Gilbert et al. argue that the concerns about the influence of Deep Brain Stimulation on – as they lump together – personality, identity, agency, autonomy, authenticity and the self are due to an ethics hype. They argue that there is only a small empirical base for an extended ethics debate. We will critically examine their claims and argue that Gilbert and colleagues do not show that the identity debate in DBS is a bubble, they in fact give very little evidence (...) for that. Rather they show the challenges of doing research in a field that is stretched out over multiple disciplines. In that sense their paper is an important starting point for a discussion on methodology and offers valuable lessons for a future research agenda. (shrink)

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At present, the debate on global justice, a debate which is at the core of global ethics, is largely being conducted by European and American scholars from different disciplines without taking into account views and concepts from other regions of the world, particularly, from the Global South. The lack of a truly intercultural, interreligious, and international exchange of ideas provokes doubts whether the concepts of global justice introduced so far are able to transcend regional and cultural horizons. The article introduces (...) concepts of justice from African scholars, whose voices have remained marginal until now, like the Kenyan philosopher Henry Odera Oruka, the Ethiopian philosopher Teodros Kiros, and the debate on ubuntu, one of the most controversial concepts in southern Africa today. These concepts focus on issues that are seldom considered in the debate on global justice, such as the importance of bodily needs as a prerequisite for human beings to act as moral beings and the importance of human rel.. (shrink)

People struggling with addiction are neither powerless over their addiction, nor are they fully in control. Lewis vigorously objects to the brain disease model of addiction, because it makes people lose belief in their self-efficacy, and hence hinders their recovery. Although he acknowledges that there is a compulsive state in addiction, he objects to the claim that this compulsion is carved in stone. Lewis argues that the BDMA underestimates the agency of addicted people, and hence hinder their recovery. Lewis’s work (...) offers us a very much to be welcomed neurobiology of recovery. It offers addicted people a hopeful and respectful narrative for their recovery that treats them as agents rather than as damaged brains. However, I argue that overestimating people’s agency can also result in people losing belief in their self-efficacy. Lewis’s strong focus on the agency of addicted people might not match their experiences of struggle, hence reinforcing their feelings of guilt when they fail to control their use. I propose to replace the notion of addiction as a disease with a notion of a disease-like stage in addiction. I call this stage the duress stage in addiction, in which the addictive behaviour is largely impervious to the agent’s values and to available techniques of self-control. However, the agent can overcome this stage by developing new techniques of self-control, by building on their self-concept and belief in self-efficacy, by changing their environments and habits, and by engaging in projects that are meaningful to the agent. (shrink)

Psychiatric classification, as exemplified by the Diagnostic and Statistical Manual of Mental Disorders, is dealing with a lack of trust and credibility—in the scientific, but also in the public realm. Regarding the latter in particular, one possible remedial measure for this crisis in trust lies in an increased integration of patients into the DSM revision process. The DSM, as a manual for clinical practice, is forced to make decisions that exceed available data and involve value-judgments. Regarding such decisions, public epistemic (...) trustworthiness requires that these value-judgments should be representative of those of the affected public, and that the public has a reason to believe such a representation to be realized. Due to the long tradition of distrust in psychiatry, such a reason can in this case best be provided by an actual integration of patients into the decision-making process, rather than by their representation through scientific experts. (shrink)

There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

When doing research among vulnerable populations, researchers are obliged to protect their subjects from harm. We will argue that traditional ethical guidelines are not sufficient to do this, since they mainly focus on direct harms that can occur: for example, issues around informed consent, fair recruitment and risk/harm analysis. However, research also entails indirect harms that remain largely unnoticed by research ethical committees and the research community. Indirect harms do not occur during data collection, but in the analysis of the (...) data, and how the data is presented to the scientific and wider societal community. Highly stigmatized research subjects, like substance‐dependent parents, are especially at risk of encountering indirect harm, because the prejudice against them is so persistent. In this paper we discuss two forms of indirect harm. First, researchers have to be aware how their results will be preceived by society. Even when subjects are presented in an objective way, further, out of porportion stigmatization can occur. Researchers sometimes try to counteract this by whitewashing their results, at the risk of downplaying their respondents’ problems. The second risk researchers face is that their own normative judgements influence how they question such parents, report results and interpret statements. Researchers’ own normative judgements may influence the way they present their subjects. This article reviews a broad range of research that exhibits such indirect harms, discussing how and why indirect harms occur and formulating corresponding recommendations on how to prevent them. (shrink)

This article critical examines Gilbert and colleagues’ study (Gilbert et al. 2017) claims on how deep brain stimulation (DBS) as a treatment for Parkinson’s disease (PD) can influence people’s self-concept.

This paper gives insight into the Islamic bioethical discussion on harvesting and using human embryonic and adult stem cells. It describes some of the Islamic legal mechanisms involved in the bioethical discourse among Muslims. As the contemporary Islamic bioethical discourse is very diverse, the paper focuses on the critical discussion of related resolutions of the Saudi-based Islamic Fiqh Academy due to the esteem in which the IFA is held in the Islamic world and the pertinence of their rulings on this (...) issue. This study discusses the different sources of human adult and embryonic stem cells and their use from an Islamic perspective, while questioning some directions the Islamic bioethical discourse has taken. The paper invites interested parties to deliberate the use of some of the legal means resorted to in the ongoing Islamic bioethical discourse. (shrink)

The need for a shift toward healthier and more sustainable diets is evident and is supported by universalized standards for a “planetary health diet” as recommended in the recent EAT-Lancet report. At the same time, differences exist in tastes, preferences and food practices among diverse ethnic groups, which becomes progressively relevant in light of Europe’s increasingly multi-ethnic cities. There is a growing tension between current sustainable diets standards and how diverse ethnic resident groups relate to it within their ‘culturally appropriate’ (...) foodways, raising questions around inclusion. What are dynamics of inclusiveness in migrant food practices? And what does this mean towards the transition to healthy and sustainable food? We study this question among Syrian migrants with different lengths of stay in the Netherlands. Our theoretical framework is based on practice theories, which emphasize the importance of socio-material context and of bodily routines and competences. We use qualitative methods, combining in-depth semi-structured life-history interviews with participant observation. Our findings indicate that inclusiveness takes different forms as migrants’ food practices and the food environment change. Regarding health and sustainability in food practices, understandings and competences around particularly fresh food change over time among both short- and long-term migrants, replacing making things from scratch with seasonal products with buying more processed products and out-of-season vegetables and fruits. We conclude that the performances of food practices and their configurations in food environments and lifestyles are dynamic and cannot unequivocally be interpreted as in- or exclusive, but that a more nuanced understanding is required. (shrink)

The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice (...) of Dutch independent midwives, however it is less clear and outspoken than in hospital policies. (shrink)

This article gives an overview of the influence of the work of Michel Foucault on the philosophy of Agamben. Discussed are Foucault’s influence on the Homo Sacer cycle, on (the development) of Agamben’s notion of power (and on his closely related notion of freedom and art of life), as well as on Agamben’s philosophy of language and methodology. While most commentaries focus on Agamben’s interpretation of Foucault’s concept of biopower, his work also contains many interesting references to Foucault on freedom (...) and possibilities—and I think that it is here that Foucault’s influence on Agamben is most deeply felt. This article focuses on the shifts Agamben takes while looking for the Entwicklungsfähigkeit in the work of Foucault. (shrink)

Gender-medicine has been very successful in discovering gaps in medical knowledge, disclosing biases in earlier research, and generating new results. It has superseded a more androcentric and sexist medicine. Yet, its development should not be understood in terms of a further approximation of value-freedom. Rather, it is a case of better value-laden science due to an enhanced pluralism in medicine and society. This interpretation is based on an account of the origins of gender-medicine in the feminist women’s health movement and (...) an analysis of the debate on inclusion of women in clinical trials. Consequently, the history of gender-medicine provides support for a procedural account of objectivity that stresses the importance of a diversity of perspectives. (shrink)

This research examines how the fit between employees moral development and the ethical work climate of their organization affects employee attitudes. Person-organization fit was assessed by matching individuals' level of cognitive moral development with the ethical climate of their organization. The influence of P-O fit on employee attitudes was assessed using a sample of 304 individuals from 73 organizations. In general, the findings support our predictions that fit between personal and organizational ethics is related to higher levels of commitment and (...) job satisfaction and lower levels of turnover intent. Ethical P-O fit was related to higher levels of affective commitment across all three ethical climate types. Job satisfaction was only associated with ethical P-O fit for one of the three P-O fit variables and turnover intentions were significantly associated with two of the ethical P-O fit variables. The most consistent effect was found for the Conventional - Caring fit variable, which was significantly related to all three attitudes assessed. The weakest effect was found for the Preconventional - Instrumental fit variable, which was only predictive of affective commitment. The pattern of findings and implications for practice and future research are discussed. (shrink)

Pickard (2012) claims that the neurobiological or disease model of addiction hinders the recovery of people because it undermines their feeling of self-efficacy and agency. Sub- stance users are “not aided by being treated as victims of a neurobiological disease, as opposed to agents of their own recovery” (40).Although Pickard acknowledges that claims of powerlessness or loss of agency can have a functional role in the self-narratives of substance users in excusing them from blame, she primarily focuses on the negative (...) effects of the diseasemodel on the recovery of substance users. Preliminary evidence from in-depth interviews with heroin-dependent participants in our current cohort study on addiction and moral identity supports Pickard’s claims in part: Substance users describe grades of control, psychological distress, and loss of options, and an ambivalent attitude toward their belief in self-efficacy. However the interviews also provide points of critique. While Pickard is right to dismiss the more extreme claims of proponents of the disease model—namely, that drug use in addicts is literally compelled—user responses suggest that an understanding of the neurobiology of addiction might in some respects support rather than undermine a sense of agency. Moreover, there is reason to suppose that the relation be- tween substance use and psychological distress is not as straightforward as Pickard claims. In this respect we believe the debate must become more nuanced and move beyond a simple opposition between the disease model and the rational choice model endorsed by Pickard. (shrink)

ABSTRACTThis is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task, an Emotional Visual Search Task, and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: (...) evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying... (shrink)

This research examines how the fit between employees moral development and the ethical work climate of their organization affects employee attitudes. Person-organization fit was assessed by matching individuals' level of cognitive moral development with the ethical climate of their organization. The influence of P-O fit on employee attitudes was assessed using a sample of 304 individuals from 73 organizations. In general, the findings support our predictions that fit between personal and organizational ethics is related to higher levels of commitment and (...) job satisfaction and lower levels of turnover intent. Ethical P-O fit was related to higher levels of affective commitment across all three ethical climate types. Job satisfaction was only associated with ethical P-O fit for one of the three P-O fit variables and turnover intentions were significantly associated with two of the ethical P-O fit variables. The most consistent effect was found for the Conventional - Caring fit variable, which was significantly related to all three attitudes assessed. The weakest effect was found for the Preconventional - Instrumental fit variable, which was only predictive of affective commitment. The pattern of findings and implications for practice and future research are discussed. (shrink)

Ethical thought experiments such as the trolley dilemma have been investigated extensively in the past, showing that humans act in utilitarian ways, trying to cause as little overall damage as possible. These trolley dilemmas have gained renewed attention over the past few years, especially due to the necessity of implementing moral decisions in autonomous driving vehicles. We conducted a set of experiments in which participants experienced modified trolley dilemmas as drivers in virtual reality environments. Participants had to make decisions between (...) driving in one of two lanes where different obstacles came into view. Eventually, the participants had to decide which of the objects they would crash into. Obstacles included a variety of human-like avatars of different ages and group sizes. Furthermore, the influence of sidewalks as potential safe harbors and a condition implicating self-sacrifice were tested. Results showed that participants, in general, decided in a utilitarian manner, sparing the highest number of avatars possible with a limited influence by the other variables. Derived from these findings, which are in line with the utilitarian approach in moral decision making, it will be argued for an obligatory ethics setting implemented in ADVs. (shrink)

This supplement serves a double purpose. It presents, on the one hand, a selection of papers devoted to the title question “How much philosophy in the philosophy of science?”. On the other hand, it signalizes the newly established cooperation between the German Society for the Philosophy of Science and the Journal for General Philosophy of Science .The GWP was founded in Hannover in 2011 and had its inaugural conference in March 2013 [for a report on the “GWP.2013” by H. Lyre (...) see EPSA Newsletter 2 2013]. The society was launched for several reasons. Albeit the German community of philosophers of science is quite large , it is at the same time a rather distributed and dispersed community. This has to do with the university landscape in Germany, which is dispersed rather t .. (shrink)

This paper seeks to advance our thinking about values and justice by studying the relationship between these constructs at the organizational level. We hypothesize that collective perceptions of moral values in organizational settings will influence collective perceptions of justice. Survey results from 619 individuals in 108 departments strongly support our hypothesis that collective values influence perceptions of both procedural and overall justice climate. We discuss these results, and their implications for thinking about relationships between moral values and justice at even (...) higher levels of analysis such as society overall. (shrink)

In this introduction we set out some salient themes that will help structure understanding of a complex set of intersecting issues discussed in this special issue on the work of Marc Lewis: conceptual foundations of the disease model, tolerating the disease model given socio-political environments, and A third wave: refining conceptualization of addiction in the light of Lewis’s model.

Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem (...) to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction. (shrink)

Historians have usually connected the presentation of nature as a part of natural history with the natural cabinet or the natural history museum. A closer look at travel and field work, however, shows that display of nature as a spatial concept and set of material conditions begins already in the first moment of collecting objects, specimens and economic information about a region. In 1720 Tsar Peter I of Russia sent the German physician Daniel Gottlieb Messerschmidt to Siberia to explore this (...) hitherto terra incognita. During his travels Messerschmidt established two main instruments for collecting data and things, which I shall describe as organizing, material principles for his field work: written lists and notes, and boxes and cases. An analysis of these material objects and their specific uses reveals the intellectual and practical traditions in which learned activities and strategies took place at the beginning of the eighteenth century. (shrink)

While there is an increased interest in describing attitudes of teachers, parents and peers towards students with special educational needs in regular education, there is a lack of knowledge about various variables relating to the attitudes of these three groups. The aims of this study are: (1) to examine which variables relate to the attitudes of teachers (N?=?44), parents (N?=?508) and peers (N?=?1113) towards students with Attention Deficit/Hyperactivity Disorder, Autistic Spectrum Syndrome or a cognitive disability in regular primary education and (...) (2) to examine whether teachers and parents? attitudes affect the attitudes of peers. An attitude survey was used to assess attitudes and data were analysed by means of multilevel analyses. The variables found in this study relating to attitudes can be used as a foundation to develop interventions to change attitudes. (shrink)

Neuroscientific findings have often been argued to undermine notions of free will and to require far-reaching changes of our political and legal systems. Making a difference between the metaphysical notion of free will and the political notion of autonomy,Dubljevi´c (2013) argues this switchover to be mistaken. While we appreciate attention to the social limits of neuroscientific findings, we also have a twofold concern with his proposal. The first covers the nontransparent way in which he either rejects or embraces certain scientific (...) findings, which renders the background andmotivation of his argument unclear. The second revolves around his idea of a “rational life-plan,” which, while it covers a person’s capacity to conform to social and external factors, misses out what it means to act for a reason or be the source of one’s actions. Revisiting the example of former addict Tommy McHugh and invoking the example of a resigned addict, we present the idea of an “autonomous life-plan,” which is metaphysically sound and practically relevant. (shrink)

Self-narrative is often, perhaps primarily, a tool of self- constitution, not of truth representation. We explore this theme with reference to our own recent qualitative interviews of substance-dependent agents. Narrative self- constitution, the process of realizing a valued narrative projection of oneself, depends on one’s narrative tracking truth to a certain extent. Therefore, insofar as narratives are successfully realized, they have a claim to being true, although a certain amount of self-deception typically comes along for the ride. We suggest that, (...) because agents typically value certain outcomes more highly than truth for truth’s sake, it makes sense to narrate in ways that aren’t strictly true if that helps ensure highly valued outcomes do come true. Walker (2012) outlines three ways of defending the truth of past-directed narratives, but the role of future-directed narratives in realizing highly valued truths provides her a fourth way. (shrink)

This paper starts from the presupposition that moral codes often do not suffice to make agents understand their moral responsibility. We will illustrate this statement with a concrete example of engineers who design a truck’s trailer and who do not think traffic safety is part of their responsibility. This opinion clashes with a common supposition that designers in fact should do all that is in their power to ensure safety in traffic. In our opinion this shows the need for a (...) moral philosophy that helps engineers to interpret their responsibility and think more critically about it. For this purpose we will explore the moral philosophy of Alasdair MacIntyre, which is particularly interesting because he locates the beginning of moral thinking in the daily practice of a profession. This is consistent with the history of moral codes, for codes are also the product of moral reflection by professionals. We will use MacIntyre’s philosophy to (1) explain what is wrong with the designers’ understanding of their responsibility and (2) show a possible way to bring their reflection to a more self-critical level. We will also inspect MacIntyre’s proposal critically. (shrink)

The significance of enset for thefood and livelihood security of ruralhouseholds in Southwestern Ethiopia, where thiscrop is the main staple, raises two majorquestions. The first concerns the relatedissues of household food security andlivelihood security and the contribution of theenset farming and food system in achievingthese. The second deals with the issue ofbiodiversity in enset cultivation. What roledoes biodiversity play in food and livelihoodsecurity and how is it perceived and measured?To answer the latter question, it is necessaryto look at the issue (...) of classification of ensetvarieties, comparing indigenous and scientificclassifications. In answering the questions, aninterdisciplinary approach is used, and bothetic and emic perspectives are applied. Agender perspective is applied as well becauseof the gendered division of labor in ensetcultivation and the gendered nature ofindigenous knowledge. The analysis draws mainlyon the findings of a recent study on ensetcultivation in Ethiopia [Negash PhD thesis,Wageningen University, The Netherlands]. Thefindings show that enset farming guaranteeshousehold food security to a large extent, butthat household livelihood security depends onthe cultivation of additional crops andhousehold ownership of livestock and otherassets. It was also found that maximizingdiversity in enset is of importance to farmers,and that the farmers' classification of ensetvarieties yields a finer grid than theclassification of enset clones on the basis ofmolecular analysis. (shrink)

The distinction between ‘disease’ and ‘illness’ has played an important role in the debate between naturalism and normativism. Both employ these notions, yet disagree on whether to assign priority to ‘disease’ or ‘illness’. I argue that this discussion suffers from implicit differences in the underlying interpretations: While for naturalists the distinction between ‘disease’ and ‘illness’ is one between a descriptive and a prescriptive notion, for normativists it is one between cause and effect. This discrepancy is connected to different interpretations of (...) priority, which also tend to be conflated in the debate. I disambiguate these different usages and develop a distinction between ‘disease’ and ‘illness’ that is theoretically neutral with regard to naturalism or normativism. Moreover, I propose a concept of heuristic priority that could serve as a common focus. This framework can avoid common confusions by providing a shared terminology and thereby help to make debates on disease-concepts more fruitful. (shrink)

This article presents estimates of the global cost of collective and interpersonal violence for the period of one year. This includes war, terrorism, homicides, assaults and domestic violence against women and children. The cost of conventionally defined interpersonal violence, that is, homicides and assault, are about 7.5 times higher than the cost due to war and terrorism. I also estimate the costs of non-fatal domestic violence against children and women and suggest that these costs are much higher than the combined (...) costs of homicide, assault, terrorism and war. The main reason is that the prevalence of these types of violence is very high: possibly as many as 16 per cent of all children are punished using violent methods and about 12 per cent of all women experience intimate partner violence. Richer societies have lower levels of violence, and there is evidence that prevalence rates have been declining over time. However, it is often unclear why this is the case. Much of the evidence from violence red... (shrink)

In this paper I will argue that liberal multiculturalism is neither a necessary nor a convincing extension of liberalism. In evaluating the two main strands of liberal multiculturalism, I will first analyse the approaches of Charles Taylor and Bhikhu Parekh as the main proponents of the version that focuses on the cultures themselves and raises the issue of the value of cultures in connection with public discourse. I will then turn to Amy Gutmann and Will Kymlicka as liberal multiculturalists who (...) use the liberal norm of individual equality as a starting point. I will show that the arguments adduced in favour of liberal multiculturalism fail, due to the following shortcomings. Taylor’s approach is underspecified with respect to the relationship between the process of evaluating cultures and its outcome. Gutmann’s theory fails to bridge the gaps between the individual, cultural belonging and positive duties of the state. Parekh’s and Kymlicka’s theories lead back to liberalism. I conclude that the idea of cultural difference has little of substance to add to the liberal view of social justice. (shrink)

In this paper I will analyze several cases from the American Civil War, the two World Wars and the American Vietnam War, and contemporary research in enhancement substance, to determine how drug use can be analyzed and understood in both physical and moral (ethical) terms. This will require a discussion of drug use at different levels. First, I will address the consequences of drug use for the physical and mental sanity of soldiers, during and after wartime, irrespective of the reason (...) for drug use. Second, I will look into the moral questions related to drug use for the enhancement of soldiers, that is, as a method for modern warfare. The moral dimension has at least two different angles: (i) the moral responsibility of superiors administering drugs to their inferiors who are exposed to the rule of full obedience, and (ii) the ethical consequences of enhancement for moral judgment by soldiers in the gray zone between acts of war and war crimes (the difference between the Super soldier and the Killing machine). (shrink)