Consent ought to be required to withhold treatment that is in a patient’s best interests to receive. Do not resuscitate orders are examples of best interests assessments at the end of life. Such assessments represent value judgments that cannot be validly ascertained without patient input. If patient input results in that patient dissenting to the DNR order then individual physicians are not justified in overriding such dissent. To do so would give unjustifiable primacy to the values of the individual physician. (...) Therefore patient consent is effectively required to write a DNR order. Patient dissent to a DNR order should trigger a fair process mechanism to resolve the dispute. (shrink)

The risk that direct-to-consumer advertising of prescription pharmaceuticals (DTCA) may increase inappropriate medicine use is well recognized. The U.S. Food and Drug Administration addresses this concern by subjecting DTCA content to strict scrutiny. Its strictures are, however, heavily focused on the explicit claims made in commercials, what we term their “propositional content.” Yet research in social psychology suggests advertising employs techniques to influence viewers via nonpropositional content, for example, images and music. We argue that one such technique, evaluative conditioning, is (...) operative in DTCA. We further argue that evaluative conditioning fosters unjustified beliefs about drug safety and efficacy, antagonising the autonomy of viewers’ choices about advertised medicines. We conclude that current guidelines are deficient in failing to account for evaluative conditioning, and that more research and debate are needed to determine the permissibility of this and other forms of nonpropositional persuasion. (shrink)

Reflection Principles are commonly thought to produce only strong axioms of infinity consistent with V = L. It would be desirable to have some notion of strong reflection to remedy this, and we have proposed Global Reflection Principles based on a somewhat Cantorian view of the universe. Such principles justify the kind of cardinals needed for, inter alia , Woodin’s Ω-Logic.

Antidepressant medication and evidence-based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self-knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor-related decisions. (...) I further argue that such an effect comprises a compelling moral reason for doctors to see evidence-based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression. (shrink)

Evolutionary fitness threats and rewards are associated with subjectively unpleasant and pleasant sensations, respectively. Initially, these correlations appear explainable via adaptation by natural selection. But here I analyse the major metaphysical perspectives on consciousness – physicalism, dualism, and panpsychism – and conclude that none help to understand the adaptive-seeming correlations via adaptation. I also argue that a recently proposed explanation, the phenomenal powers view, has major problems that mean it cannot explain the adaptive-seeming correlations via adaptation either. So the mystery (...) – call it the evolutionary paradox of consciousness – remains. Some have used this mystery to argue for non-naturalistic (e.g. theistic) explanations. But I propose a naturalistic, non-adaptive explanation of the adaptive-seeming correlations: namely, ‘sensational associative learning’ during development. In this perspective, pairing of particular sensations with unconditioned stimuli – fitness rewards or threats – cause the sensations themselves to come to be interpreted as good or bad, respectively. Sensations, like colours, that are not reliably paired with either fitness rewards or threats remain largely unvalenced. Sensational associative learning also provides explanations for adaptive-seeming structural aspects of sensations, such as the observation that sounds of different pitch are experienced as ordinal in correspondence to their wavelengths while the same is not true of colours of different hue. The sensational associative learning perspective appears compatible with physicalism, panpsychism, and dualism (though not epiphenomenalism). (shrink)

A prime is a cue that makes associated concepts, behaviors, and goals more psychologically accessible to people, influencing their responses in subsequent related environments. I build a case that Direct to Consumer Advertising of Prescription Pharmaceuticals (DTCA) operates as a prime that causes some viewers to prefer and pursue the advertised drug. Drawing on literature from social psychology I show that people subject to priming are mostly unaware of its influence and liable to misattribute the reasons for their primed actions. (...) Misattribution typically includes heightened appraisals of the value of a primed goal. Consistent with this account, I argue that viewers primed by DTCA hold favorable, yet false beliefs about the safety and efficacy of the advertised drug. I further argue that, because those drug properties are material to viewers with the relevant illness, priming in DTCA can undermine the autonomy of their medicine choices. The threat to autonomy posed by priming in DTCA suggests it warrants attention from both regulators and the wider research community. It also adds further reason to be sceptical about the permissibility of this form of advertising. (shrink)

A central goal in regulating direct-to-consumer advertising of prescription pharmaceuticals is to ensure that explicit drug claims are truthful. Yet imagery can also alter viewer attitudes, and the degree to which this occurs in DTCA is uncertain. Addressing this data gap, we provide evidence that positive feelings produced by images can promote favourable beliefs about pharmaceuticals. We had participants view a fictitious anti-influenza drug paired with unrelated images that elicited either positive, neutral or negative feelings. Participants who viewed positive images (...) rated the influenza drug as significantly more effective, safe, and beneficial than did participants who viewed negative images. This effect, known as evaluative conditioning, is well described in experimental social psychology but has not previously been shown with pharmaceuticals. We discuss how evaluative conditioning in DTCA may compromise viewer autonomy, and canvass possible regulatory responses. (shrink)

We invoke a triple rationale to rebut Hooper and Spicer's argument against mandatory helmet laws. First, we use the laws of physics and empirical studies to show how bicycle helmets afford substantial protection to the user. We show that Hooper and Spicer erroneously downplay helmet utility and that, as a result, their attack on the utilitarian argument for mandatory helmet laws is weakened. Next, we refute their claim that helmet legislation comprises unjustified paternalism. We show the healthcare costs of bareheaded (...) riding to pose significant third party harms. It follows, we argue, that a utilitarian case for helmet laws can be sustained by appeal to Mill's Harm Principle. Finally, we reject Hooper and Spicer's claim that helmet laws unjustly penalise cyclists for their own health-affecting behaviour. Rather, we show their argument to suffer by disanalogy with medical cases where injustice may be more evident, for example, denial of bypass surgery to smokers. We conclude that mandatory helmet laws offer substantial utility and are entirely defensible within the framework of a liberal democracy. (shrink)

Advertisements for pharmaceuticals may promote placebo responses by generating an expectation of therapeutic success. Some cite this as reason to favour Direct to Consumer Advertising of Prescription Pharmaceuticals (DTCA). Against this, I show placebo responses to emanate from beliefs rendered unjustified by the influence of a conditioning process. I argue that drug safety and efficacy are material properties and that unjustified beliefs in these domains entail costs to autonomy that outweigh any prudential gains attending a placebo response. I conclude that (...) its placebogenic potential ought not to count as reason to favour DTCA. (shrink)

The doctrine of consent is built upon presumptions of mental capacity. Those presumptions must be tested according to legal rules that may be difficult to apply to COVID-19 patients during emergency presentations. We examine the principles of mental capacity and make recommendations on how to assess the capacity of COVID-19 patients to consent to emergency medical treatment. We term this the CARD approach.

Giubilini and Minerva argue that, in cases where in utero abortion is currently condoned, ‘after-birth abortion’, or infanticide, ought also to be permitted.1 For example, a third-trimester abortion might be defended on the basis of foetal genetic abnormality, or through appeal to unacceptable parental suffering should the child live. On the authors’ formulation, infanticide in neonates of the same corrected age, in otherwise identical circumstances, ought also to be defended. The paper has, unsurprisingly, provoked public criticism, and even revulsion. I (...) argue that the distress evoked is a moral consideration in its own right. Community interests ought to inform …. (shrink)

인간의 이성적 의식과 법의 관계를 밝히고 법의 해석 과 판단에 인간의 의식이 어떻게 작용하는가를 고찰 한 저술. 제1부에서는 법의 형이상학적인 측면에서 법의 실체, 그리스의 법, 데카르트의 법, 로크와 법, 칸트와 법, 헤겔과 법, 아담스미스의 법의 경제, 중국의 도덕과 법사상을 다루었다. 제2부에서는 심리학적 분석으로 헌법의 심리학적 해석, 법의 판결절차, 증거법, 형법과 죄, 청소년과 가족법, 조세법, 플라톤의 법, 칸트의 도덕론의 경험적 확인, 헤겔의 자아와 노동법, 법의 4차원에 대해 다뤘다.

Inleidend overzicht van de wijsgerige ethiek.

This influential study of Kant in which Strawson seeks to detach the true analytical and critical achievement of Kant's work from the unacceptable metaphysics with which it is entangled. This title available in eBook format. Click here for more information.Visit our eBookstore at: www.ebookstore.tandf.co.uk.

t. 1. Dialog s V. V. Davydovym -- t. 2. Nereshennye problemy razvivai︠u︡shchego obrazovanii︠a︡.

Together again for the first time, Marx and Durkheim join forces in the pages of Disintegration: Bad Love, Collective Suicide, and the Idols of Imperial Twilight for a dialectical exploration of the moral economy of neoliberalism, animated, as it is not only by the capitalist chase for surplus value, but also by an immortal vortex of sacred powers. Classical sociology and psychoanalysis are reconstituted within Hegelian social ontology and dialectical method that differentiates between the ephemeral and free and the eternal (...) and fixed aspects of modern life. (shrink)

George Berkeley is one of the greatest and most influential modern philosophers. In defending the immaterialism for which he is most famous, he redirected modern thinking about the nature of objectivity and the mind's capacity to come to terms with it. Along the way, he made striking and influential proposals concerning the psychology of the senses, the workings of language, the aims of science, and the scope of mathematics. In this Companion volume a team of distinguished authors not only examines (...) Berkeley's achievements but also his neglected contributions to moral and political philosophy, his writings on economics and development, and his defense of religious commitment and religious life. The volume places Berkeley's achievements in the context of the many social and intellectual traditions - philosophical, scientific, ethical, and religious - to which he fashioned a distinctive response. (shrink)

Doctors’ strikes are legally permissible in the UK, with the situation differing in other countries. But are they morally permissible? Doug McConnell and Darren Mann have systematically attempted to dismiss the arguments for the moral impermissibility of doctors’ strikes and creatively attempted to provide further moral justification for them. Unfortunately for striking doctors, they fail to achieve this. Meanwhile, junior doctors’ strikes have continued in the UK through 2023 and have now extended into 2024. In this response, which focuses on (...) the UK situation and specifically junior doctors’ strikes in the National Health Service (NHS) in England, I will demonstrate a central problem with their arguments—namely that they underplay the harms caused by prolonged doctors’ strikes by ignoring the harms to patients with cancer. This weakens their conclusion that strikes are morally permissible in terms of the conditions and thresholds they set. I then provide a psychological critique of their justification for strikes in terms of the interests of the public. It follows that invoking the controversial concept of supererogatory action is ungrounded but also absurd when you consider time-critical cancer care. If those representing striking doctors wish to maintain a modicum of moral respectability, they should mitigate for patients with cancer and negotiate reasonably and with urgency. (shrink)

The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between “scanning the body” and “sequencing the genome” from an ethical (...) perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate. (shrink)

The achievements of the textile industry in Roman Britain are often underestimated as a result of the meagreness of our available evidence. The Edict on maximum prices issued by Diocletian in A.D. 301 shows that British capes commanded high prices on the markets of the Empire, and that in the late third century A.D. British rugs were the best in the world. In view of the competition from the traditional centres of rug manufacture in the East, this is an astonishing (...) achievement. (shrink)

The received translation and interpretation of many of the technical terms current in the textile industry of the Roman Empire are inaccurate, because lexicographers have either fought shy of being precise, or have thought that they recognized in the ancient world technical processes which originated at a much later date. The evidence is often equivocal or insufficient, but may still yield details that have been overlooked. The textile expression scutulatus, to take an example, deserves more attention than Blümner has devoted (...) to it. When it refers to the appearance of a garment, Lewis and Short, s.v. scutulatus, translate ‘diamond or lozenge-shaped, checkered’. It seems worth while to attempt a more precise translation, and, if possible, to estimate the significance in context of the goods so designated. (shrink)

For Hume, one task of logic is “to explain the principles and operations of our reasoning faculties”; this chapter is a study of his logic of inductive reasoning, as presented in Book I of his Treatise and in the Enquiry Concerning Human Understanding. Like other early modern logics—especially those composed, as Hume’s was, under the influence of Locke—Hume’s logic is descriptive, explanatory, and normative. It also aspires to be revelatory. It is descriptive in documenting how our reasoning actually proceeds, explanatory (...) in telling us why it so proceeds, normative in telling us how it should proceed, and revelatory in using those findings to arrive at larger truths about human nature and human life. Hume formulates rules of inductive reasoning and ranks inductive arguments as better and worse. He also advocates the reform of intellectual disciplines. Yet his logic, it is argued, is at the same time deeply skeptical. (shrink)

The author argues that the core of Hume’s Academic skepticism lies in his commitment to an external world and objective causal powers that are cognitively opaque to human understanding. Three central topics of Hume’s theory of the understanding are discussed—the existence of absolute space, the existence of a world external to our senses, and the existence of objective causal powers. In each case, Hume draws a Pyrrhonian opposition between judgments based on his “Copy Principle” and the “fictions” or “illusions” formed (...) through association of ideas. While he suspends judgment concerning the existence of absolute space, he argues that the association-based beliefs in an external world and objective causal powers are necessary for human life and indispensible in science. In adopting such beliefs about external reality, while at the same time denying their intelligibility, Hume was following ancient Academic skepticism. (shrink)

There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice still requires (...) interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research. (shrink)

As family physicians, general practitioners play a key role in safeguarding children. Should they suspect child abuse or neglect they may experience a conflict between responding to the needs and interests of the child and those of an adult patient. English law insists on the paramountcy of the interests of the child, but in family practice many other interests may be at stake. The authors argue that uncritical adoption of the paramountcy principle is too simplistic and can lead, paradoxically, to (...) greater harm. They argue for a more subtle and nuanced view of interests and of conflicts of interest in safeguarding children. (shrink)