My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

To what extent should parents be allowed to use reproductive technologies to determine the characteristics of their future children? Is there something morally wrong with choosing what their sex will be, or with trying to 'screen out' as much disease and disability as possible before birth? Stephen Wilkinson offers answers to such questions.

Various decision theories share a troubling implication. They imply that, for any finite amount of value, it would be better to wager it all for a vanishingly small probability of some greater value. Counterintuitive as it might be, this fanaticism has seemingly compelling independent arguments in its favour. In this paper, I consider perhaps the most prima facie compelling such argument: an Egyptology argument (an analogue of the Egyptology argument from population ethics). I show that, despite recent objections from Russell (...) (2023) and Goodsell (2021), the argument’s premises can be justified and defended, and the argument itself remains compelling. (shrink)

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

Birth asphyxia is the most common single cause of death in term newborn infants. The majority of deaths in developed countries follow decisions to withdraw intensive care. Recent technological advances, particularly the use of magnetic resonance imaging (MRI) of the brain, may affect the process of prognostication and decision-making. There is little existing evidence about how prognosis is determined in newborn infants and how this relates to treatment withdrawal decisions.An exploratory qualitative study was performed using in-depth semi-structured interviews with a (...) sample of ten neonatologists from tertiary intensive care units in the UK. Participants were purposively selected to ensure a range of experience and type of unit. They were asked about the process of prognostication for infants with birth asphyxia and decisions about treatment withdrawal. Interviews were transcribed and thematically analysed.MRI played a significant role in decision-making about life-sustaining treatment for a number of clinicians. Clinicians did not identify particular ethical concerns related to MRI, though wider discussion revealed issues relating to uncertainty around predictions, the timing of prognostication and decision-making, and difficulty in predicting quality of life. (shrink)

Identifying a range of key concerns related to representation and difference, Representing the Other offers a provocative agenda for the future development of feminist theory and practice. The book's contributors, including many key international researchers in women's studies, draw on personal experiences of speaking "for" and "about" others in their research, professional practice, academic writing, or political activism. They highlight problems of representing the Other with an ethnic or cultural background different from one's own and extend discussions of "Othering" to (...) representations of children, prostitutes, infertile women, fat women, gay men with HIV/AIDS, and people with disabilities. The reader, which includes articles and discussions from four issues of the journal Feminism & Psychology, also features new pieces and an extensive editorial introduction. Representing the Other will be integral reading for students and academics in women's studies, gender studies, and feminist theory across a range of social science disciplines, including social psychology, sociology, anthropology, sociolinguistics, social policy, and political science. (shrink)

Various philosophers accept moral views that are impartial, additive, and risk-neutral with respect to moral betterness. But, if that risk neutrality is spelt out according to expected value theory alone, such views face a dire reductio ad absurdum. If the expected sum of value in humanity's future is undefined--if, e.g., the probability distribution over possible values of the future resembles the Pasadena game, or a Cauchy distribution--then those views say that no option is ever better than any other. And, as (...) I argue, this holds in practice: our evidence supports such a probability distribution. Indeed, it supports a probability distribution that cannot be evaluated even if we adopt one of the various extensions of expected value theory proposed in the literature. Must we therefore reject all impartial, additive, risk-neutral moral theories? It turns out that we need not. I develop an alternative solution: a new method of extending expected value theory, which allows us to deal with this distribution and to salvage those moral views. I also examine how this solution affects one of the most notable implications of those views--namely, longtermism. (shrink)

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

One of the most contentious ethical issues in the neonatal intensive care unit is the withdrawal of life-sustaining treatment from infants who may otherwise survive. In practice, one of the most important factors influencing this decision is the prediction that the infant will be severely intellectually disabled. Most professional guidelines suggest that decisions should be made on the basis of the best interests of the infant. It is, however, not clear how intellectual disability affects those interests. Why should intellectual disability (...) be more important than physical disability to the future interests of an infant? Is it discriminatory to base decisions on this? This paper will try to unravel the above questions. It seems that if intellectual disability does affect the best interests of the child it must do so in one of three ways. These possibilities will be discussed as well as the major challenges to the notion that intellectual disability should have a role in such decisions. The best interests of the child can be affected by severe or profound intellectual disability. It is, though, not as clear-cut as some might expect. (shrink)

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

The current position on the deceased’s consent and the family’s consent to organ and tissue donation from the dead is a double veto—each has the power to withhold and override the other’s desire to donate. This paper raises, and to some extent answers, questions about the coherence of the double veto. It can be coherently defended in two ways: if it has the best effects and if the deceased has only negative rights of veto. Whether the double veto has better (...) effects than other policies requires empirical investigation, which is not undertaken here. As for rights, the paper shows that it is entirely possible that individuals have a negative right of veto but no positive right to compel acceptance of their offers. Thus if intensivists and transplant teams turn down the deceased’s offer, they do not thereby violate the deceased’s right. This leaves it open whether non-rights based reasons—such as avoiding bad publicity or distress —require intensivists and transplant teams to turn down or accept the deceased’s offer. This, however, is beyond the scope of this paper. The current position may or may not be wrong, but it is at least coherent. (shrink)

A particular feature of this book is substantial "Stretch and Challenge" material throughout which allows students to develop further.

Predictive processing accounts of neural function view the brain as a kind of prediction machine that forms models of its environment in order to anticipate the upcoming stream of sensory stimulation. These models are then continuously updated in light of incoming error signals. Predictive processing has offered a powerful new perspective on cognition, action, and perception. In this chapter we apply the insights from predictive processing to the study of emotions. The upshot is a picture of emotion as inseparable from (...) perception and cognition, and a key feature of the embodied mind. (shrink)

Only human beings have a rich conceptual repertoire with concepts like tort, entropy, Abelian group, mannerism, icon and deconstruction. How have humans constructed these concepts? And once they have been constructed by adults, how do children acquire them? While primarily focusing on the second question, in The Origin of Concepts , Susan Carey shows that the answers to both overlap substantially. Carey begins by characterizing the innate starting point for conceptual development, namely systems of core cognition. Representations of core (...) cognition are the output of dedicated input analyzers, as with perceptual representations, but these core representations differ from perceptual representations in having more abstract contents and richer functional roles. Carey argues that the key to understanding cognitive development lies in recognizing conceptual discontinuities in which new representational systems emerge that have more expressive power than core cognition and are also incommensurate with core cognition and other earlier representational systems. Finally, Carey fleshes out Quinian bootstrapping, a learning mechanism that has been repeatedly sketched in the literature on the history and philosophy of science. She demonstrates that Quinian bootstrapping is a major mechanism in the construction of new representational resources over the course of childrens cognitive development. Carey shows how developmental cognitive science resolves aspects of long-standing philosophical debates about the existence, nature, content, and format of innate knowledge. She also shows that understanding the processes of conceptual development in children illuminates the historical process by which concepts are constructed, and transforms the way we think about philosophical problems about the nature of concepts and the relations between language and thought. (shrink)

In a well known British case, the relatives of a dead man consented to the use of his organs for transplant on the condition that they were transplanted only into white people. The British government condemned the acceptance of racist offers and the panel they set up to report on the case condemned all conditional offers of donation. The panel appealed to a principle of altruism and meeting the greatest need. This paper criticises their reasoning. The panel’s argument does not (...) show that conditional donation is always wrong and anyway overlooks a crucial distinction between making an offer and accepting it. But even the most charitable reinterpretation of the panel’s argument does not reject selective acceptance of conditional offers. The panel’s reasoning has no merit. (shrink)

One of the pressures placed upon researchers is the process of ethics review. This frequently provides considerable conflict. The process of review of student projects of little inherent risk is identical to that of their more senior colleagues. In this article I propose that we should be more tolerant of design problems within student research if the overall risk is minimal in order that the student can learn about the process of carrying out research.The frequency and content of papers discussing (...) research ethics review in specialist,1 professional2 3 and lay4 press suggests that many senior researchers find the process challenging. The opinion most frequently expressed is that research ethics committees work to an imprecise set of rules and represent a barrier to significant pieces of clinical research. In particular, specific criticism has been aimed at the review of student research5–8 and the difficulties that students and their supervisors face.In ethics committees we usually police research very carefully, monitoring the detail of projects, including how participants will be selected, what data will be collected, how it will be handled and how the research is funded in addition to the adequacy of the consent process and information that underlies it. My experience as a member of NHS REC and governance committees and, more particularly, coordinator of student research, is that National Research Ethics Service REC usually apply the same standards to student research with little inherent risk as to complex phase 1 studies with significant risk. Guidance in the standard operating procedures for NHS REC is at best unhelpful and at worst supportive of this view. …. (shrink)

This Is A New Release Of The Original 1864 Edition.

In this important book, Susan Hurley sheds new light on consciousness by examining its relationships to action from various angles. She assesses the role of agency in the unity of a conscious perspective, and argues that perception and action are more deeply interdependent than we usually assume. A standard view conceives perception as input from world to mind and action as output from mind to world, with the serious business of thought in between. Hurley criticizes this picture, and considers (...) how the interdependence of perceptual experience and agency at the personal level (of mental contents and norms) may emerge from the subpersonal level (of underlying causal processes and complex dynamic feedback systems). Her two-level view has wide implications, for topics that include self-consciousness, the modularity of mind, and the relations of mind to world. The self no longer lurks hidden somewhere between perceptual input and behavioral output, but reappears out in the open, embodied and embedded in its environment. Hurley traces these themes from Kantian and Wittgensteinian arguments through to intriguing recent work in neuropsychology and in dynamic systems approaches to the mind, providing a bridge from mainstream philosophy to work in other disciplines. Consciousness in Action is unique in the range of philosophical and scientific work it draws on, and in the deep criticism it offers of centuries-old habits of thought. (shrink)

In bioethical discussions of preimplantation genetic diagnosis and prenatal screening, accusations of eugenics are commonplace, as are counter-claims that talk of eugenics is misleading and unhelpful. This paper asks whether “eugenics talk”, in this context, is legitimate and useful or something to be avoided. It also looks at the extent to which this linguistic question can be answered without first answering relevant substantive moral questions. Its main conclusion is that the best and most non-partisan argument for avoiding eugenics talk is (...) the Autonomy Argument. According to this, eugenics talk per se is not wrong, but there is something wrong with using its emotive power as a means of circumventing people’s critical–rational faculties. The Autonomy Argument does not, however, tell against eugenics talk when such language is used to shock people into critical–rational thought. These conclusions do not depend on unique features of eugenics: similar considerations apply to emotive language throughout bioethics. (shrink)

Written with the beginner in mind, Robert Wilkinson carefully introduces the reader to the fundamental components of the philosophy of mind. Each chapter is then helpfully linked to a reading from key thinkers in the field such as Descartes and John R. Searle.

_Minds and Bodies_ is a clear introduction to the mind-body problem. It requires no prior philosophical knowledge and is ideally suited to newcomers to philosophy and philosophy of mind. Robert Wilkinson carefully introduces the fundamental components of the philosophy of mind: Descartes's dualist account of mind and body; monist views including eliminativism; computer science and artificial intelligence. Each chapter is linked to a reading from key thinkers in the field, from Descartes to Paul Churchland.

The moral and political thought of Herbert Spencer is usually associated with some form of evolutionism. This is unsurprising, since Spencer himself thought of his ideas as founded on evolutionary theory. But it is regrettable, because no one believes in Spencer's form of evolutionism any more, and even if they did, they would not think that it supported his views in the way that he confidently believed. And so Spencer has been largely neglected since his death. His libertarianism is thought (...) to be without foundation, and so few have thought it worth study. But in this paper I try to show that Spencer's moral and political conclusions can be based on some of the non-evolutionary arguments that he offered. Although these arguments are not entirely compelling, they have force in a way that his evolutionary claims do not. (shrink)

Preimplantation genetic diagnosis and some prenatal screening programmes have been criticized for being 'eugenic'. This paper aims to analyse this criticism and to evaluate one of the main ethical arguments lying behind it. It starts with a discussion of the meaning of the term 'eugenics' and of some relevant distinctions: for example, that between objections to eugenic ends and objections to certain means of achieving them. Next, a particular argument against using preimplantation genetic diagnosis to 'screen out' disability is considered, (...) one based on the Equal Value Principle, which says that we should value disability and non-disability equally. It is argued that present practice and policy probably do violate the Equal Value Principle, but that this principle is itself unsound. (shrink)