Historians of medicine generally credit the hospital standardization movement of the early 20th century with establishing the record as a sign of hospital and staff quality. The medical record's role had already been the subject of intense interest at the New York Hospital several decades before, however. In the 1880s malpractice and insurance concerns caused the administration to attempt to supervise record creation, quality, and access, over the objections of physicians. Contemporary concerns about the uses of the medical record were (...) in play well before 1910. (shrink)
In this paper, I first argue that waste is best understood as (a) any process wherein something useful becomes less useful and that produces less benefit than is lost—where benefit and usefulness are understood with reference to the same metric—or (b) the result of such a process. I next argue for the immorality of waste. My concluding suggestions are that (W1) if one person needs something for her preservation and a second person has it, is avoidably wasting it, and refuses (...) to allow the first to make some greater use of it, the second may be morally wrong and that (W2) if one person needs something for her preservation understood according to her metric and a second person has it, is avoidably wasting it according to his own metric, and refuses to allow the first to make some greater use of it, the second is morally wrong. (shrink)
Major Philosophers of Jewish Prayer in the Twentieth Century addresses the troubling questions posed by the modern Jewish worshiper, including such obstacles to prayer as the inability to concentrate on the words and meanings of formal liturgy, the paucity of emotional involvement, the lack of theological conviction, the anthropomorphic and particularly the masculine emphasis of prayer nomenclature, and other matters. In assessing these difficultites, Cohen brings to the reader the writings on prayer of some seminal 20th century Jewish theologians. (...) These include Herman Cohen, Franz Rosenzweig, Avraham Yitzhak, Hoakohen Kook, Mordecai M. Kaplan, R. Arele, Aaron Rote, Elie Munk, Abraham J. Heschel, Jakob J. Petuchowski, Eugene B. Borowitz, and Lawrence A. Hoffman. (shrink)
We discuss Aristotle's "Categories" as an answer to Plato's One-over-Many argument. For Plato, F-ness is something "over against" particular F things; to predicate "F" of these things is to assert that they all stand in a certain relation to F-ness. Aristotle answers that predication is classification; and there being a classification of a certain sort is a fact correlative with there being things classifiable in the way the classification in question would classify them.
Clinics and hospitals around the globe are offering stem cell treatments to persons with serious conditions for whom no effective therapies are available in their home countries. Many of these treatments, which are touted as cures for such conditions as Parkinson's and Alzheimer's Diseases, multiple sclerosis, and spinal cord injuries, have not gone through clinical trials that establish their safety and efficacy. Indeed, it is unclear whether some of them even utilize stem cells. State regulation of these therapies tends to (...) be weak or nonexistent in some of the countries in which they are offered. This puts those who believe they must travel abroad for stem cell treatments at risk of injury from procedures that .. (shrink)
Anthony Kenny says it is impossible to want what one already has and knows one has. We present a counter-example and then suggest that Kenny may have been misled by the fact that wanting expresses itself in goal-directed behavior. From the truism that one's behavior cannot be directed toward a goal that one knows one has already attained, Kenny may have been led to suppose that behavior directed toward an as yet unattained goal cannot express one's desire for what one (...) has and knows one has. (shrink)
European animal disease policy seems to find its justification in a “harm to other” principle. Limiting the freedom of animal keepers—e.g., by culling their animals—is justified by the aim to prevent harm, i.e., the spreading of the disease. The picture, however, is more complicated. Both during the control of outbreaks and in the prevention of notifiable, animal diseases the government is confronted with conflicting claims of stakeholders who anticipate running a risk to be harmed by each other, and who ask (...) for government intervention. In this paper, we first argue that in a policy that aims to prevent animal diseases, the focus shifts from limiting “harm” to weighing conflicting claims with respect to “risks of harm.” Therefore, we claim that the harm principle is no longer a sufficient justification for governmental intervention in animal disease prevention. A policy that has to deal with and distribute conflicting risks of harm needs additional value assumptions that guide this process of assessment and distribution. We show that currently, policies are based on assumptions that are mainly economic considerations. In order to show the limitations of these considerations, we use the interests and position of keepers of backyard animals as an example. Based on the problems they faced during and after the recent outbreaks, we defend the thesis that in order to develop a sustainable animal disease policy other than economic assumptions need to be taken into account. (shrink)
Attempting to settle various debates from recent literature regarding its precise nature, I offer a detailed conceptual analysis of toleration. I begin by isolating toleration from other notions; this provides us some guidance by introducing the eight definitional conditions of toleration that I then explicate and defend. Together, these eight conditions indicate that toleration is an agent’s intentional and principled refraining from interfering with an opposed other (or their behavior, etc.) in situations of diversity, where the agent believes she has (...) the power to interfere. This non-normative definition can serve as a preliminary to normative discussions of toleration. (shrink)
: Gill and Sade, in the preceding article in this issue of the Kennedy Institute of Ethics Journal, argue that living individuals should be free from legal constraints against selling their organs. The present commentary responds to several of their claims. It explains why an analogy between kidneys and blood fails; why, as a matter of public policy, we prohibit the sale of human solid organs, yet allow the sale of blood; and why their attack on Kant's putative argument against (...) the sale of human body parts is misplaced. Finally, it rejects the claim that the state is entitled to interfere with the actions of individuals only if such actions would harm others. We draw certain lines grounded in what Rawls has termed "public reason" beyond which we do not give effect to the autonomous self-regarding decisions of individuals. Public resistance to the sale of human body parts, no matter how voluntary or well informed, is grounded in the conviction that such a practice would diminish human dignity and our sense of solidarity. A system of organ donation, in contrast, conveys our respect for persons and honors our common humanity. (shrink)
Communitarians like Alasdair MacIntyre, Charles Taylor, and Michael Sandel, defend what we may call the ‘social constitution thesis.’ This is the view that participation in society makes us what we are. This claim, however, is ambiguous. In an attempt to shed some light on it and to better understand the impact its truth would have on our beliefs regarding autonomy, I offer four possible ways it could be understood and four corresponding senses of individual independence and autonomy. I also indicate (...) what senses liberals can accept that we are socially constituted and in what sense I take communitarians to argue we are socially constituted. (shrink)
Critics of liberalism have argued that liberal individualismmisdescribes persons in ignoring the degree to which they aredependent on their communities. Indeed, they argue that personsare essentially socially constituted. In this paper, however, Iprovide two arguments – the first concerning communitariandescriptive claims about persons, our society, and the communitarian ideal society, and the second regarding thecommunitarian view of individual autonomy – that the communitariantheory of Alasdair MacIntyre, Charles Taylor, and Michael Sandel,relies on individuals either being independent from theircommunities or having a (...) community-independent desire. Thisis indicative of a deep contradiction in communitarian thought. (shrink)
I defend a neo-Kantian view wherein we are capable of being completely autonomous and impartial and argue that this ability can ground normativity. As this view includes an existentialist conception of the self, I defend radical choice, a primary component of that conception, against arguments many take to be definitive. I call the ability to use radical choice “existentialist voluntarism” and bring it into a current debate in normative philosophy, arguing that it allows that we can be distanced from all (...) ends at once so as to be completely impartial. Finally, I indicate how this can be the source of normativity as it provides a purely impartial reason for being rational. (shrink)
This essay explores whether dependent relationships might justify extending direct moral consideration to nonhuman animals. After setting out a formal conception of moral standing as relational, scalar, and unilateral, I consider whether and how an appeal to dependencies might be the basis for an animal’s moral standing. If dependencies generate reasons for extending direct moral consideration, such reasons will admit of significant variations in scope and stringency.
: The transplantation of adult human neural stem cells into prenatal non-humans offers an avenue for studying human neural cell development without direct use of human embryos. However, such experiments raise significant ethical concerns about mixing human and nonhuman materials in ways that could result in the development of human-nonhuman chimeras. This paper examines four arguments against such research, the moral taboo, species integrity, "unnaturalness," and human dignity arguments, and finds the last plausible. It argues that the transfer of human (...) brain or retinal stem cells to nonhuman embryos would not result in the development of human-nonhuman chimeras that denigrate human dignity, provided such stem cells are dissociated. The article provides guidelines that set ethical boundaries for conducting such research that are consonant with the requirements of human dignity. (shrink)
In this paper I look at three versions of the charge that liberalism’s emphasis on individuals is detrimental to community—that it encourages a pernicious disregard of others by fostering a particular understanding of the individual and the relation she has with her society. According to that understanding, individuals are fundamentally independent entities who only enter into relations by choice and society is seen as nothing more than a venture voluntarily entered into in order to better oneself. Communitarian critics argue that (...) since liberals neglect the degree to which individuals are dependent upon their society for their self-understanding and understanding of the good, they encourage individuals to maintain a personal distance from others in their society. The detrimental effect this distancing is said to have on communities is often called “asocial individualism” or “asocialism.” I argue that all three versions of the charge fail against liberalism and that liberalism—with its insistence on the normative import of individuals—is not detrimental to communities, but can actually foster strong communities. (shrink)
It is often claimed that liberalism is falsely and perniciously universalist. I take this charge seriously, exploring three positions: the communitarians’, Rorty’s, and that of “comprehensive” liberalism. After explaining why universalism is thought impossible, I examine the communitarian view that value is determined within communities and argue that it results in a form of relativism that is unacceptable. I next discuss Richard Rorty’s liberal acceptance of “conventionalism” and explain how, despite his rejection of universalism, Rorty remains a liberal. I then (...) present a defense of universalism, based in part on arguments that parallel Thomas Nagel’s arguments in defense of a “view from nowhere” and Jean Hampton’s objectivist arguments against Rawls’s moves to a “merely political” theory. That defense requires that we can distance ourselves from our ends to make moral judgments shorn of all partialities. (shrink)
Two normative principles of toleration are offered, one individual-regarding, the other group-regarding. The first is John Stuart Mill’s harm principle; the other is “Principle T,” meant to be the harm principle writ large. It is argued that the state should tolerate autonomous sacrifices of autonomy, including instances where an individual rationally chooses to be enslaved, lobotomized, or killed. Consistent with that, it is argued that the state should tolerate internal restrictions within minority groups even where these prevent autonomy promotion of (...) members of the group. Finally, it is argued that toleration excludes external protections of minority groups. (shrink)
Religious beliefs, including those about an afterlife and omniscient spiritual beings, vary across cultures. We theorize that such variations may be predictably linked to ecological variations, just as differences in mating strategies covary with resource distribution. Perhaps beliefs in a soul or afterlife are more common when resources are unpredictable, and life is brutal and short.
Using Alasdair MacIntyre as a foil, I defend what I take to be a viable Nietzschean genealogical account, showing that a proper perspectivism is neither perniciously subjectivist nor absolutist. I begin by arguing against MacIntyre’s assertion that genealogists are committed to the view that rationality requires neutrality and that as there is no neutrality, there is no rationality. I then continue by offering something of a reconstruction of Nietzsche’s view, designed partly to clarify the error pinpointed in MacIntyre’s arguments, but (...) primarily to amplify the Nietzschean solution. This reconstruction involves claiming that Nietzsche is committed to three different senses of “truth:” the “Truth” (with a capital “T”) of correspondence theories, “truth” which is really pragmatic knowledge that helps us survive, and, finally, “truth” that is nothing more that “metaphors and metonyms” which are falsely taken to be useful to survival. (shrink)
: National bioethics commissions have struggled to develop ethically warranted methods for conducting their deliberations. The National Bioethics Advisory Commission in its report on stem cell research adopted an approach to public deliberation indebted to Rawls in that it sought common ground consistent with shared values and beliefs at the foundation of a well-ordered democracy. In contrast, although the research cloning and stem cell research reports of the President's Council on Bioethics reveal that it broached two different methods of public (...) deliberation—balancing goods and following an overarching moral principle—it adopted neither. Thereupon its prime mover, Leon Kass, influenced particularly by the approach of Leo Strauss, sought to develop a method of public deliberation guided by tradition and practical wisdom. When this failed, the Council fell back on a method that took account of shared fundamental values of a free democracy—a method remarkably akin to that employed by the National Bioethics Advisory Commission. Respect for diverse reasonable conceptions of the good in a democratic polity requires national bioethics commissions to seek and incorporate that which is valuable in opposing positions. (shrink)
In this essay I describe how contractarianism might approach interspecies welfare conflicts. I start by discussing a contractarian account of the moral status of nonhuman animals. I argue that contractors can agree to norms that would acknowledge the of some animals. I then discuss how the norms emerging from contractarian agreement might constrain any comparison of welfare between humans and animals. Contractarian agreement is likely to express some partiality to humans in a way that discounts the welfare of some or (...) all animals. While the norms emerging from the contract might be silent or inconsistent in some tragic or catastrophic cases, in most ordinary conflicts of welfare, contractors will agree to norms that produce some determinate resolution. What the agreement says can evolve depending upon how the contractors or the circumstances change. I close with some remarks on contractarian indeterminacy. (shrink)
Who blows the whistle — a loner or a well-liked team player? Which of them is more likely to lead a successful opposition to perceived organizational wrongdoing? The potential influence of co-worker pressures to conform on whistle-blowing activity or the likely effects of whistle-blowing on the group have not been addressed. This paper presents a preliminary model of whistle-blowing as an act of nonconformity. One implication is that the success of an opposition will depend on the characteristics of the whistle-blower (...) and how the complaint is pursued. Specific hypotheses and general suggestions for future research and practice are offered. (shrink)
Current evolutionary and cognitive theories of religion posit that supernatural agent concepts emerge from cognitive systems such as theory of mind and social cognition. Some argue that these concepts evolved to maintain social order by minimizing antisocial behavior. If these theories are correct, then people should process information about supernatural agents’ socially strategic knowledge more quickly than non-strategic knowledge. Furthermore, agents’ knowledge of immoral and uncooperative social behaviors should be especially accessible to people. To examine these hypotheses, we measured response-times (...) to questions about the knowledge attributed to four different agents—God, Santa Claus, a fictional surveillance government, and omniscient but non-interfering aliens—that vary in their omniscience, moral concern, ability to punish, and how supernatural they are. As anticipated, participants respond more quickly to questions about agents’ socially strategic knowledge than non-strategic knowledge, but only when agents are able to punish. (shrink)
Critics of liberalism in the past two decades have argued that the fact that we are necessarily "situated" or "embedded" means that we can not always choose our own ends (for example, our conceptions of the good or our loyalties to others). Some suggest that we simply discover ourselves with these "connections." If correct, this would argue against (Rawlsian) hypothetical contract models and liberalism more broadly, make true impartiality impossible, and give support to traditionalist views like those of Alasdair MacIntyre, (...) Charles Taylor, and Michael Sandel. These same critics argue that liberalism's rejection or neglect of this supposed fact of our moral life has pernicious anti-social affects. I argue that the critics are wrong in both cases, defending what I call "strong voluntarism." In contrast both to recent critics of liberalism and the dominant trend in recent liberal thought, my defense of strong voluntarism allows that we can always choose to accept or reject any end we happen to have but that this does not lead to any pernicious anti-social effects. (shrink)
: Genetics professionals have been reluctant to test children for adult-onset conditions because they believe this would create psychosocial harm to children not counterbalanced by significant benefits. An additional concern they express is that such testing would violate the autonomy of these children as adults. Yet weighing the harms and benefits of such testing results in a draw, with no substantial harms proven. Moreover, such testing can enhance, rather than violate the adult autonomy of these children. In deciding whether (...) to proceed with predictive testing of children, parents, mature children, and health care professionals should consider a complex of factors relevant to the particular child. The importance of these factors will vary depending on the condition at issue, the age and stage of development of the child, family dynamics, and the concerns, values, and objectives of the parents and mature child. The final decision whether to test a child for an adult-onset condition should rest with the parents and the mature child. (shrink)
Atran & Norenzayan (A&N) correctly claim that religion reduces emotions related to existential concerns. Our response adds to their argument by focusing on religious differences in the importance of emotion, and on other emotions that may be involved in religion. We believe that the important differences among religions make it difficult to have one theory to account for all religions.
Reproductive medicine, a sector of a health care system increasingly captured by the demands of the marketplace, is enmeshed in a drive to sell certain human bits and pieces, such as gametes, cells, fetal eggs, and fetal ovaries, for reproductive purposes. The ethical objection raised by Kant and Radin to the sale of human organs -that this is incompatible with human dignity and worth - also applies to these sales. Moreover, such sales nullify the reproductive paradigm, irretrievably replacing it with (...) a ma nufacturing paradigm. This represents a change in kind, not just of degree, in the way that we view our capacity to generate children and destroys our concept of reproduction as an essentially human activity. In the face of a struggle to retain those common ethical values at the foundation of reproductive medicine, this form of commodification of the human body should be viewed as ethically unacceptable. (shrink)
into treatment decisions is viewed as pernicious by some who claim that these presuppose the Nazi position that those who are ‘devoid of value’ must be exterminated. ‘Quality of life’ judgments are said to deny the equal value of human beings and to assume that some lives are not ‘worthy to be lived’. It is argued that the analogy misconstrues the senses of ‘value’ and ‘quality’ employed by Naziism and a ‘quality of life’ position. This leads the analogizers incorrectly to (...) claim that both views assimilate the value of human beings to the value of their condition. A ‘quality of life’ position is grounded in recognition of the logical priority of the value of human beings as self-reflective evaluators and agents, which is a matter of kind, not degree. The ‘quality of life’ is explicated in terms of the standards of well-being of individuals, which are derived from their basic human needs and their individual priorities and goals. The use of ‘quality of life’ judgments is morally required to ensure that considerations of justice and individual autonomy govern treatment decisions. The purported analogy misconstrues the views of both the Nazi position and a ‘quality of life’ position and so is seriously misdirected. CiteULike Connotea Del.icio.us What's this? (shrink)
Recently various gedankenexperiments have been formulated which argue that the assumption that “elements of reality” are Lorentz invariant cannot be reconciled with standard quantum mechanics. Two of these gedankenexperiments were subsequently analyzed using the notion of pre- and postselected quantum systems, and it was claimed that elements of reality can be made Lorentz invariant if the “product rule” of standard quantum mechanics is abandoned. In this paper we show that the apparent violations of the product rule in these gedankenexperiments are (...) not as significant as they appeared to be in the previous analysis. We conclude that the problems with Lorentz invariance which arise in these gedankenexperiments are essentially unrelated to the product rule violations. (shrink)
We examine, in the context of the Einstein-Podolsky-Rosen-Bohm gedankenexperiment, problems associated with state reduction and with nonlocal influences according to different interpretations of quantum mechanics, when attempts are made to apply these interpretations in the relativistic domain. We begin by considering the significance of retrodiction within four different interpretations of quantum mechanics, and show that three of these interpretations, if applied in a relativistic context, can lead to ambiguities in their description of a process. We consider ways of dealing with (...) these ambiguities, in particular focussing on the “preferred frame” hypothesis. We then re-examine an argument involving nonlocal measurements which claimed that the preferred frame hypothesis is not tenable, and show that this argument does not in fact necessitate a rejection of the preferred frame. We then suggest that, to avoid confusion, the preferred frame could be extended to cover unitary interactions as well as state reductions. We conclude with a brief examination of a proposal that state reduction should take effect across the backward light cone of a measurement event. (shrink)