The majority of Dutch physicians feel pressure when dealing with a request for euthanasia or physician-assisted suicide. This study aimed to explore the content of this pressure as experienced by general practitioners. We conducted semistructured in-depth interviews with 15 Dutch GPs, focusing on actual cases. The interviews were transcribed and analysed with use of the framework method. Six categories of pressure GPs experienced in dealing with EAS requests were revealed: emotional blackmail, control and direction by others, doubts about fulfilling the (...) criteria, counterpressure by patient’s relatives, time pressure around referred patients and organisational pressure. We conclude that the pressure can be attributable to the patient–physician relationship and/or the relationship between the physician and the patient’s relative, the inherent complexity of the decision itself and the circumstances under which the decision has to be made. To prevent physicians to cross their personal boundaries in dealing with EAS request all these different sources of pressure will have to be taken into account. (shrink)

Post-modernism offers a revolutionary approach to the study of society: in questioning the validity of modern science and the notion of objective knowledge, this movement discards history, rejects humanism, and resists any truth claims. In this comprehensive assessment of post-modernism, Pauline Rosenau traces its origins in the humanities and describes how its key concepts are today being applied to, and are restructuring, the social sciences. Serving as neither an opponent nor an apologist for the movement, she cuts through post-modernism's (...) often incomprehensible jargon in order to offer all readers a lucid exposition of its propositions. Rosenau shows how the post-modern challenge to reason and rational organization radiates across academic fields. For example, in psychology it questions the conscious, logical, coherent subject; in public administration it encourages a retreat from central planning and from reliance on specialists; in political science it calls into question the authority of hierarchical, bureaucratic decision-making structures that function in carefully defined spheres; in anthropology it inspires the protection of local, primitive cultures from First World attempts to reorganize them. In all of the social sciences, she argues, post-modernism repudiates representative democracy and plays havoc with the very meaning of "left-wing" and "right-wing." Rosenau also highlights how post-modernism has inspired a new generation of social movements, ranging from New Age sensitivities to Third World fundamentalism. In weighing its strengths and weaknesses, the author examines two major tendencies within post-modernism, the largely European, skeptical form and the predominantly Anglo-North-American form, which suggests alternative political, social, and cultural projects. She draws examples from anthropology, economics, geography, history, international relations, law, planning, political science, psychology, sociology, urban studies, and women's studies, and provides a glossary of post-modern terms to assist the uninitiated reader with special meanings not found in standard dictionaries. (shrink)

Paulin and Cahill‐Lane explore the origins of event processing and event prediction in animal evolution. They propose that the evolutionary benefit of being able to predict and thus to quickly react to anticipated events may have triggered the evolution of the earliest nervous systems.

Kant is famous for his universalist moral theory, which emphasizes human dignity, equality, and autonomy. Yet he also defended sexist and (until late in his life) racist views. In this essay, I address the question of how current readers of Kant should deal with Kant’s sexism and racism. I first provide a brief description of Kant’s views on sexual and racial hierarchies, and of the way they intersect. I then turn to the question of whether we should set aside Kant’s (...) sexism and racism or ‘translate’ his egalitarian principles into inegalitarian ones. I argue for a third position, namely, that we should highlight the tensions that pervade Kant’s theory. In the final section, I argue that the use of inclusive language and female pronouns in recent discussions of Kant’s moral and political philosophy carries significant risks. I end by articulating several preconditions for fruitfully using Kant’s moral principles to criticize sexism and racism. (shrink)

In the present book, Pauline Phemister argues against traditional Anglo-American interpretations of Leibniz as an idealist who conceives ultimate reality as a plurality of mind-like immaterial beings and for whom physical bodies are ultimately unreal and our perceptions of them illusory. Re-reading the texts without the prior assumption of idealism allows the more material aspects of Leibniz's metaphysics to emerge. Leibniz is found to advance a synthesis of idealism and materialism. His ontology posits indivisible, living, animal-like corporeal substances as (...) the real metaphysical constituents of the universe; his epistemology combines sense-experience and reason; and his ethics fuses confused perceptions and insensible appetites with distinct perceptions and rational choice. In the light of his sustained commitment to the reality of bodies, Phemister re-examines his dynamics, the doctrine of pre-established harmony and his views on freedom. The image of Leibniz as a rationalist philosopher who values activity and reason over passivity and sense-experience is replaced by the one of a philosopher who recognises that, in the created world, there can only be activity if there is also passivity; minds, souls and forms if there is also matter; good if there is evil; perfection if there is imperfection. (shrink)

This is the first comprehensive account of Kant’s cosmopolitanism, highlighting its moral, political, legal, economic, cultural, and psychological aspects. Contrasting Kant’s views with those of his German contemporaries, and relating them to current debates, Pauline Kleingeld sheds new light on texts that have been hitherto neglected or underestimated. In clear and carefully argued discussions, she shows that Kant’s philosophical cosmopolitanism underwent a radical transformation in the mid 1790s and that the resulting theory is philosophically stronger than is usually thought. (...) Using the work of figures such as Fichte, Cloots, Forster, Hegewisch, Wieland, and Novalis, Kleingeld analyzes Kant’s arguments regarding the relationship between cosmopolitanism and patriotism, the importance of states, the ideal of an international federation, cultural pluralism, race, global economic justice, and the psychological feasibility of the cosmopolitan ideal. In doing so, she reveals a broad spectrum of positions in cosmopolitan theory that are relevant to current discussions of cosmopolitanism. -/- TABLE OF CONTENTS: Acknowledgments; Abbreviations; Introduction; 1. World citizens in their own country: Wieland and Kant on moral cosmopolitanism and patriotism; 2. Universal republic of world citizens or international federation?: Cloots and Kant on global peace; 3. Global hospitality: Kant's concept of cosmopolitan right; 4. Hierarchy or diversity?: Forster and Kant on race, culture, and cosmopolitanism; 5. International trade and justice: Hegewisch and Kant on cosmopolitanism and globalization; 6. Cosmopolitanism and feeling: Novalis and Kant on the development of a universal human community; 7. Kant's cosmopolitanism and current philosophical debates; Bibliography; Index. (shrink)

Conversing happily with my son we had been driving home when my mobile phone rang. Startled at the sound of my obstetrician's voice I had pulled off to the side of the road. At 18 weeks gestation I was told in a factual tone that the results from my serum screen had come back, indicating that our baby was at increased risk of Trisomy 18. Gripping the steering wheel my head had spun as he talked, explaining that Trisomy 18 was (...) worse than Trisomy 21 because our baby was not going to live. We had been thrilled when we heard the news of my pregnancy but now my temples throbbed and tears brimmed in my eyes. Suddenly my world was turned upside down and it had felt like someone reached into my chest and ripped my heart out.My husband and I decided that an amniocentesis was needed for a positive diagnosis and this was arranged for the following day. Studiously the sonographer performed the diagnostic ultrasound with a furrow across his brow. Watching the monitor I saw my baby moving as I watched the colours of red and blue flow through the heart and heard the regular, fast rhythm of the heartbeat. Quietly I hoped that the news was good but the creased brow had told me otherwise. Holding the amniotic fluid in his right hand the sonographer had glanced from it to me and empathetically informed me that the news wasn't good and that he didn't need to send the sample off for a positive diagnosis. Once again my world was crashing and all I wanted to do was bury my head in a pillow and sob. The following weekend dragged and had been filled with streams of tears and emotional turmoil. All I wanted to …. (shrink)

Within Kantian ethics and Kant scholarship, it is widely assumed that autonomy consists in the self-legislation of the principle of morality. In this paper, we challenge this view on both textual and philosophical grounds. We argue that Kant never unequivocally claims that the Moral Law is self-legislated and that he is not philosophically committed to this claim by his overall conception of morality. Instead, the idea of autonomy concerns only substantive moral laws, such as the law that one ought not (...) to lie. We argue that autonomy, thus understood, does not have the paradoxical features widely associated with it. Rather, our account highlights a theoretical option that has been neglected in the current debate on whether Kant is best interpreted as a realist or a constructivist, namely that the Moral Law is an a priori principle of pure practical reason that neither requires nor admits of being grounded in anything else. (shrink)

In this essay, “The Principle of Autonomy in Kant’s Moral Theory: Its Rise and Fall,” Pauline Kleingeld notes that Kant’s Principle of Autonomy, which played a central role in both the Groundwork for the Metaphysics of Morals and the Critique of Practical Reason, disappeared by the time of the Metaphysics of Morals. She argues that its disappearance is due to significant changes in Kant’s political philosophy. The Principle of Autonomy states that one ought to act as if one were (...) giving universal laws through one’s maxims. The criterion of just legislation that Kant accepted in the mid-1780s does not require any actual consent on the part of the citizens—genuine universality is sufficient for a law to be just. Hence, at that time, Kant could indeed explicate the criterion governing the moral permissibility of one’s maxims by drawing an analogy with the criterion governing the justice of political laws. In the Metaphysics of Morals and in other works in the 1790s, however, he added the further condition that laws must be given with the consent of the citizens. With this further condition, the moral criterion was no longer fully analogous to the criterion for political laws being just. Accordingly, Kleingeld argues, Kant dropped the Principle of Autonomy, which was firmly based on that analogy. (shrink)

The Moral Self addresses the question of how morality enters into our lives. Pauline Chazan draws upon psychology, r ral philosophy and literary interpretation to rebut the view that morality's role is to limit desire and control self-love. Perserving the ancients' connection between what is good for the self and what is morally good, Chazan argues that a certain kind of care for the self is central to moral agency. Her intriguing argument begins with a critical examination of the (...) views of Hume, Rousseau and Hegel. The constructive part of the book takes a more unusual turn by synthesising the work on the analyst Heinz Kohut and Aristotle into Chazan's own positive account, which is then illustrated by the use of Russian literature. (shrink)

Hume’s account of how the self enters the moral domain and comes to a consciousness of itself as a moral being is one which he superimposes upon his Treatise account of the constitution of the non-metaphysical self. This primordial self is for Hume constructed out of the passions of pride and humility which are themselves in tum constructed out of certain feelings of pain and pleasure, these feelings being worked on by memory and imagination, and converted back and forth into (...) series of ideas and impressions. In presenting this account of the way in which we achieve a coherent self-awareness and self-knowledge such that we ‘know our own force’, Hurne in fact employs a radical psychology which he must discard once the moral self comes into view. The use Hume makes of this psychology has gone unnoticed in the literature, but once we understand its implications we will be able to dispel the confusion that some have found in his story. (shrink)

The prohibition on using others ‘merely as means’ is one of the best-known and most influential elements of Immanuel Kant’s moral theory. But it is widely regarded as impossible to specify with precision the conditions under which this prohibition is violated. On the basis of a re-examination of Kant’s texts, the article develops a novel account of the conditions for using someone ‘merely as a means’. It is argued that this account has not only strong textual support but also significant (...) philosophical advantages over alternative conceptions. (shrink)

Kant’s most prominent formulation of the Categorical Imperative, known as the Formula of Universal Law (FUL), is generally thought to demand that one act only on maxims that one can will as universal laws without this generating a contradiction. Kant's view is standardly summarized as requiring the 'universalizability' of one's maxims and described in terms of the distinction between 'contradictions in conception' and 'contradictions in the will'. Focusing on the underappreciated significance of the simultaneity condition included in the FUL, I (...) argue, by contrast, that the principle is better read as requiring that one be able to will two things simultaneously without self-contradiction, namely, that a maxim be one's own and that it be a universal law. This amounts to a new interpretation of the FUL with significant interpretive and philosophical advantages. (shrink)

'Autonomy' is originally a political notion. In this chapter, I argue that the political theory Kant defended while he was writing the _Groundwork_ sheds light on the difficulties that are commonly associated with his account of moral autonomy. I argue that Kant's account of the two-tiered structure of political legislation, in his _Feyerabend Lectures on Natural Law_, parallels his distinction between two levels of moral legislation, and that this helps to explain why Kant could regard the notion of 'autonomy' as (...) apt to express the principle of morality---at least in the mid 1780s. (shrink)

Brown, Pauline I recently came across an article by Meg Keneally in The Guardian. I can think of no better description of our policies and practices on immigration detention than the following extract: It's a well-worn solution to an intractable human problem involving a large group of inconvenient people - ship them off somewhere, put a wall around them, and try to forget about the whole thing. You could argue that our country was founded as a result of this (...) approach. You could also argue that we learned our lesson too well, because it's an approach we are still using when it comes to vulnerable people who have undertaken hazardous ocean journeys - and the outcomes are no more humane than they were in the 18th and 19th centuries. (shrink)

One of the most important difficulties facing Kant’s Formula of Universal Law (FUL) is its apparent inability to show that it is always impermissible to kill others for the sake of convenience. This difficulty has led current Kantian ethicists to de-emphasize the FUL or at least complement it with other Kantian principles when dealing with murder. The difficulty stems from the fact that the maxim of convenience killing fails to generate a ‘contradiction in conception’, producing only a ‘contradiction in the (...) will’ when subjected to the two-fold test associated with the FUL. This result is thought to imply that the FUL allows us sometimes to kill for the sake of convenience. In this essay, I argue that the very diagnosis of the problem rests on a mistake, and that if the maxim of convenience killing generates a contradiction in the will, then acting on it is never permissible. (shrink)

During the 1780s, as Kant was developing his universalistic moral theory, he published texts in which he defended the superiority of whites over non-whites. Whether commentators see this as evidence of inconsistent universalism or of consistent inegalitarianism, they generally assume that Kant's position on race remained stable during the 1780s and 1790s. Against this standard view, I argue on the basis of his texts that Kant radically changed his mind. I examine his 1780s race theory and his hierarchical conception of (...) the races, and subsequently address the question of the significance of these views, especially in the light of Kant's own ethical theory. I then show that during the 1790s Kant restricts the role of the concept of race, and drops his hierarchical account of the races in favour of a more genuinely egalitarian and cosmopolitan view. (shrink)

The Australian Army has adopted “respect” as a new addition to the existing trio of values, “courage, initiative and teamwork.” This article explores what respect may mean as an army value. The significance of respect surrounding two incidents involving Australian Defence Force personnel while on duty in Afghanistan is considered. The first is the so-called “green on blue” attack by an Afghan National Army soldier killing three Australian soldiers on 29 August 2012. The second concerns allegations of mutilation of suspected (...) Afghan insurgents’ corpses by soldiers attached to an Australian Special Forces Unit on 28 April 2013. The incidents have resulted in internal military investigations: in the second incident, with a view to possible prosecution for breach of the law of armed conflict and related disciplinary offences; and in the case of the green on blue attack, leading to a civilian coronial inquest. This article discusses the training and modelling of behaviour required to instil such a value as respect. (shrink)

This chapter proposes a solution to the Trolley Problem in terms of the Kantian prohibition on using a person ‘merely as a means.’ A solution of this type seems impossible due to the difficulties it is widely thought to encounter in the scenario known as the Loop case. The chapter offers a conception of ‘using merely as a means’ that explains the morally relevant difference between the classic Bystander and Footbridge cases. It then shows, contrary to the standard view, that (...) a bystander who diverts the trolley in the Loop case need not be using someone ‘merely as a means’ in doing so. This makes it possible to show why the Loop scenario does not undermine the explanation of the salient moral difference between the Bystander and Footbridge cases. (shrink)

In this seminal exploration of the nature and future of African philosophy, Paulin J. Hountondji attacks a myth popularized by ethnophilosophers such as Placide Temples and Alexis Kagame that there is an indigenous, collective African philosophy, separate and distinct from the Western philosophical tradition. Hountondji contends that ideological manifestations of this view that stress the uniqueness of the African experience are protonationalist reactions against colonialism conducted, paradoxically, in the terms of colonialist discourse.

Gottfried Achenwall, _Prolegomena to Natural Law_, ed. Pauline Kleingeld, trans. Corinna Vermeulen. Groningen: University of Groningen Press, 2020. Open Access, available via the 'direct download' link below. This is the first English translation of _Prolegomena iuris naturalis_ by Gottfried Achenwall (1719–1772). In this book, Achenwall presents the philosophical foundation for his comprehensive theory of natural law. The book is of interest not only because it provides the basis for a careful, systematic, and well-respected eighteenth-century theory of natural law in (...) the Leibniz-Wolffian tradition, but also because it sheds important light on the work of Immanuel Kant. Achenwall’s work influenced Kant’s legal and political philosophy as well as his ethics, and it is indispensable for understanding Kant’s _Feyerabend Lectures on Natural Law_ and his _Metaphysics of Morals_. The present volume complements the translation of Achenwall’s handbook, _Natural Law_ (London: Bloomsbury, 2020). (shrink)

The work of seventeenth-century polymath Gottfried Wilhelm Leibniz has proved inspirational to philosophers and scientists alike. In this thought-provoking book, Pauline Phemister explores the ecological potential of Leibniz’s dynamic, pluralist, panpsychist, metaphysical system. She argues that Leibniz’s philosophy has a renewed relevance in the twenty-first century, particularly in relation to the environmental change and crises that threaten human and non-human life on earth. Drawing on Leibniz’s theory of soul-like, interconnected metaphysical entities he termed 'monads', Phemister explains how an individual’s (...) true good is inextricably linked to the good of all. Phemister also finds in Leibniz’s works the rudiments of a theory of empathy and strategies for strengthening human feelings of compassion towards all living things. Leibniz and the Environment is essential reading for historians of philosophy and environmental philosophers, and will also be of interest to anyone seeking a metaphysical perspective from which to pursue environmental action and policy. (shrink)

The Moral Self addresses the question of how morality enters into our lives. Pauline Chazan draws upon psychology, moral philosophy, and literary interpretation to rebut the view that morality's role is to limit desire and control self-love. Preserving the ancients' connection between what is good for the self and what is morally good, Chazan argues that a certain kind of care for the self is central to moral agency. This book offers a dynamic interdisciplinary slant on the discussion of (...) moral theory. (shrink)

The article re-examines Marx’s liberal period as a contributor to and later as a member of the editorial board of the Rhenish Gazette and the question of the consequences of his liberalism on his transition to socialism. Far from claiming straight away to be the most politically radical of the young Hegelians, the young Marx outlined in his 1842-43 articles a version of moderate republicanism, close to that of Carl von Rotteck. It was by following the gradual distancing of the (...) young Hegelians from liberalism and their concomitant radicalisation, that Marx successively adopted democratic and then socialist positions. This political and theoretical evolution is nonetheless predicated upon the anti-liberal elaboration of what had been a liberal problematic, formulated from 1842 : the question of the autonomy of society relative to the State. It was by way of the critical comprehension of the implications of this demand that Marx gradually arrives at the critique of the constitutional State as an abstract political sphere, and to the defense of a social self-organization for which the requisite is the prior transformation of the activity in question. (shrink)

Background Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples for health care and the circumstances under which such a practice should be respected as compatible (...) with autonomous decision-making. Discussion We discuss the concept of autonomy as it applies to persons and to actions, human interdependency and gender roles in decision-making, the dynamics and outcomes of couples’ joint decision-making, and the ethics of couples’ joint decision-making. We believe that the extent to which couples’ joint decision-making might be deemed ethically acceptable will vary depending on the context. Given that in many traditional marriages the woman is the less dominant partner, we consider a spectrum of scenarios of couples’ joint decision-making about a woman’s own health care that move from those that are acceptably autonomous to those that are not consistent with respecting the woman’s autonomous decision-making. To the extent that there is evidence that both members of a couple understand a decision, intend it, and that neither completely controls the other, couples’ joint decision-making should be viewed as consistent with the principle of respect for the woman’s autonomy. At the other end of the spectrum are decisions made by the man without the woman’s input, representing domination of one partner by the other. Conclusions We recommend viewing the dynamics of couples’ joint decision-making as existing on a continuum of degrees of autonomy. This continuum-based perspective implies that couples’ joint decision-making should not be taken at face value but should be assessed against the specific cultural, ethnic, and religious backgrounds and personal circumstances of the individuals in question. (shrink)

The word ‘cosmopolitan’, which derives from the Greek word kosmopolitês (‘citizen of the world’), has been used to describe a wide variety of important views in moral and socio political philosophy. The nebulous core shared by all cosmopolitan views is the idea that all human beings, regardless of their political affiliation, do (or at least can) belong to a single community, and that this community should be cultivated. Different versions of cosmopolitanism envision this community in different ways, some focusing on (...) political institutions, others on moral norms or relationships, and still others focusing on shared markets or forms of cultural expression. The philosophical interest in cosmopolitanism lies in its challenge to commonly recognized attachments to fellow citizens, the local state, parochially shared cultures, and the like. (shrink)

Many regard Kant’s account of the highest good as a failure. His inclusion of happiness in the highest good, in combination with his claim that it is a duty to promote the highest good, is widely seen as inconsistent. In this essay, I argue that there is a valid argument, based on premises Kant clearly endorses, in defense of his thesis that it is a duty to promote the highest good. I first examine why Kant includes happiness in the highest (...) good at all. On the basis of a discussion of Kant's distinction between 'good' and 'pleasant', and in light of his methodological comments in the second chapter of the Critique of Practical Reason, I explain how Kant’s conception of the good informs his conception of the highest good. I then argue that Kant's inclusion of happiness in the highest good should be understood in light of his claim that it is a duty to promote the happiness of others. In the final section of this essay, I reconstruct Kant’s argument for the claim that it is a duty to promote the highest good and explain in what sense this duty goes beyond observance of the Categorical Imperative. (shrink)

Descartes, Spinoza and Leibniz stand out as the great 17th century rationalist philosophers who sought to construct a philosophical system in which theological and philosophical foundations serve to explain the physical, mental and moral universe. In her new book Pauline Phemister explores their contribution to the development of modern philosophy.

The central fact underlying all relations is the question of power and how it can be used to get one's way. When power does not work, we move to compromise. This paper questions the validity of compromise as an effective means of settling differences. My standpoint is that compromise debases relationships, is wrong in principle and does not work in practice either. There is a better strategy: integration, when the contending parties find the wider solution that includes both their interests. (...) Ethically right, integration also works better in practice, for it leads to longer-term, more productive and happier relations. (shrink)

The philosophy of the John Lewis Partnership is exemplified by the unique role of the Branch Registrar and her responsibilities to promote partnership. The author has wide international experience of accountancy and general management in the retail trade, and is currently a freelance lecturer on management and marketing. Her latest work is Integrative Management ‐ Creating Unity from Diversity.

A fundamental goal of biology is to understand how novel phenotypes evolved through changes in existing genes. The Dictyostelia or social amoebas represent a simple form of multicellularity, where starving cells aggregate to build fruiting structures. This review summarizes efforts to provide a framework for investigating the genetic changes that generated novel morphologies in the Dictyostelia. The foundation is a recently constructed molecular phylogeny of the Dictyostelia, which was used to examine trends in the evolution of novel forms and in (...) the divergence of genes that shape these forms. There is a major trend towards the formation of large unbranched fruiting bodies, which is correlated with the use of cyclic AMP (cAMP) as a secreted signal to coordinate cell aggregation. The role of cAMP in aggregation arose through co‐option of a pathway that originally acted to coordinate fruiting body formation. The genotypic changes that caused this innovation and the role of dynamic cAMP signaling in defining fruiting body size and pattern throughout social amoeba evolution are discussed. BioEssays 29:635–644, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Kant’s Formula of Universal Law (FUL) is generally believed to require you to act only on the basis of maxims that you can will without contradiction to become universal laws. In “Contradiction and Kant’s Formula of Universal Law” (2017), I have proposed to read the FUL instead as requiring that, for any maxim on which you act, you can will two things simultaneously, without volitional self-contradiction: (1) willing the maxim as your own action principle and (2) willing that it become (...) a universal law. In the present essay, I reply to comments by Mark Timmons, Michael Walschots, Paola Romero, and Stefano Lo Re. In response to their comments concerning the application of the FUL, I expand the interpretive framework of the Volitional Self-Contradiction Interpretation. I argue that Kant also constructs the diagnostic volitional self-contradiction as a contradiction between (1) willing a tested maxim to become a universal law and (2) willing what humans, qua finite rational beings, necessarily will, namely the means to their actual and possible future ends. I also clarify how the two ways in which Kant specifies the test are related. Furthermore, I clarify the relation between the Volitional Self-Contradiction interpretation and other interpretations of the FUL, in particular the ‘Practical Contradiction’ and ‘Logical Contradiction’ interpretations, as well as its difference from the Golden Rule. I also address the objection that the volitional self-contradiction is superfluous, clarify the relation between the Formula of Universal Law and the Formula of the Law of Nature, and explain why the will of an immoral agent does not contain a volitional self-contradiction of the type at issue. (shrink)

Though Congress passed the American Recovery and Reinvestment Act earlier this year, debate continues to swirl around the provision of funds for comparative effectiveness research. Critics warn that government bodies could use such research to dictate “appropriate” care and impose third‐party oversight so intrusive it would impinge upon the interaction between doctors and their patients. On the contrary, I believe that comparative effectiveness has the potential to strengthen the patient‐doctor relationship. How? By keeping all of us from being blindsided by (...) our own best intentions. (shrink)