ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

ABSTRACT In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy (...) and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care. (shrink)

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases’ powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro‐organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical‐ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases' powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro-organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical-ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

Syndromic surveillance uses new ways of gathering data to identify possible disease outbreaks. Because syndromic surveillance can be implemented to detect patterns before diseases are even identified, it poses novel problems for informed consent, patient privacy and confidentiality, and risks of stigmatization. This paper analyzes these ethical issues from the viewpoint of the patient as victim and vector. It concludes by pointing out that the new International Health Regulations fail to take full account of the ethical challenges raised by syndromic (...) surveillance. (shrink)

In this view from 2007–2009, the ethical challenges facing a potential global effort to control infectious disease are explored; they provide sobering insight into the challenges of later decades. Despite the devastating pandemic of HIV/AIDS that erupted in the early 1980s, despite the failure to eradicate polio and the emergence of resistant forms of tuberculosis that came into focus in the 1990s, and despite newly emerging diseases like Severe Acute Respiratory Syndrome (SARS) in 2003 and the fearsome prospect of human-to-human (...) avian flu, it is nevertheless a time of some excitement over prospects for effective control of much of infectious disease. Funded by national and international governmental and nongovernmental organizations (NGOs), private foundations, and even popular entertainers, large-scale new efforts are under way to address global killers like AIDS, tuberculosis, and malaria, among others. This “marvelous momentum” can be seen as part of a continuing effort from the time of Jenner onward. Extrapolating from this, we explore the notion of a “comprehensive global effort for the eradication, elimination or control of infectious disease”, with particular attention to the ethical issues that arise. This is to “think big” about disease-control efforts that are now often done in piecemeal ways. This chapter identifies five tracks along which such efforts need to be pursued: (1) national and international organizations and the development of collective will; (2) epidemiological and health care infrastructure; (3) scientific development; (4) religious, social, and cultural considerations; (5) legal and social protections for individuals and groups. Each of these poses significant ethical issues which, we argue, should be viewed in a comprehensive way, to ensure that practice, research, and policy in each of these areas understands the person with communicable infectious disease as both victim and (potential) vector. (shrink)

The prelims comprise: Seeing Infectious Disease as Central The Birth of Bioethics Amid the Decline of Infectious Disease The Shifting Concerns of Public Health Bioethics and Public Health: How the Twain Didn't Meet The Case of HIV Bridging the Gap: Seeing Bioethics in Terms of the Patient as Victim and Vector An Ordinary Example Summing Up: Autonomous Agency in the Context of Infectious Disease Notes.

Since testing for HIV infection became possible in 1985, testing of pregnant women has been conducted primarily on a voluntary, ‘opt-in’ basis. Faden, Geller and Powers, Bayer, Wilfert, and McKenna, among others, have suggested that with the development of more reliable testing and more effective therapy to reduce maternal-fetal transmission, testing should become either routine with ‘opt-out’ provisions or mandatory. We ask, in the light of the new rapid tests for HIV, such as OraQuick, and the development of antiretroviral treatment (...) that can reduce maternal-fetal transmission rates to <2%, whether that time is now. Illustrating our argument with cases from the United States (US), Kenya, Peru, and an undocumented Mexican worker in the US, we show that when testing is accompanied by assured multi-drug therapy for the mother, the argument for opt-out or mandatory testing for HIV in pregnancy is strong, but that it is problematic where testing is accompanied by adverse events such as spousal abuse or by inadequate intrapartum or follow-up treatment. The difference is not a ‘double standard’, but reflects the presence of conflicts between the health interests of the mother and the fetus – conflicts that would be abrogated by the assurance of adequate, continuing multi-drug therapy. In light of these conflicts, where they still occur, careful processes of informed consent are appropriate, rather than opt-out or mandatory testing. (shrink)

Based on the author's nearly 30 years' of teaching introductory philosophy — and his observations of where beginning readers run into difficulty — this compact “primer” gives readers the basic tools they need to explore philosophical reading and writing for the first time. Provides insights and strategies for helping readers get started with reading, thinking about, and discussing philosophical concepts and writing short philosophical essays about what they've been reading and thinking; includes a new chapter that illustrates techniques for probing (...) beneath the expository surface of a given question to uncover the inevitable structure of presuppositions and problems underlying it. (shrink)

Winner of the Los Angeles Times Book Prize With a new preface by the author In his most powerful and important book, renowned psychiatrist Robert Jay Lifton presents a brilliant analysis of the crucial role that German doctors played in the Nazi genocide. Now updated with a new preface, The Nazi Doctors remains the definitive work on the Nazi medical atrocities, a chilling exposé of the banality of evil at its epitome, and a sobering reminder of the darkest side of (...) human nature. (shrink)

This chapter explores the debate between contemporary projectivists or expressivists, and the advocates of sensibility theory. Both positions are best viewed as forms of sentimentalism — the theory that evaluative concepts must be explicated by appeal to the sentiments. It argues that the sophisticated interpretation of such notions as “true” and “objective” that are offered by defenders of these competing views ultimately undermines the significance of their meta-ethical disputes over “cognitivism” and “realism” about value. Their fundamental disagreement lies in moral (...) psychology; it concerns how best to understand the emotions to which sentimentalist theories must appeal. (shrink)

Attitudinal- and stress theory are used to investigate the effect of ethical climate on job outcomes. Responses from 208 service employees who work for a country health department were used to test a structural model that examines the process through which ethical climate (EC) affects turnover intention (TI). This study shows that the EC–TI relationship is fully mediated by role stress (RC), interpersonal conflict (IC), emotional exhaustion (EE), trust in supervisor (TS), and job satisfaction (JS). Results show that EC reduces (...) (RS) and increases TS. Lower stress levels result in lower EE, higher JS, and lower TI. Also, supervisor trust (TS) reduces IC and EE. The structural model predicts 53.9% of the variance of TI. (shrink)

Leaders play a critical role in setting the tone for ethical climate in organizations. In recent years, there has been an increased skepticism about the role played by corporate executives in developing and implementing ethics in business practices. Sales and marketing practices of businesses, particularly in the pharmaceutical industry, have come under increased scrutiny. This study identifies a type of leadership style that can help firms develop an ethical climate. Responses from 333 salespeople working for a North American subsidiary of (...) an international pharmaceutical company were used to analyze the impact of instrumental leadership on ethical climate. We also examined the effect of ethical climate on effort, satisfaction with the supervisor, and job satisfaction. Managerial implications are provided. (shrink)

According to Slote's ``agent-based'' virtue ethics, the rightness orwrongness of an act is determined by the motive it expresses. Thistheory has a problem with cases where an agent can do her duty onlyby expressing some vicious motive and thereby acting wrongly. In sucha situation, an agent can only act wrongly; hence, the theory seemsincompatible with the maxim that `ought' implies `can'. I argue thatSlote's attempt to circumvent this problem by appealing to compatibilism is inadequate. In a wide range of psychologically (...) realistic cases, an agent's effective choice will be between failingto do her duty and doing it from inferior motives. Then anythingshe can do will be wrong, according to the agent-based theory,contrary to the maxim Slote wishes to preserve. (shrink)

In his book, Contemporary Theories of Knowledge, John Pollock argues that all externalist theories of justification should be rejected on the grounds that they do not do justice to the action-guiding character of epistemic norms. I reply that Pollocks argument is ineffective — because not all externalisms are intended to involve action-guiding norms, and because Pollock does not give a good reason for thinking that action-guiding norms must be internalist norms. Second, I consider rehabilitating Pollocks argument by restricting his conclusion (...) to theories that do involve action-guiding norms and providing a better reason to think that action-guiding norms must be internalist norms. But I claim that if Pollocks argument is made strong enough to rule out all externalisms, it rules out too much, namely, any plausible conception of epistemic norms. (shrink)

Recently published consensus recommendations on pediatric decision-making by Salter and colleagues (2023) did not address neonatal decision-making, due to the unique complexities of neonatal care. This essay explores three areas that impact neonatal decision-making: legal and policy considerations, rapid technological advancement, and the unique emotional burdens faced by parents and clinicians during the medical care of neonates. The authors evaluate the six consensus recommendations related to these considerations and conclude that the consensus recommendations apply to neonates.

In this eye-opening look at the doctor-patient decision-making process, physician and law professor Jay Katz examines the time-honored belief in the virtue of silent care and patient compliance. Historically, the doctor-patient relationship has been based on a one-way trust -- despite recent judicial attempts to give patients a greater voice through the doctrine of informed consent. Katz criticizes doctors for encouraging patients to relinquish their autonomy, and demonstrates the detrimental effect their silence has on good patient care. Seeing a growing (...) need in this age of medical science and sophisticated technology for more honest and complete communication between physician and patients, he advocates a new, informed dialogue that respects the rights and needs of both sides. In a new foreword to this edition of The Silent World of Doctor and Patient , Alexander Morgan Capron outlines the changes in medical ethics practice that have occurred since the book was first published in 1984, paying particular attention to the hotly debated issues of physician-assisted suicide and informed consent in managed care. (shrink)

Force Fields collects the recent essays of Martin Jay, an intellectual historian and cultural critic internationally known for his extensive work on the history of Western Marxism and the intellectual migration from Germany to America.

Philosophers often call emotions appropriate or inappropriate. What is meant by such talk? In one sense, explicated in this paper, to call an emotion appropriate is to say that the emotion is fitting: it accurately presents its object as having certain evaluative features. For instance, envy might be thought appropriate when one's rival has something good which one lacks. But someone might grant that a circumstance has these features, yet deny that envy is appropriate, on the grounds that it is (...) wrong to be envious. These two senses of `appropriate' have much less in common than philosophers have supposed. Indeed, the distinction between propriety and correctness is crucial to understanding the distinctive role of the emotions in ethics. We argue here that an emotion can be fitting despite being wrong to feel, and that various philosophical arguments are guilty of a systematic error which we term the moralistic fallacy. (shrink)

Several recent contextualist theorists (e.g. David Lewis, Michael Williams, andKeith DeRose) have proposed contextualizing the skeptic. Their claim is that oneshould view satisfactory answers to global doubts regarding such subjects as theexternal world, other minds, and induction as requirements for justification incertain philosophical contexts, but not in everyday and scientific contexts. Incontrast, the skeptic claims that a satisfactory answer to a global doubt in eachof these areas is a context-invariant requirement for justified belief. In this paper,I consider and reject the (...) arguments Michael Williams develops in his bookUnnatural Doubts that are intended to show that the skeptic's interpretationof the significance of global doubts is mistaken. In addition, I argue that Williams'general strategy in opposing the skeptic is extremely interesting and worth furtherinvestigation, even if his particular execution of it is unsuccessful. To this end, Iclarify the general strategy, distinguish it from a variety of others, and discuss itsprospects as an answer to the skeptic. (shrink)

This book is the first collection of feminist essays on one of the central figures in the history of English-speaking philosophy.

During John Dewey's lifetime, one public opinion poll after another revealed that he was esteemed to be one of the ten most important thinkers in American history. His body of thought, conventionally identified by the shorthand word "Pragmatism," has been the distinctive American philosophy of the last fifty years. His work on education is famous worldwide and is still influential today, anticipating as it did the ascendance in contemporary American pedagogy of multiculturalism and independent thinking. His University of Chicago Laboratory (...) School thrives still and is a model for schools worldwide, especially in emerging democracies. But how was this lifetime of thought enmeshed in Dewey's emotional experience, in his joys and sorrows as son and brother, husband and father, and in his political activism and spirituality? Acclaimed biographer Jay Martin recaptures the unity of Dewey's life and work, tracing important themes through the philosopher's childhood years, family history, religious experience, and influential friendships. Based on original sources, notably the vast collection of unpublished papers in the Center for Dewey Studies, this book tells the full story, for the first time, of the life and times of the eminent American philosopher, pragmatist, education reformer, and man of letters. In particular, _The Education of John Dewey_ highlights the importance of the women in Dewey's life, especially his mother, wife, and daughters, but also others, including the reformer Jane Addams and the novelist Anzia Yezierska. A fitting tribute to a master thinker, Martin has rendered a tour de force portrait of a philosopher and social activist in full, seamlessly reintegrating Dewey's thought into both his personal life and the broader historical themes of his time. (shrink)

This book expounds and defends a new conception of the relation between truth and meaning. Atlas argues that the sense of a sense-general sentence radically underdetermines its truth-conditional content. He applies this linguistic analysis to illuminate old and new philosophical problems of meaning, truth, falsity, negation, existence, presupposition, and implicature. In particular, he demonstrates how the concept of ambiguity has been misused and confused with other concepts of meaning, and how the interface between semantics and pragmatics has been misunderstood. The (...) problems he tackles are common to philosophy, linguistics, cognitive psychology, and artificial intelligence, and his conclusions will be of interest to all those working in these fields. (shrink)

Reason and Value collects 15 new papers by leading contemporary philosophers on themes from the work of Joseph Raz. Raz has made major contributions in a wide range of areas, including jurisprudence, political philosophy, and the theory of practical reason; but all of his work displays a deep engagement with central themes in moral philosophy. The subtlety and power of Raz's reflections on ethical topics make his writings a fertile source for anyone working in this area. Especially significant are his (...) explorations of the connections between practical reason and the theory of value, which constitute a sustained and penetrating treatment of a set of issues at the very center of moral philosophy as it is practiced today. The contributors to the volume acknowledge the importance of Raz's contributions by engaging critically with his positions and offering independent perspectives on the topics that he has addressed. The volume aims both to honour Raz's accomplishments in the area of ethical theorizing, and to contribute to an enhanced appreciation of the significance of his work for the subject. (shrink)

This fresh look at the philosophy of language focuses on the interface between a theory of literal meaning and pragmatics--a philosophical examination of the relationship between meaning and language use and its contexts. Here, Atlas develops the contrast between verbal ambiguity and verbal generality, works out a detailed theory of conversational inference using the work of Paul Grice on Implicature as a starting point, and gives an account of their interface as an example of the relationship between Chomsky's Internalist Semantics (...) and Language Performance. Atlas then discusses consequences of his theory of the Interface for the distinction between metaphorical and literal language, for Grice's account of meaning, for the Analytic/Synthetic distinction, for Meaning Holism, and for Formal Semantics of Natural Language. This book makes an important contribution to the philosophy of language and will appeal to philosophers, linguists, and cognitive scientists. (shrink)

Selon le «cognitivisme fort», toutes les raisons d’une action trouvent leurs sources dans des caractéristiques normatives par lesquelles l’individu motivé (explicitement ou implicitement) prend des objets comme avoir (ou manque), indépendamment de son attitude à l’égard de ces objets. L’objectif majeur de cet article est de contester les arguments du cognitivisme fort, en d’autres termes, de démontrer que toute attitude volitive donne aux individus des raisons pour entreprendre une action. À cette fin, l’argument principal consistera à procéder par le biais (...) de l’analyse du phénomène complexe de la préoccupation, pour en extrapoler une conclusion relative à la nature (incitative et normative) d’un phénomène mental plus fondamental encore : les désirs spécifiques. (shrink)

Achieving genuine engagement and understanding between communities with radically divergent worldviews is challenging. If there is no common ground on which to stand and have a discussion, the likely outcomes of an apparent intercultural disagreement are a stalemate, or the (sometimes colonialist) imposition of a single worldview, or a kind of relativistic tolerance that falls short of genuine engagement. In this paper, we suggest a way forward that takes as its starting point the philosophical discussion of deep disagreement, using the (...) example of taniwha (powerful water beings that must be treated with respect) to outline a strategy for building intercultural understanding and enabling constructive intercultural dialogue. (shrink)

This is a book for scholars of Western philosophy who wish to engage with Buddhist philosophy, or who simply want to extend their philosophical horizons. It is also a book for scholars of Buddhist studies who want to see how Buddhist theory articulates with contemporary philosophy. Engaging Buddhism: Why it Matters to Philosophy articulates the basic metaphysical framework common to Buddhist traditions. It then explores questions in metaphysics, the philosophy of mind, phenomenology, epistemology, the philosophy of language and ethics as (...) they are raised and addressed in a variety of Asian Buddhist traditions. In each case the focus is on philosophical problems; in each case the connections between Buddhist and contemporary Western debates are addressed, as are the distinctive contributions that the Buddhist tradition can make to Western discussions. Engaging Buddhism is not an introduction to Buddhist philosophy, but an engagement with it, and an argument for the importance of that engagement. It does not pretend to comprehensiveness, but it does address a wide range of Buddhist traditions, emphasizing the heterogeneity and the richness of those traditions. The book concludes with methodological reflections on how to prosecute dialogue between Buddhist and Western traditions. (shrink)

Over a decade ago, John Sowa did the AI community the great service of introducing it to the Existential Graphs of Charles Sanders Peirce. EG is a formalism which lends itself well to the kinds of thing that Conceptual Graphs are aimed at. But it is far more; it is a central element in the mathematical, logical, and philosophical thought of Peirce; this thought is fruitful in ways that are seldom evident when we first encounter it. In one of his (...) major works on Existential Graphs, Peirce remarks that. (shrink)

Journal of Applied Philosophy, EarlyView.