In response to the charge that deontic ("argent-centered") restrictions are paradoxical, several recent writers suggest that such restrictions find support within T.M. Scanlon's contractualism. I suggest that this claim is only interesting if these restrictions are stronger than those supported by indirect consequentialism. I argue that contractualism cannot support restrictions any stronger than those supported by indirect consequentialism. The contractualists have mislocated the source of the paradox, which arises under any theory that defines right action in patient-focused terms. Consequentialism and (...) contractualism share this feature, so contractualism cannot support stronger deontic restrictions than consequentialism supports. (shrink)

: Biomedical ethicists often assume that common morality constitutes a largely consistent normative system. This premise is not taken for granted in general normative ethics. This paper entertains the possibility of inconsistency within common morality and explores methodological implications. Assuming common morality to be inconsistent casts new light on the debate between principlists and descriptivists. One can view the two approaches as complementary attempts to evade or transcend that inconsistency. If common morality proves to be inconsistent, then principlists might have (...) reason to prefer a less pluralistic theory, thereby moving closer to descriptivism. Descriptivists, by contrast, might want to qualify their claim to accommodate all of people's basic moral convictions. Finally, both camps might wish to adopt a more revisionist posture, accepting that an adequate ethical theory occasionally will contradict some of people's deepest moral convictions. Proper application of the method of reflective equilibrium, to which both descriptivists and principlists claim allegiance, may entail greater openness to revisionism than either camp admits. (shrink)

Introduction -- Practical reasons and judicial use of force -- Deviating from legal standards -- The legal duties of judges -- The normative classification of legal results -- Reasons to deviate -- Adherence rules -- Obeying adherence rules -- The judicial oath -- Legal duty and political obligation -- Systemic effects -- Agent-relative principles -- Optimal adherence rules -- Guidance rules -- Treating like cases alike -- Implementation -- Theoretical implications -- Conclusion.

Retributive restrictions are principles of justice according to which what a criminal deserves on account of his individual conduct and character restricts how states are morally permitted to treat him. The main arguments offered in defense of retributive restrictions involve thought experiments in which the state punishes the innocent, a practice known as telishment. In order to derive retributive restrictions from the wrongness of telishment, one must engage in moral argument from generalization. I show how generalization arguments of the same (...) form can be used subversively to derive morally unacceptable conclusions from other scenarios in which the state intentionally inflicts undeserved coercion. For example, our considered moral convictions approve of punishment policies that inflict collateral damage, such as the ubiquitous policy of excluding the family members of inmates from prison facilities outside visiting hours. I present a generalization argument for the conclusion that these policies are seriously unjust. If we firmly believe that these policies are not unjust, then we should put less stock in generalization arguments. We should not use them to support retributive restrictions. This conclusion has broad implications for the theory and practice of criminal justice. (shrink)

Legal theorists in this century have often perceived a need for a theory capable of occupying a stable middle ground between natural law theory and nineteenth-century legal positivism. The prolific German-American legal philosopher, Hans Kelsen, was perhaps not the first to feel the need for such a theory, but he was certainly among the first to attempt to construct one. n1 Although Kelsen's own efforts failed, in many ways they defined the ambitions of twentieth-century legal theory and inspired others to (...) take up the challenge. In order to understand the nature of the challenge, which confronts us still today, it is helpful to examine central difficulties with Kelsen's own Pure Theory of Law. (shrink)

Aspects of Law and Legal Systems -- Courts and Legal Reasoning -- Making, Justifying, and Evaluating Law -- Law and Individual Obligation -- Private Law -- Criminal Law -- Sentencing and punishment-- Statutes -- Constitutions -- International Law.

Principle monists believe that our moral duties, such as fidelity and non-maleficence, can be justified in terms of one basic moral principle. Principle pluralists disagree, some suggesting that only an excessive taste for simplicity or a desire to mimic natural science could lead one to endorse monism. In Ideal Code, Real World (Oxford, 2000), Brad Hooker defends a monist theory, employing the method of reflective equilibrium to unify the moral duties under a version of rule consequentialism. Hooker's arguments have drawn (...) powerful criticisms from pluralists such as Alan Thomas, Phillip Montague and Philip Stratton-Lake. Against these critics, I argue that Hooker's monism enjoys certain practical advantages associated with the simplicity of a single basic principle. These advantages are often overlooked because they appear primarily in cases of second-order deliberation, in which one must decide whether our basic moral duties support a certain derivative duty. I argue that these advantages of monism over pluralism are analogous to the advantages that generalists claim over moral particularism. Because pluralists are generalists, I conclude that they are in an awkward dialectical position to dismiss Hooker's monism for the reasons they usually offer. (shrink)

This best-selling anthology of readings with case studies provides insightful and comprehensive treatment of ethical issues in medicine. Appropriate for courses taught in philosophy departments, bioethics programs, as well as schools of medicine and nursing, the collection covers such provocative topics as biomedical enhancement, clinical trials in developing countries, animal research, physician-assisted suicide, and health care reform. The text's effective pedagogical features include chapter introductions, argument sketches, explanations of medical terms, headnotes, and annotated bibliographies.

Under the general tutelage of Kant, Charles Sanders Peirce (1839–1914) introduced American pragmatism to yet another philosophical dialectic: between a neglected transcendental instinct and earthly authorities. The dialectic became Peirce’s response to various evolutionary schemes in the 19th century. Guided by the recollected voices of Socrates, Jesus, St. John, Anselm, and Kant, as well as his own brand of pragmatism, Peirce eventually developed a “Neglected Argument for the Reality of God” a century ago, in 1908. Here, Peirce endorsed (...) a more adventurous god than ecclesiastical or theological authorities could imagine, a god of love (agapism) and chance (tychism), but still rife with fallibility. (shrink)

Patronizing the Public is the first detailed and comprehensive examination of how American philanthropy has transformed culture, communication, and the humanities. Drawing on an impressive range of archival and secondary sources, the chapters in the volume shed light on philanthropic foundations have shaped numerous fields, including film, television, radio, journalism, drama, local history, museums, as well as art and the humanities in general.

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases’ powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro‐organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical‐ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

Repeat offenders receive longer sentences than first offenders in virtually every modern jurisdiction. Such prior-record enhancements are politically popular. Scholars are more divided, especially regarding severe enhancements. Retributivists have long disagreed about which enhancements, if any, are morally justifiable and on what basis. This article advances the debate, offering lessons for retributivists on all sides. I address an intuitive argument that justifies enhancements in terms of character. This argument has been caricatured and dismissed, with defenders of enhancements preferring character-independent arguments. (...) I reconstruct an argument for enhancements that assumes recidivism constitutes evidence of culpability-aggravating character traits. The argument seems at least coherent, inferentially valid, and intuitively plausible. I then raise what I see as the real threats to the argument, which are neither conceptual nor normative, but empirical. I identify some formal features that the character argument requires of culpability-aggravating traits. To support enhancements, such traits must also correlate properly with criminal records. One place to look for characterizations of such traits, and evidence of correlation, is criminology, in theories of criminogenesis and criminality. I conclude that character arguments for prior-record enhancements cannot be dismissed, although their thorough evaluation awaits answers to complex empirical questions. (shrink)

The Monty Hall Problem (MHP), a process of two-stage decision making, was presented in atypical form via a custom software game. Differing from the normal three-box MHP, the game added one additional box on-screen for each game—culminating on game 23 with 25 on-screen boxes to initially choose from. A total of 108 participants played 23 games (trials) in one of four conditions; (1) “Vanish” condition—all non-winning boxes totally removed from the screen; (2) “Empty” condition—all non-winning boxes remain on-screen, but with (...) an “empty” label on them; (3) “Steroids” condition—all non-winning boxes removed from the screen, with initially chosen box becoming 25% larger; (4) “Steroids2” condition—all non-winning boxes removed from the screen, box not currently chosen becomes 25% larger. Results indicate second-stage on-screen presence of boxes influences switching; with their absence having the opposite effect. Size manipulation appears to elicit demand characteristics resulting in indeterminate influence. (shrink)

The ancient Greeks hard‑wired a tragic sensibility into their culture. By looking disaster squarely in the face, by understanding just how badly things could spiral out of control, they sought to create a communal sense of responsibility and courage—to spur citizens and their leaders to take the difficult actions necessary to avert such a fate. Today, after more than seventy years of great‑power peace and a quarter‑century of unrivaled global leadership, Americans have lost their sense of tragedy. They have forgotten (...) that the descent into violence and war has been all too common throughout human history. This amnesia has become most pronounced just as Americans and the global order they created are coming under graver threat than at any time in decades. In a forceful argument that brims with historical sensibility and policy insights, two distinguished historians argue that a tragic sensibility is necessary if America and its allies are to address the dangers that menace the international order today. Tragedy may be commonplace, Brands and Edel argue, but it is not inevitable—so long as we regain an appreciation of the world’s tragic nature before it is too late. (shrink)

_An eloquent call to draw on the lessons of the past to address current threats to international order_ The ancient Greeks hard‑wired a tragic sensibility into their culture. By looking disaster squarely in the face, by understanding just how badly things could spiral out of control, they sought to create a communal sense of responsibility and courage—to spur citizens and their leaders to take the difficult actions necessary to avert such a fate. Today, after more than seventy years of great‑power (...) peace and a quarter‑century of unrivaled global leadership, Americans have lost their sense of tragedy. They have forgotten that the descent into violence and war has been all too common throughout human history. This amnesia has become most pronounced just as Americans and the global order they created are coming under graver threat than at any time in decades. In a forceful argument that brims with historical sensibility and policy insights, two distinguished historians argue that a tragic sensibility is necessary if America and its allies are to address the dangers that menace the international order today. Tragedy may be commonplace, Brands and Edel argue, but it is not inevitable—so long as we regain an appreciation of the world’s tragic nature before it is too late. (shrink)

Physician religion/spirituality has the potential to influence the communication between physicians and parents of children at the end of life. In order to explore this relationship, the authors conducted two rounds of narrative interviews to examine pediatric physicians’ perspectives (N=17) of how their religious/spiritual beliefs affect end–of–life communication and care. Grounded theory informed the design and analysis of the study. As a proxy for religiosity/spirituality, physicians were classified into the following groups based on the extent to which religious/spiritual language was (...) infused into their responses: Religiously Rich Responders (RRR), Moderately Religious Responders (MRR), and Low Religious Responders (LRR). Twelve of the 17 participants (71%) were classified into the RRR or MRR groups. The majority of participants suggested that religion/spirituality played a role in their practice of medicine and communication with parents in a myriad of ways and to varying degrees. Participants used their religious/spiritual beliefs to support families’ spirituality, uphold hope, participate in prayer, and alleviate their own emotional distress emerging from their patients’ deaths. (shrink)

BackgroundDespite rapid growth of the scientific literature, no consensus guidelines have emerged to define the optimal criteria for editors to grade submitted manuscripts. The purpose of this project was to assess the peer reviewer metrics currently used in the surgical literature to evaluate original manuscript submissions.MethodsManuscript grading forms for 14 of the highest circulation general surgery-related journals were evaluated for content, including the type and number of quantitative and qualitative questions asked of peer reviewers. Reviewer grading forms for the seven (...) surgical journals with the higher impact factors were compared to the seven surgical journals with lower impact factors using Fisher’s exact tests.ResultsImpact factors of the studied journals ranged from 1.73 to 8.57, with a median impact factor of 4.26 in the higher group and 2.81 in the lower group. The content of the grading forms was found to vary considerably. Relatively few journals asked reviewers to grade specific components of a manuscript. Higher impact factor journal manuscript grading forms more frequently addressed statistical analysis, ethical considerations, and conflict of interest. In contrast, lower impact factor journals more commonly requested reviewers to make qualitative assessments of novelty/originality, scientific validity, and scientific importance.ConclusionSubstantial variation exists in the grading criteria used to evaluate original manuscripts submitted to the surgical literature for peer review, with differential emphasis placed on certain criteria correlated to journal impact factors. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

Heidegger's Being and Time: Critical Essays provides a variety of recent studies of Heidegger's most important work. Twelve prominent scholars, representing diverse nationalities, generations, and interpretive approaches deal with general methodological and ontological questions, particular issues in Heidegger's text, and the relation between Being and Time and Heidegger's later thought. All of the essays presented in this volume were never before available in an English-language anthology. Two of the essays have never before been published in any language ; three of (...) the essays have never been published in English before , and two of the essays provide previews of works in progress by major scholars. (shrink)