Medea killed her children to take away the smile from her husband's face, according to Euripides, an offence against nature and morality. What if Medea had still been carrying her two children, perhaps due to give birth within a week or so, and had done the same? If this would also have been morally reprehensible, would that be a judgment based on her motives or on her action? We argue that the act has multiple and holistic moral features and that, (...) in fact, there is no absolute principle, such as the right of the fetus to life, which governs our moral judgments about fetal-maternal conflicts. We suggest that they illustrate a pervasive feature of human moral discourse and can only be addressed by attending to a range of negotiable moral considerations which depend on particular features of each situation. (shrink)

Decompressive craniectomy is a technically straightforward procedure whereby a large section of the cranium is temporarily removed in cases where the intracranial pressure is dangerously high. While its use has been described for a number of conditions, it is increasingly used in the context of severe head injury. As the use of the procedure increases, a significant number of patients may survive a severe head injury who otherwise would have died. Unfortunately some of these patients will be left severely disabled; (...) a condition likened to the RUB, an acronym for the Risk of Unacceptable Badness. Until recently it has been difficult to predict this outcome, however an accurate prediction model has been developed and this has been applied to a large cohort of patients in Western Australia. It is possible to compare the predicted outcome with the observed outcome at 18 months within this cohort. By using predicted and observed outcome data this paper considers the ethical implications in three cases of differing severity of head injury in view of the fact that it is possible to calculate the RUB for each case. (shrink)

The rule of rescue describes the powerful human proclivity to rescue identified endangered lives, regardless of cost or risk. Deciding whether or not to perform a decompressive craniectomy as a life-saving or ‘rescue’ procedure for a young person with a severe traumatic brain injury provides a good example of the ethical tensions that occur in these situations. Unfortunately, there comes a point when the primary brain injury is so severe that if the patient survives they are likely to remain severely (...) disabled and fully dependent. The health resource implications of this outcome are significant. By using a web-based outcome prediction model this study compares the long-term outcome and designation of two groups of patients. One group had a very severe injury as adjudged by the model and the other group a less severe injury. At 18 month follow-up there were significant differences in outcome and healthcare requirements. This raises important ethical issues when considering life-saving but non-restorative surgical intervention. The discussion about realistic outcome cannot be dichotomised into simply life or death so that the outcome for the patient must enter the equation. As in other ‘rescue situations’, the utility of the procedure cannot be rationalised on a mere cost–benefit analysis. A compromise has to be reached to determine at what point either the likely outcome would be unacceptable to the person on whom the procedure is being performed or the social utility gained from the rule of rescue intervention fails to justify the utilitarian value and justice of equitable resource allocation. (shrink)

Almaatouq et al. propose a novel integrative approach to experiments. We provide three examples of how unaddressed measurement issues threaten the feasibility of the approach and its promise of promoting commensurability and knowledge integration.

The debates about human free will are traditionally the concern of metaphysics but neuroscientists have recently entered the field arguing that acts of the will are determined by brain events themselves causal products of other events. We examine that claim through the example of free or voluntary switch of perception in relation to the Necker cube. When I am asked to see the cube in one way, I decide whether I will follow the command (or do as I am asked) (...) using skills that reason and language give to me and change my brain states accordingly. The voluntary shift of perspective in seeing the Necker cube this way or that exemplifies the top-down control exercised by a human being on the basis of the role of language and meaning in their activity. It also indicates the lived story that is at the centre of each human consciousness. In the third part of this essay, three arguments are used to undermine metaphysical objections to the very idea of top-down self control. (shrink)

The period 800–200 B.C.E. has been called an axial period or age because it was a period of major technological and cultural change that led to the development of new worldviews, which in turn called for and led to the emergence of the current major world religious traditions. The world is now in the midst of another period of major global scientific, technological, and cultural change that is leading to the development of a new global worldview. In this worldview, the (...) cosmos is taken to be more like an activity than a thing—more like an emergent complex of interrelated and interactive doing in space–time than a created complex of beings in space and time–and its complexity and space—time scale are understood to be enormously greater than heretofore supposed.These changes in worldview call for changes in theology, religion, and ethics. Most workers in the field of science and religion are heeding this call by attempting to reconcile traditional religious concepts with the new scientific concepts. Others, however, have become convinced that the new worldview differs so radically from the previous ones as to mark a new axial age, which calls for a new, post‐traditional theology, religion, and ethics, with a theos that is more like an activator of doing than a ground of being, and with meaning and purpose achieved more by a quality of doing than a quantity or quality of being. (shrink)

THE FIRST PART OF MY RESPONSE to the commentaries on my earlier paper is about the place of language and logical systems in the understanding of the personal positions that recovering patients occupy in their life experiences. It includes the main reasons for using Frege's philosophy. Thereafter, I make the point that relational positions in recovery extend broader than positions of actor and patient.

Reading Grant Gillett (2009) is a bit like watching a supreme tightrope artist: his balance is always impeccable and his footing sure; and yet one cannot help occasionally holding one's breath. Ove...

ABSTRACT A discussion of some issues from Grant Gillett's book Reasonable Care. At the metaethical level, Gillett's views about the origin, scope and bindingness of morality are outlined and criticised. Against him it is argued that (a) moral capacity does not follow from linguistic ability, (b) things can matter to non‐concept‐users and (c) universalisability arguments fail to show that immorality is irrational. At the first order level, Gillett's arguments against surrogacy and euthanasia are answered.

This book is an analysis and discussion of the soul as a psychophysical process and its role in mental representation, meaning, understanding and agency. Grant Gillett and Walter Glannon combine contemporary neuroscience and philosophy to address fundamental issues about human existence and living and acting in the world. Based in part on Aristotle's hylomorphism and model of the psyche, their approach is informed by a neuroscientific model of the brain as a dynamic organ in which patterns of neural oscillation and (...) synchronization are shaped by biological, social and cultural factors inside and outside of it. The authors provide a richer and more robust account of the soul, or mind, than other accounts by framing it in neuroscientific and philosophical terms that do not explain it away but explain it as something that is shaped by how it responds to the natural and social environment in enabling flexible and adaptive behavior. (shrink)

Neuroscience and technological medicine in general increasingly faces us with the imminent reality of cyborgs—integrated part human and part machine complexes.If my brain functions in a way that is supported by and exploits intelligent technology both external and implantable, then how should I be treated and what is my moral status—am I a machine or am I a person? I explore a number of scenarios where the balance between human and humanoid machine shifts, and ask questions about the moral status (...) of the individuals concerned. The position taken is very much in accordance with the Aristotelian idea that our moral behaviour is of a piece with our social and personal skills and forms a reactive and reflective component of those skills. (shrink)

Compatibilism has become an increasingly popular position amongst contemporary philosophers. However, within the philosophy of religion the majority of philosophers continue to adopt an incompatibilist, usually libertarian, view of free will. This book seeks to explore whether it is possible to formulate a coherent compatibilist response to the problem of evil and, if so, whether such a response could help compatibilism to be seen as a viable, or even preferable, alternative to incompatibilism within philosophy of religion."--Back cover.

This open access book is a systematic update of the philosophical and scientific foundations of the biopsychosocial model of health, disease and healthcare. First proposed by George Engel 40 years ago, the Biopsychosocial Model is much cited in healthcare settings worldwide, but has been increasingly criticised for being vague, lacking in content, and in need of reworking in the light of recent developments. The book confronts the rapid changes to psychological science, neuroscience, healthcare, and philosophy that have occurred since the (...) model was first proposed and addresses key issues such as the model’s scientific basis, clinical utility, and philosophical coherence. The authors conceptualise biology and the psychosocial as in the same ontological space, interlinked by systems of communication-based regulatory control which constitute a new kind of causation. These are distinguished from physical and chemical laws, most clearly because they can break down, thus providing the basis for difference between health and disease. This work offers an urgent update to the model’s scientific and philosophical foundations, providing a new and coherent account of causal interactions between the biological, the psychological and social. (shrink)

In this unique study Fulford combines the disciplines of rigorous philosophy with an intimate knowledge of psychopathology to overturn traditional hegemonies. The patient replaces the doctor at the heart of medicine. Moral theory and the logic of evaluation replace epistemology as the focus of philosophical enquiry. Ever controversial, mental illness is at the interface of philosophy and medicine. Mad or bad? Dissident or diseased? Dr Fulford shows that it is possible to achieve new insights into these traditional dilemmas, insights at (...) once practically relevant and philosophically significant. (shrink)

Employing a thematic approach and drawing on disciplines ranging from neurobiology to philosophy, Film and Morality examines how morality is presented in films and how films serve as a source of moral values. While the role of censorship in upholding moral standards has been considered comprehensively, the presence of moral dilemmas in films has not attracted the same level of interest. Film-makers may address moral concerns explicitly, but moral dilemmas can serve as plot devices, creating dramatic tension by providing pivotal (...) moments when characters are called upon to make life-changing decisions. Drawing on a range of well-known and neglected films mainly from Britain and America, this book provides numerous examples of how film-makers make use of morality and how audiences are invited to explore moral issues by following characters who live with the consequences of their choices. Film and Morality introduces philosophical debates on such topics as free will, conscience and the place of moral codes in everyday life, showing the relevance of film to these issues. The book presents a distinct approach to how films might be analysed. (shrink)

The diagnosis of bipolar disorder has been linked to giftedness of various sorts and this raises a special problem in that it is likely that the condition has a genetic basis. Therefore it seems possible that in the near future we will be able to detect and eliminate the gene predisposing to the disorder. This may mean, however, that, as a society, we lose the associated gifts. We might then face a difficult decision either way in that it is unclear (...) that we are preventing an unalloyed bad when we diagnose and eliminate bipolar disorder through prenatal genetic testing and yet if we allow the individual to be born we are condemning that person to being an unwitting sacrifice in that they might well suffer considerable net distress as a result of our need to keep our gene pool enriched in the relevant way. (shrink)

This study adapts the theory of reasoned action (Ajzen and Fishbein, 1980) to the behavior of fraudulent reporting on financial statements so as to examine the effects of moral reasoning and self-monitoring on intention to report fraudulently, using structural equation modeling. The paper seeks to investigate two of the red flags for financial statement fraud identified in Loebbecke et al.'s (1989) paper: client management displays a significant lack of moral fiber and client personnel exhibit strong personality anomalies. As expected, high (...) moral reasoners are more influenced than low moral reasoners by their own attitude towards the behavior. Contrary to prior research, low self-monitors are found to be more influenced than high self-monitors by subjective norms. Future research is recommended to investigate the counter-intuitive results for self-monitors, to consider the implications of group decision making as regards the promulgation of fraudulent financial statements, and to examine additional red flags for financial statement fraud. (shrink)

“Probably Peirce’s best-known works are the first two articles in a series of six that originally were collectively entitled Illustrations of the Logic of Science and published in Popular Science Monthly from November 1877 through August 1878. The first is entitled ‘The Fixation of Belief’ and the second is entitled ‘How to Make Our Ideas Clear.’ In the first of these papers Peirce defended, in a manner consistent with not accepting naive realism, the superiority of the scientific method over other (...) methods of overcoming doubt and ‘fixing belief.’” — Robert Burch, “Charles Sanders Peirce,” entry in the Stanford Encyclopedia of Philosophy (2021 revision) -/- “Pragmatist epistemologies often explore how we can carry out inquiries in a self-controlled and fruitful way. (Where much analytic epistemology centres around the concept of knowledge, considered as an idealised end-point of human thought, pragmatist epistemology centres around the concept of inquiry, considered as the process of knowledge-seeking and how we can improve it.) So pragmatists often provide rich accounts of the capacities or virtues that we must possess in order to inquire well, and the rules or guiding principles that we should adopt. A canonical account is Peirce’s classic early paper ‘The Fixation of Belief‘. Here Peirce states that inquiry is a struggle to replace doubt with “settled belief“, and that the only method of inquiry that can make sense of the fact that at least some of us are disturbed by inconsistent beliefs, and will subsequently reflect upon which methods of fixing belief are correct is the Method of Science, which draws on the Pragmatic Maxim described above. This contrasts with three other methods of fixing belief: i) refusing to consider evidence contrary to one’s favored beliefs (the Method of Tenacity), ii) accepting an institution’s dictates (the Method of Authority), iii) developing the most rationally coherent or elegant-seeming belief-set (the A Priori Method).“ — Catherine Legg, “Pragmatism,” entry in the Stanford Encyclopedia of Philosophy (2021 revision). (shrink)

Topics in Cognitive Science, Volume 14, Issue 2, Page 363-387, April 2022.

According to most accounts of trust, you can only trust other people (or groups of people). To trust is to think that another has goodwill, or something to that effect. I sketch a different form of trust: the unquestioning attitude. What it is to trust, in this sense, is to settle one’s mind about something, to stop questioning it. To trust is to rely on a resource while suspending deliberation over its reliability. Trust lowers the barrier of monitoring, challenging, checking, (...) and questioning. Trust sets up open pipelines between yourself and parts of the external world. Trust permits external resources to have a similar relationship to one as one’s internal cognitive faculties. This creates efficiency, but at the price of exquisite vulnerability. We must trust in this way because we are cognitively limited beings in a cognitively overwhelming world. Crucially, we can hold the unquestioning attitude towards objects and technologies. When I trust my climbing rope, I stop worrying about its reliability. When I trust my online calendaring system, I simply go to the events indicated, without question. But, one might worry, how could one ever hold such a normatively loaded attitude as trust towards mere objects? How could it ever make sense to feel betrayed by an object? Trust is our engine for expanding and outsourcing our agency — for binding external processes into our practical selves. Thus, we can be betrayed by our smartphones in the same way that we can be betrayed by our memory. When we trust, we try to make something a part of our agency, and we are betrayed when our part lets us down. To unquestioningly trust something is to let it in—to attempt to bring it inside one’s practical functioning. This suggests a new form of gullibility: agential gullibility, which occurs when agents too hastily and carelessly integrate external resources into their own agency. (shrink)

A concept of diversity is an understanding of what makes a group diverse that may be applicable in a variety of contexts. We distinguish three diversity concepts, show that each can be found in discussions of diversity in science, and explain how they tend to be associated with distinct epistemic and ethical rationales. Yet philosophical literature on diversity among scientists has given little attention to distinct concepts of diversity. This is significant because the unappreciated existence of multiple diversity concepts can (...) generate unclarity about the meaning of “diversity,” lead to problematic inferences from empirical research, and obscure complex ethical-epistemic questions about how to define diversity in specific cases. We illustrate some ethical-epistemic implications of our proposal by reference to an example of deliberative mini-publics on human tissue biobanking. (shrink)

Value capture occurs when an agent’s values are rich and subtle; they enter a social environment that presents simplified — typically quantified — versions of those values; and those simplified articulations come to dominate their practical reasoning. Examples include becoming motivated by FitBit’s step counts, Twitter Likes and Re-tweets, citation rates, ranked lists of best schools, and Grade Point Averages. We are vulnerable to value capture because of the competitive advantage that such crisp and clear expressions of value have in (...) our private reasoning and our public justification. There is, however, a price. In value capture, we take a central component of our autonomy — our ongoing deliberation over the exact articulation of our values — and we outsource it. And the metrics to which we outsource usually engineered for the interests of some external force, like a large-scale institution’s interest in cross-contextual comprehensibility and quick aggregability. That outsourcing cuts off one of the key benefits to personal deliberation. In value capture, we no longer adjust our values and their articulations in light of own rich experience of the world. Our values should often be carefully tailored to our particular selves or our small-scale communities, but in value capture, we buy our values off the rack. In some cases – like decreasing CO2 emissions – the costs of non-tailored values are outweighed by the benefit of precise collective coordination. In other cases, like in our aesthetic lives, they are not. This suggests that we should want different values suited to different scales. We should want value federalism. Some values are perhaps best pursued at the largest-scale level, others at smaller scales. The problem occurs when we exhibit an excess preference for the largest-scale values – when we consistently let the universal metrics swamp our quieter interests. (shrink)

Bioethical debates such as those surrounding the manipulation of human embryos are often based on metaphysical assumptions that lack a foundation in the natural sciences. In this paper we support a gradualist position whereby the embryo progressively takes on the form and associated ethical significance of a human being. We support this position by introducing a concept of biological structure or form to show how the gradualist position has its metaphysical foundations in modern biology. The conceptual basis for form and (...) structure are outlined and their compatibility with and basis in current empirical biology is demonstrated by some recent advances in our understanding of the processes of development from single cell to organism. We then briefly explore the ethical significance of accepting a form or structure based conception of biology for the status of the early embryo. (shrink)

The embodied human subject is dynamically connected to his or her historico-sociocultural context, the soil from which a person’s psyche is nourished as multiplex meanings are absorbed and enable personal development. In each culture certain towering artistic works embody this perspective. The Dream of the Red Chamber introduces Jia Bao-yu—a scion of the prestigious Jia family—and his relationships with a large cast of characters. Bao-yu is controversial but, at the time of the family’s tragic collapse, he can be seen as (...) embodying a spiritual struggle in which his instinct, nature, sensitivity, and creativity are grounded in his transcendent relationship with a fragment of the world stone, an eternal source of energy and creativity. We are invited to draw on a metaphysical level of thought to consider his struggles with man-made hierarchies and a situated historico-sociocultural order in such a way as to live out his spiritual being. As such, the novel is closely relevant to questions of spirituality in bioethics. Through personal experiences, passions, creativity, and relationships with others, the body is inscribed, forming the soul, which may be misconstrued (for instance, through a medical or Cartesian reformulation of events) but which can be seen as the site of ethical and spiritual thought. (shrink)

The Cognitive Integration (henceforth CI) framework posits the existence of integrated cognitive systems (henceforth ICS). In this chapter we outline the nature of ICS and their phylogenetic history. We shall argue that phylogenetically earlier forms of cognition are built upon by more recent cultural innovations. Many of the phylogenetically earlier components are forms of sensorimotor interactions with the environment (Menary 2007a, 2010a, 2016). These sensorimotor interactions are redeployed (or retrained) to service more recent cultural innovations (Dehaene & Cohen 2007). The (...) main aim of this chapter is to give an overview of the CI framework in terms of phylogenetically ancient embodied interactions with the environment and the more recent culturally evolved practices that redeploy our primitive capacities for sensorimotor interactions and manipulations of tools, objects and, in a very recent innovation, public systems of representation. In doing so, we provide a case for the enculturation of our bodies and brains. (shrink)

Delusions, a key feature of psychosis, are usually thought of as a type of belief, as in the definition of the American Psychiatric Association: A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person’s culture or subculture (e.g. it is not an article of religious (...) faith). This characterization is often criticized, but other definitions typically comprise similar elements. For some, delusions are only loosely considered as beliefs (Jaspers 1963; Moor and Tucker .. (shrink)

In this paper we argue that the human form should be seen to exist, in a longitudinal way, throughout the continuum of human growth and development. This entails that the moral value of that form, which we link analytically to the adult, interacting, social and rational being, attaches to all phases of human life to some extent. Having established this we discuss the consequences it has for the moral status of the human embryo. We then apply this argument, and the (...) resulting moral status, to the area of reproductive technology. In doing this we show that there are certain regulations and controls which ought to apply to the use of these infertility treatments. (shrink)

Abortion is permitted in many jurisdictions after the age at which an infant is viable on the basis of intensive neonatal care techniques. Does this cause special concerns for those involved in perinatal care and termination of pregnancy services or is the overlap mainly an abstract issue fretted over by ethicists and academics? In order to explore this question, a group of clinicians involved in this area of care were interviewed and their interviews analysed using qualitative measures. The clinicians concerned (...) were exercised by the ethical issues and had various ways of resolving them which tended to reflect a gradualist, multifaceted and, to some extent, particularist approach to ethical decision-making in relation to the edges of human life. The ways in which those strands of ethical thought are instanced in the interview material are reported and discussed. (shrink)

This collection examines prevalent assumptions in moral reasoning which are often accepted uncritically in medical ethics. It introduces a range of perspectives from philosophy and medicine on the nature of moral reasoning and relates these to illustrative problems, such as New Reproductive Technologies, the treatment of sick children, the assessment of quality of life, genetics, involuntary psychiatric treatment and abortion. In each case, the contributors address the nature and worth of the moral theories involved in discussions of the relevant issues, (...) and focus on the types of reasoning which are employed. 'Medical ethics is in danger of becoming a subject kept afloat by a series of platitudes about respect for persons or the importance of autonomy. This book is a bold and imaginative attempt to break away from such rhetoric into genuine informative dialogue between philosophers and doctors, with no search after consensus.' Mary Warnock. (shrink)

Many senior doctors have had little in the way of formal ethics training, but express considerable interest in extending their education in this area. This paper is the report of an initiative in continuing medical education in which doctors were introduced to narrative ethics. We review the theoretical basis of narrative ethics, and the structure of and response to the two-day workshop.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.1 (2005) 83-85 [Access article in PDF] Lacan, Science, and Determinism Douglas McConnell Grant Gillett Keywords Lacan, the unconscious, free will Van Staden And Hinshelwood's commen-taries raise a number of issues, but there are two particular themes common to both that we pick up in this response.The first theme concerns the reconcilability of Lacanian theory to the disciplines of analytic philosophy and "Anglo-American positivist psychiatry." (...) This is closely related to the relationship between the unconscious and the empirical sciences discussed in the editorial (McConnell and Pickering 2005). The second theme concerns the relevance of Lacanian theory to our understanding of free will and the structure of the mind. Lacan, Analytic Philosophy, and Scientific Psychiatry First, psychoanalysis or psychotherapy generally should not try to reunite with neuroscience because of the fundamental difference in their approaches to the patient, which is likely to mean that even if a theoretical rapprochement can be found, a working relationship is unlikely.Although there are many facets of Lacan's theory that were not addressed in our paper and even if many of those are totally irreconcilable to analytic philosophy, we believe that we have addressed the most ontologically fundamental issues and that these can genuinely contribute to and challenge analytic philosophy of mind.As Hinshelwood points out, psychiatry does operate with a philosophical basis, critical (or sometimes relatively uncritical) scientific realism (even though it may not be acknowledged), and it as such it can legitimately be contributed to or challenged by the philosophical aspects of Lacanian theory outlined in our paper.In fact, the theoretical basis is evinced in van Staden's commentary when he remarks on the relation between Lacanian theory and psychiatry: "... the unconscious is not only structured like a language but actually reflects and is produced by linguistic interaction between the subject and others. This is a difficult claim to verify, no doubt, but it prompts further related questions... whether the conscious mind is structured like a language" (van Staden 2005, 78). And one must ask whether this is the kind of claim that can be verified or whether it is a hermeneutic claim (in somewhat the way suggested by Jaspers), serving more as a framing belief to allow people to make sense of what has influenced them in their life histories and is currently played out in their relationships with others. We would lean toward this interpretation of the unconscious, explicitly distancing ourselves from any overreaching, quasi-scientific realism about unconscious contents and mental structures, but clinging to the thought that dealing with such contents is an essential part of the therapeutic encounter. [End Page 83]Looked at in this way, both the Lacanian unconscious and conscious mental life bear the imprint of language due to the subject's immersion and participation in the symbolic realm. This may seem a "difficult claim to verify," but because verification is linked to the scientific framework of inquiry rather than the hybrid that is clinical knowledge, we would better regard it as being difficult to establish as an axiom of therapy. The linguistic structure of the conscious and unconscious mind is, on this account, a conceptual implication of the role of the symbolic register in thought and not a thesis that requires verification (a Wittgensteinian thesis espoused by a number of contemporary philosophers, including Dummett and Davidson).As it happens, cognitive science has found linguistic structure to be important in operations of the cognitive unconscious (arguably different from the dynamic unconscious due to the former's dependence on scientific experiment and the latter's connections to life history rather than mere psychological or cognitive traits [see Gillett and McConnell 2005]). Given that language and problem solving are so closely intertwined, it would suggest that cognitive science was overlooking something important rather than damaging Lacanian theory if linguistic structure did not appear on cognitive science's "radar." So, how does language logically (in the sense defended by Husserl and Frege, that is, to do with the sense or content of thoughts not merely the processes underpinning one's contingently evolving stream... (shrink)