Western society today is less unified by a set of core values than ever before. Undoubtedly, the concept of moral consensus is a difficult one in a liberal, democratic and pluralistic society. But it is imperative to avoid a rigid majoritarianism where sensitive personal values are at stake, as in bioethics. Bioethics has become an influential part of public and professional discussions of health care. It has helped frame issues of moral values and medicine as part of a more general (...) effort to find consensus about some of the most perplexing questions of our time. But why is it thought that a moral consensus is important or that it deserves respect? How does moral consensus acquire legitimacy in a society that includes diverse value systems? How is moral consensus possible and how do small groups help create or distort consensus processes? Written by a medical school professor trained in philosophy, this timely work tackles these questions from philosophical, historical, and social scientific standpoints. It begins by describing the traditional ambivalence about consensus in Western culture as well as the uncertain relationship in modernity between consensus and expertise. After outlining the current bioethical consensus, the book gives philosophical and political analyses of the idea of consensus, then assesses the role of consensus in national ethics commissions and in the ethics committee movement. Moreno constructs an original, naturalistic philosophy of moral consensus, referred to as "bioethical naturalism", and then applies sociology and social psychology to actual consensus processes. The book concludes with an account of bioethics as a consensus-oriented social reform movement. This insightful volume will be essential reading for bioethicists, philosophers, physicians, members of ethics committees, and all those concerned with ethical and social issues in health care. (shrink)
Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received in a lukewarm fashion by (...) most clinicians, many simply rejecting what they commonly refer to as the `myth of informed consent'. The purpose of this book is to defuse this seemingly intractable controversy by offering an efficient and effective operational model of informed consent. This goal is pursued first by reviewing and evaluating, in detail, the agendas, arguments, and supporting materials of its proponents and detractors. A comprehensive review of empirical studies of informed consent is provided, as well as a detailed reflection on the common clinician experience with attempts at informed consent and the exercise of autonomy by patients. In the end, informed consent is recast as a management tool for pursuing clinically and ethically important goods and values that any clinician should see as meriting pursuit. Concurrently, the model incorporates a flexible, anticipatory approach that recognizes that no static, generic ritual can legitimately pursue the quite variable goods and values that may be at stake with different patients in different situations. Finally, efficiency of provision is addressed by not pursuing the unattainable and ancillary. Throughout, the traditional principle of beneficence is appealed to toward articulating an operational model of informed consent as an intervention that is likely to change outcomes at the bedside for the better. (shrink)
There is consensus that children have questionable decisional capacity and, therefore, in general a parent or a guardian must give permission to enroll a child in a research study. Moreover, freedom from duress and coercion, the cardinal rule in research involving adults, is even more important for children. This principle is embodied prominently in the Nuremberg Code (1947) and is embodied in various federal human research protection regulations. In a program named "SATURN" (Student Athletic Testing Using Random Notification), each school (...) in the Oregon public-school system may implement a mandatory drug-testing program for high school student athletes. A prospective study to identify drug use among student-athletes, SATURN is designed both to evaluate the influence of random drug testing and to validate the survey data through identification of individuals who do not report drug use. The enrollment of students in the drug-testing study is a requirement for playing a school sport. In addition to the coercive nature of this study design, there were ethically questionable practices in recruitment, informed consent, and confidentiality. This article concerns the question of whether research can be conducted with high school students in conjunction with a mandatory drug-testing program, while adhering to prevailing ethical standards regarding human-subjects research and specifically the participation of children in research. (shrink)
This study builds upon the top management literature to predict and test antecedents to firms’ engagement in corruption. Building on a survey of 341 executives in India, we find that if executives have social ties with government officials, their firms are more likely to engage in corruption. Further, these executives are likely to rationalize engaging in corruption as a necessity for being competitive. The results collectively illustrate the role that executives’ social ties and perceptions have in shaping illegal actions of (...) their respective firms. (shrink)
Consensus is commonly identified as the goal of ethics committee deliberation, but it is not clear what is morally authoritative about consensus. Various problems with the concept of an ethics committee in a health care institution are identified. The problem of consensus is placed in the context of the debate about realism in moral epistemology, and this is shown to be of interest for ethics committees. But further difficulties, such as the fact that consensus at one level of discourse need (...) not imply consensus at another, oblige us to look more closely at the deliberative process itself. That yields two complementary methods of deliberation that have proven their worth. Finally, placing ethics committees in the context of Dewey's philosophy of social intelligence suggests that consensus should be regarded primarily as a condition rather than as the goal of inquiry. Keywords: ethics committee, consensus, moral authority CiteULike Connotea Del.icio.us What's this? (shrink)
Physicians have long tinkered with ways to "improve" the human brain, but as our understanding of that organ's inner workings quickly grows, artificial enhancement is becoming more feasible. Military research is at the forefront of this work, much of it focused on drugs. The goal is to produce a better soldier, but the emerging techniques could just as easily be applied to any individual. The military wants to juice up personnel's brains because the human being is the weakest instrument of (...) warfare. Although for centuries astonishing and terrifying advances have been made in the technology of conflict, soldiers are basically the same. They must eat, sleep, discern friend from foe, heal when wounded, and so forth. The first state (or nonstate) actor to build superior fighters will make an enormous leap in the arms race. In the short run, researchers are trying to devise aids that would overcome a person's inherent limitations, such as mental fatigue. Long-term results could lead to individuals everywhere who are tireless, less fearful or even better speakers. (shrink)
: President Clinton's charge to the Advisory Committee on Human Radiation Experiments included the identification of ethical and legal standards for evaluating government-sponsored radiation experiments conducted during the Cold War. In this paper, we review the traditional account of the history of American research ethics, and then highlight and explain the significance of a number of the Committee's historical findings as they relate to this account. These findings include both the national defense establishment's struggles with legal and insurance issues concerning (...) human experiments, and the medical profession's perspective on human experimentation in the years following the Nuremberg Medical Trials. We conclude that the Committee's work both enriches the traditional view of the history of research ethics and opens important new areas for study. (shrink)
Following a brief account of the puzzle that ethics committees present for the Western Philosophical tradition, I will examine the possibility that social contract theory can contribute to a philosophical account of these committees. Passing through classical as well as contemporary theories, particularly Rawls' recent constructivist approach, I will argue that social contract theory places severe constraints on the authority that may legitimately be granted to ethics committees. This, I conclude, speaks more about the suitability of the theory to this (...) level of analysis than about the ethics committee phenomenon itself. Keywords: ethics committees, moral consensus, social contract theory CiteULike Connotea Del.icio.us What's this? (shrink)
Too much contemporary bioethical discourse is weak on science, lazily citing and adopting science fiction scenarios rather than science facts in the framing of analyses and policies. We challenge bioethicists to take more seriously the role of providing informed insight into and oversight over contemporary science and its implications and applications. Bioethicists must work harder to understand the fast-changing truths and limits of basic science, and they must incorporate only appropriate and authentic science into their discourse, just as they did (...) in the past when addressing the quandaries of clinical medicine. The field of bioethics is not so old and entrenched that its future is assured. Bioethicists must make themselves useful to society in order to deserve and retain the public's trust. They can best do this by ensuring that decision making and public policy are grounded in facts, not fictions and fantasies. (shrink)
Although the neoconservative movement has come to dominate American conservatism, this movement has its origins in the old Marxist Left. Communists in their younger days, as the founders of neoconservatism, inverted Marxist doctrine by arguing that moral values and not economic forces were the primary movers of history. Yet the neoconservative critique of biotechnology still borrows heavily from Karl Marx and owes more to the German philosopher Martin Heidegger than to the Scottish philosopher and political economist Adam Smith. Loath to (...) identify these sources - or perhaps unaware of them - neoconservatives do not acknowledge these intellectual underpinnings or their implications. Thus, in the final analysis, their critique is incoherent and even internally inconsistent. By not acknowledging and embracing their intellectual roots, neoconservatives are left with a deeply ambivalent and often confused view of biotechnology and the society that gives rise to it. (shrink)
Who owns science? -- Science in America -- Thepolitics of heredity -- Dangerous ideas -- The stem Cell debate -- Valuing humanity -- Crossing lines -- In defense of "progress".
Appels au meurtre et à la haine, apologie de la pédophilie, propos racistes ou sexistes, quelles sont les limites de la liberté d'expression en littérature ? Le style et la fiction autorisent-ils toutes les transgressions ?
We prove strong completeness of the □-version and the ◊-version of a Gödel modal logic based on Kripke models where propositions at each world and the accessibility relation are both infinitely valued in the standard Gödel algebra [0,1]. Some asymmetries are revealed: validity in the first logic is reducible to the class of frames having two-valued accessibility relation and this logic does not enjoy the finite model property, while validity in the second logic requires truly fuzzy accessibility relations and this (...) logic has the finite model property. Analogues of the classical modal systems D, T, S4 and S5 are considered also, and the completeness results are extended to languages enriched with a discrete well ordered set of truth constants. (shrink)
This text brings together a collection of new essays by a number of philosophers to honor Hugh Mellor's contribution to philosophy. The collection stands as an original exploration of some of the most central issues in philosophy.
Book Information Resemblance Nominalism: A Solution to the Problem of Universals. By Gonzalo Rodriguez-Pereyra. Clarendon Press. Oxford. 2002. Pp. xii + 238. £35.
The notion of similarity plays a central role in Quine’s theory of Universals and it is with the help of this notion that Quine intends to define the concept of kind which also plays a central role in the theory. But as Quine has admitted, his attempts to define kinds in terms of similarities were unsuccessful and it is mainly because of this shortcoming that Quine’s theory has been ignored by several philosophers (see, e.g., Armstrong, D. M. (1978a). Nominalism and (...) realism: Universals and Scientific realism (Vol. I). Cambridge: Cambridge University Press). In the present paper, I propose an alternative framework that accounts for the phenomena that Quine intends to explain with his resemblance theory. The framework agrees with Quine’s austere ontology; in particular, it does not assume the existence of properties and of possible worlds. (I will mention below Quine’s reason for rejecting properties and possible worlds. For a theory of Universals that assumes possible worlds, see, e.g., Rodriguez-Pereyra, G. (2002). Resemblance nominalism: A solution to the problem of Universals. Oxford: Clarendon Press.) Moreover, the framework is extensionalist since the abstract entities it assumes are classes and these can be individuated extensionally, for classes are identical if their members are identical. Finally, I will refute some of the objections to Quine’s approach that have been raised by Armstrong and Oliver [(1996). The metaphysics of properties. Mind, 105, 1–80.] and I will argue that, contrary to what has been claimed by Oliver in a comment on Lewis [(1986). On the plurality of worlds. Oxford: Blackwell.], Quine is able to specify an important set of sparse properties. (shrink)
The Ethics of Bioethics: Mapping the Moral Landscape is a compelling, thoughtful, sobering examination of the moral practice of bioethics. Jonathan D. Moreno sets the tone in the foreword by unsettling the reader with questions from critics about the intellectual legitimacy of bioethics (e.g., the frequent tensions of political ideology with normative expertise in the public debate) and the practices of some in bioethics (e.g., the controversial roles in for-profit industry or health care). Twenty-five essays follow, addressing issues and activities (...) that mark the relatively brief history and much of the scope of bioethics practice. Each essay turns bioethics practice inward to lay bare, explore, and possibly .. (shrink)
This study examined health professionals’ (HPs) experience, beliefs and attitudes towards brain death (BD) and two types of donation after circulatory death (DCD)—controlled and uncontrolled DCD. Five hundred and eighty-seven HPs likely to be involved in the process of organ procurement were interviewed in 14 hospitals with transplant programs in France, Spain and the US. Three potential donation scenarios—BD, uncontrolled DCD and controlled DCD—were presented to study subjects during individual face-to-face interviews. Our study has two main findings: (1) In the (...) context of organ procurement, HPs believe that BD is a more reliable standard for determining death than circulatory death, and (2) While the vast majority of HPs consider it morally acceptable to retrieve organs from brain-dead donors, retrieving organs from DCD patients is much more controversial. We offer the following possible explanations. DCD introduces new conditions that deviate from standard medical practice, allow procurement of organs when donors’ loss of circulatory function could be reversed, and raises questions about “death” as a unified concept. Our results suggest that, for many HPs, these concerns seem related in part to the fact that a rigorous brain examination is neither clinically performed nor legally required in DCD. Their discomfort could also come from a belief that irreversible loss of circulatory function has not been adequately demonstrated. If DCD protocols are to achieve their full potential for increasing organ supply, the sources of HPs’ discomfort must be further identified and addressed. (shrink)
in Angelique M. Rietsma and Jonathan D. Moreno eds., Ethical Guidelines for Innovative Surgery. (Hagerstown, MD: University Publishing Group) 19-52. [PDF].
Machine generated contents note: -- Preface -- Acknowledgements -- Notes on Contributors -- PART I: COMPLEXITY IN ANIMAL MINDS -- Introduction: M.McGonigle-Chalmers -- Relational and Absolute Discrimination Learning by Squirrel Monkeys: Establishing a Common Ground with Human Cognition; B.T.Jones -- Serial List Retention by Non-Human Primates: Complexity and Cognitive Continuity; F.R.Treichler -- The Use of Spatial Structure in Working Memory: A Comparative Standpoint; C.De Lillo -- The Emergence of Linear Sequencing in Children: A Continuity Account and a Formal Model; M.McGonigle-Chalmers&I.Kusel (...) -- Sensitivity to Quantity: What Counts Across Species?; S.T.Boysen&A.M.Yocom -- PART II: COMPLEXITY IN ROBOTS -- Editorial Introduction; D.McFarland -- Towards Cognitive Robotics: Robotics, Biology and Developmental Psychology; M.Lee, U.Nehmzow&M.Rodriguez -- Structuring Intelligence: The Role of Hierarchy, Modularity and Learning in Generating Intelligent Behaviour; J.J.Bryson -- Epistemology, Access, and Computational Models; G.Luger -- Reasoning About Representations in Autonomous Systems: What P´Olya and Lakatos Have To Say; A.Bundy -- PART III: LANGUAGE, EVOLUTION AND THE COMPLEX MIND -- Editorial Introduction; K.Stenning -- How to Qualify for a Cognitive Upgrade: Executive Control, Glass Ceilings, and the Limits of Simian Success; A.Clark -- Private Codes and Public Structures; C.Allen -- The Emergence of Complex Language; W.Hinzen -- Language Evolution: Enlarging the Picture; K.Stenning&M.Van Lambalgen -- Epilogue: Reminiscences of Brendan McGonigle -- Index. (shrink)
En contraste d’avec la pensée de Spinoza, pour qui la foi n’est qu’un phénomène extérieur et étrange, une notable exception à sa théorie du salut par le control des passions et l’amour intellectuelle à Dieu et par Dieu que l’homme de connaissance peut atteindre seulement grâce à la véritable philosophie, on analyse ici très brièvement la compréhension que de la foi nous proposent, en ayant l’expérience intérieure, surtout Descartes mais aussi Pascal. Pour le premier la foi relève de la volonté, (...) à qui la grâce incline d’embrasser le message révélé à peu près comme la perception claire et distincte incline au jugement dans l’acte deconnaissance. Pour Pascal la foi et la connaissance sont de l’ordre, toutes deux, du coeur, qui comme on sait a des raisons que la raison ne connait pas. (shrink)
