Mammals have an XX:XY system of chromosomal sex determination in which a small heterochromatic Y controls male development. The Y contains the testis determining factor SRY, as well as several genes important in spermatogenesis. Comparative studies show that the Y was once homologous with the X, but has been progressively degraded, and now consists largely of repeated sequences as well as degraded copies of X linked genes. The small original X and Y have been enlarged by cycles of autosomal addition (...) to one partner, recombination onto the other and continuing attrition of the compound Y. This addition–attrition hypothesis predicts that the pseudoautosomal region of the human X is merely the last relic of the latest addition. Genes (including SRY) on the conserved or added region of the Y evolved functions in male sex determination and differentiation distinct from the general functions of their X‐linked partners. Although the gonadogenesis pathway is highly conserved in vertebrates, its control has probably changed radically and rapidly in vertebrate – even mammalian – evolution. (shrink)

The molecular mechanism of temperature‐dependent sex determination (TSD) is a long‐standing mystery. How is the thermal signal sensed, captured and transduced to regulate key sex genes? Although there is compelling evidence for pathways via which cells capture the temperature signal, there is no known mechanism by which cells transduce those thermal signals to affect gene expression. Here we propose a novel hypothesis we call 3D‐TSD (the three dimensions of thermolabile sex determination). We postulate that the genome has capacity to remodel (...) in response to temperature by changing 3D chromatin conformation, perhaps via temperature‐sensitive transcriptional condensates. This could rewire enhancer–promoter interactions to alter the expression of key sex‐determining genes. This hypothesis can accommodate monogenic or multigenic thermolabile sex‐determining systems, and could be combined with upstream thermal sensing and transduction to the epigenome to commit gonadal fate. (shrink)

Comparative mapping and sequencing show that turnover of sex determining genes and chromosomes, and sex chromosome rearrangements, accompany speciation in many vertebrates. Here I review the evidence and propose that the evolution of therian mammals was precipitated by evolution of the male‐determining SRY gene, defining a novel XY sex chromosome pair, and interposing a reproductive barrier with the ancestral population of synapsid reptiles 190 million years ago (MYA). Divergence was reinforced by multiple translocations in monotreme sex chromosomes, the first of (...) which supplied a novel sex determining gene. A sex chromosome‐autosome fusion may have separated eutherians (placental mammals) from marsupials 160 MYA. Another burst of sex chromosome change and speciation is occurring in rodents, precipitated by the degradation of the Y. And although primates have a more stable Y chromosome, it may be just a matter of time before the same fate overtakes our own lineage. (shrink)

Wynn's claims are, in principle, entirely reasonable; although, as always, the devil is in the details. With respect to Wynn's discussion of the cultural evolution of artifactual symmetry, we provide a few more arguments for the utility of mirror symmetry and extend the enquiry into the tacit and explicit processing of natural and artifactual symmetry.

Neuroimaging has provided insight into numerous neurological disorders in children, such as epilepsy and cerebral palsy. Many clinicians and investigators believe that neuroimaging holds great promise, especially in the areas of behavioral and cognitive disorders. However, concerns about the risks of various neuroimaging modalities and the potential for misinterpretation of imaging results are mounting. Imaging evaluations also raise questions about stigmatization, allocation of resources, and confidentiality. Children are particularly vulnerable in this milieu and require special attention with regards to safety (...) guidelines and modality adaptations. This article examines pediatric neuroimaging practice through an ethics lens. Most authors in the field of neuroethics focus on the future concerns of neuroimaging. In contrast, our paper examines ethical matters surrounding current clinical applications in the pediatric population. We first provide a brief overview of the neuroimaging technologies most commonly used in a pediatric clinical context and then discuss a variety of ethical issues arising from the use of these technologies. (shrink)

In order to illuminate the potential harms of MRI research, we present data obtained by examining MRI research proposal files that had been submitted for review to several Canadian Research Ethics Boards. The data reveal that REB review of the studies contained omissions, considerable variability, and sometimes confusion regarding MRI research risks and risk classification. If our findings reflect the general state of REB review of MRI research in Canada and elsewhere, there is a pressing need for REBs to be (...) educated about MRI risks in order to responsibly facilitate the disclosure of these research risks in consent forms and during the consent process. Developing a standard template consent form that discloses MRI research risks might be a way to ensure attention to and disclosure of risks. (shrink)

We outline some ways in which motor neglect (the underutilization of a limb despite adequate strength) and hysterical paralysis (failure to move a limb despite no relevant structural damage or disease) may throw light on the pathophysiology of catatonia. We also comment on the manifold inadequacies of distinguishing too firmly between symptoms of “neurologic origin” and of “psychiatric origin.”.

Current medical genetics research is dominated by a single theory that supports the Human Genome Project rationale. This thesis investigates this and several alternative hypotheses and the ethical context related to their development. Firstly, the hypotheses are discussed in detail followed by a subsection in which research evidence based on each hypothesis is cited. Secondly, these medical genetics hypotheses are situated within the contemporary medical paradigm. To conclude, the thesis examines in depth the ethical and practical implications of medical genetics (...) research. A framework of analysis of scientific responsibility is used to explore these implications. Scientific responsibility, as presented in this thesis, is a process consisting of three steps: scientific discourse; the development of the nature of scientific responsibility; and, effective criticism. Once scientific responsibility is defined, the term is applied specifically to the field of medical genetics research. (shrink)

Many opinions and ideas about aging exist. Biological theories have taken hold of the popular and scientific imagination as potential answers to a “cure” for aging. However, it is not clear what exactly is being cured or whether aging could be classified as a disease. Some scientists are convinced that aging will be biologically alterable and that the human lifespan will be vastly extendable. Other investigators believe that aging is an elusive target that may only be “statistically” manipulatable through a (...) better understanding of the operational principles of systems situated within complex environments. Not only is there confusion over definitions but also as to the safety of any potential intervention. Curing cell death, for example, may lead to cell cancer. The search for a cure for aging is not a clearly beneficial endeavour. This paper will first, describe contemporary ideas about aging processes and second, describe several current life extension technologies. Third, it analyses these theories and technologies, focusing on two representative and differing scientific points of view. The paper also considers the public health dilemma that arises from life extension research and examines two issues, risk/benefit ratio and informed consent, that are key to developing ethical guidelines for life extension technologies. (shrink)

Community engagement has been recognised as an important aspect of the ethical conduct of biomedical research, especially when research is focused on ethnically or culturally distinct populations. While this is a generally accepted tenet of biomedical research, it is unclear what components are necessary for effective community engagement, particularly in the context of genomic research in Africa.

In this paper, we first briefly describe neuroimaging technology, our reasons for studying magnetic resonance imaging (MRI) technology, and then provide a discussion of what we have identified as priority issues for paediatric MRI research. We examine the issues of respectful involvement of children in the consent process as well as privacy and confidentiality for this group of MRI research participants. In addition, we explore the implications of unexpected findings for paediatric MRI research participants. Finally, we explore the ethical issues (...) concerning advances in functional MRI. This paper aims to provide a clear description of priority paediatric MRI research ethics issues to make some preliminary recommendations regarding next steps. (shrink)

Ideas of racial genetic determinism, though unsupported by scientific evidence and atavistic, are common and readily apparent in American medical education. These theories of biologic essentialism have documented negative effects in learners, including increased measures of racial prejudice.

In his latest book, Marshall Gregory begins with the premise that our lives are saturated with stories, ranging from magazines, books, films, television, and blogs to the words spoken by politicians, pastors, and teachers. He then explores the ethical implication of this nearly universal human obsession with narratives. Through careful readings of Katherine Anne Porter's "The Grave," Thurber's "The Catbird Seat," as well as _David Copperfield_ and _Wuthering Heights_, Gregory asks the question: How do the stories we absorb in (...) our daily lives influence the kinds of persons we turn out to be? "__Shaped by Stories___ _weaves its own compelling story about the pervasive ethical effects of reading narrative, with Marshall Gregory serving as a highly engaging and ethically admirable narrator--a very model of good company." --_James Phelan, Distinguished University Professor of English, Ohio State University_ "Marshall Gregory's __Shaped by Stories_ _brings ethical criticism to the level of felt experience. Witty and passionate, full of personal reflections and sharp examples, this book will help anyone who has been drawn to the mysterious power of stories to think more carefully about the connections between narrative art and human ethos. Gregory reminds us that the urgency of our need for stories is tied permanently to the need to exercise judgment, belief, and empathy in the process of becoming who we are." --_Annette Federico, James Madison University _ "From a lifetime of reflecting on the ethics of fiction, Marshall Gregory has given us an elegant analysis of the power of stories to instruct and delight. No one interested in storytelling will want to be without this incisive guide to both the myriad ways that stories shape our lives and the strategies writers use to affect our responses. Both the theoretical and practical halves of __Shaped by Stories __have clarity and eloquence." --_Robert D. Denham, Fishwick Professor of English, Emeritus, Roanoke College_. (shrink)

This book was inspired originally by the debates at the turn of the century about placebo controlled trials of antiretrovirals in HIV positive pregnant women in developing countries. Moving forward from this one limited example, the book includes several additional controversial cases of clinical research conducted in developing countries, and asks probing philosophical questions about the ethics of such trials. All clinical research by its very nature uses people to acquire generalizable knowledge to help future people. But what sorts of (...) "use" are morally permissible? What is it to exploit people? Suppose that a trial conducted in a developing country would not be ethically permissible in the developed world. Can we automatically conclude from this that the trial is unethical, that some sort of morally problematic double standard is in operation? Or might the differences in the two settings justify differences in trial design? This collection of philosophical essays examines these important questions about what exploitation is and when clinical research counts as exploitative. -/- "This is an outstanding contribution to the growing literature on the ethics of research with human subjects and a fine example of what bioethics can offer at its best. Anyone with a serious interest in these issues will need to read this book from start to finish." -Daniel Wikler, Harvard School of Public Health "This book contributes significantly to the literature on exploitation in clinical research conducted in the developing world."--Patricia Marshall, Case Western Reserve University . (shrink)

In this brief piece, Jennifer McErlean comments on Kevin Elliott’s thesis that we should decrease or even cease philosophical efforts to build more inclusive biocentric ethical accounts and instead increase efforts to build indirect anthropocentric arguments. While McErlean agrees that it is sensible to marshal a multiplicity of standpoints to strengthen policies that protect the natural world, she disagrees that philosophers no longer need to consider whether nature has intrinsic value. Two specific criticisms are offered. One is that indirect (...) arguments are utilitarian and ethicists ought not to limit themselves a morality of consequences. The second is that underlying principles will make a difference, so that even if anthropocentric arguments currently converge with biocentric ones, we should not anticipate this will continue in future instances. (shrink)

This study explored relations between willingness to disclose in 5 psychotherapy scenarios and 2 independent variables. Scenarios involved suicidal, gravely disabled, physically abusive, and sexually abusive patients, and a police officer patient who shot a suspect. For each of the 5 scenarios, participants in the privilege condition had significantly higher willingness-to-disclose scores than participants in the no-privilege condition. There were no significant differences between willingness-to-disclose scores of participants with and without therapy experience; neither was there a significant interaction between privilege (...) condition and therapy experience. Privilege condition was more predictive of willingness to disclose than personal characteristics or therapy experience. Results provide empirical support for the U.S. Supreme Court's recognition of the psychotherapist-patient privilege in Jaffee v. Redmond. (shrink)

Melanie presented at twenty weeks of gestation to an obstetrics clinic in a critical access hospital in rural Vermont. She was excited to undergo routine fetal ultrasonography, but her obstetrician gave her grave news: the ultrasound revealed hypoplastic left heart syndrome, a devastating congenital heart defect. Initially, Melanie agreed in general to pursue surgical care for her fetus—a three‐stage process that has somewhat uncertain results and could only be done in tertiary care facilities far from her home in Vermont. A (...) week later, while the maternal fetal medicine and pediatric cardiology units made arrangements with colleagues in Boston, Melanie began having second thoughts. An ethics meeting was called to discuss conflicting clinician reactions to Melanie's dilemma. Most of the clinicians were stunned that the patient would change her mind. What advice should the ethics consultant offer the team about caring for Melanie? (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Environment 7.1 (2002) 147-153 [Access article in PDF] Book Review Rattling the Cage: Toward Legal Rights for Animals Rattling the Cage: Toward Legal Rights for Animals Steven M. Wise. Foreward by Jane Goodall. Cambridge, Mass.: Perseus Books, 2000. pp. 384. US $17.50. ISBN 0-7382-0437-4 (Paperback) "Ancient philosophers claimed that all nonhuman animals had been designed and placed on this earth just for human beings. Ancient jurists (...) declared that law had been created just for human beings. Although philosophy and science have long since recanted, the law has not." Steven M. Wise, Rattling the Cage, p. 4. Readers of this journal are well-versed in the myriad ways in which nonhuman animals are harmfully exploited at the hands of human beings—from battery hens and veal calves to mass-produced pigs; from Pennsylvania pigeon shoots to canned hunts on Texas ranches; from rodeos to roadside zoos; from LD-50 toxicity tests on rats and Draize eye tests on rabbits to head trauma and infectious disease experimentation on primates. Despite other sticking points, it is by now uncontroversial among [End Page 147] nonanthropocentric theorists that, in utilitarian terms, the benefits to humans of the above practices fall far short of justifying the harms they cause to their nonhuman victims or, in deontological terms, that they violate the rights of creatures with inherent value. Indeed, these arguments are so well-rehearsed and so widely regarded as compelling that it no longer seems particularly bold to predict that if reason ever prevails over tradition and prejudice, the future will look back on this generation's treatment of our fellow creatures with the same kind of shame and condemnation with which European Americans regard our slaveholding past.More sobering but equally familiar is the observation that decisive arguments for the gross immorality of existing practices will bring about neither their elimination nor significant reform as long as the presumed legitimacy of human exploitation of nonhuman beings remains entrenched in both popular consciousness and economic, political, and legal institutions. In the interests of chipping away at popular apathy, academics should no doubt go on repeating the well-worn arguments against speciesism in classrooms, popular venues, and professional research. But in a world structured far more directly by the interests of a powerful few than by the values of the many, this consciousness-raising strategy properly plays at most a supporting role to the even more vital project of challenging and ultimately restructuring the institutions that sanction and carry out these injustices. In short, what nonhuman animals need from ethically sensitive intellectuals is not just rational argument, but effective legal and political action.One of the main institutional obstacles to progress in this area is undoubtedly the legal relegation of animals to property status—which is why Steve M. Wise's Rattling the Cage: Toward Legal Rights for Animals is such an important book. Wise teaches animal rights law at Harvard, Vermont, and John Marshall Law Schools and has spent more than twenty years fighting for animals in the legal system; his book displays the bittersweet fruit of that experience. The tenor throughout is a mixture of conviction in the justice of his cause—which cannot but sustain a vision of its eventual success—together with the frustration and determined patience borne from decades of butting up against an utterly implacable wall. An eloquent foreword by Jane Goodall, together with Wise's own harrowing first chapter, describe the nightmarish existences imposed on our nearest nonhuman relatives, the chimpanzees and bonobos, for the sake of science, entertainment, and profit—nightmares enabled by a legal system that [End Page 148] treats all nonhumans as mere things. An engaging storyteller with a synthetic conception of the history of ideas, Wise unearths the origins of this conception of animals in the Great Chain of Being, demonstrates its defeat by Darwinian science, and builds piece by piece a case—drawing heavily on research into animal consciousness—for extending legal rights at least to chimpanzees and bonobos.The substantive theses of this case are, first, that the denial of... (shrink)

Metamorphoses of the Zoo marshals a unique compendium of critical interventions that envision novel modes of authentic encounter that cultivate humanity's biophilic tendencies without abusing or degrading other animals. These take the form of radical restructurings of what were formerly zoos or map out entirely new, post-zoo sites or experiences. The result is a volume that contributes to moral progress on the inter-species front and eco-psychological health for a humankind whose habitats are now mostly citified or urbanizing.

We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad and The (...) Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)

This essay will focus on the moral issues relating to surrogacy in the global context, and will critique the liberal arguments that have been offered in support of it. Liberal arguments hold sway concerning reproductive arrangements made between commissioning couples from wealthy nations and the surrogates from socioeconomically weak backgrounds that they hire to do their reproductive labor. My argument in this paper is motivated by a concern for controlling harms by putting the practice of globalized commercial surrogacy into the (...) context of care ethics. As I will argue, the unstable situations into which children of global surrogacy arrangements are born is symbolic of the crisis of care that the practice raises. Using the Baby Manji case as my touch point, I will suggest that liberalism cannot address the harms experienced by Manji and children like her who are created through the global practice of assisted reproductive technology. I will argue that, if commissioning couples consider their proposed surrogacy contracts from a care ethics point of view, they will begin to think relationally about their actions, considering the practice from an ethical lens, not just an economic or contractual one. (shrink)

The ethical naturalist asks us to take seriously the idea that practical norms are a species of natural norms, such that moral goodness is a kind of natural goodness. The ethical naturalist has not demonstrated, however, how it is possible for a power of reason to be governed by natural norms, because her own attempts to do this have led her into a dilemma. If she takes the first horn and stresses that ethical naturalism provides objective, natural norms of the (...) species, then she fails to show how such norms are practical, or operative from a deliberative point of view. If she takes the second horn and stresses that ethical naturalism yields a picture of knowledge of human life that is practical because it comes through virtuous dispositions of intellect and will, then she fails to have an account of how it is knowledge of facts about a life form, potentially accessible to a non-human knower. In this paper, I argue that one potential resolution to this dilemma can be found in the writings of Thomas Aquinas. On a broadly Thomist account of practical reason, the first principles of practical reason are our common human ends or goods, which are constitutive of a good human life. The work of practical reason on this naturalistic account is twofold: to conceive and order these ends into some general conception of how to live, and to apply this general conception to the particular situations of one’s life in order to realize one’s vision of the good life, here and now. (shrink)

This paper treats the political and ethical issues associated with the new caretaking technologies. Given the number of feminists who have raised serious concerns about the future of care work in the United States, and who have been critical of the degree to which society “free rides” on women's caretaking labor, I consider whether technology may provide a solution to this problem. Certainly, if we can create machines and robots to take on particular tasks, we may lighten the care burden (...) that women currently face, much of which is heavy and repetitious, and which results in injury and care “burnout” for many female caretakers. Yet, in some contexts, I argue that high-tech robotic care may undermine social relationships, cutting individuals off from the possibility of social connectedness with others. (shrink)

Very little research into women farmers in developed countries has been produced by economists, but much of what has been studied by scholars in other disciplines has economic implications. This article reviews such research produced by scholars in all disciplines to explore to what extent women farmers are becoming more equal to men farmers and to suggest further contributions to the literature. As examples, topics that has been widely researched in developing countries but have received almost no attention in developed (...) countries include comparisons of men and women farmers’ productivity and their access to and use of resources. Discoveries in these and other areas will be important not only for their insights into the agricultural industry in developed countries, but also because they will inform, and be informed by, research on women farmers in developing countries. (shrink)

Augustine famously claimed that the virtues of pagan Rome were nothing more than splendid vices. This critique reinvented itself as a suspicion of acquired virtue as such, and true Christian virtue has, ever since, been set against a false, hypocritical virtue alleged merely to conceal pride. _Putting On Virtue_ reveals how a distrust of learned and habituated virtue shaped both early modern Christian moral reflection and secular forms of ethical thought. Jennifer Herdt develops her claims through an argument of (...) broad historical sweep, which brings together the Aristotelian tradition as taken up by Thomas Aquinas with the early modern thinkers who shaped modern liberalism. In chapters on Luther, Bunyan, the Jansenists, Mandeville, Hume, Rousseau, and Kant, she argues that efforts to make a radical distinction between true Christian virtue and its tainted imitations actually created an autonomous natural ethics separate from Christianity. This secular value system valorized pride and authenticity, while rendering graced human agency less meaningful. Ultimately, _Putting On Virtue_ traces a path from suspicion of virtue to its secular inversion, from confession of dependence to assertion of independence. (shrink)

This essay revisits Elizabeth Anscombe's ‘Modern Moral Philosophy' with two goals in mind. The first is to recover and reclaim its radical vision, by setting forth a unified account of its three guiding theses. On the interpretation advanced here, Anscombe's three theses are not independently intelligible; their underlying unity is the perceived necessity of absolute prohibitions for any sound account of practical reason. The second goal is to show that Anscombe allows for a thoroughly unmodern sense of ‘moral' that applies (...) to human actions; the paper concludes with some reasons to think that this unmodern sense of ‘moral' is worthy of further philosophical attention and defense. (shrink)

Augustine famously claimed that the virtues of pagan Rome were nothing more than splendid vices. This critique reinvented itself as a suspicion of acquired virtue as such, and true Christian virtue has, ever since, been set against a false, hypocritical virtue alleged merely to conceal pride. _Putting On Virtue_ reveals how a distrust of learned and habituated virtue shaped both early modern Christian moral reflection and secular forms of ethical thought. Jennifer Herdt develops her claims through an argument of (...) broad historical sweep, which brings together the Aristotelian tradition as taken up by Thomas Aquinas with the early modern thinkers who shaped modern liberalism. In chapters on Luther, Bunyan, the Jansenists, Mandeville, Hume, Rousseau, and Kant, she argues that efforts to make a radical distinction between true Christian virtue and its tainted imitations actually created an autonomous natural ethics separate from Christianity. This secular value system valorized pride and authenticity, while rendering graced human agency less meaningful. Ultimately, _Putting On Virtue_ traces a path from suspicion of virtue to its secular inversion, from confession of dependence to assertion of independence. (shrink)

Introduction -- From paideia to humanism -- Pietism and the problem of human craft (Menschen-Kunst) -- The harmonious harp-playing of humanity: J. G. Herder -- Ethical formation and the invention of the religion of art -- The rise of the Bildungsroman and the commodification of literature -- Authorship and its resignation in Goethe's Wilhelm Meister -- "The Bildung of self-consciousness itself towards science": Hegel.

Behavioural evidence suggests that cephalopod molluscs may have a form of primary consciousness. First, the linkage of brain to behaviour seen in lateralization, sleep and through a developmental context is similar to that of mammals and birds. Second, cephalopods, especially octopuses, are heavily dependent on learning in response to both visual and tactile cues, and may have domain generality and form simple concepts. Third, these animals are aware of their position, both within themselves and in larger space, including having a (...) working memory of foraging areas in the recent past. Thus if using a ‘global workspace’ which evaluates memory input and focuses attention is the criterion, cephalopods appear to have primary consciousness. (shrink)

Neoliberal cultural frames of individual choice inform mothers’ accounts of why they refuse state-mandated vaccines for their children. Using interviews with 25 mothers who reject recommended vaccines, this article examines the gendered discourse of vaccine refusal. First, I show how mothers, seeing themselves as experts on their children, weigh perceived risks of infection against those of vaccines and dismiss claims that vaccines are necessary. Second, I explicate how mothers see their own intensive mothering practices—particularly around feeding, nutrition, and natural living—as (...) an alternate and superior means of supporting their children’s immunity. Third, I show how they attempt to control risk through management of social exposure, as they envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable. Finally, I examine how these mothers focus solely on their own children by evaluating—and often rejecting—assertions that their choices undermine community health, while ignoring how their children benefit from the immunity of others. By analyzing the gendered discourse of vaccines, this article identifies how women’s insistence on individual maternal choice as evidence of commitment to their children draws on and replicates structural inequality in ways that remain invisible, but affect others. (shrink)

In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also (...) have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann’s notion of “holding” persons’ identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this “holding” work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be “held” in place. (shrink)

This paper applies a relational and familial ethic to address concerns relating to nursing home deaths and advance care planning during Covid‐19 and beyond. The deaths of our elderly in nursing homes during this pandemic have been made more complicated by the restriction of visitors even at the end of life, a time when families would normally be present. While we must be vigilant about preventing unnecessary deaths caused by coronavirus outbreaks in nursing homes, some deaths of our elders are (...) inevitable. Thus, it is essential that advanced care planning occurs in a way that upholds the familial and relational aspects of elders’ lives that often matter to them the most. We invoke concepts from feminist ethicists like Hilde Lindemann and Eva Kittay and introduce Avery Weisman and Thomas Hackett’s concept of “appropriate death” to suggest better ways of planning for those deaths of our elderly that cannot be avoided. Our hope is to allow for deaths that are as meaningful as possible for both the elderly and the family members who survive them. (shrink)

The perennial appeal of Kantian ethics surely lies in its conception of autonomy. Kantianism tells us that the good life is fundamentally about acting in accordance with an internal rather than an external authority: a good will is simply a will in agreement with its own rational, self-constituting law. In this paper, I argue against Kantian autonomy, on the grounds that it excessively narrows our concept of the good, it confuses the difference between practical and theoretical modes of knowing the (...) good, and it cannot respect the essential efficacy of the principles of practical reason. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

Are women's requests for aid in dying honored more often than men's, or less? Feminist arguments can support conclusions either that gendered perceptions of women as self‐sacrificing predispose physicians to accede to women's requests to die — or that cultural understandings of women as not fully rational agents lead physicians to reject their requests as irrational.

Constitutivism locates the ground of practical normativity in features constitutive of rational agency and rests on the concept of a constitutive norm – a norm that is internal to a thing such that...

One of the ethical issues that has been raised recently regarding emerging neurotherapies is that people will be coerced explicitly or implicitly in the workplace or in schools to take cognitive enhancing drugs. This article builds on this discussion by showing how the law may pressure people to adopt emerging neurotherapies. It focuses on a range of private law doctrines that, unlike the criminal law, do not come up very often in neuroethical discussions. Three doctrines—the doctrine of mitigation, the standard (...) of care in negligence, and child custody determinations in family law—are addressed to show how the law may pressure people to consent to treatment by offering a choice between accepting medical treatment and suffering a legal disadvantage. The doctrines considered in this article apply indirect pressure to submit to treatment, unlike court-ordered medical treatment, which applies direct pressure and is not addressed here. The outcome of this discussion is to show that there is a greater range of social pressures that may encourage the uptake of novel neurotherapies than one might initially think. Once treatments that were developed and offered with therapeutic benefits in mind become available, their existence gives rise to unintended legal consequences. This certainly does not mean we should cease developing new therapies that may be of tremendous benefit to patients, but it does raise some questions for physicians and for legal policy-makers. How should physicians, who are required by medical ethical principles to obtain valid consent to treatment, react to a patient’s reluctant consent that is driven by legal pressure? From the legal policy perspective, are our legal doctrines satisfactory or should they be changed because, for example, they unduly promote the collective interest over individual freedom to reject medical treatment or because they channel us toward economically efficient treatments to the detriment of more costly but potentially superior approaches of dealing with behavioural problems? (shrink)

Tool use research has suffered from a lack of consistent theoretical frameworks. There is a plethora of tool use definitions and the most widespread ones are so inclusive that the behaviors that fall under them arguably do not have much in common. The situation is aggravated by the prevalence of anecdotes, which have played an undue role in the literature. In order to provide a more rigorous foundation for research and to advance our understanding of the interrelation between tool use (...) and cognition, we suggest the adoption of Fragaszy and Mangalam's (2018) tooling framework, which is characterized by the creation of a body-plus-object system that manages a mechanical interface between tool and surface. Tooling is limited to a narrower suite of behaviors than tool use, which might facilitate its neurocognitive investigation. Indeed, evidence in the literature indicates that tooling has distinct neurocognitive underpinnings not shared by other activities typically classified as tool use, at least in primates. In order to understand the extent of tooling incidences in previous research, we systematically surveyed the comprehensive tool use catalog by Shumaker et al. (2011). We identified 201 tool use submodes, of which only 81 could be classified as tooling, and the majority of the tool use examples across species were poorly supported by evidence. Furthermore, tooling appears to be phylogenetically less widespread than tool use, with the greatest variability found in the primate order. However, in order to confirm these findings and to understand the evolution and neurocognitive mechanisms of tooling, more systematic research will be required in the future, particularly with currently underrepresented taxa. (shrink)

This book explores Hume's concern with the destructiveness of religious factions and his efforts to develop, in his moral philosophy, a solution to factional conflict. Sympathy and the related capacity to enter into foreign points of view are crucial to the neutralization of religious zeal and the naturalization of ethics. Jennifer Herdt suggests that Hume's preoccupation with religious faction is the key which reveals the unity of his varied philosophical, aesthetic, political and historical works.