Standard views on surrogate decision making present alternative ideal models of what ideal surrogates should consider in rendering a decision. They do not, however, explain the physician''s responsibility to a patient who lacks decisional capacity or how a physician should regard surrogates and surrogate decisions. The authors argue that it is critical to recognize the moral difference between a patient''s decisions and a surrogate''s and the professional responsibilities implied by that distinction. In every case involving a patient who lacks decisional (...) capacity, physicians and the treatment team have to make judgments about the appropriateness of both the surrogate and the surrogate''s decision. They have to assess the surrogate''s decisional capacity and attitude toward the patient as well as the reasons that support the surrogate''s decision. This paper provides a model for acceptable surrogate decisions and a standard for blocking inappropriate surrogates. Only decisions based on widely shared reasons are allowable for surrogate refusal of highly beneficial treatment. (shrink)
I would like to present the details of an actual case from my own experience over which I, along with the family, have agonized. I think this case brings into focus some of the unique issues in perinatal medicine where multiple patients, some real and some potential, can enter into a single decision. I hope that through this presentation others may gain insight into the complexities of applied ethics in perinatal medicine.
There is nothing more humbling to one’s inner moral compass than to realize that you do not initially know what is right or wrong! I found myself in just such a situation after reading the above case. Much has been written, both in the professional literature and the popular media, about the “Ashley Treatment” since Gunther and Diekema published their article in 2006. It is unclear if others in the United States or around the world have, to any significant degree, (...) adopted growth attenuation therapy and/or surgical intervention for children with severe neurological compromise, but the case quoted above suggests that hospital ethics committees may also be struggling with these decisions. An informal survey of pediatric endocrinologists, mentioned in a recent article on the topic, claims that many physicians are facing this dilemma as well. (shrink)
The rosy dawn of my title refers to that optimistic time when the logical concept of a natural kind originated in Victorian England. The scholastic twilight refers to the present state of affairs. I devote more space to dawn than twilight, because one basic problem was there from the start, and by now those origins have been forgotten. Philosophers have learned many things about classification from the tradition of natural kinds. But now it is in disarray and is unlikely to (...) be put back together again. My argument is less founded on objections to the numerous theories now in circulation, than on the sheer proliferation of incompatible views. There no longer exists what Bertrand Russell called ‘the doctrine of natural kinds’—one doctrine. Instead we have a slew of distinct analyses directed at unrelated projects. (shrink)
How is a person's freedom related to his or her preferences? Liberal theorists of negative freedom have generally taken the view that the desire of a person to do or not do something is irrelevant to the question of whether he is free to do it. Supporters of the “pure negative” conception of freedom have advocated this view in its starkest form: they maintain that a person is unfree to Φ if and only if he is prevented from Φ-ing by (...) the conduct or dispositions of some other person. This definition of freedom is value-neutral in the sense that no reference is made to preferences over options or indeed to any other indicators of the values of options, either in the characterization of “Φ-ing” itself or in the characterization of the way in which Φ-ing can be constrained. (shrink)
From the time of its clearest origins with Pascal, the theory of probabilities seemed to offer means by which the study of human affairs might be reduced to the same kind of mathematical discipline that was already being achieved in the study of nature. Condorcet is to a great extent merely representative of the philosophers of the seventeenth and eighteenth centuries who were led on by the prospect of developing moral and political sciences on the pattern of the natural sciences, (...) specifically physics. The development of economics and the social sciences, from the eighteenth century onwards, may be said in part to have fulfilled and in a manner to have perpetuated these ambitions. In so far as the new sciences have been susceptible of mathematical treatment, this has not been confined to the calculus of probabilities. But there is a temptation at every stage to ascribe fundamental significance and universal applicability to each latest mathematical device that is strikingly useful or illuminating on its first introduction. It is the theory of games that enjoys this position at present, and shapes the common contemporary conception of the very same problems that preoccupied Condorcet. (shrink)
In the first part of chapter 2 of book II of the Physics Aristotle addresses the issue of the difference between mathematics and physics. In the course of his discussion he says some things about astronomy and the ‘ ‘ more physical branches of mathematics”. In this paper I discuss historical issues concerning the text, translation, and interpretation of the passage, focusing on two cruxes, the first reference to astronomy at 193b25–26 and the reference to the more physical branches at 194a7–8. In (...) section I, I criticize Ross’s interpretation of the passage and point out that his alteration of has no warrant in the Greek manuscripts. In the next three sections I treat three other interpretations, all of which depart from Ross's: in section II that of Simplicius, which I commend; in section III that of Thomas Aquinas, which is importantly influenced by a mistranslation of, and in section IV that of Ibn Rushd, which is based on an Arabic text corresponding to that printed by Ross. In the concluding section of the paper I describe the modern history of the Greek text of our passage and translations of it from the early twelfth century until the appearance of Ross's text in 1936. (shrink)
Classical logic has been attacked by adherents of rival, anti-realist logical systems: Ian Rumfitt comes to its defence. He considers the nature of logic, and how to arbitrate between different logics. He argues that classical logic may dispense with the principle of bivalence, and may thus be liberated from the dead hand of classical semantics.
In this paper we argue that ill persons are particularly vulnerable to epistemic injustice in the sense articulated by Fricker. Ill persons are vulnerable to testimonial injustice through the presumptive attribution of characteristics like cognitive unreliability and emotional instability that downgrade the credibility of their testimonies. Ill persons are also vulnerable to hermeneutical injustice because many aspects of the experience of illness are difficult to understand and communicate and this often owes to gaps in collective hermeneutical resources. We then argue (...) that epistemic injustice arises in part owing to the epistemic privilege enjoyed by the practitioners and institutions of contemporary healthcare services—the former owing to their training, expertise, and third-person psychology, and the latter owing to their implicit privileging of certain styles of articulating and evidencing testimonies in ways that marginalise ill persons. We suggest that a phenomenological toolkit may be part of an effort to ameliorate epistemic injustice. (shrink)
There is, I gloomily suspect, little which is significantly new that remain to be said about psycho-analysis by philosophers. The almost profligate theorising that goes on within the psycho-analytic journals will, no doubt, continue unabated. It simply strikes me as unlikely that such theorising will generate further issues of the kind that excite the philosophical mind. Though in making such an observation, I recognise that I lay claim upon the future in a manner that many might believe to be unwise. (...) The place of psycho-analysis upon the intellectual map, the implications that psycho-analytic theory and practice have for the various kinds of judgements that we make about human behaviour, have been exhaustively discussed in recent times. Rather more specifically, whether psycho-analysis should be accorded the dignity of being labelled a ‘science’, what the significance is of psycho-analysis for those complex problems bounded by the notions of Reason, Freedom, Motivation, have occasioned much fruitful philosophical debate. It is not any wish of mine to add to the literature on these problems in the forlorn hope that even slightly different answers might be forthcoming. (shrink)
Was there an Enlightenment in Ireland? Was there even a distinctively Irish Enlightenment? Few scholars have bothered even to pose this question. Historians of Ireland during the era of Protestant Ascendancy have tended to be all-rounders rather than specialists; their traditional preoccupations are constitutional clashes between London and Dublin, religious conflict, agrarian unrest and popular politicization. With few exceptions there has been no tradition of intellectual history, and little interest in the methodological debates associated with the rise of the “Cambridge (...) school”. Most advances in our understanding of Irish philosophical writing have consequently originated outside Ireland's history departments. One by-product of recent work on the Scottish Enlightenment has been the rediscovery of the “Molesworth Circle” by two scholars engaged in a painstaking reconstruction of Francis Hutcheson's early career in Dublin. At the other end of the century, meanwhile, some of the most exciting and ambitious attempts to conceptualize the republicanism of the United Irishmen have come from a leading historian of revolutionary France, James Livesey. His previous research on the “commercial republicanism” of Montesquieu, Adam Ferguson and Brissot has suggested a new framework for understanding Irish radicals such as Wolfe Tone, Thomas Addis Emmet and, in particular, Arthur O'Connor. (shrink)
In days past, epistemologists expended a good deal of effort trying to analyze the basing relation—the relation between a belief and its basis. No satisfying account was offered, and the project was largely abandoned. Younger epistemologists, however, have begun to yearn for an adequate theory of basing. I aim to deliver one. After establishing some data and arguing that traditional accounts of basing are unsatisfying, I introduce a novel theory of the basing relation: the dispositional theory. It begins with the (...) pedestrian observation that beliefs stand or fall with their bases. The theory I offer is an elucidation and refinement of this thought. (shrink)
The analytical notion of ‘scientific style of reasoning’, introduced by Ian Hacking in the middle of the 1980s, has become widespread in the literature of the history and philosophy of science. However, scholars have rarely made explicit the philosophical assumptions and the research objectives underlying the notion of style: what are its philosophical roots? How does the notion of style fit into the area of research of historical epistemology? What does a comparison between Hacking’s project on styles of thinking and (...) other similar projects suggest? My aim in this paper is to answer these questions. Hacking has denied that his project of styles of thinking falls into the field of historical epistemology. I shall challenge his remark by tracing out the connections of the notion of style with historical epistemology and, more in general, with a tradition of thought born in France in the beginning of twentieth-century. (shrink)
In this paper, I lend credence to the move toward non-reductive religious epistemology by highlighting the systematic failings of Alvin Plantinga’s seminal, religious epistemology when it comes to surmounting the Gettier Problem. Taking Plantinga’s account as archetypal, I argue that we have systematic reasons to believe that no reductive theory of knowledge can viably surmount the Gettier Problem, that the future of religious epistemology lies in non-reductive models of knowledge.
Most contemporary theorists regard the traditional thesis that perception is essentially conscious as just another armchair edict to be abandoned in the wake of empirical discovery. Here I reconsider this dramatic departure from tradition. My aim is not to recapture our prelapsarian confidence that perception is inevitably conscious (though much I say might be recruited to that cause). Instead, I want to problematize the now ubiquitous belief in unconscious perception. The paper divides into two parts. Part One is more purely (...) philosophical. It explains how standard arguments for unconscious perception rely on contentious background assumptions concerning the relation between ordinary perception and the explanatory constructs of scientific psychology. Part Two, in contrast, offers detailed engagement with relevant empirical work. It exposes how, even setting aside the concerns identified in Part One, a dilemma confronts the believer in unconscious perception. This dilemma arises because ordinary perception is an individual-level state or occurrence, yet criteria sufficiently stringent to guarantee that a putatively perceptual state is unconscious vitiate the grounds for its attribution to the individual. The dilemma foments a hypothesis, namely that the conditions for genuine, individual-level perception are sufficient conditions for perceptual consciousness. The viability of this hypothesis should unnerve anyone who thinks unconscious perception is simply an empirical given. (shrink)
Philosophers have lately seized upon Sperling's partial report technique and subsequent work on iconic memory in support of controversial claims about perceptual experience, in particular that phenomenology overflows cognitive access. Drawing on mounting evidence concerning postdictive perception, I offer an interpretation of Sperling's data in terms of cue-sensitive experience which fails to support any such claims. Arguments for overflow based on change-detection paradigms (e.g. Landman et al., 2003; Sligte et al., 2008) cannot be blocked in this way. However, such paradigms (...) are fundamentally different from Sperling's and, for rather different reasons, equally fail to establish controversial claims about perceptual experience. (shrink)
Block () highlights two experimental studies of neglect patients which, he contends, provide ‘dramatic evidence’ for unconscious seeing. In Block's hands this is the highly non-trivial thesis that seeing of the same fundamental kind as ordinary conscious seeing can occur outside of phenomenal consciousness. Block's case for it provides an excellent opportunity to consider a large body of research on clinical syndromes widely held to evidence unconscious perception. I begin by considering in detail the two studies of neglect to which (...) Block appeals. I show why their interpretation as evidence of unconscious seeing faces a series of local difficulties. I then explain how, even bracketing these issues, a long-standing but overlooked problem concerning our criterion for consciousness problematizes the appeal to both studies. I explain why this problem is especially pressing for Block given his view that phenomenal consciousness overflows access consciousness. I further show that it is epidemic—not only affecting all report-based studies of unconscious seeing in neglect, but also analogous studies of the condition most often alleged to show unconscious seeing, namely blindsight. (shrink)
Religion and Science is a comprehensive examination of the major issues between science and religion in today's world. With the addition of three new historical chapters to the nine chapters (freshly revised and updated) of Religion in an Age of Science, winner of the Academy of Religion Award for Excellence in 1991, Religion and Science is the most authoritative and readable book on the subject, sure to be used by science and religion courses and discussion groups and to become the (...) introduction of choice for general readers. (shrink)
A growing number of authors defend putative examples of knowledge from falsehood (KFF), inferential knowledge based in a critical or essential way on false premises, and they argue that KFF has important implications for many areas of epistemology (whether evidence can be false, the Gettier debate, defeasibility theories of knowledge, etc.). I argue, however, that there is no KFF, because in any supposed example either the falsehood does not contribute to the knowledge or the subject lacks knowledge. In particular, I (...) show that if the subject actually has knowledge in putative KFF cases, then there is always a veridical evidential path meeting the basing conditions that accounts for her knowledge; if there is no such path, then the subject is in a type of Gettier case. All the recent arguments that rely on KFF are therefore based on a mistake. (shrink)
The problem at the heart of the faith/reason relationship can be set out as follows. Faith implies total commitment whilst reason requires a certain detachment. One cannot be totally committed yet rationally detached at the same time. Therefore faith and reason are two mutually exclusive approaches to religion. Alasdair MacIntyre in Whose Justice? Which Rationality? has offered a very interesting perspective on this problem. He has argued, albeit indirectly, that this faith/reason question is a modern problem generated by a certain (...) set of liberal and relativist presuppositions. This paper will summarize Maclntyre's contribution to the discussion, and then point to some of the inadequacies of his account. I will be arguing that commitment to a tradition is largely justified by internal explanations for disagreement. Faith seems to need an intolerant explanation for different traditions. Therefore, MacIntyre is, in fact, handling liberalized forms of the traditions. By tackling MacIntyre's work from the faith/reason angle, I hope to show certain more fundamental problems with his work. (shrink)
Philosophers have long struggled to understand our perceptual experience of temporal properties such as succession, persistence and change. Indeed, strikingly, a number have felt compelled to deny that we enjoy such experience. Philosophical puzzlement arises as a consequence of assuming that, if one experiences succession or temporal structure at all, then one experiences it at a moment. The two leading types of theory of temporal awareness—specious present theories and memory theories—are best understood as attempts to explain how temporal awareness is (...) possible within the constraints of this principle. I argue that the principle is false. Neither theory of temporal awareness can be made workable unless it is rejected. Our experience of temporal phenomena cannot be understood if we attempt to break experience down into instantaneous slices. In order to understand the perception of temporal properties we must look beyond the instant. (shrink)
Introductions to the theory of knowledge are plentiful, but none introduce students to the most recent debates that exercise contemporary philosophers. Ian Evans and Nicholas D. Smith aim to change that. Their book guides the reader through the standard theories of knowledge while simultaneously using these as a springboard to introduce current debates. Each chapter concludes with a “Current Trends” section pointing the reader to the best literature dominating current philosophical discussion. These include: the puzzle of reasonable disagreement; the so-called (...) “problem of easy knowledge”; the intellectual virtues; and new theories in the philosophy of language relating to knowledge. Chapters include discussions of skepticism, the truth condition, belief and acceptance, justification, internalism versus externalism, epistemic evaluation, and epistemic contextualism. Evans and Smith do not merely offer a review of existing theories and debates; they also offer a novel theory that takes seriously the claim that knowledge is not unique to humans. Surveying current scientific literature in animal ethology, they discover surprising sophistication and diversity in non-human cognition. In their final analysis the authors provide a unified account of knowledge that manages to respect and explain this diversity. They argue that animals know when they make appropriate use of the cognitive processes available to animals of that kind, in environments within which those processes are veridically well-adapted. _Knowledge_ is a lively and accessible volume, ideal for undergraduate and post-graduate students. It is also set to spark debate among scholars for its novel approaches to traditional topics and its thoroughgoing commitment to naturalism. (shrink)
It is often said that one person or society is `freer' than another, or that people have a right to equal freedom, or that freedom should be increased or even maximized. Such quantitative claims about freedom are of great importance to us, forming an essential part of our political discourse and theorizing. Yet their meaning has been surprisingly neglected by political philosophers until now. Ian Carter provides the first systematic account of the nature and importance of our judgements about degrees (...) of freedom. He begins with an analysis of the normative assumptions behind the claim that individuals are entitled to a measure of freedom, and then goes on to ask whether it is indeed conceptually possible to measure freedom. Adopting a coherentist approach, the author argues for a conception of freedom that not only reflects commonly held intuitions about who is freer than who but is also compatible with a liberal or freedom-based theory of justice. (shrink)
Democracy and justice are often mutually antagonistic ideas, but in this innovative book Ian Shapiro shows how and why they should be pursued together. Justice must be sought democratically if it is to garner legitimacy in the modern world, he claims, and democracy must be justice-promoting if it is to sustain allegiance over time. _Democratic Justice_ meets these criteria, offering an attractive vision of a practical path to a better future. Wherever power is exercised in human affairs, Shapiro argues, the (...) lack of democracy will be experienced as injustice. The challenge is to democratize social relations so as to diminish injustice, but to do this in ways that are compatible with people’s values and goals. Shapiro shows how this can be done in different phases of the human life cycle, from childhood through the adult worlds of work and domestic life, retirement, old age, and approaching death. He spells out the implications for pressing debates about authority over children, the law of marriage and divorce, population control, governing the firm, basic income guarantees, health insurance, retirement policies, and decisions made by and for the infirm elderly. This refreshing encounter between political philosophy and practical politics will interest all those who aspire to bequeath a more just world to our children than the one we have inherited. (shrink)
I introduce the concept pathophobia, to capture the range of morally objectionable forms of treatment to which somatically ill persons are subjected. After distinguishing this concept from sanism and ableism, I argue that the moral wrongs of pathophobia are best analysed using a framework of vice ethics. To that end I describe five clusters of pathophobic vices and failings, illustrating each with examples from three influential illness narratives.
This article offers two arguments for the conclusion that we should refuse on moral grounds to establish a human presence on the surface of Mars. The first argument appeals to a principle constraining the use of invasive or destructive techniques of scientific investigation. The second appeals to a principle governing appropriate human behavior in wilderness. These arguments are prefaced by two preliminary sections. The first preliminary section argues that authors working in space ethics have good reason to shift their focus (...) away from theory-based arguments in favor of arguments that develop in terms of pretheoretic beliefs. The second argues that of the popular justifications for sending humans to Mars only appeals to scientific curiosity can survive reflective scrutiny. (shrink)
Often we feel there is something odd about death, and especially about our own. This latter at least we often feel beyond our ken. Well, I think in a sense it may be; but in another, clearly is not. Among those who have felt this strangeness is Ramchandra Gandhi who, in an excellent recent work, The Availability of Religious Ideas , maintained – There is no difficulty in seeing that I cannot intelligibly conceive of my own death – the ceasing (...) to be, for good, of myself, my consciousness. I can conceive of temporary lapses into unconsciousness, always overcome by a return to consciousness. The difficulty is this: in asking myself the question 'What will it be like to be irreversibly unconscious?' , I want both to remain self-conscious and visualize actual loss of capacity for self-consciousness. This cannot be done. (shrink)
Amongst other countries, the Netherlands currently allows euthanasia, provided the physician performing the procedure adheres to a strict set of requirements. In 2016, Second Chamber member Pia Dijkstra submitted a law proposal which would also allow euthanasia without the reason necessarily having any medical foundation; euthanasia on the basis of a completed life. The debate on this topic has been ongoing for over two decades, but this law proposal has made the discussion much more immediate and concrete. This paper considers (...) the moral permissibility of Pia Dijkstra’s law proposal, focusing on the ethics of the implementation Dijkstra describes in her proposal. I argue that, at present, Dijkstra’s law proposal is unsuitable for implementation, due to a number of as of yet unaddressed problems, including the possible development of an ageist stigma and undue pressure on the profession of end-of-life coordinator. Perhaps adequate responses can be conceived to address these issues. However, the existence of a radically different, yet currently equally unacceptable position regarding the implementation of euthanasia for a completed life as proposed by fellow party member Paul Schnabel suggests it may be difficult to formulate an ethically acceptable implementation for this, in principle, ethically acceptable concept. (shrink)