Exploring the economic, cultural and political role of slavery in different societies, this volume includes selections from historians, economists and contemporaries - from those enslaved as well as from free members of slave owning societies.

Made-Up Minds addresses fundamental questions of learning and concept invention by means of an innovative computer program that is based on the cognitive ...

In Good and Real, Gary Drescher examines a series of provocative paradoxes about consciousness, choice, ethics, quantum mechanics, and other topics, in an effort to reconcile a purely mechanical view of the universe with key aspects of our ...

From the materialist stance that I find compelling, the metaproblem of consciousness -- explaining why the problem of consciousness seems hard -- is hardly distinct from the 'easy' problem of explaining how the underlying physical/computational system works, and how it gives rise to perceptions of its own functioning. I discuss several confusions that might plausibly arise in that process, and propose that these confusions could create apparent gaps, ontological and epistemic, in materialist accounts of consciousness, thereby making the hard problem (...) hard. Inversely, resolving these confusions may help solve the hard problem. (shrink)

When making decisions, humans can observe many kinds of information about others' activities, but their effects on performance are not well understood. We investigated social learning strategies using a simple problem-solving task in which participants search a complex space, and each can view and imitate others' solutions. Results showed that participants combined multiple sources of information to guide learning, including payoffs of peers' solutions, popularity of solution elements among peers, similarity of peers' solutions to their own, and relative payoffs from (...) individual exploration. Furthermore, performance was positively associated with imitation rates at both the individual and group levels. When peers' payoffs were hidden, popularity and similarity biases reversed, participants searched more broadly and randomly, and both quality and equity of exploration suffered. We conclude that when peers' solutions can be effectively compared, imitation does not simply permit scrounging, but it can also facilitate propagation of good solutions for further cumulative exploration. (shrink)

This paper presents a speculative model of the cognitive mechanisms underlying the transition from episodic to mimetic (or memetic) culture with the arrival of Homo erectus, which Donald [1991] claims paved the way for the unique features of human culture. The model draws on Kauffman's [1993] theory of how an information-evolving system emerges through the formation of an autocatalytic network. Though originally formulated to explain the origin of life, this theory also provides a plausible account of how discrete episodic memories (...) become woven into an internal model of the world, or worldview, that both structures, and is structured by, self-triggered streams of thought. Social interaction plays a role in (and may be critical to) this process. Implications for cognitive development are explored. (shrink)

Reproductive autonomy is central to women’s welfare both because childbearing takes place in women’s bodies and because they are generally expected to take primary responsibility for child rearing. In 2005, the factors that influence their autonomy most strongly are poverty and belief systems that devalue such autonomy. Unfortunately, such autonomy is a low priority for most societies, or is anathema to their belief systems altogether. This situation is doubly sad because women’s reproductive autonomy is intrinsically valuable for women and also (...) instrumentally valuable for the welfare of humankind. This paper takes for granted the moral and practical necessity of such autonomy and digs deeper into the question of what such a commitment might entail, focusing on the mid-level policy making that, at least in the US and Canada, plays a significant role in shaping women’s options. This paper examines a large teaching hospital’s policy on reduction of multifetal pregnancies. The policy permits reduction of triplets to twins, but not twins to a singleton. As there is no morally relevant difference between these two types of reduction, it is evident that inappropriate medicalisation can still limit women’s autonomy in undesirable ways. (shrink)

The current system of ethical review for medical research in the United Kingdom is changing from the current system involving large committees of 7–18 members reviewing every individual application to a system involving pre-review by small sub-committees of National Research Ethics Officers , who have a remit to approve studies if they believe there are no material ethical issues imposed by the research. The reliability of this new system depends on the reliability of the NREAs and in particular the ability (...) of small groups to effectively identify and appropriately assess the seriousness of all the material ethical issues that may be posed by an application. There is anecdotal evidence to suggest that many individual research ethics committee members have had experience of believing that a study presents no material ethical concerns, then on reaching the committee and discussing the application they realise that the committee feels it does present significant ethical concerns. If this is the case then this casts doubt on the reliability of NREAs or small groups to effectively identify ethically problematic research and appropriately respond to this to protect research participants. In this paper we describe a small questionnaire based piece of research carried out to assess how common this and other relevant experiences are. (shrink)

Benatar argues that it is better never to have been born because of the harms always associated with human existence. Non-existence entails no harm, along with no experience of the absence of any benefits that existence might offer. Therefore, he maintains that procreation is morally irresponsible, along with the use of reproductive technology to have children. Women should seek termination if they become pregnant and it would be better for potential future generations if humans become extinct as soon as humanely (...) possible. These views are challenged by the argument that while decisions not to procreate may be rational on the grounds of the harm that might occur, it may equally rational to gamble under certain circumstances that future children would be better-off experiencing the harms and benefits of life rather than never having the opportunity of experiencing anything. To the degree that Benatar’s arguments preclude the potential rationality of any such gamble, their moral relevance to concrete issues concerning human reproduction is weakened. However, he is right to emphasise the importance of foreseen harm when decisions are made to attempt to have children. (shrink)

This book presents three of the works of Abdu'l-Bahá, son of the founder of the Bahá'i Faith, dealing with social and political issues.00In 'The Secret of Divine Civilization' (1875) Abdu'l-Bahá supports the administrative and broader social reforms of Mirzá Hosayn Khán, but looks mainly for organic reform through the efforts of Iranian intellectuals to waken and educate the masses. In this work, Abdu'l-Bahá gives virtuous and progressive Islamic clerics a leading role among these intellectuals, indeed most of his appeals are (...) directed specifically to them. 'A Traveller's Narrative' (1889/90) is an authoritative statement of the broad lines of Bahá'i social and political thinking. 'The Art of Governance' (1892/93) was written as Iran entered a pre-revolutionary phase, and ideas that we recognise today as the precursors of political Islam were spreading. It sets out the principles underlying the ideal relationship between religion and politics and between the government and the people.00In addition to presenting the first parallel text translations of these works, the Persian texts incorporate notes on variants in the early published sources. An introduction outlines the intellectual and political landscape from which Abdu'l-Bahá wrote, and in which his expected readers lived. (shrink)

Sur la toile de fond de la theologie negative, tissee par la discussion des apories que soulevent les notions de l'ineffable et de l'un, Damascius, le dernier diadoque de l'Ecole d'Athenes, elaboreson systeme metaphysique, sans se departir de la rigueur de sa methode aporetique, qui est une critique radicale du langage a l'interieur des coordonnees fixees par le Parmenide de Platon et par les Oracles Chaldaiques. Damascius, dans une enquete unique par son ampleur et son originalite questionne tour a tour (...) Porphyre, Jamblique, Syrianus et Proclus sur les principes; il examine les problemes que pose, en derivation de l'un, la formation de la trinite; de l'un-tout (la limite), du tout-un (l'infini) et de l'unifie (le mixte ou l'etre). Lien a priori entre l'un-tout et le tout-un, l'unifie est le principe de constitution de tout ordre et de toute realite. Damascius etudie sa nature de mixte originaire et autoconstituant, d'etre exemplaire et de premier intelligible. Cette notion lui permet de pas au crible, pour la mieux fonder, la problematique neoplatonicienne de la manence, de la procession et de la conversion. Les divers niveaux d'unification de la pluralite intelligible l'amenent a construire une theorie generale des elements, des parties et des formes Au passage, de nombreux textes, capitaux du point de vue de l'ontologie et de la doctrine de la connaissance, font regretter qu'ils aient ete inconnus du Moyen Age et qu'ils le demeurent pour beaucoup de nos contemporains. (shrink)

Objective: To describe the frequency of support for terminal sedation among internists, determine whether support for terminal sedation is accompanied by support for physician assisted suicide , and explore characteristics of internists who support terminal sedation but not assisted suicide.Design: A statewide, anonymous postal survey.Setting: Connecticut, USA.Participants: 677 Connecticut members of the American College of Physicians.Measurements: Attitudes toward terminal sedation and assisted suicide; experience providing primary care to terminally ill patients; demographic and religious characteristics.Results: 78% of respondents believed that if (...) a terminally ill patient has intractable pain despite aggressive analgesia, it is ethically appropriate to provide terminal sedation . Of those who favoured terminal sedation, 38% also agreed that PAS is ethically appropriate in some circumstances. Along a three point spectrum of aggressiveness in end of life care, the plurality of respondents were in the middle, agreeing with terminal sedation but not with PAS. Compared with respondents who were less aggressive or more aggressive, physicians in this middle group were more likely to report having more experience providing primary care to terminally ill patients and attending religious services more frequently .Conclusions: Support for terminal sedation was widespread in this population of physicians, and most who agreed with terminal sedation did not support PAS. Most internists who support aggressive palliation appear likely to draw an ethical line between terminal sedation and assisted suicide. (shrink)

Aims and background: The present work assessed the impact of two decrees on ethics committees in Italy, aimed at bringing the national laws on the conduct of clinical trials into line with the rest of the EC, and regulating and facilitating not-for-profit research.Material and methods: Prospectively collected data from an Italian multicentre study were examined with respect to the ethics review process. Administrative and time elements of the review process were audited. Main outcome measures were time between the application submission (...) and the ethics committee definitive opinion, type and number of application submission forms, number of ethics committees that refused fee exemption, and time between the ethics committee approval and the administrative authorisation.Results: A total of 134 local research ethics committees were approached. Application submission procedures and application forms varied greatly; paper submission was mandatory. The median time from submission to approval was 72 days. Only two LRECs refused the fee exemption. The median time from LREC approval to administrative agreement was 50 days and only 9.6% of local authorities came to a verbal agreement with the sponsor.Conclusions: Italian LRECs are still not sufficiently efficient in complying with the Directive 2001/20/EC requirement . Better coordination of LRECs work is needed although the optimal level of coordination between them is still not known. In the meantime, national guidelines are needed concerning the application of Directive 2001/20/EC. The behaviour of Italian LRECs towards not-for-profit research was excellent although only the fee exemption was requested. (shrink)

Ex-vivo tissue engineering is an emerging medical technology. Its aim is to regenerate tissues and organs and to restore them to full physiological activity. Some clinical trials with human tissue engineered products have been conducted and others will follow. These trials not only have to confirm the therapeutic value of the HTEP, they also have to provide insight in its regenerative activity, its safety and long-term effects. The development of these trials is aggravated by the complexity of the tissue engineering (...) process and product. This paper investigates how this complexity influences the ethical conduct of clinical trials with HTEPs. We focus on the value and validity of the trial, the risk-benefit ratio and the protection of the trial participant. We argue that trials with HTEPs need a robust methodology. The risk-benefit ratio of a new HTEP must be determined and compared with available efficacious therapies. This requires the identification and minimisation of risks associated with tissue engineering. Finally a process as complex as tissue engineering presents serious challenges for the informed consent process, and for the protection of the trial participant during and after the trial. (shrink)

We are essentially a society of cells that come from a single cell, the fertilised egg. Research in cell biology has made major advances that are relevant to medicine and our understanding of life. Our understanding of the role of genes and proteins is impressive. But is this science dangerous? The whole of Western literature has not been kind to cell scientists and is filled with images of scientists meddling with nature, with disastrous results.1 Just consider Shelley’s Frankenstein, Goethe’s Faust (...) and Huxley’s Brave New World. One will search with very little success for a novel in which scientists come out well—the persistent image is that of scientists as a group unconcerned with ethical issues.There is a fear and distrust of cell science, particularly genetic engineering, leading to genetically modified foods, genetic modification of humans, cloning and stem cells. There is something of a revulsion in humankind’s meddling with nature and a longing for a Rousseauish-like return to golden age of innocence. There is anxiety that scientists lack both wisdom and social responsibility and are so motivated by ambition that they will follow their research anywhere, no matter what the consequences. Scientists are repeatedly referred to as “playing God”. Many of these criticisms coexist with the hope, particularly in medicine, that science will provide cures to all major illnesses, such as cancer, heart disease and genetic disabilities such as cystic fibrosis. But is cell science dangerous and what are the special social responsibilities of scientists? It is worth noting one irony: although scientists are blamed for making us live in a high-risk society, it is only because of science that we know about these risks, such as those related to health.The media must bear much of the responsibility for the misunderstanding of genetics as genetic pornography is, …. (shrink)

The Declaration of Helsinki is recognised worldwide as a cornerstone of research ethics. Working in the wake of the Nazi doctors’ trials at Nuremberg, drafters of the Declaration set out to codify the obligations of physician-researchers to research participants. Its significance cannot be overstated. Indeed, it is cited in most major guidelines on research involving humans and in the regulations of over a dozen countries.Although it has undergone five revisions,1 and most recently incorporated language aimed at addressing concerns over research (...) carried out in resource-poor countries,2–5 the Declaration could go much farther in addressing the profoundly altered landscape of research with humans. Research involving humans is now a global enterprise and often involves participants from resource-poor countries. Rather than being carried out at single institutions by veteran researchers, many studies are now conducted at many locations—including sites that are not academic medical centres—by new and relatively inexperienced investigators. A growing number of projects involve novel agents, based on innovative work in genomics and proteomics. Increasingly, research is sponsored by the for-profit sector. National governments and professional organisations around the globe provide laws, regulations and standards for the conduct of research involving humans. Considerable scholarship also critiques and guides this endeavour.In light of the current effort of the World Medical Association to revise the Declaration, we offer ideas on how to re-conceive the concept of “vulnerability” and its links with the principle of justice and, in turn, redirect the attention of researchers towards those who might be so designated.In the research context, “vulnerability” is associated with an inability partly or totally to protect one’s own interests. Typically, conceptions of vulnerability centre upon characteristics associated with particular groups that …. (shrink)

I consider reasons for questioning ‘the laws of logic’, and suggest that these laws do not accord with everyday reality. Either they are rhetorical tools rather than absolute truths, or else Plato and his successors were right to think that they identify a reality distinct from the ordinary world of experience, and also from the ultimate source of reality.

In their responses to Dr Osamu Muramoto Watchtower Society spokesmen David Malyon and Donald Ridley ,1–3 deny many of the criticisms levelled against the WTS by Muramoto.4–6 In this paper I argue as a Jehovah's Witness and on behalf of the members of AJWRB that there is no biblical basis for the WTS's partial ban on blood and that this dissenting theological view should be made clear to all JW patients who reject blood on religious grounds. Such patients should be (...) guaranteed confidentiality should they accept whole blood or components that are banned by the WTS. I argue against Malyon's and Ridley's claim that WTS policy allows freedom of conscience to individual JWs and that it is non-coercive and non-punitive in dealing with conscientious dissent and I challenge the notion that there is monolithic support of the WTS blood policy among those who identify themselves as JWs and carry the WTS “advance directive”. (shrink)

Background: The search for genetic variants between racial/ethnic groups to explain differential disease susceptibility and drug response has provoked sharp criticisms, challenging the appropriateness of using race/ethnicity as a variable in genetics research, because such categories are social constructs and not biological classifications.Objectives: To gain insight into how a group of genetic scientists conceptualise and use racial/ethnic variables in their work and their strategies for managing the ethical issues and consequences of this practice.Methods: In-depth semi-structured interviews were conducted with a (...) purposive sample of 30 genetic researchers who use racial/ethnic variables in their research. Standard qualitative methods of content analysis were used.Results: Most of the genetic researchers viewed racial/ethnic variables as arbitrary and very poorly defined, and in turn as scientifically inadequate. However, most defended their use, describing them as useful proxy variables on a road to “imminent medical progress”. None had developed overt strategies for addressing these inadequacies, with many instead asserting that science will inevitably correct itself and saying that meanwhile researchers should “be careful” in the language chosen for reporting findings.Conclusions: While the legitimacy and consequences of using racial/ethnic variables in genetics research has been widely criticised, ethical oversight is left to genetic researchers themselves. Given the general vagueness and imprecision we found amongst these researchers regarding their use of these variables, they do not seem well equipped for such an undertaking. It would seem imperative that research ethicist move forward to develop specific policies and practices to assure the scientific integrity of genetic research on biological differences between population groups. (shrink)

It remains unclear what patient advocacy actually entails and what values it ought to embody. It will be useful to ascertain whether advocacy means supporting any decision the patient makes, or if the advocate can claim to represent the patient by asserting well-intentioned paternalistic claims on the patient's behalf. This is especially significant because the position of advocate brings with it certain privileges on the basis of of presumed insight into patient-perceived interests, namely, entitlement to take part in clinical decision (...) making and increased professional standing. Three issues related to patient advocacy will be explored: are patient advocates necessary; what does advocacy entail, and who ought to represent patients in this way—arguments for and against prospective candidates will also be covered. The paper considers whether advocates are necessary since not only can they be dangerously paternalistic, but the salutary values advocacy embodies are already part of good professional health care. (shrink)

No one who cares about equal opportunity can derive much comfort from the present occupational distribution of working women. In the various industrial societies of the West, women comprise between one quarter and one-half of the national labor force. However, they tend to clustered in employment sectors – especially clerical, sales, and service J occupations – which rank relatively low in remuneration, status, autonomy, and other perquisites. Meanwhile, the more prestigious and rewarding managerial and professional positions, as well as the (...) major categories of blue-collar labor, remain largely a male preserve. In the same societies the average income earned by full-time female workers is one-half to two- J thirds that of their male counterparts. Although this disparity owes much to i other factors, including lower pay for work similar or even identical to that r standardly done by men, much of it can be explained only by the concentration of working women in traditional female job ghettos. (shrink)

When Amartya Sen defends his capability theory of well-being he contrasts it with the utility theory advocated by the classical utilitarians, including John Stuart Mill. Yet a closer examination of the two theories reveals that they are much more similar than they appear. Each theory can be interpreted in either a subjective or an objective way. When both are interpreted subjectively the differences between them are slight, and likewise for the objective interpretations. Finally, whatever differences may remain are less important (...) than they might seem, since the two theories are developed by Sen and Mill for different purposes and are in that sense not genuine rivals. (shrink)

People should be allowed to decide how and where they wish to be tested for HIV without there being a formal requirement for pretest counsellingIn his paper, Ethics of HIV testing in general practice without informed consent, Fraser argues that pretest counselling and informed consent are pillars of the ethical conduct of HIV testing. In my response I want to look critically at these contentions. While I will agree with Fraser that it is always necessary to get informed consent from (...) a patient for an HIV test I will argue that an emphasis on pretest counselling as a prerequisite for testing can actually undermine a patient’s autonomy, the very principle that informed consent seeks to promote.This response will start with an analysis of Case Two as this highlights the fundamental importance of informed consent. It will then go on to look at Case One and show how the special application of informed consent in the field of HIV testing can, in certain circumstances, lead to a reduction in patient autonomy.CASE TWOIn Fraser’s second case a 43 year old married clergyman presented with a recurrent infection of his little toe and the preliminary lab reports queried Kaposi’s sarcoma. The general practitioner thought that because of the patient’s lifestyle there was little risk of HIV infection, “suggesting the possibility of HIV, when it is unexpected and the risk low, can in itself cause anxiety and distress”. On these grounds the GP did not call the patient in for an HIV test.Some might argue that the GP should have tested the clergyman. This could have been done in one of two ways: by seeking his explicit consent for an HIV test, or by getting blanket consent for a range of tests, including HIV, without HIV being explicitly mentioned. …. (shrink)

As we die, our respiratory pattern is altered and we seem to gasp and struggle for each breath. Such gasping is commonly seen as a clear sign of dyspnoea and suffering by families and loved ones, however, it is unclear whether it is perceived at all by the dying person. Narcotics and sedatives do not seem to affect these gasping respirations. In this issue of the Journal of Medical Ethics, we are asked to consider whether the last gasp of a (...) dying patient could be or, perhaps, even should be avoided by administering neuromuscular blockers to palliate dying patients. For many reasons, such as our current failure to alleviate pain and distress, stories of inadequate analgesia and sedation in critically ill paralysed patients and the inability to know the intent—whether to palliate or to euthanise—it would seem that administering neuromuscular blockers should not be ethically permissible. (shrink)

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% of (...) respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

The publication of the article “Recent Models of the African Iron Age and the Cattle-Related Evidence” by Hromnik in a journal sponsored by Unesco raises a number of serious issues which we, as members of the International Scientific Committee charged with the responsibility of preparing an up-to-date and scientific history of Africa purged of its mists of racist propaganda, unfounded assertions and misleading and dangerous misinterpretations, cannot ignore. These issues include the scientific accuracy or authenticity of the article.

Three of the four commentators endorse our concerns about intervention by the Roman Catholic church as anamicus curiaein civil litigation, with few reservations. One commentary rejects our arguments in toto. We deal first with the three commentaries that support our arguments; secondly, with the reservations and qualifications in those commentaries, and thirdly, with the commentary that totally rejects our arguments.