Neither of the two central moral and political obstacles to human embryonic stem cell research survives critical scrutinyThis paper argues that neither of the two central moral and political obstacles to human embryonic stem cell research survives critical scrutiny: first, that derivation of HESCs requires the destruction of human embryos which are full human persons or are at least deserving of respect incompatible with their destruction; second, that creation of HESCs using somatic cell nuclear transfer or cloning is immoral. First, (...) different sources of HESCs are distinguished and the distinct moral objections that might apply to each. Second, it is argued that none of the properties plausibly conferring personhood on an entity is possessed by human embryos, and then shown how destruction of an embryo for research with the prospect of important medical benefits can be compatible with respecting it. Third, it is shown that the main objection to human cloning is only to reproductive cloning and that the objection to creating human beings with the intention of destroying them does not apply to SCNT. Finally, the concern that acquiring human eggs for SCNT would involve exploiting women donors is addressed, and it is shown how that can be avoided.Human embryonic stem cell research has become one of the more politically and morally controversial issues of our time. There is wide variability in what HESC research, if any, is permitted in countries around the world. Within the United States HESC research was a major issue in the last presidential election and some states, such as California, are devoting substantial public monies to fund this research while others prohibit it. In this paper I will explore some of the main obstacles to reaching consensus on this issue in the hope of at least narrowing the disagreement …. (shrink)

There are substantial data establishing that surrogates are often mistaken in predicting what treatments incompetent patients would have wanted and that supplements such as advance directives have not resulted in significant improvements. Rid and Wendler’s Patient Preference Predictor (PPP) proposal will attempt to gather data about what similar patients would prefer in a variety of treatment choices. It accepts the usual goal of patient autonomy and the Substituted Judgment principle for surrogate decisions. I provide reasons for questioning sole reliance on (...) autonomy when surrogates, not patients, are deciding and for giving some independent weight to patient well-being. Moreover, that family members, typical surrogates, will know best what the patient if incompetent would have wanted is not the only reason why they are chosen. The more pressing problem is that the PPP would fail to remove the more serious mistakes that empirical psychology over the last few decades has shown to infect such decision making. (shrink)

The ethical implications of the growth of for-profit health care institutions are complex. Two major moral criticisms of for-profit medicine are analyzed. The first claim is that for-profit health care institutions fail to fulfill their obligations to do their fair share in providing health care to the poor and so exacerbate the problem of access to health care. The second claim is that profit seeking in medicine will damage the physician-patient relationship, creating conflicts of interest that will diminish the quality (...) of care and erode patients' trust in their physicians and the public's trust in the medical profession. The authors conclude that while the continued expansion of for-profit health care may exacerbate in some respects problems of access, trust and conflicts of interest, it is a mistake to consider these problems as unique to for-profit health care; they are problems for not for-profit health care as well. Though these issues justify continuing moral concern, they do not at this time provide decisive grounds for substantially curbing or eliminating for-profit enterprise in health care. (shrink)

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

Conventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life-sustaining treatment from the forbidden practice of active euthanasia by means of a lethal injection. When clinicians justifiably withdraw life-sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a lethal dose of medication. We argue that the differential moral assessment of these two practices (...) is based on a series of moral fictions – motivated false beliefs that erroneously characterize withdrawing life-sustaining treatment in order to bring accepted end-of-life practices in line with the prevailing moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end-of-life decisions is radically mistaken. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

There has been a good deal of interest in recent years in what Franz Brentano had to say about the notion of ‘intentional objects’ and about intentionality as a criterion of the mental. There has been less interest in his classification of mental phenomena. In his Psychology from an Empirical Standpoint Brentano asserts and argues for the thesis that mental phenomena can be classified in terms of three kinds of mental act or activity, all of which are directed towards an (...) immanent object. These are, respectively, presentation, judgment and what he calls the phenomena of love and hate. Once again, less interest has been shown in what he has to say about the last of these three than in what he says about the others. I wish to take Brentano's views as the point of departure for a discussion of love and hate, since these notions seem to me to have a good deal of philosophical interest, for at least two main reasons. First, I have recently had some concern with the part that personal relations play in our understanding of others and of ourselves, and love and hate seem to be very important elements in such relations. Second, love and hate have long seemed to me to provide important counter-examples to some prevalent philosophical theories about the emotions. I shall take this issue first. (shrink)

Human aesthetic experiences are pervasive; they are triggered by faces, art, natural scenery, foods, ideas, theories, and decision-making situations, among many sources, and seem to be a distinctive trait of our species. Our moral sense, understood as our capacity to judge events, actions, or people as good or bad, appropriate or inappropriate, also seems to be an exclusively human endowment (Ayala 2010). As part of the scientific efforts to characterize the biological foundations of our human uniqueness, recently there has been (...) interest in the brain’s underpinnings of aesthetic reactions to art on the one hand, and in the neural correlates of moral judgment and decision-making on the other (Greene and Paxton .. (shrink)

The book attempts, in as comprehensive a way as possible, to make clear the central issues for the theory of knowledge, so as to provide a framework for that subject and also to indicate something of the way in which, as the author believes, the issues should be faced.

Social scientists could learn some useful things from philosophy. Here I shall discuss what I take to be one such thing: a better understanding of the concept of utility. There are several reasons why a better understanding may be useful. First, this concept is commonly found in the writings of social scientists, especially economists. Second, utility is the main ingredient in utilitarianism, a perspective on morality that, traditionally, has been very influential among social scientists. Third, and most important, with a (...) better understanding of utility comes, as I shall try to show here, a better understanding of “personal welfare”. or, in other words, of what may be said to be in people's best interests. Such an understanding is useful to social scientists and philosophers alike, whether for utilitarian purposes or not. (shrink)

This book is available either individually, or as part of the specially-priced Arguments of the Philosphers Collection.

Is it possible to do something intentionally and yet be unconscious of so doing? Many philosophers would answer ‘No’ to this question on the grounds that it is of the essence of intention that if we do something intentionally we do it knowing what we are doing.

It is through our actions that we affect the way the world goes. Whenever we face a choice of what to do, we also face a choice of which of various possible worlds to actualize. Moreover, whenever we act intentionally, we act with the aim of making the world go a certain way. It is only natural, then, to suppose that an agent's reasons for action are a function of her reasons for preferring some of these possible worlds to others, (...) such that what she has most reason to do is to bring about the possible world which, of all those available to her, is the one that she has most reason to want to obtain. This is what is known as the `teleological conception of practical reasons'. Whether this is the correct conception of practical reasons is important not only in its own right, but also in virtue of its potential implications for what sort of moral theory we should accept. Below, I argue that the teleological conception is indeed the correct conception of practical reasons. (shrink)

There have in recent years been at least two important attempts to get to grips with Aristotle's conception of dialectic. I have in mind those by Martha C. Nussbaum in ‘Saving Aristotle's appearances’, which is chapter 8 of her The Fragility of Goodness, and by Terence H. Irwin in his important, though in my opinion somewhat misguided, book Aristotle's First Principles. There is a sense in which both of these writers are reacting to the work of G. E. L. Owen (...) on cognate matters, particularly his well-known paper ‘Tithenai ta phainomena’. Owen himself was in part reacting to what I suppose is the traditional view of how Aristotle regarded dialectic, as revealed in Topics I. 1. On that view dialectic is for Aristotle a lesser way of proceeding than is demonstration, the method of science. For demonstration proceeds from premises which are accepted as true in themselves and moves from them to conclusions which follow necessarily from those premises; and the middle term of such a demonstrative syllogism then provides the ‘reason why’ for the truth of the conclusion. Dialectic proceeds from premises which are accepted on a lesser basis ‘by everyone or by the majority or by the wise, i.e. by all, or by the majority, or by the most notable and reputable of them’, and proceeds deductively from them to further conclusions. (shrink)

To those who think that an institution must be a function of its history it must seem a considerable anomaly that when universities were first set up in the Middle Ages their main aim, apart from being communities of scholars, was to produce theologians, lawyers and doctors of medicine. For arts and what then had some connection with what we now know as science, as incorporated in the traditional seven liberal arts of grammar, logic and rhetoric, followed by arithmetic, geometry, (...) music and astronomy, were thought of as merely propaedeutic to the study of theology, law and medicine. Those seven liberal arts occupied the student during the course for the B.A., which gave the licence to teach, and some students went no further than that. But the main concern of a university lay in what happened after the B.A., in the attainment of a mastership or in what was in effect the doctorate in one of the three areas which I have mentioned before. Indeed, in some universities, particularly those in the south of Europe, the B.A. was given only scant attention and only lip service was given to the idea of liberal arts. (shrink)