Although an invasive medical intervention, Deep Brain Stimulation (DBS) has been regarded as an efficient and safe treatment of Parkinson’s disease for the last 20 years. In terms of clinical ethics, it is worth asking whether the use of DBS may have unanticipated negative effects similar to those associated with other types of psychosurgery. Clinical studies of epileptic patients who have undergone an anterior temporal lobectomy have identified a range of side effects and complications in a number of domains: psychological, (...) behavioural, affective and social. In many cases, patients express difficulty adjusting from being chronically ill to their new status as ‘treated’ or ‘seizure free’. This postoperative response adjustment has been described in the literature on epilepsy as the ‘Burden of Normality’ (BoN) syndrome. Most of the discussion about DBS postoperative changes to self is focused on abnormal side effects caused by the intervention (ie, hypersexuality, hypomania, etc). By contrast, relatively little attention is paid to the idea that successfully ‘treated’ individuals might experience difficulties in adjusting to becoming ‘normal’. The purpose of this paper is (1) to articulate the postoperative DBS psychosocial adjustment process in terms of the BoN syndrome, (2) to address whether the BoN syndrome illustrates that DBS treatment poses a threat to the patient’s identity, and (3) to examine whether the current framework for rehabilitation after DBS procedures should be updated and take into account the BoN syndrome as a postoperative self-change response. (shrink)

This article offers a critique of Thomas Scanlon's well-known account of promissory obligation by reference to the rights of promisees. Scanlon's account invokes a moral principle, the "principle of fidelity". Now, corresponding to a promisor's obligation to perform is a promisee's right to performance. It is argued that one cannot account for this right in terms of Scanlon's principle. This is so in spite of a clause in the principle relating to the promisee's "consent", which might have been thought to (...) do the trick. Most likely this argument can be applied to all "moral principle" accounts of promissory obligation. An alternative both to these and to "social practice" accounts is needed. (shrink)

Mylan Engels paper (2004) is divided into two parts: a negative part, criticizing the costs of contextualism and a constructive part proposing a noncontextualist resolution of the skeptical problem. I will only address the constructive part here. The constructive part is composed of three elements: (i) a reconstruction or reformulation of the original skeptical argument, which draws on the notion of epistemic possibility (e-possibility), (ii) a distinction between two senses of knowledge (and two corresponding kinds of e-possibility): fallibilistic and infallibilistic, (...) and (iii) an argument which tries to hoist the skeptic by their own petard, namely the closure principle (CP). As I will argue, there are two ways to understand Engels anti-skeptical argument. Only in one interpretation does the argument depend on the proposed reconstruction of the skeptical argument in terms of e-possibility. But this version of the argument is unsound. More importantly, the skeptic has a strong prima facie objection at her disposal, which applies to both interpretations of the argument. If this objection is valid, Engels argument does not hold. But once it is invalidated, his argument is superfluous. (shrink)

Deep brain stimulation (DBS) is optimistically portrayed in contemporary media. This already happened with psychosurgery during the first half of the twentieth century. The tendency of popular media to hype the benefits of DBS therapies, without equally highlighting risks, fosters public expectations also due to the lack of ethical analysis in the scientific literature. Media are not expected (and often not prepared) to raise the ethical issues which remain unaddressed by the scientific community. To obtain a more objective portrayal of (...) DBS in the media, a deeper collaboration between the science community and journalists, and particularly specialized ones, must be promoted. Access to databases and articles, directly or through science media centers, has also been proven effective in increasing the quality of reporting. This article has three main objectives. Firstly, to explore the past media coverage of leukotomy, and to examine its widespread acceptance and the neglect of ethical issues in its depiction. Secondly, to describe how current enthusiastic coverage of DBS causes excessive optimism and neglect of ethical issues in patients. Thirdly, to discuss communication models and strategies to enhance media and science responsibility. (shrink)

I have a long-standing relation with the noun “technoscience.” In recent years, I have been concerned with its evolution and connotations, since the period when I first thought it up. This chapter presents a survey of the various uses, transfers and significations of the term. It makes a twofold claim technoscientific research and development are conducted by a plural subject in need of a moral conscience; the study of technoscientific objects requires a methodological and operational materialism.Augmented version for this volume (...) of an essay first published in French Regards sur les technosciences, Vrin, Paris, pp. 23–38, 2006). Translation by John Stewart, University of Technology Compiègne. (shrink)

Jay Coen Gilbert, co-founder of B Lab, discusses his vision for a “new economy” where business is a “force for good.” In this interview, Coen Gilbert provides an overview of how B Lab’s various initiatives—Certified B Corporations, the B Impact Assessment, B Analytics, GIIRS, and Benefit Corporations—function interdependently to accelerate a culture shift to redefine success in business. Coen Gilbert then focuses on the role of benefit corporations in this larger movement. The benefit corporation is a new (...) legal form of business that requires a corporate purpose dedicated to “general public benefit” and the delivery of demonstrable “material positive impact on society and the environment.” Novel fiduciary and reporting requirements differentiate the benefit corporation from the traditional corporation founded on shareholder primacy. Coen Gilbert explains how the benefit corporation is better suited to create long-term shareholder value as well as sustainable value for society, the environment, and other stakeholders. He addresses critiques of and challenges to the benefit corporation as an agent of change for business. (shrink)

The Convention for the Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Medicine is now one of the most important bioethics texts from the point of view of international policy and law. It is the result of five years of discussions and negotiations between the different instances of the Council of Europe. In this article I analyze several problems. First, there are problems of articulation between the Convention and the joint (...) Explanatory Report. The oriented exegesis of the Explanatory Report raises suspicion about the Convention, which appears as a smooth façade for an instrument actually serving ideological positions many people do not share. Second, there are problems of formulation within the Convention. These are mainly problems with articles that state prohibitions without any distinction, relativization, contextualization or sense of evolution. Finally, there are problems of substance, leading to the conclusion that the Convention is not a good illustration of the human rights philosophical tradition in the name of which it has been proclaimed. This tradition is the one of Enlightenment. And when Kant summarizes the motto of Enlightenment, the injunction is "Sapere Aude!": "Dare to know!" It is difficult to hear such a message through the Convention, and the Explanatory Report includes too many passages and sentences that mean the opposite. (shrink)

In essays written throughout his career, Stanley Hauerwas has unfolded a Christian vision of the marriage bond and the presence of children that seeks insistently to place these seemingly natural bonds within the new family of God that is the church. I examine his understanding, aiming to appreciate the Christian vision displayed while also suggesting that his emphasis on the new thing God does in the church is sometimes allowed to absorb and thereby lose the distinctive significance of the created (...) bonds of marriage and family. (shrink)

Le présent ouvrage a pour fins de : clarifier l'origine du terme "technoscience" et l'évolution de son usage. Rendre accessible un texte fondateur qui n'avait jamais encore été publié intégralement : Philosophie et futur (1976). Encourager la lecture et l'étude de la science-fiction, passée et actuelle, en raison de sa pertinence pour le questionnement et la réflexion philosophiques. Illustrer l'intérêt de la notion de technoscience comme outil heuristique pour la lecture critique de la science-fiction. [ed.].

L'histoire de la philosophie voit d'abord en Hobbes un spécialiste de la philosophie politique, au point qu'on en oublie souvent l'importance du reste de son oeuvre. Sans doute, il n'est pas faux d'insister sur la contribution hobbienne à la philosophie politique. Et de l'avis de Hobbes lui-même, c'est dans ce domaine qu'il avait été particulièrement novateur. Cependant, son ambition était plus large: il voulait construire un système entier de philosophie, dont la politique ne devait représenter que la dernière partie. En (...) effet, selon l'ordre de sa grande oeuvre, les Eléments de la philosophie, l'exposé du système total se divisait en trois grands livres: Du corps, De l'homme et Du citoyen. Apparemment, le système devait donc se composer des trois parties suivantes: une physique, une anthropologie et une science politique. En fait, le premier volume, sur le corps, comporte également la méthodologie, la logique et la philosophie première. La division en trois a pourtant sa vérité, et même une vérité troublante si l'on prend au sérieux la volonté hobbienne de constituer un système rigoureux dans lequel les sciences de l'homme et de la politique résulteraient de celle des corps en général, en ce sens du moins que les dernières sciences supposeraient les principes des premières. Car il semble que Hobbes ait admis une certaine autonomie des trois grandes parties de son système, au point que, par exemple, la politique paraît pouvoir trouver son propre fondement en elle-même, sans référence particulière aux développements de la physique. (shrink)

Purpose With the increasing sophistication of neuroimaging technologies in medicine, new language is being sought to make sense of the findings. The aim of this paper is to explore whether the brain-reading metaphor used to convey current medical or neurobiological findings imports unintended significations that do not necessarily reflect the genuine findings made by physicians and neuroscientists. Methods First, the paper surveys the ambiguities of the readability metaphor, drawing from the history of science and medicine, paying special attention to the (...) sixteenth through nineteenth centuries. Next, the paper addresses more closely the issue of how metaphors may be confusing when used in medicine in general, and neuroscience in particular. The paper then explores the possible misleading effects associated with the contemporary use of the brain-reading metaphor in neuroimaging research. Results Rather than breaking new ground, what we see in current scientific language is a persistence of both a constraining and expansive set of language practices forming a relatively continuous tradition linking current neuroimaging to past scientific investigations into the brain. Conclusions The use of the readability metaphor thus carries with it both positive and negative effects. Physicians and neuroscientists must resort to the use of terms already laden with abstracted meanings, and often burdened by tradition, at the risk of importing through these words connotations that do not tally with the sought-after objectivity of empirical science. (shrink)

The purpose of this commentary is to address an ethical issue introduced by Walter Glannon regarding whether responsibility can be affected by the use of performance enhancing drugs. Glannon uses the example of a surgeon taking drugs to enhance her capacities. I explore whether conducting surgeries while under the influence of performance enhancing drugs will affect the surgeon’s responsibility for performing more surgeries ‘and’ the surgeon’s responsibility for assuming the consequences of performing these surgeries. Here, the ‘and’ is cumulative: one (...) is responsible for performing ‘and’ one is responsible for having taken performance enhancing drugs. Given that such accumulation could be interpreted as “more responsible”, this might challenge Glannon’s conclusion and impact the normative practices associated with enhancement drugs. (shrink)

This paper brings to the attention of the reader some examples of how the words of the Qur’an, when examined in their literal sense, appear to connect with languages or cultures other than those acknowledged by traditional Muslim apologetics. As such, they may be echoing origins that these apologetics have dismissed from their discourse. In fact, whereas traditional exegesis has generally tended to limit the Qur’an exclusively to the Arabic language as sufficient guarantee by itself of its authenticity, the words (...) of the text reveal a linguistic and cultural multiplicity which demonstrates the richness of its roots. In pursuing this repression exerted on outside contextual influences, the author focuses on three avenues: the pre-Islamic culture of the nomadic Arabs, the Judeo-Christian culture and the Hellenic culture. Those languages which go wilfully unrecognized, those practices whose recollection is passed over, prove to be of great assistance to understanding the sense of certain verses of the Qur’an. (shrink)

The shape of the moral life is determined for Christians at least in part by beliefs peculiar to Christians, and a perennial problem for Christian ethics is relating that peculiar understanding to more general claims about moral knowledge. Since the problem is perennial, I propose not to solve it but to think about it. I do so by considering first the sense in which Christian ethics may be a kind of "insider's" ethic-the shared language of believers. Despite the strengths of (...) such a view, it may too greatly restrict both human and divine freedom. Having considered its difficulties from both those angles, I return to the sense of Christian life as a tradition of conduct in order to illustrate the importance of such a vision in our cultural setting. (shrink)