In bioethics, discussions of justice have tended to focus on questions of fairness in access to health care: is there a right to medical treatment, and how should priorities be set when medical resources are scarce. But health care is only one of many factors that determine the extent to which people live healthy lives, and fairness is not the only consideration in determining whether a health policy is just. In this pathbreaking book, senior bioethicists Powers and Faden confront foundational (...) issues about health and justice. How much inequality in health can a just society tolerate. The audience for the book is scholars and students of bioethics and moral and political philosophy, as well as anyone interested in public health and health policy. (shrink)
In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...) in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)
In this paper, we argue that Plotinus denies deliberative forethought about the physical cosmos to the demiurge on the basis of certain basic and widely shared Platonic and Aristotelian assumptions about the character of divine thought. We then discuss how Plotinus can nonetheless maintain that the cosmos is «providentially» ordered.
Social evolution theory conventionally takes an externalist explanatory stance, treating observed cooperation as explanandum and the positive assortment of cooperative behaviour as explanans. We ask how the circumstances bringing about this positive assortment arose in the first place. Rather than merely push the explanatory problem back a step, we move from an externalist to an interactionist explanatory stance, in the spirit of Lewontin and the Niche Construction theorists. We develop a theory of ‘social niche construction’ in which we consider biological (...) entities to be both the subject and object of their own social evolution. Some important cases of the evolution of cooperation have the side-effect of causing changes in the hierarchical level at which the evolutionary process acts. This is because the traits that act to align the fitness interests of particles in a collective can also act to diminish the extent to which those particles are bearers of heritable fitness variance, while augmenting the extent to which collectives of such particles are bearers of heritable fitness variance. In this way, we can explain upward transitions in the hierarchical level at which the Darwinian machine operates in terms of particle-level selection, even though the outcome of the process is a collective-level selection regime. Our theory avoids the logical and metaphysical paradoxes faced by other attempts to explain evolutionary transitions. (shrink)
Eleven teachers and 254 urban middle-school students comprised the sample of this study examining the social and moral development outcomes of the integration of social cognitive domain theory within regular classroom instruction. Participating teachers were trained to construct and implement history lessons that stimulated students’ moral reasoning and conceptions of societal convention. In comparison with baselines and controls, teachers reduced didactic instruction and increased the proportion of class time devoted to small group discussions. Student engagement in transactive discourse significantly increased (...) in participating classes with significantly greater post-test levels of moral reasoning, concepts of social convention, and cross-domain coordination. Student production of operational versus representational transacts through transactive discussion was associated with growth in moral and societal concepts. Teachers continued teaching lessons constructed in the project a year after the research ended. (shrink)
Beginning with the well-knowncyber-rape in LambdaMOO, I argue that it ispossible to have real moral wrongs in virtualcommunities. I then generalize the account toshow how it applies to interactions in gamingand discussion communities. My account issupported by a view of moral realism thatacknowledges entities like intentions andcausal properties of actions. Austin's speechact theory is used to show that real people canact in virtual communities in ways that bothestablish practices and moral expectations, andwarrant strong identifications betweenthemselves and their online identities. Rawls'conception (...) of a social practice is used toanalyze the nature of the wrong and thestage-setting aspect of engaging in a practice. (shrink)
Articles by Lyn Horn and Alison Thompson highlight several points crucial to understanding how our theory figures in wider debates about social justice as well as the particular relevance of our theory for assessing the overall practice of public health (Horn, 2013; Thompson, 2013). We begin with these two articles, first to respond to and concur with many of their central points, and second to set the stage for dealing more efficiently with some points raised in the other articles.
: The increasing reliance upon, and perhaps the growing public and professional skepticism about, the special expertise of bioethicists suggests the need to consider the limits of moral expertise. For all the talk about method in bioethics, we, bioethicists, are still rather far off the mark in understanding what we are doing, even when we may be going about what we are doing fairly well. Quite often, what is most fundamentally at stake, but equally often insufficiently acknowledged, are inherently political, (...) essentially contested visions of the most compelling and attractive forms of life for individuals and social organization. The current situation in bioethics parallels similar debates in eighteenth-century jurisprudence, especially Jeremy Bentham's withering critique of the prevalent forms of judicial argument and his own, equally unsuccessful, attempt to develop a decision-making procedure in ethics that would operate on a plane above politics. The risk, both then and now, is that we will fail to appreciate the wide range of reasonable disagreement that will remain past the point of extended reflection and discussion. (shrink)
This paper reports research on the influence of corporate and individual characteristics on managers'' social orientation in Germany. The results indicate that mid-level managers expressed a significantly lower social orientation than low-level managers, and that job activity did not impact social orientation. Female respondents expressed a higher social orientation than male respondents. No impact of the political system origin (former East Germany versus former West Germany) on social orientation was shown. Overall, corporate position had a significantly higher impact on social (...) orientation than did the characteristics of the individuals surveyed. (shrink)
Can computer systems ever be considered moral agents? This paper considers two factors that are explored in the recent philosophical literature. First, there are the important domains in which computers are allowed to act, made possible by their greater functional capacities. Second, there is the claim that these functional capacities appear to embody relevant human abilities, such as autonomy and responsibility. I argue that neither the first (Domain-Function) factor nor the second (Simulacrum) factor gets at the central issue in the (...) case for computer moral agency: whether they can have the kinds of intentional states that cause their decisions and actions. I give an account that builds on traditional action theory and allows us to conceive of computers as genuine moral agents in virtue of their own causally efficacious intentional states. These states can cause harm or benefit to moral patients, but do not depend on computer consciousness or intelligence. (shrink)
The goal of this article is to explore how a social justice framework can help illuminate the role that consent should play in health and science policy. In the first section, we set the stage for our inquiry with the important case of Henrietta Lacks. Without her knowledge or consent, or that of her family, Mrs. Lacks’s cells gave rise to an enormous advance in biomedical science—the first immortal human cell line, or HeLa cells.
In this paper, we focus attention on the role of computer system complexity in ascribing responsibility. We begin by introducing the notion of technological moral action (TMA). TMA is carried out by the combination of a computer system user, a system designer (developers, programmers, and testers), and a computer system (hardware and software). We discuss three sometimes overlapping types of responsibility: causal responsibility, moral responsibility, and role responsibility. Our analysis is informed by the well-known accounts provided by Hart and Hart (...) and Honoré. While these accounts are helpful, they have misled philosophers and others by presupposing that responsibility can be ascribed in all cases of action simply by paying attention to the free and intended actions of human beings. Such accounts neglect the part played by technology in ascriptions of responsibility in cases of moral action with technology. For both moral and role responsibility, we argue that ascriptions of both causal and role responsibility depend on seeing action as complex in the sense described by TMA. We conclude by showing how our analysis enriches moral discourse about responsibility for TMA. (shrink)
My One Fallacy theory says there is only one fallacy: equivocation, or playing on an ambiguity. In this paper I explain how this theory arose from rnetaphilosophical concerns. And I contrast this theory with purely logical, dialectical, and psychological notions of fallacy.
What determines whether an action is right or wrong? Morality, Rules, and Consequences: A Critical Reader explores for students and researchers the relationship between consequentialist theory and moral rules. Most of the chapters focus on rule consequentialism or on the distinction between act and rule versions of consequentialism. Contributors, among them the leading philosophers in the discipline, suggest ways of assessing whether rule consequentialism could be a satisfactory moral theory. These essays, all of which are previously unpublished, provide students in (...) moral philosophy with essential material and ask key questions on just what the criteria for an adequate moral theory might be. (shrink)
: The focus of questions of justice in health policy has shifted during the last 20 years, beginning with questions about rights to health care, and then, by the late 1980s, turning to issues of rationing. More recently, attention has focused on alternatives to cost-effectiveness analysis. In addition, health inequalities, and not just inequalities in access to health care, have become the subject of moral analysis. This article examines how such trends have transformed the philosophical landscape and encouraged some in (...) bioethics to seek guidance on normative questions from outside of the contours of traditional philosophical arguments about justice. (shrink)
Abstract This paper examines research and theory regarding the process of moral judgement development within the family environment. Four major issues in research on the family's influence on moral judgement development are outlined and the existing data relevant to these issues are briefly presented. The author's approach to studying these issues is described. The implications of research on moral development within the family for moral education are also addressed.
Approaches to programming ethical behavior for computer systems face challenges that are both technical and philosophical in nature. In response, an incrementalist account of machine ethics is developed: a successive adaptation of programmed constraints to new, morally relevant abilities in computers. This approach allows progress under conditions of limited knowledge in both ethics and computer systems engineering and suggests reasons that we can circumvent broader philosophical questions about computer intelligence and autonomy.
New biotechnologies have the potential to both dramatically improve human well-being and dramatically widen inequalities in well-being. This paper addresses a question that lies squarely on the fault line of these two claims: When as a matter of justice are societies obligated to include a new biotechnology in a national healthcare system? This question is approached from the standpoint of a twin aim theory of justice, in which social structures, including nation-states, have double-barreled theoretical objectives with regard to human well-being. (...) The first aim is to achieve a sufficient level of well-being in each of six core dimensions. In the special case of healthcare systems, this aim is focally but not exclusively attentive to achieving health sufficiency as one of the core dimensions. The second aim is to combat the emergence and persistence of densely woven patterns of systematic disadvantage that tend to undermine the achievement of a sufficient level of health and the other core elements of well-being of some persons and groups. Judgments about entitlements to health related resources, including new biotechnologies, are made in light of a threshold notion of health sufficiency. What is enough or sufficient health? The answer that is defended here is that sufficient health is enough health for a decent human life, understood as enough health to live a full life course without preventable, significant functional disability or decrement in health, or treatable pain or suffering. When a state must include a new biotechnology in its national healthcare system is also influenced by ancillary concerns about the connection between health and other core dimensions of well-being. What counts as a significant functional impairment or health decrement is thus explicated, in part, in relation to the theory’s sufficiency aim for the other essential dimensions of well-being, and thus for a decent life, overall. Those elements of health that play a critical role in the experience of sufficient reasoning, affiliation, security, respect and self determination are especially important; any loss of health function or capacity that threatens the individual’s prospects for sufficiency in these other dimensions, including the relational egalitiarian concerns they entail, constitutes a significant functional impairment. Within national borders, individuals are thus entitled to those health-related goods and services that are essential for a sufficiency of each of the dimensions of well-being; with regard to self determination and respect, what is sufficient by way of guaranteed access to specific goods and services is going to depend on the implications of such access for where an individual stands in relation to her co-nationals. The content of any entitlement to health-related goods and services is also necessarily dynamic. What can be done for health and the other core dimensions of well-being as a function of technological innovation and diffusion is in constant flux. The paper concludes by considering the implications of this analysis for the conditions under which states are obligated to include access in their healthcare systems to one biotechnology, deep brain stimulation. (shrink)
Many of the contemporary disagreements regarding privacy are conceptual in nature. They concern the meaning or definition of privacy and the analytic basis of distinguishing privacy rights from other kinds of rights recognized within moral, political, or legal theories. The two main alternatives within this debate include reductionist views, which seek a narrow account of the kinds of invasions or intrusions distinctly involving privacy losses, and anti-reductionist theories, which treat a much broader array of interferences with a person as separate (...) and irreducible kinds of privacy invasions. Other theorists have expressed doubts about the prospects for achieving greater analytical precision even within a fairly expansive anti-reductionist approach. However, a reductionist privacy definition is defended in this article, and its primary theoretical virtues are its ability to unify and explain the insights of several competing definitions and its role in developing an account of privacy rights that is both internally coherent and consistent with a plausible understanding of the theoretical basis for a number of related rights. (shrink)
While it is customary for instructors when teaching a philosophical text to point to where a philosopher lays out their overall plan and then let students fill in the pieces, no such passage exists in Aristotle’s “Nicomachean Ethics.” While many philosophy courses focus on analyzing arguments, Aristotle’s work provides students a unique opportunity to learn how to assemble the parts into a coherent whole. This paper describes an assignment where students are asked to construct a diagram that visually represents the (...) structure of Aristotle’s work. In response to the tremendous success of this assignment, the paper examines the assignment’s precedents, suggests a theoretical basis for its success, and details its practical benefits. (shrink)
Rule-based ethical theories like Kant's appear to be promising for machine ethics because of the computational structure of their judgments. On one formalist interpretation of Kant's categorical imperative, for instance, a machine could place prospective actions into the traditional deontic categories (forbidden, permissible, obligatory) by a simple consistency test on the maxim of action. We might enhance this test by adding a declarative set of subsidiary maxims and other "buttressing" rules. The ethical judgment is then an outcome of the consistency (...) test. While this kind of test can generate results, it may be vacuous in the sense that it would do no more than forbid obviously contradictory maxims of action. It is also possible that the kind of inference in such a rule-based system may be non-monotonic. I discuss these challenges to a rule-based machine ethics, starting from the framework of Kantian ethics. (shrink)
Numerous reports have noted decreasing numbers of antibiotic approvals. To determine the context for this decline, we examined all new molecule entities (NMEs) and new biologic licenses (NBLs) approved by the FDA from 1980–2009, and compared approval rates of the 61 approved antibiotics to trends in other drug classes. We also tracked withdrawals of approved drugs and found more withdrawals for antibiotics than other drug classes. After adjusting for drugs subsequently withdrawn, the record for antibiotic innovation is less dire than (...) previously reported. We also report problems with the quality of the approved antibiotics studied. Future policies providing incentives for new antibiotic development should not be based on simple numerical targets and key provisions should ensure appropriate quality as well as quantity of antibiotic drug innovation. (shrink)
Drawing from a four-year study of US science institutions that support biological control of arthropods, this article examines the decline in biological control institutional capacity in California within the context of both declining public interest science and declining agricultural research activism. After explaining how debates over the public interest character of biological control science have shaped institutions in California, we use scientometric methods to assess the present status and trends in biological control programs within both the University of California Land (...) Grant System and the California Department of Food and Agriculture. We present available data on the number of scientific positions and the types of positions to discuss the impact on the amount of public interest research on biological control in California. We use sociograms to depict how biological control science networks have been reconfigured over time. Our quantitative and qualitative analyses indicate that the following factors contributed to the decline of biological control science in California over the 45-year period analyzed: (1) the institutional reconfiguration of university research priorities; (2) the fraying networks within and increasing specialization of biological control science; (3) the transformation of the social organization of the life science work, including privatization; and (4) the abandonment of this thematic area by civil society activist groups. This broad array of forces suggests that biological control, as a public interest science, will require a deliberate intervention, based on advocacy of clear public interest criteria. (shrink)
Ad hominem arguments argue that some opponent should not be heard and no argument of that opponent should be heard or considered. The opponent has generally pernicious views, false and harmful. Moreover he is diabolically clever at arguing for his views. Thus, the ad hominem argument is essentially a device by which non-intellectuals try to wrest control of a dialectical situation from intellectuals. Stifling intellectuals, disrupting the dialectical situation, is an unpleasant conclusion, but no fallacy has been shown in what (...) leads up to that conclusion. (shrink)