The perception of reality by biosystems is based on different, and in certain respects more effective, principles than those utilized by the more formal procedures of science. As a result, what appears as random pattern to the scientific method can be meaningful pattern to a living organism. The existence of this complementary perception of reality makes possible in principle effective use by organisms of the direct interconnections between spatially separated objects shown to exist in the work of J. S. Bell.

The following progress report views language acquisition as primarily the attempt to create processes that connect together in a fruitful way linguistic input and other activity. The representations made of linguistic input are thus those that are optimally effective in mediating such interconnections. An effective Language Acquisition Device should contain mechanisms specific to the task of creating the desired interconnection processes in the linguistic environment in which the language learner finds himself or herself. Analysis of this requirement gives clear indications (...) as to what these mechanisms may be. (shrink)

Niels Bohr's arguments indicating the non-applicability of quantum methodology to the study of the ultimate details of life, given in his bookAtomic Physics and Human Knowledge, conflict with the commonly held opposite view. The bases for the usual beliefs are examined and shown to have little validity; significant differences do exist between the living organism and the type of system studied successfully in the physics laboratory. Dealing with living organisms in quantum-mechanical terms with the same degree of rigor as is (...) normal for non-living systems would seem not to be possible without considering also questions of the origins of life and of the universe. (shrink)

This paper examines the processes involved in attempting to capture the subtlest aspects of nature by the scientific method and argues on this basis that nature is fundamentally elusive and may resist grasping by the methods of science. If we wish to come to terms with this resistance, then a shift in the direction of taking direct experience into account may be necessary for science’s future complete development.

What makes conscious experience a difficult or confusing subject for science to deal with is its personal or individualistic character (that is to say the fact that a given experience is an experience apparently tied to a particular individual). It is in this respect very different from the other phenomena studied by science, where while the phenomena may be observed by a particular individual they are considered to be in principle independent of that individual. To say that an individual’s experience (...) is merely the functioning ofthat individual’s brain does not fully resolve the problem, since experiences are so very different in nature from brain processes. (shrink)

The INBIOSA project brings together a group of experts across many disciplines who believe that science requires a revolutionary transformative step in order to address many of the vexing challenges presented by the world. It is INBIOSA’s purpose to enable the focused collaboration of an interdisciplinary community of original thinkers. This paper sets out the case for support for this effort. The focus of the transformative research program proposal is biology-centric. We admit that biology to date has been more fact-oriented (...) and less theoretical than physics. However, the key leverageable idea is that careful extension of the science of living systems can be more effectively applied to some of our most vexing modern problems than the prevailing scheme, derived from abstractions in physics. While these have some universal application and demonstrate computational advantages, they are not theoretically mandated for the living. A new set of mathematical abstractions derived from biology can now be similarly extended. This is made possible by leveraging new formal tools to understand abstraction and enable computability. [The latter has a much expanded meaning in our context from the one known and used in computer science and biology today, that is "by rote algorithmic means", since it is not known if a living system is computable in this sense (Mossio et al., 2009).] Two major challenges constitute the effort. The first challenge is to design an original general system of abstractions within the biological domain. The initial issue is descriptive leading to the explanatory. There has not yet been a serious formal examination of the abstractions of the biological domain. What is used today is an amalgam; much is inherited from physics (via the bridging abstractions of chemistry) and there are many new abstractions from advances in mathematics (incentivized by the need for more capable computational analyses). Interspersed are abstractions, concepts and underlying assumptions “native” to biology and distinct from the mechanical language of physics and computation as we know them. A pressing agenda should be to single out the most concrete and at the same time the most fundamental process-units in biology and to recruit them into the descriptive domain. Therefore, the first challenge is to build a coherent formal system of abstractions and operations that is truly native to living systems. Nothing will be thrown away, but many common methods will be philosophically recast, just as in physics relativity subsumed and reinterpreted Newtonian mechanics. -/- This step is required because we need a comprehensible, formal system to apply in many domains. Emphasis should be placed on the distinction between multi-perspective analysis and synthesis and on what could be the basic terms or tools needed. The second challenge is relatively simple: the actual application of this set of biology-centric ways and means to cross-disciplinary problems. In its early stages, this will seem to be a “new science”. This White Paper sets out the case of continuing support of Information and Communication Technology (ICT) for transformative research in biology and information processing centered on paradigm changes in the epistemological, ontological, mathematical and computational bases of the science of living systems. Today, curiously, living systems cannot be said to be anything more than dissipative structures organized internally by genetic information. There is not anything substantially different from abiotic systems other than the empirical nature of their robustness. We believe that there are other new and unique properties and patterns comprehensible at this bio-logical level. The report lays out a fundamental set of approaches to articulate these properties and patterns, and is composed as follows. -/- Sections 1 through 4 (preamble, introduction, motivation and major biomathematical problems) are incipient. Section 5 describes the issues affecting Integral Biomathics and Section 6 -- the aspects of the Grand Challenge we face with this project. Section 7 contemplates the effort to formalize a General Theory of Living Systems (GTLS) from what we have today. The goal is to have a formal system, equivalent to that which exists in the physics community. Here we define how to perceive the role of time in biology. Section 8 describes the initial efforts to apply this general theory of living systems in many domains, with special emphasis on crossdisciplinary problems and multiple domains spanning both “hard” and “soft” sciences. The expected result is a coherent collection of integrated mathematical techniques. Section 9 discusses the first two test cases, project proposals, of our approach. They are designed to demonstrate the ability of our approach to address “wicked problems” which span across physics, chemistry, biology, societies and societal dynamics. The solutions require integrated measurable results at multiple levels known as “grand challenges” to existing methods. Finally, Section 10 adheres to an appeal for action, advocating the necessity for further long-term support of the INBIOSA program. -/- The report is concluded with preliminary non-exclusive list of challenging research themes to address, as well as required administrative actions. The efforts described in the ten sections of this White Paper will proceed concurrently. Collectively, they describe a program that can be managed and measured as it progresses. (shrink)

Edited proceedings of an interdisciplinary symposium on consciousness held at the University of Cambridge in January 1978. Includes a foreword by Freeman Dyson. Chapter authors: G. Vesey, R.L. Gregory, H.C. Longuet-Higgins, N.K. Humphrey, H.B. Barlow, D.M. MacKay, B.D. Josephson, M. Roth, V.S. Ramachandran, S. Padfield, and (editorial summary only) E. Noakes. A scanned pdf is available from this web site (philpapers.org), while alternative versions more suitable for copying text are available from https://www.repository.cam.ac.uk/handle/1810/245189. -/- Page numbering convention for the pdf (...) version viewed in a pdf viewer is as follows: 'go to page n' accesses the pair of scanned pages 2n and 2n+1. Applicable licence: CC Attribution-NonCommercial-ShareAlike 2.0. (shrink)

This volume provides an analysis of divine aseity in Karl Barth's thought and appreciates the vital role that this doctrine can play in contemporary theology. Brian D. Asbill begins by setting the general theological context, first through a broad sketch of the development of Barth's understanding of the relationship between the life of God pro nobis (pronobeity) and a se (aseity), and secondly through the examination of the basic theological convictions that guide his approach to the divine being in (...) Church Dogmatics II/1. The second section, 'The Love and Freedom of God', turns to the dialectical pairings which guide Barth's accounts of the divine reality in his earliest dogmatic cycle (The Göttingen Dogmatics §§16-7) as well as in his most mature treatment (Church Dogmatics §§28-31). Particular attention is given to how these themes arise from revelation and relate to one another. In the final section, 'The Aseity of God', Asbill identifies this doctrine's basic features and primary functions. Divine aseity is characterized as the self-demonstration and self-movement of God's life, a trinitarian and entirely unique reality, a primarily positive and dynamic concept, and the manner and readiness of God's love for creatures. Divine aseity is said to indicate God's lordship in the act of self-binding, God's uniqueness in the act of self-revelation, and God's sufficiency in the act of self-giving. (shrink)

An inclusive survey from Frederick Douglass to the voices of Black Lives Matter.

There is a long tradition of the value of using film as a pedagogical tool. Such use spans a variety of business disciplines including organizational behavior (Smith 2009), accounting (Bay & Felton 2012), business ethics (Fisher, Grant & Palmer 2015) and cultural competency (Greene, Barden, Richardson & Hall 2014). Presented here is a recently developed course, Business in Film, which engages students in deep reflection on business issues with an emphasis on ethics and values. The course is structured around a (...) weekly film (mix of dramas and documentaries), 15 weeks, 15 films covering approximately 40 years. For each film, students prepare a 2-3 page reflection paper. Student feedback has been consistently positive, with comments along the themes of a greater appreciation of the intersection between business and the human experience, bringing to life ethical considerations, and a greater appreciation of the historical context of business events. (shrink)

Historically, laws and policies to criminalize drug use or possession were rooted in explicit racism, and they continue to wreak havoc on certain racialized communities. We are a group of bioethicists, drug experts, legal scholars, criminal justice researchers, sociologists, psychologists, and other allied professionals who have come together in support of a policy proposal that is evidence-based and ethically recommended. We call for the immediate decriminalization of all so-called recreational drugs and, ultimately, for their timely and appropriate legal regulation. We (...) also call for criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs to be expunged, and for those currently serving time for these offenses to be released. In effect, we call for an end to the “war on drugs.”. (shrink)

The History of Psychology course occupies an unusual but critical place in the psychology curriculum at most universities. As the field has become ever more specialized, with the various subdisciplines branching off, The History of Psychology is often the one course where the common roots of all of these areas are explored. Asking not only "What is psychology?" but also "What is science?" "Why is psychology a science?" and "How did it become one?" this book examines how the paradigm of (...) Psychology was built. Discussing key figures in history in the context of their time, it takes students on a carefully formulated, chronological journey through the build-up of psychology from ancient times to the present, and seeks to draw students into the way science is done, rather than merely presenting them with historical fact. Students will learn not only the "what," but the "why" of the history of psychology and will acquire the necessary background historical material to fully understand those concepts. Organized around a series of moments and cases--such as a shift from scholasticism to rationalism or empiricism, and a shift from idealism to materialism--the book seeks to portray psychology as an on-going, evolving process, rather than a theory.--page i. (shrink)

This paper explores an emerging sub-field of both empirical bioethics and experimental philosophy, which has been called “experimental philosophical bioethics” (bioxphi). As an empirical discipline, bioxphi adopts the methods of experimental moral psychology and cognitive science; it does so to make sense of the eliciting factors and underlying cognitive processes that shape people’s moral judgments, particularly about real-world matters of bioethical concern. Yet, as a normative discipline situated within the broader field of bioethics, it also aims to contribute to substantive (...) ethical questions about what should be done in a given context. What are some of the ways in which this aim has been pursued? In this paper, we employ a case study approach to examine and critically evaluate four strategies from the recent literature by which scholars in bioxphi have leveraged empirical data in the service of normative arguments. (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)

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)

Pharmaceuticals or other emerging technologies could be used to enhance (or diminish) feelings of lust, attraction, and attachment in adult romantic partnerships. While such interventions could conceivably be used to promote individual (and couple) well-being, their widespread development and/or adoption might lead to “medicalization” of human love and heartache—for some, a source of serious concern. In this essay, we argue that the “medicalization of love” need not necessarily be problematic, on balance, but could plausibly be expected to have either good (...) or bad consequences depending upon how it unfolds. By anticipating some of the specific ways in which these technologies could yield unwanted outcomes, bioethicists and others can help direct the course of love’s “medicalization”—should it happen to occur—more toward the “good” side than the “bad.”. (shrink)

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as the same person after (...) becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves. (shrink)

The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements should be considered permissible for individuals with no particular “medical” disadvantage along any of the dimensions of interest. Less frequently addressed in the literature, however, is the fact that sometimes the _diminishment_ of a capacity or function, under the right set of circumstances, could plausibly contribute (...) to an individual's overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a _welfarist_ conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing. (shrink)

The moral enhancement (or bioenhancement) debate seems stuck in a dilemma. On the one hand, the more radical proposals, while certainly novel and interesting, seem unlikely to be feasible in practice, or if technically feasible then most likely imprudent. But on the other hand, the more sensible proposals – sensible in the sense of being both practically achievable and more plausibly ethically justifiable – can be rather hard to distinguish from both traditional forms of moral enhancement, such as non-drug-mediated social (...) or moral education, and non-moral forms of bioenhancement, such as smart-drug style cognitive enhancement. In this essay, I argue that bioethicists have paid insufficient attention to an alternative form of moral bioenhancement – or at least a likely candidate – that falls somewhere between these two extremes, namely the (appropriately qualified) use of certain psychedelic drugs. (shrink)

In this paper I ask how Timaeus explains change within the trianglebased part of his cosmos. Two common views are that change among physical items is somehow caused or enabled by either the forms or the demiurge. I argue for a competing view, on which the physical items are capable of bringing about change by themselves, prior to the intervention of the demiurge, and prior to their being turned into imitations of the forms. I outline three problems for the view (...) that physical things depend on the forms for their causal powers, and show how the view I propose solves each. I then add further arguments for my view, based on (a) statements by Timaeus that seem to favor my view directly, (b) implications of Timaeus’ positions that favor the view, and (c) Timaeus’ explanatory practice in the second half of his speech. (shrink)

In this chapter, we introduce the notion of “moral neuroenhancement,” offering a novel definition as well as spelling out three conditions under which we expect that such neuroenhancement would be most likely to be permissible (or even desirable). Furthermore, we draw a distinction between first-order moral capacities, which we suggest are less promising targets for neurointervention, and second-order moral capacities, which we suggest are more promising. We conclude by discussing concerns that moral neuroenhancement might restrict freedom or otherwise “misfire,” and (...) argue that these concerns are not as damning as they may seem at first. (shrink)

Ethical dilemmas arise when one must decide between conflicting ethical imperatives. One potential ethical dilemma is a manager’s decision of whether to engage in corporate social responsibility activities. This decision could pit the ethical imperative of honoring unwritten obligations to society against the ethical imperative of honoring contractual obligations to the firm. However, CSR activities might only be a minor ethical dilemma or none at all if they simultaneously benefit the firm and society. To examine this I test the association (...) between future-period employee productivity and current-period use of one type of CSR activity: employee volunteer programs. I use a unique sample of 1428 firm-years, hand-collected from sustainability reports of 373 firms. I find evidence that the current-period use of an employee volunteer program has a positive association with future-period employee productivity. I find this result in future periods up to 6 years after a firm uses an employee volunteer program. I also find a positive association between incentives that focus CEOs’ attention on long-term firm outcomes and more extensive employee volunteer programs. (shrink)

Volume 20, Issue 8, August 2020, Page 72-75.

Historically, empirical research in bioethics has drawn on methods developed within the social sciences, including qualitative interviews, focus groups, ethnographic studies, and opinion surveys, t...

Evidence suggests that psychedelics bring about their therapeutic outcomes in part through the subjective or qualitative effects they engender and how the individual interprets the resulting experiences. However, psychedelics are contraindicated for individuals who have been diagnosed with certain mental illnesses, on the grounds that these subjective effects may be disturbing or otherwise counter-therapeutic. Substantial resources are therefore currently being devoted to creating psychedelic substances that produce many of the same biological changes as psychedelics, but without their characteristic subjective effects. (...) In this article, we consider ethical issues arising from the prospect of such potential “nonsubjective” psychedelics. We are broadly supportive of efforts to produce such substances for both scientific and clinical reasons. However, we argue that such nonsubjective psychedelics should be reserved for those special cases in which the subjective effects of psychedelics are specifically contraindicated, whereas classic psychedelics that affect subjective experience should be considered the default and standard of care. After reviewing evidence regarding the subjective effects of psychedelics, we raise a number of ethical concerns around the prospect of withholding such typically positive, meaningful, and therapeutic experiences from most patients. (shrink)

How shall we decide for others who cannot decide for themselves? And who—or what, in the case of artificial intelligence — should make the decision? The present issue of the journal tackles several interrelated topics, many of them having to do with surrogate decision making. For example, the feature article by Jardas et al 1 explores the potential use of artificial intelligence to predict incapacitated patients’ likely treatment preferences based on their sociodemographic characteristics, raising questions about the means by which (...) we come to decide for others. And a clinical ethics round table led by Wilkinson and Pillay2 examines the case of a premature baby on life support whose primary surrogate is herself incapacitated. Together, these examples force us to think more deeply about the meaning and significance of taken-for-granted concepts: respect for autonomy, substituted judgement, best interests. We’ll consider the baby first and then turn to AI. “Baby T” is a critically ill newborn delivered prematurely by emergency caesarean section. The mother had entered into a surrogacy arrangement with a same-sex male couple, the intended parents, who were to take over the baby’s care after birth—just as soon as a formal parental order could be obtained through the court. Until then, the birth mother, who had used her own eggs to conceive Baby T along with sperm from an unidentified donor, would have legal and ethical responsibility to decide about the baby’s care. Unfortunately, she too was in critical condition, having fallen unconscious prior to delivery due to a sudden brain haemorrhage. She remained unconscious, and thus incapacitated, during a crucial period in which time-sensitive decisions about Baby T’s care needed to be made, including whether to continue life support. Given the mother’s incapacity, who should …. (shrink)

Leadership in Education, Corrections and Law Enforcement: A Commitment to Ethics, Equity and Excellence fills a unique gap in the knowledge base - the juncture between leadership, ethics, law, and how public institutions/organizations understand and practice the essence of all three. Authors from law enforcement, corrections education, and educational leadership present different yet overlapping constructs around ethics and law, and make an important step towards reconciling these differing views to demonstrate the significance of collaboration and partnerships for a common purpose.

Insight problem solving is hindered by automated verbal–conceptual processes. Because mindfulness meditation training aims at “nonconceptual awareness” which involves a reduced influence of habitual verbal–conceptual processes on the interpretation of ongoing experience, mindfulness may facilitate insight problem solving. This hypothesis was examined across two studies . Participants in both studies completed a measure of trait mindfulness and a series of insight and noninsight problems. Further, participants in Study 2 completed measures of positive affect and a mindfulness or control training. The (...) results indicated that trait mindfulness predicts better insight but not noninsight problem solving , this relation is maintained when controlling for positive affect , mindfulness training improves insight but not noninsight problem solving and this improvement is partially mediated by state mindfulness . These findings are the first to document a direct relation between mindfulness and creativity. (shrink)

The question of what makes someone the same person through time and change has long been a preoccupation of philosophers. In recent years, the question of what makes ordinary or lay people judge that someone is—or isn’t—the same person has caught the interest of experimental psychologists. These latter, empirically oriented researchers have sought to understand the cognitive processes and eliciting factors that shape ordinary people’s judgments about personal identity and the self. Still more recently, practitioners within an emerging discipline, experimental (...) philosophical bioethics or “bioxphi”—the focus of this chapter—have adopted a similar aim and employed similar methodologies, but with two distinctive features: (a) a special concern for enhanced ecological validity in the examples and populations studied; and (b) an interest in contributing to substantive normative debates within the wider field of bioethics. Our aim in this chapter is to sample illustrative work on personal identity in bioxphi, explore how it relates to studies in psychology covering similar terrain, and draw out the implications of this work for matters of bioethical concern. In pursuing these issues, we highlight recent work in bioxphi that includes the perceived validity of advance directives following neurodegeneration, the right of psychologically altered study participants to withdraw from research, how drug addiction may cause one to be regarded by others as “a completely different person,” the effect of deep-brain stimulation on perceptions of the self, and the potential influence of moral enhancement interventions on intuitive impressions of a person’s character. (shrink)

The primary objective was to review pediatric ethics consultations at a large academic health center over a nine year period, assessing demographics, ethical issues, and consultant intervention. The secondary objective was to describe the evolution of PECs at our institution. This was a retrospective review of Consultation Summary Sheets compiled for PECs at our Academic Health Center between January 2008 and April 2017. There were 165 PECs reviewed during the study period. Most consult requests came from the inpatient setting, with (...) the Pediatric and Neonatal Intensive Care Units being the highest utilizers. Consultation utilization increased over the study period. The most common patient age was less than one year. Physicians were most likely to request consultation. Patient Best Interest, Withholding/Withdrawing of Life Sustaining Therapy, and Provider Moral Distress were ethical issues most commonly identified by the consultants. Making recommendations was the most common consultant intervention. The ethics consultation process evolved over time from informal provider discussions, to a hospital infant care review committee, to a pediatric only consultation service, to a combined adult/pediatric consultation service, with variable levels of salary support for consultants. Ethics consultation requests are growing at our institution. Similarities in identified ethical issues exist between our findings and existing literature, however meaningful comparisons remains elusive secondary to variability in approaches to investigation and reporting. A combined paid/volunteer/trainee ethics consultation service model appears sustainable and real time ethics consultation is feasible using this approach. (shrink)

In this issue, Ahmadi1 reports on the practice of hymenoplasty—a surgical intervention meant to restore a presumed physical marker of virginity prior to a woman's marriage. As Mehri and Sills2 have stated, these women ‘want to ensure that blood is spilled on their wedding night sheets.’ Although Ahmadi's research was carried out in Iran specifically, this surgery is becoming increasingly popular in a number of Western countries as well, especially among Muslim populations.3 What are the ethics of hymen restoration?Consider the (...) role of the physician. Two of the doctors interviewed by Ahmadi reported being in ‘a perpetual state of guilt because of the surgery's inherent aim at deceiving the groom’ and noted their ‘personal conflict’ at being involved in this deception. Yet: "None of the doctors believed that the surgery was unethical, arguing that the girl could be ‘abused’ and ‘can even die’ if she is discovered not … ". (shrink)

The Philosophy of Quantitative Methods undertakes a philosophical examination of a number of important quantitative research methods within the behavioral sciences in order to overcome the non-critical approaches typically provided by textbooks. These research methods are exploratory data analysis, statistical significance testing, Bayesian confirmation theory and statistics, meta-analysis, and exploratory factor analysis. Further readings are provided to extend the reader's overall understanding of these methods.

Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making. In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

The WHO, American Academy of Pediatrics and other Western medical bodies currently maintain that all medically unnecessary female genital cutting of minors is categorically a human rights violation, while either tolerating or actively endorsing medically unnecessary male genital cutting of minors, especially in the form of penile circumcision. Given that some forms of female genital cutting, such as ritual pricking or nicking of the clitoral hood, are less severe than penile circumcision, yet are often performed within the same families for (...) similar reasons, it may seem that there is an unjust double standard. Against this view, it is sometimes claimed that while female genital cutting has ‘no health benefits’, male genital cutting has at least some. Is that really the case? And if it is the case, can it justify the disparate treatment of children with different sex characteristics when it comes to protecting their genital integrity? I argue that, even if one accepts the health claims that are sometimes raised in this context, they cannot justify such disparate treatment. Rather, children of all sexes and genders have an equal right to bodily autonomy. This includes the right to decide whether their own ‘private’ anatomy should be exposed to surgical risk, much less permanently altered, for reasons they themselves endorse when they are sufficiently mature. (shrink)

Much of modern ethics is built around the idea that we should respect one another’s autonomy. Here, “we” are typically imagined to be adult human beings of sound mind, where the soundness of our mind is measured against what we take to be the typical mental capacities of a neurodevelopmentally “normal” person—perhaps in their mid-thirties or forties. When deciding about what constitutes ethical sex, for example, our dominant models hold that ethical sex is whatever is consented to, while a lack (...) of consent makes sex wrong.1 Consent, in turn, is analysed in terms of autonomous decision-making: a “yes” or “no” that reflects the free and informed will of our idealised, sound-minded adult. Whether such models provide adequate normative guidance for ethical, much less good, sex between neurotypical human adults is an open question.2 3 When it comes to the ethics of sexual activity between humans and non-humans—robots, say—or between humans who don’t fit the rational stereotype, we hardly know where to begin.4–7 It is therefore heartening to see a number of papers in this issue tackling the difficult question how to respectfully facilitate or respond to the needs, desires, and decisions of people with different kinds or degrees of autonomy.8 For example, Sumytra Menon and colleagues9 explicitly discuss the notion of “borderline capacity” and argue, in the medical domain, for shared and supportive decision-making practices to “foster the autonomy of patients with compromised mental capacity while being mindful of the need to safeguard their well-being.” Touching on a similar theme, Zahra Ladan 10 asks how we should conceive of liberty in the case of persons with certain inborn physical or mental limitations. Might it sometimes be necessary to …. (shrink)

Near the end of his speech, Timaeus outlines a theory of bodily health and disease which has seemed to many commentators loosely unified or even inconsistent . But this section is better unified than it has appeared, and gives us at least one important insight into the workings of physical causality in the Timaeus. I argue first that the apparent disorder in Timaeus’s theory of disease is likely a deliberate effect planned by the author. Second, the taxonomy of disease in (...) the passage consists of one genus subsuming two species. Third, in Timaeus’s theory, health lies between perfect stability and a chaos of all possible motions; this indicates a conception of health as the activation of the body's powers in the right way. A power is a property directed towards bringing about some change. Fourth, the activation of these powers can change depending on the location of their possessors. This last point shows that causation among the physical items in the Timaeus involves structures as well as pushes. (shrink)

It is sometimes argued that the non-therapeutic, non-consensual alteration of children‘s genitals should be discussed in two separate ethical discourses: one for girls (in which such alterations should be termed 'female genital mutilation' or FGM), and one for boys (in which such alterations should be termed 'male circumcision‘). In this article, I call into question the moral and empirical basis for such a distinction, and argue that all children - whether female, male, or indeed intersex - should be free from (...) having parts of their genitals removed unless there is a pressing medical indication. (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)

INTRODUCTIONIs the non-therapeutic circumcision of infant males morally permissible? The most recent major development in this long-simmering debate was the 2012 release of a policy statement and technical report on circumcision by the American Academy of Pediatrics . In these documents, the US paediatricians’ organisation claimed that the potential health benefits of infant circumcision now outweigh the risks and costs. They went on to suggest that their analysis could be taken to justify the decision of parents to choose circumcision for (...) their incompetent children.1Circumcision and ‘health benefits’The AAP's pronouncement unleashed a firestorm of commentary, much of it censorious. In this issue, human rights attorney J Steven Svoboda and Professor of Clinical Paediatrics Robert Van Howe take the AAP to taski for committing numerous significant errors, both in their analysis of relevant evidence and in basic medical-ethical reasoning.3 In addition, an independent international panel—composed of 38 leading paediatricians, paediatric surgeons, urologists, medical ethicists and heads of hospital boards and children's health societies—has likewise condemned the findings of the AAP. Writing in the journal Pediatrics, these authors state: "Only one of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.4"My own analysis of the AAP documents—and of ‘health benefits’ defences of circumcision generally—can be found elsewhere.5 Let me turn my attention in this editorial, then, to …. (shrink)