This is a new edition of Joseph Fletcher's 1966 work that ignited a firestorm of controversy at the time of its publication.

In this wide-ranging study, Levine explores both sides of the mind-body dilemma, presenting the first book-length treatment of his highly influential ideas on the How does one explain the physical nature of an experience? This puzzle, the "explanatory gap" between mind and body, is the focus of this work by an influential scholar in the field.

Bottlenecks introduces a powerful new way of understanding equal opportunity. Rather than literal equalization, Joseph Fishkin argues that Americans ought to aim to broaden the range of opportunities open to people, at every stage in life, to pursue different paths.

The number of clinical trials for experimental brain implants continues to grow, and with this growth comes an increased reliance upon patients with treatment-refractory conditions to volunteer as...

Joseph Raz presents a penetrating exploration of the interdependence of value, reason, and the will. These essays illuminate a wide range of questions concerning fundamental aspects of human thought and action. Engaging Reason is a summation of many years of original, compelling, and influential work by a major contemporary philosopher.

Joseph Raz presents a penetrating exploration of the interdependence of value, reason, and the will. These essays illuminate a wide range of questions concerning fundamental aspects of human thought and action. Engaging Reason is a summation of many years of original, compelling, and influential work by a major contemporary philosopher.

What motives underlie the ways humans interact socially? Are these the same for all societies? Are these part of our nature, or influenced by our environments?Over the last decade, research in experimental economics has emphatically falsified the textbook representation of Homo economicus. Literally hundreds of experiments suggest that people care not only about their own material payoffs, but also about such things as fairness, equity and reciprocity. However, this research left fundamental questions unanswered: Are such social preferences stable components of (...) human nature; or, are they modulated by economic, social and cultural environments? Until now, experimental research could not address this question because virtually all subjects had been university students, and while there are cultural differences among student populations throughout the world, these differences are small compared to the full range of human social and cultural environments. A vast amount of ethnographic and historical research suggests that people's motives are influenced by economic, social, and cultural environments, yet such methods can only yield circumstantial evidence about human motives. Combining ethnographic and experimental approaches to fill this gap, this book breaks new ground in reporting the results of a large cross-cultural study aimed at determining the sources of social preferences that underlie the diversity of human sociality. The same experiments which provided evidence for social preferences among university students were performed in fifteen small-scale societies exhibiting a wide variety of social, economic and cultural conditions by experienced field researchers who had also done long-term ethnographic field work in these societies. The findings of these experiments demonstrated that no society in which experimental behaviour is consistent with the canonical model of self-interest. Indeed, results showed that the variation in behaviour is far greater than previously thought, and that the differences between societies in market integration and the importance of cooperation explain a substantial portion of this variation, which individual-level economic and demographic variables could not. Finally, the extent to which experimental play mirrors patterns of interaction found in everyday life is traced.The book starts with a succinct but substantive introduction to the use of game theory as an analytical tool and its use in the social sciences for the rigorous testing of hypotheses about fundamental aspects of social behaviour outside artificially constructed laboratories. The results of the fifteen case studies are summarized in a suggestive chapter about the scope of the project. (shrink)

Volume 20, Issue 3, March 2020, Page 44-46.

As scholars envision a new regulatory or statutory neurorights schema it is important to imagine unintended consequences if reforms are implemented before their implications are fully understood. This paper critically evaluates provisions proposed for a new Chilean Constitution and evaluates this movement against efforts to improve the diagnosis of, and treatment for, individuals with disorders of consciousness within the broader context of disability law, international human rights, and a capabilities approach to health justice as advanced by Amartya Sen and Martha (...) Nussbaum. Framed in this way, any neurorights regime would need to satisfy several criteria. First it would be obliged to balance both positive and negative rights in the furtherance of human capabilities. Second, it would need to be future oriented and informed about the science it sought to regulate and not fall prey to science fiction fantasies that remain ungrounded in reality. Third, it would need to be specific and avoid generalizations that would lead to conceptual confusion and litigation that could delay scientific progress. Finally, it would need to harmonize novel neurorights with long-established norms in international disability and human rights law. A failure to meet these criteria will destine any novel neurorights regime to the periphery. At this juncture Chile’s nascent constitutional venture into neurorights fails to satisfy these criteria. While there yet may be a role for a more capacious and bivalent articulation of neurorights that account for capabilities and precedent, the current Chilean neurorights reforms are vague and premature. As such they should undergo additional scholarly scrutiny and should not be adopted by other jurisdictions. (shrink)

The drive to describe cultural history as an evolutionary process has two sources. One from within social theory is part of the impetus to convert social studies into "social sciences" providing them with the status accorded to the natural sciences. The other comes from within biology and biological anthropology in the belief that the theory of evolution must be universal in its application to all functions of all living organisms. The social scientific theory of cultural evolution is pre-Darwinian, employing a (...) developmental model of unfolding characterized by intrinsic directionality, by definable stages that succeed each other and by some criterion of progress. It is arbitrary in its definitions of progress and has had the political problem that a diachronic claim of cultural progress implies a synchronic differential valuation of present-day cultures. The biological scheme creates an isomorphism between the Darwinian mechanism of evolution and cultural history, postulating rules of cultural "mutation", cultural inheritance and some mechanism of natural selection among cultural alternatives. It uses simplistic ad hoc notions of individual acculturation and of the differential survival and reproduction of cultural elements. It is unclear what useful work is done by substituting the metaphor of evolution for history. (shrink)

One of the most influential ideas in the field of business ethics has been the suggestion that ethical conduct in a business contextshould be analyzed in terms of a set of fiduciary obligations toward various “stakeholder” groups. Moral problems, according to this view, involve reconciling such obligations in cases where stakeholder groups have conflicting interests. The question posed in this paper is whether the stakeholder paradigm represents the most fruitful way of articulating the moral problems that arise in business. By (...) way of contrast, I outline two other possible approaches to business ethics: one, a more minimal conception, anchored in the notion of a fiduciary obligation toward shareholders; and the other, a broader conception, focused on the concept of market failure. I then argue that the latter offers a more satisfactory framework for the articulation of the social responsibilities of business. (shrink)

Consciousness is currently a thriving area of research in psychology and neuroscience. While this is often attributed to events that took place in the early 1990s, consciousness studies today are a continuation of research that started in the late 19th century and that continued throughout the 20th century. From the beginning, the effort built on studies of animals to reveal basic principles of brain organization and function, and of human patients to gain clues about consciousness itself. Particularly important and our (...) focus here is research in the 1950s, 1960s, and 1970s involving three groups of patients—amnesia, split brain, and blindsight. Across all three groups, a similar pattern of results was found—the patients could respond appropriately to stimuli that they denied seeing (or in the case of amnesiacs, having seen before). These studies paved the way for the current wave of research on consciousness. The field is, in fact, still grappling with the implications of the findings showing that the ability to consciously know and report the identity of a visual stimulus can be dissociated in the brain from the mechanisms that underlie the ability to behave in a meaningful way to the same stimulus. (shrink)

Moral values in healthcare range widely between interest groups and are principally subjective. Disagreements diminish dialogue and marginalize alternative viewpoints. Extremely premature births exemplify how discord becomes unproductive when conflicts of interest, cultural misunderstanding, constrained evidence review, and peculiar hierarchy compete without the balance of objective standards of reason. Accepting uncertainty, distributing risk fairly, and humbly acknowledging therapeutic limits are honorable traits, not relativism, and especially crucial in our world of constrained resources. We think dialogics engender a mutual understanding that: (...) i) transitions beliefs beyond bias, ii) moves conflict toward pragmatism (i.e., the truth of any position is verified by subsequent experience), and iii) recognizes value pluralism (i.e., human values are irreducibly diverse, conflicting, and ultimately incommensurable). This article provides a clear and useful Point-Counterpoint of extreme prematurity controversies, an objective neurodevelopmental outcomes table, and a dialogics exemplar to cultivate shared empathetic comprehension, not to create sides from which to choose. It is our goal to bridge the understanding gap within and between physicians and bioethicists. Dialogics accept competing relational interests as human nature, recognizing that ultimate solutions satisfactory to all are illusory, because every choice has downside. Nurturing a collective consciousness via dialogics and pragmatism is congenial to integrating objective evidence review and subjective moral-cultural sentiments, and is that rarest of ethical constructs, a means and an end. (shrink)

This book collects 13 papers that explore Wittgenstein's philosophy throughout the different stages of his career. The author writes from the viewpoint of critical rationalism. The tone of his analysis is friendly and appreciative yet critical. Of these papers, seven are on the background to the philosophy of Wittgenstein. Five papers examine different aspects of it: one on the philosophy of young Wittgenstein, one on his transitional period, and the final three on the philosophy of mature Wittgenstein, chiefly his Philosophical (...) Investigations. The last of these papers, which serves as the concluding chapter, concerns the analytical school of philosophy that grew chiefly under its influence. Wittgenstein’s posthumous Philosophical Investigations ignores formal languages while retaining the view of metaphysics as meaningless -- declaring that all languages are metaphysics-free. It was very popular in the middle of the twentieth century. Now it is passé. Wittgenstein had hoped to dissolve all philosophical disputes, yet he generated a new kind of dispute. His claim to have improved the philosophy of life is awkward just because he prevented philosophical discussion from the ability to achieve that: he cut the branch on which he was sitting. This, according to the author, is the most serious critique of Wittgenstein. (shrink)

This scarce antiquarian book is a facsimile reprint of the original. Due to its age, it may contain imperfections such as marks, notations, marginalia and flawed pages. Because we believe this work is culturally important, we have made it available as part of our commitment for protecting, preserving, and promoting the world's literature in affordable, high quality, modern editions that are true to the original work.

The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move (...) these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness. (shrink)

This Is A New Release Of The Original 1899 Edition.

This book reviews and integrates the most recent research and theories on this exciting topic, and features original contributions from leading researchers ...

While neuroethics is generally thought to be a modern addition to the broader field of bioethics, this subdiscipline has existed in clinical practice throughout the course of the 20th century. In this essay, Fins describes an older tradition of clinical neuroethics that featured such physician-humanists as Sir William Osler, Wilder Penfield, and Fred Plum, whose work and legacy exploring disorders of consciousness is highlighted. Their normative work was clinically grounded and focused on the needs of patients, in contrast to modern (...) neuroethics, which is more speculative and distant from the lived reality of the clinic. Using recent developments in the diagnosis and treatment of disorders of consciousness, and the history of the vegetative and minimally conscious states, Fins asks why modern neuroethics has taken this turn and what can be done to restore clinical neuroethics to a more proportionate place in the field. (shrink)

Scheduling surgical procedures among operating rooms is mistakenly regarded as merely a tedious administrative task. However, the growing demand for surgical care and finite hours in a day qualify OR time as a limited resource. Accordingly, the objective of this manuscript is to reframe the process of OR scheduling as an ethical dilemma of allocating scarce medical resources. Recommendations for ethical allocation of OR time—based on both familiar and novel ethical values—are provided for healthcare institutions and individual surgeons.

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

Taking a critical look at some of the recent controls over human life, health, and death, Fletcher draws a vivid picture of contemporary biological needs and ethical responsibility. Genetic engineering, fetal research, abortion, suicide, human experimentation, infanticide, and euthanasia are some of the issues explored.

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

From his long years of experience as a local executive until he was ushered into the presidency, Duterte was able to master the masses’ longings. He understands what the public expects in a leader-- gathered from information he collected in unorthodox fashion. He plunges into the grassroots even (at times) resorting to disguises; and sometimes he maintains his own intelligence group that feeds him necessary information. The shock that he generates in all corners, factions, sectors and even countries would qualify (...) him (perhaps) to be the unnamed monster that can disrupt the realm of Philippine politics. But despite his monstrous image, quite surprisingly, Duterte remains popular and appealing to the electorate. This essay foregrounds the ambivalent monster that the Philippine president wittingly or unwittingly assumes; a monster that is ready to devour victims while protecting those he (supposedly) loves. The essay argues that Duterte is a monster that represents a rapture—a kind of abrupt transition. He represents a monster leader that does not care about the elite’s and traditional pundits’ definition of a leader. He represents a leader that is hindi-iba (sa masa) but at the same time iba sa marami (trapo/traditional politicians). (shrink)

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

By considering the history of bioethics and international humanitarian law, Joseph J. Fins contends that bioethics as an academic and moral community should stand in solidarity with Ukraine as it defends freedom and civility.

I propose to analyze the concept of basing beliefs on reasons. The concept is an important one in understanamg the so-called "inferential" or "indirect" knowledge. After briefly stating the causal analyses of this concept given by D.M. Armstrong and Marshall Swain I will present two cases which show these analyses to be too strong and too weak. Finally, I will propose an analysis which avoids these twin difficulties.

The COVID-19 Pandemic a stress test for clinical medicine and medical ethics, with a confluence over questions of the proportionality of resuscitation. Drawing upon his experience as a clinical ethicist during the surge in New York City during the Spring of 2020, the author considers how attitudes regarding resuscitation have evolved since the inception of do-not-resuscitate orders decades ago. Sharing a personal narrative about a DNR quandry he encountered as a medical intern, the author considers the balance of patient rights (...) versus clinical discretion, warning about the risk of resurgent physician paternalism dressed up in the guise of a public health crisis. (shrink)

The literature on time perception is discussed. This is done with reference both to the ''cognitive-timer'' model for time estimation and to the subjective experience of apparent duration. Three assumptions underlying the model are scrutinized. I stress the strong interplay among attention, arousal, and time perception, which is at the base of the cognitive-timer model. It is suggested that a multiplicative function of two key components (the number of subjective time units and their size) should predict apparent duration. Implications for (...) other cognitive domains are drawn, and in particular an analogy is suggested between apparent duration and apparent movement. (shrink)

Ang kolektibong sanaysay na ito ay nagtatasa sa kalagayan at estado ng edukasyong pansining biswal sa mga piling pamantasan sa Pilipinas. Sakop ng papel ang mga sumusunod na paaralan: Politeknikong Unibersidad ng Pilipinas, De La Salle-Lipa, Mindanao State UniversityIligan Institute of Technology, at Notre Dame of Marbel University. Dalawang tanong ang tinangkang sagutin ng papel: Una, ano ang estado ng edukasyong pansining biswal sa mga piling pamantasan sa Pilipinas? Pangalawa, ano-ano ang mga posibleng solusyon sa mga suliranin na nakahahadlang sa (...) patuloy na pag-unlad ng edukasyong pansining biswal? Isinagawa ang panunuring dokumentaryo at pakikipanayam sa mga tagapangasiwa ng sining kultural at pangakademiko. Upang masagot at matalakay nang lubos ang katanungan, ang mga may-akda ay nagkaroon ng tuon sa dalawang parametro: panloob (pamamahalang pang-akademiko tulad ng pagtatalaga ng guro, paghahanda sa mga kagamitan at kasanayan,at kawalan ng tuon sa edukasyong pansining) at panlabas (suporta mula sa mga institusyong nasa labas ng pamantasan). Sa dulo ng papel, natuklasan ang mga karaniwang suliranin na kinahaharap ng mga pamantasang sakop ng papel-pananaliksik na ito; may mga payak na rekomendasyon ding pinanukala ang papel. (shrink)