Next SectionThe dominant conception of medical ethics being taught in British and American medical schools is at best pointless and at worst dangerous, or so it will be argued. Although it is laudable that medical schools have now given medical ethics a secure place in the curriculum, they go wrong in treating it like a scientific body of knowledge. Ethics is a unique subject matter precisely because of its widespread familiarity in all areas of life, and any teaching has to (...) start from this shared ethical understanding and from the familiar ethical concepts of ordinary language. Otherwise there is a real risk that spurious technocratic jargon will be deployed by teacher and student alike in the futile search for intellectual respectability, culminating in a misplaced sense of having “done” the ethics module. There are no better examples of such jargon than “consequentialism”, “deontology”, and the “Four Principles”. At best, they cannot do the work they were designed to do and, at worst, they can lead student and practitioner into ignoring their own healthy ethical intuitions and vocabulary. (shrink)

Five proposals for admitting better applicants into medical school are discussed in this article: An A level in a humanity or social science would be required, to supplement—not replace—the stringent science requirement. This would ensure that successful candidates would be better “primed” for the medical curriculum. Extra points in the applicant’s initial screening would be awarded for an A level in English literature. There would be a minimum age of 23 for applicants, although a prior degree would not be required. (...) This is to ensure that the applicants are mature enough to know themselves and the world better, to make a more informed and motivated choice of career, and to get more out of the humanities components of the curriculum. A year’s full-time experience in a healthcare or charity environment would be desirable. Applicants would be given two lists of interview discussion topics to prepare: works of literature and topics in healthcare politics. (shrink)

In a recent Bioethics editorial, Udo Schuklenk argues against allowing Canadian doctors to conscientiously object to any new euthanasia procedures approved by Parliament. In this he follows Julian Savulescu's 2006 BMJ paper which argued for the removal of the conscientious objection clause in the 1967 UK Abortion Act. Both authors advance powerful arguments based on the need for uniformity of service and on analogies with reprehensible kinds of personal exemption. In this article I want to defend the practice of conscientious (...) objection in publicly-funded healthcare systems, at least in the area of abortion and end-of-life care, without entering either of the substantive moral debates about the permissibility of either. My main claim is that Schuklenk and Savulescu have misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors. However, I acknowledge Schuklenk's point about differential access to lawful services in remote rural areas, and I argue that the health service should expend more to protect conscientious objection while ensuring universal access. (shrink)

The concept of business responsibility, usually termed as corporate social responsibility (CSR), originated in the early 1930s after the Wall Street crash of 1929 exposed corporate irresponsibility in large organisations. The understanding of CSR has evolved since then and its scope has now broadened from mere compliance to corporate laws to active alignment of internal business goals with externally set societal aspirations. Unfortunately, the significance of this multidimensional concept within the small and medium enterprise (SME) sector has continued to be (...) overshadowed by its application in large and multinational organisations. More importantly, this has led to the practice of judging SMEs, which are experiencing increasing pressure to engage in social activities, as if they are no different from their larger counterparts. This study therefore investigates CSR from the perspective of SMEs in Australia without any theoretical presumptions and then comments on the relevance and applicability of the two theories that have been commonly used to investigate business responsibility, namely, stakeholder theory (ST) and social capital theory (SCT). The research findings indicate that CSR within the SME sector is more aligned to the fundamentals of SCT, mainly owing to the unique resource and survival challenges that they face, and which are, arguably, not so pronounced in large organisations. (shrink)

This article considers the theme of discernment in the tradition of Ignatian spirituality emanating from the Spiritual Exercises of St Ignatius of Loyola, the founder of the Society of Jesus. After a brief introduction which addresses the central problematic of bad influences that manifest themselves as good, the article turns to the life and work of two Jesuits, the 16th C English missionary to India, Thomas Stephens and the 20th C French historian and cultural critic, Michel de Certeau. Both kept (...) up a constant dialogue with local culture in which they sought authenticity in their response to ‘events’, whether a hideous massacre which shaped the pastoral commitment and writing of Stephens in the south of the Portuguese enclave of Goa or the 1968 student-led protests in Paris that so much affected the thinking of de Certeau. Very different in terms of personal background and contemporary experience, they both share in a tradition of discernment as a virtuous response to what both would understand as the ‘wisdom of the Spirit’ revealed in their personal interactions with ‘the other’. (shrink)

Different opinions about the simplicity of God may be connected with different understandings of how abstract terms are used to name the properties which are affirmed of a being. If these terms are taken to signify parts of that being, this being is not a simple one. Thomas Aquinas, who attributes essence, existence and perfections to God, nevertheless thinks that these are not different parts of God. When essence, existence and perfections are attributed to God, they all denominate the same, (...) the Being of the first cause. For Aquinas, this is a consequence of his way of introducing the language about God by basing it upon the philosophical ways leading to God as first cause. Awareness of this connection between Divine attributes and the arguments for God’s existence is crucial for an adequate understanding of Aquinas’ position. (shrink)

Als im Jahr 1992 die Frage aufgeworfen wurde, ob der französische Philosoph Jacques Derrida den Ehrendoktortitel der University of Cambridge verliehen bekommen sollte, lehnte ein Teil der Jury-Mitglieder die Vergabe ab. Man könne nicht, so hieß es damals, einen Denker würdigen, der in seinen Schriften vormalig Gedankenspiele inszeniere und »überall seine eigenen Urteile wieder umstößt«. Die zuletzt zitierten Worte wurden so nicht geäußert, da sie aus dem dritten Jahrhundert von dem griechischen Philosophen Porphyrius stammten und gegen den 〉theoretischen Gründungsvater〈 des (...) Christentums, Paulus, gerichtet waren. Porphyrius war in seiner Kritik an Paulus nicht weniger kleinlich als die oben erwähnten Jurymitglieder. Es sei die Inkohärenz eines Denkens, das er bei Paulus kritisiere und das »jeder Bildung entbehre«. Denn »beinahe wie ein Schwert wetzt er [Paulus] seine Zunge und zerstückelt ohne Schonung die Glieder des Gesetzes, er, der an vielen Stellen den Gehorsam gegen das Gesetz eingeschärft und das Leben nach demselben für lobenswert erklärt hat.«. (shrink)

There seem to be two clearly-defined camps in the debate over the problem of moral expertise. On the one hand are the “Professionals”, who reject the possibility entirely, usually because of the intractable diversity of ethical beliefs. On the other hand are the “Ethicists”, who criticise the Professionals for merely stipulating science as the most appropriate paradigm for discussions of expertise. While the subject matter and methodology of good ethical thinking is certainly different from that of good clinical thinking, they (...) argue, this is no reason for rejecting the possibility of a distinctive kind of expertise in ethics, usually based on the idea of good justification. I want to argue that both are incorrect, partly because of the reasons given by one group against the other, but more importantly because both neglect what is most distinctive about ethics: that it is personal in a very specific way, without collapsing into relativism. (shrink)

This chapter applies the parity principle in discussing “active externalism,” which claims that the mind need not be confined within either the brain or body. Consequently, how one brain or body interacts with other brains and bodies must be explored, together with the problems that may arise out of this interaction. This chapter is not concerned with beliefs and desires as mental states but whether they play a role in controlling behavior. It argues the notion that any course of action (...) considered part of the cognitive process going on inside the brain is still part of the cognitive process no matter where it is being implemented. Divided into two parts, this chapter first establishes some points of reference regarding language and cognition, and then proceeds to an attempt to connect the issues by directly discussing the parity principle. (shrink)

ABSTRACT In a recent (2015) Bioethics editorial, Udo Schuklenk argues against allowing Canadian doctors to conscientiously object to any new euthanasia procedures approved by Parliament. In this he follows Julian Savulescu's 2006 BMJ paper which argued for the removal of the conscientious objection clause in the 1967 UK Abortion Act. Both authors advance powerful arguments based on the need for uniformity of service and on analogies with reprehensible kinds of personal exemption. In this article I want to defend the practice (...) of conscientious objection in publicly‐funded healthcare systems (such as those of Canada and the UK), at least in the area of abortion and end‐of‐life care, without entering either of the substantive moral debates about the permissibility of either. My main claim is that Schuklenk and Savulescu have misunderstood the special nature of medicine, and have misunderstood the motivations of the conscientious objectors. However, I acknowledge Schuklenk's point about differential access to lawful services in remote rural areas, and I argue that the health service should expend more to protect conscientious objection while ensuring universal access. (shrink)

Clark and Chalmers (1998) defend the hypothesis of an ‘Extended Mind’, maintaining that beliefs and other paradigmatic mental states can be implemented outside the central nervous system or body. Aspects of the problem of ‘language acquisition’ are considered in the light of the extended mind hypothesis. Rather than ‘language’ as typically understood, the object of study is something called ‘utterance-activity’, a term of art intended to refer to the full range of kinetic and prosodic features of the on-line behaviour of (...) interacting humans. It is argued that utterance activity is plausibly regarded as jointly controlled by the embodied activity of interacting people, and that it contributes to the control of their behaviour. By means of specific examples it is suggested that this complex joint control facilitates easier learning of at least some features of language. This in turn suggests a striking form of the extended mind, in which infants’ cognitive powers are augmented by those of the people with whom they interact. (shrink)

Although some healthcare professionals have the legal right to conscientiously object to authorise or perform certain lawful medical services, they have an associated duty to provide the patient with enough information to seek out another professional willing to authorise or provide the service (the ‘duty to refer’). Does the duty to refer morally undermine the professional's conscientious objection (CO)? I narrow my discussion to the National Health Service in Britain, and the case of a general practitioner (GP) being asked by (...) a pregnant woman to authorise an abortion. I will be careful not to enter the debate about whether abortion should be legalised, or the debate about whether CO should be permitted—I will take both as given. I defend the objecting GP's duty to refer against those I call the ‘conscience absolutists’, who would claim that if a state is serious enough in permitting the GP's objection in the first place (as is the UK), then it has to recognise the right to withhold any information about abortion. (shrink)

We trace how cognition arises beyond the skin. Experimental work on insight problem solving is used to examine how external artifacts can be used to reach the goal of assembling a `cheap necklace'. Instead of asking how insight occurs `in the head', our participants in Experiment 1 can either draw solution attempts or manipulate real objects . Even though performance with real chain links is significantly more successful than on paper, access to objects does not make this insight problem simple: (...) objects themselves do not shape cognition. This challenges extended mind views. While failure often results from the inappropriate application of hill-climbing, material artifacts can trigger solutions. In Experiment 2, we used `open link' conditions of the concretized problem to prompt participants to act . Solutions arrived via insight, serendipity, or trial-and-error. By investigating how objects are used, we show that they do more than supplement neural events. Rather, participants monitor and anticipate the effects of action within an organism-environment system. By analogy, language too draws on experience of monitoring real-time effects as bodily dynamics play out in a normative and cultural world. In engaging with public language, it is likely that verbal patterns function by constraining anticipatory cognitive processes. (shrink)

We trace how cognition arises beyond the skin. Experimental work on insight problem solving is used to examine how external artifacts can be used to reach the goal of assembling a ‘cheap necklace’. Instead of asking how insight occurs ‘in the head’, our participants in Experiment 1 can either draw solution attempts or manipulate real objects. Even though performance with real chain links is significantly more successful than on paper, access to objects does not make this insight problem simple: objects (...) themselves do not shape cognition. This challenges extended mind views. While failure often results from the inappropriate application of hill-climbing, material artifacts can trigger solutions. In Experiment 2, we used ‘open link’ conditions of the concretized problem to prompt participants to act. Solutions arrived via insight, serendipity, or trial-and-error. By investigating how objects are used, we show that they do more than supplement neural events. Rather, participants monitor and anticipate the effects of action within an organism-environment system. By analogy, language too draws on experience of monitoring real-time effects as bodily dynamics play out in a normative and cultural world. In engaging with public language, it is likely that verbal patterns function by constraining anticipatory cognitive processes. (shrink)

In a recent article, Henri Wijsbek discusses the 1991 Chabot “psychiatric euthanasia” case in the Netherlands, and argues that Chabot was justified in helping his patient to die. Dutch legislation at the time permitted physician assisted suicide when the patient’s condition is severe, hopeless, and unbearable. The Dutch Supreme Court agreed with Chabot that the patient met these criteria because of her justified depression, even though she was somatically healthy. Wijsbek argues that in this case, the patient’s integrity had been (...) undermined by recent events, and that this is the basis for taking her request seriously; it was unreasonable to expect that she could start again. In this paper, I do not challenge the Dutch euthanasia criteria in the case of somatic illness, but I argue that both Chabot and Wijsbek are wrong because we can never be sufficiently confident in cases of severe exogenous depression to assist the patient in her irreversible act. This is partly because of the essential difference between somatic and mental illness, and because of the possibility of therapy and other help. In addition, I argue that Wijsbek’s concept of integrity cannot do the work that he expects of it. Finally, I consider a 2011 position paper from the Royal Dutch Medical Association on euthanasia, and the implications it might have for Chabot-style cases in the future. (shrink)

In 1965 Peter Winch published ‘The Universalisability of Moral Judgements’. I feel that the argument in this paper has never been successfully refuted, and that it remains relevant to many contemporary debates in moral philosophy. Winch argued against the widespread assumption that a moral judgement, if true, ought to be universalisable for all people in relevantly similar situations. He considers the example of Captain Vere in Melville’s ‘Billy Budd’: Vere managed to condemn a man he considered innocent, while Winch concludes (...) that in the same situation he could not have done it. Many contemporary moral realists would demand that at least one of them was incorrect, probably because of misperceiving the situation . Instead, says Winch, there is a sense in which one action legitimately ‘struck’ Vere, but not Winch, as correct, and that this is the end of the ‘dispute’ between them. However, this requires a robust defence against counter-charges of relativism. Part of the problem with Winch’s article, I argue, is his ambiguous use of the concept of ‘moral rightness’, but I remedy this, and defend Winch against two further sympathetic criticisms. (shrink)

Summary of contribution to history of ideas in Scotland in context of debates on self-determination.

In a recent issue of Bioethics, Bernard Gesang asks whether a moral philosopher possesses greater moral expertise than a non-philosopher, and his answer is a qualified yes, based not so much on his infallible access to the truth, but on the quality of his theoretically-informed moral justifications. I reject Gesang's claim that there is such a thing as moral expertise, although the moral philosopher may well make a valid contribution to the ethics committee as a concerned and educated citizen. I (...) suggest that wisdom is a lot more interesting to examine than moral expertise. Again, however, moral philosophers have no monopoly on wisdom, and the study of philosophy may even impede its cultivation. (shrink)

Temporality underpins how living systems coordinate and function. Unlike measures that use mathematical conventions, lived temporalities grant functional cohesion to organisms-in-the-world. In foxtail grasses, for example, self-maintenance meshes endogenous processes with exogenous rhythms. In embrained animals, temporalities can contribute to learning. And cowbirds coordinate in a soundscape that includes conspecifics: social learning allows them to connect copulating with past events such that females exert ‘long-distance’ control over male singing. Using Howard Pattee’s work, we compare the foxtail’s self-maintenance, gender-based cowbird learning (...) and how humans manage multi-scalar activity. We argue that, while all living things coordinate, temporal ranging is typical of vertebrates. As primates, humans too use temporal ranging – they can draw on social learning, anticipate winter and manage coordinated action. However language behaviour grants new control over the scales of time. People connect the impersonal to lived experience in narratives, as they draw on autobiography and enact cultural practices. Humans become singular individuals who use temporal experience to manage affect, relationships, beliefs, fictions, and knowledge. Individual subjectivity permits collaborative and competitive activity based on linking events with quite different histories. As a result, alone of the vertebrates, we claim that humans become time-rangers. (shrink)

Language is coordination. Pursuing this, the present Special Issue of Pragmatics & Cognition challenges two widely held positions. First, the papers reject the claim that language is essentially ‘symbolic’. Second, they deny that minds represent verbal patterns. Rather, language is social, individual, and contributes the feeling of thinking. Simply, it is distributed. Elucidating this claim, the opening papers report empirically-based work on the anticipatory dynamics of reading, their cognitive consequences, Shakespearean theatre, what images evoke, and insight problem-solving. Having given reasons (...) for rejecting linguistic autonomy, the papers turn to theory building. Initially, attention is given to a possible origin for semiotic cognition. Then, it is claimed that language functions by realizing values. Next, it is argued that human dynamics are co-regulated by cultural and biological symbols. Finally, in a review article, the distributed view of language is used to contrast Clark’s organism-centered cognition with what is here called ecologically extended cognition. (shrink)