The proposal to allow assisted dying for people who are not severely ill reignited the Dutch end‐of‐life debate when it was submitted in 2016. A key criticism of this proposal is that it is too radical a departure from the safe and well‐functioning system the Netherlands already has. The goal of this article is to respond to this criticism and question whether the Dutch system really can be described as safe and well functioning. I will reconsider the usefulness of the (...) suffering criterion, and I will ultimately argue this criterion should be rejected altogether. Instead, we should consider moving towards an autonomy‐only approach to assisted dying. This would resolve some significant issues occurring under the current system of assisted dying in the Netherlands and ultimately make the process safer and better functioning. I will then consider some possible objections to adopting an autonomy‐only approach and provide some preliminary responses to these also. I will finally highlight some potential areas where further research may be necessary, namely, how to mitigate the effect of external factors such as poverty or other life aspects that may have the potential to distort the individual's ability to make autonomous decisions. I will also consider some possible international lessons that can be taken from both current as well as the proposed practice in the Netherlands. (shrink)

Blumenthal-Barby (2024) argues that bioethicists should stop using the concept of "personhood" in both well-established bioethics debates (e.g., regarding cognitive disability) and emerging ones (e...

Our aim was to employ a critical analytic lens to explicate the role of nursing research in supporting the notion of caring realities. To do this, we used case exemplars to illustrate the infusion of such discourses. The first exemplar examines the fundamental concept of caring: using Florence Nightingale's Notes on Nursing, the case study surfaces caring as originally grounded in ritualized practice and subsequently describes its transmutation, via competing discourses, to a more holistic concept. It is argued that in (...) the many and varied attempts to define the dynamic concept of care, caring has now become paradoxically, a more fragmented concept despite attempts to render it more holistic and inclusive. In the second exemplar, one of the authors draws on her personal experience of the gap between theory and practice, so pronounced that it pushed the author to revisit the concept of evidence‐based practice and nursing education. In our third and final exemplar, we refer to the absence of knowledge and practice generated through natural enquiry and curiosity, an absence which has led to production of corporate led rhetoric. Drawing together the central arguments of the three exemplars, we reflect on the influential role of nursing research in enabling the deconstruction of taken for granted assumptions such as caring, evidence‐based practice and empowerment; assumptions which have been generated by discourses riddled with confusion and alienation from the reality of practice and the natural spirit of professional enquiry. (shrink)

In this paper I argue that there is a class of attitudes that have questions (rather than propositions or something else) as contents.

There has been much discussion about whether traditional epistemology's doxastic attitudes are reducible to degrees of belief. In this paper I argue that what I call the Straightforward Reduction - the reduction of all three of believing p, disbelieving p, and suspending judgment about p, not-p to precise degrees of belief for p and not-p that ought to obey the standard axioms of the probability calculus - cannot succeed. By focusing on suspension of judgment (agnosticism) rather than belief, we can (...) see why the Straightforward Reduction is bound to fail. I argue that, in general, suspending about p is not just a matter of having some specified standard credence for p, and in the end I suggest some ways to extend the arguments that will put pressure on other credence-theoretic accounts of belief and suspension of judgment as well. (shrink)

Calls for the “translation” of research from bench to bedside are increasingly demanding. What is translation, and why does it matter? We sketch the recent history of outcome-oriented translational research in the United States, with a particular focus on the Roadmap Initiative of the National Institutes of Health (Bethesda, MD). Our main example of contemporary translational research is stem cell research, which has superseded genomics as the translational object of choice. We explore the nature of and obstacles to translational research (...) and assess the ethical and biomedical challenges of embracing a translational ethos. (shrink)

The abortion debate rages on. Yet the two most popular positions seem to be clearly mistaken. Conservatives maintain that a human life begins at conception and that therefore abortion must be wrong because it is murder. But not all killings of humans are murders. Most notably, self defense may justify even the killing of an innocent person.Liberals, on the other hand, are just as mistaken in their argument that since a fetus does not become a person until birth, a woman (...) may do whatever she pleases in and to her own body. First, you cannot do as you please with your own body if it affects other people adversely. Second, if a fetus is not a person, that does not imply that you can do to it anything you wish. Animals, for example, are not persons, yet to kill or torture them for no reason at all is wrong. (shrink)

In the Netherlands, in 2002, euthanasia became a legitimate medical act, only allowed when the due care criteria and procedural requirements are met. Legally, an Advanced Euthanasia Directive can replace direct communication if a patient can no longer express his own wishes. In the past decade, an exponential number of persons with dementia share a euthanasia request with their physician. The impact this on physicians, and the consequent support needs, remained unknown. Our objective was to gain more insight into the (...) experiences and needs of Dutch general practitioners and elderly care physicians when handling a euthanasia request from a person with dementia. We performed a qualitative interview study. Participants were recruited via purposive sampling. The interviews were transcribed verbatim, and analyzed using the conventional thematic content analysis. Eleven general practitioners and elderly care physicians with a variety of experience and different attitudes towards euthanasia for PWD were included. Euthanasia requests appeared to have a major impact on physicians. Difficulties they experienced were related to timing, workload, pressure from and expectations of relatives, society’s negative view of dementia in combination with the ‘right to die’ view, the interpretation of the law and AEDs, ethical considerations, and communication with PWD and relatives. To deal with these difficulties, participants need support from colleagues and other professionals. Although elderly care physicians appreciated moral deliberation and support by chaplains, this was hardly mentioned by GPs. Euthanasia requests in dementia seem to place an ethically and emotionally heavy burden on Dutch GPs and elderly care physicians. The awareness of, and access to, existing and new support mechanisms needs further exploration. (shrink)

The concept of vulnerability is deployed in bioethics to, amongst other things, identify and remedy harms to participants in research, yet although nonhuman animals in experimentation seem intuitively to be vulnerable, this concept and its attendant protections are rarely applied to research animals. I want to argue, however, that this concept is applicable to nonhuman animals and that a new taxonomy of vulnerability developed in the context of human bioethics can be applied to research animals. This taxonomy does useful explanatory (...) work, helping to pinpoint the limitations of the 3Rs/welfare approach currently adopted in the context of animal experimentation. On this account, the 3Rs/welfare approach fails to deliver for nonhuman animals in experimentation because it effectively addresses only one element of their vulnerability (inherent) and paradoxically through the institution of Animal Ethics Committees intended to protect experimental animals in fact generates new vulnerabilities that exacerbate their already precarious situation. (shrink)

The ArgumentThis paper argues that different epistemic styles exist in science, and that these make up an important unit of analysis for studying science. On occasion these different sets of commitments to ways of doing and knowing about the world may fall along national boundaries. The case presented here examines German and American embryology around 1900 and shows that differences in goals and approaches make up different epistemic styles.In particular, the Germans sought causal mechanical explanations of as many phenomena as (...) possible, guided by strong theories which achieved confirmation when they fit with as much of the available data as possible. The Americans, in contrast, sought definitive facts, as many as possible, which might be quite specific or narrowly based. These facts could lead to empirical generalizations which, in turn, could guide the generation of new knowledge in the form of new facts. Thus, the two epistemic styles emphasized different goals, processes of investigation, and standards of evidence. (shrink)

The use of genome-wide association studies in medical research and the increased ability to share data give a new twist to some of the perennial ethical issues associated with genomic research. GWAS create particular challenges because they produce fine, detailed, genotype information at high resolution, and the results of more focused studies can potentially be used to determine genetic variation for a wide range of conditions and traits. The information from a GWA scan is derived from DNA that is a (...) powerful personal identifier, and can provide information not just on the individual, but also on the individual's relatives, related groups, and populations. Furthermore, it creates large amounts of individual-specific digital information that is easy to share across international borders. This paper provides an overview of some of the key ethical issues around GWAS: consent, feedback of results, privacy, and the governance of research. Many of the questions that lie ahead of us in terms of the next generation sequencing methods will have been foreshadowed by GWAS and the debates around ethical and policy issues that these have created. (shrink)

Using an approach developed in the context of human bioethics, we argue that chimpanzees in research can be regarded as vulnerable subjects. This vulnerability is primarily due to communication barriers and situational factors—confinement and dependency—that make chimpanzees particularly susceptible to risks of harm and exploitation in experimental settings. In human research, individuals who are deemed vulnerable are accorded special protections. Using conceptual and moral resources developed in the context of research with vulnerable humans, we show how chimpanzees warrant additional safeguards (...) against harm and exploitation paralleling those for human subjects. These safeguards should include empowering third parties to act as surrogate decision makers for chimpanzees, ensuring participant “assent,” and avoiding recruitment of animal subjects based merely on convenience. (shrink)

_Disputed Subjects_ analyzes some of the assumptions behind the contemporary attraction to rationalistic notions of justice and knowledge and discusses why modernity cannot be emancipatory. The effects of gender relations in constituting modern political ideas and theories of knowledge are explored, while at the same time the author identifies problematic aspects of discourses such as psychoanalysis, postmodernism and feminist theorizing. Flax pays special attention to recurrent difficulties concerning maternity, sexuality and race within feminist theorizing, and she addresses the inadequacies of (...) postmodernist accounts of subjectivity and gender. She analyzes psychoanalysis as a discursive formation to identify its particular organization of knowledge and power. (shrink)

Innovative surgery raises four kinds of ethical challenges: potential harms to patients; compromised informed consent; unfair allocation of healthcare resources; and conflicts of interest. Lack of adequate data on innovations and lack of regulatory oversight contribute to these ethical challenges. In this paper these issues and the extent to which problems may be resolved by better evidence-gathering and more comprehensive regulation are explored. It is suggested that some ethical issues will be more resistant to resolution than others, owing to special (...) features of both surgery and innovation. (shrink)

There has been much attention devoted in recent years to the question of whether our moral principles can be related to our biological nature. This collection of new essays focuses on the connection between biology, in particular evolutionary biology, and foundational questions in ethics. The book asks such questions as whether humans are innately selfish, and whether there are particular facets of human nature that bear directly on social practices. The volume is organised historically beginning with Aristotle and covering such (...) major figures as Hume and Darwin down to the present and the work of Harvard sociobiologist, E. O. Wilson. This is the first book to offer this historical perspective on the relation of biology and ethics, and has been written by some of the leading figures in the history and philosophy of science, whose work stands very much at the cutting edge of these disciplines. (shrink)

Diagrams make it possible to present scientific facts in more abstract and generalized form. While some detail is lost, simplified and accessible knowledge is gained. E. B. Wilson's work in cytology provides a case study of changing uses of diagrams and accompanying abstraction. In his early work, Wilson presented his data in photographs, which he saw as coming closest to “fact.” As he gained confidence in his interpretations, and as he sought to provide a generalized textbook account of cell development, (...) he relied on increasingly abstract diagrams. In addition, he came to see that highly abstract and even schematic drawings could provide more than pictures directly from life. (shrink)

ABSTRACT This paper offers an account of the early career of Martha Kneale, née Hurst, and of the five papers she published between 1934 and 1950. One on metaphysical and logical necessity, from 1938, is particularly interesting. In it she considers the metaphysics of time and offers an explanation of ‘the necessity of the past’, which has some resemblance to Kripke’s ideas about metaphysical necessities, in that it assigns an important role to experience in how we come to know them. (...) But Kneale’s view is very different from Kripke’s, depending not on doctrines about rigid designation but rather on recognition of the failure of the atomist/empiricist account of ‘simple’ and ‘complex’ concepts. That account cannot deal with such things as the relations of the determinates of a determinable like colour. A plausible corollary of this, which Kneale exploits, is that some of our experience reveals to us that there are phenomena which are intrinsically complex in having multiple distinguishable aspects, but where those aspects are inseparable. Other of the papers show Kneale to have been pursuing interesting lines of thought about McTaggart’s argument against the reality of time and on the mind-body problem. (shrink)

As philosophers throughout the ages have asked: What is justice? What is truth? What is art? What is law? In _Education Reconfigured_, the internationally acclaimed philosopher of education, Jane Roland Martin, now asks: What is education? In answer, she puts forward a unified theory that casts education in a brand new light. Martin’s "theory of education as encounter" places culture alongside the individual at the heart of the educational process, thus responding to the call John Dewey made over a (...) century ago for an enlarged outlook on education. Look through her theory’s lens and you can see that education takes place not only in school but at home, on the street, in the mall—everywhere and all the time. Look through that lens and you can see that education does not always spell improvement; rather, it can be for the better or the worse. Indeed, you can see that education is inevitably a maker and shaper of both individuals and cultures. Above all, Martin’s new educational paradigm reveals that education is too important to be left solely to the professionals; that it is one of the great forces in human society and, as such, deserves the attention and demands the vigilance of every thoughtful person. (shrink)

Prompted by the ever-increasing cesarean rate, this paper considers the interpretive disjunct between two significant strands of feminist analysis that have arisen in the last four decades as a consequence of the phenomenon of medicalized birth. In contrast to the dominant paradigm of bioethical “Principalism,” both modes of analysis, understood as “the critique of industrialized labor” and “the critique of idealized labor,” are attentive to the way in which social discourses inform bioethical deliberation and practice, but significantly diverge in the (...) nature of their accounts. The “industrialization critique” understands the culture of medical intervention to be impelled by an “obstetric desire” to appropriate women's reproductive potency, whereas the “idealization critique” relates new mothers’ “low childbirth satisfaction” to a pernicious normative ideal propagated by the natural childbirth movement. This paper will explore the anatomy of both critiques and interrogate their fidelity to the phenomenological insight of the body as chiasm between material and ideal. I will argue that while the insights of the idealization critique are well grounded, we must exercise caution about the critique's tendency to reductively understand the embodied experience of labor as entirely discursively produced, a gesture that risks re-performing the dematerialization of women often effected through obstetric intervention itself. (shrink)

Historians have emphasized the appearance of a productive research program in genetics after 1910, and philosophers and biologists have considered endorsement of genetics as a progressive move, indeed as a starting point for modern experimental biology. These efforts focus on what biology had changed to. This paper examines the condition from which biology moved, stressing the way in which Americans held heredity and development as a natural, intimately intertwined couple. Heredity accounts for likenesses, development for variation, and the two act (...) together throughout an individual's life. This discussion establishes the antecedent conditions necessary to explain the split of genetics and embryology and addresses the reasons for the split. (shrink)

In this paper we propose a new way of conceptualizing animals in experimentation – the animal-as-patient. Construing and treating animals as patients offers a way of successfully addressing some of the entrenched epistemological and ethical problems within a practice of animal experimentation directed to human clinical benefit. This approach is grounded in an epistemological insight and builds on work with so-called ‘pet models’. It relies upon the occurrence and characterization of analogous human and nonhuman animal diseases, where, if certain criteria (...) of homology and mechanism are met, the animal simultaneously becomes a patient and a spontaneous model of the human disease. (shrink)

Two major lines of argument support the notion that Hildegard of Bingen’s metaphysics is peculiarly gynocentric. Contra the standard commentary on her work, the focus is not on the notion of viriditas; rather, the first line of argument presents a specific delineation of her ontology, demonstrating that it is a graded hierarchy of beings, many of which present feminine aspects of the divine, and all of which establish the metaphysical notion of interpenetrability. The second line of argument specifically contrasts her (...) thought to that of Aquinas and Meister Eckhart, noting areas of similarity and difference. It is concluded that the visionary origins of Hildegard’s work may have to some extent precluded our understanding of it, and that her work merits consideration not only philosophically and theologically but from the standpoint of its early presentation of a gynocentric worldview. (shrink)

The phrase “regenerative medicine” is used so often and for so many different things, with such enthusiasm or worry, and often with a sense that this is something radically new. This paper places studies of regeneration and applications in regenerative medicine into historical perspective. In fact, the first stem cell experiment was carried out in 1907, and many important lines of research have contributed since. This paper explores both what we can learn about the history and what we can learn (...) from the history of regenerative medicine research. (shrink)

Anton Dohrn rejected the popular Amphioxus-ascidian theory of vertebrate origin, which saw Amphioxus as the most primitive vertebrate and ascidians as vertebrate ancestors. Instead he argued for the segmented annelids as the more likely candidate. Attacked for being 'unscientific' by such popular morphologists as Carl Gegenbaur and Ernst Haeckel, Dohrn countered with similar accusations. Since the debate peaked as Dohrn was establishing his Stazione Zoologica in Naples at the end of the nineteenth century, it gained him valuable attention and may (...) have encouraged him to retain his view even in the face of new and problematic evidence. This paper explores Dohrn's contributions and the underlying commitments revealing what he regarded as important in science. (shrink)

Abstract“Development” suggests that there is something that is developing, or changing over time. We can ask about temporal boundaries of that developmental process, asking when development begins or ends and whether it has defined stages along the way, for example. We can ask about spatial boundaries as well: where does the developing object start and end? For this article, I ask about the boundary definition of the developing organism in particular. What is an individual organism, and what defines it as (...) the same organism as it changes over time? In particular, how has this been answered historically: how have researchers described and explained what an individual developing organism is? This article explores ideas and approaches especially starting in the late 19th century, and in particular looks at the role of “organization.”. (shrink)

The University of Greenwich Generator is setting sail on a thrilling new journey of knowledge exchange with the launch of its first-ever podcast the Navigator. Crafted in collaboration with Lucien von Schomberg, Senior Lecturer in Creativity and Innovation at Greenwich Business School it promises to be an exciting platform for innovation, entrepreneurship, and thought-provoking conversation. The podcast aims to bridge the gap between academic insights and real-world issues in an easily digestible way. Through engaging conversations, listeners can expect to gain (...) valuable knowledge from industry leaders and academic experts alike. Operating on three key principles—knowledge communication, knowledge exchange, and knowledge creation—this podcast embodies the essence of the Generator's mission, inspiring, educating and fostering collaboration. The first episode explores the limitless potential of AI in today's world, unravelling its impact on business, education, and society. Guests share their profound insights, experiences, and practical advice, shedding light on how AI is shaping our future. The episode delved deep into the ethical implications but also vast potential of using AI in the future and how it will affect both education and the wider world. The episode boasts an impressive lineup of inaugural guests, including Jane Harrington, the Vice-Chancellor of The University of Greenwich, Carl Thomas, Enterprise Advisor, and founder of Audiowings, Ghislaine Boddington, Professor in Digital Immersion, and Neil Saunders, Senior Lecturer in Mathematical Sciences. Together, these guests provide diverse perspectives on the future of AI at the university and beyond. (shrink)

By 1900 most biologists accepted experimentation as appropriate for at least parts of biology. Some claimed experimentation as the best or only proper approach to biology, while others regarded it as an acceptable addition to existing methodologies. Different researchers defined experimentation in different ways, and they held different aspirations for their experimental programs. This paper explores three sets of ideas, represented respectively by the French in the 1870s, the Germans in the 1880s, and the Americans in the 1890s. It examines (...) what an experiment was thought to be, what experimentation was, and what the goals of experimentation were for each group, revealing suggestive differences. (shrink)

The study of ethical decision-making has made significant advances, particularly with regard to the ways in which different types of processing are implicated. In recent decades, much of this advancement has been driven by the influence of dual-process theories of cognition. Unfortunately, the wealth of findings in this context can be confusing for management scholars and practitioners who desire to know how best to encourage ethical behavior. While some studies suggest that deliberate reflection leads to more ethical behavior, other studies (...) find, in contrast, that intuitive decision-making leads to more ethical results. The goal of this integrative conceptual review is to help make sense of such apparently contradictory findings by identifying the moderating influences that lead to more versus less ethical decisions, whether they are made via intuitive or deliberative processes. Based on our integrative review of moderators from different disciplines and eras, we develop a taxonomy that can aid researchers in the task of identifying when similar constructs have been studied under different names. We organize our findings concerning these influences in accordance with four emergent moderator categories—psychological, situational, social, and physiological. This work helps us identify patterns of moderating factors across both intuitive and deliberative ethical decision-making, gaps that suggest future research directions and practical implications. (shrink)

The United Kingdom is a leader in genomics research, and the presence of numerous types of biobanks and the linking of health data and research within the UK evidences the importance of biobank-based research in the UK. There is no biobank-specific law in the UK and research on biobank materials is governed by a confusing set of statutory law, common law, regulations, and guidance documents. Several layers of applicable law, from European to local, further complicate an understanding of privacy protections. (...) Finally, biobanks frequently contain data in addition to the samples; the legal framework in the UK generally differentiates between data and samples and the form of the data affects the applicability of legal provisions. Biobanks must be licensed by the Human Tissue Authority; certain projects must be reviewed by Research Ethics Committees, and all projects are encouraged to be reviewed by them. Data Access Committees in biobanks are also common in the UK. While this confusing array of legal provisions leaves privacy protections in biobanking somewhat unclear, changes at the EU level may contribute to harmonization of approaches to privacy. (shrink)

The study reported in this paper explored the ethical requirements of social research participants, an area where there is still little empirical research, by interviewing people who had participated in one of five recent social research studies. The findings endorse the conceptualization of informed consent as a process rather than a one-off event. Four different dynamics of decision-making were followed by participants in terms of the timing of decisions to participate and the information on which they were based. Multiple information (...) events were important, as was verbal as well as written information. Study participants reacted unfavourably to the idea of written consent. Although prior information was relevant to participant experience of the interview, what emerged more strongly as relevant was the behaviour of interviewers and the interviewing strategy used. The authors suggest that naturalistic, authentic approaches to information-giving are necessary, and that in scrutinizing them research ethics committees need to look not only at written information but also at verbal information giving, and how interviewer information-giving is supported by training and supervision. They suggest that committees also need to concern themselves more broadly with who will carry out interviews and the training, mentoring and monitoring in place to shape their conduct of interviews. In considering research instruments, research ethics committees need to consider not only whether interviewers will capture accurate and appropriate data but also whether they are likely to lead to a satisfactory interaction for participants. Given the impossibility of anticipating each individual participants information needs and their reaction to the interviewing strategy, the authors suggest that interviewers and participants need to be encouraged to negotiate the conduct of interviews jointly, and discuss how such negotiating roles might be supported. (shrink)