Current bioethical debate is bizarre because it concentrates on exceptional cases while it does not pay attention to underlying value perspectives that determine the agenda of the debate.

This is an exciting time for brain science. Recent progress has been such that it now seems realistic to look toward an explanation of mind in terms of the brain's anatomy and physiology. Models based on artificially symmetrical arrays of idealized neurons are now being superseded by ones which properly take into account the brain's actual circuitry. This book presents a comprehensive overview of the current state of brain modeling, containing contributions from many leading researchers in this field. It will (...) be of interest not only to researchers in the fields of brain science and neurobiology, but also to psychologists and those involved in the study of artificial intelligence. (shrink)

In this paper, I offer a view beyond that which would narrowly reduce the role of parents in medical decision making to acting as custodians of the best interests of children and toward an account of family authority and family autonomy. As a fundamental social unit, the good of the family is usually appreciated, at least in part, in terms of its ability successfully to instantiate its core moral and cultural understandings as well as to pass on such commitments to (...) future generations. The putative rights of children to expression, information, freedom of thought, conscience, religion, and to freedom of association with others are, in this essay, assessed from the perspective of those conditions necessary for the family to function as a moral community. In so doing, I respond to the move to liberate children from parental authority and to effect the transformation of the family as implied by the United Nations’ "Convention on the Rights of the Child" and the pediatric bioethics it supports. (shrink)

In Roper v. Simmons (2005) the United States Supreme Court announced a paradigm shift in jurisprudence. Drawing specifically on mounting scientific evidence that adolescents are qualitatively different from adults in their decision-making capacities, the Supreme Court recognized that adolescents are not adults in all but age. The Court concluded that the overwhelming weight of the psychological and neurophysiological data regarding brain maturation supports the conclusion that adolescents are qualitatively different types of agents than adult persons. The Supreme Court further solidified (...) its position regarding adolescents as less than fully mature and responsible decisionmakers in Graham v. Florida (2010) and Miller v. Alabama (2012). In each case, the Court concluded that the scientific evidence does not support the conclusion that children under 18 years of age possess adult capacities for personal agency, rationality, and mature choice. This study explores the implications of the Supreme Court decisions in Roper v. Simmons, Graham v. Florida, and Miller v. Alabama for the “mature minor” standard for medical decision making. It argues that the Supreme Court’s holdings in Roper, Graham, and Miller require no less than a radical reassessment of how healthcare institutions, courts of law, and public policy are obliged to regard minors as medical decisionmakers. The “mature minor” standard for medical decision making must be abandoned. (shrink)

The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assigned it by strong anti-paternalists. (...) This weight is sufficient, in their estimation, to justify honouring the patient's refusal. There is thus a tension between the strong anti-paternalist's commitment to the sufficiency of autonomy and our intuitions respecting such cases. Attempts can be made to relieve this tension, such as arguing that patients aren't really rational in the circumstances envisaged, or that other values, such as privacy or bodily integrity, if added to autonomy, are sufficient to justify an anti-paternalistic stance. All such attempts fail, however. But what does not fail is the addition of religious freedom, freedom respecting a patient's religious beliefs and values. Why religious freedom reduces the tension is then explained, and the specialness of religious beliefs and values examined. (shrink)

In Kidney for Sale by Owner: Human Organs, Transplantation, and the Market, I argued that the market is the most efficient and effective—and morally justified—means of procuring and allocating human organs for transplantation. This special issue of The Journal of Medicine and Philosophy publishes several articles critical of this position and of my arguments mustered in its support. In this essay, I explore the core criticisms these authors raise against my conclusions. I argue that clinging to comfortable, but unfounded, notions (...) that human body parts are not commodities, that the physician-patient relationship transcends commercial practices, and that medicine rises above market-place morality (where “market-place morality” is presented rhetorically as a criticism) leads to a real failure adequately to appreciate the complex reality of modern medicine. Denying the illicit moral intuitions that commodification of body parts is immoral or that it necessarily violates human dignity would benefit donors and recipients alike, while also reinforcing virtuous transplantation practice and policy. Honestly acknowledging the medical marketplace would shed light on what is often a hazy and shrouded policy setting. At stake is not solely the efficiency of procuring human organs for transplantation but also the recognition of the moral authority of persons over themselves. (shrink)

Neuroethics has developed rapidly, driven in large part by developments in neuroscience. This article reviews neuroethics from the standpoint of its growing real-world relevance. It opens up with an analysis of the history of neuroscience that suggests the reason for the emergence of neuroethics now, in the early twenty-first century. It proceeds to survey current applications of neuroscience to diverse real-world problems. Published research in the field of neuromarketing is more focused on academic issues, such as the nature of the (...) brain activity underlying consumer behavior and the accuracy of brain-behavior predictions, than it is on the real-world utility of neuromarketing for improving business. Finally, this article concludes with a discussion of the ethical issues raised by these developments, and outlines three general challenges for society in the age of neuroscience. (shrink)

Truth of x (independently of any description of x) that it is f. A property f which holds of x but is not per se of x is said to hold per accidens of x. The essence of an individual is the sum of its per se properties. We can formulate the following: doctrine a: concrete individuals do not have essences though abstract entities do. Doctrine b: concrete individuals have essences but they do not individuate, whereas abstract entities have essences (...) which do individuate. Assumption i: we shall say that a thing exists insofar as it has an essence. Assumption ii: we shall say that we know a thing when we know what its per se properties are. We argue that plato held doctrine a and aristotle doctrine b (with assumptions i and ii). (edited). (shrink)

(No abstract is available for this citation).

This article discusses the argument we cannot have knowledge of abstract entities because they are not part of the causal order. The claim of this article is that the argument fails because of equivocation. Assume that the “causal order” is concerned with contingent facts involving time and space. Even if the existence of abstract entities is not contingent and does not involve time or space it does not follow that no truths about abstract entities are contingent or involve time or (...) space. I argue that it is the latter which is required to obtain the desired conclusion. (shrink)

Individuals make decisions under uncertainty every day. Decisions are based on in- complete information concerning the potential outcome or the predicted likelihood with which events occur. In addition, individuals’ choices often deviate from the rational or mathematically objective solution. Accordingly, the dynamics of human decision making are difficult to capture using conventional, linear mathematical models. Here, we present data from a 2-choice task with variable risk between sure loss and risky loss to illustrate how a simple nonlinear dynamical system can (...) be employed to capture the dynamics of human decision making under uncertainty (i.e., multistability, bifurcations). We test the feasibility of this model quantitatively and demonstrate how the model can account for up to 86% of the observed choice behavior. The implications of using dynamical models for explaining the nonlin- ear complexities of human decision making are discussed as well as the degree to which the theory of nonlinear dynamical systems might offer an alternative framework for understanding human decision making processes. (shrink)

It has become almost commonplace to recognise that teaching is an embodied practice. Most analyses of teaching as embodied practice focus on the embodied nature of the teacher as subject. Here, we use Butler's concept of performativity to analyse the reiterated acts that are intelligible as—performatively constitute—teaching, rather of the teacher as subject. We suggest that this simultaneously helps explain the persistence of teaching as a narrow repertoire of actions recognisable as ‘teaching’, and the policing of conformity to teaching thus (...) embodied. However, like performatively accomplished subjectivity, this repertoire is unstable and ambiguous, and thus open to change and disruption. Moreover, teacher subjectivities may lead them to mobilise these possibilities of disruption. (shrink)

The United Nations Educational, Scientific, and Cultural Organization's (UNESCO) Universal Declaration on Bioethics and Human Rights announces a significant array of welfare entitlements—to personal health and health care, medicine, nutrition, water, improved living conditions, environmental protection, and so forth—as well as corresponding governmental duties to provide for such public health measures, though the simple expedient of announcing that such entitlements are “basic human rights.” The Universal Declaration provides no argument for the legitimacy of the sweeping governmental authority, taxation, and regulation (...) to create and impose such “rights.” As this paper explores that some action promotes a purported good, such as “health,” does not thereby make the action morally permissible. Just as there are moral limits on legitimate personal actions, there are also moral limits on legitimate governmental actions to promote purported goods, including health. A core question of any governmental regulation, therefore, is whether it is a legitimate application of moral political authority or an unauthorized act of state coercion. Pace UNESCO's wide-ranging assertions, this paper argues that promoting health only falls within the legitimate authority of governments in very narrowly defined circumstances. As the paper critically explores, at stake are foundational moral and political questions concerning the limits of governmental authority to intervene in the consensual interaction of persons. Imposing such duties on others, including citizens of a state through regulatory activity and taxation, must be justified, nonarbitrary, and demonstrably within the limits of moral political authority. UNESCO's assertions do not meet this burden of proof. (shrink)

Television medical dramas sometimes depict medical professionalism and bioethical issues, but their nature and extent are unclear. The authors systematically analysed the bioethical and professionalism content of one season each of Grey's Anatomy and House M.D., two of the most popular current television medical dramas. The results indicate that these programmes are rife with powerful portrayals of bioethical issues and egregious deviations from the norms of professionalism and contain exemplary depictions of professionalism to a much lesser degree.

This book critically analyses experiences with bioethics education in various countries across the world and identifies common challenges and interests. It presents ethics teaching experiences in nine different countries and the basic question of the goals of bioethics education. It addresses bioethics education in resource-poor countries, as the conditions and facilities are widely different, and set limits and provide challenges to bioethics educators. Further, the question of how bioethics education can be improved is explored by the contributors. Despite the volume (...) of journal publications agreement on bioethics education is rather limited. There are only few examples of core curricula, demonstrating consensus on the contents, goals, methods and assessment of teaching programs. We need ask: How can agreement on the best modalities of bioethics education be promoted? (shrink)

The growth of knowledge and its effects on the practice of medicine have been issues of philosophical and ethical interest for several decades and will remain so for many years to come. The outline of the present volume was conceived nearly three years ago. In 1987, a conference on this theme was held in Maastricht, the Netherlands, on the occasion of the founding of the European Society for Philosophy of Medicine and Health Care (ESPMH). Most of the chapters of this (...) book are derived from papers presented at that meeting, and for the purpose of editing the book Stuart Spicker, Ph. D., joined two founding members of ESPMH, Henk ten Have and Gerrit Kimsma. The three of them successfully brought together a number of interesting contribu tions to the theme, and ESPMH is grateful and proud to have initiated the production of this volume. The Society intends that annual meetings be held in different European countries on a rotating basis and to publish volumes related to these meetings whenever feasible. In 1988, the second conference was held in Aarhus, Denmark on "Values in Medical Decision Making and Resource Allocation in Health Care". In 1989, a meeting was held in Czestochowa, Poland, on "European Traditions in Philosophy of Medicine. From Brentano to Bieganski". It is hoped that these conferences and the books to be derived from them, will initiate a new European tradition, lasting well into the 21 st century! P. J. (shrink)

A truly Christian bioethics challenges the nature, substance, and application of secular morality, dividing Christians from non-Christians, accenting central moral differences, and providing content-full forthrightly Christian guidance for action. Consequently, Christian bioethics must be framed within the metaphysical and theological commitments of Traditional Christianity so as to provide proper orientation toward God. In contrast, secular bioethicists routinely present themselves as providing a universal bioethics acceptable to all reasonable and rational persons. Yet, such secular bioethicists habitually insert their own biases and (...) prejudices into their moral conclusions, ethical consultations, and political aspirations, without any real justification. As this article explores, the ideologically driven anti-Christian commitments, including commitments to human rights and social justice, embodied within contemporary bioethics routinely illustrate the increasing gap between the traditionally Christian and the devoutly secular, further deepening the culture wars. (shrink)

To comprehend pain, disease, death and suffering as being meaningful - beyond the firing of synapses, the collapse of human abilities, and the mere end of life - requires a context in which to evaluate essential connotations, as well as to place and integrate understandings. If pain and suffering are to have enduring significance, they must be situated within a nest of ontological background assumptions, standards of inquiry, and epistemological foundations. Where secular bioethics fails to give deep meaning to suffering, (...) Christian bioethics succeeds. This essay analyzes the divergent meanings of suffering endorsed by the various Christian religions as conceptualized through the different metaphysical, epistemological, and sociological assumptions of each religion. (shrink)

To many who develop and use free software, the GNU General Public License represents an embodiment of the meaning of free software. In this paper we examine the definition and meaning of free software in the context of three events surrounding the GNU General Public License. We use a case involving the GPU software project to establish the importance of Freedom 0 in the meaning of free software. We analyze version 3 of the GNU General Public License and conclude that (...) although a credible case can be made that the added restrictions are consistent with the definition of free software, the case requires subtle arguments. Strong arguments against the added restrictions are less subtle, and may therefore be more convincing to many users and developers. We also analyze the Affero General Public License and conclude that it is inconsistent with the definition of free software. (shrink)

The master-module theory of consciousness is considered in the light of experimental evidence that has emerged since the model was first published. It is found that these new results tend to strengthen the original hypothesis. It is also argued that the master module is involved in generation of the schemata previously postulated to be associated with consciousness . The recent discovery of attention-related activity in the thalamic intralaminar nuclei is taken to indicate that these structures constitute an important part of (...) the feedback loop which the theory conjectured to mediate thought. The theory is shown to lead to a remarkably simple rationalization of the cerebral cortex, and it offers explanations of attention, binocular rivalry and qualia. It also makes the surprising prediction that Broca's area might not exclusively serve speech. (shrink)

We suggest an equilibrium concept for a strategic model with a large number of players in which each player observes the actions of only a small number of the other players. The concept fits well situations in which each player treats his sample as a prediction of the distribution of actions in the entire population, and responds optimally to this prediction. We apply the concept to a strategic voting model and investigate the conditions under which a centrist candidate can win (...) the popular vote although his strength in the population is smaller than the strengths of the right and left candidates.  2003 Elsevier Inc. All rights reserved. (shrink)

Individuals make decisions under uncertainty every day based on incomplete information concerning the potential outcome of the choice or chance levels. The choices individuals make often deviate from the rational or mathematically objective solution. Accordingly, the dynamics of human decision-making are difficult to capture using conventional, linear mathematical models. Here, we present data from a two-choice task with variable risk between sure loss and risky loss to illustrate how a simple nonlinear dynamical system can be employed to capture the dynamics (...) of human decision-making under uncertainty (i.e., multi-stability, bifurcations). We test the feasibility of this model quantitatively and demonstrate how the model can account for up to 86% of the observed choice behavior. The implications of using dynamical models for explaining the nonlinear complexities of human decision-making are discussed, as well as the degree to which nonlinear dynamical systems theory might offer an alternative framework for understanding human decision-making processes. (shrink)

This article raises three challenges to Richard McCormick's proportionalism. First, adequately to judge proportionate reason requires the specification of a particular background moral content and metaphysical context. Absent such specification, evaluation of proportionate reason is inherently and deeply ambiguous. Second, to resolve such ambiguity and yet remain Christian, proportionalism must adopt a forthrightly Christian moral content set within a straightforwardly Christian metaphysics. This move will, however, set Christian bioethics off as sectarian—a conclusion McCormick wishes to avoid. Third, even if proportionalism (...) were to adopt a Christian moral content and metaphysics to avoid such ambiguity, its methodology sets aside a key aspect of the Christian life: repentance. Proportionalism does not account for the core reality that repentance plays in one's personal encounter with and knowledge of God. As I will argue, the challenge in part is that moral action cannot be adequately conceptualized, nor can moral theology be properly understood, outside of the authentic practice of the religious life, and repentance is central to that Christian reality. (shrink)