Background: Caring for terminally ill patients is a meaningful task, however the patient’s suffering can be a considerable burden and cause of frustration.Objectives: The aim of this study is to describe the experiences of general practitioners in The Netherlands in dealing with a request for euthanasia from a terminally ill patient.Methods: The data, collected through in-depth interviews, were analysed according to the constant comparative method.Results: Having to face a request for euthanasia when attempting to relieve a patient’s suffering was (...) described as a very demanding experience that GPs generally would like to avoid. Nearly half of the GPs strive to avoid euthanasia or physician assisted suicide because it was against their own personal values or because it was emotional burdening to be confronted with this issue. They explained that by being directed on promoting a peaceful dying process, or the quality of end-of-life of a patient by caring and supporting the patient and the relatives it was mainly possible to shorten patient’s suffering without “intentionally hastening a patient’s death on his request”. The other GPs explained that as sometimes the suffering of a patient could not be lessened they were open to consider a patient’s request for euthanasia or physician assisted suicide. They underlined the importance of a careful decision-making process, based on finding a balance between the necessity to shorten the patient’s suffering through euthanasia and their personal values.Conclusion: Dealing with requests for euthanasia is very challenging for GPs, although they feel committed to alleviate a patient’s suffering and to promote a peaceful death. (shrink)

This article analyzes the thesis of ethical relativism, as defended by Alchourrón and Bulygin. These authors offer, on the one hand, a suggestive conception according to which the question “what are our obligations?” is equivalent to thinking about what is to be done; on the other hand, they defend a relativist conception of ethics. They present three objections to constructivist accounts of ethics that are not relativist: a) the argument of the burden of the proof; b) a version of (...) the dilemma of Euthyphro, and c) the argument of particularism. This article presents counterarguments to these objections in the attempt to show that they are not conclusive and that a space therefore remains for objectivity in the normative sphere. Keywords: Alchourrón-Bulygin, ethical relativism, ethical constructivism, burden of proof, particularism. (shrink)

An ecumenical effort, sensitive to both the scriptural and dogmatic issues, and directed at laying open the often overlooked, historical and doctrinal affinities underlying Protestant and Catholic Marian theology. As O'Meara correctly points out, while Luther and Calvin did indeed remove Mary from some aspects of the Church, it was some of their later followers who removed her entirely from any essential involvement with the mystery of Christ and the Church. But as in all ecumenical discussions worthy of that name, (...) genuine difficulties are not glossed over. In particular O'Meara questions the prevailing, either/or tendency in Protestant theology not to admit the possibility of a middle range of worship, i.e., hyperdulia, as falling between latria and dulia. While the treatment is for the most part scrupulously fair, O'Meara's defense of the traditional Catholic exegesis of the "I know not man" passage, which is crucial for the Catholic teaching on the virginity of Mary, seems to place an unfair burden of proof on the Protestant interpretation, which is prima facie the more obvious one.—J. J. O. (shrink)

In this volume Professor Sciacca publishes lectures which he gave at Louvain in 1954 in the series ‘Chaire Cardinal Mercier’. A brief introduction sets the scene: in 384 Augustine is a believing, if not a professing, Catholic but he is still burdened with philosophical perplexities left him by Manicheism. At this point Neoplatonic influence is felt; pp. 3-19 analyse its effect. Augustine christianises the Plotinian Intellect identifying it with the Word; but this doctrine does not present the Word made flesh. (...) Augustine had still to learn the humble mystery of the Incarnation; he was in danger of proudly thinking of Christ philosophically rather than theologically, and of becoming a convert to philosophy instead of to a religion. But St. Paul’s words convinced him of the humble reality of the Incarnation. Thus Neoplatonism had to be ignored and played no part in Augustine’s intellectual conversion to the theological truths of Christianity. The Platonists’ contribution was to remove his philosophical difficulties: he can now conceive God as a spirit ; evil, now regarded as something negative, does not need a principle to create it. Plotinus serves as a starting-point, but the Christian doctrine of creation gives his teaching an entirely different direction; Augustine’s doctrine is a Christianized Neoplatonism and not Neoplatonised Christianity. (shrink)

Background Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of (...) orofacial clefts.Methods Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains.Results Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%).Conclusions Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent. (shrink)

We present a one per cent measurement of the cosmic distance scale from the detections of the baryon acoustic oscillations in the clustering of galaxies from the Baryon Oscillation Spectroscopic Survey, which is part of the Sloan Digital Sky Survey III. Our results come from the Data Release 11 sample, containing nearly one million galaxies and covering approximately 8500 square degrees and the redshift range 0.2 < z < 0.7. We also compare these results with those from the publicly released (...) DR9 and DR10 samples. Assuming a concordance Λ cold dark matter cosmological model, the DR11 sample covers a volume of 13 Gpc3 and is the largest region of the Universe ever surveyed at this density. We measure the correlation function and power spectrum, including density-field reconstruction of the BAO feature. The acoustic features are detected at a significance of over 7σ in both the correlation function and power spectrum. Fitting for the position of the acoustic features measures the distance relative to the sound horizon at the drag epoch, rd, which has a value of rd,fid = 149.28 Mpc in our fiducial cosmology. We find DV = at z = 0.32 and DV = at z = 0.57. At 1.0 per cent, this latter measure is the most precise distance constraint ever obtained from a galaxy survey. Separating the clustering along and transverse to the line of sight yields measurements at z = 0.57 of DA = and H =. Our measurements of the distance scale are in good agreement with previous BAO measurements and with the predictions from cosmic microwave background data for a spatially flat CDM model with a cosmological constant. © 2014 The Author Published by Oxford University Press on behalf of the Royal Astronomical Society. (shrink)

The use of do not resuscitate (DNR) orders in Dutch hospitals was studied as part of a nationwide study on medical decisions concerning the end of life. DNR decisions are made in 6 per cent of all admissions, and 61 per cent of all in-hospital deaths were preceded by a DNR decision. We found that in only 14 per cent of the cases had the patients been involved in the DNR decision (32 per cent of competent patients). The concept of (...) futility is analysed as these findings are discussed. We conclude that determining the effectiveness of resuscitation is a medical judgement whereas determining the proportionality (burden/benefit ratio) of it requires a discussion between doctor and patient (or his or her surrogates). Since the respondents in the cases without patient involvement gave many reasons for their decision that went beyond determining effectiveness, we conclude that more patient involvement would have been desirable. (shrink)

In the literature on vagueness one finds two very different kinds of degree theory. The dominant kind of account of gradable adjectives in formal semantics and linguistics is built on an underlying framework involving bivalence and classical logic: its degrees are not degrees of truth. On the other hand, fuzzy logic based theories of vagueness—largely absent from the formal semantics literature but playing a significant role in both the philosophical literature on vagueness and in the contemporary logic literature—are logically nonclassical (...) and give a central role to the idea of degrees of truth. Each kind of degree theory has a strength: the classical kind allows for rich and subtle analyses of the comparative form of gradable adjectives and of various types of gradable precise adjectives, while the fuzzy kind yields a compelling solution to the sorites paradox. This paper argues that the fuzzy kind of theory can match the benefits of the classical kind and hence that the burden is on the latter to match the advantages of the former. In particular, we develop a new version of the fuzzy logic approach that—unlike existing fuzzy theories—yields a compelling analysis of the comparative as well as an adequate account of gradable precise predicates, while still retaining the advantage of genuinely solving the sorites paradox. (shrink)

The clinical introduction of medical devices often occurs with relatively little oversight, regulation and (long-term) follow-up. Some recent controversies underscore the weaknesses of the current regime, such as the complications surrounding the metal-on-metal hip implants and the scandal surrounding the global breast implant scare of silicone implants made by France's Poly Implant Prothese (PIP) Company. The absence of national registries hampered the collection of reliable information on the risks and harms of the PIP breast implants. To warrant long-term safety, a (...) case can be made for mandatory post-marketing surveillance by means of the establishment of compulsory registries. In this edition of Public Health Ethics, Schofield calls for debate on how such a registry system should be initiated and maintained and how it would relate to the ethical requirement of consent. Here we use breast implant registries as a case to discuss whether and when a so-called ‘thick opt-out’ would be an appropriate method to include people in medical device registries. We conclude that a thick opt-out procedure for medical device registries is only justifiable in cases where inclusion does not involve burdens (or very low), when it does not involve a sensitive subject and when the data are stored anonymously (or at least not directly linked to the medical record). Otherwise, inclusion should be sought by means of an opt-in. (shrink)

The paper discusses the philosophical and historical doctrine of the Russian philosopher and historian George Petrovich Fedotov. The author focuses on the analysis of imperial issues in the works of G.P. Fedotov, especially of his views on the cultural history of the Russian empire and the essence of imperial project in Russia. Fedotov reconsiders the historical experience and revolutionary catastrophe of Russia and searches for the foundations of the social and cultural processes determining the events of Russian history. Fedotov’s works (...) offer a variety of interpretations of the political and cultural phenomenon of empire. This reflects his evolution as a philosopher of history: the focus of his vision shifts from the Medieval Rus to the Empire of Peter the Great, then to the collapsed empire of Nicholas II and finally to the USSR. Fedotov’s concept of Empire evolves into a timeless cultural-philosophical phenomenon but originates from the historical description of the centralization of power in the feudal monarchy of Ivan the Terrible. The evolution of the philosophical and historical views of Fedotov is influenced by the changes of his attitude to the historical conception of Klyuchevsky. In the 1940s Fedotov considers the empire as a universal idea. The concept of empire proposed by Fedotov gives an understanding of the Russian historical development, especially the causes of the decline and fall of the Russian Empire. Fedotov associates the cause of the salvation of Russia with the study of ancient Russian culture, in which he founds a moral and political ideal of the “Republic of Saint Sophia.” The paper shows heuristic potential of Fedotov’s cultural and philosophical ideas on the vocation of spiritual elite and the creative role of personality in the process of nation-building. (shrink)

This article discusses the place of mystery in Christian thought and practice. Both Christians themselves and their critics have historically thought that the concept of mystery is central to Christian reflection and Christian worship. It is initially surprising, then, to find that the indices of recent important reference works contain few if any references to mystery. The most important reason for the neglect of mystery may be this. William Alston begins his recent ‘Two Cheers for Mystery’ by observing that ‘contemporary (...) Anglo-American analytic philosophy of religion’ exhibits ‘a considerable degree of confidence in’ its ability ‘to determine what God is like; how to construe his basic attributes; and what his purposes, plans, standards, values and so on are’. No one ‘thinks we can attain a comprehensive knowledge of God's nature and doings. But on many crucial points, there seems to be a widespread confidence in our ability to determine exactly how things are with God.’ And, of course, the more confident one is, the less one will see any need for according the concept of mystery a central place in one's reflections on God. But what if failing to do so distorts these reflections? The burden of this article is that it does. (shrink)

Recourse to a being’s moral status is the ‘nuclear option’ of moral theorising—it tells us not only what obligations we have and to what degree, but whether we have obligations to them in the first place and whether their moral concern trumps concern for other beings simply in virtue of the kind of being they are. As such, we should only explain obligations in terms of a being’s moral status if doing so is principled and necessary to defend that obligation. (...) In ‘Pregnancy and Superior Moral Status: A Proposal for Two Thresholds of Personhood’, Robinson1 argues that pregnant women achieve a second and therefore superior threshold of moral status to ‘mere persons’. She insists that this is not a view about the woman and the fetus together but that ‘the pregnant woman herself is more than one individual’. This gives us strong reason to re-balance the imbalanced burdens experienced by women due to pregnancy. I will argue her proposal is neither principled nor necessary. We can explain special obligations to pregnant women without appealing to a distinct moral status, without reaching for the ‘nuclear option’. First, consider Robinson’s1 claim that pregnant women ‘are performing a role which is of supreme importance: that of creating new human life, and maintaining the survival of the human species’. …. (shrink)

This is a response to Macleod 2012's argument that the history of unjust property acquisitions requires rich libertarians to give away everything in excess of equality. At first, problematic questions are raised. How much property is usually inherited or illegitimate? Why should legitimate inheritance be affected? What of the burden of proof and court cases? A counterfactual problem is addressed. Three important cases are considered: great earned wealth; American slavery; land usurpation. All are argued to be problematic for Macleod (...) 2012's thesis. Various problems are explained concerning using the Nozickian argument to decide the alleged excess that rich libertarians own. The essay's main error is the presupposition that free markets do not help the worst-off. The majority of unjust holdings today are not the result of historical injustices but arise through continuing transfers enabled by taxation and state-regulation. More study of libertarian contributions to the social sciences and philosophy would appear to be desirable "personal behavior" among socialists. (shrink)

This work, written from a neo-Pyrrhonian perspective, is an examination of contemporary theories of knowledge and justification. It takes ideas primarily found in Sextus Empiricus's Outlines of Pyrrhonism, restates them in a modern idiom, and then asks whether any contemporary theory of knowledge meets the challenges they raise. The first part, entitled "Gettier and the Problem of Knowledge," attempts to rescue our ordinary concept of knowledge from those philosophers who have assigned burdens to it that it cannot bear. Properly understood, (...) Fogelin shows that the concept of knowledge is unproblematic. The second part of this study, called "Agrippa and the Problem of Justification," examines Agrippa's contribution to Pyrrhonism, a systematic reduction of its procedures which came to be known as the "Five Modes Leading to the Suspension of Belief." These modes present a completely general procedure for refuting any claim a dogmatist might make. Though largely unnoticed, there is, according to Fogelin, an uncanny resemblance between problems posed by Agrippa's "Five Modes" and those that contemporary epistemologists address under the heading of a theory of justification. Fogelin examines the strongest contemporary theories of justification--in both foundationalist and anti-foundationalist forms. The conclusion is that recent philosophical writings on justification have made no significant progress in responding to the Pyrrhonian problems these writings have addressed. (shrink)

This article revisits long-standing questions about consent, membership and emigration in Locke’s thought. Commentators such as A John Simmons have argued that Locke opens political membership to both express consenters and some kind of tacit consenters, and not just to the former, as some have suggested. Simmons’s reading seems to render Locke more sensible in that it does not exclude large numbers of people from membership or burden the few members with all the civic duties, and also in that (...) it allows at least tacit-consenting members the right to relocate, while this right is denied to express-consenting members. Against this reading, the article shows, by resolving seemingly conflicting claims in the text, that people become members only by express consent. It also responds to the criticism that the express-consent-only reading would limit membership to a few and so would render Locke’s account implausible from a practical point of view. The article then addresses the purported restriction Locke imposes on express consenters’ right to emigrate, arguing that the restriction concerns the change of membership and not the right to relocate. (shrink)

The advent of personal genomics companies offering direct translation of scientific data into personal health information, calls into question traditional policies to refuse disclosure of such scientific data to research participants. This seems especially true for population biobanks, as they collect not only genotype information but also associated phenotype information, and thus may be in a unique position to translate their scientific findings into personal health information for their participants. Disclosure of such information seems mandated by the expectations raised by (...) biobanks and their participants' rights to know health information, to know clinical research results, to life and health and particularly their right to benefit. Refusals to disclose such information can be grounded in the lack of analytical validity and/or clinical utility of most findings, the need to avoid the therapeutic misconception, the complexity and costs involved in translation and disclosure and the disproportionate burden resulting from the obligation to respect participants' right not to know before any disclosure can be made. Currently, any demands by participants in population biobanks for full disclosure of all pertinent personal health information potentially resulting from the biobank's scientific findings are unlikely to be granted by a Dutch court under Dutch and international law. As the law stands now, a population biobank is neither a doctor nor a personal genomics company. However, in view of the rapid scientific, medical, technological, commercial and social developments, population biobanks must prepare to take more care of their participants' legitimate interest in receiving as much validated personal health information as reasonably possible, in a timely fashion, by developing appropriate translation and disclosure mechanisms. This paper examines whether population biobank participants have the right, under Dutch civil law and international law, to full disclosure, i.e. to all information generated by the biobank that is pertinent to their present and future health. It pioneers the format of a hypothetical court case to elucidate the legal and policy arguments" for and against full disclosure. (shrink)

This chapter suggests that descriptive epidemiological studies like the Global Burden of Disease Study can usefully be divided into four tasks: describing individuals’ health states over time, assessing their health states under a range of counterfactual scenarios, summarizing the information collected, and then packaging it for presentation. The authors show that each of these tasks raises important and challenging ethical questions. They comment on some of the philosophical issues involved in measuring health states, attributing causes to health outcomes, choosing (...) the counterfactual against which to assess causes, aggregating and summarizing complex information across multiple domains, discounting, age-weighting, handling fetal deaths, measuring health inequalities, representing uncertainty, and assessing personal responsibility for health outcomes. (shrink)

Obtaining prospective written consent from women to participate in trials when they are experiencing an obstetric emergency is challenging. Alternative consent pathways, such as gaining verbal consent at enrolment followed, later, by obtaining written consent, have been advocated by some clinicians and bioethicists but have received little empirical attention. We explored women’s and staff views about the consent procedures used during the internal pilot of a trial, where the protocol permitted staff to gain verbal consent at recruitment. Interviews with staff (...) and participating women. Data were analysed thematically and interviews were cross-compared to identify differences and similarities in participants’ views about the consent procedures used. Women and some staff highlighted benefits to obtaining verbal consent at trial enrolment, including expediting recruitment and reducing the burden on those left exhausted by their births. However, most staff with direct responsibility for taking consent expressed extreme reluctance to proceed with enrolment until they had obtained written consent, despite being comfortable using verbal procedures in their clinical practice. To account for this resistance, staff drew a strong distinction between research and clinical care and suggested that a higher level of consent was needed when recruiting into trials. In doing so, staff emphasised the need to engage women in reflexive decision-making and highlighted the role that completing the consent form could play in enabling and evidencing this process. While most staff cited their ethical responsibilities to women, they also voiced concerns that the absence of a signed consent form at recruitment could expose them to greater risk of litigation were an individual to experience a complication during the trial. Inexperience of recruiting into peripartum trials and limited availability of staff trained to take consent also reinforced preferences for obtaining written consent at recruitment. While alternative consent pathways have an important role to play in advancing emergency medicine research, and may be appreciated by potential recruits, they may give rise to unintended ethical and logistical challenges for staff. Staff would benefit from training and support to increase their confidence and willingness to recruit into trials using alternative consent pathways. This qualitative research was undertaken as part of the GOT-IT Trial. Date of registration 26/03/2014. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Royce, Racism, and the Colonial IdealWhite Supremacy and the Illusion of Civilization in Josiah Royce's Account of the White Man's Burden1Tommy J. CurryNo colony can be made by a theory of Imperialism, it can only be made by people who want to colonize and are capable of maintaining themselves as colonists.—Sir Sydney OlivierIntroductionAs with most historic white figures in philosophy, their repopularization and reintroduction into contemporary circles commits their (...) work, regardless of its initial silence, to speak to the problem of anti-Black racism in America. Josiah Royce is no different in this regard. In recent years, white scholars like Jacquelyn Kegley and Shannon Sullivan have introduced revisions to Royce's thought that make it appear multicultural and antiracist, despite the anachronism of such a contention. According to Kegley, "Royce believes, as others in the contemporary scene, that 'race' as a concept cannot be eliminated, [because] it plays too crucial a role, both positive and negative, in self- and social identification" (216). While Kegley is correct that contemporary scholars like Lucius Outlaw and Cornel West have adamantly defended the importance of race as a social and cultural entity, her claim is in stark contradiction to the racial eliminativism of other scholars like Anthony Appiah and Alain Locke, whom she also contends that Royce agrees with simultaneously.2 While it makes perfect sense for Kegley to try to put Royce in conversation with contemporary Black thinkers in race theory, her work is indicative of a trend aiming to gain currency for historic white thinkers in current race debates at the expense of historical accuracy. Black scholars who studied under Royce and applied his theories to the race problem from the mid-1900s onward, like William H. Ferris3 and William T. Fontaine,4 are ignored by white scholars because the first application of Roycean philosophy supported assimilationism. It is only today with the political and ideological [End Page 10] ethicizations of racial diversity and multiculturalism that Royce's work is interpreted as critically conserving race.5In contrast to contemporary works on Royce and race, this article seeks to evaluate the current claims for the relevance of Royce's views in contemporary debates on race. I maintain that only by taking Royce out of his historical context (late nineteenth-and early twentieth-century thought) do his ideas on race acquire a level of importance that cannot be supported by the actual evidence he himself advances. Conversely, by actually placing Royce in his historical context, this article will demonstrate that Royce's 1905 article entitled "Race Questions" (later published as "Race Questions and Prejudices" in 1906) is an unapologetic extension of his 1900 article entitled "Characteristic Tendencies of American Civilization," where Royce adamantly champions British colonialism and assimilation as the remedy to the burgeoning race problem both at home and abroad. I begin with a critical analysis that places Josiah Royce's attitudes firmly within the boundaries of his times. In what follows, I will attempt to contextualize Royce's seemingly progressive stance on Japan as part of a more general reaction whites had during the early 1900s to Russia's defeat by the Japanese. Instead of reading Royce's stance on Japan as a moment of exceptionalism, I contend that Royce's attitude was in fact a popular disposition that signaled the inevitable shift of race science away from biological determinism toward more environmentalist explanations. Secondly, and perhaps more importantly, I will show that Royce's disposition toward Blacks was firmly rooted in a colonial and assimilationist logic that ultimately sought the cultural destruction of African-descended people. A closer look at Royce's prefatory remarks on British colonialism from 1900 and his valorization of English colonial administration in Jamaica actually reveals an insidious racial dynamic in Royce's thought that is anything but antiracist. Finally, having established Royce's philosophical stake in American assimilation and Western domination, I argue that the "provincial revision" currently in vogue amongst American philosophers working with Royce is simply not enough to overturn Royce's clearly racist investments in dealing with the race question.If I Can Think It... Then I Can Do It—Reading Royce... (shrink)

A common strategy in bioethics is to posit a prima facie case in favour of one policy, and to then claim that the burden of proof falls on those with opposing views. If the burden of proof is not met, it is claimed, then the policy in question should be accepted. This article illustrates, and critically evaluates, examples of this strategy in debates about the sale of organs by living donors, human enhancement, and the precautionary principle. We highlight (...) general problems with this style of argument, and particular problems with its use in specific cases. We conclude that the burden ultimately falls on decision-makers to choose the policy supported by the best reasons. (shrink)

This paper joins the voices warning against hasty transference of legal concepts of presumption to other kinds of argumentation, especially to deliberation about future acts and policies. Comparison of the pragmatics which respectively constitute the illocutionary acts of accusing and proposing reveals important differences in the ways presumptions prompt accusers and proposers to undertake probative responsibilities and, also, points to corresponding differences in their probative duties. This comparison has theoretically important implication regarding the norms governing persuasive argumentation. The paper is (...) based on a broadly Gricean account of speech acts. (shrink)

Open peer commentary on the article “Exploring the Depth of Dream Experience: The Enactive Framework and Methods for Neurophenomenological Research” by Elizaveta Solomonova & Xin Wei Sha. Upshot: Enaction and neurophenomenology are indeed appropriate and productive theoretical and methodological tools for studying perception. But moving from the perceptual domain to the hallucinatory and dreaming domain with these tools requires a prior careful examination of the similarities and differences across these domains. The authors point in the right direction for studying dream (...) experience, but underestimate the objective and subjective differences between domains, producing thereby both an unwarranted blurring of their boundaries and an unnecessary explanatory burden on the approach defended. (shrink)

If Savulescu's controversial principle of Procreative Beneficence is correct, then an important implication is that couples should employ genetic tests for non-disease traits in selecting which child to bring into existence. Both defenders as well as some critics of this normative entailment of PB have typically accepted the comparatively less controversial claim about non-disease traits: that there are non-disease traits such that testing and selecting for them would in fact contribute to bringing about the child who is expected to have (...) the best life. We challenge this less controversial claim, not by arguing deductively for its falsity, but by showing that Savulescu's central argument for this presumably less controversial claim fails. Savulescu offers intelligence as the paradigm example of a testable non-disease trait such that testing and selecting for it would increase the likelihood that the child selected would be the one who is expected to have the best life. We provide a series of arguments aimed at demonstrating that Savulescu's argument from intelligence fails. If our arguments are successful, the upshot is not that PB is false, but more modestly, that the burden of proof remains squarely with Savulescu. (shrink)

We provide a new wrinkle to the Argument from Unfair Advantage, a rather popular one in the ethics of doping in sports discussions. But we add a new argument that we believe places the moral burden on those who favor doping in sports. We also defend our position against some important concerns that might be raised against it. In the end, we argue that for the time being, doping in sports ought to be banned until it can be demonstrated (...) that our concerns can be satisfied. (shrink)

In assigning the benefits and burdens of society, we sometimes discriminate using a broad category (age, gender, race, etc.) we think correlates well with the possession of some other skill, qualification, or character trait. In this essay, I explore one rationale for this type of discrimination. I suggest a method for determining when this rationale provides a moral justification for the discrimination, and when it does not. I defend the method against some potential criticisms, and point out some exceptions to (...) its application. (shrink)

“Spinoza's Extended Substance: Cartesian and Leibnizian Reflections” This essay examines Woolhouse's interpretation of Spinoza's extended substance. According to that interpretation, the extended substance is a quasi‐Platonic form, and Spinoza's substance is not actually extended. This essay argues that the burden of defending such an interpretation is very great indeed, and requires that we read Spinoza's understanding of Descartes and Leibniz's understanding of Spinoza in unusual and awkward ways.

In this paper I examine the ethics of benefit-sharing agreements between victims and beneficiaries of injustice in the context of trans-national bodily giving, selling, and sharing. Some obligations are the same no matter who the parties to a transaction are. Prohibitions on threats, fraud and harm apply universally and their application to transactions in unjust contexts is not disputed. I identify three sources of obligations that are affected by unjust background conditions. First, power disparities may illegitimately influence transactions in unintentional (...) ways. Second, better-off individuals have duties to ameliorate injustices. These are not specifically duties to those with whom they interact, though often it is easier and more effective to help those with whom one already interacts. Third, the power differentials created by injustice make exploitative transactions more likely. I summarize a transactional account of exploitation and argue that avoiding exploitation is usually easiest to achieve by ensuring that the more powerful party does not obtain an unfair share of the benefits from the transaction. The beneficiaries of a transaction do not have to be only those individuals directly involved in it. Indeed, in many cases it is thought that exploitation may be avoided by providing benefits to third parties. Working out when this is the case requires working out when a contribution or burden on another’s behalf can count towards the avoidance of exploitation. I argue that it counts as such in two main cases: when the people in question are already involved in relationships of reciprocation, and when the individual making the contribution identifies with the interests of the other people. (shrink)

There is a popular and widely accepted version of the precautionary principle which may be expressed thus: “If you are in a hole—stop digging!”. Tom Baldwin, as Deputy Chair of the Human Fertilisation and Embryology Authority , may be excused for rushing to the defence of the indefensible,1 the HFEA’s sex selection report,2 but not surely for recklessly abandoning so prudent a principle. Baldwin has many complaints about my misrepresenting the HFEA and about my supposed elitist contempt for public opinion; (...) readers of this exchange will decide for themselves.REDRAFTING THE REPORTBaldwin begins with a piece of wishful thinking:"Harris objects that in this recommendation “an absurdly high standard of caution is employed”, since a theoretical risk is associated with almost all medical procedures. This objection is misplaced: as paragraph 142 of the report indicates, the phrase “theoretical risk” is to be understood here in the light of the earlier discussion of the risks arising from the fact that flow cytometry exposes sperm to laser energy, a procedure which is known to be liable to damage DNA."Paragraph 142 does not make that clear. It does indeed refer back to a set of earlier paragraphs but these give, if anything, an upbeat assessment of the safety of flow cytometry. Paragraph 121 states: “However whilst potentially less intrusive, and with potentially lower risk to the health of patients, flow cytometry …” .2 But even if the overall burden of the report does indicate unresolved fears, the standard is still absurdly high. However, so far from endorsing the report’s judgement that flow cytometry has “potentially lower risk to the health of patients”, Baldwin now regards the risk of flow cytometry as “serious”1:"Since the application of flow cytometry to humans is a new procedure, the risk of … ". (shrink)

Deflationists hold that it does not seem to us, in experience, as though time robustly passes. There is some recent empirical evidence that appears to support this contention. Equally, empirical evidence suggests that we naïvely represent time as dynamical. Thus deflationists are faced with an explanatory burden. If, as they maintain, the world seems to us in experience as though it is non-dynamical, then why do we represent time as dynamical? This paper takes up the challenge of investigating, on (...) the part of the deflationist, one candidate explanation. We hypothesise that people’s belief that the future is what we call deliberatively open partly explains why they represent time as dynamical. In a series of two experiments we test this hypothesis. We find no evidence that beliefs about deliberative openness explain why people represent time as dynamical. Hence there remains an explanatory burden for the deflationist to discharge. (shrink)

I begin with a paraphrase of Plato Laws X 887de, which has suggested the arguments to be developed in this brief article. ‘The Athenian’ speaks to the following effect: ‘How can one admonish in all patience those who deny the existence of gods ? For no sufficient reason they disbelieve the myths which, in infancy, they heard from nurses and mothers in sportive or in serious vein. They disbelieve also those myths which, at sacrifices, from boyhood onwards, they heard recounted (...) in prayers and saw represented in spectacles. They reject the testimony of their own parents, nay, of all Greeks and barbarians, who by continual prayer and worship show clearly their unanimous belief in the existence of gods. Despising all these things, they lay on us the burden of refuting by reasoned argument their perverse opinions.’. (shrink)

Open peer commentary on the target article “How and Why the Brain Lays the Foundations for a Conscious Self” by Martin V. Butz. Excerpt: This paper is full of stimulating and creative ideas. It posits that an anticipatory drive is what guides the development in the brain of a set of internal motor models, specifically a set of inverse and forward models. Through these models becoming increasingly complex, a conscious self develops. This is a simple and important thesis, if true. (...) But is it? As my title suggests, it may be so for sportsmen, with their emphasis on ever more refined motor responses. However, those of a more cerebral nature may find themselves burdened by all those coupled internal motor models and not able to think as clearly as they would like. This is not to say that prediction isn’t a useful property to possess, both for finance (especially now) and in one’s general living patterns. But the question I wish to consider is: What sort of predictive model can lead to thinking? (shrink)

In two recent essays, Thomas Pogge addresses the question of how research and development of essential drugs should be incentivized. Essential drugs are drugs for diseases that ruin human lives. The current incentivizing scheme for such drugs is, according to Pogge, a significant causal factor in bringing about a state of affairs in which millions of people die or suffer from lack of access to essential drugs. Pogge, therefore, suggests a reform plan for how to incentivize research and development of (...) these drugs, and he is of the opinion that implementation of this plan will have a significant positive impact on the global disease burden. This paper is a critical examination of Pogge's reform plan. In the first part of the paper, Pogge's reasons for being dissatisfied with the current incentivizing scheme are spelled out. The reform plan is then presented, and in the final part of the paper, it is argued that the reform plan is flawed at a number of levels. (shrink)

If Savulescu's (2001, 2009) controversial principle of Procreative Beneficence (PB) is correct, then an important implication is that couples should employ genetic tests for non‐disease traits in selecting which child to bring into existence. Both defenders as well as some critics of this normative entailment of PB have typically accepted the comparatively less controversial claim about non‐disease traits: that there are non‐disease traits such that testing and selecting for them would in fact contribute to bringing about the child who is (...) expected to have the best life. We challenge this less controversial claim, not by arguing deductively for its falsity, but by showing that Savulescu's central argument for this presumably less controversial claim fails. Savulescu offers intelligence as the paradigm example of a testable non‐disease trait such that testing and selecting for it would increase the likelihood that the child selected would be the one who is expected to have the best life (or at least as good a life as the others). We provide a series of arguments aimed at demonstrating that Savulescu's argument from intelligence fails. If our arguments are successful, the upshot is not that PB is false, but more modestly, that the burden of proof remains squarely with Savulescu. (shrink)

In this paper, we report results from experiments in which people read conversational arguments and then judge the convincingness of each claim and the individual speakers' burden of proof. The results showed an "anti-primacy" effect: People judge the speaker who makes the first claim as having greater burden of proof. This effect persists even when each speaker's claims are rated equally convincing. We also find that people rate claims less convincing when they appear in the first part of (...) an argument than when they appear in isolation. (shrink)

While the UK Home Office’s proposals to preventively detain people with what it has called dangerous severe personality disorder have been subjected to debate and criticism the deeply troubling jurisprudential issues in these proposals have not yet entered into public debate in a way that their seriousness deserves.1 It is good that a commentator as well known as Professor Szasz is speaking out on this issue.Professor Szasz focuses upon a crucial question by calling into question the medicalisation of terms like (...) dangerousness and mental illness.2 There is a great temptation for legislators and the public to treat these terms as if they are purely scientific terms and to think of risk assessment as a precise science. I don’t share Professor’s Szasz’s worry about how psychiatry is using these terms but I think there are some important questions about how these concepts function in the public sphere.This issue is important enough to justify the use of some rhetorical claims because such claims can serve to bring out what are neglected and important issues. In raising the following objections I am not attempting to refute the message that is in Szasz’s article or to say that he is not making an important point but rather to attempt to sharpen the issues and to suggest ways that we can respond to Professor Szasz’s challenge.Psychiatry has progressed in a number of ways since Professor Szasz wrote The Myth of Mental Illness.3 The science is much better, we have much better medications, and psychiatrists are acutely aware of the tension between treating their patient and their obligations to the public interest.So when Professor Szasz says: “Psychiatrists offer to relieve the disturbed person of the burden of coping …. (shrink)

Online shaming is a subject of import for social philosophy in the Internet age, and not simply because shaming seems generally bad. I argue that social philosophers are well-placed to address the imaginal relationships we entertain when we engage in social media; activity in cyberspace results in more relationships than one previously had, entailing new and more responsibilities, and our relational behaviors admit of ethical assessment. I consider the stresses of social media, including the indefinite expansion of our relationships and (...) responsibilities, and the gap between the experiences of those shamed and the shamers’ appreciation of the magnitude of what they do when they shame; I connect these to the literature suggesting that some intuitions fail to guide our ethics. I conclude that we each have more power than we believe we do or than we think carefully about exerting in our online imaginal relations. Whether we are the shamers or the shamed, we are unable to control the extent to which intangible words in cyberspace take the form of imaginal relationships that burden or brighten our self-perceptions. (shrink)

Introduction -- Part I: Starting points -- Some decisions are easier than others -- Easy decisions -- More difficult decisions -- Moral dilemmas -- The deep basis of the moral life -- Practical decision making -- Why ethics is ultimately religious -- Acceptable and unacceptable forms of revelation -- The useful incomplete ness of religious tradition -- Moral virtue and character -- Intuition and deliberation in moral decision-making -- The absolute and the relative in moral life -- Have we become (...) too relativistic? -- The natural law approach -- God as the absolute -- Facts and values -- Individual integrity and communal authority -- The transcendent absolute -- Rules and relationships -- The moral burden of proof -- The legal analogy -- Applying the idea of "presumption" to ethical decision-making -- Moral presumptions as a common starting point -- Basic moral presumptions -- Uses of scripture -- Positive Christian value presumptions -- The limits and flaws in human nature -- Presumptions that preserve balance -- A presumption for Scripture and tradition -- When presumptions are in conflict -- Part II: Applications and illustrations -- Difficult personal decisions -- Sexual intimacy and family life -- Contraception and abortion -- Choosing a spouse -- Divorce -- Vocational choices -- The uses of our money -- Political choices -- Hard choices in the public arena -- Abortion -- Homosexuality -- The dilemma of "affirmative action" -- Securing economic justice -- Environmental policies -- Criminal justice -- Uses of military power -- Hard choices at the global level -- International institution building -- International security and policing -- Nuclear disarmament -- Economic globalization -- Global warming -- Hard choices in communities of faith. (shrink)

The recent political “left turn” in Latin America has led to an increased emphasis on social policy and poverty alleviation programs aimed at women. Drawing on ethnographic fieldwork and interviews in a rural village in Nicaragua, I argue that one of the consequences of such programs is an increase in women’s daily workload, which I call the gendered burden of development. By exploiting women’s unpaid community care labor, these non-governmental organizations and state-led programs entrench established gender roles and responsibilities. (...) Furthermore, through their selective interventions, these programs reinforce the neoliberal ideal of self-sufficiency in women’s everyday lives, contributing to the formation of a particular kind of developmental subject who assumes responsibility for her own hardships. Although these programs have produced some tangible improvements in women’s lives, they ultimately do little to alter the structural conditions affecting the precariousness of women’s survival. (shrink)

The COVID-19 pandemic has helped to clarify the fair and equitable allocation of scarce medical resources, both within and among countries. The ethical allocation of such resources entails a three-step process: (1) elucidating the fundamental ethical values for allocation, (2) using these values to delineate priority tiers for scarce resources, and (3) implementing the prioritisation to faithfully realise the fundamental values. Myriad reports and assessments have elucidated five core substantive values for ethical allocation: maximising benefits and minimising harms, mitigating unfair (...) disadvantage, equal moral concern, reciprocity, and instrumental value. These values are universal. None of the values are sufficient alone, and their relative weight and application will vary by context. In addition, there are procedural principles such as transparency, engagement, and evidence-responsiveness. Prioritising instrumental value and minimising harms during the COVID-19 pandemic led to widespread agreement on priority tiers to include health-care workers, first responders, people living in congregate housing, and people with an increased risk of death, such as older adults and individuals with medical conditions. However, the pandemic also revealed problems with the implementation of these values and priority tiers, such as allocation on the basis of population rather than COVID-19 burden, and passive allocation that exacerbated disparities by requiring recipients to spend time booking and travelling to appointments. This ethical framework should be the starting point for the allocation of scarce medical resources in future pandemics and other public health conditions. For instance, allocation of the new malaria vaccine among sub-Saharan African countries should be based not on reciprocity to countries that participated in research, but on maximally reducing serious illness and deaths, especially among infants and children. (shrink)