The essays in this special issue of HEC Forum provide reflections that make explicit the implicit anthropology that our current pandemic has brought but which in the medical ethics literature around COVID-19 has to a great extent ignored. Three of the essays are clearly “journalistic” as a literary genre: one by a hospital chaplain, one by a medical student in her pre-clinical years, and one by a fourth-year medical student who reports her experience as she completed her undergraduate clerkships and (...) applied for positions in graduate medical education. Other essays explore the pandemic from historical, sociological, and economic perspectives, particularly how triage policies have been found to be largely blind to structural healthcare disparities, while simultaneously unable to appropriately address those disparities. Central issues that need to be addressed in triage are not just whether a utilitarian response is the most just response, but what exactly is the greatest good for the greatest number? Together, the essays in this special issue of HEC Forum create a call for a more anthropological approach to understanding health and healthcare. The narrow approach of viewing health as resulting primarily from healthcare will continue to hinder advances and perpetuate disparities. Health outcomes result from a complex interaction of various social, economic, cultural, historical, and political factors. Advancing healthcare requires contextualizing the health of populations amongst these factors. The COVID-19 pandemic has made us keenly aware of how interdependent our health as a society can be. (shrink)

In this paper the author argues that a narrative approach to understanding assisted suicide has been compromised by the notion that all narratives must be both coherent and unified. He asks what we are to do with those narratives that cannot seem to cohere or be other than full of disunity? Is suicide the only way to make meaning out of suffering? He then proposes that the narrative found in the Gospel of Mark leads Christians to a life in hope (...) and compassion in spite of apparent incoherence and disunity and threats of abandonment and suffering. (shrink)

The ASBH Core Competencies Update Task Force (Tarzian and ASBH Core Competencies Update Task Force 2013) provides useful information for individual consultants performing case consultations. A grow...

Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and (...) in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically. (shrink)

“Love hurts”—as the saying goes—and a certain amount of pain and difficulty in intimate relationships is unavoidable. Sometimes it may even be beneficial, since adversity can lead to personal growth, self-discovery, and a range of other components of a life well-lived. But other times, love can be downright dangerous. It may bind a spouse to her domestic abuser, draw an unscrupulous adult toward sexual involvement with a child, put someone under the insidious spell of a cult leader, and even inspire (...) jealousy-fueled homicide. How might these perilous devotions be diminished? The ancients thought that treatments such as phlebotomy, exercise, or bloodletting could “cure” an individual of love. But modern neuroscience and emerging developments in psychopharmacology open up a range of possible interventions that might actually work. These developments raise profound moral questions about the potential uses—and misuses—of such anti-love biotechnology. In this article, we describe a number of prospective love-diminishing interventions, and offer a preliminary ethical framework for dealing with them responsibly should they arise. (shrink)

Abstract Since their inception, distributional models of semantics have been criticized as inadequate cognitive theories of human semantic learning and representation. A principal challenge is that the representations derived by distributional models are purely symbolic and are not grounded in perception and action; this challenge has led many to favor feature-based models of semantic representation. We argue that the amount of perceptual and other semantic information that can be learned from purely distributional statistics has been underappreciated. We compare the representations (...) of three feature-based and nine distributional models using a semantic clustering task. Several distributional models demonstrated semantic clustering comparable with clustering-based on feature-based representations. Furthermore, when trained on child-directed speech, the same distributional models perform as well as sensorimotor-based feature representations of children’s lexical semantic knowledge. These results suggest that, to a large extent, information relevant for extracting semantic categories is redundantly coded in perceptual and linguistic experience. Detailed analyses of the semantic clusters of the feature-based and distributional models also reveal that the models make use of complementary cues to semantic organization from the two data streams. Rather than conceptualizing feature-based and distributional models as competing theories, we argue that future focus should be on understanding the cognitive mechanisms humans use to integrate the two sources. (shrink)

This work reviews the progress of children's rights 25 years since the adoption of the UN Convention on the Rights of the Child. It studies the progress of that human rights instrument as part of an ongoing process. It examines how recent past, present and future generations will benefit or suffer as part of the process in which outcomes cannot be predicted. It does not project into the future. Its emphasis is on a review of the period after 1989 and (...) it comments on what has happened and offering guidance on how children's rights might progress. The book presents a realistic but not always critical review of two and a half decades of intensive activity in the field of children's rights worldwide. It includes both failures and examples of good practice and positive experiences. It offers a review of progress and lack of progress in child rights and welfare in the twelve countries used as case studies in its predecessor, The Next Generation. Finally, the volume considers the impact of current geopolitical and economic realities on children's rights in the early years of the twenty-first century. The book is a tribute to Judith Ennew and pays homage to all of the people who have contributed so much to children's rights over the years and wishes to encourage others to take up the cause. (shrink)

A number of authors have commented on the topic of mandated reporting in cases of suspected child maltreatment and the application of this requirement to researchers. Most of these commentaries focus on the interpretation of current legal standards and offer opinions for or against the imposition of mandated reporting laws on research activities. Authors on both sides of the issue offer ethical arguments, although a direct comparison and analysis of these opposing arguments is rare. This article critically examines the ethical (...) arguments made by authors on both sides of the debate. The conclusion is reached that researchers should be mandated reporters of child maltreatment because the current arguments do not justify their exclusion from current ethical and legal standards. The author makes recommendations for the ethically responsible conduct of research in regard to this topic and legal implications are discussed. (shrink)

Children approach counterfactual questions about stories with a reasoning strategy that falls short of adults’ Counterfactual Reasoning (CFR). It was dubbed “Basic Conditional Reasoning” (BCR) in Rafetseder et al. (Child Dev 81(1):376–389, 2010). In this paper we provide a characterisation of the differences between BCR and CFR using a distinction between permanent and nonpermanent features of stories and Lewis/Stalnaker counterfactual logic. The critical difference pertains to how consistency between a story and a conditional antecedent incompatible with a nonpermanent feature of (...) the story is achieved. Basic conditional reasoners simply drop all nonpermanent features of the story. Counterfactual reasoners preserve as much of the story as possible while accommodating the antecedent. (shrink)

Male circumcision—partial or total removal of the penile prepuce—has been proposed as a public health measure in Sub-Saharan Africa, based on the results of three randomized control trials showing a relative risk reduction of approximately 60 per cent for voluntary, adult male circumcision against female-to-male human immunodeficiency virus transmission in that context. More recently, long-time advocates of infant male circumcision have argued that these findings justify involuntary circumcision of babies and children in dissimilar public health environments, such as the USA, (...) Australasia and Europe. In this article, we take a close look at the necessary ethical and empirical steps that would be needed to bridge the gap between the African RCTs and responsible public health policy in developed countries. In the course of doing so, we discuss some of the main disagreements about the moral permissibility of performing a nontherapeutic surgery on a child to benefit potential future sexual partners of his. In this context, we raise concerns not only about weaknesses in the available evidence concerning such claims of benefit, but also about a child’s moral interest in future autonomy and the preservation of his bodily integrity. We conclude that circumcision of minors in developed countries on public health grounds is much harder to justify than proponents of the surgery suggest. (shrink)

First published in 1979, this book considers the culture of a multi-racial community through the eyes of six children about to start school. Each child is from a different background but all live in the same street in a town in the north of England. Following the children from home into school, their six separate lives are unveiled, illustrating the manner in which their six separate worlds are in some ways grounded in their own respective cultures, and in others interwoven (...) with the common experience of school. These Children enter school in search of a multi-cultural society, and a sympathetic appraisal is made of what happens to them as they face such initially daunting prospects as the classroom, television and the playground. The most compelling element in this book is the way in which education is shown to be able to derive benefit from this cultural diversity. The research was commissioned by the Social Sciences Research Council and the Leverhulme Trust, and will be of particular interest to those working in social work and education. (shrink)

In this paper I develop an alternative to prevailing moral development assumptions in early childhood education. Drawing on a Bakhtinian theoretical framework, theories of identity formation, and examples from my longitudinal research study of child-adult play, I reframe development as a lifelong process of coauthoring ethical identities that may begin in early childhood when adults join children in dramatic play.

There are cases where many think it would have been better for some child never to have been born. We can imagine a life characterized exclusively by suffering, never containing even the briefest moment of pleasure. The life goes exceedingly poorly – so poorly, we think, that it would have been better for the child never to have been. However, most of us think that many lives are not of this sort. Many lives are at least all right: the good (...) moments outweigh the bad, and so it’s not better for those people never to have been born.David Benatar offers a compelling and challenging argument against this common view.See David Benatar [1]. He endorses anti-natalism, which is the view that there’s always a pro tanto moral reason, grounded in the interests of a potential child, against creating the child because it’s always better for the child never to have been born.As will be mentioned in note 13, there is strictly speaking a qualification: if one’s life contains no pains at all, then it’s .. (shrink)

The ethics of research projects has become a central aspect in the discussion of how research is conceived and planned in social work and the broader social sciences. Ethics committees play an impo...

Davis called for “extreme caution” in the use of non-invasive brain stimulation to treat neurological disorders in children, due to gaps in scientific knowledge. We are sympathetic to his position. However, we must also address the ethical implications of applying this technology to minors. Compensatory trade-offs associated with NIBS present a challenge to its use in children, insofar as these trade-offs have the effect of limiting the child’s future options. The distinction between treatment and enhancement has some normative force here. (...) As the intervention moves away from being a treatment toward being an enhancement—and thus toward a more uncertain weighing of the benefits, risks, and costs—considerations of the child’s best interests diminish, and the need to protect the child’s autonomy looms larger. NIBS for enhancement involving trade-offs should therefore be delayed, if possible, until the child reaches a state of maturity and can make an informed, personal decision. NIBS for treatment, by contrast, is permissible insofar as it can be shown to be at least as safe and effective as currently approved treatments, which are themselves justified on a best interests standard. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What is Fantasy?Brian Laetz and Joshua J. JohnstonWizards, elves, dragons, and trolls—this is certainly the stuff of fantasy, populating the fictions of such giants as Tolkien, no less than the juvenilia of many aspiring writers. However, it is much easier to identify typical elements of fantasy, than it is to understand the category of fantasy itself. There can be little doubt that, in practice, the genre is pretty (...) well defined, concretely manifesting itself in the shelves reserved for it in video shops and bookstores. But stating why a work belongs on these shelves, rather than those in the near vicinity, such as horror and science fiction, or those more remote, like plain old fiction, presents a real challenge. Certainly, a mere few feet could separate fantasy from the other shelves, but the conceptual distance those feet represent appears great indeed. What, if anything, distinguishes this genre from other categories of mass art. In other words, what is fantasy?To begin, fantasy is a transmedia genre, since there are fantasy novels and movies, for instance, as is illustrated by J. R. R. Tolkien's Lord of the Rings saga and its recent cinematic adaptation. It is interesting to note that fantasy includes works from other media as well, such as paintings, which often accompany fantasy narratives, like Frank Frazetta's recognizable illustrations for Robert E. Howard's Conan the Barbarian stories. Forms of entertainment are also affiliated with the genre, such as role-playing games, like Dungeons and Dragons, though one might balk at considering such things even forms of mass art? Nonetheless, despite the variety of media and entertainments associated with fantasy, [End Page 161] narratives occupy a fundamental place within the genre. For paintings, drawings, and the like are only recognizably fantastic given some narrative background that tells us what wizards, trolls, and dragons look like.1 Plausibly, it is what allows us to see that a drawing depicts an elf, for example, rather than a child with odd pointy ears. Thus, even if some works of fantasy are, strictly speaking, non-narrative, fantastic narratives remain fundamental, since these other works would not be classified as fantasy without them. This warrants initially setting aside things like fantasy games and paintings to focus on narratives. What, precisely, makes a narrative fantastic?First, fantastic narratives are essentially fictional. For regardless of how one ultimately understands the nature of fiction, the notion of true fantasy seems patently incoherent, quite unlike, say, true crime. And it must be stressed that this point should be compatible with any theory of fiction. Second, the sort of things that can make a work fantastic, like wizards and dragons, must be prominent in the work—they cannot be minor details. For example, had there been a two-minute scene in Spartacus in which someone cast a spell, the scene would have been fantastic, but ultimately the movie would not be classified any differently; you would still find it on the drama shelf. Moreover, this condition is not peculiar to fantasy.2 For instance, no one who has suffered through a Steven Seagal film would seriously classify it as romance or even action-romance, simply because it has a minor romantic subplot. Fantasy is no different from any other genre in this regard: whatever features define a genre must be prominent in a work in order for it to belong to the relevant genre. Third, the sort of content that can make a work fantastic must not solely be viewed as symbols for things that are not fantastic. In other words, these elements cannot just be taken as allegorical.3 This alone would seem to disqualify George Orwell's Animal Farm from the genre, since most read the intelligent animals as merely symbols portraying various factions in communist Russia. It should be noted that the actual intentions of the author probably matter little here. For example, even if scholars discovered that Tolkien merely intended the Middle Earth saga as an elaborate allegory, it would remain fantasy; few would be tempted to move the books to another shelf. Fourth, the relevant content must not solely be mocked or lampooned within the work.4 This is necessary... (shrink)

Our world is full of fictional devices that let people feel better about their situation - through deception and self-deception. The legal realist, Felix Cohen, argued that law and legal reasoning is full of similarly dubious labels and bad reasoning, though of a special kind. He argued that judges, lawyers and legal commentators allow linguistic inventions and conventions to distort their thinking. Like the ancient peoples who built idols out of stone and wood and then asked them for assistance and (...) guidance, Cohen argued that within the legal world people tend to create legal concepts and then think that these concepts do or should determine how social disputes must be The philosopher Ludwig Wittgenstein similarly spoke of the way we fool ourselves, when we use a noun for some matter, and then assume that, because nouns usually name objects, here as well there must be some entity that exists out in the world, whose nature can be discovered. Our grammar misleads us. This article explores some of the ways, particularly in contract law and family law, that we have been led astray by our legal language. Because we only rarely have an Oliver Wendell Holmes, Jr., or a Felix Cohen to keep us in line, we need to learn to do the important work ourselves. The great danger is the way that inaccurate language can so easily change our substantive views about what is natural or what is right. If transparency is difficult in legal language, much of the fault may lie with lawyers and judges who want to make their conclusions sound more reasonable, less controversial, and more appealing: so we call it "consent" and "waiver" and "meeting of the minds" and "best interests of the child," when it is in fact something quite different. And at least in the common law systems the process of reasoning and law-making is tied strongly to the past. The new case has to fit into the categories and concepts that we created for a prior case - fitting cases that came up hundreds of years before, in a different society, with different technology, facing a different set of problems. So judges often end up stretching the meaning of concepts, or using legal fictions to bridge the old rule with the new equities. We may never entirely escape the tendency of our own language to mislead us, but clarity in thought and analysis is something towards which we should struggle constantly, and with determination. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Moral Traditions: An Introduction to World Religious Ethics, and: Understanding Religious Ethics, and: Moral Struggle and Religious Ethics: On the Person as Classic in Comparative Theological ContextsBrian D. BerryMoral Traditions: An Introduction to World Religious Ethics Mari Rapela Heidt Winona, Minn.: Anselm Academic, 2010. 138 pp. $22.95.Understanding Religious Ethics Charles Mathewes Malden, Mass.: Wiley-Blackwell, 2010. 277 pp. $41.95.Moral Struggle and Religious Ethics: On the Person as Classic in (...) Comparative Theological Contexts David A. Clairmont Malden, Mass.: Wiley-Blackwell, 2011. 245 pp. $99.95These three texts each make significant contributions to comparative religious ethics, a relatively recent discipline that reflects the rise of religious pluralism and globalization. Taken together, these books raise questions about what comparative religious ethics is, how it should be done, and why it should be done. What makes comparative religious ethics “comparative” and to what extent can comparative religious ethics be made genuinely “theological”?Mari Rapela Heidt, who holds a PhD in theological ethics from Marquette University and currently lectures in the religious studies department at the University of Dayton, has written a well-organized and highly accessible introduction to the ethics of the world religions for beginning undergraduate students. Each of the main chapters in her book surveys a major world religion (Hinduism, Buddhism, Judaism, Christianity, Islam, and the Chinese moral tradition) through four lenses: a brief review of the tradition; the moral world of the religion; values, principles, or virtues in the tradition; and the religious tradition on a particular moral issue (e.g., Hinduism on abortion, Buddhism on wealth and poverty, Judaism on the environment, Christianity on war and peace, Islam on men and women, and China’s one-child [End Page 202] policy). The book also includes opening chapters that introduce students to the study of ethics and religious ethics; a final chapter on additional religious moral traditions (Sikhism, Jainism, Bahá’í, and Shinto); sidebars highlighting major religious figures, texts, or events (e.g., Gandhi, Thich Nhat Hanh, Elie Wiesel, the Charter of Medina, and the Cultural Revolution); and discussion questions, bibliography (including visual media), footnotes, a glossary, and an index.Although this book briefly discusses the discipline of comparative religious ethics and some of its descriptive and conceptual methods in its opening chapters, its broad scope and concise treatment mean that the actual task of comparing the similarities and differences in the ethics of the world religions is kept to a minimum. The few detailed comparisons that are made focus largely on Hindu, Buddhist, and Christian understandings of the concepts of reincarnation (29, 34, 64), dharma (18–19, 23–24, 34–35, 64), karma (18–19, 21–23, 35–36, 64), and ahimsa (25–27, 38, 70–71). While the main chapters are organized in a way that facilitates comparison, and discussion questions are included that invite students to observe similarities and differences, the book would be strengthened by giving greater attention to comparison throughout and adding a concluding chapter that summarizes its comparative content. It ends somewhat abruptly with a discussion of the Shinto moral tradition.Charles Mathewes, associate professor of religious studies at the University of Virginia, has written a book that, while limited to Judaism, Christianity, and Islam, achieves much greater comparative sophistication. The text is based on a course he has taught for more than ten years called “Religious Ethics and Moral Problems,” and it bears the marks of a seasoned teacher whose primary audience is advanced undergraduate students, both religious and secular. Mathewes writes from a Protestant Christian perspective “having a strong apocalyptic dimension which is focused on the next life,” acknowledging that Roman Catholics and Eastern Orthodox may find his views “odd or confused” (53). Part 1 discusses the relationship between God and morality and provides an overview of the ethics of each of the three Abrahamic religions. Parts 2 and 3 then examine not only the moral positions but “the arguments animating the traditions” (3) on a wide range of personal and social matters (e.g., friendship, sexuality, marriage and family, lying, forgiveness, capital punishment, war, and the environment). Part 4 turns to the even more ordinary topics of labor, leisure, and life and the more... (shrink)

The theoretical commitments of Rust Cohle, the philosopher detective of True Detective, tend toward nihilism. Cohle appears to be a tough‐minded naturalist. True Detective is a deep enough show that it offers some genuinely penetrating insights into evil and evil personhood. In True Detective evil is Errol William Childress: the "Lawnmower Man" of True Detective, with a yen for torturing, raping, murdering, and ritualistically posing young women. Childress is described as a "green‐eared spaghetti monster". Some philosophers suggest that there is (...) a link between evil people and monsters. Most philosophers agree that being an evil person is qualitatively worse than being a bad person or even a very, very bad person. Cohle does some bad stuff— and with impunity, by his own account— however he is not a pederast and he is not a child killer. That is a qualitative distinction. Childress seems to have killed more people than Cohle; that is a quantitative distinction. (shrink)

There is a belief among many from the wide field of Youth Work there is an increasing stress on the need for ethical approval to conduct empirical research with young people. The stress on ethical approval for research with young people includes issues of safeguarding, confidentiality, competency, consent and anonymity. The distinction needs to be made between a rules-based approach and a situated based approach. The rules-based approach is based upon a notion of ethical absolutes in relation to fundamental concerns (...) such as informed consent, avoidance of harm, and guarantees of confidentiality and anonymity. A situated approach to ethics emphasizes the importance of making rational judgements on specific aspects of ethical dilemmas. Those who research young people and youth issues in general are more likely than not to argue that some form of a situated approach to research ethics represents an appropriate response to the sort of ethical dilemmas that are often faced in the conduct of research with young people. There would also be a concern for a greater emphasis on an ‘ethic of care’ as a governing principle of research practice involving young people. It is however important not to throw the baby out with the bath water. The advancement of a rules-based approach is coupled with the quandary and dilemmas of safeguarding while its importance of parental consent cannot be dismissed while it is beset with apparent contradictions. There is the assumption and misnomer that all young people live in a stable home with caring parents. A further dilemma is the contradiction of the ‘Gillick competency’. Gillick competency is based on the assumption that an under-16-year-old with ‘sufficient understanding’ can provide consent in their own right, and that under such circumstances a parent has no right to override their child's wishes. Although this ruling relates specifically to medical interventions, it is regarded as applicable to all other areas unless other legislation applies, including social research. It is the purpose of this paper to address these dilemmas and contradictions of applying a rules-based approach to the research of young people's lives whereas a situated approach would be more appropriate. (shrink)

The opinion of Mr. Justice Francis of the English High Court which denied the parents of Charlie Gard, who had been born with an extremely rare mutation of a genetic disease, the right to take their child to the United States for a proposed experimental treatment occasioned world wide attention including that of the Pope, President Trump, and the US Congress. The case raise anew a debate as old as the foundation of Western medicine on who should decide and on (...) what standard when there is a conflict between a family and the treating physicians over a possible treatment. This paper will explore the different approaches of the British and American courts on the issue and the various proposals from that of John Rawls in his A Theory of Justice to a processed-based approach for resolving such disputes. As carefully crafted as the opinion of Mr Justice Nicholas Francis in the Gard case proved to be, it left commentators unsatisfied. A widespread criticism, captured in an article by Michael Dougherty in The National Review was for the state to ‘get out of the way of the parents trying to act in the best interests of the child’.1 Although he conceded the parents could be adding to the suffering of the child by taking Charlie to America for an experimental therapy and agreed that such a choice ‘may be the wrong decision,’ in Dougherty’s view, it should still be ‘their decision’. Dougherty’s stand was the popular response to the question of ‘Who should decide?’ It fails, however, to propose any rationale for the decision. It provided no norms, no standards and no guidelines for the parents. Their motive could equally well be indifference to the suffering of the child as concern for his well-being. Furthermore, even good, loving parents may make …. (shrink)

Objective: Parental influence during children’s “everyday” pain events is under-explored, compared to clinical or experimental pains. We trialed two digital reporting methods for parents to record the real-world context surrounding their child’s everyday pain events within the family home.Methods: Parents completed a structured e-diary for 14 days, reporting on one pain event experienced by their child each day, and describing child pain responses, parental supervision, parental estimates of pain severity and intensity, and parental catastrophizing, distress, and behavioral responses. During the (...) same 2-week period, a subsample of parent-child pairs completed digital ecological momentary assessments, immediately after any chosen pain event. Children reported their current pain while parents estimated the child’s pain and indicated their own distress.Results: “Everyday” pain events frequently featured minor injuries to the child’s head, hands or knees, and child responses included crying and non-verbal comments. Pain events occurred less frequently when parents had been supervising their child, and supervising parents reported lower levels of worry and anxiety than non-supervising parents. Child sex was significantly associated with parental estimates of pain intensity, with parents of girls giving higher estimates than parents of boys. Child age was significantly associated with both the number of pain events and with parental estimates of pain intensity and child distress: the youngest children experienced the fewest pain events but received higher pain and distress estimates from parents than older children. Hierarchal Linear Modeling revealed that parental estimates of pain severity were significant positive predictors of parental distress and catastrophizing in response to a specific pain event. Furthermore, higher levels of parental catastrophic thinking in response to a specific pain event resulted in increased distress, solicitousness, and coping-promoting behaviors in parents. The EMA data revealed that children reported significantly higher pain intensity than their parents.Conclusion: The electronic pain diary provided a key insight into the nature of “everyday” pain experiences around the family home. Digital daily reporting of how the family copes with “everyday” events represents a viable means to explore a child’s everyday pains without disrupting their home environment. (shrink)

We provide a cognitive analysis of how children represent belief using mental files. We explain why children who pass the false belief test are not aware of the intensionality of belief. Fifty-one 3½- to 7-year old children were familiarized with a dual object, e.g., a ball that rattles and is described as a rattle. They observed how a puppet agent witnessed the ball being put into box 1. In the agent’s absence the ball was taken from box 1, the child (...) was reminded of it being a rattle, and emphasising its being a rattle it was put back into box 1. Then the agent returned, the object was hidden in the experimenter’s hands and removed from box 1, described as a ‘‘rattle,” and transferred to box 2. Children who passed false belief had no problem saying where the puppet would look for the ball. However, in a different condition in which the agent was also shown that the ball was a rattle they erroneously said that the agent would look for the ball in box 1, ignoring the agent’s knowledge of the identity of rattle and ball. Their problems cease with their mastery of second-order beliefs. Problems also vanish when the ball is described not as a rattle but as a thing that rattles. We describe how our theory can account for these data as well as all other relevant data in the literature. (shrink)

Advances in medical technology inevitably bring about different kinds of ethical challenges for practising doctors. The following hypothetical case of assisted reproduction is presented as an example. A boy is born with Edward's syndrome following assisted reproduction. The parents suspect that there has been an error of embryo mix-up. They challenge the parenthood and request a genetic test to determine the biological parentage of the neonate. Should the attending paediatrician in this case accede to the request? We argue that the (...) paediatrician has no legal obligation to offer the test, although it might be lawful and ethical to provide the test subject to the outcome of our proposed three-step risk assessment. (shrink)

The current legal status and medical ethics of routine or religious penile circumcision of minors is a matter of ongoing controversy in many countries. We focus on the United Kingdom as an illustrative example, giving a detailed analysis of the most recent British Medical Association guidance from 2019. We argue that the guidance paints a confused and conflicting portrait of the law and ethics of the procedure in the UK context, reflecting deeper, unresolved moral and legal tensions surrounding child genital (...) cutting practices more generally. Of particular note is a lack of clarity around how to apply the “best interests” standard—ordinarily associated with time-sensitive proxy decision making regarding therapeutic options for a medically unwell patient—to a parental request for a medically unnecessary surgery to be carried out on the genitalia of a healthy child. Challenges arise in measuring and assigning weights to intended sociocultural or religious/spiritual benefits, and even to health-related prophylactic benefits, and in balancing these against potential physical, functional, and psychosexual risks or harms. Also of concern are apparently inconsistent safeguarding standards being applied to children based on their birth sex categorization or gender of rearing. We identify and discuss recent trends in British and international medical ethics and law, finding gradual movement toward a more unified standard for evaluating the permissibility of surgically modifying healthy children's genitals before they can meaningfully participate in the decision. (shrink)

Bioethical decision‐making in pediatrics diverges from similar decisions in other medical domains because the young child is not an autonomous decision‐maker, while the teen is developing—and should be encouraged to develop—autonomy and decisional capacity. Thus the balance between autonomy and beneficence is fundamentally different in pediatrics than in adult medicine. While ethical dilemmas that reflect these fundamental issues are common, many pediatric physician and nursing training programs do not delve into the issues or offer specific training about how to deal (...) with borderline cases.To meet this need, the Children's Mercy Bioethics Center in Kansas City, Missouri, created a program specifically dedicated to serving practicing, experienced pediatric health professionals. Our students come from various professional disciplines: they are doctors, nurses, social workers, chaplains, lawyers, psychologists, counselors, and hospital administrators practicing in pediatrics. (shrink)

A central feature of Confucianism is the doctrine that an adult child has, for want of a better word, the ‘duty’ to care for his elderly parents1. Whether this doctrine should be framed in terms of an ethic of duties as opposed to an ethic of virtues is a vexed question. It might be argued that the doctrine is best framed in terms of the behaviour and dispositions appropriate to an agent who is, within the Confucian moral vision, good. Nonetheless, (...) in both popular discourse and in much the secondary literature, the doctrine is characterized in terms of a moral ‘ought’. We will adopt this perspective, and talk of the ‘filial duty of care’. We investigate the empirical question of whether Chinese communities still have a strong sense of this duty. We conclude that although there is a widespread perception among Chinese communities that their sense of filial duty of care has been eroded, in fact the adherence to it remains robust. (shrink)

Authors have a lot of leeway with regard to what they can make true in their story. In general, if the author says that p is true in the fiction we’re reading, we believe that p is true in that fiction. And if we’re playing along with the fictional game, we imagine that, along with everything else in the story, p is true. But there are exceptions to these general principles. Many authors, most notably Kendall Walton and Tamar Szabó Gendler, (...) have discussed apparent counterexamples when p is “morally deviant”. Many other statements that are conceptually impossible also seem to be counterexamples. In this paper I do four things. I survey the range of counterexamples, or at least putative counterexamples, to the principles. Then I look to explanations of the counterexamples. I argue, following Gendler, that the explanation cannot simply be that morally deviant claims are impossible. I argue that the distinctive attitudes we have towards moral propositions cannot explain the counterexamples, since some of the examples don’t involve moral concepts. And I put forward a proposed explanation that turns on the role of ‘higher-level concepts’, concepts that if they are satisfied are satisfied in virtue of more fundamental facts about the world, in fiction, and in imagination. (shrink)

Normative Externalism argues that it is not important that people live up to their own principles. What matters, in both ethics and epistemology, is that they live up to the correct principles: that they do the right thing, and that they believe rationally. This stance, that what matters are the correct principles, not one's own principles, has implications across ethics and epistemology. In ethics, it undermines the ideas that moral uncertainty should be treated just like factual uncertainty, that moral ignorance (...) frequently excuses moral wrongdoing, and that hypocrisy is a vice. In epistemology, it suggests we need new treatments of higher-order evidence, and of peer disagreement, and of circular reasoning, and the book suggests new approaches to each of these problems. Although the debates in ethics and in epistemology are often conducted separately, putting them in one place helps bring out their common themes. One common theme is that the view that one should live up to one's own principles looks less attractive when people have terrible principles, or when following their own principles would lead to riskier or more aggressive action than the correct principles. Another common theme is that asking people to live up to their principles leads to regresses. It can be hard to know what action or belief complies with one's principles. And now we can ask, in such a case should a person do what they think their principles require, or what their principles actually require? Both answers lead to problems, and the best way to avoid these problems is to simply say people should follow the correct principles. (shrink)

We provide a new interpretation of Zeno’s Paradox of Measure that begins by giving a substantive account, drawn from Aristotle’s text, of the fact that points lack magnitude. The main elements of this account are (1) the Axiom of Archimedes which states that there are no infinitesimal magnitudes, and (2) the principle that all assignments of magnitude, or lack thereof, must be grounded in the magnitude of line segments, the primary objects to which the notion of linear magnitude applies. Armed (...) with this account, we are ineluctably driven to introduce a highly constructive notion of (outer) measure based exclusively on the total magnitude of potentially infinite collections of line segments. The Paradox of Measure then consists in the proof that every finite or potentially infinite collection of points lacks magnitude with respect to this notion of measure. We observe that the Paradox of Measure, thus understood, troubled analysts into the 1880’s, despite their knowledge that the linear continuum is uncountable. The Paradox was ultimately resolved by Borel in his thesis of 1893, as a corollary to his celebrated result that every countable open cover of a closed line segment has a finite sub-cover, a result he later called the “First Fundamental Theorem of Measure Theory.” This achievement of Borel has not been sufficiently appreciated. We conclude with a metamathematical analysis of the resolution of the paradox made possible by recent results in reverse mathematics. (shrink)

Scientific Essentialism defends the view that the fundamental laws of nature depend on the essential properties of the things on which they are said to operate, and are therefore not independent of them. These laws are not imposed upon the world by God, the forces of nature or anything else, but rather are immanent in the world. Ellis argues that ours is a dynamic world consisting of more or less transient objects which are constantly interacting with each other, and whose (...) identities depend on their roles in these processes. Natural objects must behave as they do, because to do otherwise would be contrary to their natures. The laws of nature are, therefore, metaphysically necessary, and consequently, there are necessary connections between events. Brian Ellis calls for the rejection of the theory of Humean Supervenience and an implementation of a new kind of realism in philosophical analysis. (shrink)