Volume 20, Issue 6, June 2020, Page 28-30.

In the debate surrounding the morality and legality of the practices of physician-assisted death and euthanasia, a common logical argument regularly employed against these practices is the “slippery slope argument.” One formulation of this argument claims that acceptance of physician-assisted death will eventually lead down a “slippery slope” into acceptance of active euthanasia, including its voluntary, non-voluntary, and/or involuntary forms, through psychological and social processes that warp a society’s values and moral perspective of a practice over an extended period of (...) time. This formulation is known as the psychological slippery slope argument. This paper analyzes the psychological slippery slope argument as it is applied to the practice of physician-assisted death, and utilizing recent empirical evidence from various nations around the world that practice physician-assisted death and/or euthanasia, the paper argues that employing the psychological slippery slope argument against physician-assisted death is logically fallacious, this kind of slippery slope is unfounded in practice, and thus the psychological slippery slope argument is insufficient on its own to justify continued legal prohibition of physician-assisted death. (shrink)

Volume 20, Issue 7, July 2020, Page 193-195.

In Catholic moral theology, the principle of double effect has been an effective normative tool for centuries, and it can be used to determine the ethicality of actions that contain both good and evil consequences. The principle of double effect is especially useful in end-of-life care, because many end-of-life treatment options inherently have both good and evil conse­quences. The principle of double effect can be used to make both practical and moral distinctions between the acts of euthanasia, physician-assisted suicide, palliative (...) sedation, and the withholding and withdrawal of life-sustaining treatment, which can be classified as either unjustified acts of killing or jus­tifiable acts of allowing to die. (shrink)

Each year, many young professionals forego advanced education in the traditional doctoral programs of medicine, law, and philosophy in favor of pursuing a PhD or professional doctorate in bioethics or healthcare ethics that is offered by several major institutes of higher education across the United States. These graduates often leverage their degrees into careers within the broader field of bioethics. As such, they represent a growing percentage of professional bioethicists in both academia and healthcare nationwide. Given the significant role that (...) doctoral bioethics programs play in the training of future professional bioethicists, it is imperative that programs conferring bioethics degrees are attuned to the knowledge and skills students will need as they transition to professional positions, especially where this training substantially differs from more traditional doctoral degree tracks. Yet, even given this need, there is nothing in the professional literature regarding doctoral bioethics graduates’ perspectives or the overall efficacy of a bioethics doctorate as compared to more traditional doctoral degree tracks for future professional bioethicists. This paper then gives the perspective of five recent doctoral bioethics graduates on the utility of a bioethics doctorate and areas where the doctorate prepared or underprepared them in their roles as early-career professional bioethicists. (shrink)

In the United States, the field of bioethics has expanded over the last two decades. Several institutions offer graduate-level training at both the masters and doctoral level. However, a lack of published literature on the outcomes of doctoral training in bioethics from the perspective of graduates exists. Researchers conducted an online survey of doctoral students who had finished all doctoral requirements but their dissertation, as well as doctoral graduates, of four US-based institutions to ascertain their perspectives on a number of (...) items regarding their doctoral training and their perception of how that training prepared them for their current role in the workforce. Responses from 34 participants were assessed. Respondents had positive overall views on the utility of a bioethics doctorate and the educational training they received in their respective programs. A number of areas for improvement were identified, including better structured clinical ethics training, greater opportunities for research and publishing, and having the ability to teach during their doctoral program, as well as formal pedagogy training. Greater exposure to clinical ethics consultation during the doctoral program was associated with feeling fully prepared as a clinical ethics consultant. This is the first study to assess the perspectives of bioethics doctoral graduates and ABD students regarding the utility of a bioethics doctorate. Per the perspectives of graduates and ABD students, bioethics doctorates are important and effective to train professional bioethicists. We recommend that a few key changes to these programs’ curricula can further bolster their effectiveness. (shrink)

While the practice of organ donation after cardiac death has long been trending upwards in acceptance and use, it is still a highly controversial and practically inefficient method of organ procurement. One policy that has recently been proposed to try and alleviate some of the ethical and practical concerns with organ donation after cardiac death is the practice of imminent death organ donation. This type of live organ donation comes in patients at the end of their life who have decided (...) to withdraw life-sustaining treatment, but still want to ensure that their organs are donated and not wasted, which isn't always the case with organ donation after cardiac death. This paper then gives some ethical and practical reflections and recommendations regarding the potential implementation of this controversial practice into regular transplant practice and policy. (shrink)

Volume 20, Issue 2, February 2020, Page 62-64.

Propelling Clinical Ethics Forward: A Working Unconference was held from 28-29 April 2022 in Atlanta, Georgia. The event, the third installment in an ongoing series of Clinical Ethics Unconferences, brought together 77 individuals from 40 institutions to exchange innovative practices and collaborate to address issues facing the field of clinical ethics. In this article the authors highlight the five major themes that emerged from the 2022 Unconference, including: (1) tackling new and old problems in clinical ethics practice; (2) evolving models (...) of clinical ethics structure and delivery; (3) defining the scope of clinical ethics work; (4) addressing racism, ableism, and underrepresentation in clinical ethics work; and (5) collecting and utilizing data effectively. The authors also reflect on what was learned from the first three Unconferences and offer suggestions for future Unconferences. (shrink)

This paper is a clinical ethics case study which sheds light on several important dilemmas which arise in providing care to patients from cultures with non-individualistic conceptions of autonomy. Medical professionals face a difficult challenge in determining how to respond when families of patients ask that patients not be informed of bad medical news. These requests are often made for cultural reasons, by families seeking to protect patients. In these cases, the right that patients have to their own medical information (...) in order to make autonomous decisions is in tension with the possibility that patients could hold values that require limiting their autonomy with regard to medical information disclosure, often based on the idea that family should take on difficult decision-making as an act of care. We describe one such case, of an 83-year old Russian woman whose husband requested she not be informed of a new cancer diagnosis. The appropriate response to this request was to ask the patient about her values separately, without disclosing any medical information until her values were clear. This patient indicated she wanted the care team to uphold her husband’s request. This response makes the importance of determining a patient’s values before moving forward with disclosure clear: she would not have wanted to be informed of her cancer. We describe our conversation strategy, which allowed value exploration without disclosure and highlighted that the obligation to respect a patient’s autonomy sometimes includes an obligation to allow a patient to choose to limit their own autonomy. This case also highlights that this kind of conversation prioritizes the patient’s values rather than the family’s or care team’s, centering patients in the way that is ethically appropriate. (shrink)

Demonstrating value is an ongoing process and requirement for institutional survival for ethics programs. Although our ethics program has significantly increased our ethics consultation volume and maintains a robust database that tracks ethics consultation data, these data regarding ethics consultations alone do not accurately represent the program’s overall activities and value to the institution. The roles and responsibilities of clinical ethicists extend beyond clinical ethics consultation, and there are many other ways that clinical ethicists contribute and add value to their (...) institutions. This article describes our ethics program’s early efforts to systematically track ethics program activities outside of ethics consultations as a way to demonstrate additional value to the institution that goes beyond ethics consultation. By systematically tracking activities such as internal ethics education sessions, conference presentations, publications, grants, committee/policy work, and other activities, our ethics program has been able to gather substantial quantitative data that highlight our program’s numerous activities and outreach, both within and outside the institution, that provide additional value to the institution beyond our ethical consultation activities. (shrink)

With the increasing professionalization of clinical ethics, some hospitals and health systems utilize both ethics committees and professional clinical ethicists to address their ethics needs. Drawing upon historical critiques of ethics committees and their own experiences, the authors argue that, in ethics programs with one or more professional clinical ethicists, ethics committees should be dissolved when they fail to meet minimum standards of effectiveness. The authors outline several criteria for assessing effectiveness, describe the benefits of a model that places primary (...) responsibility for ethics work with professional clinical ethicists—the PCE-primary model, and offer suggestions for alternative ethics program structures that empower healthcare professionals to contribute to ethics work in ways more tailored to their strengths and skills while minimizing the shortcomings of ethics committees. (shrink)

The ‘black box problem’ is a long-standing talking point in debates about artificial intelligence. This is a significant point of tension between ethicists, programmers, clinicians and anyone else working on developing AI for healthcare applications. However, the precise definition of these systems are often left undefined, vague, unclear or are assumed to be standardised within AI circles. This leads to situations where individuals working on AI talk over each other and has been invoked in numerous debates between opaque and explainable (...) systems. This paper proposes a coherent and clear definition for the black box problem to assist in future discussions about AI in healthcare. This is accomplished by synthesising various definitions in the literature and examining several criteria that can be extrapolated from these definitions. There are no data in this work. (shrink)

How is reality really manufactured? The idea of social construction has become a commonplace part of much social research, yet precisely what is constructed, how it is constructed, and what constructionism means are often left unclear or taken for granted. In this major work, Jonathan Potter explores the central themes raised by these questions. Representing Reality explores the different traditions in constructivist thought--including sociology of scientific knowledge; conversation analysis and ethnomethodology; and semiotics, poststructuralism, and postmodernism--to provide a lucid introduction (...) to several key strands of work that have overturned the way we think about facts and descriptions. Potter illustrates his points throughout with varied and engaging examples taken from newspaper stories, relationship counseling sessions, accounts of paranormal events, social workers' assessments of violent parents, informal talk between program organizers, political arguments, and everyday conversations. Representing Reality offers the student and scholar in social psychology, rhetoric and discourse, and related fields a critical introduction to constructivism. (shrink)

This work examines the concept of trust in the light of virtue theory, and takes our responsibility to be trustworthy as central. Rather than thinking of trust as risk-taking, Potter views it as equally a matter of responsibility-taking. Her work illustrates that relations of trust are never independent from considerations of power, and that asking ourselves what we can do to be trustworthy allows us to move beyond adversarial trust relationships and toward a more democratic, just, and peaceful society.

When our nearest and dearest experience medical crises, we may need to step into caregiving roles. But in doing so, we may find that our new caregiving relationship is actually in tension with the loving relationship that motivated us towards care. What we owe and are entitled to as friends, spouses, and family members, can be different from what we owe and are entitled to as caregivers. For this reason, caregiving carries with it the risk of a type of moral (...) distress that I call “role conflict distress.” Rather than view role conflict distress as a sign that we are falling short, I suggest that it actually speaks to the commitment that we have to the loving relationship that grounds our duty of care. (shrink)

Gottlob Frege (1848–1925) was unquestionably one of the most important philosophers of all time. He trained as a mathematician, and his work in philosophy started as an attempt to provide an explanation of the truths of arithmetic, but in the course of this attempt he not only founded modern logic but also had to address fundamental questions in the philosophy of language and philosophical logic. Frege is generally seen (along with Russell and Wittgenstein) as one of the fathers of the (...) analytic method, which dominated philosophy in English-speaking countries for most of the twentieth century. His work is studied today not just for its historical importance but also because many of his ideas are still seen as relevant to current debates in the philosophies of logic, language, mathematics and the mind. The Cambridge Companion to Frege provides a route into this lively area of research. (shrink)

This chapter sets out several views of empathy that draw not only on psychology's literature but on philosophical and psychiatric writings. Empathy is a set of complex concepts involving perception, emotion, attitudinal orientation, and other cognitive processes as well as an activity that expresses character traits and, hence, one of the virtues. In other words, an examination of the philosophical and clinical literature reveals empathy to be not one unified concept but instead a set of related characteristics and qualities needed (...) to be an ethical and therapeutically effective clinician. To this end, the chapter offers reasons as to why empathy is important to clinical work: empathy is both epistemically and ethically necessary to good social relations and, in particular, clinical relations. It then distinguishes empathy from a related concept called "world"-traveling and situates its relevance to therapeutic relations. Finally it brings these ideas together by highlighting Iris Murdoch's ideas of "just vision" and "loving attention.". (shrink)

We often feel survivor guilt when the very circumstances that harm others leave us unscathed. Although survivor guilt is both commonplace and intelligible, it raises a puzzle for the standard philosophical account of guilt, according to which people feel guilt only when they take themselves to be morally blameworthy. The standard account implies that survivor guilt is uniformly unfitting, as people are not blameworthy simply for having fared better than others. In this paper, we offer a rival account of guilt, (...) the relational account of guilt, which makes sense of survivor guilt and other forms of guilt without self-blame while preserving the intelligibility of guilt about culpable wrongdoing. According to this account, guilt involves the feeling of being unable to justify ourselves to others, and we lack self-justification when we (however blamelessly) stand on the positive side of an undesirable asymmetry with them. When someone survives something that those around her do not, the disparity in outcome constitutes an asymmetry that is often undesirable, because it arises from luck or violates a requirement of solidarity. Thus, survivor guilt is often fitting. (shrink)

Philip Reed argues that laws that grant people access to euthanasia on the basis of terminal illness are discriminatory. In support of this claim, he offers an argument by analogy: it would be discriminatory to offer a person access to euthanasia because they are women or because they are disabled, as such restricted access would send the message ‘that life as a woman or as a disabled person is (very often) not worth living’.1 And so it must also be discriminatory (...) to offer people access to euthanasia because they are terminally ill. Arguments by analogies are only as good as the analogies on which they are built. Having a terminal illness, I’m going to suggest, is not relevantly similar enough to either being disabled or being a member of an oppressed social group to make Reed’s claim compelling. Let’s explore each branch of the analogy in turn. Why think that terminal illness is relevantly unlike disability, in a way that makes offering access to euthanasia in the latter case discriminatory, but not the former? For one thing, terminal illness is necessarily time-limited. When my father was dying, he found himself in constant …. (shrink)

In recent years, Charles Sanders Peirce has emerged, in the eyes of philosophers both in America and abroad, as one of America’s major philosophical thinkers. His work has forced us back to philosophical reflection about those basic issues that inevitably confront us as human beings, especially in an age of science. Peirce’s concern for experience, for what is actually encountered, means that his philosophy, even in its most technical aspects, forms a reflective commentary on actual life and on the world (...) in which it is lived. In Charles S. Peirce: On Norms and Ideals, Potter argues that Peirce’s doctrine of the normative sciences is essential to his pragmatism. No part of Peirce’s philosophy is bolder than his attempt to establish esthetics, ethics, and logic as the three normative sciences and to argue for the priority of esthetics among the trio. Logic, Potter cites, is normative because it governs thought and aims at truth; ethics is normative because it analyzes the ends to which thought should be directed; esthetics is normative and fundamental because it considers what it means to be an end of something good in itself. This study shows that pierce took seriously the trinity of normative sciences and demonstrates that these categories apply both to the conduct of man and to the workings of the cosmos. Professor Potter combines sympathetic and informed exposition with straightforward criticism and he deals in a sensible manner with the gaps and inconsistencies in Peirce’s thought. His study shows that Peirce was above all a cosmological and ontological thinker, one who combined science both as a method and as result with a conception of reasonable actions to form a comprehensive theory of reality. Peirce’s pragmatism, although it has to do with "action and the achievement of results, is not a glorification of action but rather a theory of the dynamic nature of things in which the "ideal" dimension of reality – laws, nature of things, tendencies, and ends – has genuine power for directing the cosmic order, including man, toward reasonable goals. (shrink)

1. Sexual Brains and Body Politics 2. Hormones and Hardwiring 3. Making Sense of Brain Organization Studies 4. Thirteen Ways of Looking at Brain Organization 5. Working Backward from “Distinct‘ Groups 6. Masculine and Feminine Sexuality 7. Sexual Orienteering 8. Sex-Typed Interests 9. Taking Context Seriously 10. Trading Essence for Potential.

A brief account of karma and transmigration is followed by an introduction to Indian ways of assessing arguments. The body of the work canvasses the systems of Nyaya Vaisesika, Buddhism, Jainism, Samkhya and Advaita Vedanta.

Are demands for equality motivated by envy? Nietzsche, Freud, Hayek, and Nozick all thought so. Call this the Envy Objection. For egalitarians, the Envy Objection is meant to sting. Many egalitarians have tried to evade the Envy Objection.. But should egalitarians be worried about envy? In this paper, I argue that egalitarians should stop worrying and learn to love envy. I argue that the persistent unwillingness to embrace the Envy Objection is rooted in a common misunderstanding of the nature of (...) the charge, what it reveals, and what can be said in response to it. I develop what Bernard Williams might call a vindicatory genealogy of envy, thereby allowing us to see that envy, rather than undermining egalitarian intuitions, can in fact play a distinct justificatory role (when it is fitting), which undermines the Envy Objection. (shrink)

Strawson (1994) and Peacocke (1992) introduced thought experiments that show that it seems intuitive that there is, in some way, an experiential character to mental events of understanding. Some (e.g., Siewert 1998, 2011; Pitt 2004) try to explain these intuitions by saying that just as we have, say, headache experiences and visual experiences of blueness, so too we have experiences of understanding. Others (e.g., Prinz 2006, 2011; Tye 1996) propose that these intuitions can be explained without positing experiences of understanding. (...) Call this the debate between Realism and Anti-Realism about experiences of understanding. This paper aims to advance that debate in two ways. In the first half, I develop more precise characterizations of what Realists and Anti-Realists propose. In the second half, I distinguish the four most plausible versions of Anti-Realism and argue that Realism better explains the target intuition than any of them does. (shrink)

What does everyone in the modern world need to know? Renowned psychologist Jordan B. Peterson's answer to this most difficult of questions uniquely combines the hard-won truths of ancient tradition with the stunning revelations of cutting-edge scientific research. Humorous, surprising and informative, Dr. Peterson tells us why skateboarding boys and girls must be left alone, what terrible fate awaits those who criticize too easily, and why you should always pet a cat when you meet one on the street. What (...) does the nervous system of the lowly lobster have to tell us about standing up straight (with our shoulders back) and about success in life? Why did ancient Egyptians worship the capacity to pay careful attention as the highest of gods? What dreadful paths do people tread when they become resentful, arrogant and vengeful? Dr. Peterson journeys broadly, discussing discipline, freedom, adventure and responsibility, distilling the world's wisdom into 12 practical and profound rules for life. [This book] shatters the modern commonplaces of science, faith and human nature, while transforming and ennobling the mind and spirit of its readers. (shrink)

What comes after "postmodernism"?

The #MeToo movement generated a feminist insistence that we “believe women.” But the men accused of assault, harassment, and other violations frequently defended themselves with the insistence that they had always “respected women” – sometimes, going so far as to get numerous women to sign letters swearing that these men had always respected them. This common MeToo defense reveals the core inconsistency – and the core entitlement – at the heart of misogyny and sexual injustice: some women deserve respect. But (...) the duty to respect those women relies on an invisible entitlement to disrespect – indeed, to assault, harass, dominate, or exploit – others. This chapter explores consent’s role within the superstructure of misogyny and sexual injustice, arguing what consent is a key apparatus of white supremacy. It argues that consent has been constructed through dynamics of colonial and racist sexual entitlement, mapping some (white) women as deserving of respect and the right to consent, while marking other women as expendable or disposable within the sexual economy. This means not only that consent is historically constructed as white, but also that whiteness, and in particular, white womanhood, is constructed through consent. Thus, white women’s right to consent – or to refuse – is premised upon the inability of other women to do so. In this way, the right to sexual consent does not disrupt the norm of male sexual entitlement. Consent has always been premised on non-consent, from coloniality and slavery to contemporary porn, which offers a vision of the world without proper consent, so that granting consent to actual women is an exceptional practice, an “act of respect.” By including race and class alongside gender in my analysis of consent, I argue that contemporary feminist visions of sexual justice must do more than defend or ameliorate consent, but develop intersectional interrogations of sexual justice that reckon with the complicities of consent. (shrink)

Chemical kinds are generally treated as having timelessly fixed identities. Biological kinds are generally treated as evolved and/or evolving entities. So what kind of kind is a biochemical kind? This article defends the thesis that biochemical molecules are clustered chemical kinds, some of which—namely, evolutionarily conserved units—are also biological kinds. On this thesis, a number of difficulties that have recently occupied philosophers concerned with proteins and kinds are shown to be either resolved or dissolved. 1 Introduction2 Conflicting Intuitions about Kinds (...) of Proteins3 Against Permissive Pluralism4 Against Nominalism, Toward a Duality of Kinds5 Biological Kinds, Chemical Kinds, and Their Relations6 Implications for Biological Individuals7 Implications for Monism and Scientific Practice. (shrink)

Chemical kinds (e.g. gold) are generally treated as having timelessly fixed identities. Biological kinds (e.g. goldfinches) are generally treated as evolved and/or evolving entities. So what kind of kind is a biochemical kind? This paper defends the thesis that biochemical molecules are clustered chemical kinds, some of which–namely, evolutionarily conserved units–are also biological kinds.On this thesis, a number of difficulties that have recently occupied philosophers concerned with proteins and kinds are shown to be resolved or dissolved.

Personalized genomics companies (PG; also called ‘direct-to-consumer genetics’) are businesses marketing genetic testing to consumers over the Internet. While much has been written about these new businesses, little attention has been given to their roles in science communication. This paper provides an analysis of the gene concept presented to customers and the relation between the information given and the science behind PG. Two quite different gene concepts are present in company rhetoric, but only one features in the science. To explain (...) this, we must appreciate the delicate tension between PG, academic science, public expectation, and market forces. (shrink)