As bioethics gains more prominence in public policy debates, it is time to more fully reflect on the following: what is its role in the public square, and what limitations relate to and barriers impede its fulfilment of this role? I contend we should consider the how of bioethics (as a policy influencer) rather than simply focus on the who or what of bioethical enquiry. This is not to suggest considerations of latter categories are not important, only that too little (...) attention has been paid to parallel or resulting policy involvement—involvement that will require specialised skills and knowledge that we can develop with a proactive (vs reactive) stance. Moreover, and equally critically, this how of public policy involvement will require more transparency regarding influences (eg, philosophical, ideological, cultural, socio-political) on what bioethicists bring to the table and what constituency base each represents—a humility as to the scope of one's role. In this vision, bioethics is not one single person or belief system for a policymaker to call to guide or give support to a position; rather, it offers tools—formed and utilised by a diverse disciplinary range of individuals—to help guide ethical analysis of biomedical endeavours, with the goal of infusion and diffusion of ethical enquiry and prioritisation in health policymaking, and greater humility among bioethicists who inform this discussion. (shrink)

Medical-legal partnerships (MLPs) — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. This article examines the unique, interrelated ethical issues that confront the clinical and legal partners (...) involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. The commonalities in ethical approaches represent a potential bridge between legal and health care advocacy for patient/client well-being. Bioethics has a role to play in building and analyzing this bridge: bioethics may serve as a discourse and method to enhance collaboration by highlighting common ethical foundations and refocusing legal and clinical partners on their similar goals of service for patients/clients. This article explores this bridging role of bioethics, through a series of case studies. It concludes with recommendations to strengthen the collaborations. (shrink)

Medical-legal partnerships — collaborative endeavors between health care clinicians and lawyers to more effectively address issues impacting health care — have proliferated over the past decade. The goal of this interdisciplinary approach is to improve the health outcomes and quality of life of patients and families, recognizing the many non-medical influences on health care and thus the value of an interdisciplinary team to enhance health. There are currently over 180 MLPs at over 200 hospitals and health centers in the United (...) States, with increasing federal interest and potential legislative support of this model.This article examines the unique, interrelated, and often similar ethical issues that confront the clinical and legal partners involved in MLPs. We contend that the ethical precepts of the clinical and legal professions should be seen as opportunities, not barriers, to further the interdisciplinary nature of MLPs. (shrink)

Law is now routinely included in the medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework. There seems to lack, however, a systematic understanding of what works in terms of getting across an effective depth and breadth of legal knowledge for medical students — or what such would even look like. Moreover, and more critically, while some literature addresses these what, when, how, and who questions, a more fundamental question is left unanswered: why teach law in medical (...) school? This article suggests a process to reveal a more consensual understanding of this latter question. The author highlights findings and recommendations of some of the leading literature to date related to teaching law in medical schools, and also recent U.K. projects addressing legal teaching in medical schools. Reflecting on these materials and activities, the author suggests that we take a “pause” before we argue for more or different legal topics within the medical curriculum. Before we alter the curricula for more and/or different “law,” first, it is critical to have a meaningful, stakeholder-driven, consensus-seeking discussion of the goals of legal education: why do we think it matters that medical students learn about “the law”? (shrink)

[T]each the law to empower physicians individually and collectively to use the law and law colleagues to serve patients and promote public welfare; in short to better foster the goals of the medical profession.And yet:[A]ntipathy appears to be deeper and more pervasive than ever before, making it hard to imagine that relations between attorneys and physicians can get much worse.It has long been recognized that an understanding of at least some core legal rules and concepts is an important piece of (...) medical training. To address this, law is now typically part of the core medical school curriculum, often incorporated into bioethics and/or practice of medicine coursework — whether as part of a distinct course or series of courses or threaded through the curriculum. While often this education focuses on rules, some have recommended that it also include fundamentals of legal reasoning, and go beyond knowledge to include skills, attitudes, and behaviors vis-à-vis the law. (shrink)

This article describes implementation of a longitudinal curriculum in public health law, building on doctrinal coursework with skills-based coursework and opportunities for interdisciplinary, community-based engagement and service learning. It specifically describes development of a Policy Practicum, giving an example of how law students can learn policy skills and skills of effective community coalition work through a healthy homes partnership, highlighting areas where the curriculum can incorporate interdisciplinary education. It offers lessons learned during the curriculum-building process, and concludes with a more (...) intensive service-learning strategy through the development of a Policy Lab. (shrink)

Cultural effects can influence the results of causal genetic analyses, such as Mendelian randomisation, but the potential influences of culture on genotype–phenotype associations are not currently well understood. Different genetic variants could be associated with different phenotypes in different populations, or culture could confound or influence the direction of the association between genotypes and phenotypes in different populations.

The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

Against the background of the exclusion of many feminist methodologies from mainstream philosophy, and in light of the methodological challenges of providing accounts of experience responsive to the lives of agents, in this paper I return to early feminist philosophers of emotion to highlight how they anticipate and respond to methodological criticisms. Sue Campbell (1956–2011) was one philosopher who used methodological quandaries to strengthen her account of the formation and expression of feelings (Campbell ). By rereading selected texts (...) together intentionally for their structural and methodological strategies, I emphasize the power of formal characteristics to make insightful claims about experience possible. I consider how feminist philosophers of “experienced agency” can put these strategies to use in facing ongoing methodological criticisms, taking as a case study an account of how it can feel to act responsibly against injustice. (shrink)

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development (...) of agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

"Il faudrait que quelqu'un chez vous fasse un roman sur un intellectuel d'Europe centrale sous le coup des derniers événements. Pas seulement pour la curiosité psychologique. Pour apprendre à voir ce que vous n'aimez pas regarder", écrivait le phénoménologue tchèque Jan Patocka, en juillet 1949, à son ami Robert Campbell, philosophe et mathématicien français, auteur, en 1945, du premier ouvrage consacré aux écrits et à la pensée de Jean-Paul Sartre. Mieux qu'un roman, la correspondance amicale et philosophique que les (...) deux hommes échangeront pendant une trentaine d'années, avec deux hiatus dus aux aléas des circonstances, publiques et privées, depuis le lendemain de la Seconde Guerre mondiale, à travers le virage totalitaire de l'"autre Europe", le relatif dégel des années 1960 et l'avant-"printemps de Prague", jusqu'à l'engagement de Patocka dans le mouvement de la Charte 77 pour la défense des droits de l'homme, représente, dans ses trois dimensions indissolublement enchevêtrées de l'intime-quotidien, de l'historico-politique et de la pensée, un document d'une rare valeur précisément en ce sens. Un document qui nous met sous les yeux un exemple concret de ce que Patocka nomme "la vie dans l'idée". (shrink)

In this book John Campbell shows that the general structural features of human thought can be seen as having their source in the distinctive ways in which we...

Imagination is celebrated as our vehicle for escape from the mundane here and now. It transports us to distant lands of magic and make-believe, and provides us with diversions during boring meetings or long bus rides. Yet the focus on imagination as a means of escape from the real world minimizes the fact that imagination seems also to furnish us with knowledge about it. Imagination seems an essential component in our endeavor to learn about the world in which we live--whether (...) we're planning for the future, aiming to understand other people, or figuring out whether two puzzle pieces fit together. But how can the same mental power that allows us to escape the world as it currently is also inform us about the world as it currently is? Ten original essays grapple with this neglected question; in doing so, they present a diverse array of positions ranging from cautious optimism to deep-seated pessimism. Blending perspectives from philosophy of mind, cognitive science, epistemology, aesthetics, and ethics, Knowledge Through Imagination sheds new light on the epistemic role of imagination. (shrink)

In Markets with Limits: How Commodification of Academia Derails Debate, James Stacey Taylor presents a well-written book that is, in great part, a response to Peter Jaworski and Jason Brennan’s work Markets Without Limits: Moral Virtues and Commercial Interests. In the first part of Taylor’s book, he effectively illustrates the misguided nature of many of Jaworski and Brennan’s arguments. Taylor maintains that Brennan and Jaworski misinterpret the work of their “anti-commodification” opponents. After this critique, the book takes a dramatic turn (...) as Taylor critiques the market incentives involved in academia and attempts to explain the structures that allow for inferior work, like that of Brennan and Jaworski, to be incentivized. By directly linking the two parts of the work and holding up Markets Without Limits: Moral Virtues and Commercial Interests as an example of inferior academic work, there is sometimes an undercurrent of an academic spat at play. Also, given the shift in the book and scope of both projects undertaken by Taylor, I believe this work could have been developed into several manuscripts, or a series of articles. In its current form, chapters 8–10 seem more rushed than the rest of the work and could have benefitted from additional space to be flushed out in the detail they deserve. It is this later section that I believe could benefit the most from revision and expansion. (shrink)

A fresh explication of the Thomist justification of self-defense casts off the hobbles of the principle of double effects to find a more secure footing in the historicaldevelopment of subjective natural rights by medieval jurists, and a straight-forward application to the latent threat of death in childbirth posed by non-consensual pregnancy. By articulating the implicit Thomistic right to defensive abortion in terms of conditional rights bestowed in Creation as correlative to particular natural law duties, justly proportionate limits to defensive abortion (...) are identified, and balanced against the forfeited or reserved natural rights variously imputed to conceptus and embryo in non-consensual pregnancies. Subsequently, the varieties of involuntary consent are examined from a Thomist perspective with a view to their relevance in justifying recourse to a rehabilitated practice of defensive abortion when free and full consent to impregnation and childbirth is absent. (shrink)

In recent analytic metaphysics, the view that ‘ordinary inanimate objects such as sticks and stones, tables and chairs, simply do not exist’ has been defended by some noteworthy writers. Thomasson opposes such revisionary ontology in favour of an ontology that is conservative with respect to common sense. The book is written in a straightforward, methodical and down-to-earth style. It is also relatively non-specialized, enabling the author and her readers to approach problems that are often dealt with in isolation in a (...) more unified way.Thomasson's arguments are mainly counter-attacks on six ‘eliminativist’ arguments against ordinary objects. A causal redundancy argument espoused by Trenton Merricks holds that to suppose that there are ordinary objects is to suppose that these objects have distinctive causal powers. However, the casual efficacy of a baseball, for example, is exhausted by that of some suitably arranged …. (shrink)

Taking a fundamentally critical approach to the subject of business ethics, this book deals with the traditional material of ethics in business, as well as introducing and surveying some of the most interesting developments in critical ethical theory which have not yet been introduced to the mainstream. Including chapters on different philosophical approaches to ethics, this is a highly structured and clearly written textbook, the first book of its kind on this often neglected aspect of business.

Irrelevant emotional stimuli often capture attention, disrupting ongoing cognitive processes. In two experiments, we examined whether availability of rewards can prevent...

This book is a philosophical exploration of disorientation and its significance for action. Disorientations are human experiences of losing one's bearings, such that life is disrupted and it is not clear how to go on. In the face of life experiences like trauma, grief, illness, migration, education, queer identification, and consciousness raising, individuals can be deeply disoriented. These and other disorientations are not rare. Although disorientations can be common and powerful parts of individuals' lives, they remain uncharacterized by Western philosophers, (...) and overlooked by ethicists.Disorientations can paralyze, overwhelm, embitter, and misdirect moral agents, and moral philosophy and motivational psychology have important insights to offer into why this is. More perplexing are the ways disorientations may prompt improved moral action.Ami Harbin draws on first person accounts, philosophical texts, and qualitative and quantitative research to show that in some cases of disorientation, individuals gain new forms of awareness of political complexity and social norms, and new habits of relating to others and an unpredictable moral landscape. She then argues for the moral and political promise of these gains. A major contention of the book is that disorientations have 'non-resolutionary effects': they can help us act without first helping us resolve what to do. In exploring these possibilities, Disorientation and Moral Life contributes to philosophy of emotions, moral philosophy, and political thought from a distinctly feminist perspective. It makes the case for seeing disorientations as having the power to motivate profound and long-term shifts in moral and political action. A feminist re-envisioning of moral psychology provides the framework for understanding how they do so. (shrink)

Quietist Moral Realists accept that there are moral facts and properties, while aiming to avoid many of the explanatory burdens thought to fall on traditional moral realists. This chapter examines the forms that Quietist Moral Realism has taken and the challenges it has faced, in order to better assess its prospects. The best hope, this chapter argues, lies in a pragmatist approach that distinguishes the different functions of diverse areas of discourse. This paves the way for a form of Quietism (...) that does not simply remain quiet about the explanatory demands of metaethics, but rather is able to diagnose where they go wrong. By combining a neopragmatic analysis of the discourse with an easy approach to ontology, , we can develop a form of Quietist Moral Realism that is far stronger than critics of quietism have appreciated. (shrink)

Despite tendencies to compete for a prime place in moral theory, neither virtue ethics nor the four principles approach should claim to be superior to, or logically prior to, the other. Together they provide a more adequate account of the moral life than either can offer on its own. The virtues of principlism are clarity, simplicity and (to some extent) universality. These are well illustrated by Ranaan Gillon’s masterly analysis of the cases he has provided. But the vices of this (...) approach are the converse of its virtues: neglect of emotional and personal factors, oversimplification of the issues, and excessive claims to universality. Virtue ethics offers a complementary approach, providing insights into moral character, offering a blend of reason and emotion, and paying attention to the context of decisions. The cases provided can be more adequately understood if we combine the approaches. Both should foster the virtues of humility and magnanimity. (shrink)

A vision of a living code of ethics is proposed to counter the emphasis on negative phenomena in the study of organizational ethics. The living code results from the harmonious interaction of authentic leadership, five key organizational processes (attraction–selection–attrition, socialization, reward systems, decision-making and organizational learning), and an ethical organizational culture (characterized by heightened levels of ethical awareness and a positive climate regarding ethics). The living code is the cognitive, affective, and behavioral manifestation of an ethical organizational identity. We draw (...) on business ethics literature, positive organizational scholarship, and management literature to outline the elements of positive ethical organizations as those exemplary organizations consistently practicing the highest levels of organizational ethics. In a positive ethical organization, the right thing to do is the only thing to do. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

The ‘No Ought From Is’ principle (or ‘NOFI’) states that a valid argument cannot have both an ethical conclusion and non-ethical premises. Arthur Prior proposed several well-known counterexamples, including the following: Tea-drinking is common in England; therefore, either tea-drinking is common in England or all New Zealanders ought to be shot. My aim in this paper is to defend NOFI against Prior’s counterexamples. I propose two novel interpretations of NOFI and prove that both are true.

To 'consequentialise' is to take a putatively non-consequentialist moral theory and show that it is actually just another form of consequentialism. Some have speculated that every moral theory can be consequentialised. If this were so, then consequentialism would be empty; it would have no substantive content. As I argue here, however, this is not so. Beginning with the core consequentialist commitment to 'maximising the good', I formulate a precise definition of consequentialism and demonstrate that, given this definition, several sorts of (...) moral theory resist consequentialisation. My strategy is to decompose consequentialism into three conditions, which I call 'agent neutrality', 'no moral dilemmas', and 'dominance', and then to exhibit some moral theories which violate each of these. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.1 (2002) 35-39 [Access article in PDF] The Ownership of Thoughts John Campbell Keywords: schizophrenia, thought insertion, immunity to error through misidentification. SYDNEY SHOEMAKER FORMULATED a basic point about first-person, present-tense ascriptions of psychological states when he declared that they are, in general, immune to error through misidentification (Shoemaker 1984). Assuming Shoemaker's point to be correct, the puzzle it raises is this: how are (...) we to explain this datum? Why should it be that first-person, present-tense ascriptions of psychological states are immune to error through misidentification? One type of explanation is in terms of the meaning of the first person: that "I" just stands for whoever is the owner of these (demonstrated) psychological states (including any states being self-ascribed). I argued against this account of the first person in a number of places, and in favor of an alternative explanation of Shoemaker's datum. On the alternative explanation, the reason for the immunity is provided by an account of the ownership of psychological states, on which what makes a psychological state mine is the possibility of self-ascription of it by me (Campbell 1986, 1999a). Suppose we call this the Introspectionist explanation of the immunity to error through misidentification of present-tense self-ascriptions of psychological states. I do think, though, that the simple Introspectionist account is too simple an account of Shoemaker's datum (Campbell 1999a, 1999b). The reason is that there is a certain complexity in our notion of the ownership of a token thought. We cannot give a full account of our ordinary notion of the ownership of a thought simply in terms of the person who is capable of introspective knowledge of the thought. The reason is that there is another dimension to our ordinary notion of the ownership of a thought. We also think of the possessor of a thought as being the person who generated that very thought; we think of the owner of the thought as being the person who brought that particular token thought into existence, the person who formed it. Of course, that token thought may be a copying of someone else's idea; that other person may have influenced my formation of that particular thought. But the point remains that I play a special role in the production of my thoughts.Suppose we have a document bearing a signature and we ask, "Whose signature is that?" In this case we are asking about the authorship of the signature; we are asking who made those particular marks on that bit of paper. Of course, someone else can copy my signature, trying to make it look as if what they write was written by me. But for a particular piece of writing to be an authentic signature of mine, the thing has to be generated by me personally. I think it is helpful to bear in mind this aspect of the notion of the ownership of a signature, when we consider a certain complexity in the notion of the ownership of a thought—I mean, an occurrent, episodic [End Page 35] thought. There are, I am saying, two strands in the ordinary notion of the ownership of a thought, which we do not ordinarily have any reason to separate. First, there is the notion of the person who generated that particular thought, which we might think of on the model of the person who inscribed a particular signature. Of course, in generating a particular token thought, you may be subject to all sorts of influences. Perhaps your thought is derivative, largely shaped by others. Perhaps your thoughts are sometimes simply echoes of the things other people have said. Nonetheless, when we consider how your individual token thoughts are being brought about, you play a proximal role in their formation that no one else does. To give an analogy, suppose that I am taking notes at your dictation. Then there is a sense in which the contents of my notes are entirely determined by you. But there is also a sense in which the token sentences are being generated by... (shrink)