All disciplines must define their basic units and core processes. In evolutionary biology, the core process is natural selection and the basic unit of selection and adaptation is the individual. To operationalize the theory of natural selection we must count individuals, as they are the bearers of fitness. While canonical individuals have often been taken to be multicellular organisms, the hierarchy of life shows that new kinds of individuals have evolved. A variety of criteria have been used to define biological (...) individuality. Some criteria rely on the presence/absence of a particular property while others advocate an approach that reflects the process of natural selection. The plethora of approaches to classifying individuality has resulted in confusion regarding how to study individuality in a given taxon. (shrink)

The empirical literature exploring lawyers and their moral decision making is limited despite the “crisis” of unethical and unprofessional behavior in the bar that has been well documented for over a decade. In particular we are unaware of any empirical studies that investigate the moral landscape of the health lawyer’s practice. In an effort to address this gap in the literature, an interdisciplinary team of researchers at Vanderbilt University designed an empirical study to gather preliminary evidence regarding the moral reasoning (...) of health care attorneys. The primary research question was how health lawyers respond when they encounter ethical or moral dilemmas in their practice for which the law fails to offer a bright-line solution. In exploring this question, we sought to understand better what motivations or influences guide action when health lawyers confront ethical quandaries, and whether there are specific differences, e.g., gender, experience, or religiosity, that are associated with specific responses to situations testing ethical or moral boundaries. (shrink)

Writing in 1999, legal ethics scholar Brad Wendel noted that “[v]ery little empirical work has been done on the moral decision making of lawyers.” Indeed, since the mid-1990s, few empirical studies have attempted to explore how attorneys deliberate about ethical dilemmas they encounter in their practice. Moreover, while past research has explored some of the ethical issues confronting lawyers practicing in certain specific areas of practice, no published data exists probing the moral mind of health care lawyers. As signaled by (...) the creation of a regular column “devoted to ethical issues arising in the practice of health law” in the Journal of Law, Medicine & Ethics, the time to address the empirical gap in the professional ethics literature is now. Accordingly, this article presents data collected from 120 health care lawyers. Presenting this population with a number of hypothetical scenarios relating to how they would respond when confronting an ethical dilemma without an obvious solution or when facing a situation in which their personal values were in tension with their professional obligations, this article represents a first step toward better understanding how lawyers who practice in health care settings understand and resolve the moral discomfort they encounter in their professional lives. (shrink)

Ethical questions about information and communications technologies have been debated since World War II. Western democracies have had more than 50 years of experience in addressing and organising the ethical, social and legal aspects of scientific and technological developments. However, this expertise, tradition and experience are not enough to manage the most urgent ethical and social issues and contemporary challenges involving ICT. A systematic and institutional organisation of social values in the context of modern ICT tools is needed.This paper focuses (...) on four major areas: developing a specific approach to ethical issues raised by ICT; describing in more detail the age-related digital divide in Europe; identifying technology trends and emerging challenges; and defining the legal framework for inclusion of senior citizens in the digital society. The paper then concludes with a summary of its key points on the basis of which it makes three proposals as a contribution to efforts aimed at overcoming the exclusion of senior citizens from today's Information Society. (shrink)

Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...) interact —impacts such patients’ access to research.Such persons may be under guardianship because they have lost decisional capacity (i.e., those in a coma or... (shrink)

Canada has a marked shortfall between the supply and demand for kidneys for transplantation. Median wait times for deceased donor kidney transplantation vary from 5.8 years in British Columbia, 5.2 years in Manitoba and 4.5 years in Ontario to a little over 2 years in Quebec and Nova Scotia. Living donation provides a viable option for some, but not all people. Consequently, a small number of people travel abroad to undergo kidney transplantation by commercial means. The extent to which they (...) are aware of the potential risks to their health and the health of the kidney vendors is unclear. Travel abroad to obtain a kidney commercially i.e. transplant tourism (TT), raises ethical issues which include the exploitation of the poor, uncertainty of donor informed consent to nephrectomy, poor clinical care and lack of follow up for the donor, commodification of the body and inequity of access to medical care for donors. Also, TT widens socioeconomic disparities in access to transplantation, differing from the Canadian system of universal coverage for healthcare. The Canadian transplant community has discussed how to respond to patients who plan to travel abroad for TT or return with a purchased kidney. Unease rests in the tension between the duty to care for legitimate Canadian residents and the unwillingness to enable TT. This paper discusses three anonymized cases and the Canadian responses to TT as recorded in academic literature and a formal statement by relevant professional bodies. (shrink)

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

Hypocretin regulates brain reward function and cocaine consumption in rats. The hypocretinergic (Hcrt) system is implicated in energy homeostasis, feeding and sleep regulation. Hypocretinergic cell bodies are located in the lateral hypothalamus (LH) and project throughout the brain. The aim of the present studies was to investigate the role of the Hcrt system in regulating brain reward function and the reinforcing properties of cocaine in rats. Intracranial self-stimulation (ICSS) thresholds provide an accurate measure of brain reward function in rats. Here (...) we show that a single injection of Hcrt-1 (5 µg icv) induced persistent, long-lasting elevations in ICSS thresholds in drug-naïve rats. Indeed, Hrct-1 elevated ICSS thresholds for 36 h, with peak elevations between 6 and 12 hours after injection. Hrct-1-induced threshold elevations were attenuated by an antibody known to neutralize the binding of hcrt-1 to its receptors. Taken together, these observations suggest that Hrct-1 negatively regulates brain reward function in rats. Because Hrct-1 negatively regulates brain reward function, we hypothesized that it may attenuate the increased brain reward function usually observed after cocaine consumption, and thereby alter cocaine self-administration behavior. A daily injection of Hrct-1 (1 µg icv), for 4 consecutive days, slightly increased cocaine self-administration (0.25 mg/infusion) in rats. Overall, these data demonstrate that Hrct-1 negatively regulates brain reward function, and as such may indirectly alter cocaine self-administration. Given the well-established role of hypocretin neurons in regulating feeding behavior and sleep, we hypothesize that hypocretinergic regulation of brain reward function may provide a mechanism by which appropriate and competing behaviors (e.g. sleep or feeding) may be engaged to maintain energy homeostasis. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Emotional Responding Is to Blame It Might Not Be to ResponsibilityR. J. R. Blair (bio)Keywordsblame, responsibility, emotional responses, psychopathyIn this interesting paper, Levy argues that by failing the moral/conventional distinction task (Blair 1995), individuals with psychopathy show a fundamental inability to categorize moral harms and as such their moral responsibility for their actions is reduced. He argues that, although we might still wish to incarcerate such individuals to (...) prevent them inflicting further harm on others, we should be less enthusiastic to blame them for their actions.In many respects, I agree with much of Levy's treatise. I certainly do not regard ascriptions of blame as useful in my own work with this population. I believe that our goal should be to fully understand the nature of their emotional deficit to be able to treat it similarly to other researchers who work to treat other emotional disorders. To me, Levy's argument appears sound.However, I offer three considerations and raise questions within these considerations that might further the debate. First, not all rules involve care-based emotional responses to victims. As Levy notes, this is the origin of the moral/conventional distinction. The problem here is that we do consider someone responsible if they break a conventional transgression. The student talking in class is generally considered blameworthy for this action as long as they knew that the rule of not talking during the lesson applied to that classroom. Yet, there is no victim and no care-based emotional response. Here, the only thing necessary to ascribe blame and responsibility is that the individual knew that a rule exists. Given this holds for conventional transgressions, why must we necessarily make a special case, with respect to responsibility, for moral transgressions?I believe that Levy is fully aware of this concern. He specifically makes reference to moral responsibility and writes that:the kind and degree of wrongness, and therefore blame, which attaches to infringements of the rules [against double parking or line-jumping] is very different, and usually much less significant, than the kind and degree attaching to moral wrongs. For psychopaths, all offences are merely conventional, and therefore—from their point of view—none of them are all that serious.(2007, p. 132)But the danger here is that issues of blame and responsibility may become highly relativistic and hinge on the strength of the emotional reaction. This is a problem because, although we might judge someone as more blameworthy if he intentionally [End Page 149] runs over five people rather than one, do we really consider that there is a distinction in moral responsibility between these two cases? If not, might not responsibility relate to factual knowledge of the existence of the rule against the transgression rather than the emotional response to the transgression?Second, there is considerable debate regarding whether psychopathy represents a taxon or a continuum (e.g., Vasey et al. 2005; Edens et al. 2006). Assuming it does represent a continuum, then we have an additional concern. How little of an emotional response to the transgression reduces one's moral responsibility and blame? Is it only the very reduced (although usually not absent) levels of emotional response that are shown by individuals with psychopathy? Or should we consider moral responsibility and blame proportional to the level of the emotional response? If this latter option is adopted, then what should we do about individuals who show heightened emotional responses, for example, patients with specific anxiety disorders (Rauch, Shin, and Wright 2003)? There are already some data that inhibited children (a developmental precursor to some anxiety disorders; Kagan and Snidman 1999) show heightened conscience development (Asendorpf and Nunner-Winkler 1992). If such children commit moral transgressions, should we regard them as more morally responsible and more blameworthy than regular folks?Third, the issue of intention received little attention in this paper. I have been considered to show a similar lack of attention to intention in the past (Nichols 2002) and, moreover, in some respects the issue was of limited concern given Levy's main goals. However, I mention it because so much of whether we consider someone responsible for their actions and... (shrink)

This paper examines the type of theory used to justify the application of physical scale modelling to the solution of mid-nineteenth century engineering problems. To do this, it discusses three particular examples: the initial Britannia Bridge breaking experiments of E. Hodgkinson, the vibrating railway bridge experiments of R. Willis and G. G. Stokes; and the ship resistance experiments of W. Froude. The theory invoked in these case histories is viewed against the background of the response of the contemporary engineering community (...) and compared with the notion of engineering science as proposed by W. J. M. Rankine. (shrink)

Despite all its merits, the vast majority of critical attention devoted to colonialist literature restricts itself by severely bracketing the political context of culture and history. This typical facet of humanistic closure requires the critic systematically to avoid an analysis of the domination, manipulation, exploitation, and disfranchisement that are inevitably involved in the construction of any cultural artifact or relationship. I can best illustrate such closures in the field of colonialist discourse with two brief examples. In her book The Colonial (...) Encounter, which contrasts the colonial representations of three European and three non-European writers, M. M. Mahood skirts the political issue quite explicitly by arguing that she chose those authors precisely because they are “innocent of emotional exploitation of the colonial scene” and are “distanced” from the politics of domination.`1We find a more interesting example of this closure in Homi Bhabha’s criticism. While otherwise provocative and illuminating, his work rests on two assumptions—the unity of the “colonial subject” and the “ambivalence” of colonial discourse—that are inadequately problematized and, I feel, finally unwarranted and unacceptable. In rejecting Edward Said’s “suggestion that colonial power and discourse is possessed entirely by the colonizer,” Bhabha asserts, without providing any explanation, the unity of the “colonial subject .”2 I do not wish to rule out, a priori, the possibility that at some rarefied theoretical level the varied material and discursive antagonisms between conquerors and natives can be reduced to the workings of a single “subject”; but such a unity, let alone its value, must be demonstrated, not assumed. Though he cites Frantz Fanon, Bhabha completely ignored Fanon’s definition of the conqueror/native relation as a “Manichean” struggle—a definition that is not a fanciful metaphoric caricature but an accurate representation of a profound conflict.3 1. M. M. Mahood, The Colonial Encounter: A Reading of Six Novels , pp. 170, 171; and see p. 3. As many other studies demonstrate, the emotional innocence and the distance of the six writers whom Mahood has chosen—Joseph Conrad, E. M. Forster, Graham Greene, Chinua Achebe, R. K. Narayan, and V. S. Naipaul—are, at best, highly debatable.2. Homi K. Bhabha, “The Other Question—The Stereotype and Colonial Discourse,” Screen 24 : 25, 19.3. Frantz Fanon, The Wretched of the Earth, trans. Constance Farrington , p. 41. Abdul R. JanMohamed, assistant professor of English at the University of California, Berkeley, is the author of Manichean Aesthetics: The Politics of Literature in Colonial Africa. He is a founding member and associate editor of Cultural Critique and is currently working on a study of Richard Wright. (shrink)

Translational ethics (TE) has been developed into a specific approach, which revolves around the argument that strategies for bridging the theory‐practice gap in bioethics must themselves be justified on ethical terms. This version of TE incorporates normative, empirical and foundational ethics research and continues to develop through application and in the face of new ethical challenges. Here, I explore the idea that the academic field of bioethics has not yet sufficiently analysed its own philosophical foundation for how it can, and (...) should, be practically relevant; neither has it comprehensively discussed the limitations on what impacts bioethicists should pursue. As a result, there has not been adequate training on how to suitably and appropriately impact real‐world practices. Moreover, bioethical perspectives are often competing with other strong interests, for example, economic and political, which may weaken their impact on policy‐making. The TE approach I propose can not only facilitate practical impacts of academic bioethics by being better informed by real‐world ethical issues but it also supports targeted and ethical justifications of the actual impact of academic work in real‐world contexts. In this paper, I clarify the premises for this TE approach, identify further challenges and sketch out potential solutions for the implementation of this methodological framework. (shrink)

Translational research in medicine requires researchers to identify the steps to transfer basic scientific discoveries from laboratory benches to bedside decision-making, and eventually into clinical practice. On a parallel track, philosophical work in ethics has not been obliged to identify the steps to translate theoretical conclusions into adequate practice. The medical ethicist A. Cribb suggested some years ago that it is now time to debate ‘the business of translational’ in medical ethics. Despite the very interesting and useful perspective on the (...) field of medical ethics launched by Cribb, the debate is still missing. In this paper, I take up Cribb’s invitation and discuss further analytic distinctions needed to base an ethics aiming to translate between theory and practice. (shrink)

This study represents an improvement in the ethics scales inventory published in a 1988 Journal of Business Ethics article. The article presents the distillation and validation process whereby the original 33 item inventory was reduced to eight items. These eight items comprise the following ethical dimensions: a moral equity dimension, a relativism dimension, and a contractualism dimension. The multidimensional ethics scale demonstrates significant predictive ability.

Should we let personal responsibility for health-related behavior influence the allocation of healthcare resources? In this paper, we clarify what it means to be responsible for an action. We rely on a crucial conceptual distinction between being responsible and holding someone responsible, and show that even though we might be considered responsible and blameworthy for our health-related actions, there could still be well-justified reasons for not considering it reasonable to hold us responsible by giving us lower priority. We transform these (...) philosophical considerations into analytical use first by assessing the general features of health-related actions and the corresponding healthcare needs. Then, we identify clusters of structural features that even adversely affected people cannot reasonably deny constitute actions for which they should be held responsible. We summarize the results in an analytical framework that can be used by decision-makers when considering personal responsibility for health as a criterion for setting priorities. (shrink)

This collection demonstrates the strong influence that humanism and freethought had in developing the history and ideals of black intellectualism. Most people are quick to note the profound influence that religion has played in African-American history: consoling the downtrodden slave or inspiring the abolitionists, the underground railroad, and the civil rights movement. But few are aware of the role humanism played in shaping the black experience: developing the thought and motivating the actions of powerful African-American intellectuals. Section One of this (...) book offers biographical sketches of such prominent black humanists as Frederick Douglass, Cheikh Anta Diop, W.E.B. DuBois, Hubert H. Harrison, and Richard Wright. Section Two features essays by black humanists: Douglass, DuBois, Charles W. Faulkner, Langston Hughes, Zora Neale Hurston, Ishmael Jaffree, Claude McKay, Melvin B. Tolson, and Bruce Wright. Section Three offers the views of contemporary black African humanists: Freda Amakye Ansah, Emmanuel Kofi Mensah, Nkeonye Otakpor, Franz Vanderpuye, and Kwasi Wiredu. Section Four contains interviews conducted by Allen on the subjects of black humanist activism, the Afroasiatic roots of classical civilization, and the Harlem Renaissance with: Martin G. Bernal, Charles Faulkner, Leonard Harris, Norman Hill, and Alaine Locke. (shrink)

Rich with historical and cultural value, these works are published unaltered from the original University of Minnesota Press editions.

This dissertation argues for a particular interpretation of John Stuart Mill’s utilitarianism, namely that Mill is best read as a sanction utilitarian. In general, scholars commonly interpret Mill as some type of act or rule utilitarian. In making their case for these interpretations, it is also common for scholars to use large portions of Mill’s Utilitarianism as the chief source of insight into his moral theory. By contrast, I argue that Utilitarianism is best read as an ecumenical text where Mill (...) explains and defends the general tenets of utilitarianism rather than setting out his own preferred theory. The exception to this ecumenical approach to the text comes in the fifth chapter on justice which, I argue on textual and historical grounds, outlines the central features of Mill’s utilitarianism. -/- With this understanding of Utilitarianism in place, many of the passages commonly cited in favor of the previous interpretations are rendered less plausible, and interpretations emphasizing Mill’s other writings are strengthened. Using this methodology, I critique four of the most prominent act or rule utilitarian interpretations of Mill’s moral theory. I then provide an interpretation of Mill’s theory of moral obligation and utilitarianism. On Mill’s account of moral obligation (which purportedly holds for moral theories generally, not just utilitarianism) there is a tight relation between an action being wrong and it being subject to punishment by an agent’s conscience. The utilitarian aspect of Mill’s theory concerns the role of rules in an agent’s conscience. According to Mill’s sanction utilitarian view, the actions that are punished are those actions that violate the moral rules which, if widely internalized across society, would promote general utility. On this account, an action is wrong when an agent violates a justified moral rule and is properly punished, at least by one’s conscience. An action is right when conditions are such that if the action were not performed, then the action would be properly punished by at least the agent’s conscience. I apply this interpretation to other notable components of Mill’s approach such as his account of practical action (the Art of Life) and his theory of liberty. (shrink)

Scientists use a variety of modes of representation in their work, but philosophers have studied mainly sentences expressing propositions. I ask whether diagrams are mere conveniences in expressing propositions or whether they are a distinct, ineliminable mode of representation in scientific texts. The case of path analysis, a statistical method for quantitatively assessing the relative degree of causal determination of variation as expressed in a causal path diagram, is discussed. Path analysis presents a worst case for arguments against eliminability since (...) path diagrams are usually presumed to be mathematically or logically “equivalent” in an important sense to sets of linear path equations. I argue that path diagrams are strongly generative, i.e., that they add analytical power to path analysis beyond what is supplied by linear equations, and therefore that they are ineliminable in a strong scientific sense. (shrink)

The thesis of this article is that there has never been any ground for the controversy between the doctrine of free will and determinism, that it is based upon a misapprehension, that the two assertions are entirely consistent, that one of them strictly implies the other, that they have been opposed only because of our natural want of the analytical imagination. In so saying I do not tamper with the meaning of either phrase. That would be unpardonable. I mean free (...) will in the natural and usual sense, in the fullest, the most absolute sense in which for the purposes of the personal and moral life the term is ever employed. I mean it as implying responsibility, merit and demerit, guilt and desert. I mean it as implying, after an act has been performed, that one " could have done otherwise " than one did. I mean it as conveying these things also, not in any subtly modified sense but in exactly the sense in which we conceive them in life and in law and in ethics. These two doctrines have been opposed because we have not realised that free will can be analysed without being destroyed, and that determinism is merely a feature of the analysis of it. And if we are tempted to take refuge in the thought of an "ultimate ", an "innermost" liberty that eludes the analysis, then we have implied a deterministic basis and constitution for this liberty as well. For such a basis and constitution lie in the idea of liberty. -/- The thesis is not, like that of Green or Bradley, that the contending opinions are reconciled if we adopt a certain metaphysic of the ego, as that it is timeless, and identifies itself with a desire by a " timeless act". This is to say that the two are irreconcilable, as they are popularly supposed to be, except by a theory that delivers us from the conflict by taking us out of time. Our view on the contrary is that from the natural and temporal point of view itself there never was any need of a reconciliation but only of a comprehension of the meaning of terms. (The metaphysical nature of the self and its identity through time is a problem for all who confront memory, anticipation, etc.; it has no peculiar difficulties arising from the present problem.) -/- I am not maintaining that determinism is true; only that it is true insofar as we have free will. That we are free in willing is, broadly speaking, a fact of experience. That broad fact is more assured than any philosophical analysis. It is therefore surer than the deterministic analysis of it, entirely adequate as that in the end appears to be. But it is not here affirmed that there are no small exceptions, no slight undetermined swervings, no ingredient of absolute chance. All that is here said is that such absence of determination, if and so far as it exists, is no gain to freedom, but sheer loss of it; no advantage to the moral life, but blank subtraction from it. -- When I speak below of "the indeterminist" I mean the libertarian indeterminist, that is, him who believes in free will and holds that it involves indetermination. (shrink)

Volume 20, Issue 4, May 2020, Page 71-73.

There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order to ensure (...) that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines’ recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients’ claims on health care resources. Moreover, I suggest the basic structure of such a framework. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we attempt to capture a comprehensive (...) overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

The overall aim of this article is to discuss the organization of limit setting in healthcare in terms of legitimacy. We argue there is a strong ethical demand that such processes should be arranged to provide adversely affected people well-justified reasons to confer legitimacy to the processes despite favouring a different decision-making outcome. Two increasingly popular approaches, Accountability for Reasonableness (A4R) and Multi-Criteria Decision Analysis (MCDA), can both be applied to support legitimate decision-making processes. However, the role played by ‘fair-minded (...) people’ in the A4R framework can be shown to undermine an adequate conceptualization of legitimacy according to the ethical demand. We discuss and specify conditions enabling A4R to meet this ethical demand when being implemented in a real-world setting without having to renounce the aim of striving for ‘reasonableness’ and impartiality. The methodological approach MCDA describes how to arrange for transparent resource allocation. This approach does not encompass any normative guidance on how to shape limit settings in terms of ‘reasonableness’; it basically promotes ‘rational’ decisions. We discuss how this practical methodology can be integrated with the theoretical A4R framework to meet the ethical demand while at the same time promoting politically required impartiality of healthcare limit setting. (shrink)