As we aggressively pursue research to cure and prevent Alzheimer’s disease, we encounter important ethical challenges. None of these challenges, if handled thoughtfully, would pose insurmountable barriers to research. But if they are ignored, they could slow the research process, alienate potential study subjects and do damage to research recruits and others. These challenges are the necessity of very large cohorts of research subjects, recruited for lengthy studies, probably ending only in the subjects’ death; the creation of cohorts of ’study (...) ready' volunteers, many of whom will be competent to consent at the beginning of the process, but move into cognitive impairment later; reliance on adaptive trial design, creating challenges for informed consent, equipoise and justice; the use of biomarkers and predictive tests that describe risk rather than certainty, and that can threaten participants’ welfare if the information is obtained by insurance companies or long-term care providers; the use of study partners that creates unique risks of harm to the relationship of subject and study partner. We need greater attention, at all levels, to these complex ethical issues. Work on these issues should be included in research plans, from the federal to the local, and should be supported through NIH in the same way that it supported work on the ethical, legal and social implications of genetic research. (shrink)
According to Jules Coleman, Rational Choice Theory holds that human action is both intentional and rational. “The rationality of intentional action is evaluated along the two dimensions corresponding to the two elements of the belief-desire model.” On the belief-dimension, RC Theory assumes that people are “able to draw appropriate inferences from the information they possess.”.
There is strong sentiment for a policy which would exclude foreigners from access to organs from American cadaver donors. One common argument is that foreigners are free riders; since they are not members of the community whichgives organs, it would be unfair to allow them toreceive such a scarce resource.This essay examines the philosophical basis for the free rider argument, and compares that with the empirical data about organ donation in the U.S. The free rider argument ought not to be (...) used to exclude foreign nationals because it is based on fallacious assumptions about group membership, and how the giving community is defined. Polls show that even among the seventy-five per cent of Americans who support organ donation, only seventeen per cent had taken the small step of filling out donor cards. Therefore, it goes against logic to define the giving community as coextensive with American residency, while excluding foreigners who might well have become donors had they lived in countries which provided that option. (shrink)
The question of whether to allow children with AIDS to attend public school generates explosive emotions and has wide-reaching consequences. This paper focuses on the perspective of parents of well children who may be asked to attend school with children who have AIDS. These parents are poised at the heart of the dilemma: they are the ethical “bottom line,” and an argument that fails to satisfy them ought not to satisfy anyone.The conflicting commitments these parents face are first to the (...) parentchild covenant which requires them to act in their child's best interests, and second, to the principles of beneficence and justice, which require them not to further burden a sick child with ostracism and isolation.Almost exact parallels exist between this issue and that of proxy consent by parents for children's participation in low-risk, non-therapeutic research. The lengthy and important debate between Paul Ramsey and Richard McCormick on this question is analyzed, concluding that McCormick's position in favor of thoughtful proxy consent is the more compelling. Returning to the question of allowing children with AIDS to attend school, the essay shows why the parallels are persuasive. On the ethical level, the apparent conflict of obligations is almost exactly the same; on the pragmatic level, the essay shows why sharing a classroom with a child who has AIDS is comparable to the “low-risk” category that the National Commission for the Protection of Human Subjects found acceptable in its 1978 guidelines. The essay concludes that parents of healthy childrenmay and ought to accept the presence of children with AIDS in the public school. (shrink)
The ancient practice of metzitzah b'peh, direct oral suction, is still practiced by ultra-Orthodox Jews as part of the religious rite of male newborn circumcision. Between 2000 and 2011, 11 children have died in New York and New Jersey, following infection by herpes simplex virus, presumably from infected practitioners. The City responded by requiring signed parental consent before oral suction, with parents being warned of the dangers of the practice. This essay argues that informed consent is not an appropriate response (...) to this problem. An outright ban would a better response to a practice that is dangerous to children, but might prove unconstitutional under New York State law. (shrink)
: Because I reject the notion that physical characteristics constitute cultural membership, I argue that, even if the claim were persuasive that deafness is a culture rather than a disability, there is no reason to fault hearing parents who choose cochlear implants for their deaf children.
Advances in genetic research and technology can have a profound impact on identity and family dynamics when genetic findings disrupt deeply held assumptions about the nuclear family. Ancestry tracing and paternity testing present parallel risks and opportunities. As these latter uses are now available over the internet directly to the consumer, bypassing the genetic counselor, consumers need adequate warning when making use of these new modalities.
This paper probes the implications of a genetic basis for sexual orientation for traditional branches of Judaism, which are struggling with how accepting to be of noncelibate gays and lesbians in their communities. The paper looks at the current attitudes toward homosexuality across the different branches of Judaism; social and cultural factors that work against acceptance; attitudes toward science in Jewish culture; and the likelihood that scientific evidence that sexual orientation is at least partly genetically determined will influence Jewish scholars' (...) and leaders' thinking on this issue. (shrink)
: It is possible and necessary to compare stretches of human life with other goods, such as the good of conserving resources for others. A minute of human life is not of infinite value; all else being equal, a minute of life is less valuable than 10 years of the same life. Nevertheless, this ability to evaluate human life does not necessarily lead to total commodification of human life.
Grice’s Razor is a methodological principle that many philosophers and linguists have used to help justify pragmatic explanations of linguistic phenomena over semantic explanations. A number of authors in the debate over contextualism argue that an invariant semantics together with Grice’s (1975) conversational principles can account for the contextual variability of knowledge claims. I show here that the defense of Grice’s Razor found in these “Gricean invariantists,” and its use against epistemic contextualism, display all the problems pointed out earlier in (...)Davis (1998). The everyday variation in acceptable knowledge claims is better explained in terms of implicature than indexicality, but general conversational principles shed little light on whether ‘know’ is used hyperbolically, meiotically, or loosely in a context, although this issue is crucial in deciding what if anything ‘S knows p’ implicates. I present reasons favoring an account of the representative bank case in terms of loose use, making clear how they differ from Grice’s Razor. (shrink)
Much has been written about recidivist punishments, particularly within the area of criminology. However there is a notorious lack of penal philosophical reflection on this issue. This book attempts to fill that gap by presenting the philosopher’s view on this matter as a way of furthering the debate on recidivist punishments.
The Dispossessed has been described by political thinker Andre Gorz as 'The most striking description I know of the seductions—and snares—of self-managed communist or, in other words, anarchist society.' To date, however, the radical social, cultural, and political ramifications of Le Guin's multiple award-winning novel remain woefully under explored. Editors Laurence Davis and Peter Stillman right this state of affairs in the first ever collection of original essays devoted to Le Guin's novel. Among the topics covered in this wide-ranging, (...) international and interdisciplinary collection are the anarchist, ecological, post-consumerist, temporal, revolutionary, and open-ended utopian politics of The Dispossessed. The book concludes with an essay by Le Guin written specially for this volume, in which she reassesses the novel in light of the development of her own thinking over the past 30 years. (shrink)
Drawing on extensive ethnographic fieldwork in Cambodia, Erik W. Davis radically recasts attitudes toward the nature of Southeast Asian Buddhism's interactions with local religious practice and, by extension, reorients our understanding of Buddhism itself. Through a vivid study of contemporary Cambodian Buddhist funeral rites, he reveals the powerfully integrative role monks play as they care for the dead and negotiate the interplay of non-Buddhist spirits and formal Buddhist customs. Buddhist monks perform funeral rituals rooted in the embodied practices of (...) Khmer rice farmers and the social hierarchies of Khmer culture. The monks' realization of death underwrites key components of the Cambodian social imagination: the distinction between wild death and celibate life, the forest and the field, and moral and immoral forms of power. By connecting the performative aspects of Buddhist death rituals to Cambodian history and everyday life, Davis undermines the theory that elite Buddhist monks universally oppose rural belief systems. Instead, he shows Cambodian Buddhism to be a robust tradition with ethical and popular components extending throughout Khmer society. (shrink)
In this compelling book, John B. Davis examines the change and development in Keynes's philosophical thinking, from his earliest work through to The General Theory, arguing that Keynes came to believe himself mistaken about a number of his early philosophical concepts. The author begins by looking at the unpublished 'Apostles' papers, written under the influence of the philosopher G. E. Moore. These display the tensions in Keynes's early philosophical views, and outline his philosophical concepts of the time, including the (...) concept of intuition. Davis then shows how Keynes's later philosophy is implicit in the economic argument of The General Theory. He argues that Keynes's philosophy had by this time changed radically, and that he had abandoned the concept of intuition for the concept of convention. The author sees this as being the central idea in The General Theory, and looks at the philosophical nature of this concept of convention in detail. (shrink)