engineering. Second, the idea that the value of conceptual engineering relies on successful implementation is in tension with widespread assumptions about normative theorizing. (shrink)

It is an important feature of creatures like us that our various motivations compete for control over our behaviour, including mental behaviour such as imagining and attending. In large part, this competition is adjudicated by the stimulation of affect — the intrinsically pleasant or unpleasant aspects of experience. In this paper I argue that the motivation-affect system controls a sub-type of attention called 'alerting attention' to bring various goals and stimuli to consciousness and thereby prioritize those contents for action. This (...) view allows me to flesh out the global workspace theory of consciousness, as well as some of the phenomenal characteristics of conscious experience. (shrink)

To understand Self-Representationalism you need to understand its family. Self-Representationalism is a branch of the Meta-Representationalist family, and according to theories in this family what distinguishes conscious mental representations from unconscious mental representations is that conscious ones are themselves the target of a mental meta¬-representational state. A mental state M1 is thus phenomenally conscious in virtue of being suitably represented by some mental state M2. What distinguishes the Self-Representationalist branch of the family is the claim that M1 and M2 must (...) be the same token mental state, so a mental state is phenomenally conscious in virtue of suitably representing itself. This Self-Representationalist branch of the family divides into further branches, giving us specific implementations of the Self-Representationalist approach. But before asking whether we should adopt Self-Representationalism, and in what form, we should reflect on why Meta-Representationalism is an attractive family in the first place. After all, Self-Representationalist theories trade on their family name, claiming to deliver on the promises that drive the Meta-Representationalist approach. The two most important promises of Meta-Representationalism are: a) the promise of capturing the transitivity of consciousness and; b) the promise of rendering consciousness naturalisable. I discuss each in turn. (shrink)

Abstract Temporal Externalism is the view that future events can contribute to determining the present content of our thoughts and utterances. Two objections to Temporal Externalism are discussed and rejected. The first is that Temporal Externalism has implausible consequences for the epistemology of biology and other taxonomic sciences (Brown, 2000). The second is that it is committed to implausible claims about dispositions.

If we were to connect two individuals’ brains together, how would this affect the individuals’ conscious experiences? In particular, it is possible for two people to share any of their conscious experiences; to simultaneously enjoy some token experiences while remaining distinct subjects? The case of the Hogan twins—craniopagus conjoined twins whose brains are connected at the thalamus—seems to show that this can happen. I argue that while practical empirical methods cannot tell us directly whether or not the twins share conscious (...) experiences, considerations about the locality of content processing in the brain entails that they most likely do so. (shrink)

How wrong is it to deceive someone into sex by lying, say, about one's profession? The answer is seriously wrong when the liar's actual profession would be a deal breaker for the victim of the deception: this deception vitiates the victim's sexual consent, and it is seriously wrong to have sex with someone while lacking his or her consent.