Readings in Health Care Ethics provides a wide-ranging selection of important and engaging contributions to the field of health care ethics. The second edition adds a chapter on health care in Canada, and the introduction has been expanded to include discussion of a new direction in feminist naturalized ethics. The book presupposes no prior knowledge, only an interest in the bioethical issues that are shaping our world.

Recent discussions of genetic information have highlighted the need for ethical disclosure guidelines. For instance, the (Canadian) Royal Commission on New Reproductive Technologies points out the range of third-party interests in genetic information and the lack of clear ethical and professional guidelines governing its dissemination. Among the more worrying interests are those of insurance companies and prospective employers. However, also worrisome is the problem of negotiating the first-party interest in privacy (from which the professional obligation of confidentiality arises) and strong (...) third-party claims from family members. The survey by Knoppers and Laberge of consent forms currently used in DNA testing in Canada shows that fewer than half mention access by family members, and only three out of 20 alert subjects to the possibility of finding nonpaternity. Both the Royal Commission and the Knoppers research group recommend integrated, national consent standards, with the Knoppers group explicitly approving a standard of disclosure. While endorsing the call for integrated consent guidelines, in this paper I intend to raise some doubts about the adequacy of the reasonable person standard in light of gender differences in reproductive burden and risk perception. (shrink)

Much debate concerning ‘precedent autonomy’ – that is, the authority of former, competent selves to govern the welfare of later, non-competent selves – has assumed a radical discontinuity between selves, and has overlooked the ‘bridging’ role of intimate proxy decision-makers. I consider a recent proposal by Lynn et al. (1999) that presents a provocative alternative, foregrounding an imagined dialogue between the formerly competent patient and her/his trusted others. I consider what standards must be met for such dialogues to have moral (...) force, appealing to narrative and feminist ethics. I then critique the dualistic construction of selves implicit in much of the advance directive literature, noting the continuities of dependence, character, and body, as well as the social dimension of the construction of selves. (shrink)

If You're an Egalitarian, How Come You're So Rich? is a persuasive extension of Cohen's critique of Rawls's egalitarianism, embedded in reflections on the inadequacies of Marxist theory, on the rationality of "nurtured" beliefs, on Cohen's own personal and intellectual journey, and, finally, on the issue named in the title, the responsibility of the wealthy just in an unjust society. It is an uneven, but highly readable, book. Based on Cohen's 1996 Gifford Lectures, the book is divided into a Prospectus (...) and ten Lectures, one of which was apparently a multimedia sing-along on the "lighter side of the problem of evil" and could not be reproduced! (shrink)

Ten years ago, one of us proposed a dynamic hierarchical model of intentions that brought together philosophical work on intentions and empirical work on motor representations and motor control (Pacherie, 2008). The model distinguished among Distal intentions, Proximal intentions, and Motor intentions operating at different levels of action control (hence the name DPM model). This model specified the representational and functional profiles of each type of intention, as well their local and global dynamics, and the ways in which they interact. (...) A core insight of the model was that action control is the result of integrated, coordinated activity across these levels of intention. Since the proposal of the model, empirical and theoretical works in philosophy and cognitive science have emerged that would seem to support and expand on this central insight. In particular, an updated understanding of the nature of sensorimotor processing and motor representations, as well as of how the different levels of intention and control interface and interact, allows for the further specification and precisification of the original DPM model. (shrink)

Elisabeth Porter's guide to the development of feminist thought on ethics & moral agency surveys feminist debates on the nature of feminist ethics, intimate relationships, professional ethics, politics, sexual politics, abortion and reproductive choices.

Abstract:This article addresses the geospeculation of Kuannersuit, a mountain in southwest Greenland that holds a major deposit of rare earth minerals, including uranium. Through the concepts of “geofetishism” and “tender violence,” we consider the history of mineral speculation in Greenland, and how its colonial history bears on the now independent (Inuit) Greenlandic government, and the township of Narsaq. With a focus on the anti-uranium activist group, Urani? Naamik!, we show the challenges posed to Greenlanders in their resistance to the mobilization (...) of their mineral resources by the Australian mining company, Greenland Minerals and Energy (now renamed Energy Transition Minerals). A highlight of this resistance, in our view, is Urani Naamik’s counter-analysis of GME’s environmental assessment report. (shrink)

Most of us create and use a panoply of non-sentential representations throughout our ordinary lives: we regularly use maps to navigate, charts to keep track of complex patterns of data, and diagrams to visualize logical and causal relations among states of affairs. But philosophers typically pay little attention to such representations, focusing almost exclusively on language instead. In particular, when theorizing about the mind, many philosophers assume that there is a very tight mapping between language and thought. Some analyze utterances (...) as the outer vocalizations of inner thoughts (e.g. Grice 1957, Devitt 2005), while others treat thought as a form of inner speech (e.g. Sellars 1956/1997, Carruthers 2002). But even philosophers who take no stand on the relative priority of language and thought still tend to individuate mental states in terms of the sentences we use to ascribe them. Indeed, Dummett (1993) claims that it is constitutive of analytic philosophy that it approaches the mind by way of language. In many ways, this linguistic model is salutary. Our thoughts are often intimately intertwined with their linguistic expression, and public language does provide a comparatively tractable proxy for, and a window into, the messier realm of thought. However, an exclusive focus on thought as it is expressed in language threatens to leave other sorts of thought unexplained, or even to blind us to their possibility. In particular, many cognitive ethologists and psychologists find it useful to talk about humans, chimpanzees, birds, rats, and even bees as employing cognitive maps. We need to make sense of this way of talking about minds as well as more familiar sentential descriptions. In what follows, I investigate the theoretical and practical possibility of non-sentential thought. Ultimately, I am most interested in the contours of distinctively human thought: what forms does human thought take, and how do those different forms interact? How does human thought compare with that of other animals? In this essay, however, I focus on a narrower and more basic theoretical question: could thought occur in maps? Many philosophers are convinced that in some important sense, thought per se must be language-like.. (shrink)

I take up three puzzles about our emotional and evaluative responses to fiction. First, how can we even have emotional responses to characters and events that we know not to exist, if emotions are as intimately connected to belief and action as they seem to be? One solution to this puzzle claims that we merely imagine having such emotional responses. But this raises the puzzle of why we would ever refuse to follow an author’s instructions to imagine such responses, since (...) we happily imagine many other implausible things. A natural response to this second puzzle is that our responses to fiction are real, and so can’t just be conjured up in response to an author’s demands. However, this simple response is inadequate, because we often respond differently to people and events in fiction than we would if we encountered them in real life. Solving these three puzzles in a consistent way requires the notion of a “perspective” on a fictional world. I sketch an account of this intuitive but frustratingly amorphous notion: perspectives are tools for organizing our thinking, which can in turn alter our emotional and evaluative responses. Cultivating a perspective can be illuminating, entertaining, or corrupting — or all three at once. (shrink)

On realist terms, politics is about power, security, and order, and the question of whether politics can practice compassion is irrelevant. The author argues that a politics of compassion is possible and necessary in order to address human security needs. She extend debates on care ethics to develop a politics of compassion, using the example of asylum seekers to demonstrate that politics can practice compassion with attentiveness to the needs of vulnerable people who are suffering, an active listening to the (...) voices of the vulnerable, and open, compassionate, and appropriate responses to particular needs. (shrink)

Traditional theories of sarcasm treat it as a case of a speaker's meaning the opposite of what she says. Recently, 'expressivists' have argued that sarcasm is not a type of speaker meaning at all, but merely the expression of a dissociative attitude toward an evoked thought or perspective. I argue that we should analyze sarcasm in terms of meaning inversion, as the traditional theory does; but that we need to construe 'meaning' more broadly, to include illocutionary force and evaluative attitudes (...) as well as propositional content. I distinguish four subclasses of sarcasm, individuated in terms of the target of inversion. Three of these classes raise serious challenges for a standard implicature analysis. (shrink)

On a familiar and prima facie plausible view of metaphor, speakers who speak metaphorically say one thing in order to mean another. A variety of theorists have recently challenged this view; they offer criteria for distinguishing what is said from what is merely meant, and argue that these support classifying metaphor within 'what is said'. I consider four such criteria, and argue that when properly understood, they support the traditional classification instead. I conclude by sketching how we might extract a (...) workable notion of 'what is said' from ordinary intuitions about saying. (shrink)

I argue that we can reconcile two seemingly incompatible traditions for thinking about concepts. On the one hand, many cognitive scientists assume that the systematic redeployment of representational abilities suffices for having concepts. On the other hand, a long philosophical tradition maintains that language is necessary for genuinely conceptual thought. I argue that on a theoretically useful and empirically plausible concept of 'concept', it is necessary and sufficient for conceptual thought that a thinker be able to entertain many of the (...) potential thoughts produced by recombining her representational abilities apart from a direct confrontation with the states of affairs being represented. Such representational abilities support a cognitive engagement with the world that is flexible, abstract, and active. (shrink)

: On realist terms, politics is about power, security, and order, and the question of whether politics can practice compassion is irrelevant. The author argues that a politics of compassion is possible and necessary in order to address human security needs. She extend debates on care ethics to develop a politics of compassion, using the example of asylum seekers to demonstrate that politics can practice compassion with attentiveness to the needs of vulnerable people who are suffering, an active listening to (...) the voices of the vulnerable, and open, compassionate, and appropriate responses to particular needs. (shrink)

Metaphors are powerful communicative tools because they produce ”framing effects’. These effects are especially palpable when the metaphor is an insult that denigrates the hearer or someone he cares about. In such cases, just comprehending the metaphor produces a kind of ”complicity’ that cannot easily be undone by denying the speaker’s claim. Several theorists have taken this to show that metaphors are engaged in a different line of work from ordinary communication. Against this, I argue that metaphorical insults are rhetorically (...) powerful because they combine perspectives, presupposition, and pragmatics in the service of speech acts with assertoric force. (shrink)

On realist terms, politics is about power, security, and order, and the question of whether politics can practice compassion is irrelevant. The author argues that a politics of compassion is possible and necessary in order to address human security needs. She extend debates on care ethics to develop a politics of compassion, using the example of asylum seekers to demonstrate that politics can practice compassion with attentiveness to the needs of vulnerable people who are suffering, an active listening to the (...) voices of the vulnerable, and open, compassionate, and appropriate responses to particular needs. (shrink)

From antiquity, Galenic physicians extensively discussed the active powers of simple and compound drugs. In their views, simple drugs, that is, single ingredients, acted according to their material qualities and the properties of their substance. As for compound drugs, their efficacy resulted from the mutual interaction of their ingredients and their modes of preparation. In the late Renaissance, Galenic physicians and naturalists, such as Leonhart Fuchs and Pietro Andrea Mattioli, attempted to explain these pharmacological properties or “faculties” at the intersection (...) of medicine, botany, and natural philosophy. This chapter examines the case of the Italian physician and botanist Andrea Cesalpino. His pharmacological treatise De medicamentorum facultatibus [On the Faculties of Drugs, 1593] was particularly significant for its reception of ancient and medieval texts on drug properties, materia medica, and the role of the senses in the knowledge of bodies. (shrink)

Does thought precede language, or the other way around? How does having a language affect our thoughts? Who has a language, and who can think? These questions have traditionally been addressed by philosophers, especially by rationalists concerned to identify the essential difference between humans and other animals. More recently, theorists in cognitive science, evolutionary biology, and developmental psychology have been asking these questions in more empirically grounded ways. At its best, this confluence of philosophy and science promises to blend the (...) respective strengths of each discipline, bringing abstract theory to bear on reality in a principled and focused way. At its worst, it risks degenerating into a war of words, with each side employing key expressions in its own idiosyncratic way – or worse, contaminating empirical research with a priori dogmas inherited from outmoded philosophical worldviews. In Baboon Metaphysics (2007), Dorothy Cheney and Robert Seyfarth offer an analysis of baboon cognition that promises to exemplify the very best interaction of philosophical theory and empirical research. They argue that baboons have a language of thought: a language-like representational medium, which supports the sophisticated cognitive abilities required to negotiate their complex social environment. This claim is intended to be surprising in its own right, and also to shed light on the evolution of spoken language. Because our own ancestors likely lived in a similarly complex social environment, Cheney and Seyfarth propose that the earliest humans also developed language first as a cognitive medium, and that spoken language evolved as a means to express those thoughts. There are two potential difficulties here. First, ‘Language of Thought’ (LOT) is a term of art, with much associated theoretical baggage and often comparatively little careful exposition. Thus, evaluating the claim requires getting clearer about just what LOT implies in this context.. (shrink)

After a long period of neglect, the phenomenology of action has recently regained its place in the agenda of philosophers and scientists alike. The recent explosion of interest in the topic highlights its complexity. The purpose of this paper is to propose a conceptual framework allowing for a more precise characterization of the many facets of the phenomenology of agency, of how they are related and of their possible sources. The key assumption guiding this attempt is that the processes through (...) which the phenomenology of action is generated and the processes involved in the specification and control of action are strongly interconnected. I argue in favor of a three-tiered dynamic model of intention, link it to an expanded version of the internal model theory of action control and specification, and use this theoretical framework to guide an analysis of the contents, possible sources and temporal course of complementary aspects of the phenomenology of action. (shrink)

Most models of generational succession in sexually reproducing populations necessarily move back and forth between genic and genotypic spaces. We show that transitions between and within these spaces are usually hidden by unstated assumptions about processes in these spaces. We also examine a widely endorsed claim regarding the mathematical equivalence of kin-, group-, individual-, and allelic-selection models made by Lee Dugatkin and Kern Reeve. We show that the claimed mathematical equivalence of the models does not hold.

Recently, philosophers have discovered that they have a lot to learn from, or at least to ponder about, fiction. Many metaphysicians are attracted to fiction as a model for our talk about purported objects and properties, such as numbers, morality, and possible worlds, without embracing a robust Platonist ontology. In addition, a growing group of philosophers of mind are interested in the implications of our engagement with fiction for our understanding of the mind and emotions: If I don’t believe that (...) Anna Karenina exists, can I really pity her, or hope or desire that she extricate herself from her tragic situation? And why is there no “morality fiction,” analogous to science fiction? I suspect that philosophers have been especially comfortable thinking about fiction because it seems, at least prima facie, to employ the imagination in a way that conforms to a standard model of the mind. Specifically, contemporary philosophers tend to think of imagination as a form of mental pretense. Mental pretense can take two main forms: a cognitive attitude of supposing a set of propositions to be true (make-believe) or else an experiential state of imaging a scenario as if it were before one (imaging). Much of our pretense intertwines the cognitive and experiential modalities, of course. But both share a crucial common feature: all of one’s imaginative effort is invested in pretending that certain contents obtain. In this sense, we can understand imagination as the “offline” simulation of actual beliefs and perceptions (and perhaps other attitudes as well), where we analyze these in the normal way, as states individuated by their attitude and representational content. While I share the burgeoning interest in fiction, I want to suggest that we also have a lot to learn from poetry, and in particular from poetic metaphor. I will argue.. (shrink)

Philosophers have traditionally inclined toward one of two opposite extremes when it comes to metaphor. On the one hand, partisans of metaphor have tended to believe that metaphors do something different in kind from literal utterances; it is a ‘heresy’, they think, either to deny that what metaphors do is genuinely cognitive, or to assume that it can be translated into literal terms. On the other hand, analytic philosophers have typically denied just this: they tend to assume that if metaphors (...) express any genuine content at all, then that content can in principle be paraphrased into literal terms. They often conclude on this basis that metaphor is theoretically dispensable, and so that it poses no special challenges and affords no distinctive insights for the philosophy of language and mind. (shrink)

We should not admit categorial restrictions on the significance of syntactically well formed strings. Syntactically well formed but semantically absurd strings, such as ‘Life’s but a walking shadow’ and ‘Caesar is a prime number’, can express thoughts; and competent thinkers both are able to grasp these and ought to be able to. Gareth Evans’ generality constraint, though Evans himself restricted it, should be viewed as a fully general constraint on concept possession and propositional thought. For (a) even well formed but (...) semantically cross-categorial strings often do possess substantive inferential roles; (b) hearers exploit these inferential roles in interpreting such strings metaphorically; (c) there is no good reason to deny truth-conditions to strings with inferential roles. (shrink)

The objective of this paper is to characterize the rich interplay between automatic and cognitive control processes that we propose is the hallmark of skill, in contrast to habit, and what accounts for its flexibility. We argue that this interplay isn't entirely hierarchical and static, but rather heterarchical and dynamic. We further argue that it crucially depends on the acquisition of detailed and well-structured action representations and internal models, as well as the concomitant development of metacontrol processes that can be (...) used to shape and balance it. (shrink)

Autonomy of people on the autism-spectrum has only been very rarely conceptually explored. Autism spectrum is commonly considered a hetereogenous disorder, and typically described as a behaviorally-defined neurodevelopmental disorder associated with the presence of social-communication deficits and restricted and repetitive behaviors. Autism research mainly focuses on the behavior of autistic people and ways to teach them skills that are in line with social norms. Interventions such as therapies are being justified with the assumption that autists lack the capacity to be (...) self-reflective and to be “author of their lives”. We question this assumption, as some empirical research shows that autists are aware of their strengths and are critical about social norms, we take this as a starting point to reconsider the beliefs about autistic people’s capacities. As a theoretical framework, we draw on Berlin’s idea of positive and negative liberty as he clearly distinguishes between one’s own developed preferences and the simple absence of interference. By drawing on the concept of positive liberty, we illustrate that a lot of autists are aware of their own needs, and usually do not deny their own needs, values and interests. This makes them less prone than non-autistic people to adapt their preferences to external influences, which might be seen as sticking to an authentic way of living. Our analysis shows that many autists are hindered to be autonomous due to unjustified interference, unreflected assumptions about their self-determination, or by paternalistic actions. These observations contribute to a better understanding when help and interference are justified and a more differentiated understanding of autonomy of autistic people. (shrink)

Can machines be conscious and what would be the ethical implications? This article gives an overview of current robotics approaches toward machine consciousness and considers factors that hamper an understanding of machine consciousness. After addressing the epistemological question of how we would know whether a machine is conscious and discussing potential advantages of potential future machine consciousness, it outlines the role of consciousness for ascribing moral status. As machine consciousness would most probably differ considerably from human consciousness, several complex questions (...) must be addressed, including what forms of machine consciousness would be morally relevant forms of consciousness, and what the ethical implications of morally relevant forms of machine consciousness would be. While admittedly part of this reflection is speculative in nature, it clearly underlines the need for a detailed conceptual analysis of the concept of artificial consciousness and stresses the imperative to avoid building machines with morally relevant forms of consciousness. The article ends with some suggestions for potential future regulation of machine consciousness. (shrink)

Theorists often associate certain “poetic” qualities with metaphor – most especially, producing an open-ended, holistic perspective which is evocative, imagistic and affectively-laden. I argue that, on the one hand, non-cognitivists are wrong to claim that metaphors only produce such perspectives: like ordinary literal speech, they also serve to undertake claims and other speech acts with propositional content. On the other hand, contextualists are wrong to assimilate metaphor to literal loose talk: metaphors depend on using one thing as a perspective for (...) thinking about something else. I bring out the distinctive way that metaphor works by contrasting it with two other poetic uses of language, juxtapositions and “telling details,” that do fit the accounts of metaphor offered by non-cognitivists and contextualists, respectively. (shrink)