A practical and thought provoking introduction to the most important ethical issues in medicine today. Over 700 entries, from short essays to brief definitions of key terms and concepts, have been contributed by leading clinicians and medical ethicists.

Health care services today lack the resources to meet everybody's exspectations. Patients, professional workers and trade unions have legitimate but frequently conflicting claims, and so too have the different interest groups and specialties within medicine. This book provides an account of how resource allocation dilemmas appear to those confronted by them, in the hospital, on health boards and in the community, and it offers a critique of the moral and political arguments most commonly employed in discussing them.

Like many other locals, I was unprepared for the global media's invasion of Roslin. The former mining village just outside the southern city limits is best known to most Edinburgh citizens for its tiny, ornately carved medieval chapel. Constructed for Crusading Knights and long associated with Freemasons, Rosslyn Chapel was made famous by Sir Walter Scott's LayoftheLastMinstrel. Nowadays it is visited, in coachloads, by devotees of less literary and historically more dubious esoterica, many of whom believe that the Holy Grail (...) and/or a version of the gospels are buried beneath it. In the local media, demands for the chapel's foundations to be excavated in search of secret clues to the meaning of life, death, and everything, have figured just as prominently as articles agonizing over scientific developments at the Roslin Institute, half a country mile away. (shrink)

This book is the result of a three-year study undertaken by a multidisciplinary working party of the Institute of Medical Ethic (UK). The group was chaired by a moral theologian, and its members included biological and ethological scientists, toxicologists, physicians, veterinary surgeons, an expert in alternatives to animal use, officers of animal welfare organizations, a Home Office Inspector, philosophers, and a lawyer. Coming from these different backgrounds, and holding a diversity of moral views, the members produced the agreed report as (...) a result of detailed and rigorous discussions. The book sets out facts about animal experiments and about animal abilities to experience pain, distress and anxiety. There is a detailed examination of the moral claims related to the benefits likely to accrue from animal research, and of strategies for weighing these benefits against the harm caused to animals, in order to decide whether particular research projects ought or ought not to proceed. This leads to consideration of the statutory and non-statutory controls which safeguard standards in such research. The final section explores a variety of philosophical arguments about the use of animals in research, and offers a philosophical justification for the Working Party's more practical conclusions. Written in clear, nontechnical language, this book is accessible to lay people as well as to scientists. It is the first such document to emerge from a meeting of people with such widely differing views on this highly controversial subject, and represents a major contribution towards informing and raising the quality of contemporary debate. The book is unique in drawing together material and ideas never before found in one volume. It will interest a broad spectrum of readers, from ethicists and animal rights advocates to scientific researchers and laboratory administrators, along with general readers concerned about this compelling issue. (shrink)

Based on a study undertaken by the Institute of Medical Ethics and the Royal College of Nursing, this book examines what nurses, midwives and health visitors are taught about ethics in the UK. It defines ethics and related terms and discusses their relevance to the practice of nursing.

Ethics in nursing: continuity and change -- Cultural issues, methods and approaches to nursing ethics -- Nursing ethics: what do we mean by 'ethics'? -- Becoming a nurse and member of the profession -- Power and responsibility in nursing practice and management -- Professional responsibility and accountability in nursing -- Classical areas of controversy in nursing and biomedical ethics -- Direct responsibility in nurse/patient relationships -- Conflicting demands in nursing groups of patients -- Ethics in healthcare management: research, evaluation and (...) performance management -- The political ethics of healthcare: health policies and resource allocation -- Corporate ethics in healthcare: strategic planning and ethical policy development -- Making moral decisions and being able to justify our actions -- The relevance of moral theory: justifying our ethical policies. (shrink)

At the beginning of his Metaphysics, Aristotle attributed several strange-sounding theses to Plato. Generations of Plato scholars have assumed that these could not be found in the dialogues. In heated arguments, they have debated the significance of these claims, some arguing that they constituted an 'unwritten teaching' and others maintaining that Aristotle was mistaken in attributing them to Plato. In a prior book-length study on Plato's late ontology, Kenneth M. Sayre demonstrated that, despite differences in terminology, these claims correspond (...) to themes developed by Plato in the Parmenides and the Philebus. In this book, he shows how this correspondence can be extended to key, but previously obscure, passages in the Statesman. He also examines the interpretative consequences for other sections of that dialogue, particularly those concerned with the practice of dialectical inquiry. (shrink)

Corporate social responsibility (CSR) is increasingly becoming a popular business concept in developed economies. As typical of other business concepts, it is on its way to globalization through practices and structures of the globalized capitalist world order, typified in Multinational Corporations (MNCs). However, CSR often sits uncomfortably in this capitalist world order, as MNCs are often challenged by the global reach of their supply chains and the possible irresponsible practices inherent along these chains. The possibility of irresponsible practices puts global (...) firms under pressure to protect their brands even if it means assuming responsibilities for the practices of their suppliers. Pressure groups understand this burden on firms and try to take advantage of the situation. This article seeks to challenge the often taken-for-granted-assumption that firms should be accountable for the practices of their suppliers by espousing the moral (and sometimes legal) underpinnings of the concept of responsibility. Except where corporate control and or corporate grouping exist, it identifies the use of power as a critical factor to be considered in allocating responsibility in firm-supplier relationship; and suggests that the more powerful in this relationship has a responsibility to exert some moral influence on the weaker party. The article highlights the use of code of conducts, corporate culture, anti-pressure group campaigns, personnel training and value reorientation as possible sources of wielding positive moral influence along supply chains. (shrink)

The charged debate on the ‘C‐S‐R‐ization’ of organizational practices seems to have produced two opposing and seemingly incompatible explanations for why organizations should engage in corporate social responsibility (CSR): one, the normative rationale based on an appeal to ethics; and the other, the instrumental rationale, based on an appeal to business pragmatism. This paper argues that a missing link in this debate is the failure to recognize that the normative and instrumental approaches to corporate social responsibility are underpinned by substantively, (...) differentiating, relative logics of emotional rationalism on the one hand, and instrumental rationalism on the other. The paper makes a case that for CSR as a management practice to be practicable and actionable within a sustainable business agenda, it will need to be stripped of its current normative undertone and reconstructed in the instrumentally, pragmatic (utlish) language of business. Otherwise, the whole concept of CSR may continue to dwell in the realm of abstract theorizing without yielding many beneficial and practicable outcomes. The paper concludes that such an approach that situates CSR within a pragmatic business lingua, rather than a non‐business lingua, will help in legitimizing CSR as a ‘neutral’ management practice. (shrink)

The charged debate on the ‘C‐S‐R‐ization’ of organizational practices seems to have produced two opposing and seemingly incompatible explanations for why organizations should engage in corporate social responsibility (CSR): one, the normative rationale based on an appeal to ethics; and the other, the instrumental rationale, based on an appeal to business pragmatism. This paper argues that a missing link in this debate is the failure to recognize that the normative and instrumental approaches to corporate social responsibility are underpinned by substantively, (...) differentiating, relative logics of emotional rationalism on the one hand, and instrumental rationalism on the other. The paper makes a case that for CSR as a management practice to be practicable and actionable within a sustainable business agenda, it will need to be stripped of its current normative undertone and reconstructed in the instrumentally, pragmatic (utlish) language of business. Otherwise, the whole concept of CSR may continue to dwell in the realm of abstract theorizing without yielding many beneficial and practicable outcomes. The paper concludes that such an approach that situates CSR within a pragmatic business lingua, rather than a non‐business lingua, will help in legitimizing CSR as a ‘neutral’ management practice. (shrink)

What is the nature of law and what is the best way to discover it? This book argues that law is best understood in terms of the social functions it performs wherever it is found in human society. In order to support this claim, law is explained as a kind of institution and as a kind of artefact. To say that it is an institution is to say that it is designed for creating and conferring special statuses to people so (...) as to alter their rights and responsibilities toward each other. To say that it is an artefact is to say that it is a tool of human creation that is designed to signal its usability to people who interact with it. This picture of law's nature is marshalled to critique theories of law that see it mainly as a product of reason or morality, understanding those theories via their conceptions of law's function. It is also used to argue against those legal positivists who see law's functions as relatively minor aspects of its nature. -/- This method of conceptualizing law's nature helps us to explain how the law, understood as social facts, can make normative demands upon us. It also recommends a methodology for understanding law that combines elements of conceptual analysis with empirical research for uncovering the purposes to which diverse peoples put their legal activities. (shrink)

The chapters in this book have evolved from talks originally presented at The First International Workshop on Human and Machine Cognition.

The COVID-19 pandemic that struck New York City in the spring of 2020 was a natural experiment for the clinical ethics services of NewYork-Presbyterian (NYP). Two distinct teams at NYP’s flagship academic medical centers—at NYP/ Columbia University Medical Center (Columbia) and NYP/ Weill Cornell Medical Center (Weill Cornell)—were faced with the same pandemic and operated under the same institutional rules. Each campus used time as an heuristic to analyze our collective response. The Columbia team compares consults during the pandemic with (...) the same period during the year prior. The Weill Cornell service describes the phases of the pandemic to depict its temporal evolution and subsequent ethical challenges. Both sites report that the predominant ethical challenges centered around end-of-life decision making, setting goals of care, and medical futility, all complicated by resource allocation questions and the ambiguity of state law under crisis standards of care. The Columbia campus saw a statistically significant increase in ethics consultations provided to Hispanic patients, perhaps reflective of the disproportionate burden of COVID-19 suffered by this demographic. While Weill Cornell and Columbia saw a surge in clinical ethics consultations, the two services assumed a more expansive role than one normally played in institutional life. Serving as intermediaries between frontline clinicians and senior hospital administrators, consultants provided critical intelligence to hospital leadership about the evolution of the pandemic, disseminated information to clinicians, and attended to the moral distress of colleagues who were asked to provide care under truly extraordinary circumstances. The COVID-19 surge in New York City revealed latent capabilities in ethics consultation that may prove useful to the broader clinical ethics community as it responds to the current pandemic and reconceptualizes its potential for future service. (shrink)

This book, published in 1976, presents an entirely original approach to the subject of the mind-body problem, examining it in terms of the conceptual links between the physical sciences and the sciences of human behaviour. It is based on the cybernetic concepts of information and feedback and on the related concepts of thermodynamic and communication-theoretic entropy. The foundation of the approach is the theme of continuity between evolution, learning and human consciousness. The author defines life as a process of energy (...) exchange between organism and environment, and evolution as a feedback process maintaining equilibrium between environment and reproductive group. He demonstrates that closely related feedback processes on the levels of the behaving organism and of the organism’s nervous system constitute the phenomena of learning and consciousness respectively. He analyses language as an expedient for extending human information-processing and control capacities beyond those provided by one’s own nervous system, and shows reason to be a mode of processing information in the form of concepts removed from immediate stimulus control. The last chapter touches on colour vision, pleasure and pain, intentionality, self-awareness and other subjective phenomena. Of special interest to the communication theorist and philosopher, this study is also of interest to psychologists and anyone interested in the connection between the physical and life sciences. (shrink)

The primary aim of this chapter is to show that several missteps made by others in in their thinking about law as an artefact are due to misconceptions about the role of intentions in understanding law as an artefact. I first briefly recap my own contention that law is a genre of institutionalized abstract artefacts (put forth in The Functions of Law (OUP 2016) and subsequent papers), mostly following Searle’s understanding of institutions and Thomasson’s understanding of public artefacts. I highlight (...) the central place that this theory affords law’s functions, without requiring the theorist to say that possession or performance of the function is either necessary or sufficient for inclusion in the class of law. Some of the most common misunderstandings are exemplified in Brian Leiter’s paper ‘Legal Positivism about the Artifact Law’. He thinks that holding an intentionalist view of artefacts commits the theorist to privileging drafters’ intentions when interpreting law. (It doesn’t.) He also has confusions about the differences between artefact tokens and artefact types leading him to a problematically broad understanding of artefacts. Another problem can be seen in thinking that functional understandings of artefacts are vulnerable to the same problems that arise in functional explanations for biological systems. I go on to consider the work of Luka Burazin and Corrado Roversi, addressing worries that making intentionality central to artefacts implies too much conscious thought is required to make one, noting that several theories of intentionality do not require conscious thought in the execution of intentional action. While those who think a central place for intentionality threatens to leave us unable to explain customary law, this can be dealt with by noting the important distinction between customary rules and customary laws (where the latter requires a decision to enlist public aid in redressing violations). I claim that authors’ intentions are communicated requests for the artefacts’ audiences to see the artefacts as members of their putative kinds. Finally, I address the question of whether or not legal systems are themselves artefacts and institutions, given that they may or may not have been intentionally created. An early lawgiver might have created a legal system by accident in the process of handing down the first laws. I raise the possibility that we might want to impute intentionality to necessary by-products of artefact creation, seeing those by-products as artefacts as well. (shrink)

This article responds to two unresolved and crucial problems of cognitive science: (1) What is actually accomplished by functions of the nervous system that we ordinarily describe in the intentional idiom? and (2) What makes the information processing involved in these functions semantic? It is argued that, contrary to the assumptions of many cognitive theorists, the computational approach does not provide coherent answers to these problems, and that a more promising start would be to fall back on mathematical communication theory (...) and, with the help of evolutionary biology and neurophysiology, to attempt a characterization of the adaptive processes involved in visual perception. Visual representations are explained as patterns of cortical activity that are enabled to focus on objects in the changing visual environment by constantly adjusting to maintain levels of mutual information between pattern and object that are adequate for continuing perceptual control. In these terms, the answer proposed to (1) is that the intentional functions of vision are those involved in the establishment and maintenance of such representations, and to (2) that semantic features are added to the information processes of vision with the focus on objects that these representations accomplish. The article concludes with proposals for extending this account of intentionality to the higher domains of conceptualization and reason, and with speculation about how semantic information-processing might be achieved in mechanical systems. (shrink)

The most influential theory of law in current analytic legal philosophy is legal positivism, which generally understands law to be a kind of institution. The most influential theory of institutions in current analytic social philosophy is that of John Searle. One would hope that the two theories are compatible, and in many ways they certainly are. But one incompatibility that still needs ironing out involves the relation of the social rule that undergirds the validity of any legal system (H.L.A. Hart's (...) rule of recognition) to Searle's notion of codification: the idea that institutions need official declarations of their constitutive rules in order to enjoy the full benefits of institutions. The incompatibility arises from the fact that, in order to do its institutional work, the basic validity rule must be codified in Searle's sense—yet, given the particular role it has in legal positivism, it may be impossible to codify in the Searlean sense. In this paper I develop the incompatibility in detail, consider and reject consigning the basic validity rule to Searle's “Background” capacities that support institutional facts, and conclude that the best route to eliminating it while doing a minimum of damage to the two theories is to make a slight emendation to Searle's theory of institutions. (shrink)

Business school faculty have begun to increase ethics instruction, but very little has been done to assess the effectiveness of this instruction. Curricula-wide studies present conflicting results of the effect of ethics integration into the business curricula. Several studies suggest that courses like business ethics and business and society might have an effect on the ethical awareness or ethical reasoning of business students. A belief of many individuals interested in business ethics is that students must be exposed to ethical awareness (...) and ethical reasoning in business ethics and business and society-type courses and this should be supplemented by discussions of these topics in various business courses such as Accounting, Finance, Marketing, and others.This study reports the results of integrating a unit of business ethics into eleven accounting classes at two universities. An approach for measuring the effect of ethics integration into accounting and other business courses is suggested, and an assessment is made of the impact of ethics integration on students in accounting classes. Results indicate that the principles on which students rely when making moral decisions were affected by ethics integration. After ethics integration, students relied more heavily on the disclosure rule, the golden rule, and the professional ethic. (shrink)

Abstract: We sometimes say our moral claims are "objectively true," or are "right, even if nobody believes it." These additional claims are often taken to be staking out metaethical positions, representative of a certain kind of theorizing about morality that "steps outside" the practice in order to comment on its status. Ronald Dworkin has argued that skepticism about these claims so understood is not tenable because it is impossible to step outside such practices. I show that externally skeptical metaethical theory (...) can withstand his attacks, thereby defending the possibility of this kind of metatheoretical method and showing that the additional objectivity claims still make sense as external claims. Four interpretations of the additional objectivity claims can still be understood externally: as secondary properties, as arguing for some form of causal correspondence, as explaining error, and under Blackburn's expressivism. In the end, Dworkin's argument can be turned against itself. (shrink)

A monolithic model that ignores functional and topographic distinctions among its components has dominated clinical accounts of pain behavior. This model contributes to a pretence of knowledge that affects the treatment of sufferers. This commentary addresses the role of the target article in correcting knowledge-pretence and introduces a complementary caveat about evolutionary psychology concepts.

The aim of this project was to explore the possibility of constructing a psychologic inference engine that might enhance introspective self-awareness by delivering inferences about a user based on what he said in interactive dialogues about his closest opposite-sex relation. To implement this aim, we developed a computer program (guru) with the capacity to simulate human conversation in colloquial natural language. The psychologic inferences offered represent the authors' simulations of their commonsense psychology responses to expected user-input expressions. The heuristics of (...) the natural language processor and its relation to output responses are described in enough detail for the operations of the implementation to be understood. Evaluation of this new cognitive agent presents, we hope, puzzles for artificial intelligence and cognitive science. (shrink)

I argue that there is methodological space for a functional explanation of the nature of law that does not commit the theorist to a view about the value of that function for society, nor whether law is the best means of accomplishing it. A functional explanation will nonetheless provide a conceptual framework for a better understanding of the nature of law. First I examine the proper role for function in a theory of law and then argue for the possibility of (...) a neutral functional theory, addressing issues raised by Leslie Green, Stephen Perry, Michael Moore and John Finnis. (shrink)

I argue that law is not best considered an essentially contested concept. After first explaining the notion of essential contestability and disaggregating the concept of law into several related concepts, I show that the most basic and general concept of law does not fit within the criteria generally offered for essential contestation. I then buttress this claim with the additional explanation that essential contestation is itself a framework for understanding complex concepts and therefore should only be applied when it is (...) useful to gain a greater understanding of uses of the concept to which it is applied (adducing criteria for making such judgments of usefulness). With that in mind, I then show that applying the appellation of essential contestation to the concept of law does not helpfully illuminate the most general concept of law (usually of most interest to legal philosophers) and therefore it should not be used, while allowing that it might be more useful for the related concept of the rule of law. (shrink)

This chapter provides an explanation of precedent as a kind of artefact, in keeping with broader accounts of law that do so, specifically the author’s account of law as a genre of institutionalized abstract artefact. The chapter develops its explanation by responding to an argument by Dan Priel against seeing the common law as an artefact when understood to be a form of custom. The chapter shows that customs can themselves be artefacts but also that the precedential elements of common (...) law are not necessarily quite as customary as sometimes considered, showing that the common law built from precedents fits within a distributed design model of artefacts and that stare decisis has a wider systemic function of upholding certain rule of law principles. It ends with some considerations about the institutional nature of precedents, specifically that judicial decisions are most often both applications and developments of legal norms, but also determinations of legal validity. (shrink)

Readable and accessible collection of papers re thinking machines.

Just as recognition and pursuit of the human good take place in language and action, so too do they unfold in encounter with the material and visual. The ethical crises, projects, and striving we see in everyday religious life are worked out not just in the intersubjective play and politics of language but also in encounter with, in dwelling with, material and visual substances and forms. This essay considers the material conditions that make possible the “ethical pleasures” sought by Indonesian (...) painter A. D. Pirous in making and displaying contemporary works of “Islamic art,” most especially works that make “visual recitation” of passages from the Qur'an. (shrink)

I have argued that law is a genre of institutionalized abstract artifact, meaning that laws are purposive products of human creation designed to signal norms of behavior with respect to them. Its institutional nature is seen in the fact that it is a system of artificial statuses that convey deontic powers to status holders understood in their institutional roles. Following Searle in explaining institutions, however, is also to see the institution as the 'continuing possibility of a practice.' Hence there is (...) no tension in seeing law as both a practice and a genre of artifact. (shrink)

The Struggle for the Soul of Teacher Education is a much-needed exploration of the unprecedented current controversies and debates over teacher education and professionalism. Set within the context of neo-liberal education reforms across the globe, the book explores how the current struggles over teaching and teacher education in the US came about, as well as reflections on where we should head in the future. Zeichner provides specific examples of work that moves teacher education toward greater congruency between ideals and practices, (...) while outlining the basis for a new form of community-based teacher education, where universities and other program providers, local communities, school districts, and teacher unions share responsibility for the preparation of teachers. Ultimately, Zeichner problematizes an uncritical shift to more practice and clinical experience, and discusses the enduring problems of clinical teacher education needed for this shift to be educative. (shrink)

A new edition of a classic work compares Plato's dialogues to Aristotle's depiction of them. Reprint.

In lieu of an abstract, here is a brief excerpt of the content:Of Dialogues and SeedsKenneth SeeskinPlato’s Literary Garden: How to Read a Platonic Dialogue, by Kenneth M. Sayre; xxiii & 292 pp. Notre Dame: University of Notre Dame Press, 1995, $34.95.One of the best known paradoxes in the Platonic corpus occurs in the Seventh Letter (341), when Plato says that he has never written about the problems which concern him and never will. His reason: “This knowledge can never (...) be put into words like other subjects; but is generated by living with the matter itself and from many conversations (ek polle\s sunousias). Then like a flashing light when a fire is kindled, it is born in the soul and nourishes itself.” Why would the most gifted philosophical writer in history say that when it comes to goodness, beauty, or justice, language is an inadequate medium in which to convey truth?One answer is that Plato had an esoteric doctrine that he divulged to a few close associates but did not express in the dialogues. 1 The crux of the esotericist position is that Plato’s objection is not to language as such but to written language in particular. A more satisfying answer is offered by Kenneth M. Sayre in this recent book. According to Sayre, Plato wrote dialogues to allow the reader to have conversation (sunousia) with the author “in an indirect manner” and to facilitate the reader’s own discovery of truth. In other words, the dialogues are surrogates for the sort of discussions Plato shared with Socrates “in hopes of producing a similar effect in the mind of the reader.” [End Page 167]If Sayre is right, the problem discussed in the Seventh Letter is not limited to written communication but involves “logoi in whatever form we might identify them today” (p. 159). Sayre enlarges on this insight by claiming (p. 18) that for Plato “philosophic knowledge is not awareness of the truth of propositions” but “discernment of some aspect of reality.” 2 Nor is this view limited to the Seventh Letter; Sayre finds it expressed in dialogues ranging from the Meno to the Statesman. Although I have problems with some of the details of this interpretation, it is noteworthy that the Seventh Letter (342a) does claim its epistemology is not new and “has been expounded many times before.” 3The title of Sayre’s book is taken from a famous passage in the Phaedrus (276), where Socrates says that while written language gives the appearance of finality and inviolability, it is an image (eido\lon) of living speech, by which he means words that can defend themselves and are accompanied by knowledge. But as Sayre points out, the passage also carves out a role for written speech by claiming that it is legitimate for the dialectician to plant seeds in “a literary garden” to assist memory in later years and to help others who “wish to walk in the same path.” In fact, the passage tells us that the dialectician will select a soul of the right type and take pleasure in watching the seeds grow and mature. In keeping with Plato’s metaphor, Sayre organizes his chapters into functions associated with gardening: some dialogues prepare the ground, others sow the seeds, train the shoots, or allow us to reap the fruit. The book ends with an appendix on how to read a specific dialogue, the Theaetetus, in a way that emphasizes indirect or imagined conversation. As one might expect, Sayre takes the Theaetetus to imply that knowledge cannot be defined as true belief with a logos.Although not a highly technical work, Plato’s Literary Garden is a thoughtful and thought-provoking one designed for someone who wants students to see that Plato is not just another philosopher with another doctrine to peddle. So the first step in reading a Platonic dialogue is to recognize with Sayre that the dialogues are not “proto-essays” and that the decision to write dialogues is tied up with important features of Plato’s epistemology. But does that mean, as Sayre claims (p. 12), that “Plato’s dialogues were not conceived by their author as contexts in which to develop and to display positive arguments for... (shrink)