A mixture of facts and philosophy. Jean-Paul Sartre, William Blake, lao Tzu, Groucho Marx, Albert Einstein - hold forth on poetry religion, quantum physics.

Non-Invasive Prenatal Testing is a technology which provides information about fetal genetic characteristics very early in pregnancy by examining fetal DNA obtained from a sample of maternal blood. NIPT is a morally complex technology that has advanced quickly to market with a strong push from industry developers, leaving many areas of uncertainty still to be resolved, and creating a strong need for health policy that reflects women’s social and ethical values. We approach the need for ethical policy-making by studying the (...) use of NIPT and emerging policy in the province of Ontario, Canada. Using an adapted version of constructivist grounded theory, we conducted interviews with 38 women who have had personal experiences with NIPT. We used an iterative process of data collection and analysis and a staged coding strategy to conduct a descriptive analysis of ethics issues identified implicitly and explicitly by women who have been affected by this technology. The findings of this paper focus on current ethical issues for women seeking NIPT, including place in the prenatal pathway, health care provider counselling about the test, industry influence on the diffusion of NIPT, consequences of availability of test results. Other issues gain relevance in the context of future policy decisions regarding NIPT, including funding of NIPT and principles that may govern the expansion of the scope of NIPT. These findings are not an exhaustive list of all the potential ethical issues related to NIPT, but rather a representation of the issues which concern women who have personal experience with this test. Women who have had personal experience with NIPT have concerns and priorities which sometimes contrast dramatically with the theoretical ethics literature. These findings suggest the importance of engaging patients in ethical deliberation about morally complex technologies, and point to the need for more deliberative patient engagement work in this area. (shrink)

This narrative ethics exploration stems from my happy prostate-specific antigen story, though it should not have been, as I annually refuse my family physician’s recommendation to purchase PSA screening. The reason for my refusal is I teach ethics to medical students and of course must walk the talk, and PSA screening is not publicly funded in the province of Ontario, Canada. In addition, I might have taken false comfort in ‘but all you need is a good index finger’ to detect (...) prostate cancer, expounded by a senior physician at a national medical conference in 2010, and applauded by the large audience of physicians. I was compelled to begin this exploration out of survivor guilt, although I will not be a survivor for long, and as a mea culpa to the men similarly situated to me in having late diagnosis of prostate cancer, aggressive tumours and multiple metastases, but who unlike me are dead because they did not experience the physician–educator-based exceptionisms and coincidences that permit me to still be alive. Although my PSA story will always be a happy story, even when my life ends in a few years, the initiation of public funding of PSA screening for all men over 50 would make my PSA story an even happier story. (shrink)

This narrative ethics exploration stems from my happy prostate-specific antigen story, though it should not have been, as I annually refuse my family physician’s recommendation to purchase PSA screening. The reason for my refusal is I teach ethics to medical students and of course must walk the talk, and PSA screening is not publicly funded in the province of Ontario, Canada. In addition, I might have taken false comfort in ‘but all you need is a good index finger’ to detect (...) prostate cancer, expounded by a senior physician at a national medical conference in 2010, and applauded by the large audience of physicians. I was compelled to begin this exploration out of survivor guilt, although I will not be a survivor for long, and as a mea culpa to the men similarly situated to me in having late diagnosis of prostate cancer, aggressive tumours and multiple metastases, but who unlike me are dead because they did not experience the physician–educator-based exceptionisms and coincidences that permit me to still be alive. Although my PSA story will always be a happy story, even when my life ends in a few years, the initiation of public funding of PSA screening for all men over 50 would make my PSA story an even happier story. (shrink)

Public attention on embryo research has never been greater. Modern reproductive medicine technology and the use of embryos to generate stem cells ensure that this will continue to be a topic of debate and research across many disciplines. This multidisciplinary book explores the concept of a 'healthy' embryo, its implications on the health of children and adults, and how perceptions of what constitutes child and adult health influence the concept of embryo 'health'. The concept of human embryo health is considered (...) from preconception to pre-implantation genetic diagnosis to recent foetal surgical approaches. Burgeoning capacities in both genetic and reproductive science and their clinical implications have catalysed the necessity to explore the concept of a 'healthy' embryo. The authors are from five countries and 13 disciplines in the social sciences, humanities, biological sciences and medicine, ensuring that the book has a broad coverage and approach. (shrink)

With the cure rate for many pediatric malignancies now between 70% and 90%, infertility becomes an increasingly important issue. Strategies for preserving fertility in girls and adolescent women occur in two distinct phases. The first phase includes oophorectomy and cryopreservation of ovarian cortex slices or individual oocytes; ultrasound-guided needle aspiration of oocytes, with or without in vitro maturation, followed by cryopreservation; and ovarian autografting to a distant site. The second phase occurs if the woman chooses to pursue pregnancy, and includes (...) IVM of the oocytes, followed by in vitro fertilization and transfer of any created embryos to the woman's uterus. For ovarian autografting, the woman would undergo menotropin ovarian stimulation and retrieval of matured oocytes. The ethical challenges with each of these phases are many of fertility preservation and include issues of informed choice. The lack of proven benefit with these strategies and the associated potential physical and psychological harms require careful attention to the key elements of informed choice, which include decisional capacity, disclosure, understanding and voluntariness, and to the benefits of in-depth counseling to promote free and informed choice at a time that is emotionally difficult for the decision makers. (shrink)

This paper explores the power of theatre to engage the public and my personal journey using theatre as a research tool in reproductive science. I argue that the capacity of theatre to simultaneously engage the minds and hearts of audience members qua research participants affords audience members the capacity to provide researchers with insightful comments informed by the scientific, social and tacit knowledge derived from the performance, integrated with their lived experience. Theatre is a particularly important research strategy when investigating (...) public understandings and desires about complex issues such as those related to reproductive and genetic science. (shrink)

The purpose of this study was to explore the views of members of the general public regarding ethical issues in adult predictive genetic testing. The literature pertaining to ethical issues regarding to adult predictive genetic testing is largely restricted to the views of ‘experts’ who have emphasized informed consent, patent issues, and insurance discrimination. Occasionally the views of patients who have undergone genetic counselling and testing have been elicited, adding psychosocial and family issues. However, the general public has not had (...) the opportunity to contribute. In order to explore theatre as a health policy research tool, 1,200 audience members attended the play ‘Sarah’s Daughters’ in seven Canadian cities, following which audience discussions were audiotaped. This study performed a secondary qualitative analysis of the data to identify the ethical issues of adult predictive genetic testing important to members of the general public. The identified issues were: (1) need for public education; (2) choice to undergo genetic counselling and testing; (3) access to genetic counselling and testing; and (4) obligations regarding the handling of genetic information. Audience members emphasized public education and access to information regarding potential choices, which was different from the emphasis on informed consent and other ethical issues prominent in the literature. Members of the general public emphasized ethical issues that were different than those identified by experts and patients. It is essential that members of the public be included in complex and controversial public policy decisions. (shrink)

If God commanded something that was obviously evil, would we have a moral obligation to do it? I critically examine three radically different approaches divine-command theorists may take to the problem posed by this question: (1) reject the possibility of such a command by appealing to God's essential goodness; (2) avoid the implication that we should obey such a command by modifying the divine-command theory; and (3) accept the implication that we should obey such a command by appealing to divine (...) transcendence and mystery. I show that each approach faces significant challenges, and that none is completely satisfying. (shrink)

It is clear that beliefs can be assessed both as to their justification and their rationality. What is not as clear, however, is how the rationality and justification of belief relate to one another. Stewart Cohen has stumped for the popular proposal that rationality and justification come to the same thing, that rational beliefs just are justified beliefs, supporting his view by arguing that ‘justified belief’ and ‘rational belief’ are synonymous. In this paper, I will give reason to think that (...) Cohen’s argument is spurious. I will show that ‘rational’ and ‘justified’ occupy two distinct semantic categories – ‘rational’ is an absolute gradable adjective and ‘justified’ is a relative gradable adjective – telling against the thought that ‘rational belief’ and ‘justified belief’ are synonymous. I will then argue that the burden of proof is on those who would equate rationality and justification, making the case that those who hold this prominent position face the difficulty of explaining how rationality and justification come to the same thing even though ‘rational’ and ‘justified’ are not synonymous. (shrink)

In recent years, William Lane Craig has vigorously championed a moral argument for God's existence. The backbone of Craig's argument is the claim that only God can provide a ' sound foundation in reality' for morality. The present article has three principal aims. The first is to interpret and clarify the account of the ontological foundation of morality proposed by Craig. The second is to press home an important objection to that account. The third is to expose the weakness of (...) Craig's case for saying that without God morality would be groundless and illusory. (shrink)

A strength of liberal political institutions is their ability to accommodate pluralism, both allowing divergent comprehensive doctrines as well as constructing the common ground necessary for diverse people to live together. A pressing question is how far such pluralism extends. Which comprehensive doctrines are simply beyond the pale and need not be accommodated by a political consensus? Rawls attempted to keep the boundaries of reasonable disagreement quite broad by infamously denying that political liberalism need make reference to the concept of (...) truth, a claim that has been criticized by Joseph Raz, Joshua Cohen, and David Estlund. In this paper, we argue that these criticisms fail due to the fact that political liberalism can remain non-committal on the nature of truth, leaving the concept of truth in the domain of comprehensive doctrines while still avoiding the issues raised by Raz, Cohen, and Estlund. Further substantiating this point is the fact that Rawls would, and should, include parties in the overlapping consensus whose views on truth may be incoherent. Once it is seen that political liberalism allows such incoherence to reasonable parties, it is clear that the inclusion of truth and the requirement of coherence urged by Raz, Cohen, and Estlund requires more of reasonable people than is necessary for a political consensus. (shrink)

On a Molinist account of creation and providence, not only is there is a complete set of truths about what every possible person would freely do in any possible set of circumstances, but these conditional truths are part of the very explanation of our existence. Robert Adams has recently argued that the explanatory priority of these conditionals undermines libertarian freedom. In the present essay, I take at close look at Adams’ argument and at the Molinist response of Thomas Flint. After (...) showing that Flint’s response is inadequate, I develop what I believe to be a more successful Molinist response to Adams’ argument. Along the way, I seek to provide some insight into the nature of libertarian freedom and the proper interpretation of the much discussed “principle of alternate possibilities.”. (shrink)

Novel developments in neuroscience, psychology, and anthropology have spawned a thriving empirical literature on religious experience. Previous literature in the cognitive science of religion has largely ignored empirical results from these fields, focusing narrowly on results from evolutionary psychology. Additionally, it has ignored the epistemological relevance of non-paradigmatic cases of religious experience discussed in the literature from these subspecialties. In this article I submit that philosophical research on religious experience should take empirical work outside of evolutionary psychology as its primary (...) foci towards uncovering fresh perspectives. I focus on three different literatures from neuroscience, psychology, and anthropology as case studies for generating novel philosophical research. I show that empirically-discovered factors related to non-paradigmatic religious experiences raise crucial and unique epistemological questions. (shrink)

Weber argues that causal modelers face a dilemma when they attempt to model systems in which the underlying mechanism operates according to some set of differential equations. The first horn is that causal models of these systems leave out certain causal effects. The second horn is that causal models of these systems leave out time-dependent derivatives, and doing so distorts reality. Either way causal models of these systems leave something important out. I argue that Weber’s reasons for thinking causal modeling (...) is limited in this domain are lacking. (shrink)

Logicians and theoretical physicists will also benefit from this book.

The Doomsday Argument is alive and kicking, and since its formulation in the beginning of the Eighties by the astrophysicist Brandon Carter it has gained wide attention, been strongly criticized and has been described in many different, and sometimes non-interchangeable analogies. I will briefly present the argument here, and departing from Nick Bostrom's interpretation, I will defend that doom may be sooner than we think if we start building conscious machines soon in the future.

We like to rate each other. We rate restaurants on Yelp, drivers on Lyft, and movies on Rotten Tomatoes. And these ratings can help us make decisions. With all of this rating going on, wouldn’t it be helpful if we rated how ethical other people are? Knowing the moral scruples of others could help us make friends, choose who to date, and avoid getting ripped off. But even though lots of ratings are useful, I don’t think that giving each other (...) a moral score is a good idea. In fact, I think it might make us even more unethical. (shrink)

ABSTRACT According to an influential line of argument, the past must be finite because no infinite series can be formed by successive addition. The present paper pinpoints the non sequitur at the heart of this argument, disentangles the ambiguities that disguise it, and dismantles the misleading picture of ‘traversing the infinite’ that gives the argument so much of its allure. Finally, the paper critically explores the related argument that a beginningless series of past events is impossible because there could be (...) no explanation of its having been ‘completed’ at one time rather than another. (shrink)

Public and academic medical ethics debates surrounding justice and age discrimination often proceed from a problematic understanding of old age that ignores the diversity of older people. This article introduces the feminist perspective of intersectionality to medical ethical debates on aging and old age in order to analyze the structural discrimination of older people in medicine and health care. While current intersectional approaches in this field focus on race, gender, and sexuality, we thus set out to introduce aging and old (...) age as an additional category that is becoming more relevant in the context of longer life expectancies and increasing population aging. We analyze three exemplary cases on the individual, institutional, and public health level, and argue that considering the intersections of old age with other social categories helps to accommodate the diverse identities of older people and detect inequality and structural discrimination. (shrink)

Sober develops an account of adaptations on which they must have been positive causal factors for reproductive success. Glymour defends an account of a proper subset of adaptations—adaptations to particular environmental conditions—on which traits must interact in a special way with adapting conditions to cause reproductive success. These theories render conflicting judgments about which traits count as adaptations in some interesting cases. In this article I explore one such case and argue that we ought to replace the notion of adaptation (...) qua positive causal factor with a novel notion of adaptation. (shrink)

Brandon claims that to explain adaptation one must specify fitnesses in each selective environment and specify the distribution of individuals across selective environments. Glymour claims, using an example of the adaptive evolution of costly plasticity in a symmetric environment, that there are some predictive or explanatory tasks for which Brandon’s claim is limited. In this paper, I provide necessary conditions for carrying out Brandon’s task, produce a new version of the argument for his claim, and show that Glymour’s reasons for (...) making his claim are problematic. I provide a few interpretations of Glymour’s argument but ultimately raise worries for what I take to be the key premises. (shrink)

One of the principal lines of argument deployed by the friends of the kalām cosmological argument against the possibility of a beginningless series of events is a quite general argument against the possibility of an actual infinite. The principal thesis of the present paper is that if this argument worked as advertised, parallel considerations would force us to conclude, not merely that a series of discrete, successive events must have a first member, but also that such a series must have (...) a final member. Anyone who thinks that an endless series of events is possible must therefore reject this popular line of argument against the possibility of an actual infinite. (shrink)