Benjamin Gregg’s Creating Human Nature: The Political Challenges of Genetic Engineering is a wide-ranging and controversial approach to the politics of genetic engineering. The book consists of thr...

The biophilosophic justification for the idea that “brain death” is death needs to support two claims: that what dies in human death is a human organism, not merely a psychological entity distinct from it; that total brain failure signifies the end of the human organism as a whole. Defenders of brain death typically assume without argument that the first claim is true and argue for the second by defending the “integrative unity” rationale. Yet the integrative unity rationale has fallen on (...) hard times. In this article, I give reasons for why we should think of ourselves as organisms, and why the “fundamental work” rationale put forward by the 2008 President’s Council is better than the integrative unity rationale, despite persistent objections to it. (shrink)

Although much has been written on the dead-donor rule in the last twenty-five years, scant attention has been paid to how it should be formulated, what its rationale is, and why it was accepted. The DDR can be formulated in terms of either a Don’t Kill rule or a Death Requirement, the former being historically rooted in absolutist ethics and the latter in a prudential policy aimed at securing trust in the transplant enterprise. I contend that the moral core of (...) the rule is the Don’t Kill rule, not the Death Requirement. This, I show, is how the DDR was understood by the transplanters of the 1960s, who sought to conform their practices to their ethics—unlike today’s critics of the DDR, who rethink their ethics in a question-begging fashion to accommodate their practices. A better discussion of the ethics of killing is needed to move the debate forward. (shrink)

Shavelson et al., argues that California’s End of Life Option Act (ELOA) violates the Americans with Disabilities Act (ADA), because the ELOA requires the patient to “self-administer” their prescri...

Arian Lewis provides a comprehensive overview of how the United Kingdom’s medicolegal context manages challenges to determining death by neurologic criteria (DNC) and suggests that a well-crafted s...

The dead donor rule (DDR) prohibits retrieval protocols that would be lethal to the donor. Some argue that compliance with it can be maintained by satisfying the requirements of double‐effect reasoning (DER). If successful, one could support organ donation without reference to the definition of death while being faithful to an ethic that prohibits intentionally killing innocent human life. On the contrary, I argue that DER cannot make lethal organ donation compatible with the DDR, because there are plausible ways it (...) fails DER's requirements. A key takeaway is that the theories of intention and proportionality assumed in DER matter for its plausibility as a constraint on practical reasoning. (shrink)

There are increasing calls for rejecting the ‘dead donor’ rule and permitting ‘organ donation euthanasia’ in organ transplantation. I argue that the fundamental problem with this proposal is that it would bestow more worth on the organs than the donor who has them. What is at stake is the basis of human equality, which, I argue, should be based on an ineliminable dignity that each of us has in virtue of having a rational nature. To allow mortal harvesting would be (...) to make our worth contingent upon variable quality of life of judgments that can only be based on properties that come in degrees. Thus, rejecting the ‘dead donor’ rule comes at the expense of our egalitarian principles with respect to the value each individual human life has in relation to the protections against killing. (shrink)

Nielsen Bush and Mjaaland (“the authors” hereafter) argue that controlled donation after circulatory death (cDCD) protocols that target abdominal organs are consistent with the dead donor rule (DDR...

Giubilini and Minerva argue that the permissibility of abortion entails the permissibility of infanticide. Proponents of what we refer to as the Birth Strategy claim that there is a morally significant difference brought about at birth that accounts for our strong intuition that killing newborns is morally impermissible. We argue that strategy does not account for the moral intuition that late-term, non-therapeutic abortions are morally impermissible. Advocates of the Birth Strategy must either judge non-therapeutic abortions as impermissible in the later (...) stages of pregnancy or conclude that they are permissible on the basis of premises that are far less intuitively plausible than the opposite conclusion and its supporting premises. (shrink)

The themes of this issue—which include the meaning of our health and disease concepts, the so-called “medical gaze” and its embedded power relations, and the epistemic value of mixing therapy with research—are introduced by reflecting on a case about an infant girl whose head is observed to be somewhat flat.

Walter Sinnott-Armstrong and Franklin G Miller recently argued that the wrongness of killing is best explained by the harm that comes to the victim, and that ‘total disability’ best explains the nature of this harm. Hence, killing patients who are already totally disabled is not wrong. I maintain that their notion of total disability is ambiguous and that they beg the question with respect to whether there are abilities left over that remain relevant for the goods of personhood and human (...) worth. If these goods remain, then something more is lost in death than in ‘total disability,’ and their explanation of what makes killing wrong comes up short. But if total disability is equivalent with death, then their argument is an interesting one. (shrink)

In a recent article Steven Cowan defended the claim that female subordination and male authority are merely functional differences. Drawing insights from Natural Law, I argue that complementarianism typically speaks of these as proper functions of male and female designs, thus making men and women metaphysically unequal in being. Furthermore, I maintain that the function "serving as a means to an end" is less valuable than the function "having the authority to direct the end." Hence, Cowan fails to defeat the (...) objection that the claim that women are equal to men in being, but subordinate in role is incoherent. (shrink)

Some of the most difficult consultations for an ethics consultant to resolve are those in which the patient is ready to leave the acute-care setting, but the patient or family refuses the plan, or the plan is impeded by deficiencies in the healthcare system. Either way, the patient is “stuck” in the hospital and the ethics consultant is called to help get the patient “unstuck.” These encounters, which we call “complex discharges,” are beset with tensions between the interests of the (...) institution and the interests of the patient as well as tensions within the ethics consultant whose commitments are shaped both by the values of the organization and the values of their own profession. The clinical ethics literature on this topic is limited and provides little guidance. What is needed is guidance for consultants operating at the bedside and for those participating at a higher organizational level. To fill this gap, we offer guidance for facilitating a fair process designed to resolve the conflict without resorting to coercive legal measures. We reflect on three cases to argue that the approach of the consultant is generally one of mediation in these types of disputes. For patients who lack decision making capacity and lack a surrogate decision maker, we recommend the creation of a complex discharge committee within the organization so that ethics consultants can properly discharge their duties to assist patients who are unable to advocate for themselves through a fair and transparent process. (shrink)

Smith argues that death caused by transplant surgery will not harm permanently unconscious patients, because they will not suffer a setback to their interests in the context of donation. Therefore, so the argument goes, the dead donor rule can be abandoned, because requiring a death declaration before procurement does not protect any relevant interest from being thwarted. Smith contends that a virtue of his argument is that it avoids the controversies over defining and determining death. I argue that it does (...) not and explain why no change in policy is justified. (shrink)

In this paper, I introduce the ideas to be discussed in the articles of this journal with reference to an imaginary case involving a pregnant woman declared dead on the basis of neurological criteria. I highlight the fact that although these ideas have proved useful for advancing certain claims in bioethical debates, their implications are not always well understood and may complicate our arguments. The ideas to be discussed are an ethic internal to the profession of medicine; the difference between (...) killing and letting die; the organism as a whole; and the “lives” and interests of the dead. (shrink)

In ‘Dilemma for Appeals to the Moral Significance of Birth’, we argued that a dilemma is faced by those who believe that birth is the event at which infanticide is ruled out. Those who reject the moral permissibility of infanticide by appeal to the moral significance of birth must either accept the moral permissibility of a late-term abortion for a non-therapeutic reason or not. If they accept it, they need to account for the strong intuition that her decision is wrong (...) as well as deny the underlying normative principle that killing a viable fetus requires good reason, and not wanting to care for the child when the child could be easily placed for adoption is not a good enough reason to abort. If they reject the moral permissibility of the late-term abortion, they need to explain why her decision is wrong. Doing so, however, will undermine their own project of denying infanticide by appeal to birth. Walter Veit argues that the dilemma relies too much on intuition and does not live up to biological continuity. We explain why his criticisms are unconvincing. (shrink)

Joshua Mezrich is a practicing transplant surgeon who draws on his experiences, and those of his patients, to provide a "here's where we're at" moment in the story of transplant medicine. In so doing, he explains what it is like to practice while telling the stories of his patients, donors, and the pioneering surgeons who persisted in the face of failure to make what Mezrich does a work of healing. Written for a popular audience, When Death Becomes Life is perhaps (...) the most accessible work yet on the modern history of organ transplantation and what the current "standard of care" actually looks like. Indeed, it rounds out a "trinity" of quality books about the transplant experience, this one from the surgeon's... (shrink)

Preclinical xenotransplantation research using genetically engineered pigs has begun to show some promising results and could one day offer a scalable means of addressing organ shortage. While it is a fundamental tenet of ethical human subject research that participants have a right to withdraw from research once enrolled, several scholars have argued that the right to withdraw from xenotransplant research should be suspended because of the public health risks posed by xenozoonotic transmission. Here, we present a comprehensive critical evaluation of (...) the claim that xenotransplant recipients should be required to waive their right to withdraw from lifelong biosurveillance. We conclude that if xenotransplantation requires participants to waive their right to withdraw, then clinical trials may not be justifiable, given the ethical and legal obstacles involved with doing so. Consequently, if clinical trials are permitted with a right to withdraw, then they may pose a significant public health risk. (shrink)

It is envisioned that one day xenotransplantation will bring about a future where transplantable organs can be safely and efficiently grown in transgenic pigs to help meet the global organ shortage. While recent advances have brought this future closer, worries remain about whether it will be beneficial overall. The unique challenges and risks posed to humans that arise from transplanting across the species barrier, in addition to the costs borne by non-human animals, has led some to question the value of (...) xenotransplantation altogether. In response, we defend the value of xenotransplantation research, because it can satisfy stringent welfare conditions on the permissibility of animal research and use. Along the way, we respond to the alleged concerns, and conclude that they do not currently warrant a cessation or a curtailing of xenotransplantation research. (shrink)

When one encounters disagreement about the truth of a factual claim from a trusted advisor who has access to all of one's evidence, should that move one in the direction of the advisor's view? Conciliatory views on disagreement say "yes, at least a little." Such views are extremely natural, but they can give incoherent advice when the issue under dispute is disagreement itself. So conciliatory views stand refuted. But despite first appearances, this makes no trouble for *partly* conciliatory views: views (...) that recommend giving ground in the face of disagreement about many matters, but not about disagreement itself. (shrink)

The claim of this paper is that the everyday functions of knowledge make most sense if we see knowledge as contrastive. That is, we can best understand how the concept does what it does by thinking in terms of a relation “a knows that p rather than q.” There is always a contrast with an alternative. Contrastive interpretations of knowledge, and objections to them, have become fairly common in recent philosophy. The version defended here is fairly mild in that there (...) is no suggestion that we cannot think in terms of a simpler not explicitly contrastive relation “a knows that p.” Some, for instance Schaffer (2005) and Karjalainen and Morton (2003), have hinted that this stronger possibility may be right. But all that I am arguing now is that facts that are easily expressed in contrastive terms are vital to understanding why we need the concept of knowledge. In a piece that is in some ways a companion to this one ("Contrastivism" in Duncan Pritchard and Sven Bernecker, eds. The Routledge Companion to Epistemology. Routledge 2010, 513-522), I give a general survey of theories of contrastive knowledge and the differences between them. (shrink)

Many favor representationalism about color experience. To a first approximation, this view holds that experiencing is like believing. In particular, like believing, experiencing is a matter of representing the world to be a certain way. Once you view color experience along these lines, you face a big question: do our color experiences represent the world as it really is? For instance, suppose you see a tomato. Representationalists claim that having an experience with this sensory character is necessarily connected with representing (...) a distinctive quality as pervading a round area out there in external space. Let us call it “sensible redness” to highlight the fact that the representation of this property is necessarily connected with the sensory character of the experience. Is this property, sensible redness, really co-instantiated with roundness out there in the space before you? (shrink)

In order to predict and explain behavior, one cannot specify the mental state of an agent merely by saying what information she possesses. Instead one must specify what information is available to an agent relative to various purposes. Specifying mental states in this way allows us to accommodate cases of imperfect recall, cognitive accomplishments involved in logical deduction, the mental states of confused or fragmented subjects, and the difference between propositional knowledge and know-how .

Some philosophical theories of the nature of color aim to respect a "common sense" conception of color: aligning with the common sense conception is supposed to speak in favor of a theory and conflicting with it is supposed to speak against a theory. In this paper, we argue that the idea of a "common sense" conception of color that philosophers of color have relied upon is overly simplistic. By drawing on experimental and historical evidence, we show how conceptions of color (...) vary along several dimensions and how even supposedly "core" components of the contemporary "common sense" conception of color are less stable than they have been thought to be. (shrink)

In this paper, I do a few things. I develop a (largely) empirical argument against naïve realism (Campbell, Martin, others) and for representationalism. I answer Papineau’s recent paper “Against Representationalism (about Experience)”. And I develop a new puzzle for representationalists.

Quantum mechanics is humanity's finest scientific achievement. It explains why the sun shines and how your eyes can see. It's the theory behind the LEDs in your phone and the nuclear hearts of space probes. Every physicist agrees quantum physics is spectacularly successful. But ask them what quantum physics means, and the result will be a brawl. At stake is the nature of the Universe itself. What does it mean for something to be real? What is the role of consciousness (...) in the Universe? And do quantum rules apply to very small objects like electrons and protons, but not us? In What is Real?, Adam Becker brings to vivid life the brave researchers whose quest for the truth led them to challenge Bohr: David Bohm, who picked up Einstein's mantle and sought to make quantum mechanics deterministic, all while being hounded by the forces of McCarthyism; Hugh Everett, who argued that everything, big and small, must be governed by the same rules; and John Bell, who went to great lengths to eradicate the power of the god-like observer from the core of quantum physics. And they paid dearly, their reputations, careers, and sometimes lives ruined completely. But history has been kinder to them than their contemporaries were. As Becker shows, the brave intellectual giants have inspired a growing army of physicists and philosophers intent both on making a philosophically more satisfying theory of the universe and a more useful one as well. A gripping story of some of humanity's greatest ideas and the high cost with which many have pursued them, What is Real? is intellectual history at its passionate best. (shrink)

The Carol J. Adams Reader gathers together Adams's foundational and recent articles in the fields of critical studies, animal studies, media studies, vegan studies, ecofeminism and feminism, as well as relevant interviews and conversations in which Adams identifies key concepts and new developments in her decades-long work. This volume, a companion to The Sexual Politics of Meat (Bloomsbury Revelations), offers insight into a variety of urgent issues for our contemporary world: Why do batterers harm animals? What is the relationship between (...) genocide and attitudes toward other animals? How do activism and theory feed each other? How do race, gender, and species categories interact in strengthening oppressive attitudes? In clear language, Adams identifies the often hidden aspects of cultural presumptions. The essays and conversations found here capture the decades-long energy and vision that continue to shape new ways of thinking about and responding to oppression. (shrink)

How best to think about quantum systems under permutation invariance is a question that has received a great deal of attention in the literature. But very little attention has been paid to taking seriously the proposal that permutation invariance reflects a representational redundancy in the formalism. Under such a proposal, it is far from obvious how a constituent quantum system is represented. Consequently, it is also far from obvious how quantum systems compose to form assemblies, i.e. what is the formal (...) structure of their relations of parthood, overlap and fusion. In this paper, I explore one proposal for the case of fermions and their assemblies. According to this proposal, fermionic assemblies which are not entangled—in some heterodox, but natural sense of ‘entangled’—provide a prima facie counterexample to classical mereology. This result is puzzling; but, I argue, no more intolerable than any other available interpretative option. (shrink)

The problem of trust in social relationships was central to the emergence of the modern form of civil society and much discussed by social and political philosophers of the early modern period. Over the past few years, in response to the profound changes associated with postmodernity, trust has returned to the attention of political scientists, sociologists, economists, and public policy analysts. In this sequel to his widely admired book, The Idea of Civil Society, Adam Seligman analyzes trust as a (...) fundamental issue of our present social relationships. Setting his discussion in historical and intellectual context, Seligman asks whether trust--which many contemporary critics, from Robert Putnam through Francis Fukuyama, identify as essential in creating a cohesive society--can continue to serve this vital role. Seligman traverses a wide range of examples, from the minutiae of everyday manners to central problems of political and economic life, showing throughout how civility and trust are being displaced in contemporary life by new "external' system constraints inimical to the development of trust. Disturbingly, Seligman shows that trust is losing its unifying power precisely because the individual, long assumed to be the ultimate repository of rights and values, is being reduced to a sum of group identities and an abstract matrix of rules. The irony for Seligman is that, in becoming postmodern, we seem to be moving backward to a premodern condition in which group sanctions rather than trust are the basis of group life. (shrink)

Discusses recent work on representationalism, including: the case for a representationalist theory of consciousness, which explains consciousness in terms of content; rivals such as neurobiological type-type identity theory (Papineau, McLaughlin) and naive realism (Allen, Campbell, Brewer); John Campbell and David Papineau's recent objections to representationalism; the problem of the "laws of appearance"; externalist vs internalist versions of representationalism; the relation between representationalism and the mind-body problem.

The foundation for a system of morals, this 1749 work is a landmark of moral and political thought. Its highly original theories of conscience, moral judgment, and virtue offer a reconstruction of the Enlightenment concept of social science, embracing both political economy and theories of law and government.

A scholarly edition of a work by Adam Smith. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

This paper introduces a novel strategy for responding to skeptical arguments based on the epistemic possibility of error or lack of certainty. I show that a nonclassical logic motivated by recent work on epistemic modals can be used to render such skeptical arguments invalid. That is, one can grant that knowledge is incompatible with the possibility of error and grant that error is possible, all while avoiding the skeptic’s conclusion that we lack knowledge.

The book analyzes the sources of widespread dissatisfaction with democracies around the world and identifies directions for feasible reforms"--Provided by publisher.

This paper considers the possibility that ‘epistemic hypocrisy’ could be relevant to our blaming practices. It argues that agents who culpably violate an epistemic norm can lack the standing to blame other agents who culpably violate similar norms. After disentangling our criticism of epistemic hypocrites from various other fitting responses, and the different ways some norms can bear on the legitimacy of our blame, I argue that a commitment account of standing to blame allows us to understand our objections to (...) epistemic hypocrisy. Agents lack the epistemic standing to blame when they are not sufficiently committed to the epistemic norms they are blaming others for violating. This not only gives us a convincing account of epistemic standing to blame, it leaves us with a unified account of moral and epistemic standing. (shrink)

There are 1,000 of us and one victim. We each increase the level at which a "discomfort machine" operates on the victim---leading to great discomfort. Suppose that consecutive levels of the machine are so similar that the victim cannot distinguish them. Have we acted permissibly? According to the "no-difference argument" the answer is "yes" because each of our actions was guaranteed to make the victim no worse off. This argument is of interest because if it is sound, similar arguments threaten (...) intuitive moral verdicts about many cases in which a large number of individual choices cumulatively make a great difference, while each choice seems to make no difference on its own. But the argument is not sound, as is shown by a simple objection based on a plausible dominance principle---an objection that avoids challenges that have been brought against previous criticisms of the no difference argument. (shrink)

This book offers a novel account of grace, framed in terms of Bruno Latour's "principle of irreduction.

In January 1975, Michel Foucault contemplated the nature and formation of what in subsequent years he would come to know as governmentality. For Foucault, plague marks the rise of the invention of positive technologies of power, where these relations center around inclusion, multiplication, and security, rather than exclusion, negation, and rejection. In a point that might at first seem ancillary to his central argument, Foucault comments on stylized works about plague, such as those, according to the lecture series’ editors, exemplified (...) by Albert Camus. In footnote fifteen of the January 15, 1975 lecture, in reference to what Foucault deemed the “literary dream of” plagues, the editors list Camus’ 1947 novel La Peste, among other works, as representative of what Foucault described as “a kind of orgiastic dream in which plague is the moment when individuals come apart and when the law is forgotten.”. This article places Camus’ novel and other works in conversation with Foucault on governmentality, subjectivation, and truth to demonstrate the ways in which individualism itself can be viewed biopolitically. In so doing, it offers an urgent intervention that speaks powerfully to and is exemplified by the current global pandemic. Plague serves both as this literary dream and as a discursive mechanism engaged simultaneously with regimes of truth and the individuals constructing them. By pairing Foucault’s historical understanding of the invention of positive technologies of power with Camus’ treatment of “the absurd” in and out of the plague context, one uncovers the interrelation of governmentality, subjectivation, and truth. (shrink)

This thoughtful new abridgment is enriched by the brilliant commentary which accompanies it. In it, Laurence Dickey argues that the _Wealth of Nations_ contains--and conceals--a great deal of how Smith actually thought a commercial society works. Guided by his conviction that the so-called Adam Smith Problem--the relationship between ethics and economics in Smith's thinking--is a core element in the argument of the work itself, Dickey's commentary focuses on the devices Smith uses to ground his economics in broadly ethical and (...) social categories. An unparalleled guide to an often difficult and perplexing work. (shrink)

In this paper I attempt to address what appears to be a novel theoretical and practical problem concerning physician-assisted suicide (PAS). This problem arises out of a newly created set of circumstances in which persons are hospitalized in jurisdictions where PAS, though now legally available to patients, remains morally contentious. When moral disagreements over PAS come to divide physicians, patients, and family members, it is quite likely they will today find their way to the hospital’s consulting ethicist, a member of (...) an emerging group of professionals charged with the responsibility (so we are told) of resolving moral conflict in the clinic. What can or should an ethics consultant do to fulfill this mandate in such circumstances? I argue that the now predominant conception of clinical ethics consultation is importantly deficient in that it provides no final guidance to ethicists on how they should respond in such cases. The ethicist may only recommend—or assist others to reach—solutions to moral disagreements falling within the limits of established norms. Since the normative landscape of PAS appears to be changing, whether it falls within these limits is unsettled. I conclude that the accepted goals of ethics consultation require a revised and expanded conception of the ethicist's role in cases involving PAS. I close by outlining what that revised understanding would look like and the further questions it raises. (shrink)

“Moorean Dogmatist” responses to external world skepticism endorse courses of reasoning that many people find objectionable. This paper seeks to locate this dissatisfaction in considerations about epistemic responsibility. I sketch a theory of immediate warrant and show how it can be combined with plausible “inferential internalist” demands arising from considerations of epistemic responsibility. The resulting view endorses immediate perceptual warrant but forbids the sort of reasoning that “Moorean Dogmatism” would allow. A surprising result is that Dogmatism’s commitment to immediate epistemic (...) warrant isn’t enough to avoid certain standard arguments for skepticism about the external world. (shrink)

This chapter provides empirical evidence about everyday attitudes concerning euthanasia. These attitudes have important implications for some ethical arguments about euthanasia. Two experiments suggested that some different descriptions of euthanasia have modest effects on people’s moral permissibility judgments regarding euthanasia. Experiment 1 (N = 422) used two different types of materials (scenarios and scales) and found that describing euthanasia differently (‘euthanasia’, ‘aid in dying’, and ‘physician assisted suicide’) had modest effects (≈3 % of the total variance) on permissibility judgments. These (...) effects were largely replicated in Experiment 2 (N = 409). However, in Experiment 2, judgments about euthanasia’s moral permissibility were best predicted by the voluntariness of the treatment. Voluntariness was a stronger predictor than some demographic factors and some domain general elements of moral judgments. These results help inform some debates about the moral permissibility of euthanasia (e.g., the slippery slope argument) suggesting that some of the key premises of those arguments are unwarranted. (shrink)

This paper addresses ethical questions surrounding death given imagined but not unlikely technological advancements in the near future. For example, how will highly detailed interactive simulations of deceased personalities affect the way we deal with dying and interact with the dead? Most cultures have at least a vague sense of duties to the dead, and many of these duties are related to the memorial preservation of decedents. I worry that our advances might be paralleled by a deteriorating grasp of what (...) proper preservation is all about. With the phenomenological assistance of the 19th and 20th century philosophers Søren Kierkegaard, Martin Heidegger, and Jean-Paul Sartre, we can get a sense of some potential problems for what we ordinarily call ‘progress’. (shrink)