Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

This paper presents a critical comparative reading of Ulrich Beck and Herbert Marcuse. Beck's thesis on ‘self-critical society’ and the concept of ‘sub-politics’ are evaluated within the framework of Marcusian critical theory. We argue for the continued relevance of Marcuse for the project of emancipatory politics. We recognise that a focus upon the imminent and spontaneous possibilities for radical social change within the ‘sub-political’ is a useful provocation to the high abstractionism of much critical theory, but suggest that such possibilities (...) are better captured in a Marcusian theoretical frame than they are in Beck's account. (shrink)

ABSTRACTThe financial crisis of 2008 was unforeseen partly because the academic theories that underpin policy making do not sufficiently account for uncertainty and complexity or learned and evolved human capabilities for managing them. Mainstream theories of decision making tend to be strongly normative and based on wishfully unrealistic “idealized” modeling. In order to develop theories of actual decision making under uncertainty, we need new methodologies that account for how human actors often manage uncertain situations “well enough.” Some possibly helpful methodologies, (...) drawing on digital science, focus on the role of emotions in determining people's choices; others examine how people construct narratives that enable them to act; still others combine qualitative with quantitative data. (shrink)

When phylogenetic trees constructed from morphological and molecular evidence disagree (i.e. are incongruent) it has been suggested that the differences are spurious or that the molecular results should be preferred a priori. Comparing trees can increase confidence (congruence), or demonstrate that at least one tree is incorrect (incongruence). Statistical analyses of 181 molecular and 49 morphological trees shows that incongruence is greater between than within the morphological and molecular partitions, and this difference is significant for the molecular partition. Because the (...) level of incongruence between a pair of trees gives a minimum bound on how much error is present in the two trees, our results indicate that the level of error may be underestimated by congruence within partitions. Thus comparisons between morphological and molecular trees are particularly useful for detecting this incongruence (spurious or otherwise). Molecular trees have higher average congruence than morphological trees, but the difference is not significant, and both within- and between-partition incongruence is much lower than expected by chance alone. Our results suggest that both molecular and morphological trees are, in general, useful approximations of a common underlying phylogeny and thus, when molecules and morphology clash, molecular phylogenies should not be considered more reliable a priori. (shrink)

This paper presents a critical comparative reading of Ulrich Beck and Herbert Marcuse. Beck's thesis on 'selfcritical society' and the concept of 'sub-politics' are evaluated within the framework of Marcusian critical theory. We argue for the continued relevance of Marcuse for the project of emancipatory politics. We recognise that a focus upon the imminent and spontaneous possibilities for radical social change within the 'sub-political' is a useful provocation to the high abstractionism of much critical theory, but suggest that such possibilities (...) are better captured in a Marcusian theoretical frame than they are in Beck's account. (shrink)

Once the preserve of philosophy and theology, what Weber called `the problem of theodicy' - the problem of reconciling normative ideals with the reality in which we live - recurs in the social sciences in the secular form of `sociodicy'. Within a functionalist framework, sociodicies have offered legitimizing rationalizations of social adversities, inequalities and injustice, but seldom address the existential meaning and ethical implications of human affliction and suffering in social life. We suggest that an apparent indifference to these questions (...) in social theory reflects a deeper tension between modernity's millennial expectations of moral progress and the escalating history of violence, exploitation and suffering in the modern world. The task of sociodicy, we argue, should be reconstructed as a critique of the decivilizing implications of this tension, not just to document the consequences of suffering on people's lives, but in order to reassess the experience of modernity at the end of one of the most disturbed and violent centuries the world has known. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

The discovery of exoplanets is a small part of the array of scientific arguments for and against the existence of extraterrestrial intelligence. Yet the recent stunning achievement of this program of observational astronomy has had a significant effect on scientific opinion and public interest. It also raises some key theological questions. New observing techniques are leading to the discovery of extrasolar planets daily. Earth-like planets outside of our Solar System can now be identified and in future years explored for signs (...) of life. This article maps the history of these discoveries and highlights some of the theological issues which are important to bring into dialogue with these scientific insights. (shrink)

If the discovery of life elsewhere in the universe is just around the corner, what would be the consequences for religion? Would it represent another major conflict between science and religion, even leading to the death of faith? Some would suggest that the discovery of any suggestion of extraterrestrial life would have a greater impact than even the Copernican and Darwinian revolutions. It is now over 50 years since the first modern scientific papers were published on the search for extraterrestrial (...) intelligence. Yet the religious implications of this search and possible discovery have never been systematically addressed in the scientific or theological arena. SETI is now entering its most important era of scientific development. New observation techniques are leading to the discovery of extra-solar planets daily, and the Kepler mission has already collected over 1000 planetary candidates. This deluge of data is transforming the scientific and popular view of the existence of extraterrestrial intelligence. Earth-like planets outside of our solar system can now be identified and searched for signs of life. Now is a crucial time to assess the scientific and theological questions behind this search. This book sets out the scientific arguments undergirding SETI, with particular attention to the uncertainties in arguments and the strength of the data already assembled. It assesses not only the discovery of planets but other areas such as the Fermi paradox, the origin and evolution of intelligent life, and current SETI strategies. In all of this it reflects on how these questions are shaped by history and pop culture and their relationship with religion, especially Christian theology. It is argued that theologians need to take seriously SETI and to examine some central doctrines such as creation, incarnation, revelation, and salvation in the light of the possibility of extraterrestrial life. (shrink)

Recent work has shown that segmentation underlies the patterning of the vertebrate hindbrain and its neural crest derivatives. Several genes have been identified with segment‐restricted expression, and evidence is now emerging regarding their function and regulatory relationships. The expression patterns of Hox genes and the phenotype of null mutants indicate roles in specifying segment identity. A zinc finger gene Krox‐20 is a segment‐specific regulator of Hox expression, and it seems probable that retinoic acid receptors also regulate Hox genes in the (...) hindbrain. The receptor tyrosine kinase gene Sek may mediate cell‐cell interactions that lead to segmentation. These studies provide a starting point for understanding the molecular basis of segmental patterning in the hindbrain. (shrink)

Zygon®, Volume 56, Issue 4, Page 1087-1109, December 2021.

The discovery of homeobox genes in vertebrates may allow analysis of a basic problem in developmental neurobiology: how regional differences in CNS organization are specified during development. This view is based on the roles defined for homologous genes in Drosophila development, and is supported by studies of the patterns of homeobox gene expression in vertebrate embryos. Homeobox genes comprise a multigene family, members of which are expressed in different spatially restricted domains along the anterior‐posterior axis of the CNS. These observations (...) are consistent with homeobox genes having roles in the positional specification of CNS organization, and experimental tests of this should be forthcoming shortly. (shrink)

In their thoughtful article, Malm and Navin (2020) raise concerns about a potentially unjust generational welfare tradeoff between children and adults when it comes to chicken pox. We share their c...

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

Our recent article begins by describing a new technique for creating human–animal chimeras. This technique—known as interspecies blastocyst complementation—may enable us to generate human organs inside of human–pig chimeras. One central concern about farming human–pig chimeras for their organs is that their moral status would be uncertain and potentially significant. Our article is partly, but not only, about such concerns. At the heart of our paper are two broader questions. First, how should we treat beings of uncertain moral status? And (...) second, do our reasons for thinking that human–pig chimeras have uncertain moral status also provide reason to think regular, non-chimeric pigs have uncertain moral status? We thank Mike King, Christian Munthe, David Resnik, Per Sandin and Rob Streiffer for their commentaries on our paper, each of which serves to clarify the ethical issues at play. In this response, we want to respond to one criticism, acknowledge the force of several others, and point towards some philosophical work that remains to be done. First, the criticism. Resnik questions the parallel we draw between human–pig chimeras and regular pigs. In the case of regular pigs, there is currently a social consensus that it is morally acceptable to farm pigs for food. For Resnik, this consensus imposes a special burden on those who wish to argue against it; ‘one needs substantial evidence that the majority view is wrong’.1 Since an equivalent consensus does not exist in relation to human–pig chimeras, one might think that moral uncertainty concerns have less force in the context of meat production than human–animal chimera research. We do not think the social consensus in favour …. (shrink)

In their feature article, ‘Moral uncertainty and the farming of human-pig chimeras,’ Koplin and Wilkinson argue that there is a tension between thinking that creating pig-human chimaeras with partly humanised brains as a source of organs for transplantation as morally problematic because of the uncertainty of their moral status and thinking that the raising normal pigs for food is not morally problematic because of the certainty concerning their moral status.1 Koplin and Wilkson claim that the reasons that we are (...) uncertain about the moral status of human-pig chimaeras with partly humanised brains also apply to normal pigs. Our moral uncertainty derives from philosophical uncertainty concerning the characteristics that convey moral status and epistemological uncertainty concerning the extent to which pigs with partly humanised brains or normal pigs possess such characteristics. If we think it is morally problematic to create pigs with humanised brains for organ transplantation, we should also think it is morally problematic to raise normal pigs for food, given our uncertainty about the moral status of both kinds of animals. Their view implies that it would be inconsistent to have moral qualms about creating pigs with humanised brains for organ transplantation but to no such misgivings about raising pigs for food. While I find Koplin and Wilkson’s arguments …. (shrink)

Dominic Wilkinson, a neonatal physician and medical ethicist, has written a searching, moving, and philosophically sophisticated book about the ethics of life and death decision making in the neonatal intensive care unit. Although I will devote much of this review to criticism, I want to say at the outset that Death or Disability represents interdisciplinary work at its very best. Wilkinson’s exposition is both rich in detail and uncompromising in its ethical analysis. He spares the reader none of (...) the clinical, psychological, and moral complexities and uncertainties of the decisions made daily in the neonatal intensive care unit.I especially recommend this book to moral philosophers and practical ethicists... (shrink)

Dominic Wilkinson’s defence of identity-relative paternalism raises many important issues that are well worth considering. In this short paper, I will argue that there could be two important differences between the first-party and third-party cases that Wilkinson discusses, namely, a difference in associative duties and how the decision relates to the decision maker’s own autonomous life. This could mean that identity-relative paternalism is impermissible in a greater number of cases than he suggests.

Wilkinson's (1) critique of psychoanalysis and psychoanalytically oriented psychotherapy is weakened by inconsistent use of crucial terms, a systematically biased selectivity in reviewing empirical evidence and prior debates, and a failure to address issues crucial for a scientific understanding of psychotherapy.

The two target articles in this issue draw an important connection between disability bioethics and geriatric bioethics. Dominic JC Wilkinson makes a pragmatic case for using frailty as a fa...

Gilbertson, Savulescu, Oakley and Wilkinson propose extending the availability of terminal sedation (TS) to patients with intractable pain and/or suffering who are expected to live more than 2 weeks (hence the designation of extended TS (ETS)) and to patients whose values are known but who do not have decision-making capacity.1 Their plan is worthy of serious consideration: it is, after all, based on the fundamental and well-recognised medical ethical values of patient autonomy and beneficence. But, even when restricted to (...) jurisdictions that allow assisted dying, the ETS proposal raises three important issues. When the authors speak of ‘assisted dying’ and of ‘Voluntary Assisted Dying (VAS)’, they refer specifically to the laws in Australia and similar ones in New Zealand, the Netherlands, Belgium, Luxembourg, Switzerland, Spain and Canada that permit clinicians either to provide patients with lethal medications for self-administration (formerly called physician-assisted suicide) or to administer lethal medications themselves (voluntary euthanasia). First, the authors distinguish—as do many patients and the public—between sedation to unconsciousness and death. Indeed, as the authors point out, the difference seems obvious: unconsciousness can be reversed, death cannot. Yet in the case of TS, this may be …. (shrink)

The demonstration of a sequential congruency effect in sequence learning has been offered as evidence for control processes that act to inhibit automatic response tendencies via unconscious conflict monitoring. Here we propose an alternative interpretation of this effect based on the associative learning of chains of sequenced contingencies. This account is supported by simulations with a Simple Recurrent Network, an associative model of sequence learning. We argue that the control- and associative-based accounts differ in their predictions concerning the magnitude of (...) the sequential congruency effect across training. These predictions are tested by reanalysing data from a study by Shanks, Wilkinson, and Channon . The results support the associative learning account which explains the sequential congruency effect without appealing to control processes. (shrink)

Persia’s Imperial Power in Late Antiquity: The Great Wall of Gorgān and Frontier Landscapes of Sasanian Iran. By Eberhard W. Sauer; Hamid Omrani Rekavandi; Tony J. Wilkinson; and Jebrael Nokandeh. British Institute of Persian Studies Archaeological Monographs. Oxford: Oxbow Books, 2013. Pp. xvi + 711, illus. $150. [Distributed by the David Brown Book Co., Oakville, CT.].

Here the philosopher and physicist David Z Albert argues, among other things, that the difference between past and future can be understood as a mechanical phenomenon of nature and that quantum mechanics makes it impossible to present the entirety of what can be said about the world as a narrative of “befores” and “afters.”.

In this monograph I propose to interpret John Locke's view of central metaphysical notions such as substance, essence and identity to the backdrop of his distinction between distinct and confused ideas. I show that Locke draws this traditional distinction in a novel way—as a distinction pertaining only to the way ideas are related to our use of language. This distinction, I argue, allows him to radically rethink traditional questions of metaphysics and to mount a linguistic criticism of traditional metaphysical views (...) about substance, essence and identity. Furthermore, I propose that taking into account the linguistic dimension of Locke's metaphysical thought helps recognize the coherence of his overall picture of substance, essence and identity. (shrink)

Longtermism is the thesis that in a large class of decision situations, the best thing we can do is what is best for the long-term future. The scope question for longtermism asks: how large is the class of decision situations for which this is true? In this paper, I suggest that the scope of longtermism may be narrower than many longtermists suppose. I identify a restricted version of longtermism: swamping axiological strong longtermism (swamping ASL). I identify three scope-limiting factors - (...) probabilistic and decision-theoretic phenomena which, when present, tend to reduce the prospects for swamping ASL. I argue that these scope-limiting factors are often present in human decision problems, then use two case studies from recent discussions of longtermism to show how the scope-limiting factors lead to a restricted, if perhaps nonempty, scope for swamping ASL. (shrink)

There are not enough solid organs available to meet the needs of patients with organ failure. Thousands of patients every year die on the waiting lists for transplantation. Yet there is one currently available, underutilized, potential source of organs. Many patients die in intensive care following withdrawal of life-sustaining treatment whose organs could be used to save the lives of others. At present the majority of these organs go to waste.In this paper we consider and evaluate a range of ways (...) to improve the number and quality of organs available from this group of patients. Changes to consent arrangements (for example conscription of organs after death) or changes to organ donation practice could dramatically increase the numbers of organs available, though they would conflict with currently accepted norms governing transplantation.We argue that one alternative, Organ Donation Euthanasia, would be a rational improvement over current practice regarding withdrawal of life support. It would give individuals the greatest chance of being able to help others with their organs after death. It would increase patient autonomy. It would reduce the chance of suffering during the dying process. We argue that patients should be given the choice of whether and how they would like to donate their organs in the event of withdrawal of life support in intensive care.Continuing current transplantation practice comes at the cost of death and prolonged organ failure. We should seriously consider all of the alternatives. (shrink)

Suppose you found that the universe around you was infinite—that it extended infinitely far in space or in time and, as a result, contained infinitely many persons. How should this change your moral decision-making? Radically, it seems, according to some philosophers. According to various recent arguments, any moral theory that is ’minimally aggregative’ will deliver absurd judgements in practice if the universe is (even remotely likely to be) infinite. This seems like sound justification for abandoning any such theory. -/- My (...) goal in this thesis is simple: to demonstrate that we need not abandon minimally aggregative theories, even if we happen to live in an infinite universe. I develop and motivate an extension of such theories, which delivers plausible judgements in a range of realistic cases. I show that this extended theory can overcome key objections—both old and new—and that it succeeds where other proposals do not. With this proposal in hand, we can indeed retain minimally aggregative theories and continue to make moral decisions based on what will promote the good. (shrink)

Current models of auditory verbal hallucinations tend to focus on the mechanisms underlying their occurrence, but often fail to address the content of the auditory experience. In other words, they tend to ask why there are AVHs at all, instead of asking why, given that there are AVHs, they have the properties that they have. One such property, which has been largely overlooked and which we will focus on here, is why the voices are often experienced as coming from agents, (...) and often specific, individualised agents. In this article, we argue not only that the representation of agents is important in accurately describing many cases of AVH, but also that deeper reflection on what is involved in the representation of agents has potentially vital consequences for our aetiological understanding of AVH, namely, for understanding how and why AVHs come about. (shrink)

In early 2020, a number of countries developed and published intensive care triage guidelines for the pandemic. Several of those guidelines, especially in the UK, encouraged the explicit assessment...