The paper aims to present a critical analysis of the phenomenon and notion of exceptionalism in bioethics. The authors demonstrate that exceptionalism pertains to phenomena that are not (yet) entirely familiar to us and could potentially bear risks regarding their regulation. After an overview of the state of the art, we briefly describe the origins and evolution of the concept, compared to exception and exclusion. In the second step, they look at the overall development debates on genetic exceptionalism, compared to (...) other bioethical debates on exceptionalism, before presenting a detailed analysis of a specific case of early regulation of genetic screening. In the last part, the authors explain the historical background behind the connection between exceptionalism and exclusion in these debates. Their main conclusion is that while the initial stage of the discussion is shaped by the concept of exceptionalism and awareness of risks of exclusion, the later development centers around exceptions that are needed in detailed regulatory procedures. (shrink)

The article deals with the problem of compatibility of the extended mind thesis with the concept of epistemic responsibility. This compatibility problem lies at the intersection of two current trends in Virtue Epistemology (VE): the study of extended cognition, and the return of VE to the topic of epistemic responsibility. I give objections to two seemingly independent positions; their acceptance makes it difficult or even impossible to make the concept of epistemic responsibility applicable to the agents of digital society whose (...) cognition is extended. The core of both positions can be illustrated by the following thesis: “Since the subject cannot voluntarily change his/her beliefs, we cannot ascribe to him/her either epistemic responsibility or intellectual virtues that allow him/her to take responsibility”. The counter-arguments to this thesis are based on the distinction between the causal (responsibility-in) and normative (responsibility-for) components of responsibility. The absence of the former allows us to characterize the subject as not responsible, the absence of the latter as irresponsible. I propose two conceptual foundations that can make possible the consistent talk about the epistemic responsibility of an extended subject. 1) The subject may not be responsible for the beliefs taken from the epistemic environment, but the subject bears significant responsibility for what environment he finds himself in. 2) Being epistemically responsible means deliberately reducing the number of possible causal excuses – excuses based on agent’s unresponsibiity due to his causal dependence on his epistemic environment (‘cognitive extensions’). (shrink)

Uncertainty can’t be understood without taking into account both properties of the problem situation and agent’s knowledge about it. The correspondence of knowledge and situation of decision-making is crucial for understanding the onto-epistemological nature of uncertainty. At the same time, this correspondence is the key topic in virtue epistemology, especially in its ‘non-classical’, regulatory, branch, related to works of R. Roberts and W.J. Wood. In this article, genetic consultation is chosen as an example of such a problematic situation since a (...) doctor and a patient explicitly deal with the uncertainty of genetic risks. The problems of communication and joint decision-making in the context of medical-genetic consultation are comprehensively described in bioethics. At the same time, its social dimension is limited to the direct interaction of two individual agents, that allows us to use it as a model for constructing the ethics of uncertainty. In this article, four forms of uncertainty are identified: descriptive, normative and radical uncertainties, and translation uncertainty. Referring to the approaches of virtue epistemology, the author brings each of these forms into conformity with the proposed regulatory principle. The regulations assume that generating or disseminating knowledge under conditions of uncertainty require taking into account the incompleteness of the presented model of reality in its four aspects. A modelled fragment of reality could change in a predictable (descriptive uncertainty) or unexpected (radical uncertainty) way. The goals and values of a model’s user can not be hierarchically ordered, and may also change in the future (normative uncertainty). User’s interpretations of the model may be diverse, and can never be strictly defined by the intentions of the model’s author (indeterminancy of translation, or uncertainty whether success of co-reference is achieved). (shrink)

Semantic framework of the discussion about the equivalence and interchangeability of the original drugs and generics is considered in the article. Generics are identical to the original drugs in terms of chemical structure, nevertheless some patients and doctors consider that generics are less effective and have more severe side effects than original drugs. These discussions are considered as an example of a public deliberation concerning the achievements of technoscience. The conflicting parties determined the identity either from the chemical structure of (...) the drug (according to D. Chalmers – secondary intensional) or from the phenomenal characteristics of the situation of its application (primary intensional). In this regard, the method of resolving the conflict is the alignment of the hierarchy of methods for determining equivalence in biomedicine. The methodology of evidence-based medicine already has such a hierarchy, which makes it possible to determine the validity of outcomes of clinical trial. According to this hierarchy, the phenomenal characteristics of the outcome of treatment (quality and life expectancy of patients) are more important than instrumentally established indicators. Thus, new clinical data on the efficacy and safety of a generic should give the opportunity to cancel the recognition of drug equivalence. More generally, this means that technoscience achievement which directly affects a person can only be assessed by him/her. The recognition of such priority is the basis of the ‘division of linguistic labor’ during public deliberation concerning the achievements of technoscience. (shrink)