The Covid‐19 pandemic has concentrated bioethics attention on the “lifeboat ethics” of rationing and fair allocation of scarce medical resources, such as testing, intensive care unit beds, and ventilators. This focus drives ethics resources away from persistent and systemic problems—in particular, the structural injustices that give rise to health disparities affecting disadvantaged communities of color. Bioethics, long allied with academic medicine and highly attentive to individual decision‐making, has largely neglected its responsibility to address these difficult “upstream” issues. It is time (...) to broaden our teaching, research, and practice to match the breadth of the field in order to help address these significant societal inequities and unmet health needs. (shrink)

Cheating through the use of illegal performance enhancements (such as doping) is a persistent problem in sport. It has been suggested that one response to this problem is to separate sport into two parallel leagues. One league would resemble sport as it is currently practised ? i.e. with restrictions on use of particular enhancements ? and the other would not possess these restrictions, allowing those that wish to use currently illegal enhancements to do so. In this paper I articulate the (...) ?two leagues? proposal further and subject it to critical scrutiny. The proposal fails. It does so by failing to address conceptual confusion regarding enhancement use in sport; by replicating in the new league the current problems associated with enhancement-based cheating; and by creating new problems. In an attempt to revive it I describe other possible justifications for the proposal, based on its promotion of personal autonomy, and rights-based justifications. These fail, with the exception of a group right claiming provision of the enhanced league as a participatory good. I conclude that this latter use of the proposal is the only sensible one, but it nevertheless faces significant obstacles. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

Bioethics needs an expanded moral vision. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, and (...) greater appreciation of the profound health implications of global warming. (shrink)

"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

The three important target articles make a strong case for regarding racism as a public health crisis. Each calls for advocacy by the bi...

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

Mental timing studies may be influenced by powerful cognitive illusions that can produce an asymmetry in their rate of progress relative to neuronal timing studies. Both types of timing research are also governed by a temporal asymmetry, expressed by the fact that the direction of causation must follow time's arrow. Here we refresh our earlier suggestion that the temporal asymmetry offers promise as a means of timing mental activities. We update our earlier analysis of Libet's data within this framework. Then (...) we consider the surprises which often occur on those rare occasions when neural timing experiments parallel mental timing work exactly. Together, these surprises and asymmetries prescribe a relentlessly meticulous and fully transparent exposition of timing methods, terms, and concepts which shuns plausible narratives, even when buttressed by rigorous formal models, unless guided by apposite empirical evidence. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

The volume presents essays on the philosophical explanation of the relationship between body and soul in antiquity from the Presocratics to Galen. The title of the volume alludes to a phrase found in Plato, Aristotle and Plotinus, referring to aspects of living behaviour involving both body and soul, and is a commonplace in ancient philosophy, dealt with in very different ways by different authors.

ABSTRACT:Good science fiction can be a successful vehicle for portraying justice. Science fiction can stimulate moral imagination in much the same way as the most effective justice theories, connecting the world in which we live with a range of alternative futures deliberately and creatively made plausible. A selective examination of classic and recent science fiction stories and novels provides contextual framing for considering questions of climate justice, virtuous personal action in the face of structural injustice, and the problem of what (...) justice means when some people are regarded as “other.” By connecting compelling images of individual responsibility with the complex challenges posed by striving for social justice, science fiction can also help render justice work appealing and achievable—an essential step that is reinforced in closing by a brief set of maxims. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

This book assesses how Vatican II opened up the Catholic Church to encounter, dialogue, and engagement with other world religions. Opening with a contribution from the President of the Pontifical Council for Interreligious Dialogue, Cardinal Jean-Louis Tauran, it next explores the impact, relevance, and promise of the Declaration Nostra Aetate before turning to consider how Vatican II in general has influenced interfaith dialogue and the intellectual and comparative study of world religions in the postconciliar decades, as well as the contribution (...) of particular past and present thinkers to the formation of current interreligious and comparative theological methods. Additionally, chapters consider interreligious dialogue vis-à-vis theological anthropology in conciliar documents; openness to the spiritual practices of other faith traditions as a way of encouraging positive interreligious encounter; the role of lay and new ecclesial movements in interreligious dialogue; and the development of Monastic Interreligious Dialogue. Finally, it includes a range of perspectives on the fruits and future of Vatican’s II’s opening to particular faiths such as Judaism, Islam, Hinduism, and Buddhism. (shrink)

This article is the lead piece in a special report that presents the results of a bioethical investigation into chimeric research, which involves the insertion of human cells into nonhuman animals and nonhuman animal embryos, including into their brains. Rapid scientific developments in this field may advance knowledge and could lead to new therapies for humans. They also reveal the conceptual, ethical, and procedural limitations of existing ethics guidance for human‐nonhuman chimeric research. Led by bioethics researchers working closely with an (...) interdisciplinary work group, the investigation focused on generating conceptual clarity and identifying improvements to governance approaches, with the goal of helping scholars, funders, scientists, institutional leaders, and oversight bodies (embryonic stem cell research oversight [ESCRO] committees and institutional animal care and use committees [IACUCs]) deliver principled and trustworthy oversight of this area of science. The article, which focuses on human‐nonhuman animal chimeric research that is stem cell based, identifies key ethical issues in and offers ten recommendations regarding the ethics and oversight of this research. Turning from bioethics’ previous focus on human‐centered questions about the ethics of “humanization” and this research's potential impact on concepts like human dignity, this article emphasizes the importance of nonhuman animal welfare concerns in chimeric research and argues for less‐siloed governance and oversight and more‐comprehensive public communication. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

Rare copy number variants have a prominent role in the aetiology of schizophrenia and other neuropsychiatric disorders. Substantial risk for schizophrenia is conferred by large CNVs at several loci, including microdeletions at 1q21.1, 3q29, 15q13.3 and 22q11.2 and microduplication at 16p11.2. However, these CNVs collectively account for a small fraction of cases, and the relevant genes and neurobiological mechanisms are not well understood. Here we performed a large two-stage genome-wide scan of rare CNVs and report the significant association of copy (...) number gains at chromosome 7q36.3 with schizophrenia. Microduplications with variable breakpoints occurred within a 362-kilobase region and were detected in 29 of 8,290 patients versus 2 of 7,431 controls in the combined sample. All duplications overlapped or were located within 89 kilobases upstream of the vasoactive intestinal peptide receptor gene VIPR2. VIPR2 transcription and cyclic-AMP signalling were significantly increased in cultured lymphocytes from patients with microduplications of 7q36.3. These findings implicate altered vasoactive intestinal peptide signalling in the pathogenesis of schizophrenia and indicate the VPAC2 receptor as a potential target for the development of new antipsychotic drugs. © 2011 Macmillan Publishers Limited. All rights reserved. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

William of Malmesbury's Regesta Regum Anglorum is one of the great histories of England, and one of the most important historical works of the European Middle Ages. Although its focus is national, its scope encompasses most of Western Europe and beyond, providing a full-scale account of the First Crusade. Apart from its formidable learning, it is characterized by narrative skill and entertainment value - with topics including unpowered flight and Henry I's zoo. This edition in the Oxford Medieval Texts series (...) is the first modern translation and edition. A full historical introduction is supplied in Volume II. (shrink)

Greek text, english translation and commentary on the surviving fragments of Empedocles (fragments as known in 1981, does not include more recent finds).

Can a businessman be moral? What are the values implicit in a business deal? How can we think responsibly about economic decisions? An academic philosopher and a practical businessman together examine the fundamental principles of economic activity to discover how we can think responsibly about economic decisions. Ethics must play a part as business relations are only sustainable when the parties have some values in common, but significant divergences of interest can limit the importance of ethical considerations. The responsibilities of (...) business towards employees, employers, customers, competitors, the state, the environment and the third world are all discussed. (shrink)

Debate continues to rage among philosophers of religion over Anthony Flew's famous little paper ‘Theology and Falsification’ and the responses it provoked, most notably R. M. Hare's response that religious claims are in no way like scientific hypotheses. For now, twenty years later, we still find many theists taking a similar tack to Hare's. A particularly interesting example is J. F. Miller in Religious Studies , 1969, who replies to Flew that propositions like ‘God loves mankind’ cannot be subject to (...) falsifiability conditions because they are used as claims expressing ‘ religious first-order principles of the Judaeo-Christian Weltanschauung and as such are not amenable to falsification’ . Miller seems to put his faith in some kind of great gulf fixed between what he would consider decently falsifiable scientific hypotheses and what he takes to be unfalsifiable first-order principles both of theology and of contemporary science. In what follows we will try to sketch a more rational strategy for modern believers of a liberal empiricist type, for those whose interest in appealing and deferring to experience includes but is not restricted to so-called ‘sense experience’. This will involve accepting analogies between theological statements and so-called hypotheses, insofar as the latter are propositions held and put forward in a somewhat tentative spirit with a view to explaining what we experience. (shrink)

Writing from a scientifically and philosophically informed perspective, the authors provide a critical overview of the conceptual difficulties encountered in many current neuroscientific and psychological theories.

In this paper I interrogate the notion of `debunking conspiracy theories’, arguing that the term `debunk’ carries with it pejorative implications, given that the verb `to debunk’ is commonly understood as `to show the wrongness of a thing or concept’. As such, the notion of `debunking conspiracy theories’ builds in the notion that such theories are not just wrong but ought to be shown as being wrong. I argue that we should avoid the term `debunk’ and focus on investigating conspiracy (...) theories. Looking at recent research work in epistemology on conspiracy theory, I argue that the best way to avoid talk of `debunking’ conspiracy theories is by working with a non-pejorative definition of `conspiracy theory’, and forming communities of inquiry which allow us to investigate the warrant of such theories without the prejudice associated with working with a pejorative definition. (shrink)

Polyhedral functions provide a model for an important class of problems that includes both linear programming and applications in data analysis. General methods for minimizing such functions using the polyhedral geometry explicitly are developed. Such methods approach a minimum by moving from extreme point to extreme point along descending edges and are described generically as simplicial. The best-known member of this class is the simplex method of linear programming, but simplicial methods have found important applications in discrete approximation and statistics. (...) The general approach considered in this text, first published in 2001, has permitted the development of finite algorithms for the rank regression problem. The key ideas are those of developing a general format for specifying the polyhedral function and the application of this to derive multiplier conditions to characterize optimality. Also considered is the application of the general approach to the development of active set algorithms for polyhedral function constrained problems and associated Lagrangian forms. (shrink)

A remarkable feature of the philosophical work on conspiracy theory theory has been that most philosophers agree there is nothing inherently problematic about conspiracy theories (AKA the thesis of particularism). Recent work, however, has challenged this consensus view, arguing that there really is something epistemically wrong with conspiracy theorising (AKA generalism). Are particularism and generalism incompatible? By looking at just how much particularists and generalists might have to give away to make their theoretical viewpoints compatible, I will argue that particularists (...) can accept many of the concerns that motivate generalism because generalism can never be about ‘all’ conspiracy theories without being either ahistorical or apolitical. In the end generalist critiques are best seen as useful guidelines or considerations for the appraising of particular conspiracy theories. (shrink)

Debate continues to rage among philosophers of religion over Anthony Flew's famous little paper ‘Theology and Falsification’ and the responses it provoked, most notably R. M. Hare's response that religious claims are in no way like scientific hypotheses. For now, twenty years later, we still find many theists taking a similar tack to Hare's. A particularly interesting example is J. F. Miller in Religious Studies, 1969, who replies to Flew that propositions like ‘God loves mankind’ cannot be subject to falsifiability (...) conditions because they are used as claims expressing ‘religious first-order principles of the Judaeo-Christian Weltanschauung and as such are not amenable to falsification’ (p. 50). Miller seems to put his faith in some kind of great gulf fixed between what he would consider decently falsifiable scientific hypotheses and what he takes to be unfalsifiable first-order principles both of theology and of contemporary science. In what follows we will try to sketch a more rational strategy for modern believers of a liberal empiricist type, for those whose interest in appealing and deferring to experience includes but is not restricted to so-called ‘sense experience’. This will involve accepting analogies between theological statements and so-called hypotheses, insofar as the latter are propositions held and put forward in a somewhat tentative spirit with a view to explaining what we experience. (shrink)

Recent controversies in Japanese Buddhist scholarship have focused upon the Mah y na notion of a “Buddha nature” within all sentient beings and whether or not the concept is compatible with traditional Buddhist teachings such as an tman. This controversy is not only relevant to Far Eastern Buddhism, for which the notion of a Buddha-nature is a central doctrinal theme, but also for the roots of this tradition in those Indian Mah y na s tras which utilised the notion of (...) tath gatagarbha. One of the earliest Buddhist texts to discuss this notion is the Queen r m l S tra, which appears to display a transitional and revisionist attitude towards traditional Mah y na doctrines such as emptiness and no-abiding-self. These and related issues are examined as they occur in the r m l S tra and as they might relate to the issue of the place of Buddha-nature thought within the Buddhist tradition. Finally some concluding remarks are made about the quest for “true” Buddhism. (shrink)

Conspiracy theories and conspiracy theorists have been accused of a great many sins, but are the conspiracy theories conspiracy theorists believe epistemically problematic? Well, according to some recent work, yes, they are. Yet a number of other philosophers like Brian L. Keeley, Charles Pigden, Kurtis Hagen, Lee Basham, and the like have argued ‘No!’ I will argue that there are features of certain conspiracy theories which license suspicion of such theories. I will also argue that these features only license a (...) limited suspicion of these conspiracy theories, and thus we need to be careful about generalising from such suspicions to a view of the warrant of conspiracy theories more generally. To understand why, we need to get to the bottom of what exactly makes us suspicious of certain conspiracy theories, and how being suspicious of a conspiracy theory does not always tell us anything about how likely the theory in question is to be false. (shrink)

Conspiracy theories are often portrayed as unwarranted beliefs, typically supported by suspicious kinds of evidence. Yet contemporary work in Philosophy argues provisional belief in conspiracy theories is—at the very—least understandable (because conspiracies occur) and if we take an evidential approach—judging individual conspiracy theories on their particular merits—belief in such theories turns out to be warranted in a range of cases. Drawing on this work, I examine the kinds of evidence typically associated with conspiracy theories, showing that the evidential problems typically (...) associated with conspiracy theories are not unique to such theories. As such, if there is a problem with the conspiracy theorist’s use of evidence, it is one of principle: is the principle which guides their use of evidence somehow in error? I argue that whatever we might think about conspiracy theories generally, there is no prima facie case for a scepticism of conspiracy theories based purely on their use of evidence. (shrink)