Bioethics represents a dramatic revision of the centuries-old professional ethics that governed the behavior of physicians and their relationships with patients. This venerable ethics code was challenged in the years after World War II by the remarkable advances in the biomedical sciences and medicine that raised questions about the definition of death, the use of life-support systems, organ transplantation, and reproductive interventions. In response, philosophers and theologians, lawyers and social scientists joined together with physicians and scientists to rethink and revise (...) the old standards. Governments established commissions to recommend policies. Courts heard arguments and legislatures passed laws. This book is the first broad history of the growing field of bioethics. Covering the period 1947-1987, it examines the origin and evolution of the debates over human experimentation, genetic engineering, organ transplantation, termination of life-sustaining treatment, and new reproductive technologies. It assesses the contributions of philosophy, theology, law and the social sciences to the expanding discourse of bioethics. Written by one of the field's founders, The Birth of Bioethics is based on extensive archival research into sources that are difficult to obtain and on interviews with many of the leading figures in the moral debates in medicine. A very readable and comprehensive account of the evolution of bioethics, this book stresses the history of ideas but does not neglect the social and cultural context and the people involved. It will serve the information needs of philosophers, ethicists, social historians, and everyone interested in the origins of some of today's most hotly debated issues. (shrink)

A physician says, "I have an ethical obligation never to cause the death of a patient," another responds, "My ethical obligation is to relieve pain even if the patient dies." The current argument over the role of physicians in assisting patients to die constantly refers to the ethical duties of the profession. References to the Hippocratic Oath are often heard. Many modern problems, from assisted suicide to accessible health care, raise questions about the traditional ethics of medicine and the medical (...) profession. However, few know what the traditional ethics are and how they came into being. This book provides a brief tour of the complex story of medical ethics evolved over centuries in both Western and Eastern culture. It sets this story in the social and cultural contexts in which the work of healing was practiced and suggests that, behind the many different perceptions about the ethical duties of physicians, certain themes appear constantly, and may be relevant to modern debates. The book begins with the Hippocratic medicine of ancient Greece, moves through the Middle Ages, Renaissance and Enlightenment in Europe, and the long history of Indian and Chinese medicine, ending as the problems raised modern medical science and technology challenge the settled ethics of the long tradition. (shrink)

The overall goal of this target article is to demonstrate a mechanism for an embodied cognition. The particular vehicle is a much-studied, but still widely debated phenomenon seen in 7–12 month-old-infants. In Piaget's classic “A-not-B error,” infants who have successfully uncovered a toy at location “A” continue to reach to that location even after they watch the toy hidden in a nearby location “B.” Here, we question the traditional explanations of the error as an indicator of infants' concepts of objects (...) or other static mental structures. Instead, we demonstrate that the A-not-B error and its previously puzzling contextual variations can be understood by the coupled dynamics of the ordinary processes of goal-directed actions: looking, planning, reaching, and remembering. We offer a formal dynamic theory and model based on cognitive embodiment that both simulates the known A-not-B effects and offers novel predictions that match new experimental results. The demonstration supports an embodied view by casting the mental events involved in perception, planning, deciding, and remembering in the same analogic dynamic language as that used to describe bodily movement, so that they may be continuously meshed. We maintain that this mesh is a pre-eminently cognitive act of “knowing” not only in infancy but also in everyday activities throughout the life span. Key Words: cognitive development; dynamical systems theory; embodied cognition; infant development; motor control; motor planning; perception and action. (shrink)

This essay focuses on how casuistry can become a useful technique of practical reasoning for the clinical ethicist or ethics consultant. Casuistry is defined, its relationship to rhetorical reasoning and its interpretation of cases, by employing three terms that, while they are not employed by the classical rhetoricians and casuists, conform, in a general way, to the features of their work. Those terms are (1) morphology, (2) taxonomy, (3) kinetics. The morphology of a case reveals the invariant structure of the (...) particular case whatever its contingent features, and also the invariant forms of argument relevant to any case of the same sort: these invariant features can be called topics. Taxonomy situates the instant case in a series of similar cases, allowing the similarities and differences between an instant case and a paradigm case to dictate the moral judgment about the instant case. This judgment is based, not merely on application of an ethical theory or principle, but upon the way in which circumstances and maxims appear in the morphology of the case itself and in comparison with other cases. Kinetics is an understanding of the way in which one case imparts a kind of moral movement to other cases, that is, different and sometimes unprecedented circumstances may move certain marginal or exceptional cases to the level of paradigm cases. In conclusion, casuistry is the exercise of prudential or practical reasoning in recognition of the relationship between maxims, circumstances and topics, as well as the relationship of paradigms to analogous cases. (shrink)

Reasoning about bedrock abstract concepts such as time, number, and valence relies on spatial metaphor and often on multiple spatial metaphors for a single concept. Previous research has documented, for instance, both future-in-front and future-to-right metaphors for time in English speakers. It is often assumed that these metaphors, which appear to have distinct experiential bases, remain distinct in online temporal reasoning. In two studies we demonstrate that, contra this assumption, people systematically combine these metaphors. Evidence for this combination was found (...) in both directly elicited and spontaneous co-speech gestures about time. These results provide first support for the hypothesis that the metaphorical representation of time, and perhaps other abstract domains as well, involves the continuous co-activation of multiple metaphors rather than the selection of only one. (shrink)

Abstract[I] want to single out one phenomenon that could be called the ‘politics of sources’. It points to the extent to which the histories that both scientists and historians can write are artifacts of the available sources. The Rockefeller Foundation not only opened its archives very early on for historical work but also invested a lot in making the archives readily available for historical exploration. During the 1980s, many young historians took advantage of this opportunity. Thus, in a relatively early (...) phase of the professional historiography of molecular biology, one could have gained the impression that the development of the new biology as a whole was a bio‐politically directed enterprise of the Rockefeller Foundation sustained by the vision that social processes could ultimately be controlled by biological processes. (shrink)

While we often talk about time using spatial terms, experimental investigation of space-time associations has focused primarily on the space in front of the participant. This has had two consequences: the disregard of the space behind the participant and the creation of potential task demands produced by spatialized manual button-presses. We introduce and test a new paradigm that uses auditory stimuli and vocal responses to address these issues. Participants made temporal judgments about deictic or sequential relationships presented auditorily along a (...) body-centered sagittal or transversal axis. Results involving the transversal axis replicated previous work while sagittal axis results were surprising. Deictic judgments did not use the sagittal axis but sequential judgments did, in a previously undocumented way. Participants associated earlier judgments with the space in front of them and later judgments with the space behind them. These findings, using a new approach, p.. (shrink)

Rebbetzin Esther Greenberg was famous throughout Israel as a mentor to countless women, including some of the best-known teachers and counselors.

This chapter surveys essentialist and anti-essentialist theories of sex and gender. It does so by engaging three approaches to sex and gender: externalism, internalism, and contextualism. The chapter also draws attention to two key debates about sex and gender in the feminist literature: the debate about the sex/gender distinction (the distinction debate) and the debate about whether sex and gender have essences (the essentialism/anti-essentialism debate). In addition, it describes three problems that theories of sex and gender tend to face: the (...) Inclusion Problem, the Definition Problem, and the Exclusion Problem. Lastly, the chapter highlights why the division between essentialist and anti-essentialist accounts of sex and gender is not clear. (shrink)

This paper enquires into the politics of real-time in online media. It suggests that real-time cannot be accounted for as a universal temporal frame in which events happen, but explores the making of real-time from a device perspective focusing on the temporalities of platforms. Based on an empirical study exploring the pace at which various online media produce new content, we trace the different rhythms, patterns or tempos created by the interplay of devices, users’ web activities and issues. What emerges (...) are distinct forms of ‘realtimeness’ which are not external from but specific to devices, organized through socio-technical arrangements and practices of use. Realtimeness thus unflattens more general accounts of the real-time web and research, and draws attention to the agencies built into specific platform temporalities and the political economies of making real-time. (shrink)

This commentary comprises three different responses to Counted and Zock’s article: “Place Spirituality: An Attachment Perspective.” The first response is from Esther Sternberg, MD, who gives a psychophysiological and neuroscience critique. The second is from Altaf Engineer, PhD, from the perspective of architecture and environmental psychology, and the last response is from Hester Oberman, PhD, who gives a psychology of religion rebuttal.

The link between oncogenesis and normal development is well illustrated by the study of the Wnt family of proteins. The first Wnt gene (int‐1) was identified over a decade ago as a proto‐oncogene, activated in response to proviral insertion of a mouse mammary tumor virus. Subsequently, the discovery that Drosophila wingless, a developmentally important gene, is homologous to int‐1 supported the notion that int‐1 may have a role in normal development. In the last few years it has been recognized that (...) int‐1 and Wingless belong to a large family of related glyco‐proteins found in vertebrates and invertebrates. In recognition of this, members of this family have been renamed Wnts, an amalgam of int and Wingless. Investigation of Wnt genes in Xenopus and mouse indicates that Wnts have a role in cell proliferation, differentiation and body axis formation. Further analysis in Drosophila has revealed that Wingless function is required in several developmental processes in the embryo and imaginal discs. In addition, a genetic approach has identified some of the molecules required for the transmission and reception of the Wingless signal. We will review recent data which have contributed to our growing understanding of the function and mechanism of Drosophila Wingless signaling in cell fate determination, growth and specification of pattern. (shrink)

Libertarians, like Thomas Reid, hold that motives do not causally necessitate our choices. The problem that arises is to explain how the agent decides to act according to one motive and not the other. In light of some objections brought up by Leibniz and Edwards but also by contemporary compatibilists such as Haji and Goetz, I examine Thomas Reid's possible answer to this problem. I argue that to explain our choices Reid would appeal not only to motives and character traits (...) but also to the amount of effort needed to choose what is best. I also address Reid's criticism of the implicit presupposition of the Principle of Suffi cient Reason. My aim is therefore to explore, clarify and defend Reid's account of agency in choicemaking. (shrink)

Book reviewed in this article: Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine. By Albert R. Jonsen, Mark Siegler, and William J. Winslade.

En Self-Constitution. Agency, Identity, and Integrity (2009), Christine Korsgaard defiende la conclusión de que el imperativo categórico rige la acción humana porque es el único principio que permite alcanzar la unidad psíquica plena, la cual, según Korsgaard, es un prerrequisito esencial para la acción efectiva. Para los agentes humanos, alcanzar esa unidad -que consiste en hacer coherentes distintos impulsos hacia la acción- es una actividad constante, denominada "autoconstitución". De acuerdo con Korsgaard, ésta es la fuente originaria de la normatividad y (...) de las identidades prácticas e incluso de la identidad personal. Después de exponer las ideas centrales del libro, presento dos objeciones: primero, critico la equiparación del imperativo categórico con la autoconstitución exitosa, pues no toda falla de auto-constitución es una falla moral. Segundo, argumento que la tesis de que la identidad personal es producto de la autoconstitución es problemática y que, al defenderla, Korsgaard confunde identidad práctica con identidad personal. In Self-Constitution. Agency, Identity, and Integrity (2009), Christine Korsgaard argues that the categorical imperative rules human action because it is the sole principle that allows us to reach the complete psychic unity that, Korsgaard thinks, is an essential prerequisite for effective action. Reaching this unity -which consists in making cohere diverging impulses for action- is for human agents a constant activity called "self-constitution." According to Korsgaard, this activity is the source of normativity, of human practical identities and even of personal identity. After explaining the main ideas of the book, I present two objections. First, I criticize the linkage of the categorical imperative to successful self-constitution, for not every failure of the latter counts as a moral failure. Second, I argue that the thesis that personal identity is a product of self-constitution is problematic and that it betrays a confusion between practical identity and personal identity. (shrink)

La adolescencia es un periodo crítico de la vida para el desarrollo de depresión. Durante este periodo la prevalencia de adolescentes que sufren trastornos depresivos aumenta considerablemente, debido a múltiples factores biológicos, sociales y psicológicos. Además entre los 14 y 18 años emergen importantes diferencias de género en depresión, de forma que al final de este periodo las tasas de depresión en las chicas llegan a doblar las observadas en los chicos (Hankin et al., 1998). Estas diferencias tenderán a mantenerse (...) a lo largo del ciclo vital. De este modo las estadísticas indican que en la vida adulta las mujeres experimentan el Trastorno Depresivo Mayor dos veces más que los hombres, siendo las diferencias aún mayores para el Trastorno Distímico. (shrink)

Article published in Stance by Wolfe and Grosz.

In this engaging study, the authors put casuistry into its historical context, tracing the origin of moral reasoning in antiquity, its peak during the sixteenth and early seventeenth century, and its subsequent fall into disrepute from the mid-seventeenth century.

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

Book reviewed in this article: The Abuse of Casuistry: A History of Moral Reasoning. By Albert R. Jonsen and Stephen Toulmin.

Whether mathematical truths are syntactical (as Rudolf Carnap claimed) or empirical (as Mill actually never claimed, though Carnap claimed that he did) might seem merely an academic topic. However, it becomes a practical concern as soon as we consider the role of questions. For if we inquire as to the truth of a mathematical statement, this question must be (in a certain respect) meaningless for Carnap, as its truth or falsity is certain in advance due to its purely syntactical (or (...) formal-semantical) nature. In contrast, for Mill such a question is as valid as any other. These differing views have their consequences for contemporary erotetic logic. (shrink)

: This paper discusses how Herbert Simon's initial interest in decision making became transformed into a focus on understanding human problem solving in response to the concrete conditions of the Cold War and the practical goals of the military. In particular, it suggests a connection between the seachange in Simon's interest and his shift in patronage. As a result, Simon is portrayed as a component of the scientific-military World War II cyborg that further evolved during the Cold War. Moving from (...) decision making to problem solving, Simon's cyborg science not only required large sums of money, but also managed to acquire these. (shrink)

In several jurisdictions, irremediable suffering from a medical condition is a legal requirement for access to assisted dying. According to the expressivist objection, allowing assisted dying for a specific group of persons, such as those with irremediable medical conditions, expresses the judgment that their lives are not worth living. While the expressivist objection has often been used to argue that assisted dying should not be legalised, I show that there is an alternative solution available to its proponents. An autonomy-based approach (...) to assisted suicide regards the provision of assisted suicide (but not euthanasia) as justified when it is autonomously requested by a person, irrespective of whether this is in her best interests. Such an approach has been put forward by a recent judgment of the German Federal Constitutional Court, which understands assisted suicide as an expression of the person’s right to a self-determined death. It does not allow for beneficence-based restrictions regarding the person’s suffering or medical diagnosis and therefore avoids the expressivist objection. I argue that on an autonomy-based approach, assisted suicide should not be understood as a medical procedure but rather as the person’s autonomous action. (shrink)

This article echoes those voices that demand new approaches and ‹senses’ for management education and business programs. Much of the article is focused on showing that the polemic about the educative model of business schools has moral and epistemological foundations and opens up the debate over the type of knowledge that practitioners need to possess in order to manage organizations, and how this knowledge can be taught in management programs. The article attempts to highlight the moral dimension of management through (...) a reinterpretation of the Aristotelian concept of practical wisdom. I defend the ideas that management is never morally neutral and that Aristotelian practical wisdom allows the recovery of moral considerations in management practice. I analyze the impact and implications that the introduction of practical wisdom in business schools entails for the conception and objectives of management education. This view reconfigures management education in terms of attention to values, virtues and context. Therefore, management programmes should prepare students to critically evaluate what they hear and to make decisions coherent with their values and virtues. In the final section, I reflect on the pedagogical implications of this approach. I point out that an integrated model of ethics and practical wisdom promotes education of cognition and education of affect as well. I provide an example to illustrate my perspective and to support my conclusions. (shrink)

The essays in this Special Section are about the ethics of Commercialism in Medicine. They are written, for the most part, by bioethicists, with the support of several prominent physicians and a health policy lawyer. This journal is, of course, devoted to ethics. Thus, our intent is to subject the question of commercialism in medicine to ethical scrutiny. Much has been written about commercialism in healthcare but very little about the ethics of commercialism in healthcare. One of our authors, Dr. (...) Jerome Kassirer, has encouraged a national dialogue about these issues. We hope to start that dialogue in the bioethical community and, through that community, into the nation. (shrink)

Many years ago, the esteemed patriarch of bioethics, Joseph Fletcher, spoke loud and clear in favor of rationality in reproduction. By rationality, he meant not merely limiting population growth, which he certainly favored, but bringing to bear human analytic and creative intelligence on the random and instinctive activities of sexual intercourse and procreation that we share with all mammals. In his 1974 book, The Ethics of Genetic Control: Ending Reproductive Roulette, he foresaw most of the issues that we are facing (...) today. He reflected on artificial insemination, prenatal diagnosis, cloning, eugenics, ectogenesis, ovum transfers, and genetic engineering. He examined these innovations to the extent that he felt that each of them represents a way of exercising rational and responsible control over life and reproduction. The subtitle of his book, “Ending Reproductive Roulette,” proclaims his faith. Dr. Fletcher's dedication to rationality led him to make the astonishing statement, “Man is a maker and the more rationally contrived and deliberate anything is, the more human it is. Therefore, laboratory reproduction is radically human compared to conception by ordinary heterosexual intercourse.”. (shrink)

The famous first aphorism of Hippocrates, "Life is short, the art is long" was long considered a perfect summary of medical ethics. Modern physicians find the words impossible to understand. But it can be interpreted as a fundamental insight into the ethical problems of modern medicine. The technology of modern scientific medicine can sustain life, even when life is losing its vitality. How should decisions be made about the use of technology and by whom? This is the incessant question of (...) modern medical ethics. (shrink)

We argue that mentalistic constructs like the “object concept” are not substitutes for process explanations of cognition, and that it is impossible to prove the existence of such constructs with behavioral tasks. We defend the field theory as an appropriate level for modeling embodiment. Finally, we discuss the model's biological plausibility and its extensions to other tasks and other species.

Pessimism over a democracy’s ability to produce good outcomes is as longstanding as democracy itself. On one hand, democratic theorists consider democracy to be the only legitimate form of government on the basis that it alone promotes or safeguards intrinsic values like freedom, equality, and justice. On the other, skepticism toward the ordinary citizen’s cognitive capacities remains a perennial concern. Qualms about the epistemic value of democracy have only been made more pertinent by a fundamental problem of deep epistemic disagreement (...) which underlies the post-truth phenomenon. I argue that the democratic theorists who have sought to defend democracy on epistemic grounds have thus far neglected such deep and intractable disagreements. Without addressing this oversight, the epistemic democrat will find that collective decision-making processes quickly become paralyzed and will not be able to yield the epistemic benefits they promise. Hence, the work for epistemic democrats is to recognize and take into account the ramifications of epistemic disagreements so as to make a stronger case for epistemic democracy. (shrink)

Interviews with female impersonators reveal the social, cultural, and economic aspects of their occupation and the subculture of the homosexual transvestite.

In a recent article, Wilkinson puts forward the notion of identity-relative paternalism. According to Wilkinson’s final formulation of this principle, ‘[i]ndividuals should be prevented from doing to future selves (where there are weakened prudential unity relations between the current and future self) what it would be justified to prevent them from doing to others’.1 In medical ethics, it is usually assumed that hard paternalism, that is, acting against a competent person’s wishes for their own benefit, is not justified. According to (...) Mill’s harm principle, we may only limit people’s freedom if they cause harm to others.2 Harm to self is not a sufficient reason for overriding competent persons’ decisions. Wilkinson, however, draws on Parfit’s reductionist view of personal identity to argue that sometimes, patients’ future selves are sufficiently disconnected from their present selves to treat future selves like different persons. If a competent person’s medical decision negatively affects a future self, this should be treated like a case of harm to others. Thus, overriding competent persons’ decisions in such cases—and treating them against their will—could be justified. In this commentary, I point out two problems with this approach. First, I demonstrate that the cases Wilkinson’s argument is based on are not examples of harm to others but rather cases of surrogate decision making gone wrong, …. (shrink)

This case study discusses the scope of responsibilities and the basis of legitimacy of multinational corporations in a complex operating environment. In January 2013 a precedent was set when Shell was held liable in The Hague for oil pollution in the Niger Delta. The landmark ruling climaxed the ongoing dispute over the scope of Shell’s responsibilities for both the company’s positive and negative impact. Shell’s was considered a forerunner in corporate social responsibility and had even assumed public responsibilities in a (...) context of a public responsibility void. However, the company remained a regular target of civil society activism and legal proceedings concerned with malpractice. The court case attracted international attention for its novelty and increasing media and civil society pressure required immediate action. How can Shell respond to this negative publicity to keep its license to operate? What is the scope of the company’s responsibilities in such a controversial human rights context? Students are expected to discuss these questions going beyond a simple moralistic or liability thinking. They are encouraged to take into account the complex structural processes that connect persons and institutions in very different social and geographical positions. The experiences of Shell are an excellent case in point since attention is drawn to the background conditions of globally operating companies, in which the isolation of perpetrators based on causality is not realistic. The case also reveals the particular challenges, which MNCs face in the context of increasing demands to take on public responsibilities while respecting their economic mandate. (shrink)

A formal Ethics Consultation Service (ECS) can provide significant help to patients, families and hospital staff. As with any other form of clinical consultation, documentation of the process and the advice rendered is very important. Upon review of the published consult documentation practices of other ECSs, we judged that none of them were sufficiently detailed or structured to meet the needs and purposes of a clinical ethics consultation. Thus, we decided to share our method in order to advance the practice (...) of ethics consultation. Here, we describe a method of ECS documentation practice, including use of a formal consult report template, as well as a log for maintaining a chronological record of the consultations performed. These two documents facilitate order and organisation of the ECS. They also enable the ECS to keep an account of professional time and experience, enable quick consult trend assessments (by consult theme or ward, for example) and establish a potential registry of consults for future research study. This method of documentation, we believe, not only contributes significantly to the primary purpose of the consultation—namely, the evincing and sharing of ethical opinion about a case—but also enables consultants to improve their practice and to pursue research on clinical ethics consultation. (shrink)

It is widely thought that knowledge is factive – only truths can be known. However, this view has been recently challenged. One challenge appeals to approximate truths. Wesley Buckwalter and John Turri argue that false-but-approximately-true propositions can be known. They provide experimental findings to show that their view enjoys intuitive support. In addition, they argue that we should reject the factive account of knowledge to avoid widespread skepticism. A second challenge, advanced by Nenad Popovic, appeals to multidimensional geometry to build (...) a case where it seems intuitive that a person knows p even though p is false. In addition, Popovic argues that we should reject the factive account of knowledge because most of us would not become widespread skeptics if we discovered that ordinary objects in our world are actually four-dimensional. In this paper, we defend the factive account of knowledge against these arguments by challenging the intuitive appeal of the cases and arguing that there is no real threat of widespread skepticism for the factive account of knowledge. (shrink)

Our world is under going an enormous digital transformation. Nearly no area of our social, informational, political, economic, cultural, and biological spheres are left unchanged. What can philosophy contribute as we try to under- stand and think through these changes? How does digitization challenge past ideas of who we are and where we are headed? Where does it leave our ethical aspirations and cherished ideals of democracy, equality, privacy, trust, freedom, and social embeddedness? Who gets to decide, control, and harness (...) the powers of digitization and for which purposes? Epistemologically, do most of us understand these new mediations – and thus fabrics – of our new world? Lastly – how is the new technological landscape shaping not only our living conditions but also our collective imaginary and our self-identities? (shrink)