Background: Due to the important role of depression in major illnesses, screening measures for depression are commonly used in medical research. The protocol for managing participants with positive screens is unclear and raises ethical concerns. The aim of this article is to identify and critically discuss the ethical issues that arise when a positive screen for depression is detected, and offer some guidance on managing these issues.DiscussionDeciding on whether to report positive screens to healthcare practitioners is both an ethical and (...) a pragmatic dilemma. Evidence suggests that reporting positive depression screens should only be considered in the context of collaborative care. Possible adverse effects, such as the impact of false-positive results, potentially inappropriate labelling, and potentially inappropriate treatment also need to be considered. If possible, the psychometric properties of the selected screening measure should be determined in the target population, and a threshold for depression that minimises the rate of false-positive results should be chosen. It should be clearly communicated to practitioners that screening scores are not diagnostic for depression, and they should be informed about the diagnostic accuracy of the measure. Research participants need to be made aware of the consequences of the detection of high scores on screening measures, and to be fully informed about the implications of the research protocol.SummaryFurther research is needed and the experiences of researchers, participants, and practitioners need to be collated before the value of reporting positive screens for depression can be ascertained. In developing research protocols, the ethical challenges highlighted should be considered. Participants must be agreeable to the agreed protocol and efforts should be made to minimise potentially adverse effects. (shrink)

This book is about the respective roles of intuition and reasoning in ethics. It responds to a number of well-known philosophers and psychologists, and proposes a new perspective – radical in its moderation. It examines in depth the work of the philosopher Joshua Greene and the psychologist Jonathan Haidt. With the so-called empirical turn in ethics, much work has been done to try to isolate the role of reason and intuition in forming our moral judgements, with Haidt and Greene leading (...) the research programmes and attracting much of the professional and public attention, and many others following. The current view – shared by both camps – is that intuition is largely the driver of our moral judgements – a view summed up in Haidt’s slogan ‘intuition first, strategic reasoning second’. Haidt believes we have to live with this and accept it. Greene does not: he contends that our intuitions, while suitable for the environments in which we evolved, are worthless in the modern, global, technological age, and to avoid ethical disaster we must learn to adopt reason as the arbiter of moral truth. This book steers a middle course between these two positions and is therefore of great interest to philosophers and psychologists alike. (shrink)

Political Monsters and Democratic Imagination explores the democratic thought of Spinoza and its relation to the thought of William Blake, Victor Hugo, and James Joyce. As a group, these visionaries articulate: a concept of power founded not on strength or might but on social cooperation; a principle of equality based not on the identity of individuals with one another but on the difference between any individual and the intellectual power of society as a whole; an understanding of thought as a (...) process that operates between rather than within individuals; and a theory of infinite truth, something individuals only partially glimpse from their particular cultural situations. For Blake, God is the constellation of individual human beings, whose collective imagination produces revolutionary change. In Hugo's novel, Jean Valjean learns that the greatest truth about humanity lies in the sewer or among the lowest forms of social existence. For Joyce, Leopold and Molly Bloom are everybody and nobody, singular beings whose creative power and truth is beyond categories and social hierarchies. (shrink)

In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) passed a mandate that all its approved hospitals put in place a means for addressing ethical concerns.Although the particular process the hospital uses to address such concernsmay vary, the hospital or healthcare ethics committee (HEC) is used most often. In a companion study to that reported here, we found that in 1998 over 90% of U.S. hospitals had ethics committees, compared to just 1% in 1983, and that many (...) have some and a few have sweeping clinical powers in hospitals. (shrink)

This chapter contains section titled: Introduction.

Unlocking the debate behind the headlines, this book combines clear thinking with the very latest in science and medicine, enabling readers to decide for themselves exactly what the scientific future should hold.

Up against capacity‐based approaches to animal ethics, Cora Diamond has put the idea of animals as our fellow creatures. The aim of this article is to explore the implications of this concept for our treatment of fish. Fish have traditionally been placed at the borders or even outside of the moral community, although there is growing evidence that they have perceptual and social capacities comparable to animals that are considered morally significant. Given that a fellow creature's approach is not primarily (...) concerned with capacities, fish may pose a challenge: Can fish be seen as our fellow creatures, and if so, on what grounds? In exploring these questions, we defend Diamond against Jeff McMahan's critique of her account and its implications that the fellow creature‐concept is reducible to either capacities or special relationships and leaves no room for argument‐based moral reform. We suggest that moral attention is key to grasping the moral significance of fish and discuss how scientific research can support such attention. In so doing, we demonstrate how Diamond's approach to animal ethics provides a viable alternative to the dominant animal ethics approaches. Finally, we indicate how this approach can be useful for discussions on industrial fish farming. (shrink)

A unique selection of the most significant interviews given by Hannah Arendt, including the last she gave before her death in 1975. Some are published here in English for the first time. Arendt was one of the most important thinkers of her time, famous for her idea of "the banality of evil" which continues to provoke debate. This collection provides new and startling insight into Arendt's thoughts about Watergate and the nature of American politics, about totalitarianism and history, and (...) her own experiences as an emigre. Hannah Arendt: The Last Interview and Other Conversations is an extraordinary portrait of one of the twentieth century's boldest and most original thinkers. As well as Arendt's last interview with French journalist Roger Errera, the volume features an important interview from the early 60s with German journalist Gunter Gaus, in which the two discuss Arendt's childhood and her escape from Europe, and a conversation with acclaimed historian of the Nazi period, Joachim Fest, as well as other exchanges. These interviews show Arendt in vigorous intellectual form, taking up the issues of her day with energy and wit. She offers comments on the nature of American politics, on Watergate and the Pentagon Papers, on Israel; remembers her youth and her early experience of anti-Semitism, and then the swift rise of the Hitler; debates questions of state power and discusses her own processes of thinking and writing. Hers is an intelligence that never rests, that demands always of her interlocutors, and her readers, that they think critically. As she puts it in her last interview, just six months before her death at the age of 69, "there are no dangerous thoughts, for the simple reason that thinking itself is such a dangerous enterprise.". (shrink)

ABSTRACT It used to be said that shame culture waned in early modernity, but there is a growing body of historiography on the vital role that recognition and the opinion of others continued to play. Honour mattered; for some it was the mark and the maker of your true self. While philosophers like Hobbes, Locke, Mandeville, Hume, Smith, and Rousseau disagreed in their evaluations of the phenomenon, they were united in thinking that the great engine of recognition whirred like furious (...) clockwork through human society. When one listens to voices from the margins of power, however, to formerly enslaved black women and men, and white women, one hears a different story – that the machine is broken. I argue that, albeit from incomparable positions, they articulate a theory of misrecognition in the face of systematic power. Sensitive to the entanglements of epistemology and naturalised inequality, they offer a politics of vision that deconstructs the punitive lenses of gender and race which render people invisible and misunderstood, and in so doing they try to write themselves into view. They offer an account of the mysterious intractability of hegemonic ways of seeing that poses a challenge to both the putatively laissez-faire economy of recognition of their enlightened contemporaries, and to the emancipatory teleology of modern recognition theorists. (shrink)

Revolutions in semiconductor device miniaturization, bioelectronics, and applied neural control technologies are enabling scientists to create machine-assisted minds, science fiction's “cyborgs.” In a paper published in 1999, we sought to draw attention to the advances in prosthetic devices, to the myriad of artificial implants, and to the early developments of this technology in cochlear and retinal implants. Our concern, then and now, was to draw attention to the ethical issues arising from these innovations. Since that time, breakthroughs have occurred at (...) a breathtaking pace. Scientists, researchers, and engineers using differing methodologies are pursuing the possibilities of direct interfaces between brains and machines. Technological innovations as such are neither good nor evil; it is the uses devised for them that create moral implications. As there can be ethical problems inherent in the proper human uses of technologies and because brain chips are a very likely future technology, it is prudent to formulate policies and regulations that will mitigate their ill effects before the technologies are widespread. Unlike genetic technologies, which have received widespread scrutiny within the scientific community, national governments, and international forums, brain–machine interfaces have received little social or ethical scrutiny. However, the potential of this technology to change and significantly affect humans is potentially far greater than that of genetic enhancements, because genetic enhancements are inherently limited by biology and the single location of an individual, whereas hybrids of human and machine are not so restricted. Today, intense interest is focused on the development of drugs to enhance memory; yet, these drugs merely promise an improvement of normal memory, not the encyclopedic recall of a computer-enhanced mind combined with the ability to share information at a distance. The potential of brain chips for transforming humanity are astounding. This paper describes advances in hybrid brain–machine interfaces, offers some likely hypotheses concerning future developments, reflects on the implications of combining cloning and transplanted brain chips, and suggests some potential methods of regulating these technologies. (shrink)

There are better and worse ways to blame others. Likewise, there are better and worse ways to blame yourself. And though there is an ever-expanding literature on the norms that govern our blaming practices, relatively little attention has been paid to the norms that govern expressions of self-blame. In this essay, I argue that when we blame ourselves, we ought not do so privately. Rather, we should, ceteris paribus, express our self-blame to those we have wronged. I then explore how (...) this norm can contribute to our understanding of the ethics of self-blame as well as the nature of blameworthiness itself. (shrink)

Auf den ersten Blick haben Hannah Arendt und Michel Foucault kaum etwas gemein. Tatsächlich beziehen sie sich jedoch auf die identischen Topoi der Philosophiegeschichte - wenn ihre Auslegungen der Quellen auch denkbar verschieden sind. Als Grund hierfür bestimmt Hannah Holme die komplementären Perspektiven der beiden, die sie als Aneignungen des heideggerschen Sorgebegriffs deutet: die ethische Sorge um sich Foucaults und die politische Sorge um die Welt Arendts. Am Ende steht ein Plädoyer für eine Verbindung des machtkritischen Ethos der (...) Sorge um sich mit der Macht des politischen Handelns, das der Sorge um die Welt unterstellt ist. (shrink)

We explore multi-scale relations in artificial intelligence (AI) use in order to identify difficulties with coordinating relations between users, machine learning (ML) processes, and “sociobuilt contexts”—specifically in terms of their applications to medical technologies and decisions. We begin by analyzing a recent COVID-19 machine learning case study in order to present the difficulty of traversing the detailed causal topography of “sociobuilt contexts.” We propose that the adequate representation of the interactions between social and built processes that occur on many scales (...) ought to drive interdisciplinary approaches for ML modification. Next, we describe ML algorithm development as a process that is partly dependent on methodological stabilization for reliability and partly on coordinating relations. In the coordination between user, ML process, and sociobuilt contexts, we propose that new methods can be explored that promote the inclusion of patients and communities for the purpose of cross-checking portions of the ML process. Finally, we suggest that the advantages of responsible innovation emerge through the iterative entanglement of ethical, methodological, and ontological considerations within the broader conceptual infrastructure of epistemic responsibility. (shrink)

I defend the normativity of meaning against recent objections by arguing for a new interpretation of the ‘ought’ relevant to meaning. Both critics and defenders of the normativity thesis have understood statements about how an expression ought to be used as either prescriptive or semantic. I propose an alternative view of the ‘ought’ as conveying the primitively normative attitudes speakers must adopt towards their uses if they are to use the expression with understanding.

When one examines the emerging debate about genetic patenting, it becomes clear that those who oppose so-called misunderstand genetics or apply inappropriate moral and jurisprudential theory. In this brief essay I examine some arguments against gene patents of the variety, and conclude that patents on methods for detecting the presence of a genetic correlation with disease-related (and other) phenotypes can be appropriate, and that with several precautions the U.S. Patent and Trademark Office should continue granting patent protection to investigators who (...) generate genetic disease diagnostic innovations. (shrink)

A number of philosophers, including Kant, Kripke, Boghossian, Gibbard and Brandom, can be read as endorsing the view that concepts are normative. I distinguish two versions of that view: a strong, non-naturalistic version which identifies concepts with norms or rules (Kant, Kripke), and a weaker version, compatible with naturalism, on which the normativity of concepts amounts only to their application’s being governed by norms or rules (Boghossian, Gibbard, Brandom). I consider a problem for the strong version: grasp of a rule (...) seems to require grasp of the concepts which constitute the content of that rule, so how can we explain concept acquisition without falling into regress? I offer a Kantian response, on which grasp of a rule does not require antecedent grasp of concepts, but still involves the recognition of normativity in one’s rule-governed behavior. I distinguish the normativity of concepts, so understood, from the normativity associated with truth or warrant. Keywords: concepts, normativity, rules, Kant, Kripke, Boghossian, Gibbard, Brandom. (shrink)

Genetic counselors are on the front lines of the genetic revolution, presented with tests of varying predictive values and reliability, unfair testing distribution mechanisms, tests for conditions where no treatment exists, and companies that oversell the usefulness of their tests to physicians and nurses. Many scholars, both genetic testing task forces as well as the newly formed National Bioethics Advisory Commission, have all noted that genetic counseling programs and services are critical for adequate genetic testing. At the same time, in (...) our own work at the University of Pennsylvania we have encountered many requests for new materials for training genetic counselors in ethics and providing ethics resources for genetic counseling. One of us has noted elsewhere that it is crucial that resources from the Human Genome Project, the Centers for Disease Control, and other public agencies be devoted to providing better resources for genetic counselors facing difficult ethical issues. Although the American Board of Genetic Counseling requires that training programs include some formal coursework in ethics, many wonder whether enough is being done to prepare genetic counselors for an ever-tougher job, and in particular there has been much concern expressed about whether is an outmoded ideal that hampers this profession as it attempts to grow and identify the value of its practice. On the basis of many comments to us by genetic counselors and on the basis of our review of the current literature, we hypothesized that accredited genetic counseling training programs are poised at the turn of the century to begin planning a new approach toteaching the philosophy of genetic counseling, one that integrates philosophical, theoretical, and ethical training throughout thecurriculum in genetic counseling. (shrink)

is the newest section of CambridgeQuarterly. Twice each year these pages will feature a colloquium on a breaking issue in bioethics.

The role of the healer is expanding. Attempts by physicians to enhance human capacity are but one among many new medical projects. The twentieth century ushered in significant changes in therapeutic modalities, and the past two decades have seen the role of the physician reshaped by economic, political, and dramatic new social mores. People ask new and different things of their clinicians. Under managed care, the primary care clinician is expected to have much more skill than was traditionally expected of (...) a general internist, and new incentives force physicians to much more explicitly ration the care they provide to patients and to patient populations. But perhaps no change in the contemporary world of health portends more long-term effects than the introduction of enhancement technologies. (shrink)

When we consider some controversies among scholars about whether brainstem death is death, we should clearly identify what the controversy is about. Is it about whether the brainstem dead can be ca...

For years, _Multicultural Education_ has served as an essential resource for education professionals, featuring scholarly articles written by industry leaders and topics, following current trends in education instruction today. The text helps educators understand the concepts, paradigms, and explanations necessary for becoming effective practitioners in the ever-evolving classroom environment, highlighting cultural, raocial and language-focused topics. Each chapter now incorporates new theoretical, conceptual, and research developments within the field, providing an adaptable approach to classroom techniques. With growing classroom diversity, the text (...) also features a chapter that focuses on lesbian, gay, bisexual and transgender issues. Statistical tables, figures and charts have been updated to present the most current information. (shrink)

This new translation is an extremely welcome addition to the continuing Cambridge Edition of Kant’s works. English-speaking readers of the third Critique have long been hampered by the lack of an adequate translation of this important and difficult work. James Creed Meredith’s much-reprinted translation has charm and elegance, but it is often too loose to be useful for scholarly purposes. Moreover it does not include the first version of Kant’s introduction, the so-called “First Introduction,” which is now recognized as indispensable (...) for an understanding of the work. Werner Pluhar’s more recent translation, which does include the First Introduction, is highly accurate when it confines itself to rendering Kant’s German. However, it is often more of a reconstruction than a translation, containing so many interpretative interpolations that it is often difficult to separate out Kant’s original text from the translator’s contributions. Paul Guyer and Eric Matthews have provided a translation that compares to or exceeds Pluhar’s in its literal approach to the German, but that confines all interpretative material to footnotes and endnotes, so that the text itself, with all its unclarities and ambiguities, lies open to view. In addition, Guyer, as editor of the volume, has provided a great deal of valuable supplementary material. This includes an introduction with an outline of the work and details of the history of its composition and publication, and a wealth of endnotes offering clarifications of the text, background information, and, most strikingly, many references to related passages in Kant’s voluminous writings, particularly in connection with Kant’s earlier writings related to aesthetics. The edition also records differences among the first three editions of the work, and—of particular interest—erasures from and additions to Kant’s manuscript of the First Introduction. Although the introduction and endnotes reflect interpretative views that are sometimes disputable, this supplementary material makes the present edition into a valuable resource even for those able to read the text in German. (shrink)

Imagination comes with varying degrees of sensory accompaniment. Sometimes imagining is phenomenologically lean (cognitive imagining); at other times, imagining involves or requires sensory presentation such as mental imagery (sensory imagining). Philosophers debate whether contradictions can obtain in fiction and whether cognitive imagining is robust enough to explain our engagement with fiction. In this paper, I defend the Principle of Poetic License by arguing for the Permissive View of fictional truth: we can have fictions in which a contradiction is true, everything (...) is true, or nothing is true. I show that imagination-based worries about impossible, unlimited, and empty fictions can be shown to be about sensory imagination and that sensory imagination isn’t necessary for fictional truth. (shrink)

There's Something about Gödel is a bargain: two books in one. The first half is a gentle but rigorous introduction to the incompleteness theorems for the mathematically uninitiated. The second is a survey of the philosophical, psychological, and sociological consequences people have attempted to derive from the theorems, some of them quite fantastical.The first part, which stays close to Gödel's original proofs, strikes a nice balance, giving enough details that the reader understands what is going on in the proofs, without (...) giving so many that the reader feels overburdened. Perhaps he skimps too much on details, as when he decides not to explain how to convert recursive definitions into explicit ones. Also, I wish he had talked about Löb's theorem. But these are small complaints.The second half discusses a sampling of what one reads about Gödel's theorems in philosophy journals and in the popular press, and here Berto often finds himself exasperated, especially by …. (shrink)

This article examines the inherently ethical nature of resource allocation in policing. Decision-makers must make trade-offs between values such as efficiency vs. equity, individual vs. collective benefit, and adopt principles of distribution which allocate limited resources fairly. While resource allocation in healthcare has been the subject of extensive discussion in both practitioner and academic literature, ethical resource allocation in policing has received almost no attention. We first consider whether approaches used in healthcare settings would be suitable for policing. Whilst there (...) are some high-level similarities in the relevant ethical considerations and processes—such as aiming for efficient and equitable resource deployment—there are also fundamental differences between the two settings, which we argue necessitate a different approach. These differences include: (1) greater diversity and incommensurability of the benefits of policing, (2) more frequent non-linearity in returns on policing investment, (3) greater “ethical divisibility” (permissible scaling down) of programs in policing, (4) a requirement to assess “need” for policing resources at the collective (rather than individual) level, and (5) clearer primacy of equity considerations in policing. Having drawn out the implications of these differences, we sketch some tentative proposals for ethical resource allocation in policing. (shrink)