Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

Background Encounters of moral distress have long-term consequences on healthcare workers’ physical and mental health, leading to job dissatisfaction, reduced patient care, and high levels of burnout, exhaustion, and intentions to quit. Yet, research on approaches to ameliorate moral distress across the health workforce is limited. Research Objective The aim of our study was to qualitatively explore multi-professional perspectives of healthcare social workers, chaplains, and patient liaisons on ways to reduce moral distress and heighten well-being at a southern U.S. academic (...) medical center. Participants & Research Context Purposive sampling and chain-referral methods assisted with recruitment through hospital listservs, staff meetings, and newsletters. Interested participants contacted the principal investigator and all interviews were conducted in-person. Consent was attained prior to interviews. All interviews were recorded and transcribed verbatim. Research Design Directed content analysis was used to deductively organize codes and to develop themes in conjunction with the National Academy of Medicine’s National Plan for Health Workforce Well-Being. Rigor was attained through peer-debriefing, data triangulation methods, and frequent research team meetings. Ethical Considerations Ethics approval was obtained from the university and medical center institutional review boards. Findings Themes demonstrate that rather than offering interventions in the aftermath of moral distress, multilevel daily practices ought to be considered that pre-emptively identify and reduce morally distressing encounters through (1) the care team, (2) management and leadership, and (3) the health care industry. Strategies include interdisciplinary decision-making, trusting managerial relationships, and organizational policies and practices that explicitly invest in mental health promotion and diverse leadership opportunities. Conclusion Moral distress interventions ought to target short-term stress reactions while also addressing the long-term impacts of moral residue. Health systems must financially commit to an ethical workplace culture that explicitly values mental health and well-being. (shrink)

Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and (...) in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically. (shrink)

We critically evaluate arguments in a recent Journal of Law, Medicine & Ethics article by Svoboda, Adler, and Van Howe disputing the 2012 affirmative infant male circumcision policy recommendations of the American Academy of Pediatrics. We provide detailed evidence in explaining why the extensive claims by these opponents are not supported by the current strong scientific evidence. We furthermore show why their legal and ethical arguments are contradicted by a reasonable interpretation of current U.S. and international law and ethics. After (...) all considerations are taken into account it would be logical to conclude that failure to recommend male circumcision early in infancy may be viewed as akin to failure to recommend childhood vaccination to parents. In each case, parental consent is required and the intervention is not compulsory. Our evaluation leads us to dismiss the arguments by Svoboda et al. Instead, based on the evidence, infant male circumcision is both ethical and lawful. (shrink)

From around 1800, shortly before Pasquale Galluppi's first book, until 1950, just before Benedetto Croce died, the most formative influences on Italian philosophers were Kant and the post-Kantians, especially Hegel. In many ways, the Italian philosophers of this period lived in turbulent but creative times, from the Restoration to the Risorgimento and the rise and fall of Fascism. -/- From Kant to Croce is a comprehensive, highly readable history of the main currents and major figures of modern Italian philosophy, described (...) in a substantial introduction that details the development of the discipline during this period. Brian P. Copenhaver and Rebecca Copenhaver provide the only up-to-date introduction in English to Italy's leading modern philosophers by translating and analysing rare and original texts and by chronicling the lives and times of the philosophers who wrote them. Thoroughly documented and highly readable, From Kant to Croce examines modern Italian philosophy from the perspective of contemporary analytic philosophy. (shrink)

There are challenges to the dominant research paradigm in breast cancer science. In the United States, science and social activism create paradigmatic shifts. Using interviews, ethnographic observations, and an extensive review of the literature, we create a three-dimensional model to situate changes in scientific controversy concerning environmental causes of breast cancer. We identify three paradigm challenges posed by activists and some scientists: to move debates about causation upstream to address causes; to shift emphasis from individual to modifiable societal-level factors beyond (...) an individual’s control; and to allow direct lay involvement in research, which may raise new questions and change how questions are approached, the methods used, and the standards of proof. We use our model to examine controversies about doing scientific research, interpreting scientific results, and acting on science. Ultimately, we aim to understand what impedes construction of new methodologies and knowledge about environmental factors in human disease. (shrink)

Many recent experiments have used parallel Implicit Association Test (IAT) and selfreport measures of attitudes. These measures are sometimes strongly correlated. However, many of these studies find apparent dissociations in the form of (a) weak correlations between the two types of measures, (b) separation of their means on scales that should coincide if they assess the same construct, or (c) differing correlations with other variables. Interpretations of these empirical patterns are of three types: single-representation — the two types of measures (...) assess a single attitude, but under the influence of different extra-attitudinal process influences; dual-representation — the two types of measures assess distinct forms of attitudes (e.g., conscious vs. unconscious; implicit vs. explicit); and person vs. culture — a variant of the dualrepresentation view in which self-report measures reflect personal attitudes, whereas IAT measures reflect non-attitudinal cultural or semantic knowledge. Proponents sometimes interpret evidence for single versus dual constructs as evidence for single versus dual structural representations. Behavioral evidence can establish the discriminant validity of implicit and explicit attitude phenomena (dual constructs), but cannot choose among single- vs. dual-representation interpretations because the distinct constructs remain susceptible to interpretation in terms of either one or two representations. Selecting among representational accounts must therefore be based on considerations of explanatory power or parsimony. (shrink)

Researchers commonly use long-term average production inequalities to characterize cross-cultural patterns in foraging divisions of labor, but little is known about how the strategies of individuals shape such inequalities. Here, we explore the factors that lead to daily variation in how much men produce relative to women among Martu, contemporary foragers of the Western Desert of Australia. We analyze variation in foraging decisions on temporary foraging camps and find that the percentage of total camp production provided by each gender varies (...) primarily as a function of men’s average bout successes with large, mobile prey. When men target large prey, either their success leads to a large proportional contribution to the daily harvest, or their failure results in no contribution. When both men and women target small reliable prey, production inequalities by gender are minimized. These results suggest that production inequalities among Martu emerge from stochastic variation in men’s foraging success on large prey measured against the backdrop of women’s consistent production of small, low-variance resources. (shrink)

The moral domain is broader than the empathy and justice concerns assessed by existing measures of moral competence, and it is not just a subset of the values assessed by value inventories. To fill the need for reliable and theoretically grounded measurement of the full range of moral concerns, we developed the Moral Foundations Questionnaire on the basis of a theoretical model of 5 universally available sets of moral intuitions: Harm/Care, Fairness/Reciprocity, Ingroup/Loyalty, Authority/Respect, and Purity/Sanctity. We present evidence for the (...) internal and external validity of the scale and the model, and in doing so we present new findings about morality: Comparative model fitting of confirmatory factor analyses provides empirical justification for a 5-factor structure of moral concerns; convergent/discriminant validity evidence suggests that moral concerns predict personality features and social group attitudes not previously considered morally relevant; and we establish pragmatic validity of the measure in providing new knowledge and research opportunities concerning demographic and cultural differences in moral intuitions. These analyses provide evidence for the usefulness of Moral Foundations Theory in simultaneously increasing the scope and sharpening the resolution of psychological views of morality. (shrink)

Graphical AbstractScience and technology consortia provide a viable solution for the recent unsustainable academic growth in biomedical research.

The current legal status and medical ethics of routine or religious penile circumcision of minors is a matter of ongoing controversy in many countries. We focus on the United Kingdom as an illustrative example, giving a detailed analysis of the most recent British Medical Association guidance from 2019. We argue that the guidance paints a confused and conflicting portrait of the law and ethics of the procedure in the UK context, reflecting deeper, unresolved moral and legal tensions surrounding child genital (...) cutting practices more generally. Of particular note is a lack of clarity around how to apply the “best interests” standard—ordinarily associated with time-sensitive proxy decision making regarding therapeutic options for a medically unwell patient—to a parental request for a medically unnecessary surgery to be carried out on the genitalia of a healthy child. Challenges arise in measuring and assigning weights to intended sociocultural or religious/spiritual benefits, and even to health-related prophylactic benefits, and in balancing these against potential physical, functional, and psychosexual risks or harms. Also of concern are apparently inconsistent safeguarding standards being applied to children based on their birth sex categorization or gender of rearing. We identify and discuss recent trends in British and international medical ethics and law, finding gradual movement toward a more unified standard for evaluating the permissibility of surgically modifying healthy children's genitals before they can meaningfully participate in the decision. (shrink)

Marine interstitial environments are teeming with an extraordinary diversity of coexisting microeukaryotic lineages collectively called “meiofauna.” Interstitial habitats are broadly distributed across the planet, and the complex physical features of these environments have persisted, much like they exist today, throughout the history of eukaryotes, if not longer. Although our general understanding of the biological diversity in these environments is relatively poor, compelling examples of developmental heterochrony (e.g., pedomorphosis) and convergent evolution appear to be widespread among meiofauna. Therefore, an improved understanding (...) of meiofaunal biodiversity is expected to provide some of the deepest insights into the following themes in evolutionary biology: (i) the origins of novel body plans, (ii) macroevolutionary patterns of miniaturization, and (iii) the intersection of evolution and community assembly – e.g., “community convergence” involving distantly related lineages that span the tree of eukaryotes. (shrink)

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

BackgroundPast research shows that physicians experience high ill-being but also high well-being.ObjectiveTo shed light on how medical faculty’s experiences of their job demands and job resources might differentially affect their ill-being and their well-being with special attention to the role that the work-life interface plays in these processes.MethodsQualitative thematic analysis was used to analyze interviews from 30 medical faculty at a top research hospital in Canada.FindingsMedical faculty’s experiences of work-life conflict were severe. Faculty’s job demands had coalescing effects on their (...) stress, work-life conflict, and exhaustion. Although supportive job resources helped to mitigate the negative effects of job demands, stimulating job resources contributed to greater work-life conflict, stress, and exhaustion. Thus, for these medical faculty job resources play a dual-role for work-life conflict. Moreover, although faculty experienced high emotional exhaustion, they did not experience the other components of burnout. Some faculty engaged in cognitive reappraisal strategies to mitigate their experiences of work-life conflict and its harmful consequences.ConclusionThis study suggests that the precise nature and effects of job demands and job resources may be more complex than current research suggests. Hospital leadership should work to lessen unnecessary job demands, increase supportive job resources, recognize all aspects of job performance, and, given faculty’s high levels of work engagement, encourage a climate that fosters work-life balance. (shrink)

This is the first book to explore the cognitive science of effortless attention and action. Attention and action are generally understood to require effort, and the expectation is that under normal circumstances effort increases to meet rising demand. Sometimes, however, attention and action seem to flow effortlessly despite high demand. Effortless attention and action have been documented across a range of normal activities--from rock climbing to chess playing--and yet fundamental questions about the cognitive science of effortlessness have gone largely unasked. (...) -/- This book draws from the disciplines of cognitive psychology, neurophysiology, behavioral psychology, genetics, philosophy, and cross-cultural studies. Starting from the premise that the phenomena of effortless attention and action provide an opportunity to test current models of attention and action, leading researchers from around the world examine topics including effort as a cognitive resource, the role of effort in decision making, the neurophysiology of effortless attention and action, the role of automaticity in effortless action, expert performance in effortless action, and the neurophysiology and benefits of attentional training. -/- Contributors: Joshua M. Ackerman, James H. Austin, John A. Bargh, Roy F. Baumeister, Sian L. Beilock, Chris Blais, Matthew M. Botvinick, Brian Bruya, Mihaly Csikszentmihalyi, Marci S. DeCaro, Arne Dietrich, Yuri Dormashev, László Harmat, Bernhard Hommel, Rebecca Lewthwaite, Örjan de Manzano, Joseph T. McGuire, Brian P. Meier, Arlen C. Moller, Jeanne Nakamura, Evgeny N. Osin, Michael I. Posner, Mary K. Rothbart, M. R. Rueda, Brandon J. Schmeichel, Edward Slingerland, Oliver Stoll, Yiyuan Tang, Töres Theorell, Fredrik Ullén, Robert D. Wall, Gabriele Wulf. (shrink)

BackgroundThe increased risk of developing attention-deficit hyperactivity disorder (ADHD) in extremely preterm infants is well-documented. Better understanding of perinatal risk factors, particularly those that are modifiable, can inform prevention efforts.MethodsWe examined data from the Extremely Low Gestational Age Newborns (ELGAN) Study. Participants were screened for ADHD at age 10 with the Child Symptom Inventory-4 (N = 734) and assessed at age 15 with a structured diagnostic interview (MINI-KID) to evaluate for the diagnosis of ADHD (N = 575). We studied associations (...) of pre-pregnancy maternal body mass index (BMI), pregestational and/or gestational diabetes, maternal smoking during pregnancy (MSDP), and hypertensive disorders of pregnancy (HDP) with 10-year and 15-year ADHD outcomes. Relative risks were calculated using Poisson regression models with robust error variance, adjusted for maternal age, maternal educational status, use of food stamps, public insurance status, marital status at birth, and family history of ADHD. We defined ADHD as a positive screen on the CSI-4 at age 10 and/or meeting DSM-5 criteria at age 15 on the MINI-KID. We evaluated the robustness of the associations to broadening or restricting the definition of ADHD. We limited the analysis to individuals with IQ ≥ 70 to decrease confounding by cognitive functioning. We evaluated interactions between maternal BMI and diabetes status. We assessed for mediation of risk increase by alterations in inflammatory or neurotrophic protein levels in the first week of life.ResultsElevated maternal BMI and maternal diabetes were each associated with a 55–65% increase in risk of ADHD, with evidence of both additive and multiplicative interactions between the two exposures. MSDP and HDP were not associated with the risk of ADHD outcomes. There was some evidence for association of ADHD outcomes with high levels of inflammatory proteins or moderate levels of neurotrophic proteins, but there was no evidence that these mediated the risk associated with maternal BMI or diabetes.ConclusionContrary to previous population-based studies, MSDP and HDP did not predict ADHD outcomes in this extremely preterm cohort, but elevated maternal pre-pregnancy BMI, maternal diabetes, and perinatal inflammatory markers were associated with increased risk of ADHD at age 10 and/or 15, with positive interaction between pre-pregnancy BMI and maternal diabetes. (shrink)

What accounts for the continued lack of clarity over the legal procedures for the patenting of DNA sequences? The patenting system was built for a "bricks-and-mortar" world rather than an information economy. The fact that genes are both material molecules and informational systems helps explain the difficulty that the patent system is going to continue to have.

This paper reviews and synthesizes emerging multi-disciplinary evidence toward understanding the development of social and political organization in the Last Glacial. Evidence for the prevalence and scope of political egalitarianism is reviewed and the biological, social, and environmental influences on this mode of human organization are further explored. Viewing social and political organization in the Last Glacial in a much wider, multi-disciplinary context provides the footing for coherent theory building and hypothesis testing by which to further explore human political systems. (...) We aim to overcome the claim that our ancestors’ form of social organization is untestable, as well as counter a degree of exaggeration regarding possibilities for sedentism, population densities, and hierarchical structures prior to the Holocene with crucial advances from disparate disciplines. (shrink)

This article aims to highlight the extent to which Kant’s account of belief draws on the views of his contemporaries. Situating the non-evidentialist features of Crusius’s account of belief within his broader account, I argue that they include antecedents to both Kant’s distinction between pragmatic and moral belief and his conception of a postulate of pure practical reason. While moving us closer to Kant’s arguments for the first postulate, however, both Crusius’s and Meier’s arguments for the immortality of the soul (...) fail to anticipate the most important aspect of their Kantian counterparts. Developing the non-evidentialist features of Basedow’s account of belief, I distinguish it from its Pascalian and Jamesian relatives and argue that it is the clearest antecedent to Kant’s arguments for the first and second postulates. Finally, I consider the development of Kant’s account of belief after the first Critique in light of the foregoing, and discuss the broader implications of my analysis. (shrink)

The importance of the pure concepts of the understanding (i.e. the categories) within Kant’s system of philosophy is undeniable. As I hope to make clear in this essay, however, the categories are also an essential part of Kant’s critique of Christian Wolff. In particular, I argue that Kant’s development of the categories represents a decisive break with the Wolffian conception of the understanding and that this break is central to understanding the task of the Transcendental Analytic. This break, however, is (...) not merely that Kant affirms while Wolff and his followers deny a sharp distinction between sensibility and the understanding, which is the aspect of Kant’s rejection of Wolff that scholars most frequently note. Rather, this break concerns differences in their views about the understanding itself. For while Wolff conceives of the understanding as a mental capacity to extract and make distinct content already present in the senses, Kant conceives of the understanding in its “real use” as a capacity to produce purely intellectual content. (shrink)

It is often claimed that the structure of the Transcendental Logic is modeled on the Wolffian division of logic textbooks into sections on concepts, judgments, and inferences. While it is undeniable that the Transcendental Logic contains elements that are similar to the content of these sections, I believe these similarities are largely incidental to the structure of the Transcendental Logic. In this essay, I offer an alternative and, I believe, more plausible account of Wolff’s influence on the structure of the (...) Transcendental Logic, one that puts the focus on his empirical psychology rather than his logic. In particular, I argue that the structure of the Transcendental Logic is deeply indebted to a conception of purity that Wolff introduces in his empirical psychology and that this conception sheds more light on the overall structure of the Transcendental Logic than the accepted view. In section one, I outline two conceptions of purity found in Kant and trace them to similar views in Wolff. In section two, I turn to Kant’s views about logic as they are expressed in the Critique and argue that it is best to interpret Kant’s taxonomy of logic on its own terms rather than reading it through its terminological similarities to aspects of the Wolffian tradition. In section three, I argue that the second of the two conceptions of purity identified in section one is central to the structure of the Transcendental Logic. In doing so, I argue against the widespread view that this section of the Critique is modeled solely on what Kant calls pure general logic as opposed to both pure and applied general logic. I then conclude by briefly reviewing my account and considering some of its broader implications for our understanding of Kant. (shrink)

Hume’s account of causation is often regarded a challenge Kant must overcome if the Critical philosophy is to be successful. But from Kant’s time to the present, Hume’s denial of our ability to cognize supersensible objects, a denial that relies heavily on his account of causation, has also been regarded as a forerunner to Kant’s critique of metaphysics. After identifying reasons for rejecting Wayne Waxman’s recent account of Kant’s debt to Hume, I present my own, more modest account of this (...) debt, an account that seeks to unite the two very different pictures of Kant’s relationship to Hume sketched above. (shrink)

Kant's response to scepticism in the Critique of Pure Reason is complex and remarkably nuanced, although it is rarely recognized as such. In this paper, I argue that recent attempts to flesh out the details of this response by Paul Guyer and Michael Forster do not go far enough. Although they are right to draw a distinction between Humean and Pyrrhonian scepticism and locate Kant's response to the latter in the Transcendental Dialectic, their accounts fail to capture two important aspects (...) of this response. The first is that Kant's response to Pyrrhonian scepticism is also a response to Hume. The second is that aspects of this response are decidedly positive. In particular, I argue (1) that Kant believed Hume's scepticism manifested important elements of Pyrrhonian scepticism and (2) that both Pyrrhonian scepticism and Hume had a significant positive influence on the development of the Transcendental Dialectic. (shrink)

This paper illustrates how Priestley duality can be used in the transfer of an optimal natural duality from a minimal generating algebra for a quasi-variety to other generating algebras. Detailed calculations are given for the quasi-variety \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document} $$\mathbb{I}\mathbb{S}\mathbb{P}(\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle-}$}}{4} )$$ \end{document} of Kleene algebras and the quasi-varieties \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document} $$B$$ \end{document}n of pseudocomplemented distributive lattices (n ≥ 1).

Kant's notion of ‘discipline’ has received considerable attention from scholars of his philosophy of education, but its role in his theoretical philosophy has been largely ignored. This omission is surprising since his discussion of discipline in the first Critique is not only more extensive and expansive in scope than his other discussions but also predates them. The goal of this essay is to provide a comprehensive reading of the Discipline that emphasizes its systematic importance in the first Critique. I argue (...) that its goal is to establish a set of rules for the use of pure reason that, if followed, will mitigate and perhaps even eliminate our tendency to make judgments about supersensible objects. Since Kant's justification for these rules relies crucially on claims he has defended in the Doctrine of Elements, I argue further that, far from being a dispensable part of the Critique as commentators have tended to claim, the Discipline is, in fact, the culmination of Kant's critique of metaphysics. (shrink)

In this thesis, Semantics, Meta-Semantics, and Ontology, I provide a critique of the method of truth in metaphysics. Davidson has suggested that we can determine the metaphysical nature and structure of reality through semantic investigations. By contrast, I argue that it is not semantics, but meta-semantics, which reveals the metaphysically necessary and sufficient truth conditions of our claims. As a consequence I reject the Quinean criterion of ontological commitment. In Part I, chapter 1, I argue that the metaphysically primary truth (...) bearers are not propositions, but rather concrete representations, either beliefs or sentences. I show, in chapter 2, that we can give sense to a truth predicate applying to sentences, given a truth operator and quantification into sentence position. I argue that this strategy does not commit us to the existence of propositions serving as truth bearers. In Part II I argue that although we must assign semantic values to sentences and/or predicates, the meaningfulness of these expressions is not thereby explained. In chapter 3 I articulate Davidson’s problem of predication and his solution, but argue that he was wrong to attribute this solution to Tarski. In chapter 4 I examine the semantics of modal languages; I conclude that although they require semantic values for predicates and/or sentences we should be instrumentalists about these theories. In Part III I consider the relationship between truth and existence. In chapter 5, I defend Pluralism about truth: in some domains of discourse, I claim, semantic reference plays a merely instrumental role in explaining truth. In chapter 6, I show that Hume’s Principle, which is committed by the Quinean criterion to the existence of numbers, can be true even though numbers do not exist. In doing so, I appeal to meta-semantic and diachronic considerations. In the conclusion I compare my views on ontology and commitment to Jody Azzouni’s; and in the appendix I suggest how one might pursue diachronic linguistics. (shrink)

This chapter contains sections titled: Introduction Background Incentives and guidance from the criminal law Other regulatory incentives and guidance Civil incentives Conclusion.

This quarter’s issue of the Kennedy Institute of Ethics Journal is unusual, because it hosts a symposium focused Brian Earp’s provocative and groundbreaking article, “Between Moral Relativism and Moral Hypocrisy: Reframing the Debate on ‘FGM.’” Along with Earp’s article, we are presenting critical responses by Richard Shweder, Robert Darby, and Jamie Nelson. Earp tackles the ethics of female genital cutting or “mutilation”. This is a difficult topic that brings on board gender inequity, the integrity of the body, the value (...) of cultural traditions, sexuality, colonialism, ethnocentrism, and other fraught axes of reflection. Earp argues against the common view that all... (shrink)

This paper attempts to shed light on three sets of issues that bear directly on our understanding of Locke and Kant. The first is whether Kant believes Locke merely anticipates his distinction between analytic and synthetic judgments or also believes Locke anticipates his notion of synthetic a priori cognition. The second is what should we as readers of Kant and Locke should think about Kant’s view whatever it turns out to be, and the third is the nature of Kant’s justification (...) for the comparison he draws between his philosophy and Locke’s. I argue (1) that Kant believes Locke anticipates both the analytic-synthetic distinction and Kant’s notion of synthetic a priori cognition, (2) that the best justification for Kant’s claim draws on Locke’s distinction between trifling and instructive knowledge, (3) that the arguments against this claim developed by Carson, Allison, and Newman fail to undermine it, and (4) that Kant’s own justification for his claim is quite different from what many commentators have thought it was (or should have been). (shrink)

This essay develops a Kantian approach to the permissibility of biomedical physical, cognitive, and moral enhancement. Kant holds that human beings have an imperfect duty to promote their physical, cognitive, and moral perfection. While an agent’s individual circumstances may limit the means she may permissibly use to enhance herself, whether biomedically or otherwise, I argue (1) that biomedical means of enhancing oneself are, generally speaking, both permissible and meritorious from a Kantian perspective. Despite often being equally permissible, I also argue (...) (2) that enhancing oneself by more traditional means is, generally speaking, more meritorious (and involves the display of more virtue) than enhancing oneself by biomedical means. Nevertheless, since Kant does not fault agents for acting less meritoriously (or for displaying less virtue) than they otherwise could, I also argue (3) that those who opt for permissible biomedical enhancement over more traditional forms are not blameworthy for doing so. I also consider and reject several objections to these claims, including that biomedical enhancements (1) are too passive to count as actions by the agent who enhances herself, (2) involve a failure of the agent to treat her humanity as an end in itself or to show proper respect for her dignity, (3) might be undertaken on the basis of motives that undermine their permissibility, (4) are likely to exacerbate existing social and economic inequalities in ways that do the same, and (5) in their moral form are incompatible with Kant’s conception of duty and human freedom. (shrink)

Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and (...) ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics. (shrink)