The essays in this Journal issue offer examples of how textual analysis, literary theory, and the reading and writing of literature can contribute to an understanding of ethical issues in medicine. The editors' purpose in such an issue is to stimulate discussion between philosopher-ethicists and literary scholars whose work concerns this topic. With the concluding essays by editors Clouser and Hawkins, this discussion begins.
Theories of well-being are typically divided into subjective and objective. Subjective theories are those which make facts about a person’s welfare depend on facts about her actual or hypothetical mental states. I am interested in what motivates this approach to the theory of welfare. The contemporary view is that subjectivism is devoted to honoring the evaluative perspective of the individual, but this is both a misleading account of the motivations behind subjectivism, and a vision that dooms subjective theories to failure. (...) I suggest that we need to revisit and reinstate certain features of traditional hedonism, in particular the idea that felt experience plays a role that no theory of welfare can afford to ignore. I then offer a sketch of a theory that is subjective in my preferred sense and avoids the worst sins of hedonism as well as the problems generated by the contemporary constraints of subjective theorists. (shrink)
Desire satisfaction theorists and attitudinal-happiness theorists of well-being are committed to correcting the psychological attitudes upon which their theories are built. However, it is not often recognized that some of the attitudes in need of correction are evaluative attitudes. Moreover, it is hard to know how to correct for poor evaluative attitudes in ways that respect the traditional commitment to the authority of the individual subject's evaluative perspective. L. W. Sumner has proposed an autonomy-as-authenticity requirement to perform this task, but (...) this article argues that it cannot do the job. Sumner's proposal focuses on the social origins of our values and overlooks the deep psychological roots of other evaluative attitudes that are just as problematic for welfare. If subjective theories of welfare are to be at all plausible they may need to abandon or modify their traditional commitment to the authority of the individual subject. (shrink)
Desire is commonly spoken of as a state in which the desired object seems good, which apparently ascribes an evaluative element to desire. I offer a new defence of this old idea. As traditionally conceived, this view faces serious objections related to its way of characterizing desire's evaluative content. I develop an alternative conception of evaluative mental content which is plausible in its own right, allows the evaluative desire theorist to avoid the standard objections, and sheds interesting new light on (...) the idea of evaluative experience. (shrink)
Commentators often claim that medical research subjects are coerced into participating in clinical studies. In recent years, such claims have appeared especially frequently in ethical discussions of research in developing countries. Medical research ethics is more important than ever as we move into the 21st century because worldwide the pharmaceutical industry has grown so much and shows no sign of slowing its growth. This means that more people are involved in medical research today than ever before, and in the future (...) even more will be involved. However, despite the pressing need for reflection on research ethics, it is important to carefully identify the concerns we have about research. Otherwise we run the risk that the moral language we use, and which we hear other people use, may do our moral thinking for us. We argue that many recent claims about the occurrence of coercion in medical research are misguided and misuse the word "coercion." We try to identify the real problems, and urge people to attend carefully to the implications of their descriptions of moral problems in research. (shrink)
: Peirce was greatly influenced by Aristotle, particularly on the topic of final cause. Commentators are therefore right to draw on Aristotle in the interpretation of Peirce's teleology. But these commentators sometimes fail to distinguish clearly between formal cause and final cause in Aristotle's philosophy. Unless form and end are clearly distinguished, no sense can be made of Peirce's important claim that 'desires create classes.' Understood in the context of his teleology, this claim may be considered Peirce's answer to nominalists (...) and sceptics on the possibility and status of scientific knowledge. On the basis of an improved view of Peirce's teleology, the objection that inorganic physical events do not admit of teleological explanation can be answered. I argue that the non-teleological alternative leaves the laws of nature and the actions of inorganic matter unexplained. (shrink)
While tourism's positive contributions to societies have long been debated, commerce based tourism activities can strengthen peaceful societies by adhering to sustainable tourism principles. This study utilizes content analysis to examine 136 tourism practices from four major awards programs for their contributions to sustainability and peace. Specific practices which illuminate each of these contributions are highlighted. The findings reveal the most common initiatives focus on environmental quality, economic development, and community nourishment efforts, with substantially less focus on initiatives to engage (...) citizen diplomacy and increase transparency. The use of awards programs to further sustainable tourism is discussed, and suggestions for future research in this important area of study are shared. (shrink)
Van Gelder presents the distinction between dynamical systems and digital computers as the core issue of current developments in cognitive science. We think this distinction is much less important than a reassessment of cognition as a neurally, bodily, and environmentally embedded process. Embedded cognition lines up naturally with dynamical models, but it would also stand if combined with classic computation.
: There has been a marked expansion in our human knowledge in recent decades, and much of this new information about ourselves and our world has yet to be integrated into our human self-image. I maintain that understanding how we fit within the spectrum of lifeforms as the primates that we are will enable us to take a more active role in choosing ecologically responsible behavior and will allow us to address more effectively our major problems of overpopulation, overconsumption, and (...) militarism. (shrink)
This study compares two autobiographical descriptions of illness – the seventeenth-century John Donne's Devotions Upon Emergent Occasions and the twentieth-century Cornelius and Kathryn Ryan's A Private Battle . I begin by identifying the basic structure in both narratives as parallel to that of the case history, and then show how each individual's experience is shaped by the conditions of illness appropriate to their respective cultures. Lastly, I discuss the way in which both authors understand and represent sickness, as well as (...) their respective therapies, in terms of a particular metaphoric construct: for Donne, it is the analogy between illness of the body and illness of the soul; for Ryan it is the analogy between Ulness and war. The stance of each towards his illness is conditioned by this metaphoric model: Donne's is one of acceptance, of conforming to the will of God; Ryan's is one of resistance, of fighting heroically until the very end. Thus these metaphors are functional as well as aesthetic: they serve as figural modalities whereby the patient/author hopes to transcend his illness. Keywords: illness, patients, autobiography CiteULike Connotea Del.icio.us What's this? (shrink)
Whaling is back on the international stage as pro-whaling interests push to reopen commercial whaling by overturning the moratorium imposed in 1986. Proponents of ending the ban are using two strategies: (1) appealing to public sentiment that supports indigenous subsistence whaling by attempting to cloak commercial whaling in the same guise and (2) maintaining that reopening commercial whaling is the “scientific” option. I reject both ploys, and instead shift the focus for global debate to scrutinizing the industrial economic model that (...) Western culture is currently imposing on the rest of the world, a model which ultimately reduces all life forms to mere commodities for the marketplace. (shrink)
The government purchasing market constitutes the largest business sector in the world. While marketers would benefit from a deep understanding of both sectors, how the two sectors differ in terms of ethics and strategy largely remains unknown. The purpose of this research, therefore, is to explore differences between the for-profit and not-for-profit sectors on two critical aspects of business-to-business procurement: ethics and strategy. Using survey data from a sample of 328 procurement professionals in the for-profit and not-for-profit sectors, key differences (...) are explored. Findings suggest that buyers in the for-profit sector are more likely to behave opportunistically. Conversely, the buyers’ leaders in the not-for-profit sector behave more opportunistically and are more willing to turn a blind eye to their subordinate buyers’ opportunistic behaviors. In addition, key differences in procurement strategy are unveiled suggesting that not-for-profit procurement practices have some room for improvement. Based on the findings, theoretical and managerial implications are drawn, and a future research agenda is proposed. (shrink)
: Bioethicists have articulated an ideal of shared decision making between physician and patient, but in doing so the role of clinical uncertainty has not been adequately confronted. In the face of uncertainty about the patient's prognosis and the best course of treatment, many physicians revert to a model of nondisclosure and nondiscussion, thus closing off opportunities for shared decision making. Empirical studies suggest that physicians find it more difficult to adhere to norms of disclosure in situations where there is (...) substantial uncertainty. They may be concerned that acknowledging their own uncertainty will undermine patient trust and create additional confusion and anxiety for the patient. We argue, in contrast, that effective disclosure will protect patient trust in the long run and that patients can manage information about uncertainty. In situations where there is substantial uncertainty, extra vigilance is required to ensure that patients are given the tools and information they need to participate in cooperative decision making about their care. (shrink)
This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)
The hypothesis that there is a 1:1 correspondence between LTP and learning is simplistic, and the correlation approach to testing it is therefore too limited. The alternative hypothesis that LTP plays a role in arousal is consistent with activity-dependent neuromodulation, but ignores the Hebbian properties of LTP. LTP may involve both types of mechanisms, suggesting a possible synthesis of the two hypotheses.
With increasing appreciation that the Y2K problem may turn out to have unpredictable and potentially far-reaching effects, we are faced with what in some ways resembles the looming global ecological crisis, only this time what is at stake are not vital ecosystem services but rather the vital structures of our highly complex socially constructed reality—and this time we have a date-certain deadline for the onset of the crisis. Regardless of what actually happens when the calendar turns from 1999 to 2000, (...) this period of waiting for the millennium bug can be a productive one if it induces some of us to contemplate what things we actually depend upon to sustain our lives and, utilizing John Searle's analysis, in what ways we might reconstruct our social reality if faced with the opportunity—and why we haven't begun to do so sooner. (shrink)
The dualistic structures permeating western culture emphasize radical discontinuity between humans and nonhumans, but receptive attention to nonhuman others discloses both continuity and difference prevailing between other forms of life and our own. Recognizing that agency and subjectivity abound within nature alerts us to our potential for dominating and oppressing nonhuman others, as individuals and as groups. Reciprocally, seeing ourselves as biological beings may facilitate reconstructing our social reality to undo such destructive relationships.