This book is the result of an idea launched by the present editors of providing a gift to Dr. Runner in the form of a Festschrift written by former students. The response was overwhelming. Glenn Andreas, one of Dr. Runner's closest friends, and Paul Schrotenboer, secretary of the Reformed Ecumenical Synod, enthusiastically joined us, together with Bernard Zylstra of the Institute for Christian Studies and Harry Van Dyke of the Free University of Amsterdam, to form a committee for (...) this purpose... Upon the appearance of this publication the editors wish to express their sincere thanks to the members of the committee for the advice and encouragement they gave and for the work they have done. (shrink)

The notion of patients’ duties has received periodic scholarly attention but remains overwhelmed by attention to the duties of healthcare professionals. In a previous paper the author argued that patients in publicly funded healthcare systems have a duty to participate in clinical research, arising from their debt to previous patients. Here the author proposes a greatly extended range of patients’ duties grounding their moral force distinctively in the interests of contemporary and future patients, since medical treatment offered to one patient (...) is always liable to be an opportunity cost in terms of medical treatment needed by other patients. This generates both negative and positive duties. Ten duties—enjoining obligations ranging from participation in healthcare schemes to promoting one’s own earliest recovery from illness—are proposed. The characteristics of these duties, including their basis, moral force, extent and enforceability, are considered. They are tested against a range of objections—principled, societal, epistemological and practical—and found to survive. Finally, the paper suggests that these duties could be thought to reinforce a regrettably adversarial characteristic, shared with rights-based approaches, and that a preferable alternative might be sought through the notion of a “virtuous patient” contributing to a problem-solving partnership with the clinician. However, in defining and giving content to that partnership, there is a clear role for most, if not all, of the proposed duties; their value thus extends beyond the adversarial context in which they might first be thought to arise. (shrink)

Patients participating in the shared benefits of publicly funded health care enjoy the benefits of treatments tested on previous patients. Future patients similarly depend on treatments tested on present patients. Since properly designed research assumes that the treatments being studied are—so far as is known at the outset—equivalent in therapeutic value, no one is clinically disadvantaged merely by taking part in research, provided the research involves administering active treatments to all participants. This paper argues that, because no other practical or (...) moral considerations count decisively against so doing, we could and should oblige patients to agree to receive indicated treatment within the terms of any concurrent research protocols. This ensures their treatment will benefit not only themselves but also future patients through contributing to new knowledge. By analogy with the paying of income tax, patients should not be allowed to “veto” their social responsibility to take part in clinical research. (shrink)

Using a fictional but representative general practice consultation, involving the diagnosis of irritable bowel syndrome in a patient who is anxious for some relief from the discomfort his condition entails, this paper argues that when both a drug fails to out-perform placebo and the condition in question is a functional illness with no demonstrable underlying pathology, then the action of the drug is not only no better than placebo, and it is also no different from it either. The paper also (...) argues that, in the circumstances of the consultation described, it is striking that current governance deems it ethical for a practitioner to prescribe either a drug or a placebo, both of which appear to rely for their effectiveness on a measure of concealment on the part of the doctor, yet deems it unethical for a practitioner openly to prescribe a harmless and enjoyable substance which is likely to be no less effective than either drug or placebo and is also likely to be better-tolerated and cheaper than the drug. (shrink)

Buddhism originated and developed in an Indian cultural context that featured many first-person practices for producing and exploring states of consciousness through the systematic training of attention. In contrast, the dominant methods of investigating the mind in Western cognitive science have emphasized third-person observation of the brain and behavior. In this chapter, we explore how these two different projects might prove mutually beneficial. We lay the groundwork for a cross-cultural cognitive science by using one traditional Buddhist model of the mind (...) – that of the five aggregates – as a lens for examining contemporary cognitive science conceptions of consciousness. (shrink)

While there may be a place in some contexts for high handed, “blanket” legislative prohibitions on dissenting views of what constitutes death, the paper under consideration does not describe such a contextThis stimulating and provocative paper by Professor Appel, Defining death: when physicians and families differ, asks us to consider “whether patients’ families should be permitted to opt out of widely accepted definitions of death in favour of their own standards”. This is a striking question in many ways. It reminds (...) us that, as a simple description of fact, there are indeed different standards for human death in so far as different groups or communities have accepted and continue to accept varying notions of what constitutes human death. The question’s reference to “opting out” suggests, perhaps reasonably, that it seems prima facie odd to think of adopting a definition of death as being a matter of individual choice. The reference to “permission” invites us to suppose limitations, primarily legal, upon the extent to which such a choice could be tolerated. Also, the question ascribes to certain “definitions of death” the authority of being widely accepted. The definitions thus favoured are, we learn, the various formulations of death referring to the state of the brain, chief among them “whole brain death” although the author is troublingly vague over whether all such formulations are morally, legally, or conceptually equivalent; and the relevant communities of acceptance turn out to consist of many—but, as the author admits, not all—physicians labouring under varying and inconsistent jurisdictions in the United States.My preface to the criticisms that follow is a …. (shrink)

While functioning quite well for many years, the bioethics profession is in crisis. John H. Evans closely examines the history of the bioethics profession, and based on the sociological reasons the profession evolved as it did, proposes a radical solution to the crisis.

Bioethicists’ attraction to principlism is rooted in a Western view of how matters that affect the public ought to be deliberated and decided: their resolution ought to be so structured and constrained that it can be understood and verified even by those at a remove from the circumstances of the problem. That view of deliberation, itself fostered by the Western view of government, has encouraged principlism to spread from its source in human subjects research into other areas of bioethics discourse.

Professors are increasingly encouraged to adopt multiple role relationships with their students. Regardless of professor intent, these relationships carry risks. Left unexamined is whether student–faculty social multiple relationships impact student in-class behaviors. Provocatively, our exploratory study provides empirical support suggesting that when undergraduate students perceive that their professors engage in the multiple faculty–student relationships of friendships, drinking relationships, and sexual partnerships, students report they are more likely to engage in uncivil behaviors in the professor’s classroom. Accordingly, our study provides a (...) backdrop against which to think more substantively about the professorial role and the boundaries that accompany it. (shrink)

IPCC SPECIAL REPORT ON CLIMATE CHANGE AND LAND (SRCCL) -/- Chapter 3: Climate Change and Land: An IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems.

Philosophy of mind has made substantial progress on biologically-rooted approaches to understanding the mind and subjectivity through the enactivist perspective, but research on subjectivity within neuroscience has not kept apace. Indeed, we possess no principled means of relating experiential phenomena to neurophysiological processes. Here, we present the Nested States Model as a framework to guide empirical investigation into the relationship between subjectivity and neurobiology. Building on recent work in phenomenology and philosophy of mind, we develop an account of experiential states (...) as layered, or nested. We argue that this nested structure is also apparent in brain activity. The recognition of this structural homology — that both experiential and brain states can be characterized as systems of nested states — brings our views of subjective mental states into broad alignment with our understanding of general principles and properties of brain activity. This alignment enables a more systematic approach to formulating specific hypotheses and predictions about how the two domains relate to one another. (shrink)

Under higher education’s contemporary consumer model, students are treated as customers and professors are encouraged to increase student engagement through more personal out-of-class interactions, often in social settings. In the course of this more personal student-faculty involvement, students inevitably encounter or learn of their professors’ occasional inappropriate or unethical behavior. In the present study, we investigated the impact of 145 American undergraduate Business students’ perceptions of their professors’ inappropriate out-of-class behavior on student beliefs and in-class behavior. Results indicate that student (...) perceptions of professors engaging in inappropriate out-of-class behavior were associated with students viewing these professors as lower in ethical character and reporting a stronger likelihood of attending these professors’ classes under the influence of alcohol and illicit drugs, swearing and using vulgarity in these professors’ class discussions, and showing disregard for these professors’ rules, time, and effort. These relationships held even when student grade satisfaction and professor in-class behavior were accounted for. Our results suggest professors’ behavior outside the classroom may impact students’ behavior inside the classroom, re-igniting dialogue regarding the professorial role and the boundaries on oversight of that role. We offer suggestions as to how higher education may address these concerns without infringing upon professors’ personal freedoms. (shrink)

Sawai et al. (2022) provide a good summary of the bioethical debate about brain organoids with an eye toward future directions. Like many contemporary texts in bioethics, they call for engagement w...

In terms of intervening in embodied experience, medical treatment is wonder-full in its ambition and its metaphysical presumption; yet, wonder’s role in clinical medicine has received little philosophical attention. In this paper, I propose, to doctors and others in routine clinical life, the value of an openness to wonder and to the sense of wonder. Key to this is the identity of the central ethical challenges facing most clinicians, which is not the high-tech drama of the popular conceptions of medical (...) ethics but, rather, the routine of patients’ undramatic but unremitting demands for the clinician’s time and respectful attention. Wonder (conceived as an intense and transfiguring attentiveness) is a ubiquitous ethical source, an alternative to the more familiar respect for rational autonomy, a source of renewal galvanizing diagnostic imagination, and a timely recalling of the embodied agency of both patient and clinician. (shrink)

Many adoptees face a number of challenges relating to separation from biological parents during the adoption process, including issues concerning identity, intimacy, attachment, and trust, as well as language and other cultural challenges. One common health challenge faced by adoptees involves lack of access to genetic-relative family health history. Lack of GRFHx represents a disadvantage due to a reduced capacity to identify diseases and recommend appropriate screening for conditions for which the adopted person may be at increased risk. In this (...) article, we draw out common features of traditionally understood “health disparities” in order to identify analogous features in the context of adoptees’ lack of GRFHx. (shrink)

I greatly appreciate the opportunity provided by the editor of Zygon to further develop the ideas in my book Morals Not Knowledge: Recasting the Contemporary U.S. Conflict between Religion and Science in conversation with four critical commentaries. It is an honor to have one's work focused upon so intently, and I greatly appreciate the time and effort of the critics. The book was quite intentionally written as a provocation, an attempt at agenda setting, and as a call for changing the (...) thinking of the entire religion and science academic community. In my previous writings I have kept close to the data, allowing myself at best mid‐level conclusions, but this book is a foray into the abstraction and inevitable lack of precision required for high‐level generalization. I hope that it continues to be generative of debate. (shrink)

Volume 20, Issue 8, August 2020, Page 19-21.

Blumenthal-Barby (2024) argues that the concept of personhood should not be used in bioethics, and part of her justification is that personhood is not consistent with the public’s values. In this c...

This chapter discusses the various meanings of the two critical ideas in this book and compares them. These critical ideas are “religion” and “public bioethics”. The chapter focuses most of all not on the different religious roles, but on what we think “public bioethics” is or should be.

Volume 19, Issue 7, July 2019, Page 32-34.