ABSTRACTCertain restrictions on public funding for assisted reproductive technology are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein a source of moral (...) guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions. (shrink)

Precision medicine is an emerging approach to treatment and disease prevention that relies on linkages between very large datasets of health information that is shared amongst researchers and health professionals. While studies suggest broad support for sharing precision medicine data with researchers at publicly funded institutions, there is reluctance to share health information with private industry for research and development. As the private sector is likely to play an important role in generating public benefits from precision medicine initiatives, it is (...) important to understand what the concerns are and how they might be mitigated. This study reports outcomes of a deliberative method of citizen engagement in Singapore that asked whether sharing precision medicine data with private industry would be permissible, and if so, under what circumstances. Findings from this citizens’ jury suggest sharing with industry would be permissible under certain conditions that are set out in nine recommendations. Implications of the recommendations and their underlying assumptions for policy decision makers are discussed. This study aligns with prior international studies which found conditional acceptance for data sharing with private industry, a public benefit requirement, specific reluctance to share with insurance companies and an emphasis on accountability and transparency to demonstrate trustworthiness. However, our results differ from prior studies in that opt-in consent did not dominate the deliberations as jurors were able to set it aside as an assumed prerequisite for participation in a precision medicine programme. (shrink)

Certain restrictions on public funding for assisted reproductive technology (ART) are articulated and defended by recourse to a distinction between medical infertility and social infertility. We propose that underlying the prioritization of medical infertility is a vision of medicine whose proper role is to restore but not to improve upon nature. We go on to mark moral responses that speak of investments many continue to make in nature as properly an object of reverence and gratitude and therein (sometimes) a source (...) of moral guidance. We draw on the work of Ludwig Wittgenstein in arguing for the plausibility of an appeal to nature in opposition to the charge that it must contain a logical fallacy. We also invite consideration of the moral plausibility of some appeal to nature. Finally, we examine what follows in the case of ART. Should medicine respect as natural limits that should not be overcome: the need for a man and a woman in reproduction; menopause; and even declining fertility with age? We must first ask ourselves to what degree we should defer to nature in the conduct of medicine, at least in the particular if not the general case. This will involve also asking ourselves what we think is natural and in what instances and spirit might we defy nature. Divergent opinions and policies concerning who should receive ART treatment and public funding are more easily understood in view of the centrality, complexity and fundamental nature of these questions. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

The link between alcohol consumption and cancer is well established, but public awareness of the risk remains low. Mandated warning labels have been suggested as a way of ensuring “informed choice” about alcohol consumption. In this article we explore various ethical issues that may arise in connection with cancer warning labels on alcoholic beverages; in particular we highlight the potentially questionable autonomy of alcohol consumption decisions and consider the implications if the autonomy of drinking behavior is substantially compromised. Our discussion (...) demonstrates the need for the various ethical issues to be considered and addressed in any decision to mandate cancer warning labels. (shrink)

Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those older women (...) who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice. (shrink)

Introduction No consent for health and medical research is appropriate when the criteria for a waiver of consent are met, yet some ethics committees and data custodians still require informed consent. Methods A single-blind parallel-group randomised controlled trial: 1129 families of children born at a South Australian hospital were sent information explaining data linkage of childhood immunisation and hospital records for vaccine safety surveillance with 4 weeks to opt in or opt out by reply form, telephone or email. A subsequent (...) telephone interview gauged the intent of 1026 parents (91%) in relation to their actions and the sociodemographic differences between participants and non-participants in each arm. Results The participation rate was 21% (n=120/564) in the opt-in arm and 96% (n=540/565) in the opt-out arm (χ2 (1 df) = 567.7, p<0.001). Participants in the opt-in arm were more likely than non-participants to be older, married/de facto, university educated and of higher socioeconomic status. Participants in the opt-out arm were similar to non-participants, except men were more likely to opt out. Substantial proportions did not receive, understand or properly consider study invitations, and opting in or opting out behaviour was often at odds with parents' stated underlying intentions. Conclusions The opt-in approach resulted in low participation and a biased sample that would render any subsequent data linkage unfeasible, while the opt-out approach achieved high participation and a representative sample. The waiver of consent afforded under current privacy regulations for data linkage studies meeting all appropriate criteria should be granted by ethics committees, and supported by data custodians. Trial registration number Australian New Zealand Clinical Trials Registry ACTRN12610000332022. (shrink)

BackgroundThere is a growing concern about artificial intelligence (AI) applications in healthcare that can disadvantage already under-represented and marginalised groups (eg, based on gender or race).ObjectivesOur objectives are to canvas the range of strategies stakeholders endorse in attempting to mitigate algorithmic bias, and to consider the ethical question of responsibility for algorithmic bias.MethodologyThe study involves in-depth, semistructured interviews with healthcare workers, screening programme managers, consumer health representatives, regulators, data scientists and developers.ResultsFindings reveal considerable divergent views on three key issues. First, (...) views on whether bias is a problem in healthcare AI varied, with most participants agreeing bias is a problem (which we call the bias-critical view), a small number believing the opposite (the bias-denial view), and some arguing that the benefits of AI outweigh any harms or wrongs arising from the bias problem (the bias-apologist view). Second, there was a disagreement on the strategies to mitigate bias, and who is responsible for such strategies. Finally, there were divergent views on whether to include or exclude sociocultural identifiers (eg, race, ethnicity or gender-diverse identities) in the development of AI as a way to mitigate bias.Conclusion/significanceBased on the views of participants, we set out responses that stakeholders might pursue, including greater interdisciplinary collaboration, tailored stakeholder engagement activities, empirical studies to understand algorithmic bias and strategies to modify dominant approaches in AI development such as the use of participatory methods, and increased diversity and inclusion in research teams and research participant recruitment and selection. (shrink)

Department of Medical Education, Flinders University of South Australia, GPO Box 2100, Adelaide SA 5001. Tel. : +61-8-7225-1111; Fax: +61-8-8204-5675; Email: lee0359{at}flinders.edu.au ' + u + '@ ' + d + ' '/ /- ->.This paper analyses the role of communication strategies in pandemic influenza planning. Our central concern is with the extent to which nations are using communication to address issues of social justice. Issues associated with disadvantage and vulnerability to infection in the event of an influenza pandemic raise (...) distinct questions about how well less well off groups will be protected. The potential for a public health emergency of this type to exacerbate existing inequalities, making those in less well off positions worse off, makes social justice an important consideration for pandemic planners. National PI plans offer insights into the ways that nations may use communication to address issues of disadvantage, thereby providing a way of examining how communication strategies are presented and their potential to mitigate inequities. Our research reviewed 12 national PI plans and assessed the extent to which nations are using communication to assist and limit possible harms to less well off groups. We outline in this paper some important issues and considerations associated with social justice and flu planning, in particular if and how plans are addressing inequalities. CiteULike Connotea Del.icio.us What's this? (shrink)

Across the world, pain is under-treated in emergency departments. We canvass the literature testifying to this problem, the reasons why this problem is so important, and then some of the main hypotheses that have been advanced in explanation of the problem. We then argue for the plausibility of two new hypotheses: pain's under-treatment in the ED is due partly to an epistemic preference for signs over symptoms on the part of some practitioners, and some ED practices that themselves worsen pain (...) by increasing patients' anxiety and fear. Our argument includes the following logic. Some ED practitioners depart from formal guidance in basing their acute pain assessments on observable features rather than on patient reports of pain. This is potentially due to an epistemic preference for signs over symptoms which aims to circumvent intentional and/or unintentional misrepresentation on the part of patients. However, conducting pain assessments in line with this epistemic preference contributes to the under-treatment of pain in at least three respects, which we detail. Moreover, it may do little to help the practitioner circumvent any intentional misrepresentation on the part of the patient, as we explain. Second, we examine at least four ED practices that may be contributing to the under-treatment of pain by increasing patient anxiety and fear, which can worsen pain. These practices include failing to provide orienting information and partially objectifying patients so as to problem-solve along lines pre-established by modern medical science. We conclude by touching on some potential solutions for ED practice. (shrink)

Next SectionWhilst there has been considerable debate about the fit between moral theory and moral reasoning in everyday life, the way in which moral problems are defined has rarely been questioned. This paper presents a qualitative analysis of interviews conducted with 15 general practitioners (GPs) in South Australia to argue that the way in which the bioethics literature defines an ethical dilemma captures only some of the range of lay views about the nature of ethical problems. The bioethics literature has (...) defined ethical dilemmas in terms of conflict and choice between values, beliefs and options for action. While some of the views of some of the GPs in this study about the nature of their ethical dilemmas certainly accorded with this definition, other explanations of the ethical nature of their problems revolved around the publicity associated with the issues they were discussing, concern about their relationships with patients, and anxiety about threats to their integrity and reputation. The variety of views about what makes a problem a moral problem indicates that the moral domain is perhaps wider and richer than mainstream bioethics would generally allow. (shrink)

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals significant (...) both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice. (shrink)

(No abstract is available for this citation).

Copyright © 2008 by International Union for Health Promotion and Education.

Community-based healthcare organisations manage competing, and often conflicting, priorities. These conflicts can arise from the multiple roles these organisations take up, and from the diverse range of stakeholders to whom they must be responsive. Often such conflicts may be titled conflicts of interest; however, what precisely constitutes such conflicts and what should be done about them is not always clear. Clarity about the duties owed by organisations and the roles they assume can help identify and manage some of these conflicts. (...) Taking divisions of general practice in Australia as an example, this paper sets out to distinguish two main types of conflicts of interest, so that they may be more clearly identified and more effectively managed. (shrink)

Neglected and tropical diseases, pervasive in developing countries, are important contributors to global health inequalities. They remain largely untreated due to lack of effective and affordable treatments. Resource-poor countries cannot afford to develop the public health interventions needed to control neglected diseases. In addition, neglected diseases do not represent an attractive market for pharmaceutical industry. Although a number of international commitments, stated in the Millennium Development Goals, have been made to avert the risk of communicable diseases, tropical diseases still remain (...) neglected due to delays in international assistance. This delay can be explained by the form international cooperation has generally taken, which is limited to promoting countries’ national interests, rather than social justice at a global level. This restricts the international responsibility for global inequalities in health to a humanitarian assistance. We propose an alternative view, arguing that expanding the scope of international cooperation by promoting shared health and economic value at a global level will create new opportunities for innovative, effective and affordable interventions worldwide. It will also promote neglected diseases as a global research priority. We build our argument on a proposal to replace the patenting system that currently regulates pharmaceutical research with a global fund to reward this research based on actual decreases in morbidity and mortality at a global level. We argue that this approach is beneficent because it will decrease global health inequalities and promote social justice worldwide. (shrink)

This book addresses the problem of how to make democratically-legitimate public policy on issues of contentious bioethical debate. It focuses on ethical contests about research and their legitimate resolution, while addressing questions of political legitimacy. How should states make public policy on issues where there is ethical disagreement, not only about appropriate outcomes, but even what values are at stake? What constitutes justified, democratic policy in such conflicted domains? Case studies from Canada and Australia demonstrate that two countries sharing historical (...) and institutional characteristics can reach different policy responses. This book is of interest to policymakers, bioethicists, and philosophers, and will deepen our understanding of the interactions between large-scale socio-political forces and detailed policy problems in bioethics. (shrink)

Ethik-Komitees gehören zum festen Bestandteil des Ethikmanagements und der Organisationsethik in klinischen Einrichtungen des Gesundheitswesens. Entsprechende Ethikstrukturen und die damit verbundenen Angebote stoßen hinsichtlich ihrer Wirksamkeit allerdings an ihre Grenzen. Ihre Arbeitsweisen sind häufig reaktiv und eine Verankerung in den entsprechenden Organisationsebenen fehlt. Ausgehend von diesen Limitationen der klinischen Ethikberatung hat sich die multiprofessionelle „Arbeitsgruppe Ethik“ am Universitätsklinikum Tübingen um die Konzeption und Implementierung eines neuen Ansatzes zur nachhaltigen Integration von ethischen Reflexions- und Entscheidungsprozessen auf den Stationen des UKT bemüht. (...) Mit dem Tübinger Modell der Ethikbeauftragten der Station verfolgt sie ein Pilotprojekt, das speziell geschulte Pflegekräfte aus allen Stationen des UKT als AnsprechpartnerInnen für ethische Fragen einsetzt. Damit stellen die Ethikbeauftragten eine Erweiterung zu etablierten Strukturen der Ethikberatung dar und ergänzen vorhandene Top-Down-Strategien. Der vorliegende Beitrag stellt die Zielsetzungen des Tübinger Modells dar und schildert erste Erfahrungen in der Umsetzung. Neben der Einbettung in organisationale Strukturen der Ethikberatung werden die stationsinternen und stationsübergreifenden Aufgaben der Ethikbeauftragten dargestellt. Zudem wird das Qualifikationsprogramm für Ethikbeauftragte sowie ein Train-the-Trainer-Konzept vorgestellt, welche eine vertiefende Entwicklung von pflege- und medizinethischer Kompetenzen unterstützen und Sicherheit in den stationsbezogenen Reflexions- und Entscheidungsprozessen vermitteln. (shrink)

In these Carus Lectures, Annette Baier looks at the relation between individual and shared reasoning, intending, and moral reflection. In each case she emphasizes the interdependence of minds and the role of social practices in setting the norms governing these activities.

It is becoming more common that the decision-makers in private and public institutions are predictive algorithmic systems, not humans. This article argues that relying on algorithmic systems is procedurally unjust in contexts involving background conditions of structural injustice. Under such nonideal conditions, algorithmic systems, if left to their own devices, cannot meet a necessary condition of procedural justice, because they fail to provide a sufficiently nuanced model of which cases count as relevantly similar. Resolving this problem requires deliberative capacities uniquely (...) available to human agents. After exploring the limitations of existing formal algorithmic fairness strategies, the article argues that procedural justice requires that human agents relying wholly or in part on algorithmic systems proceed with caution: by avoiding doxastic negligence about algorithmic outputs, by exercising deliberative capacities when making similarity judgments, and by suspending belief and gathering additional information in light of higher-order uncertainty. (shrink)

We address concerns raised by Maul (2012) regarding the validity of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). We respond to requests for clarifications of our model, and explain why the MSCEIT’s scoring methods stand up to scrutiny and why many reported reliabilities of the MSCEIT may be underestimates, using reanalyses of the test’s standardization sample of N = 5,000 to illustrate our point. We also organize findings from four recent articles that provide evidence for the MSCEIT’s validity based on (...) its relations with other tests. (shrink)

We discuss the variety of sorts of sympathy Hume recognizes, the extent to which he thinks our sympathy with others’ feelings depends on inferences from the other’s expression, and from her perceived situation, and consider also whether he later changed his views about the nature and role of sympathy, in particular its role in morals.

The influence of liberal political ideology on nursing sciencePrevious notions of science as impartial and value-neutral have been refuted by contemporary views of science as influenced by social, political and ideological values. By locating nursing science in the dominant political ideology of liberalism, the author examines how nursing knowledge is influenced by liberal philosophical assumptions. The central tenets of liberal political philosophy — individualism, egalitarianism, freedom, tolerance, neutrality, and a free-market economy — are primarily manifested in relation to: (i) the (...) individualistic focus of our science; (ii) our view of society as essentially egalitarian and equitable; (iii) our preference for politically neutral knowledge development, and (iv) an economy of knowledge development that supports rather than challenges the status quo. I argue that exposing, rather than ignoring, the liberal ideological values inherent in nursing science will render these assumptions open to debate, stimulate ongoing development of critically oriented knowledge, and increase our capacity to influence the social, political and economic determinants of health. (shrink)

In this paper, I identify a theoretical and political role for ‘white ignorance’, present three alternative accounts of white ignorance, and assess how well each fulfils this role. On the Willful Ignorance View, white ignorance refers to white individuals’ willful ignorance about racial injustice. On the Cognitivist View, white ignorance refers to ignorance resulting from social practices that distribute faulty cognitive resources. On the Structuralist View, white ignorance refers to ignorance that results as part of a social process that systematically (...) gives rise to racial injustice, and is an active player in the process. I argue that, because of its greater power and flexibility, the Structuralist View better explains the patterns of ignorance that we observe, better illuminates the connection to white racial domination, and is overall better suited to the project of ameliorating racial injustice. As such, the Structuralist View should be preferred. (shrink)

David Hume's essay Of Moral Prejudices offers a spirited defense of "all the most endearing sentiments of the hearts, all the most useful biases and instincts, ...

In this paper, I identify a theoretical and political role for ‘white ignorance’, present three alternative accounts of white ignorance, and assess how well each fulfils this role. On the Willful Ignorance View, white ignorance refers to white individuals’ willful ignorance about racial injustice. On the Cognitivist View, white ignorance refers to ignorance resulting from social practices that distribute faulty cognitive resources. On the Structuralist View, white ignorance refers to ignorance that (1) results as part of a social process that (...) systematically gives rise to racial injustice, and (2) is an active player in the process. I argue that, because of its greater power and flexibility, the Structuralist View better explains the patterns of ignorance that we observe, better illuminates the connection to white racial domination, and is overall better suited to the project of ameliorating racial injustice. As such, the Structuralist View should be preferred. (shrink)

This contribution is concerned with what Hume means by reflection and sentiment. Hume’s Treatise is devoted to an account of the extent to which the mind is able to bear its own reflexion or turn mental states on themselves. This theme is likely the “new scene of thought” that inspired Hume’s major concerns in the Treatise. Although Hume found that the understanding fails to understand itself, the passions do better in satisfying curiosity about curiosity, and, most importantly, moral sentiment is (...) able to approve of itself. The author contends that the whole task of the moral sentiment is to get us to fulfill our part to mankind and society, and that, according to Hume, the sentiments are the noble source of morality itself. (shrink)

Cultural safety is a relatively new concept that has emerged in the New Zealand nursing context and is being taken up in various ways in Canadian health care discourses. Our research team has been exploring the relevance of cultural safety in the Canadian context, most recently in relation to a knowledge-translation study conducted with nurses practising in a large tertiary hospital. We were drawn to using cultural safety because we conceptualized it as being compatible with critical theoretical perspectives that foster (...) a focus on power imbalances and inequitable social relationships in health care; the interrelated problems of culturalism and racialization; and a commitment to social justice as central to the social mandate of nursing. Engaging in this knowledge-translation study has provided new perspectives on the complexities, ambiguities and tensions that need to be considered when using the concept of cultural safety to draw attention to racialization, culturalism, and health and health care inequities. The philosophic analysis discussed in this paper represents an epistemological grounding for the concept of cultural safety that links directly to particular moral ends with social justice implications. Although cultural safety is a concept that we have firmly positioned within the paradigm of critical inquiry, ambiguities associated with the notions of 'culture', 'safety', and 'cultural safety' need to be anticipated and addressed if they are to be effectively used to draw attention to critical social justice issues in practice settings. Using cultural safety in practice settings to draw attention to and prompt critical reflection on politicized knowledge, therefore, brings an added layer of complexity. To address these complexities, we propose that what may be required to effectively use cultural safety in the knowledge-translation process is a 'social justice curriculum for practice' that would foster a philosophical stance of critical inquiry at both the individual and institutional levels. (shrink)

English summary: Medicine is not only a technique or skill for obtaining or restoring health in the face of illness and death; it strives to be a component of life that has learned to deal with the inevitability of suffering and death. As meditatio vitae et mortis, it can become a field of reflection on being human par excellence. The increasing possibility of anti-aging, plastic surgery and enhancement procedures, however, again bring about questions of the limits of human medicine, even (...) moreso if, as in transhumanist utopia and cryonic practice, the possibility of postponement or even of overcoming human finitude becomes possible. Medicine, society and the presence of death and dying must respond to these challenges. Herein ies the focus of this volume: the authors reflect on finiteness and immortality in medicine from historical, philosophical, social science, and ethical perspectives. German text. German description: Die Medizin ist nicht nur Technik oder Kunst, das Leben und die Gesundheit angesichts von Krankheit und Tod zu erhalten bzw. wiederherzustellen, sondern strebt eine Praxis der Lebensfuehrung an, die mit der Unvermeidbarkeit von Leiden und Sterben umzugehen lernt. Als meditatio vitae et mortis kann sie zu einem Feld der Reflexion ueber das Menschsein par excellence werden. Die zunehmenden Moglichkeiten von Anti-Aging, Plastischer Chirurgie und Enhancement stellen dabei die Fragen nach Grenzen einer humanen Heilkunde wieder neu, noch dazu, wenn - wie in transhumanistischen Utopien und kryonischer Praxis - die Moglichkeit der Verschiebung oder gar Uberwindung menschlicher Endlichkeit in Aussicht gestellt wird. Medizin, Gesellschaft und Sterbekultur der Gegenwart muessen auf die Herausforderungen reagieren. In diesem Themenfeld liegt der Schwerpunkt des Bandes: Die Autoren reflektieren Endlichkeit und Unsterblichkeit in der Medizin aus historischer, philosophischer, sozialwissenschaftlicher wie auch ethischer Perspektive. (shrink)

" By the end, we can see the cause to which Hume has been true throughout the work.

Annette Baier's aim is to make sense of David Hume's Treatise as a whole. Hume's family motto, which appears on his bookplate, was True to the End. Baier argues that it is not until the end of the Treatise that we get his full story about truth and falsehood, reason and folly. By the end, we can see the cause to which Hume has been true throughout the work. Baier finds Hume's Treatise of Human Nature to be a carefully (...) crafted literary and philosophical work which itself displays a philosophical progress of sentiments. His starting place is an overly abstract intellectualism that deliberately thrusts passions and social concerns into the background. In the three interrelated books of the Treatise, his self-understander proceeds through partial successes and dramatic failures to emerge with new-found optimism, expecting that the exact knowledge the morally self-conscious anatomist of human nature can acquire will itself improve and correct our vision of morality. Baier describes how, by turning philosophy toward human nature instead of toward God and the universe, Hume initiated a new philosophy, a broader discipline of reflection that can embrace Charles Darwin and Michel Foucault as well as William James and Sigmund Freud. Hume belongs both to our present and to our past. (shrink)

Kaum ein Zeitabschnitt war von solch grundlegenden technischen, politischen und philosophischen Umbruchen gepragt wie die 100 Jahre bis zur Jahrtausendwende - vom Kaiserreich zur globalen Weltgesellschaft, vom Idealismus zum Werterelativismus. Die juristische Grundlagenforschung - auch die Rechtsphilosophie - ist gegenwartig in keiner guten Verfassung: Ihr fehlt die gesellschaftliche Resonanz, und damit einhergehend der qualifizierte wissenschaftliche Nachwuchs. Der Band mochte einen Anstoss geben, durch eine Ruckbesinnung auf die grossen Leistungen in der Rechtsphilosophie des letzten Jahrhunderts an diese anzuknupfen, Problemlosungen fur die (...) Zukunft zu suchen und die Unverzichtbarkeit der Rechtsphilosophie dabei wieder ernst zu nehmen. (shrink)

This is an essay at the intersection of metaethics and the history of contemporary analytic philosophy. It explores the relationships between Allan Gibbard’s mature quasi-realist expressivism and (i) three non-naturalistic varieties of what I call “non-inflationary realism” and (ii) moral fictionalism. Moral or normative realism is frequently (if mistakenly) taken to involve certain existence-affirming external assumptions about the metaphysical status of substantive normative thought and discourse. The non-inflationary realists seek to embrace moral or normative objectivity and truth without any distinctly—as (...) they see it, “inflated”—moral or normative ontology. This position, along with a shared emphasis on the primacy of substantive moral or normative thought and discourse, brings them very close to Gibbard, and so to what it is tempting to treat as a strikingly different metaethical account. Focusing on the non-inflationary realists Ronald Dworkin, T.M. Scanlon, and Derek Parfit, I examine similarities among their views, and between each of these views and Gibbard’s. I argue that the non-inflationary realist project should be understood as including the work not only of these figures, characteristically seen as among its paradigmatic representatives, but also, crucially, that of Gibbard. They all agree that our moral or normative claims purport to state normative truths and that such claims are capable of being true or false and that when true they do not depend on the particular standpoint anyone happens to take. Our moral or normative thoughts can be characterized as beliefs. We can have moral knowledge. There are substantive moral and normative facts. These facts are not reducible to non-normative facts. Normative concepts cannot be analyzed in purely naturalistic terms; and normative facts do not depend on any robustly existent truth-makers. Focusing on these shared commitments enables me to home in on the apparent differences that nonetheless remain. They differ in significant respects, for instance, about whether—and, if so, to what extent—we can make any meaningful external (non-substantive) judgments about the moral or normative and about whether there is a role for property-based explanations that minimalism about the normative fails to capture. By investigating these and other differences, I shed light on what is at stake in giving an adequate account of our moral and normative thought and talk. I pursue this aim further by considering why it might seem that quasi-realist expressivism was a form of normative fictionalism or error theory—though it is not. I attempt here to clear up confusions stemming from common assumptions associated with terms like “realism,” “cognitivism,” or “fictionalism” with respect to morality or normativity. I distinguish some differences in the ways in which normative properties can be understood by non-inflationary realists and the roles they can play in explaining normativity. I underscore the implausibility of treating the moral domain as completely autonomous. And I attempt to offer suggestions regarding some conceptual options that remain to be further explored. I maintain that Gibbard makes explicit otherwise unacknowledged implications of Scanlon’s or Dworkin’s accounts, implications regarding deep differences between normative or moral and other domains, implications which might help explain the uneasiness that prompts Scanlon and Dworkin to resist Gibbard’s account and that pushes Parfit toward what seems to be a sort of intermediate position between non-inflationary and more ontologically committed realism. Non-inflationary realism forces us to rethink metaethics in interesting and promising ways. (shrink)

What is it to deceive someone? And how is it possible to deceive oneself? Does self-deception require that people be taken in by a deceitful strategy that they know is deceitful? The literature is divided between those who argue that self-deception is intentional and those who argue that it is non-intentional. In this study, Annette Barnes offers a challenge to both the standard characterisation of other-deception and current characterizations of self-deception, examining the available explanations and exploring such questions as (...) the self-deceiver's false consciousness, bias, and the irrationality and objectionability of self-deception. She arrives at a non-intentional account of self-deception that is deeper and more complete than alternative non-intentional accounts and avoids the reduction of self-deceptive belief to wishful belief. (shrink)