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

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

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

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

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

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

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

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

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

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

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

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

Novel methods such as mass‐spectrometry enable a view of the proteomes of cells in unprecedented detail. Recently, these efforts have culminated in quantitative measurements of the number of copies per cell for most expressed proteins in organisms ranging from bacteria to mammalian cells. Here, we estimate the expected total number of proteins per unit of cell volume using known parameters related to the composition of cells such as the fraction of cell mass that is protein, and the average protein length. (...) Using simple arguments, we estimate a range of 2–4 million proteins per cubic micron (i.e. 1 fL) in bacteria, yeast, and mammalian cells. Interestingly, we find that measured values that are reported for fission yeast and mammalian cells are often about 3–10 times lower. We discuss this apparent discrepancy and how to use the estimate as benchmark to recalibrate proteome‐wide quantitative censuses or to revisit assumptions about cell composition. (shrink)

The goal of this research is to understand the interaction of implicit and explicit psychological processes in dealing with emotional distractions and meta-cognitive control of such distractions. The questions are how emotional and meta-cognitive processes can be separated into implicit and explicit components, and how such a separation can be utilized to improve self-regulation of emotion, which can have significant theoretical and practical implications.

The studio/label as auteur -- Gender and degrees of popular music authorship -- The singular and collective : the writer as auteur -- The interpreter as auteur -- The producer/re-mixer as auteur -- The Zeitgeist as auteur : contexts, scenes & technologies -- Coda : the seeker and the sought.

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

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

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

A Question of Voice: Philosophy and the Search for Legitimacy offers an explicit and comprehensive consideration of voice as a complex of rethinking aspects of the history of philosophy through issues of power, as well as contemporary issues that include and involve the desire for and the dynamics of legitimacy, for individuals and communities. By identifying voice as a significant theme and means by which and through which we might better engage some important philosophical questions, Ron Scapp hopes to expand (...) traditional philosophical discussion and discourse regarding questions about validity, legitimacy, empathy, and solidarity. He offers an innovative perspective that is informed and guided by multiculturalism, ethnic studies, queer studies, feminism, and thinkers and critics such as bell hooks, Barbara Christian, Angela Davis, Jacques Derrida, Michel Foucault, among others. A Question of Voice is an American investigation, but also suggests questions that emanate from contemporary continental thought as well as issues that arise from transnational perspectives-an approach that is motived by doing philosophy in an age of multiculturalism. (shrink)

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

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

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

ABSTRACT:This article deploys Alasdair MacIntyre’s Aristotelian virtue ethics, in which meaningfulness is understood to supervene on human functioning, to bring empirical and ethical accounts of meaningful work into dialogue. Whereas empirical accounts have presented the experience of meaningful work either in terms of agents’ orientation to work or as intrinsic to certain types of work, ethical accounts have largely assumed the latter formulation and subjected it to considerations of distributive justice. This article critiques both the empirical and ethical literatures from (...) the standpoint of MacIntyre’s account of the relationship between the development of virtuous dispositions and participation in work that is productive of goods internal to practices. This reframing suggests new directions for empirical and ethical enquiries. (shrink)

In recent years, there has been a flurry of work on the metaphysics of race. While it is now widely accepted that races do not share robust, bio-behavioral essences, opinions differ over what, if anything, race is. Recent work has been divided between three apparently quite different answers. A variety of theorists argue for racial skepticism, the view that races do not exist at all.[iv] A second group defends racial constructionism, holding that races are in some way socially constructed.[v],[vi] And (...) a third group maintains racial population naturalism, the view that races may exist as biologically salient populations albeit ones that do not have the biologically determined social significance once imputed to them.[vii] The three groups thus seem to disagree fundamentally upon the metaphysical character of race. (shrink)

This paper briefly summarizes current thinking in engineering ethics education, argues that much of that ethical instruction runs the risk of being only superficially effective, and explores some of the underlying systemic barriers within academia that contribute to this result. This is not to criticize or discourage efforts to improve ethics instruction. Rather it is to point to some more fundamental problems that still must be addressed in order to realize the full potential of enhanced ethics instruction. Issues discussed will (...) include: intellectual engagement versus emotional engagement; the gravitational pull of curricular structures; the nature of engineering faculty; and the “engineer-ization” of ethics. (shrink)

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

This article presents an overview ofregulations, guidelines and societal debates ineight member states of the EC about a)embryonic and fetal tissue transplantation(EFTT), and b) the use of human embryonic stemcells (hES cells) for research into celltherapy, including `therapeutic' cloning. Thereappears to be a broad acceptance of EFTT inthese countries. In most countries guidance hasbeen developed. There is a `strong' consensusabout some of the central conditions for `goodclinical practice' regarding EFTT.International differences concern, amongstothers, some of the informed consent issuesinvolved, and the (...) questions whether anintermediary organisation is necessary, whetherthe methods of abortion may be influenced bythe possible use of EFT, and whether EFTTshould only be used for the experimentaltreatment of rare disorders. The potential useof hES cells for research into cell therapy hasgiven a new impetus to the debate about (human)embryo research. The therapeutic prospects withregard to the retrieval and research use of hEScells appear to function as a catalyst for theintroduction of less restrictive regulationsconcerning research with spare embryos, atleast in some European countries. It remains tobe seen whether the prospect of treatingpatients suffering from serious disorders withtransplants produced by therapeutic cloningwill decrease the societal and moral resistanceto allowing the generation of embryos for`instrumental' use. (shrink)

Journal Name: Apeiron Issue: Ahead of print.

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

Many commentators suppose that the principles of Aristotle’s Politics are received from his theoretical works. Yet this way of understanding the Politics does not sufficiently appreciate Aristotle’s division of sciences, and it obscures the relevance of his political reflections for our time. We argue that Aristotle’s treatment of the polis and all it entails does not require his natural science and the principles of theoretical fields. Instead, despite wording that recalls theoretical treatises, Aristotle is careful to develop his political argumentation (...) without any such dependence. (shrink)