Placebos are arguably the most commonly prescribed drug, across cultures and throughout history. Nevertheless, today many would consider their use in the clinic unethical, since placebo treatment involves deception and the violation of patients’ autonomy. We examine the placebo's definition and its clinical efficacy from a biopsychosocial perspective, and argue that the intentional use of the placebo and placebo effect, in certain circumstances and under several conditions, may be morally acceptable. We highlight the role of a virtue-based ethical orientation and (...) its implications for the beneficent use of the placebo. In addition, the definitions of lying and deception are discussed, clarified and applied to the clinical placebo dilemma. Lastly, we suggest that concerns about patient autonomy, when invoked as a further argument against administering placebos, are extended beyond their reasonable and coherent application. (shrink)

During the past few months, the discussion over the physicians' “Right of Conscience” has been on the rise. The intervention of politics in this issue shifts the discussion to a very specific and narrow area, namely the “reproductive health laws” which bear well-known predisposing attitudes.In this article, the physician's ROC is discussed in the context in which it naturally belongs: the Patient Physician Relationship . I suggest that the physicians' rights demand is a comprehensible, predictable, and even inevitable step as (...) part of the “evolution” of the PPR. Thus, the most appropriate way to comprehend and tackle the demand for physicians' ROC is within the context of medical professionalism. While searching for practical solutions to the “reproductive health” problems, there is a need to recognize the ethical and practical implications of the change in the PPR and balance between patient and physician rights. (shrink)

Recently, the discussion regarding the physicians’ “Right of Conscience” has been on the rise. This issue is often confined to the “reproductive health” arena within the political context. The recent dispute of the Bush-Obama administrations regarding the legal protections of health workers who refuse to provide care that violates their personal beliefs is an example of the political aspects of this dispute. The involvement of the political system automatically shifts the discussion regarding physicians’ ROC into the narrow area of “reproductive (...) health laws.” Indeed, the immediate association that comes to mind when thinking about the practical implications of this dispute is related to the reproductive health arena. This is partly because of the historical context of the first “conscience clauses,” initially enacted by Congress and state legislatures in the mid-1970s; in fact, most of these clauses provided specific exemptions for abortion and few exempted sterilization as well. (shrink)

The American Journal of Bioethics, Volume 12, Issue 2, Page 18-20, February 2012.

In principle, all patients deserve to receive optimal medical treatment equally. However, in situations in which there is scarcity of time or resources, medical treatment must be prioritized based on a triage. The conventional guidelines of medical triage mandate that treatment should be provided based solely on medical necessity regardless of any non-medical value-oriented considerations (“worst-first”). This study empirically examined the influence of value-oriented considerations on medical triage decision–making. Participants were asked to prioritize medical treatment relating to four case scenarios (...) of an emergency situation resulting from a car collision. The cases differ by situational characteristics pertaining to the at-fault driver, which were related to culpability attribution. In three case scenarios most participants gave priority to the most severely injured individual, unless the less severely injured individual was their brother. Nevertheless, in the aftermath of a vehicle-ramming terror attack most participants prioritized the less severely injured individual (“victim-first”). Our findings indicate that when caregivers are presented with concrete highly conflictual triage situations their choices may be based on value-oriented considerations related to contextual characteristics of the emergency situation. Philosophical and practical ramifications of our findings are discussed. (shrink)

Extreme intentional and deliberate violence against innocent people, including acts of terror and school shootings, poses various ethical challenges, some related to the practice of medicine. We discuss a dilemma relating to deliberate violence, in this case the aftermath of a terror attack, in which there are multiple injured individuals, including the terror perpetrator. Normally, the priority of medical treatment is determined based on need. However, in the case of a terror attack, there is reason to question this. Should the (...) perpetrator of extreme violence receive medical treatment on the scene before the victims if he or she is designated as the most seriously injured? Or rather, should victims receive medical care priority if they are also in some life-threatening danger, although not at the same level of severity as the perpetrator? We present two opposing approaches: the conventional ‘no-exceptions’ approach, which gives priority to the terrorist, and the justice-oriented ‘victim first’ approach, which gives priority to the victims. Invoking concepts of retributive justice, distributive justice and corrective justice, this latter approach suggests that ‘value-neutrality’ can lead to injustice. Perpetrators of terror-like violence should be treated as an act of humanism and good ethical medical practice. However, in clear and obvious terror-like situations, to treat the perpetrators of violence before their victims may be unjust. Thus, in some specific situations, the ‘victim first’ approach may be considered a legitimate alternative triage policy. (shrink)

Background Physical morbidity is rife among patients with serious mental illness. When they are involuntarily hospitalized and even treated, they may still refuse treatment for physical illness leading clinicians to wonder about the ethics of coercing such treatments. Research aim This survey study explored psychiatric caregivers’ perceptions on whether compulsory treatment of physical illness is legal and whether it is justifiable in patients with serious mental illness and under what circumstances. Research design A questionnaire that included two case vignettes of (...) an involuntarily hospitalized psychiatric patient with diabetes refusing treatment with insulin for various reasons. The cases differed in terms of diabetes severity. Participants answered questions regarding the appropriateness of involuntary treatment. Participants and research context Psychiatric medical doctors and nurses working in a mental health center. ( N = 89, 50 female, ages 26–66). Ethical considerations The study was approved by the Medical Centre Institutional Review Board (IRB) and the University Ethics Committee. The respondents’ anonymity was kept. Participation was voluntary and consent was obtained. Results The severity of the patient’s medical condition and their reason for refusing treatment were associated with participants’ willingness to give insulin despite patient objection [( F(1, 87) = 49.41, p <.01; ( F(1, 87) = 33.44, p <.01), respectively]. Participants were more inclined to support compulsory treatment if the patient’s refusal was “illness-oriented” (i.e. directly related to psychiatric illness). Participants presented diverse views regarding the perceived legality of compulsory treatment of physical illness in such situations (illegal 63.09%; legal 23.8%; 13% unsure). The majority (53.5%–55.3%) of those who thought it was illegal supported compulsory treatment in high-severity, illness-oriented refusal situations. Conclusions The severity of the medical condition and the reason for treatment refusal influence psychiatric caregivers’ willingness to provide compulsory treatment for physical illness in involuntary hospitalized psychiatric patients. Beyond the legal framework, ethical guidelines for these situations are warranted, while decisions should be made on a case-by-case basis. (shrink)

Solnica et al argue that “Jewish law and modern secular approaches based on professional responsibilities obligate physicians to care for all patients even those with communicable diseases”. The authors base their viewpoint on the opinion of Rabbi Eliezer Waldenberg and apply it to suggest that physicians are obligated to endanger themselves during epidemics, such as COVID-19. It is argued that Solnica et al’s analysis of Rabbi Waldenberg’s text and their conclusion that healthcare workers are obligated to endanger themselves while treating (...) patient who suffer from contagious illness during epidemics according to Jewish law suffer from various shortcomings. Indeed, Jewish law looks favourably on healthcare workers who take a reasonable risk in treating their patients in the context of epidemics. However, it is considered a voluntary supererogatory act—not obligatory. Solnica et al may express a legitimate ethical viewpoint. However, it does not seem to represent the mainstream approach of what Jewish law would demand as obligatory from its practitioners. (shrink)

Physician-assisted death (PAD) of patients whose suffering does not stem from terminal conditions has become more prevalent during the last few decades. This paper is focused on decision-making competence for PAD, specifically in situations in which PAD is related solely to psychiatric illness. First, a theoretical analysis presents the premises for the argument that competence for physician-assisted death for psychiatric patients (PADPP) should be determined based on a higher threshold in comparison to the required competence for conventional medical interventions. Second, (...) the higher threshold for decision-making competence for PADPP is illustrated. Third, several real PADPP cases are critically discussed, as an illustration to decision-making competence evaluations that would not have met the higher standard. Finally, a short summary of practical suggestions regarding the assessment of decision-making competence for PADPP is presented. Psychiatrists are called to address the ethical, legal, societal and clinical challenges related to PADPP and should be prepared for its probable expansion. (shrink)

The Indian Buddhist philosopher Vasubandhu is known for his critical contribution to Buddhist Abhidharma thought, his turn to the Mahayana tradition, and his concise, influential Yogacara-Vijñanavada texts. _Paving the Great Way_ reveals another dimension of his legacy: his integration of several seemingly incompatible intellectual and scriptural traditions, with far-ranging consequences for the development of Buddhist epistemology and the theorization of tantra. Most scholars read Vasubandhu's texts in isolation and separate his intellectual development into distinct phases. Featuring close studies of Vasubandhu's (...) _Abhidharmakosabhasya_, _Vyakhyayukti_, _Vimsatika_, and _Trisvabhavanirdesa_, among other works, this book identifies recurrent treatments of causality and scriptural interpretation that unify distinct strands of thought under a single, coherent Buddhist philosophy. In Vasubandhu's hands, the Buddha's rejection of the self as a false construction provides a framework through which to clarify problematic philosophical issues, such as the nature of moral agency and subjectivity under a broadly causal worldview. Recognizing this continuity of purpose across Vasubandhu's diverse corpus recasts the interests of the philosopher and his truly innovative vision, which influenced Buddhist thought for a millennium and continues to resonate with today's philosophical issues. An appendix includes extensive English-language translations of the major texts discussed. (shrink)

It is widely held that a successful theory of the mind will be neuroscientific. In this paper we ask, first, what this claim means, and, secondly, whether it is true. In answer to the first question, we argue that the claim is ambiguous between two views--one plausible but unsubstantive, and one substantive but highly controversial. In answer to the second question, we argue that neither the evidence from neuroscience itself nor from other scientific and philosophical considerations supports the controversial view.

Examines interrelated topics in Medieval and Renaissance Latin literature: the status of women as writers, the status of women as rhetorical figures, and the status of women in society from the fifth to the early seventeenth century.

Theories of collective intentions must distinguish genuinely collective intentions from coincidentally harmonized ones. Two apparently equally apt ways of doing so are the ‘neo-reductionism’ of Bacharach (2006) and Gold and Sugden (2007a) and the ‘non-reductionism’ of Searle (1990, 1995). Here, we present findings from theoretical linguistics that show that we is not a cognitive primitive, but is composed of notions of I and grouphood. The ramifications of this finding on the structure both of grammatical and lexical systems suggests that (...) an understanding of collective intentionality does not require a primitive we-intention, but the notion of grouphood implicit in team reasoning, coupled with the individual concept I. This, we argue, supports neo-reductionism but poses difficulties for non-reductionism. (shrink)

An expanding body of research aims to identify culture in cetaceans, often positing killer whales as an exemplar species. To this end, gene-culture coevolutionary theory provides a conceptual language with which whales are discussed in raciological terms. It renders killer whale ecotypes as discrete cultures that are intrinsically xenophobic and evolutionarily divergent. Such research on whale culture intends to substantiate theories of divergent natural selection between human cultures as well. This effort furthers the essentialism, simultaneously biological and cultural, that has (...) long impelled colonial technoscientific projects of racial typologization. The exchange between the raciologies of humans and killer whales is facilitated by the infrahumanizing frameworks of gene-culture coevolutionary theory that locate whale populations alongside indigenous peoples on a spectrum of cultural simplicity and complexity. At this convergence of the animal and the human, gene-culture coevolutionary theory posits indigenous peoples and killer whales as evidence for social Darwinist theories that dehistoricize and naturalize intercultural conflict and ethnicization. The extension of raciology beyond the human species signals an urgent need to decolonize the biological sciences. (shrink)

In this paper, I explore the cognitive value of fantasy literature. Using Immanuel Kant's and Jean-Paul Sartre's discussions of the imagination, and J.R.R. Tolkien's "On Fairy Stories,” I argue that fantasy literature is cognitively valuable when it confers phenomenal knowledge. I move on to demonstrate what a work of fantasy literature requires to confer this phenomenal knowledge. Fantasy literature has the potential to reveal true insights into this world when it brings the reader into a state of “secondary belief” and (...) confers phenomenal knowledge through the union of world and story. (shrink)

Theories of collective intentions must distinguish genuinely collective intentions from coincidentally harmonized ones. Two apparently equally apt ways of doing so are the ‘neo-reductionism’ of Bacharach (2006) and Gold and Sugden (2007a) and the ‘non-reductionism’ of Searle (1990, 1995). Here, we present findings from theoretical linguistics that show that we is not a cognitive primitive, but is composed of notions of I and grouphood. The ramifications of this finding on the structure both of grammatical and lexical systems suggests that (...) an understanding of collective intentionality does not require a primitive we-intention, but the notion of grouphood implicit in team reasoning, coupled with the individual concept I. This, we argue, supports neo-reductionism but poses difficulties for non-reductionism. (shrink)

This first volume in the four-volume series The Moral Limits of the Criminal Law focuses on the "harm principle," the commonsense view that prevention of harm to persons other than the perpetrator is a legitimate purpose of criminal legislation. Feinberg presents a detailed analysis of the concept and definition of harm and applies it to a host of practical and theoretical issues, showing how the harm principle must be interpreted if it is to be a plausible guide to the lawmaker.

The rejection of behaviorism in the 1950s and 1960s led to the view, due mainly to Noam Chomsky, that language must be studied by looking at the mind and not just at behavior. It is an understatement to say that Chomskyan linguistics dominates the field. Despite being the overwhelming majority view, it has not gone unchallenged, and the challenges have focused on different aspects of the theory. What is almost universally accepted, however, is Chomsky’s view that understanding language demands a (...) theory that posits mental states that represent rules of language. Call this claim, following Cowie (1999), Representationalism or (R). According to (R), ‘‘[e]xplaining language mastery and acquisition requires the postulation of contentful mental states and processes involving their manipulation’’ (Cowie, 1999, p. 154). Although (R) is nothing more than the general assumption on which cognitive psychology is founded applied to the case of language, even it has had its detractors. Critics have argued that linguistic competence should not in fact be thought of as based on the possession of a body of linguistic knowledge but should be thought of, rather, as a kind of skill. This is an important challenge because one might be inclined to think that no recognizable form of Chomskyan linguistics could withstand the falsification of (R). In this paper we attempt to show that in fact (R) could be false without doing much damage to Chomskyan linguistics at all. Indeed, it is possible that the Chomskyan position could be made more coherent by adopting the view we will sketch. Our claim, therefore, is that critics of (R) might be right, but that this does not obviously make them serious critics of the Chomskyan program. (shrink)

Kant infamously claimed that all human beings, without exception, are evil by nature. This collection of essays critically examines and elucidates what he must have meant by this indictment. It shows the role which evil plays in his overall philosophical project and analyses its relation to individual autonomy. Furthermore, it explores the relevance of Kant's views for understanding contemporary questions such as crimes against humanity and moral reconstruction. Leading scholars in the field engage a wide range of sources from which (...) a distinctly Kantian theory of evil emerges, both subtle and robust, and capable of shedding light on the complex dynamics of human immorality. (shrink)

Demonstrates the systematic connection between Kant's ethics and his philosophy of history.

Sharon Anderson-Gold - Kant and the Ethics of Humility: A Story of Dependence, Corruption, and Virtue - Journal of the History of Philosophy 44:4 Journal of the History of Philosophy 44.4 666-667 Muse Search Journals This Journal Contents Reviewed by Sharon Anderson-Gold Rensselaer Polytechnic Institute Jeanine Grenberg. Kant and the Ethics of Humility: A Story of Dependence, Corruption, and Virtue. Cambridge-New York: Cambridge University Press, 2005. Pp. xi + 269. Cloth, $75.00 In Kant and the Ethics of Humility, (...) Jeanine Grenberg proposes to rehabilitate the virtue of humility. As she states in her introduction: "Humility is a curious virtue with a checkered history." Humility, Grenberg.. (shrink)

Software plays an important role in contemporary research. Aside from its use for administering traditional instruments like surveys and in data analysis, the widespread use of mobile and web apps for social, medical and lifestyle engagement has led to software becoming a research intervention in its own right. For example, it is not unusual to find apps being studied for their utility as interventions in health and social life. Since the software may persist in use beyond the life of an (...) investigation, this raises questions as to the extent of ethical duties for researchers involved in its production and/or study towards the participants involved. Key factors identified include the extent of affect created by the software, the effect it has on a participant’s life, the length of investigation, cost of maintenance and participant agency. In this article we discuss the issues raised in such situations, considering them in the context of post-research duties of care and suggesting strategies to balance the burden on researchers with the need for ongoing participant support. (shrink)

Human nature and its implications for moral philosophy has been a recurrent topic of philosophical inquiry. Thinkers from Plato to Arendt, struggling with the testimony of human experience, have attempted to explain the relation between reason and wickedness. Some have stressed the intrinsic rationality and goodness of human beings, relegating evil to the influence of factors alien to reason. Others have viewed humans as intrinsically evil, their capacity for reason a weak and inconsequential force.

The question of context is fundamental in the debate on “What is art?” What the uses of the term mean colour all debates about life and art. Since I am interested in the interpretation and understanding of context in art, and also in life, as well as in how visual arts reinforce or change our mind-constructs either consciously or automatically, I investigate the place of context within this scheme, while referring to various approaches to context and raise series of questions (...) that offer alternatives and point to difficulties. (shrink)

If human rights express the equal claim of every person to the recognition and protection of their vital interests, they necessarily assert universal obligations of justice that cross borders. Sharon Anderson-Gold asks here whether there is a normative consensus on human rights and articulates the role of a cosmopolitan or global community in shaping the theory and practice of international politics. She considers several important works in the field of universal human rights and discusses whether a cosmopolitan system of (...) law is a necessary condition for the stable association of nation states. _Cosmopolitanism and Human Rights_ presents an ethical foundation for the idea of human development and attempts to demonstrate the normative character of universal human rights. It claims that Kant's idea of a federation of nations based upon principles of international right remains highly relevant to contemporary aspirations for global justice, and concludes by suggesting that a ‘cosmopolitan community’ is the locus of a global democratic order and is the necessary framework for the maintenance of human rights. (shrink)

Concern over research integrity at the NIH led to the adoption of strict conflict of interest rules in 2005. An outcry from NIH scientists followed. This paper analyzes the legal and ethical issues raised by the new rules, and suggests potential areas for modification.

“Modern slavery,” a term used to describe severe forms of labor exploitation, is beginning to spark growing interest within business and society research. As a novel phenomenon, it offers potential for innovative theoretical and empirical pathways to a range of business and management research questions. And yet, development into what we might call a “field” of modern slavery research in business and management remains significantly, and disappointingly, underdeveloped. To explore this, we elaborate on the developments to date, the potential drawbacks, (...) and the possible future deviations that might evolve within six subdisciplinary areas of business and management. We also examine the value that nonmanagement disciplines can bring to research on modern slavery and business, examining the connections, critiques, and catalysts evident in research from political science, law, and history. These, we suggest, offer significant potential for building toward a more substantial subfield of research. (shrink)