This paper explores the ethical and conceptual implications of the findings from an empirical study (reported elsewhere) of decision-making capacity in anorexia nervosa. In the study, ten female patients aged thirteen to twenty-one years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semistructured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient-participants were also tested using the (...) MacArthur Competence Assessment Tool—Treatment test of competence. This is a formalized, structured, interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief, self-administered questionnaires to assess their levels of psychopathology. The issues identified from the interviews are described under two headings: difficulties with thought processing and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Studying Penguins to Understand BirdsJacinta O. A. Tan (bio), Anne Stewart (bio), Ray Fitzpatrick (bio), and Tony Hope (bio)Keywordsanorexia nervosa, treatment decision-making, competence, valuesWe are grateful to Grisso, Appelbaum, Charland, and Vollmann for their thoughtful commentaries on our paper. We would like to respond by picking up on some of the points they make, although we do not address all the issues raised.Our general aims in the (...) paper are less immediately pragmatic than are the central concerns of Grisso and Appelbaum. Our interest is primarily in a number of ethical, and related conceptual, issues that arise from empirical data. In the long run, of course, we believe that these ethical and conceptual issues are important to the care of people with mental disorders, but our focus is philosophical.Our central interest is what justifies overriding treatment refusal. We are unhappy with a "status" approach according to which, for example, the mere fact that a person suffers a mental disorder provides grounds for overriding her wishes. Such an approach, it seems to us, fails to identify reasons, and discriminates against those with mental disorder, a view shared by the Law Commission (The Law Commission 1995). We are, on the other hand, attracted by the approach that grounds any overriding of treatment refusal on lack of capacity (or competence) to make treatment decisions. The concept of capacity has been well developed through legal cases and conceptual analysis, not least by Grisso and Appelbaum themselves. We were struck, however, first through clinical experience, and subsequently from the pilot study reported in our paper, that many patients with anorexia nervosa who refuse treatment do not necessarily lack capacity, using the current criteria, and yet show features or give reasons that raise serious doubts as to whether it is right to respect their refusal of treatment.To avoid reliance on a "status" approach, the issue with which we are grappling is whether the concept of capacity (and therefore lack of capacity) can be developed to encompass some of our findings, and whether it is ethically right to do so. Charland makes the important point that the concept of competence, or capacity, has both a descriptive and a prescriptive component. It is for this reason that the question of whether, for example, we should extend the criteria for capacity is part of the question of when it is morally right to override treatment refusal.Grisso and Appelbaum suggest that our work advances "our thinking about appreciation, rather than requiring that we add new elements" (2006, 297). From our perspective, and at this stage, it is a secondary issue whether we are suggesting a development of appreciation, or a new element (e.g., "pathological values"). The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in [End Page 299] such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests.We chose to study anorexia nervosa for various reasons, but we expect that the issues raised have a more general relevance (such as to substance abuse and impulse control disorders as Grisso and Appelbaum and Charland suggest). We do not expect the results to be relevant to all, or even most, mental disorders. Our main interest is not the specific management of people with anorexia, but how the data challenge, and help to develop, the concept of capacity, and the ethical analysis of overriding patient refusal of treatment. Our paper aims to address what we understand Charland to be referring to by the "pretheoretical desiderata" (2006, 283) of the concept of capacity. One reason why we chose anorexia as the focus of this work is because it is different from many mental disorders in the issues that it raises. In this it is, perhaps, rather like studying penguins to better understand the concept of bird just because penguins, although clearly birds, have unusual features.We agree, therefore, with Grisso and Appelbaum's caution that it would be unwise to jump in and change the MacCAT-T on the basis of the results... (shrink)

It feels like there’s two of you inside—like there’s another half of you, which is my anorexia, and then there’s the real K [own name], the real me, the logic part of me, and it’s a constant battle between the two. The anorexia almost does become part of you, and so in order to get it out of you I think you do have to kind of hurt you in the process. I think it’s almost inevitable. We came to the (...) concept of authenticity belatedly, one might say. We had been talking to people who had a diagnosis of anorexia nervosa about their experiences of living with their condition, and though we had not raised issues of authenticity or identity ourselves, they often did. They struggled with questions of .. (shrink)

This article represents the outcome of a dialogue between a vet and a healthcare ethicist on the theme of ‘love’ in professional life. We focus on four types or varieties of love in relation to the professional care of humans and animals. We discuss the relevance of Fromm’s core elements of love and consider the implications of these for human and animal health care practice. We present and respond to five arguments that might be waged against embracing love as a (...) professional value in veterinary and medical practice. We argue that a moderated love can and should be reclaimed as a contemporary professional value. It is most helpfully contextualised within virtue ethics or care ethics. We suggest that love is a rich starting point from which to launch an exploration of an interprofessional humanimal clinical ethics. (shrink)

Intent and mitigating circumstances play a central role in moral and legal assessments in large-scale industrialized societies. Al- though these features of moral assessment are widely assumed to be universal, to date, they have only been studied in a narrow range of societies. We show that there is substantial cross-cultural variation among eight traditional small-scale societies (ranging from hunter-gatherer to pastoralist to horticulturalist) and two Western societies (one urban, one rural) in the extent to which intent and mitigating circumstances influence (...) moral judgments. Although participants in all societies took such factors into account to some degree, they did so to very different extents, varying in both the types of considerations taken into account and the types of violations to which such considerations were applied. The particular patterns of assessment characteristic of large-scale industrialized societies may thus reflect relatively recently culturally evolved norms rather than inherent features of human moral judgment. (shrink)

Decades of research conducted in Western, Educated, Industrialized, Rich, & Democratic (WEIRD) societies have led many scholars to conclude that the use of mental states in moral judgment is a human cognitive universal, perhaps an adaptive strategy for selecting optimal social partners from a large pool of candidates. However, recent work from a more diverse array of societies suggests there may be important variation in how much people rely on mental states, with people in some societies judging accidental harms just (...) as harshly as intentional ones. To explain this variation, we develop and test a novel cultural evolutionary theory proposing that the intensity of kin-based institutions will favor less attention to mental states when judging moral violations. First, to better illuminate the historical distribution of the use of intentions in moral judgment, we code and analyze anthropological observations from the Human Area Relations Files. This analysis shows that notions of strict liability—wherein the role for mental states is reduced—were common across diverse societies around the globe. Then, by expanding an existing vignette-based experimental dataset containing observations from 321 people in a diverse sample of 10 societies, we show that the intensity of a society's kin-based institutions can explain a substantial portion of the population-level variation in people's reliance on intentions in three different kinds of moral judgments. Together, these lines of evidence suggest that people's use of mental states has coevolved culturally to fit their local kin-based institutions. We suggest that although reliance on mental states has likely been a feature of moral judgment in human communities over historical and evolutionary time, the relational fluidity and weak kin ties of today's WEIRD societies position these populations' psychology at the extreme end of the global and historical spectrum. (shrink)

Assessing Biblical and Classical Sources for the Reconstruction of Persian Influence, History and Culture. Edited by Anne Fitzpatrick-Mckinley. Classica et Orientalia, vol. 10. Wiesbaden: Harrassowitz Verlag, 2015. Pp. 216. €52.

It is commonly accepted – not only in the philosophical literature but also in daily life – that ignorance is a failure of some sort. As a result, a desideratum of any ontological account of ignorance is that it must be able to explain why there is something wrong with being ignorant of a true proposition. This article shows two things. First, two influential accounts of ignorance – the Knowledge Account and the True Belief Account – do not satisfy this (...) requirement. They fail to provide a satisfying normative account of the badness of ignorance. Second, this article suggests an alternative explanation of what makes ignorance a bad cognitive state. In a nutshell, ignorance is bad because it is the manifestation of a vice, namely, of what Cassam calls “epistemic insouciance”. (shrink)

Is morality uniquely human or does morality exist in at least some non-human animals? Are animals full-fledged moral creatures or do they merely exhibit proto-morality—evolutionary building blocks or precursors to morality, but not quite the genuine article? Such questions, prompted by remarkable advances in empirical research into the social and emotional lives of non-human animals, have aroused much recent interest amongst scientists, philosophers, and in the popular media, not least for their apparent bearing on questions of human uniqueness, evolution, and (...) the ethical status of animals. The debate over animal morality has produced many valuable contributions and stimulated new areas for empirical and theoretical research. However, focusing on these questions has led researchers to talk at cross-purposes and down some unproductive paths. The problem concerns the terms ‘morality’ and ‘moral’. (shrink)

Following recent arguments that cultural practices in wild animal populations have important conservation implications, we argue that recognizing captive animals as cultural has important welfare implications. Having a culture is of deep importance for cultural animals, wherever they live. Without understanding the cultural capacities of captive animals, we will be left with a deeply impoverished view of what they need to flourish. Best practices for welfare should therefore require concern for animals’ cultural needs, but the relationship between culture and welfare (...) is also extremely complex, requiring us to rethink standard assumptions about what constitutes and contributes to welfare. (shrink)

Empirical studies of the social lives of non-human primates, cetaceans, and other social animals have prompted scientists and philosophers to debate the question of whether morality and moral cognition exists in non-human animals. Some researchers have argued that morality does exist in several animal species, others that these species may possess various evolutionary building blocks or precursors to morality, but not quite the genuine article, while some have argued that nothing remotely resembling morality can be found in any non-human species. (...) However, these different positions on animal morality generally appear to be motivated more by different conceptions of how the term “morality” is to be defined than by empirical disagreements about animal social behaviour and psychology. After delving deeper into the goals and methodologies of various of the protagonists, I argue that, despite appearances, there are actually two importantly distinct debates over animal morality going on, corresponding to two quite different ways of thinking about what it is to define “morality”, “moral cognition”, and associated notions. Several apparent skirmishes in the literature are thus cases of researchers simply talking past each other. I then focus on what I take to be the core debate over animal morality, which is concerned with understanding the nature and phylogenetic distribution of morality conceived as a psychological natural kind. I argue that this debate is in fact largely terminological and non-substantive. Finally, I reflect on how this core debate might best be re-framed. (shrink)

‘To Gödel via Babel’, MIND, July 1966.In (1), the last clause should read: ‘then the GN of the resulting P-sentence is x100.y’ In (21), the expression in Roman numerals should read: ‘$$Y.\frac{\hbox{ L }Y}{\hbox{ XIX }}$$’ In (25) and (27), the expression in Roman numerals should read: ‘$${(\hbox{ C }}^{\hbox{ XVII }}.\hbox{ D })\hbox{ . }\frac{\hbox{ L }\left({\hbox{ C }}^{\hbox{ XVII }}.\hbox{ D }\right)}{\hbox{ XIX }}$$’.

This article is a critical examination of two distinct linguistic approaches to religion. the first employs the principle that peripheral uses of words are parasitic on their central uses to exclude religious language on grounds of a-typicality. this is criticized on grounds that meaning of words is not simply given in language but tied to understanding or explanatory framework. hence a-typicality objections lose force. the second, represented by d z phillips, immunizes religious language against outside criticism by claiming its criteria (...) of intelligibility to be internal. this claim is argued against by means of contradiction between phillips' content and performance; claim to philosophical neutrality is also questioned. (shrink)

Dans la genese de sa constitution, la philosophie n'a pu faire l'economie d'une confrontation avec la musique qui fournissait aux anciens Grecs les schemes fondamentaux de la culture. De cette confrontation Platon est le temoin. Scindant la musique, il privilegie l'Harmonique, qui en est la partie theorique, sans toutefois lui reconnaitre la titre de science supreme. Correlativement, il condamne comme dysharmonie, tumulte fracassant et perturbateur de l'ordre cosmique, l'harmonie chromaticiste dont il s'emploie, non sans paradoxe, a decrire le detail. Par (...) cette lecture en filigrane des Dialogues de Platon, l'auteur se propose de reconstruire la pensee qui procede de l'harmonie chromaticiste et de montrer son importance dans l'elaboration de la philosophie fondatrice. Au carrefour des disciplines du savoir antique, ce livre s'adresse non seulement aux philosophes, mais aussi a tous ceux qui, musiciens ou stylisticiens, s'interessent a la forme musicale. (shrink)

_Foucault’s Law_ is the first book in almost fifteen years to address the question of Foucault’s position on law. Many readings of Foucault’s conception of law start from the proposition that he failed to consider the role of law in modernity, or indeed that he deliberately marginalized it. In canvassing a wealth of primary and secondary sources, Ben Golder and Peter Fitzpatrick rebut this argument. They argue that rather than marginalize law, Foucault develops a much more radical, nuanced and (...) coherent theory of law than his critics have acknowledged. For Golder and Fitzpatrick, Foucault’s law is not the contained creature of conventional accounts, but is uncontainable and illimitable. In their radical re-reading of Foucault, they show how Foucault outlines a concept of law which is not tied to any given form or subordinated to a particular source of power, but is critically oriented towards alterity, new possibilities and different ways of being. _Foucault’s Law_ is an important and original contribution to the ongoing debate on Foucault and law, engaging not only with Foucault’s diverse writings on law and legal theory, but also with the extensive interpretive literature on the topic. It will thus be of interest to students and scholars working in the fields of law and social theory, legal theory and law and philosophy, as well as to students of Foucault’s work generally. (shrink)

Social norms – rules governing which behaviours are deemed appropriate or inappropriate within a given community – are typically taken to be uniquely human. Recently, this position has been challenged by a number of philosophers, cognitive scientists, and ethologists, who have suggested that social norms may also be found in certain non-human animal communities. Such claims have elicited considerable scepticism from norm cognition researchers, who doubt that any non-human animals possess the psychological capacities necessary for normative cognition. However, there is (...) little agreement among these researchers about what these psychological prerequisites are. This makes empirical study of animal social norms difficult, since it is not clear what we are looking for and thus what should count as behavioural evidence for the presence (or absence) of social norms in animals. To break this impasse, we offer an approach that moves beyond contested psychological criteria for social norms. This approach is inspired by the animal culture research program, which has made a similar shift away from heavily psychological definitions of ‘culture’ and to become organized around a cluster of more empirically tractable concepts of culture. Here, we propose an analogous set of constructs built around the core notion of a normative regularity, which we define as a socially maintained pattern of behavioural conformity within a community. We suggest methods for studying potential normative regularities in wild and captive primates. We also discuss the broader scientific and philosophical implications of this research program with respect to questions of human uniqueness, animal welfare and conservation. (shrink)

Human communities teem with a variety of social norms. In order to change unjust and harmful social norms, it is crucial to identify the psychological processes that give rise to them. Most researchers take it for granted that social norms are uniquely human. By contrast, we approach this matter from a comparative perspective, leveraging recent research on animal social behaviour. While there is currently only suggestive evidence for norms in nonhuman communities, we argue that human social norms are likely produced (...) by a wide range of mechanisms, many of which we share with nonhuman animals. Approaching this variability from a comparative perspective can help norm researchers expand and reframe the range of hypotheses they test when attempting to understand the causes of socially normative behaviours in humans. First, we diagnose some of the theoretical obstacles to developing a comparative science of social norms, and offer a few basic constructs and distinctions to help norm researchers overcome these obstacles. Then we develop a six-dimensional model of the psychological and social factors that contribute to variability in both human and potential nonhuman norms. -/- This article is part of the theme issue ‘Social norm change: drivers and consequences’. (shrink)

Investigating the theoretical and empirical relationships between transparency and trust in the context of surveillance, this volume argues that neither transparency nor trust provides a simple and self-evident path for mitigating the negative political and social consequences of state surveillance practices. Dominant in both the scholarly literature and public debate is the conviction that transparency can promote better-informed decisions, greater oversight, and restore trust damaged by the secrecy of surveillance. The contributions to this volume challenge this conventional wisdom by considering (...) how relations of trust and policies of transparency are modulated by underlying power asymmetries, socio-historical legacies, economic structures, and institutional constraints. They study trust and transparency as embedded in specific socio-political contexts to show how, under certain conditions, transparency can become a tool of social control that erodes trust, while mistrust-rather than trust-can sometimes offer the most promising approach to safeguarding rights and freedom in an age of surveillance. The first book addressing the inter-relationship of trust, transparency, and surveillance practices, this volume will be of interest to scholars and students of surveillance studies as well as appeal to an interdisciplinary audience given the contributions come from political science, sociology, philosophy, law, and civil society. (shrink)

Background Community advisory boards have expanded beyond high-income countries and play an increasing role in low- and middle-income country research. Much research has examined CABs in HICs, but less is known about CABs in LMICs. The purposes of this scoping review are to examine the creation and implementation of CABs in LMICs, including identifying frequently reported challenges, and to discuss implications for research ethics. Methods We searched five databases for publications describing or evaluating CABs in LMICs. Two researchers independently reviewed (...) articles for inclusion. Data related to the following aspects of CABs were extracted from included publications: time, country, financial support, research focus, responsibilities, and challenges. Thematic analyses were used to summarize textual data describing challenges. Results Our search yielded 2005 citations, 83 of which were deemed eligible for inclusion. Most studies were published between 2010 and 2017. Upper-middle-income countries were more likely to have studies describing CABs, with South Africa, China, and Thailand having the greatest numbers. The United States National Institutes of Health was the main source of financial support for CABs. Many CABs focused on HIV research. Thirty-four studies reported how CABs influenced the informed consent process for clinical trials or other aspects of research ethics. CAB responsibilities were related to clinical trials, including reviewing study protocols, educating local communities about research activities, and promoting the ethical conduct of research. Challenges faced by CABs included the following: incomplete ethical regulations and guidance; limited knowledge of science among members of communities and CABs; unstable and unbalanced power relationships between researchers and local communities; poor CAB management, including lack of formal participation structures and absence of CAB leadership; competing demands for time that limited participation in CAB activities; and language barriers between research staff and community members. Several challenges reflected shortcomings within the research team. Conclusions Our findings examine the formation and implementation of CABs in LMICs and identify several ethical challenges. These findings suggest the need for further ethics training among CAB members and researchers in LMICs. (shrink)

Pionnière dans la pénalisation du viol en 1980, la France a été en eurocrime qu’aurait entraîné l’unanimité dans l’acceptation de la nouvelle définition proposée par la Commission européenne. L’absence de consentement devient finalement pour tous le critère principal, et de nombreux pays ont aligné récemment leur législation avec la directive européenne. Sur le droit à l’avortement, la convergence est moins sensible, plusieurs pays mettent d’importantes restrictions. La constitutionnalisation de la liberté d’avorter et de sa garantie en France va peut-être conduire (...) à son inscription dans les droits humains. (shrink)

Objective—To identify and describe the current state of clinical ethics support services in the UK.Design—A series of questionnaire surveys of key individuals in National Health Service (NHS) trusts, health authorities, health boards, local research ethics committees and health professional organisations. Interviews with chairmen/women of clinical ethics committees identified in the surveys.Setting—The UK National Health Service.Results—Responses to the questionnaires were received from all but one NHS trust and all but one health authority/board. A variety of models of clinical ethics support were (...) identified including twenty formal clinical ethics committees (CECs). A further twenty NHS trusts expressed an intention to establish a CEC within the next twelve months. Most CECs in the UK have been in existence less than five years and are still defining their role. The chairmen identified education of committee members and contact with other ethics committees as important requirements for committee development. Problems were identified around lack of support for the committee and with raising the profile of the committee within the institution. There has been little evaluation of clinical ethics support services either in the UK or in other countries with longer established services. What evaluation has occurred has focused on process rather than outcome measures.Conclusions—Clinical ethics support services are developing in the UK. A number of issues have been identified that need to be addressed if such support services are to develop effectively. (shrink)

Kline's evolutionary analysis of teaching provides welcome reframing for cross-species comparisons. However, theory based on competition cannot explain the transmission of human cultural elements that were collectively created. Humans evolved in a cultural niche andteaching-learningcoevolved to transmit culture. To study human cultural variation in teaching, we need a more articulated theory of this distinctively human engagement.