In 1941, Gellhorn and colleagues reported experiments in which modest reductions of blood sugar were induced in hypophysectomized/adrenodemedullated (HA) rats by intraperitoneal injection of human blood. Based on the effects of intraperitoneal injections of known amounts of Lilly insulin on blood sugar in HA rats, Gellhorn estimated that the "insulin" content of normal human blood (collected two and a half hours "after luncheon") was 200uU/ml (Gellhorn, Feldman, and Allen 1941). However, discrepancies between measurements of plasma insulin concentration by in vitro (...) bioassays, which began in earnest in the late 1940s and early 1950s, and, beginning in 1960, by radioimmunoassay (RIA), intimated that insulin was not .. (shrink)

The phenomenon of ambivalence is an important one for any philosophy of action. Despite this importance, there is a lack of a fully satisfactory analysis of the phenomenon. Although many contemporary philosophers recognize the phenomenon, and address topics related to it, only Harry Frankfurt has given the phenomenon full treatment in the context of action theory - providing an analysis of how it relates to the structure and freedom of the will. In this paper, I develop objections to Frankfurt's account, (...) all revolving around the charge that his account contains a serious ambiguity between willing and identifying. With such objections in place, I then develop an analysis that avoids the difficulties and ambiguities that Frankfurt's analysis is prey to. I briefly distinguish ambivalence from other types of internal conflict. This paper aims to offer conceptual clarification on the phenomenon of ambivalence, which will then allow for discussions about the normative merits and demerits of ambivalence, the effects of ambivalence on autonomous action, and methods of resolution of ambivalence. (shrink)

This paper is a companion piece to my earlier paper “Fallibilism and Concessive Knowledge Attributions”. There are two intuitive charges against fallibilism. One is that it countenances the truth (and presumably acceptability) of utterances of sentences such as “I know that Bush is a Republican, though it might be that he is not a Republican”. The second is that it countenances the truth (and presumably acceptability) of utterances of sentences such as “I know that Bush is a Republican, even though (...) I’m not certain that he is”, or “I know that Bush it a Republican, even though it isn’t certain that he is.” In “Fallibilism and Concessive Knowledge Attributions”, I argue that fallibilism in epistemology does not countenance the truth of utterances of sentences such as “I know that Bush is a Republican, though it might be that he is not a Republican”. In this paper, I argue that there are independent reasons for thinking that utterances of sentences such as “I know that Bush is a Republican, though I’m not certain that he is” and “I know that Bush is a Republican, though it’s not certain that he is” are unassertible. More specifically, I argue that these are simply instances of Moore’s Paradox, such as “Dogs bark, but I don’t know that they do.” The right account of Moore’s Paradox does not involve the falsehood of the semantic content of the relevant utterances, but rather their pragmatic unacceptability. So the anti-fallibilist intuitions turn out to have pragmatic, rather than semantic import, and therefore do not tell against the truth of fallibilism. Fallibilism in epistemology is often thought to be theoretically desirable, but intuitively problematic. My purpose with these two papers is to show that fallibilism is not intuitively problematic. (shrink)

An analysis of the identity issues involved in facial allograft transplantation is provided in this paper. The identity issues involved in organ transplantation in general, under both theoretical accounts of personal identity and subjective accounts provided by organ recipients, are examined. It is argued that the identity issues involved in facial allograft transplantation are similar to those involved in organ transplantation in general, but much stronger because the face is so closely linked with personal identity. Recipients of facial allograft transplantation (...) have the potential to feel that their identity is a mix between their own and the donor’s, and the donor’s family is potentially likely to feel that their loved one ‘‘lives on’’. It is also argued that facial allograft transplantation allows the recipients to regain an identity, because they can now be seen in the social world. Moreover, they may regain expressivity, allowing for them to be seen even more by others, and to regain an identity to an even greater extent. Informing both recipients and donors about the role that identity plays in facial allograft transplantation could enhance the consent process for facial allograft transplantation and donation. (shrink)

Although I agree with Sabine Muller’s conclusion that we should first seek to find alternatives to amputation for patients suffering from Body Integrity Identity Disorder (BIID), I disagree with one of the major premises that she uses to argue for her claim. Muller argues that patients with BIID are likely not autonomous when they request that the limb be amputated. Muller’s argument that BIID suffers are not autonomous is flawed because she conflates philosophical conceptions of autonomy with the conception of (...) autonomy that is operative in the context of medicine. (shrink)

"In describing Hauerwas' work as Christian ethics, one can allow that phrase its full scope of meaning. It is the work of an ethician who is thoroughly conversant with that branch of philosophy and comes to grips with its major issues. He is also firmly committed to the view that, in modifying the substantive 'ethics' with the adjective 'Christian, ' one is designating a distinct reality. . . . Hauerwas invites us to share an understanding of ethics in general and (...) of Christian ethics in particular that is a great deal subtler and more complicated than most currently popular versions of those subjects. For contemporary Christian ethics to accept his invitation will mean letting itself in for some very rigorous and versatile thinking." --America. (shrink)

In his paper, ‘Patients, doctors and risk attitudes,’ Nicholas Makins1 argues that healthcare professionals should defer to a patient’s higher-order risk attitudes (ie, the risk attitudes they desire to have or endorse within themselves upon reflection) when making medical decisions. We argue against Makins’ deference to higher-order risk attitudes on the basis that (1) there are significant practical concerns regarding our ability to easily and consistently access and verify the higher-order risk attitudes of patients, (2) there is a lack of (...) a theoretical limit on higher-order risk attitudes (eg, second, third, fourth order), and (3) the consideration of higher-order risk attitudes is actually more paternalistic than Makins suggests because it narrows what counts as an autonomous preference to the limited occasions in which an individual actually reflects on his or her own risk attitude. On the issue of practicality, we can reasonably expect that healthcare professionals would find difficulty eliciting the higher-order risk attitudes of their patients. Take for example the patient who has never expressed his higher-order desire to be more risk adverse and who is not willing nor comfortable expressing this desire. What is the healthcare professional expected to do in this situation? This is even more of a concern for the incapacitated patient, to which Makins seems to imply that …. (shrink)

This book is a major contribution to the study of the philosophy of action, moral philosophy, and political philosophy. Its central idea is a radically unorthodox theory of rational action. Most contemporary Anglo-American philosophers believe that action is motivated by desire. Professor Benn rejects the doctrine and replaces it with a reformulation of Kant's ethical and political theory, in which rational action can be determined simply by principles, regardless of consequences. The book analyzes the way in which value conflicts can (...) be rationally resolved, the objectivity of value, the concept of moral personality, the principles of non-interference and respect of persons, the ideals of autonomy and community and various aspects of individual rights - focusing on the rights to freedom, welfare, and privacy. (shrink)

Many philosophers believe that there is a fundamental distinction between knowing that something is the case and knowing how to do something. According to Gilbert Ryle, to whom the insight is credited, knowledge-how is an ability, which is in turn a complex of dispositions. Knowledge-that, on the other hand, is not an ability, or anything similar. Rather, knowledge-that is a relation between a thinker and a true proposition.

Development and Evolution surveys and illuminates the key themes of rapidly changing fields and areas of controversy that the redefining the theory and philosophy of biology. It continues Stanley Salthe's investigation of evolutionary theory, begun in his influential book Evolving Hierarchical Systems, while negating the implicit philosophical mechanisms of much of that work. Here Salthe attempts to reinitiate a theory of biology from the perspective of development rather than from that of evolution, recognizing the applicability of general systems thinking (...) to biological and social phenomena and pointing towards a non-Darwinian and even a postmodern biology. (shrink)

Quantification is a topic which brings together linguistics, logic, and philosophy. Quantifiers are the essential tools with which, in language or logic, we refer to quantity of things or amount of stuff. In English they include such expressions as no, some, all, both, many. Peters and Westerstahl present the definitive interdisciplinary exploration of how they work - their syntax, semantics, and inferential role.

Quantification is a topic which brings together linguistics, logic, and philosophy. Quantifiers are the essential tools with which, in language or logic, we refer to quantity of things or amount of stuff. In English they include such expressions as no, some, all, both, many. Peters and Westerstahl present the definitive interdisciplinary exploration of how they work - their syntax, semantics, and inferential role.

The concept of personhood has been central to bioethics debates about abortion, the treatment of patients in a vegetative or minimally conscious states, as well as patients with advanced dementia. More recently, the concept has been employed to think about new questions related to human-brain organoids, artificial intelligence, uploaded minds, human-animal chimeras, and human embryos, to name a few. A common move has been to ask what these entities have in common with persons (in the normative sense), and then draw (...) conclusions about what we do (or do not) owe them. This paper argues that at best the concept of “personhood” is unhelpful to much of bioethics today and at worst it is harmful and pernicious. I suggest that we (bioethicists) stop using the concept of personhood and instead ask normative questions more directly (e.g., how ought we to treat this being and why?) and use other philosophical concepts (e.g., interests, sentience, recognition respect) to help us answer them. It is time for bioethics to end talk about personhood. (shrink)

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)

The concept of personhood has been central to bioethics debates about abortion, the treatment of patients in a vegetative or minimally conscious states, as well as patients with advanced dementia. More recently, the concept has been employed to think about new questions related to human-brain organoids, artificial intelligence, uploaded minds, human-animal chimeras, and human embryos, to name a few. A common move has been to ask what these entities have in common with persons (in the normative sense), and then draw (...) conclusions about what we do (or do not) owe them. This paper argues that at best the concept of “personhood” is unhelpful to much of bioethics today and at worst it is harmful and pernicious. I suggest that we (bioethicists) stop using the concept of personhood and instead ask normative questions more directly (e.g., how ought we to treat this being and why?) and use other philosophical concepts (e.g., interests, sentience, recognition respect) to help us answer them. It is time for bioethics to end talk about personhood. (shrink)

In some views, philosophy’s glory days in bioethics are over. While philosophers were especially important in the early days of the field, so the argument goes, the majority of the work in bioethics today involves the “simple” application of existing philosophical principles or concepts, as well as empirical work in bioethics. Here, we address this view head on and ask: What is the role of philosophy in bioethics today? This paper has three specific aims: (1) to respond to skeptics and (...) make the case that philosophy and philosophers still have a very important and meaningful role to play in contemporary bioethics, (2) to discuss some of the current challenges to the meaningful integration of philosophy and bioethics, and (3) to make suggestions for what needs to happen in order for the two fields to stay richly connected. We outline how bioethics center directors, funders, and philosopher bioethicists can help. (shrink)

In an era when much of what passes for debate is merely moral posturing--traditional family values versus the cultural elite, free speech versus censorship--or reflexive name-calling--the terms "liberal" and "politically correct," are used with as much dismissive scorn by the right as "reactionary" and "fascist" are by the left--Stanley Fish would seem an unlikely lightning rod for controversy. A renowned scholar of Milton, head of the English Department of Duke University, Fish has emerged as a brilliantly original critic of (...) the culture at large, praised and pilloried as a vigorous debunker of the pieties of both the left and right. His mission is not to win the cultural wars that preoccupy the nation's attention, but rather to redefine the terms of battle. In There's No Such Thing as Free Speech, Fish takes aim at the ideological gridlock paralyzing academic and political exchange in the nineties. In his witty, accessible dissections of the swirling controversies over multiculturalism, affirmative action, canon revision, hate speech, and legal reform, he neatly eviscerates both the conservatives' claim to possession of timeless, transcendent values, and the intellectual left's icons of equality, tolerance, and non-discrimination. He argues that while conservative ideologues and liberal stalwarts might disagree vehemently on what is essential to a culture, or to a curriculum, both mistakenly believe that what is essential can be identified apart from the accidental circumstances to which the essential is ritually opposed. In the book's first section, which includes the five essays written for Fish's celebrated debates with Dinesh D'Souza, Fish turns his attention to the neoconservative backlash. In his introduction, Fish writes, "Terms that come to us wearing the label 'apolitical'--'common values', 'fairness', 'merit', 'color blind', 'free speech', 'reason'--are in fact the ideologically charged constructions of a decidedly political agenda. I make the point not in order to level an accusation, but to remove the sting of accusation from the world 'politics' and redefine it as a synonym for what everyone inevitably does." Fish maintains that the debate over political correctness is an artificial one, because it is simply not possible for any party or individual to occupy a position above or beyond politics. Regarding the controversy over the revision of the college curriculum, Fish argues that the point is not to try to insist that inclusion of ethnic and gender studies is not a political decision, but "to point out that any alternative curriculum--say a diet of exclusively Western or European texts--would be no less politically invested." In Part Two, Fish follows the implications of his arguments to a surprising rejection of the optimistic claims of the intellectual left that awareness of the historical roots of our beliefs and biases can allow us, as individuals or as a society, to escape or transcend them. Specifically, he turns to the movement for reform of legal studies, and insists that a dream of a legal culture in which no one's values are slighted or declared peripheral can no more be realized than the dream of a concept of fairness that answers to everyone's notions of equality and jsutice, or a yardstick of merit that is true to everyone's notions of worth and substance. Similarly, he argues that attempts to politicize the study of literature are ultimately misguided, because recharacterizations of literary works have absolutely no impact on the mainstream of political life. He concludes his critique of the academy with "The Unbearable Ugliness of Volvos," an extraordinary look at some of the more puzzing, if not out-and-out masochistic, characteristics of a life in academia. Penetrating, fearless, and brilliantly argued, There's No Such Thing as Free Speech captures the essential Fish. It is must reading for anyone who cares about the outcome of America's cultural wars. (shrink)

Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with (...) refractory dystonia. Given the favorable risk-benefit profile, it is concluded that offering pDBS is ethically justified for certain etiologies of dystonia, but it is less clear for others. In addition, various ethical and policy concerns are discussed, which need to be addressed to optimize the practice of offering pDBS for dystonia. Strategies are proposed to help address these concerns as pDBS continues to expand. (shrink)

The late ancient commentators on Aristotle, most of them Platonists, have been gradually re-emerging on the philosophical and scholarly horizon during the last two or three decades. Their reappearance is not likely to cause any major transformations of the scene, but they are interesting enough in themselves to deserve careful study and they have been influential in the past to the extent that proper understanding of their work sheds light on the subsequent history of the interpretation of Aristotle. This and (...) much more is borne out by Blumenthal's excellent study. A considerable number of ancient commentaries have now appeared in English translations initiated by Richard Sorabji, and books and articles on them have begun to appear as never before. After writing some pioneering works on Plotinus's psychology, in which the relevance of Aristotle for the latter's fundamentally Platonic psychology is much in focus, Blumenthal set out in the 1970s to study the commentators and thus belongs to the pioneers in the contemporary awakening. (shrink)

In ‘Reification and Assent in Research Involving Those Who Lack Capacity’, Smajdor argues that adults with impaired capacity to grant informed consent (AWIC) are often excluded from participating in biomedical research because they cannot provide informed consent, leading to decreased chances AWIC will benefit from such research. Smajdor uses Honneth’s concept of reification to propose that securing assent (rather than consent) in cases involving AWIC offers patients moral recognition that is not tied to their capacities. Assent provides this recognition by (...) including the patient in a shared moral sphere, highlighting her agency and worth without reducing her to her incapacity or a thing-to-be-managed. Assent also avoids grounding in, or a reliance on, the future development of autonomy (pp.5–6).1 Our recent research on patient and caregiver perspectives of potential paediatric deep brain stimulation (pDBS) for refractory obsessive–compulsive disorder (OCD) and dystonia demonstrates that paediatric neurosurgery patients desire the kind of recognition Smajdor associates with assent, and their caregivers largely agree.2 3 Since (generally) paediatric patients in the USA are unable to grant informed consent, their caregivers must provide it instead. This raises the question of how to properly integrate paediatric patients into the DBS decision-making process. One dimension along which this is evident is that …. (shrink)

The editors of the _Journal of Medical Ethics_ support the call of the UK Health Alliance on Climate for urgent action to ensure that the current Conference of the Parties to the United Nations Framework Convention on Climate Change ‘finally delivers climate justice for Africa and vulnerable countries’. 1 As they note ‘Africa has suffered disproportionately although it has done little to cause the crisis’. The burden of climate change has thus far fallen disproportionately on Global South countries. The monsoon (...) in Pakistan this year killed over 1100 people and the public health implications of the flooding might affect the health of over 5 million people. 2 The South Asian monsoon impacts the lives of a billion people and the flooding associated with wet seasons is likely to occur eight times more frequently in future years than at present. 3 For many pacific islands such as Kiribati,... (shrink)

This study investigated whether musical training and bilingualism are associated with enhancements in specific components of executive function, namely, task switching and dual-task performance. Participants belonging to one of four groups were matched on age and socioeconomic status and administered task switching and dual-task paradigms. Results demonstrated reduced global and local switch costs in musicians compared with non-musicians, suggesting that musical training can contribute to increased efficiency in the ability to shift flexibly between mental sets. On dual-task performance, musicians also (...) outperformed non-musicians. There was neither a cognitive advantage for bilinguals relative to monolinguals, nor an interaction between music and language to suggest additive effects of both types of experience. These findings demonstrate that long-term musical training is associated with improvements in task switching and dual-task performance. (shrink)

In these three lectures, Cavell situates Emerson at an intersection of three crossroads: a place where both philosophy and literature pass; where the two traditions of English and German philosophy shun one another; where the cultures of America and Europe unsettle one another. "Cavell’s ’readings’ of Wittgenstein and Heidegger and Emerson and other thinkers surely deepen our understanding of them, but they do much more: they offer a vision of what life can be and what culture can mean.... These profound (...) lectures are a wonderful place to make [Cavell’s] acquaintance."—Hilary Putnam. (shrink)

This handsome new edition of Stanley Cavell's landmark text, first published 20 years ago, provides a new preface that discusses the reception and influence of his work, which occupies a unique niche between philosophy and literary studies.

Policymakers, employers, insurance companies, researchers, and health care providers have developed an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. In this article, we examine how principles from behavioral economics and psychology are being used to nudge people (the public, patients, or health care providers) toward particular decisions or behaviors related to health or health care, and we identify the ethically relevant dimensions that should be considered for (...) the utilization of each principle. (shrink)

Explores the meaning of death, how people of different times, regions, and religions have coped with it, and the progress and effects of the war waged against it by researchers, physicians, and surgeons.

"This is a timely collection of important papers.

Despite increased focus on emotional language, research lacks for the most emotional language: Swearing. We used event-related potentials to investigate whether swear words have content dist...

These lectures by one of the most influential and original philosophers of the twentieth century constitute a sustained argument for the philosophical basis of romanticism, particularly in its American rendering. Through his examination of such authors as Emerson, Thoreau, Poe, Wordsworth, and Coleridge, Stanley Cavell shows that romanticism and American transcendentalism represent a serious philosophical response to the challenge of skepticism that underlies the writings of Wittgenstein and Austin on ordinary language.

Stanley Cavell, one of America's most distinguished philosophers, has written an invaluable companion volume to Walden, a seminal book in our cultural heritage. This expanded edition includes two essays on Emerson.

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

This book is Stanley Cavell’s definitive expression on Emerson. Over the past thirty years, Cavell has demonstrated that he is the most emphatic and provocative philosophical critic of Emerson that America has yet known. The sustained effort of that labor is drawn together here for the first time into a single volume, which also contains two previously unpublished essays and an introduction by Cavell that reflects on this book and the history of its emergence. -/- Students and scholars working (...) in philosophy, literature, American studies, history, film studies, and political theory can now more easily access Cavell’s luminous and enduring work on Emerson. Such engagement should be further complemented by extensive indices and annotations. If we are still in doubt whether America has expressed itself philosophically, there is perhaps no better space for inquiry than reading Cavell reading Emerson. (shrink)

This book offers philosophy in the key of life.

He had made it all up, he said, and gloated that his "prank" proved that sociologists and humanists who spoke of science as a "social construction" didn't know what they were talking about. Acknowledging the ethical issues raised by his deception, Professor Sokal declared it justified by the importance of the truths he was defending from postmodernist attack: "There is a world; its properties are not merely social constructions; facts and evidence do matter. What sane person would contend otherwise?".

Having acknowledged the recurrent theme of education in Stanley Cavell's work, the discussion addresses the topic of scepticism, especially as this emerges in the interpretation of Wittgenstein. Questions concerning rule‐following, language and society are then turned towards political philosophy, specifically with regard to John Rawls. The discussion examines the idea of the social contract, the nature of moral reasoning and the possibility of our lives' being above reproach, as well as Rawls's criticisms of Nietzschean perfectionism. This lays the way (...) for the broaching of questions of race and America. The theme of the ordinary, which emerges variously in Cavell's reflections on Emerson, Wittgenstein and Austin, is taken up and extended into a consideration of Thoreau's ‘experiment in living’. The conversation closes with brief remarks about happiness. (shrink)

Stanley Fish argues here for a narrower conception of academic freedom, one that does not grant academics a legal status different from other professionals.