Background -/- Innovative neurosurgical treatments present a number of known risks, the natures and probabilities of which can be adequately communicated to patients via the standard procedures governing obtaining informed consent. However, due to their novelty, these treatments also come with unknown risks, which require an augmented approach to obtaining informed consent. -/- Objective -/- This paper aims to discuss and provide concrete procedural guidance on the ethical issues raised by serious unexpected complications of novel deep brain stimulation treatments. -/- (...) Approach -/- We illustrate our analysis using a case study of the unexpected development of recurrent stereotyped events in patients following the use of deep brain stimulation (DBS) to treat severe chronic pain. Examining these unexpected complications in light of medical ethical principles, we argue that serious complications of novel DBS treatments do not necessarily make it unethical to offer the intervention to eligible patients. However, the difficulty the clinician faces in determining whether the intervention is in the patient's best interests generates reasons to take extra steps to promote the autonomous decision making of these patients. -/- Conclusion and recommendations -/- We conclude with clinical recommendations, including details of an augmented consent process for novel DBS treatment. (shrink)

"What is required if men and women are to feel at home in society and are to recover their vitality? Into wrestling with that question, Simone Weil put the very substance of her mind and temperament. The apparently solid edifices of our prepossessions fall down before her onslaught like ninepins, and she is as fertile and forthright in her positive suggestions . . . she can be relied upon to toss aside the superficial and to come to grips with the (...) essential and the profound." -- Time Literary Supplement. (shrink)

Simone Weil (1909-1943) was a defining figure of the twentieth century; a philosopher, Christian, resistance fighter, anarchist, feminist, labor activist and teacher. She was described by T. S. Eliot as "a woman of genius, of a kind of genius akin to that of the saints," and by Albert Camus as "the only great spirit of our time." Originally published posthumously in two volumes, these newly reissued notebooks, are among the very few unedited personal writings of Weil's that still survive today. (...) Containing her thoughts on art, love, science, God and the meaning of life, they give context and meaning to Weil's famous works, revealing a unique philosophy in development and offering a rare private glimpse of her singular personality. (shrink)

Simone Weil is one of the most profound thinkers of the twentieth century. Her writings encompass an extraordinary breadth of subjects, including philosophy, religion, sociology, and politics. A political activist and resistance fighter, her accomplishments are even more astonishing in light of her death in 1943 at the age of thirty-four. Whilst Weil was concerned with deep philosophical questions - the nature of human thought and human faculties, the limits of language, and thought's contact with reality through mediation, science and (...) beauty - the full significance of her work has frequently been obscured by her categorization as a purely religious writer or Christian mystic. Simone Weil: Basic Writings is an expertly edited anthology of her most important writings, presenting Weil's philosophy as it relates to politics, the nature of work, human nature in its duality, necessity, beauty and goodness. D. K. Levy and Marina Barabas have translated all the extracts anew, including translations of important notes and references missing from existing English language editions of Weil's work. Following an extensive introduction by D. K. Levy which places Weil's life and thought in context, each section opens with a short introduction situating the chosen passages within Weil's oeuvre. Simone Weil: Basic Writings is an outstanding starting point for anyone seeking an introduction to Weil's philosophy, and also essential reading for students and scholars of Weil's thought in related disciplines. (shrink)

Gravity and Grace was the first ever publication by the remarkable thinker and activist, Simone Weil. In it Gustave Thibon, the priest to whom she had entrusted her notebooks before her untimely death, compiled in one remarkable volume a compendium of her writings that have become a source of spiritual guidance and wisdom for countless individuals.

Simone Weil's Leçons de Philosophie are derived from a course she taught at the lyce;e for girls at Roanne in 1933-4. Anne Reynaud-Gue;rithault was a pupil in the class; her notes are not a verbatim record but are a very full and, as far as one can judge, faithful rendering, often catching the unmistakable tone of Simone Weil's voice as well as the force and the directness of her thought. The lectures form a good general introduction to philosophy, ranging widely (...) over problems about perception, mind, language, reasoning and problems in moral and political philosophy too. Her method of presentation is a characteristic combination of abstract argument, personal experience and literary or historical reference. Peter Winch points out in his introduction to the book some of the more systematic connections in her philosophical work (and between this philosophical work and her other concerns), and makes a number of suggestive comparisons between Simone Weil and Wittgenstein. The translation is by Hugh Price from the Plon edition of 1959. Dr Price has added some notes to explain references in the text that might be unfamiliar to English speaking students beginning philosophy. (shrink)

This thesis defends egalitarianism about knowledge and belief, on which neither is understood in terms of the other, from what I call the abductive argument. This argument is meant to favour views opposed to egalitarianism: doxasticism, on which knowledge is understood in terms of belief, and epistemicism, on which belief is understood in terms of knowledge. The abductive argument turns on the idea that doxasticism and epistemicism, by contrast with egalitarianism, explain certain data about knowledge and belief. I argue, however, (...) that no versions of doxasticism and epistemicism currently on offer are preferable to egalitarianism on abductive grounds. As part of my argument, I also defend the claim that knowledge, by contrast with belief, is an attitude to a fact and explore the implications of this claim for doxasticism and epistemicism. (shrink)

“Bioconservatives” in the human enhancement debate endorse the conservative claim that we should reject the use of biotechnologies that enhance natural human capacities. However, they often ground their objections to enhancement with contestable claims about human nature that are also in tension with other common tenets of conservatism. We argue that bioconservatives could raise a more plausible objection to enhancement by invoking a strain of conservative thought developed by G.A. Cohen. Although Cohen’s conservatism is not sufficient to fully revive the (...) bioconservative objection, we argue that it can be supplemented by an account of reasonable partiality for humanity in a way that provides further support to the bioconservative position in a manner congruous with broader conservatism. We propose that the idea of partiality to humanity can buttress the bioconservative objection into its strongest possible form. However, we conclude by arguing that, even in this form, the objection cannot do all the work that bioconservatives expect of it. (shrink)

In Intimations of Christianity Among the Ancient Greeks , Simone Weil discusses precursors to Christian religious ideas which can be found in ancient Greek mythology, literature and philosophy. She looks at evidence of "Christian" feelings in Greek literature, notably in Electra, Orestes, and Antigone , and in the Iliad , going on to examine God in Plato, and divine love in creation, as seen by the ancient Greeks.

自史蒂芬·霍金(Stephen Hawking) 的暢銷科普著作《時間簡史》(以下簡稱《簡史》) 在上世紀八十年代末問世以來，至今天二十一世紀，華人基督教界就他宇宙無起點的論述仍有相當之評論，但可惜對評論未有綜合分析。評論者因寫作目的，也甚少交代霍金宇宙學的來龍去脈。故本文嘗試略述霍金宇宙學的歷史 背景及發展經過，繼而舉出華人基督教界的評論，帶出其獨特性，並提出商確的地方，以反省未來可行路向。.

There is preliminary evidence, from case reports and investigational studies, to suggest that Deep Brain Stimulation could be used to treat some patients with Anorexia Nervosa. Although this research is at an early stage, the invasive nature of the intervention and the vulnerability of the potential patients are such that anticipatory ethical analysis is warranted. In this paper, we first show how different treatment mechanisms raise different philosophical and ethical questions. We distinguish three potential mechanisms alluded to in the neuroscientific (...) literature, relating to desire, control, and emotion, respectively. We explain why the precise nature of the mechanism has important implications for the patient’s autonomy and personal identity. In the second part of the paper, we consider practical dimensions of offering DBS to patients with AN in certain cases. We first discuss some limited circumstances where the mere offering of the intervention might be perceived as exerting a degree of coercive pressure that could serve to undermine the validity of the patient’s consent. Finally, we consider the implications of potential effects of DBS for the authenticity of the patient’s choice to continue using stimulation to ameliorate their condition. (shrink)

Philosophe politique et intellectuel engage dans la vie des idées aux Etats-Unis comme dans le monde, Michael Walzer est l'un des penseurs de la société parmi les plus stimulants a l'époque contemporaine. Son oeuvre défriche des pistes nouvelles de réflexion dans les domaines du politique, de la justice sociale, de la morale ou de l'identité culturelle. En même temps, Walzer, dont la pensée s'est forgée lors des luttes pour l'égalité des droits civiques aux USA et contre la guerre du Vietnam (...) dans les années 1960, poursuit une activité féconde d'animation du débat public à travers sa revue Dissent. Dans cet essai, Simon Wuhl a souhaité éclairer une autre dimension de la pensée de Michael Walzer : la relation étroite avec la pensée juive, dont les potentialités d'universalisation sont une référence majeure dans la plupart de ses écrits. Qu'elle s'exprime ouvertement comme dans son article emblématique sur " Les deux universalismes ", ou en arrière-fond comme dans son livre plus théorique sur les Sphères de justice, l'empreinte du judaïsme est toujours présente dans son oeuvre pour éclairer les grandes questions de société. Faisant par ailleurs retour, dans certains de ses travaux, sur les textes de base du judaïsme, Walzer mobilise les ressources méthodologiques des sciences humaines pour les soumettre à une relecture critique. (shrink)

We provide ethical criteria to establish when vaccine mandates for healthcare workers are ethically justifiable. The relevant criteria are the utility of the vaccine for healthcare workers, the utility for patients (both in terms of prevention of transmission of infection and reduction in staff shortage), and the existence of less restrictive alternatives that can achieve comparable benefits. Healthcare workers have professional obligations to promote the interests of patients that entail exposure to greater risks or infringement of autonomy than ordinary members (...) of the public. Thus, we argue that when vaccine mandates are justified on the basis of these criteria, they are not unfairly discriminatory and the level of coercion they involve is ethically acceptable—and indeed comparable to that already accepted in healthcare employment contracts. Such mandates might be justified even when general population mandates are not. Our conclusion is that, given current evidence, those ethical criteria justify mandates for influenza vaccination, but not COVID-19 vaccination, for healthcare workers. We extend our arguments to other vaccines. (shrink)

Violence risk assessment tools are increasingly used within criminal justice and forensic psychiatry, however there is little relevant, reliable and unbiased data regarding their predictive accuracy. We argue that such data are needed to (i) prevent excessive reliance on risk assessment scores, (ii) allow matching of different risk assessment tools to different contexts of application, (iii) protect against problematic forms of discrimination and stigmatisation, and (iv) ensure that contentious demographic variables are not prematurely removed from risk assessment tools.

Encountering Derrida explores the points of engagement between Jacques Derrida and a host of other European thinkers, past and present, in order to counter recent claims that the era of deconstruction is finally drawing to a close. The book rereads Derrida in order to renew deconstruction's various conceptions of language, poetry, philosophy, institutions, difference and the future. This impressive collection of essays from the world's leading Derrida scholars re-evaluates Derrida's legacy and looks forward to the possible futures of deconstruction by (...) confronting various challenges to Derrida's thought. Collectively, the essays argue that Derrida must be read alongside others , an approach that produces some surprising new accounts of this challenging critical thinker. _ _. (shrink)

Green bioethics is an area of research and scholarship that examines the impact of healthcare practices and policies on the environment and emphasises environmental values, such as ecological sustainability and stewardship. Some green bioethicists have argued that healthcare providers should inform patients about the environmental impacts of treatments and advocate for options that minimise adverse impacts. While disclosure of information pertaining to the environmental impacts of treatments could facilitate autonomous decision-making and strengthen the patient–provider relationship in situations where patients have (...) clearly expressed environmental concerns, it may have the opposite effect in other situations if makes patients feel like they are being judged or manipulated. We argue, therefore, that there is not a generalisable duty to disclose environmental impact information to all patients during the consent process. Providers who practice green bioethics should focus on advocating for system-level changes in healthcare financing, organisation and delivery and use discretion when bringing up environmental concerns in their encounters with patients. (shrink)

Emotions play an important part in moral life. Within clinical ethics support (CES), one should take into account the crucial role of emotions in moral cases in clinical practice. In this paper, we present an Aristotelian approach to emotions. We argue that CES can help participants deal with emotions by fostering a joint process of investigation of the role of emotions in a case. This investigation goes beyond empathy with and moral judgment of the emotions of the case presenter. In (...) a moral case deliberation, the participants are invited to place themselves in the position of the case presenter and to investigate their own emotions in the situation. It is about critically assessing the facts in the case that cause the emotion and the related (moral) thoughts that accompany the emotion. It is also about finding the right emotion in a given situation and finding the right balance in dealing with that emotion. These steps in the moral inquiry give rise to group learning. It is a process of becoming open towards the perspectives of others, leading to new insights into what is an appropriate emotion in the specific situation. We show how this approach works in moral case deliberation. A physician presents a situation in which he is faced with a pregnant woman who is about to deliver multiple extremely premature infants at the threshold of viability. The moral deliberation of the case and the emotions therein leads to the participants’ conclusion that “compassion” is a more adequate emotion than “sadness”. The emotion “sadness” is pointed towards the tragedy that is happening to the woman. The emotion “compassion” is pointed towards the woman; it combines consideration and professional responsibility. Through the shift towards compassion, participants experienced more creativity and freedom to deal with the sad situation and to support the woman. The paper ends with an analysis and reflection on the deliberation process. In the conclusion we argue for more attention to emotions in clinical ethics support and offer some directions for doing this in the right way. (shrink)

Emerging reprogenetic technologies may enable the enhancement of our offspring's genes. Beyond raising ethical questions, these biotechnologies may change some aspects of future morality. In the reproductive field, biotechnological innovations may transform moral views about reproductive choices regarding what we consider to be just or even of equal standing.

Is it tautological to call an action "wrongful discrimination?" Some philosophers and political theorists answer this question in the affirmative and claim that the term "discrimination" is intrinsically evaluative. Others agree that "discrimination" usually conveys the action’s moral wrongness but claim that the term can be used in a purely descriptive way. In this paper, we present two corpus studies and two experiments designed to test whether the folk concept of discrimination is evaluative. We demonstrate that the term has undergone (...) a historical development and is nowadays no longer used purely descriptively. Further, we show that this evaluation cannot be cancelled without yielding a contradiction. We conclude that the descriptive use of "discriminatory" is a thing of the past. (shrink)

All those interested in the thought of St Thomas Aquinas, and more generally contemporary Catholic scholarship, problems in philosophy of religion, and ...

At the end of 2015‘s The Witch, isolated and beaten protagonist, Thomasin, ultimately rejects her puritanical upbringing to become a witch, accepting the invitation of the Devil (in the guise of the family’s goat Black Philip). This essay will discuss Thomasin’s sexual deliverance in terms of her turning away from the authoritarian ‘Law of the Father’ towards female liberation that comes in the form of the Witch. Thomasin transitions from girl to woman, but does not want to do so in (...) the restrictive Puritan fashion where patriarchy and oppression rules. She becomes a woman by embracing her sexuality in the figure of the witch and Black Philip as the figure of lust helping her become free. Western folklore posits the goat as a symbol of fertility, independence, and lust; Black Philip is a figure who represents a connection to wild desires. Therefore, Black Philip becomes not only a physical representation of the devil, but also a symbolic representation of Thomasin’s sexual desire. Drawing on theories of the monstrous-feminine (Creed, Kristeva, Arnold), the symbolism of folklore and Freud’s Electra complex, this work argues that, despite its message of feminine empowerment, The Witch cannot fully reject or escape patriarchal discourse. (shrink)

Personal autonomy is often lauded as a key value in contemporary Western bioethics. Though the claim that there is an important relationship between autonomy and rationality is often treated as uncontroversial in this sphere, there is also considerable disagreement about how we should cash out the relationship. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether the reasons underpinning the choice (...) are known and rational, or indeed whether they even exist. Jonathan Pugh brings recent philosophical work on the nature of rationality to bear on the question of how we should understand personal autonomy in contemporary bioethics. In doing so, he develops a new framework for thinking about the concept of autonomy, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in it. Pugh's account allows for a deeper understanding of d the relationship between our freedom to act and our capacity to decide autonomously. His rationalist perspective is contrasted with other prominent accounts of autonomy in bioethics, and the revisionary implications it has for practical questions in biomedicine are also outlined. (shrink)

Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient’s personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, and (...) Laura Waddell Ekstrom’s coherentist approach to personal autonomy. In developing our account, we respond to Sven Nyholm and Elizabeth O’Neill’s synchronic approach to authenticity, and explain how the diachronic approach we defend can have practical utility, contrary to Alexandre Erler and Tony Hope’s criticism of autonomy-based approaches to authenticity. Having drawn a distinction between the authenticity of an individual’s traits and the authenticity of that person’s values, we consider how our conception of authenticity applies to the context of anorexia nervosa in comparison to other prominent accounts of authenticity. We conclude with some reflections on the prudential value of authenticity, and by highlighting how the language of authenticity can be invoked to justify covert forms of paternalism that run contrary to the value of individuality that seems to be at the heart of authenticity. (shrink)

This study was designed to test three competing hypotheses (impaired configural processing; impaired Theory of Mind; atypical amygdala functioning) to explain the basic facial expression recognition profile of adults with autism spectrum disorders (ASD). In Experiment 1 the Ekman and Friesen (1976) series were presented upright and inverted. Individuals with ASD were significantly less accurate than controls at recognising upright facial expressions of fear, sadness and disgust and their pattern of errors suggested some configural processing difficulties. Impaired recognition of inverted (...) facial expressions suggested some additional difficulties processing the facial features. Unexpectedly, the clinical group misidentified fear as anger. In Experiment 2 feature processing of facial expressions was investigated by presenting stimuli in a piecemeal fashion, starting with either just the eyes or the mouth. Individuals with ASD were impaired at recognising fear from the eyes and disgust from the mouth; they also confused fearful eyes as being angry. The findings are discussed in terms of the three competing hypotheses tested. (shrink)

Müller and colleagues (2015) address a range of ethical considerations associated with neurosurgical interventions for the treatment of anorexia nervosa (AN), arguing for several protective measures to safeguard clinical research and practice. This is an important article, which provides a thorough review of current neurosurgical research and presents key insights into challenges associated with compromised decision-making capacities in the context of AN and the early average age of onset. However, it is somewhat striking that they neither use nor examine the (...) concept of authenticity. We describe the way this concept features in discussions of AN, and suggest that a deeper understanding of authenticity reveals further ethical problems that Müller and colleagues do not consider. (shrink)

In response to De Proost and Segers, we provide further reflections on how technologies induce moral change. We discuss moral changes at the societal level as distinguished from changes in bioethical principles or ethical concepts, impacts on theories of justice, and whether the transformations are negative or positive.

COVID-19 vaccine requirements have generated significant debate. Here, we argue that, on the evidence available, such policies should have recognised proof of natural immunity as a sufficient basis for exemption to vaccination requirements. We begin by distinguishing our argument from two implausible claims about natural immunity: natural immunity is superior to ‘artificial’ vaccine-induced immunity simply because it is ‘natural’ and it is better to acquire immunity through natural infection than via vaccination. We then briefly survey the evidence base for the (...) comparison between naturally acquired immunity and vaccine-induced immunity. While we clearly cannot settle the scientific debates on this point, we suggest that we lack clear and convincing scientific evidence that vaccine-induced immunity has a significantly higher protective effect than natural immunity. Since vaccine requirements represent a substantial infringement of individual liberty, as well as imposing other significant costs, they can only be justified if they are necessary for achieving a proportionate public health benefit. Without compelling evidence for the superiority of vaccine-induced immunity, it cannot be deemed necessary to require vaccination for those with natural immunity. Subjecting them to vaccine mandates is therefore not justified. We conclude by defending the standard of proof that this argument from necessity invokes, and address other pragmatic and practical considerations that may speak against natural immunity exemptions. There are no data in this work. (shrink)

Although it is argued that social justice is a core concern for the discipline, nursing has not generally played a leadership role in the responses to many of the greatest social problems of our time. These include the accelerated rate of climate change, pandemic threats, systemic racism, growing health and social inequities, and the regulation of new technologies to ensure an equitable future ‘for all.’ In nursing codes of ethics, administration, education, policies, and practice, social justice is often claimed to (...) be a core value, yet it is rarely contextualized by philosophical or theoretical underpinnings. It appears that nurses’ commitment to social justice may stem more from a penchant for ‘doing good’ than an attempt to explore, understand, and enact what is meant by social justice from an ontological, epistemological, and methodological perspective. We contend that the dominance of a human science perspective in nursing contributes to a narrow definition of health and relegates many issues central to social justice to the margins of nurses’ care. In this article, we explore how the focus on ‘the human’ in the human science perspective may not only be limiting the capacity of nurses to develop strategies to adequately address social injustice, but in some instances, direct nurses to contribute to their very reproduction. We suggest that a critical interrogation of this human‐centric hegemony can identify avenues of rupture and introduce posthumanism as an additional philosophical perspective for consideration to help bridge the human‐social divide. (shrink)

This overview proceeds by outlining, albeit very briefly, something of the historical growth of Thomism, turning then to a brief account of how analytic philosophy in the twentieth century can be viewed in relation to that history, before finally turning to a further consideration of what the phrase “Analytical Thomism,” can be taken to mean in light of this brief historical account.

There is evidence to suggest that some patients who undergo Deep Brain Stimulation can experience changes to dispositional, emotional and behavioural states that play a central role in conceptions of personality, identity, autonomy, authenticity, agency and/or self. For example, some patients undergoing DBS for Parkinson’s Disease have developed hypersexuality, and some have reported increased apathy. Moreover, experimental psychiatric applications of DBS may intentionally seek to elicit changes to the patient’s dispositional, emotional and behavioural states, in so far as dysfunctions in (...) these states may undergird the targeted disorder. Such changes following DBS have been of considerable interest to ethicists, but there is a considerable degree of conflict amongst different parties to this debate about whether DBS really does change PIAAAS, and whether this matters. This paper explores these conflicting views and suggests that we may be able to mediate this conflict by attending more closely to what parties to the debate mean when they invoke the concepts lumped together under the acronym PIAAAS. Drawing on empirical work on patient attitudes, this paper outlines how these different understandings of the concepts incorporated into PIAAAS have been understood in this debate, and how they may relate to other fundamental concepts in medical ethics such as well-being and autonomy. The paper clarifies some key areas of disagreement in this context, and develops proposals for how ethicists might fruitfully contribute to future empirical assessments of apparent changes to PIAAAS following DBS treatment. (shrink)

The classic approaches -- Correspondence -- Coherence -- Pragmatism -- Deflationism -- Tarski and the semantic theory of truth -- Summary of part I -- Varieties of enquiry -- Truths of taste; truth in art -- Truth in ethics -- Reason -- Religion and truth -- Interpretations.

Would compulsory treatment or vaccination for Covid-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints—such as quarantine, isolation and ‘lockdown’—that have already been authorised to control the pandemic. We argue that, if the permissive English approach to external constraints for Covid-19 has been justified, then there is a case for a similarly permissive approach (...) to compulsory medical interventions. (shrink)

Gilbert et al. have raised important questions about the empirical grounding of neuroethical analyses of the apparent phenomenon of Deep Brain Stimulation ‘causing’ personality changes. In this paper, we consider how to make neuroethical claims appropriately calibrated to existing evidence, and the role that philosophical neuroethics has to play in this enterprise of ‘evidence-based neuroethics’. In the first half of the paper, we begin by highlighting the challenges we face in investigating changes to PIAAAS following DBS, explaining how different trial (...) designs may be of different degrees of utility, depending on how changes to PIAAAS following DBS are manifested. In particular, we suggest that the trial designs Gilbert et al. call for may not be able to tell us whether or not DBS directly causes changes to personality. However, we suggest that this is not the most significant question about this phenomenon; the most significant question is whether these changes should matter morally, however they are caused. We go on to suggest that neuroethical analyses of novel neuro-interventions should be carried out in accordance with the levels of evidence hierarchy outlined by the Centre for Evidence-Based Medicine, and explain different ways in which neuroethical analyses of changes to PIAAAS can be evidence-based on this framework. In the second half of the paper, we explain how philosophical neuroethics can play an important role in contributing to mechanism-based reasoning about potential effects on PIAAAS following DBS, a form of evidence that is also incorporated into the CEBM levels of evidence hierarchy. (shrink)

A prominent objection to non-cognitive moral bio-enhancements is that they would compromise the recipient’s ‘freedom to fall’. I begin by discussing some ambiguities in this objection, before outlining an Aristotelian reading of it. I suggest that this reading may help to forestall Persson and Savulescu’s ‘God-Machine’ criticism; however, I suggest that the objection still faces the problem of explaining why the value of moral conformity is insufficient to outweigh the value of the freedom to fall itself. I also question whether (...) the objection is compatible with Neil Levy’s parity principle. Accordingly, I go on to consider an alternative relational freedom-based objection to NCMBEs that aims to explain the fundamental moral importance of the freedom that NCMBEs would violate. I argue that although this strategy might allow the critic of NCMBEs to bypass a powerful criticism of Harris’ objection, it also weakens the freedom-based objection’s compatibility with the parity principle. (shrink)

A central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to the intervention. However, in some circumstances it is tempting to say that the moral reason to obtain informed consent prior to administering a medical intervention is outweighed. For example, if an individual’s refusal to undergo a medical intervention would lead to the transmission of a dangerous infectious disease to other members of (...) the community, one might claim that it would be morally permissible to administer the intervention even in the absence of consent. Indeed, as we shall discuss below, there are a number of examples of public health authorities implementing compulsory or coercive measures for the purposes of infectious disease control (IDC). The plausibility of the thought that non-consensual medical interventions might be justified when performed for the purpose of IDC raises the question of whether such interventions might permissibly be used to realize other public goods. In this article we focus on one possibility: whether it could be permissible to non-consensually impose certain interventions that alter brain states or processes through chemical or physical means on serious criminal offenders. We shall suggest that some such interventions might be permissible if they safely and effectively serve to facilitate the offender’s rehabilitation and thereby prevent criminal recidivism. (shrink)

This chapter describes how philosophical theorizing about justice can be connected with empirical research in the social sciences. We begin by drawing on some received distinctions between ideal and non-ideal approaches to theorizing justice along several different dimensions, showing how non-ideal approaches are needed to address normative aspects of real-world problems and to provide practical guidance. We argue that there are advantages to a transitional approach to justice focusing on manifest injustices, including the fact that it enables us to set (...) aside some reasonable disagreements about justice. The ‘bottom-up’ approach we advocate, for which we borrow Wolff’s term ‘real-world political philosophy’, is an empirically-informed normative analysis that attends to specific, identifiable injustices, and thus is partial, though not isolationist. We illustrate our approach by considering how different models of the nature of disability suggest different kinds of remedy for injustices faced by persons living with disabilities. We reflect on the nature and significance of vulnerabilities, and we assess the role of public opinion in normative theorizing, suggesting a particular significance for the opinions and experiences of marginalized groups. We finally reflect on the relevance of European legal and institutional frameworks for theorizing justice in Europe. (shrink)

Is what's true ultimately relative to your point of view? So that what's true as viewed from over here might be false if viewed from over there? In this article, Simon Blackburn grapples with the suggestion that what's true is ultimately just a matter of perspective.

It is widely accepted that children enjoy some form of a right to bodily integrity. However, there is little agreement about the precise nature and scope of this right. This paper offers a conceptual analysis of the child's right to bodily integrity, in order to further elucidate the relationship between the child's right to bodily integrity and considerations of autonomy. Following a discussion of Leif Wenar's work on the structure and justification of rights, I first explain how the adult's right (...) to bodily integrity can be distilled into separate elements that may plausibly be justified by different moral considerations. In particular, I claim that this analysis suggests that whilst the adult's right to bodily integrity is not wholly reducible to bodily autonomy, autonomy nonetheless remains entwined with our understanding of this right in a number of ways. On the basis of this discussion, I go on to outline three important complexities that arise when we consider the child's right to bodily integrity, before particularly focusing on the question of how third parties should determine whether or not to perform a physical interference upon a child who lacks decision-making capacity. Here, I raise some objections to Earp and Mazor's recent attempts to answer this question, before briefly defending an ‘autonomy-based interests’ account of permissible interference, an account that shares in what I take to be the spirit, if not the precise letter, of these earlier views. (shrink)

The use of genetic testing has prompted the question of whether insurance companies should be able to use predictive genetic test results (GTRs) in their risk classification of clients. While some jurisdictions have passed legislation to prohibit this practice, the UK has instead adopted a voluntary code of practice that merely restricts the ways in which insurance companies may use GTRs. Critics have invoked various theories of justice to argue that this approach is unfair. However, as well as sometimes relying (...) on somewhat idealised assumptions, these analyses have tended to invoke theories that have wide-ranging and highly revisionary implications for insurance. Moreover, they fail to adequately engage with a conception of justice that plausibly undergirds the status quo approach to insurance in the UK. I argue that it is a mistake to simply invoke a single contestable theory in seeking to develop sound policy on the use of GTRs in insurance. To that end, in this paper, I outline three plausible principles of justice that policy on this issue ought to balance: A principle of equity, a principle of equal access and a principle of need. In doing so, I shall offer a pluralist justice-based argument in support of the spirit, if not the precise letter, of the UK approach. (shrink)

Deep brain stimulation (DBS) is frequently described as a ‘reversible’ medical treatment, and the reversibility of DBS is often cited as an important reason for preferring it to brain lesioning procedures as a last resort treatment modality for patients suffering from treatment-refractory conditions. Despite its widespread acceptance, the claim that DBS is reversible has recently come under attack. Critics have pointed out that data are beginning to suggest that there can be non-stimulation-dependent effects of DBS. Furthermore, we lack long-term data (...) about other potential irreversible effects of neuromodulation. This has considerable normative implications for comparisons of DBS and brain lesioning procedures. Indeed, Devan Stahl and colleagues have recently argued that psychiatric DBS should be subject to the same legal safeguards as other forms of psychosurgery, supporting their position by forcibly criticising the claim that DBS is reversible. In this paper, I respond to these criticisms by first clarifying the descriptive and evaluative elements of the reversibility claim that supporters of DBS might invoke, and the different senses of ‘reversibility’ that we might employ in discussing the effects of medical procedures. I go on to suggest that it is possible to defend a nuanced version of the reversibility claim. To do so, I explain how DBS has some effects that are stimulation dependent in the short term, and argue that these effects can have significant normative implications for patient well-being and autonomy. I conclude that we should not abandon a nuanced version of the reversibility claim in the DBS debate. (shrink)