_Arguing About Bioethics_ is a fresh and exciting collection of essential readings in bioethics, offering a comprehensive introduction to and overview of the field. Influential contributions from established philosophers and bioethicists, such as Peter Singer, Thomas Nagel, Judith Jarvis Thomson and Michael Sandel, are combined with the best recent work in the subject. Organised into clear sections, readings have been chosen that engage with one another, and often take opposing views on the same question, helping students get to grips (...) with the key areas of debate. All the core issues in bioethics are covered, alongside new controversies that are emerging in the field, including: embryo research selecting children and enhancing humans human cloning using animals for medical purposes organ donation consent and autonomy public health ethics resource allocation developing world bioethics assisted suicide. Each extract selected is clear, stimulating and free from unnecessary jargon. The editor’s accessible and engaging section introductions make _Arguing About Bioethics_ ideal for those studying bioethics for the first time, while more advanced readers will be challenged by the rigorous and thought-provoking arguments presented in the readings. (shrink)

The book also introduces a host of new experimental techniques and major hypotheses to guide future research.

-/- Following the Mental Capacity Act (MCA) becoming law in 2005, and prior to its coming into force in 2007, there was a sustained effort to train support staff in the many social care settings where this new law was applicable. This training drive was necessary because, prior to the MCA, mental capacity law had evolved in the courts through consideration of a small number of cases that concerned serious medical treatments. These included the withdrawal of artificial nutrition and hydration (...) (Airedale NHS Trust v. Bland [1993]), blood transfusion (Re T [1993]), tissue donation (Re Y [1997]) and the provision of experimental medication for terminal illness (Simms v. Simms and another (2003)). In line with the Law Commission’s recommendations, the MCA extended the application of the law to ‘all acts in connection with care or treatment’ (MCA, Section 5), meaning that, overnight, social care settings and informal family care environments immediately fell within the scope of the legislation. (shrink)

We start with a simple question: If you could reinvent higher education for the 21st century, what should it look like? We began by taking a hard look at problems in traditional higher education, and innovated in many ways to address these problems head-on: We have created a new curriculum, focusing on what we call "practical knowledge"; we have developed new pedagogy, based on the science of learning; we have used technology in novel ways, to deliver small seminars in real (...) time; and we have developed an international hybrid residential model, where students take classes on the computer but live together, rotating through seven different cities around the world. The Minerva Schools at the Keck Graduate Institute (KGI) are the first university experience built for the twenty-first century. In setting up this program, we have had to confront the realities of all aspects of higher education--from admissions, through instruction, to career development, to establishing a reputation. The goal of this book is to provide an evidence-based model for a future of higher education. We have learned a lot about how to reshape all facets of higher education and this book summarizes what we have learned. We hope that our innovations can serve as models of "best practices"--and thereby have a major influence on higher education writ large. (shrink)

Burnout among physicians, nurses, and students is a serious problem in U.S. healthcare that reflects inattentive management practices, outmoded images of the “good” provider as selflessly ignoring the care of the self, and an overarching rubric of Patient Centered Care that leaves professional self-care out of the equation. We ask herein if expanding PCC to Patient and Professional Centered Care would be a useful idea to make provider self-care an explicit part of mission statements, a major part of management strategies (...) and institutional goal setting, and of educational programs. We offer several practical suggestions for PPCC implementation, including structuring healthcare systems so as to nurture professional meaning, integrity, and inter-personal reflective emotional processing as a buffer against burnout and as a key to better patient care. It should not bring into question the primacy of practitioner commitment to the good of patients, nor should it be taken to suggest in any way a shift in focus away from patients’ values and respect for patient autonomy. PPCC asserts that the respect for patient’s values and autonomous choices properly remains the ethical benchmark of modern healthcare systems, along with altruistic professional commitment to the optimal care of patients. However, it enunciates an explicit commitment to structuring systems that allow for and actively encourage the professional well-being and wellness upon which good patient care depends. (shrink)

How far should we go in protecting and promoting public health? Can we force people to give up unhealthy habits and make healthier choices, or does everyone have the right to decide their own lifestyle? Should we stop treating smokers who refuse to give up smoking? Should we put a tax on fatty foods and ban vending machines in schools to address the obesity epidemic? Should parents be required to have their children vaccinated? Are some of our screening programmes unethical (...) Downs syndrome screening, for example or should we be screening people for more conditions, such as Huntington disease? Such questions are at the heart of public health ethics. Holland shows that to understand and debate these issues requires philosophy: moral philosophies, such as utilitarianism and deontology, as well as political philosophies such as liberalism and communitarianism. And philosophy informs other aspects of public health, such as epidemiology and health promotion. The aim of this book is to provide a lively, accessible and philosophically informed introduction to such issues. It is an ideal textbook for students taking courses in public health ethics. And since this book develops systematic discussions of issues in public health ethics, there is also much here to engage and challenge the more advanced reader. (shrink)

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social (...) sciences using a pre-post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed. (shrink)

This volume presents the fruits of an extended dialogue among American and Chinese philosophers concerning the relations between virtue ethics and the Confucian tradition. Based on recent advances in English-language scholarship on and translation of Confucian philosophy, the book demonstrates that cross-tradition stimulus, challenge, and learning are now eminently possible. Anyone interested in the role of virtue in contemporary moral philosophy, in Chinese thought, or in the future possibilities for cross-tradition philosophizing will find much to engage with in the twenty (...) essays collected here. (shrink)

In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this (...) process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, ‘strategic substitute decision-making’, paralleled the MCA’s legal and ethical framework, whilst the second process, ‘relational substitute decision-making’, was markedly different from these statutory procedures. In this setting, ‘relational substitute decision-making’ underpinned everyday personal and social interventions connected with residents’ daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed. (shrink)

Ethical decision making measures are widely applied as the principal dependent variable used in studies of research integrity. However, evidence bearing on the internal and external validity of these measures is not available. In this study, ethical decision making measures were administered to 102 graduate students in the biological, health, and social sciences, along with measures examining exposure to ethical breaches and the severity of punishments recommended. The ethical decision making measure was found to be related to exposure to ethical (...) events and the severity of punishments awarded. The implications of these findings for the application of ethical decision making measures are discussed. (shrink)

Over the last fifteen years, an ambitious explanatory framework has been proposed to unify explanations across biology and cognitive science. Active inference, whose most famous tenet is the free energy principle, has inspired excitement and confusion in equal measure. Here, we lay the ground for proper critical analysis of active inference, in three ways. First, we give simplified versions of its core mathematical models. Second, we outline the historical development of active inference and its relationship to other theoretical approaches. Third, (...) we describe three different kinds of claim -- labelled mathematical, empirical and general -- routinely made by proponents of the framework, and suggest dialectical links between them. Overall, we aim to increase philosophical understanding of active inference so that it may be more readily evaluated. -/- This the final submitted version of the Introduction to the Topical Collection "The Free Energy Principle: From Biology to Cognition", forthcoming in Biology & Philosophy. (shrink)

It is commonly held that early career experiences influence ethical behavior. One way early career experiences might operate is to influence the decisions people make when presented with problems that raise ethical concerns. To test this proposition, 102 first-year doctoral students were asked to complete a series of measures examining ethical decision making along with a series of measures examining environmental experiences and climate perceptions. Factoring of the environmental measure yielded five dimensions: professional leadership, poor coping, lack of rewards, limited (...) competitive pressure, and poor career direction. Factoring of the climate inventory yielded four dimensions: equity, interpersonal conflict, occupational engagement, and work commitment. When these dimensions were used to predict performance on the ethical decision-making task, it was found that the environmental dimensions were better predictors than the climate dimensions. The implications of these findings for research on ethical conduct are discussed. (shrink)

Rivka Weinberg advances an error theory of ultimate meaning with three parts: (1) a conceptual analysis, (2) the claim that the extension of the concept is empty, and (3) a proposed fitting response, namely being very, very sad. Weinberg’s conceptual analysis of ultimate meaning involves two features that jointly make it metaphysically impossible, namely (i) the separateness of activities and valued ends, and (ii) the bounded nature of human lives. Both are open to serious challenges. We offer an internalist alternative (...) to (i) and a relational alternative to (ii). We then draw out implications for (2) and conclude with reasons to be cheerful about the prospects of a meaningful life. (shrink)

Editors' introduction to 3rd thematic issue on philosophy of medicine.

The flight to reference is a widely-used strategy for resolving philosophical issues. The three steps in a flight to reference argument are: (1) offer a substantive account of the reference relation, (2) argue that a particular expression refers (or does not refer), and (3) draw a philosophical conclusion about something other than reference, like truth or ontology. It is our contention that whenever the flight to reference strategy is invoked, there is a crucial step that is left undefended, and that (...) without a defense of this step, the flight to reference is a fatally flawed strategy; it cannot succeed in resolving philosophical issues. In this paper we begin by setting out the flight to reference strategy and explaining what is wrong with arguments that invoke the strategy. We then illustrate the problem by considering arguments for and against eliminative materialism. In the final section we argue that much the same problem undermines Philip Kitcher's attempt to defend scientific realism. (shrink)

Nursing ethics centres on how nurses ought to respond to the moral situations that arise in their professional contexts. Nursing ethicists invoke normative approaches from moral philosophy. Specifically, it is increasingly common for nursing ethicists to apply virtue ethics to moral problems encountered by nurses. The point of this article is to argue for scepticism about this approach. First, the research question is motivated by showing that requirements on nurses such as to be kind, do not suffice to establish virtue (...) ethics in nursing because normative rivals (such as utilitarians) can say as much; and the teleology distinctive of virtue ethics does not transpose to a professional context, such as nursing. Next, scepticism is argued for by responding to various attempts to secure a role for virtue ethics in nursing. The upshot is that virtue ethics is best left where it belongs – in personal moral life, not professional ethics – and nursing ethics is best done by taking other approaches. (shrink)

Some brain injured patients are left in a permanent vegetative state, i.e., they have irreversibly lost their capacity for consciousness but retained some autonomic physiological functions, such as breathing unaided. Having discussed the controversial nature of the permanent vegetative state as a diagnostic category, we turn to the question of the patients’ ontological status. Are the permanently vegetative alive, dead, or in some other state? We present empirical data from interviews with relatives of patients, and with experts, to support the (...) view that the ontological state of permanently vegetative patients is unclear: such patients are neither straightforwardly alive nor simply dead. Having defended this view from counter-arguments we turn to the practical question as to how these patients ought to be treated. Some relatives and experts believe it is right for patients to be shifted from their currently unclear ontological state to that of being straightforwardly dead, but many are concerned or even horrified by the only legally sanctioned method guaranteed to achieve this, namely withdrawal of clinically assisted nutrition and hydration. A way of addressing this distress would be to allow active euthanasia for these patients. This is highly controversial; but we argue that standard objections to allowing active euthanasia for this particular class of permanently vegetative patients are weakened by these patients’ distinctive ontological status. (shrink)