The past decade has seen a burgeoning of scholarly interest in conscientious objection in healthcare. While the literature to date has focused primarily on individual healthcare practitioners who object to participation in morally controversial procedures, in this article we consider a different albeit related issue, namely, whether publicly funded healthcare institutions should be required to provide morally controversial services such as abortions, emergency contraception, voluntary sterilizations, and voluntary euthanasia. Substantive debates about institutional responsibility have remained largely at the level of (...) first-order ethical debate over medical practices which institutions have refused to offer; in this article, we argue that more fundamental questions about the metaphysics of institutions provide a neglected avenue for understanding the basis of institutional conscientious objection. To do so, we articulate a metaphysical model of institutional conscience, and consider three well-known arguments for undermining institutional conscientious objection in light of this model. We show how our metaphysical analysis of institutions creates difficulties for justifying sanctions on institutions that conscientiously object. Thus, we argue, questions about the metaphysics of institutions are deserving of serious attention from both critics and defenders of institutional conscientious objection. (shrink)

There has been significant debate about whether the moral norms of medical practice arise from some feature or set of features internal to the discipline of medicine. In this article, I analyze Edmund Pellegrino’s conception of the internal morality of medicine, and situate it in the context of Alasdair MacIntyre’s influential account of “practice.” Building upon MacIntyre, Pellegrino argued that medicine is a social practice with its own unique goals—namely, the medical, human, and spiritual good of the patient—and that the (...) moral norms that govern medical practice are derived from these goals. After providing an overview of Pellegrino’s work, I discuss some forceful objections to his theory—specifically, that it is too rigid and incapable of entering into dialogue with contemporary values systems; that it is dependent on an external conception of human flourishing; and that it is incompatible with the rapidly changing nature of modern medicine. In the final section of this article, I consider how theorists working in the Hippocratic tradition might respond to these objections against ethical essentialism by drawing upon MacIntyre’s historico-cultural method as well as what he calls Aristotle’s “metaphysical biology.”. (shrink)

The past decade has seen a burgeoning of scholarly interest in conscientious objection in health care. Specifically, several commentators have discussed the implications that conscientious objection has for the delivery of timely, efficient, and nondiscriminatory medical care. In this paper, I discuss the main argument put forward by the most prominent critics of conscientious objection—what I call the Professional Duty Argument or PDA. According to proponents of PDA, doctors should place patients’ well-being and rights at the center of their professional (...) practice. Doctors should be prepared to set their personal moral or religious beliefs aside where these beliefs conflict with what is legal and considered good medical practice by relevant professional associations. Conscientious objection, on this account, should be heavily restricted, if even allowed at all. I discuss two powerful objections against PDA. The first objection, which I call the fallibility objection, notes that law and professional codes of conduct are fallible guides for ethical conduct and that conscientious objection has in the past and continues today to provide a check on aberrations in law and professional convention. The second, which I call the professional discretion objection, states that restrictions on conscientious objection undermine one of the cornerstones of good medical practice, namely, a practitioner’s right to independent professional judgment. I argue that these two objections give us reason to retain conscience clauses in professional codes of conduct. (shrink)

Several ethicists have defended the use of responsibility-based criteria in healthcare rationing. Yet in this article we outline two challenges to the implementation of responsibility-based healthcare rationing policies. These two challenges are, namely, that responsibility for past behavior can diminish as an agent changes, and that blame can come apart from responsibility. These challenges suggest that it is more difficult to hold someone responsible for health related actions than proponents of responsibility-sensitive healthcare policies suggest. We close by discussing public health (...) policies that could function as an alternative to contentious, responsibility-sensitive rationing policies. (shrink)

Many if not most sperm donors in the early years of IVF donated under conditions of anonymity. There is, however, a growing awareness of the ethical cost of withholding identifying parental information from donor children. Today, anonymous donation is illegal in many jurisdictions, and some jurisdictions have gone as far as retrospectively invalidating contracts whereby donors were guaranteed anonymity. This article provides a critical evaluation of the ethics and legality of anonymous donation. We defend Australian and British legislation that has (...) outlawed donor anonymity, and we argue for the establishment of a central registry that provides donor children with the ability to easily and reliably access identifying information about their donor parents. (shrink)

BackgroundViral pandemics present a range of ethical challenges for policy makers, not the least among which are difficult decisions about how to allocate scarce healthcare resources. One important question is whether healthcare workers should receive priority access to a vaccine in the event that an effective vaccine becomes available. This question is especially relevant in the coronavirus pandemic with governments and health authorities currently facing questions of distribution of COVID-19 vaccines.Main textIn this article, we critically evaluate the most common ethical (...) arguments for granting healthcare workers priority access to a vaccine. We review the existing literature on this topic, and analyse both deontological and utilitarian arguments in favour of HCW prioritisation. For illustrative purposes, we focus in particular on the distribution of a COVID-19 vaccine. We also explore some practical complexities attendant on arguments in favour of HCW prioritisation.ConclusionsWe argue that there are deontological and utilitarian cases for prioritising HCWs. Indeed, the widely held view that we should prioritise HCWs represents an example of ethical convergence. Complexities arise, however, when considering who should be included in the category of HCW, and who else should receive priority in addition to HCWs. (shrink)

In this article we critically evaluate an argument against state‐sanctioned euthanasia made by David Velleman in his 1992 paper ‘Against the right to die’. In that article, Velleman argues that legalizing euthanasia is morally problematic as it will deprive eligible patients of the opportunity of staying ‘alive by default’. That is to say, those patients who are rendered eligible for euthanasia as a result of legislative reform will face the burden of having to justify their continued existence to their epistemic (...) peers if they are to be perceived as ‘reasonable’. We discuss potential criticisms that could be made of the argument, and consider how a defender of the view might respond. Velleman’s argument is particularly interesting as it is a consequentialist argument against state‐sanctioned euthanasia, challenging the many consequentialist arguments that have been made in favour of legalizing the procedure. We conclude by suggesting that further research on the question of unfair burdens is important to adequately evaluating the potential harms of legalizing euthanasia for patients at the end of life. (shrink)

Conscience is an idea that has significant currency in liberal democratic societies. Yet contemporary moral philosophical scholarship on conscience is surprisingly sparse. This paper seeks to offer a rigorous philosophical account of the role of conscience in moral life with a view to informing debates about the ethics of conscientious objection in medicine. I argue that conscience is concerned with a commitment to moral integrity and that restrictions on freedom of conscience prevent agents from living a moral life. In section (...) one I argue that conscience is a principle of moral awareness in rational agents, and that it yields an awareness of the personal nature of moral obligation. Conscience also monitors the coherence between an agent’s identity-conferring beliefs and intentions and their practical actions. In section two I consider how human beings are harmed when they are forced to violate their conscience. Restrictions on the exercise of conscience prevent people from living in accord with their own considered understanding of the requirements of morality and undermine one’s capacity for moral agency. This article concludes with a consideration of how a robust theory of conscience can inform our understanding of conscientious objection in medicine. I argue that it is in the interest of individual practitioners and the medical profession generally to foster moral agency among doctors. This provides a prima facie justification for permitting at least some kinds of conscientious objection. (shrink)

Thomas Riisfeldt’s essay1 is a valuable contribution to the literature on palliative sedation, appropriately titrated administration of opioids and euthanasia. In this response, I will not deal with the author’s empirical claim about the relationship between opioid use, palliative sedation and survival time. Rather, I will briefly critique the author’s discussion of doctrine of double effect and its application to palliative sedation and opioid use at the end of life. That is, I will focus on the ethical claims made by (...) the author. Riisfeldt argues that DDE is incompatible with both Kantian deontology and Millian consequentialism. Yet, I will argue that the DDE is coherent and defensible when interpreted from the perspective of the philosophy of Thomas Aquinas, the theorist who first proposed the doctrine. I will also argue that Riisfeldt mischaracterises ATAOs and palliative sedation as procedures that hasten death as a means to relieve pain. While death may indeed be hastened by ATAOs and palliative sedation, it is not at all clear that clinicians intend to hasten death as a means to relieve pain. Indeed, clinical guidelines explicitly prohibit the intentional hastening of death. Riisfeldt provides a brief summary of the DDE. He describes DDE as a ‘strange hybrid of four principles’. He lists the four criteria that must be met for an act with a good and a bad effect to be permissible. These criteria are the ‘intention and means criteria’ and the ‘intrinsic and proportionality criteria’. The author uses Kant and Mill as lens through which to highlight a tension between the intrinsic and proportionality criteria of DDE. The author claims that ‘the intrinsic criterion is derived from deontology, the predominant form of which is championed by Kant’, and that ‘the proportionality criterion is derived from consequentialism, the predominant form of …. (shrink)

Savulescu argues that it may be ethically acceptable for governments to require citizens be vaccinated against COVID-19. He also recommends that governments consider providing monetary or in-kind incentives to citizens to increase vaccination rates. In this response, we argue against mandatory vaccination and vaccine incentivisation, and instead suggest that targeted public health messaging and a greater responsiveness to the concerns of vaccine-hesitant individuals would be the best strategy to address low vaccination rates.

Several bioethicists have recently discussed the complexity of defining human death, and considered in particular how our definition of death affects our understanding of the ethics of vital organ procurement. In this brief paper, we challenge the mainstream medical definition of human death—namely, that death is equivalent to total brain failure—and argue with Nair-Collins and Miller that integrated biological functions can continue even after total brain failure has occurred. We discuss the implications of Nair-Collins and Miller’s argument and suggest that (...) it may be necessary to look for alternative biological markers that reliably indicate the death of a human being. We reject the suggestion that we should abandon the dead-donor criteria for organ donation. Rather than weaken the ethical standards for vital organ procurement, it may be necessary to make them more demanding. The aim of this paper is not to justify the dead donor rule. Rather, we aim to explore the perspective of those who agree with critiques of the whole brain and cardiopulmonary definitions of death but yet disagree with the proposal that we should abandon the dead-donor rule. We will consider what those who want to retain the dead-donor rule must argue in light of Nair-Collins and Miller’s critique. (shrink)

Schuklenk and Smalling argue that it is practically impossible for civic institutions to meet the conditions necessary to ensure that conscientious objection does not conflict with the core principles of liberal democracies. In this response, I propose an alternative definition of conscience to that offered by Schuklenk and Smalling. I discuss what I call the ‘traditional’ notion of conscience, and contrast this with the existentialist conception of conscience (which I take to be a close cousin of the view targeted by (...) Schuklenk and Smalling). I argue that the traditional notion, grounded in an objective moral order, avoids the criticisms advanced by Schuklenk and Smalling; the existentialist conception, in contrast, does not. I conclude by discussing the benefits and risks of a ‘restricted view’ of respect for conscience. (shrink)

Kolbe and de Melo-Martin (2023) raise important concerns about the limited usefulness of measures of moral distress. They propose that moral distress is best measured in terms of “illegitimate inst...

Kay Toombs is an influential ethicist and disability scholar. In a new edition of her book How Then Should We Die? Two Opposing Responses to the Challenges of Suffering and Death, she critiques soc...

Organ transplant shortages are ubiquitous in healthcare systems around the world. In response, several commentators have argued for the adoption of an opt-out policy for organ transplantation, whereby individuals would by default be registered as organ donors unless they informed authorities of their desire to opt-out. This may potentially lead to an increase in donation rates. An opt-out system, however, presumes consent even when it is evident that a significant minority are resistant to organ donation. In this article, we defend (...) a mandated choice framework for consent to deceased organ donation. A mandated choice framework, coupled with good public education, would likely increase donation rates. More importantly, however, a mandated choice framework would respect the autonomous preferences of people who do not wish to donate. We focus in particular on the Australian healthcare context, and consider how a mandated choice system could function as an ethical means to increase the organ donation rate in Australia. We make the novel proposal that all individuals who vote at an Australian federal election be required to state their organ donation preferences when voting. (shrink)

The doctrine of double effect is a principle of crucial importance in law and medicine. In medicine, the principle is generally accepted to apply in cases where the treatment necessary to relieve pain and physical suffering runs the risk of hastening the patient’s death. More controversially, it has also been used as a justification for withdrawal of treatment from living individuals and physician-assisted suicide. In this paper, I will critique the findings of the controversial Victorian Civil and Administrative Tribunal hearing (...) Syme vs the Medical Board of Australia. In that hearing, Dr Rodney Syme, a urologist and euthanasia advocate, was defending his practice of prescribing barbiturates to terminally ill patients. Syme claimed that he prescribed the drugs with the intention of relieving their existential suffering and not to assist in suicide; he argued that the DDE could be applied. Pace VCAT, I argue that this is an illegitimate application of DDE. I argue that a close scrutiny of Syme’s actions reveals that, at the very least, he intended to give patients the option of suicide. He furthermore used what on a traditional definition of DDE would be considered a ‘bad’ means—the prescription of Nembutal—to achieve a ‘good’ end—the relief of suffering. The case demonstrates the crucial importance of analysing an agent’s ‘intention’ and the ‘effects’ of their actions when applying DDE. Ethicists and, indeed, the judiciary need to attend to the ethical complexities of DDE when they assess the applicability of DDE to end of life care. If they fail to do this, the doctrine risks losing its legitimacy as an ethical principle. (shrink)

Giubiliniet aloffer some helpful reflections on the conscientious provision of medical care and whether and in what circumstances professional associations ought to support the conscientious provision of abortion in circumstances where abortion is banned or heavily restricted. I have several reservations, however, about the argument developed in the article. First, the essay makes questionable use of the case of Savita Halappanavar to justify its central argument about conscientious provision. Second, there is an apparent inconsistency between this article and the authors’ (...) statements elsewhere about the conscientious refusal of care. Third, there are risks that attend to professional associations supporting practitioners who break the law, and yet Giubiliniet aldo not give sufficient attention to this. This response will briefly discuss these three concerns. (shrink)

One prominent view in recent literature on resource allocation is Persad, Emanuel and Wertheimer’s complete lives framework for the rationing of lifesaving healthcare interventions (CLF). CLF states that we should prioritise the needs of individuals who have had less opportunity to experience the events that characterise a complete life. Persadet alargue that their system is the product of a successful process of reflective equilibrium—a philosophical methodology whereby theories, principles and considered judgements are balanced with each other and revised until we (...) achieve an acceptable coherence between our various beliefs. Yet I argue that many of the principles and intuitions underpinning CLF conflict with each other, and that Persadet alhave failed to achieve an acceptable coherence between them. I focus on three tensions in particular: the conflict between the youngest first principle and Persadet al’s investment refinement; the conflict between current medical need and a concern for lifetime equality; and the tension between adopting an objective measure of complete lives and accommodating for differences in life narratives. (shrink)

Many ethicists argue that we should respect persons when we distribute resources. Yet it is unclear what this means in practice. For some, the idea of respect for persons is synonymous with the idea of respect for autonomy. Yet a principle of respect for autonomy provides limited guidance for how we should distribute scarce medical interventions. In this article, however, I sketch an alternative conception of respect for persons—one that is based on an ethic of mutual accountability. I draw in (...) particular upon Stephen Darwall’s writings on respect and the second-person standpoint. I consider the implications of this conception of respect for the distribution of scarce, lifesaving healthcare resources. A second-personal account of respect rules out aggregative approaches to distribution, and instead requires that we give individual consideration to the claims that persons in need make on the resources in our control. The principles that we use to govern our allocation of resources, furthermore, should be principles that are acceptable to all reasonable agents. Building on this insight, the final section of this paper considers how a principle of need can be used as a means to make decisions about the allocation of lifesaving resources. -/- . (shrink)

This book is centred around a traditional, vocational account of medical ethics – what is sometimes called a Hippocratic medical ethics but what Curlin and Tollefsen label ‘The Way of Medicine’. Th...

The book provides a detailed introduction to a major debate in bioethics, as well as a rigorous account of the role of conscience in professional decision-making. Exploring the role of conscience in healthcare practice, this book offers fresh counterpoints to recent calls to ban or severely restrict conscience objection. It provides a detailed philosophical account of the nature and moral import of conscience, and defends a prima facie right to conscientious objection for healthcare professionals. The book also has relevance to (...) broader debates about religious liberty and civil rights, such as debates about the rights and duties of persons and institutions who refuse services to clients on the basis of a religious objection. The book concludes with a discussion of how to regulate individual and institutional conscientious objection, and presents general principles for the accommodation of individual conscientious objectors in the healthcare system. This book will be of value to students and scholars in the fields of moral philosophy, bioethics and health law. (shrink)

Principlism is an ethical framework that has dominated bioethical discourse for the past 50 years. There are differing perspectives on its proper scope and limits. In this article, we consider to what extent principlism provides guidance for the abortion and euthanasia debates. We argue that whilst principlism may be considered a useful framework for structuring bioethical discourse, it does not in itself allow for the resolution of these neuralgic policy discussions. Scholars have attempted to use principlism to analyse the ethics (...) and legality of abortion and euthanasia; but such efforts are methodologically problematic. We close with a consideration of the proper scope of principlism in bioethics–a vision that is more modest than the manner in which principlism is often deployed in contemporary academic bioethics and medical education. (shrink)

Respect for patient autonomy is a central principle of medical ethics. However, there are important unresolved questions about the characteristics of an autonomous decision, and whether some autonomous preferences should be subject to more scrutiny than others. In this paper, we consider whether _inappropriately adaptive preferences_—preferences that are based on and that may perpetuate social injustice—should be categorised as autonomous in a way that gives them normative authority. Some philosophers have argued that inappropriately adaptive preferences do not have normative authority, (...) because they are only a reflection of a person’s social context and not of their true self. Under this view, medical professionals who refuse to carry out actions which are based on inappropriately adaptive preferences are not in fact violating their patient’s autonomy. However, we argue that it is very difficult to articulate a systematic and principled distinction between normal autonomous preferences and inappropriately adaptive preferences, especially if this distinction needs to be useful for clinicians in real-life situations. This makes it difficult to argue that inappropriately adaptive preferences are straightforwardly non-autonomous. Given this problem, we argue that there are significant theoretical issues with contemporary understandings of autonomy in bioethics. We discuss what this might mean for the practice of medicine and for medical ethics education. (shrink)

One objection to xenotransplantation is that it will require the large-scale breeding, raising and killing of genetically modified pigs. The pigs will need to be raised in designated pathogen-free facilities and undergo a range of medical tests before having their organs removed and being euthanised. As a result, they will have significantly shortened life expectancies, will experience pain and suffering and be subject to a degree of social and environmental deprivation. To minimise the impact of these factors, we propose the (...) following option for consideration—ethically defensible xenotransplantation should entail the use of genetic disenhancementifit becomes possible to do so and if that pain and suffering cannot be eliminated by other means. Despite not being a morally ideal ‘solution’, itismorally better to prevent unavoidable pain until a viable non-animal alternative becomes available. (shrink)

En enero de 1974 Zubiri dio un breve curso en la Sociedad de Estudios y Publicaciones de Madrid sobre el tema Tres dimensiones del ser humano: individual, social e histórica. Meses después publicó la última de esas lecciones bajo el título de La dimensión histórica del ser humano. El presente volumen recoge el texto de las tres conferencias, más la versión escrita de la última de ellas. La tesis que Zubiri desarrolla en estas lecciones es que el ser humano es (...) a la vez y necesariamente individual, social e histórico, y que estas dimensiones vienen exigidas por su propia realidad específica, que es pluralizante, continuante y prospectiva. (shrink)

En un diálogo continuo con la tradición filosófica, Zubiri va página a página describiendo el acto de la intelección humana y desmontando el cúmulo de hipótesis y teorías que subyacen al llamado «problema del conocimiento». Zubiri consigue descubrir, mediante el recurso a un procedimiento puramente descriptivo, en qué consiste el acto humano por excelencia, la intelección. La intelección humana, dice Zubiri, no es una síntesis trascendental, sino algo más simple a la vez que más radical, la mera actualización de lo (...) real en la inteligencia sentiente. (shrink)

This paper challenges arguments that systematic patterns of intelligent behavior license the claim that representations must play a role in the cognitive system analogous to that played by syntactical structures in a computer program. In place of traditional computational models, I argue that research inspired by Dynamical Systems theory can support an alternative view of representations. My suggestion is that we treat linguistic and representational structures as providing complex multi-dimensional targets for the development of individual brains. This approach acknowledges the (...) indispensability of the intentional or representational idiom in psychological explanation without locating representations in the brains of intelligent agents. (shrink)

This paper examines the logic of conditional obligation, which originates from the works of Hansson, Lewis, and others. Some weakened forms of transitivity of the betterness relation are studied. These are quasi-transitivity, Suzumura consistency, acyclicity and the interval order condition. The first three do not change the logic. The axiomatic system is the same whether or not they are introduced. This holds true under a rule of interpretation in terms of maximality and strong maximality. The interval order condition gives rise (...) to a new axiom. Depending on the rule of interpretation, this one changes. With the rule of maximality, one obtains the principle known as disjunctive rationality. With the rule of strong maximality, one obtains the Spohn axiom (also known as the principle of rational monotony, or Lewis’ axiom CV). A completeness theorem further substantiates these observations. For interval order, this yields the finite model property and decidability of the calculus. (shrink)

On sait que sur la question des pensées imperceptibles, Nicole, bientôt suivi par le bénédictin François Lamy, heurte l’opinion d’Arnauld. L’opposition d’Arnauld à Nicole touchant la question de la grâce est bien connue. C’est plutôt de l’originalité philosophique de Nicole qu’il s’agira dans ce travail. En tirant Nicole de « l’ombre d’Arnauld et de Pascal » et en lui faisant crédit d’une consistance spéculative propre, on retrouvera la finesse de sa psychologie, mais on découvrira également l’esquisse d’une subtile anthropologie.

Cogito, ergo sum. Ce n’est pas tiré de la plume de Descartes que cet énoncé apparaît pour la première fois dans les œuvres du philosophe. C’est en effet Caterus qui, dans la première série d’Objectiones aux Meditationes l’écrit, telle que la postérité scolaire va le considérer, comme un objet textuel autonome et digne par soi-même d’intérêt. Le fait est anecdotique, mais il est révélateur. D’abord parce que ce n’est pas Descartes qui a constitué...

Insurance is pervasive in many social settings. As a cooperative device based on risk pooling, it serves to attenuate the adverse consequences of various risks by offering policyholders coverage against the losses implied by adverse events in exchange for the payment of premiums. In the insurance industry, the concept of actuarial fairness serves to establish what could be adequate, fair premiums. Accordingly, premiums paid by policyholders should match as closely as possible their risk exposure. Such premiums are the product of (...) the probabilities of losses and the expected losses. This article presents a discussion of the fairness of actuarial fairness through three steps: defining the concept based on its formulation within the insurance industry; determining in which sense it may be about fairness; and raising some objections to the actual fairness of actuarial fairness. The necessity of a normative evaluation of actuarial fairness is justified by the influence of the concept on the current reforms of public insurance systems and the fact that it highlights the question of the repartition of the gains and burdens of social cooperation. (shrink)

The Statesman is a difficult and puzzling Platonic dialogue. In A Stranger's Knowledge Marquez argues that Plato abandons here the classic idea, prominent in the Republic, that the philosopher, qua philosopher, is qualified to rule. Instead, the dialogue presents the statesman as different from the philosopher, the possessor of a specialist expertise that cannot be reduced to philosophy. The expertise is of how to make a city resilient against internal and external conflict in light of the imperfect sociality of human (...) beings and the poverty of their reason. This expertise, however, cannot be produced on demand: one cannot train statesmen like one might train carpenters. Worse, it cannot be made acceptable to the citizens, or operate in ways that are not deeply destructive to the city's stability. Even as the political community requires his knowledge for its preservation, the genuine statesman must remain a stranger to the city. Marquez shows how this impasse is the key to understanding the ambiguous reevaluation of the rule of law that is the most striking feature of the political philosophy of the Statesman. The law appears here as a mere approximation of the expertise of the inevitably absent statesman, dim images and static snapshots of the clear and dynamic expertise required to steer the ship of state across the storms of the political world. Yet such laws, even when they are not created by genuine statesmen, can often provide the city with a limited form of cognitive capital that enables it to preserve itself in the long run, so long as citizens, and especially leaders, retain a “philosophical” attitude towards them. It is only when rulers know that they do not know better than the laws what is just or good (and yet want to know what is just and good) that the city can be preserved. The dialogue is thus, in a sense, the vindication of the philosopher-king in the absence of genuine political knowledge. (shrink)

‘Epistemic’ arguments for conservatism typically claim that given the limits of human reason, we are better off accepting some particular social practice or institution rather than trying to consciously improve it. I critically examine and defend here one such argument, claiming that there are some domains of social life in which, given the limits of our knowledge and the complexity of the social world, we ought to defer to those institutions that have robustly endured in a wide variety of circumstances (...) in the past while not being correlated with intolerable outcomes. These are domains of social life in which our ignorance of optimal institutions is radical, and there is uncertainty about the costs of error. This is an argument for the preservation of particular institutions, not particular policies or outcomes, and it specifically identifies these with the institutions that John Rawls called ‘the basic structure of society.’ The argument further implies that to the extent that there is any reason to change these institutions, changes should be calculated as far as possible to increase their ‘epistemic power.’. (shrink)

Cuerpo físico y cuerpo vivido no deben interpretarse como dos realidades separadas, sino que representan dos aspectos distintos de la misma experiencia corporal descrita en términos fenomenológicos. La experiencia de la corporalidad puede seguir dos direcciones: a) la primera es una dirección ascendente, que implica el desarrollo de las posibilidades de movimiento, acción y expresión del cuerpo en toda su plenitud; b) el otro camino o dirección, en contraste con el anterior, toma una senda descendente, y se halla estrechamente relacionado (...) con la experiencia del dolor, de la limitación, de la resistencia corporal que es experimentada como oposición a la propia voluntad: es el cuerpo vulnerable. Aquí reaparece un nuevo dualismo: el cuerpo poético de la expresión frente al cuerpo vulnerable de la enfermedad y el dolor. Mi contribución trata de cuestionar la idea de que el cuerpo poético de la expresión artística y el cuerpo vulnerable de la vejez, de la discapacidad o de la enfermedad, pertenezcan a esferas completamente separadas. Con este propósito, se intenta poner de relieve los múltiples puntos de intersección entre ambas perspectivas, al tiempo que se sostiene que tales intersecciones pueden llegar a ser interesantes puntos de partida de la investigación interdisciplinar. (shrink)

Scientific modelling is a value-laden process: the decisions involved can seldom be made using 'scientific' criteria alone, but rather draw on social and ethical values. In this paper, we draw on a body of philosophical literature to analyze a COVID-19 vaccination model, presenting a case study of social and ethical value judgments in health-oriented modelling. This case study urges us to make value judgments in health-oriented models explicit and interpretable by non-experts and to invite public involvement in making them.

Epistemic logic begins with the recognition that our everyday talk about knowing and believing has some systematic features that we can track and re‡ect upon. Epistemic logicians have studied and extended these glints of systematic structure in fascinating and important ways since the early 1960s. However, for one reason or another, mainstream epistemologists have shown little interest. It is striking to contrast the marginal role of epistemic logic in contemporary epistemology with the centrality of modal logic for metaphysicians. This article (...) is intended to help in correcting this oversight by presenting some important developments in epistemic logic and suggesting ways to understand their applicability to traditional epistemological problems. Obviously, by itself, tweaking the formal apparatus of epistemic logic does not solve traditional epistemological problems. Epistemic logic can help us to navigate through problems in a systematic fashion by unpacking the logic of the problematic concepts, it can also lead us to recognize problems that we had not anticipated. This is basically analogous to the role that modal logic has played in contemporary metaphysics. (shrink)