A growing literature documents the existence of individuals who make a living by participating in phase I clinical trials for money. Several scholars have noted that the concerns about risks, consent, and exploitation raised by this phenomenon apply to many (other) jobs, too, and therefore proposed improving subject protections by regulating phase I trial participation as work. This article contributes to the debate over this proposal by exploring a largely neglected worry. Unlike most (other) workers, subjects are not paid to (...) produce or achieve anything but to have things done to them. I argue that this passivity is problematic for reasons of distributive justice. Specifically, it fails to enable subjects to realize what Gheaus and Herzog call “the goods of work”—a failure not offset by adequate opportunities to realize these goods outside of the research context. I also consider whether granting subjects worker-type protections would accommodate this concern. (shrink)

Clinical research is increasingly ‘offshored’ to developing countries, a practice that has generated considerable controversy. It has recently been argued that the prevailing ethical norms governing such research are deeply puzzling. On the one hand, sponsors are not required to offshore trials, even when participants in developing countries would benefit considerably from these trials. On the other hand, if sponsors do offshore, they are required not to exploit participants, even when the latter would benefit from and consent to exploitation. How, (...) it is asked, can it be worse to exploit the global poor than to neglect them when exploitation is voluntary and makes them better off? The present article seeks to respond to this challenge. I argue that mutually beneficial and voluntary exploitation can be worse than neglect when — as is typically true of exploitative international research — it takes advantage of unjust background conditions. This is because, in such cases, exploitation overlaps with another, less familiar wrong: complicity in injustice. Recognising complicity as a distinct wrong should make us judge exchanges arising from background injustice more harshly than we typically do, in research and elsewhere. (shrink)

This paper challenges the view that bans on kidney sales are unjustifiably paternalistic, that is, that they unduly deny people the freedom to make decisions about their own bodies in order to protect them from harm. I argue that not even principled anti-paternalists need to reject such bans. This is because their rationale is not hard paternalism, which anti-paternalists repudiate, but soft paternalism, which they in principle accept. More precisely, I suggest that their rationale is what Franklin Miller and Alan (...) Wertheimer call ‘group soft paternalism’. Group soft paternalistic policies restrict the freedom of autonomous individuals, not for their own good (hard paternalism), but as an unavoidable consequence of seeking to protect other, non-autonomous individuals from harms that they have not voluntarily chosen (soft paternalism). Group soft paternalism supports prohibiting kidney sales on three conditions: (1) that such sales are potentially harmful to vendors, (2) that many vendors would suffer impaired autonomy, and (3) that distinguishing between autonomous and non-autonomous vendors and interfering only with the latter is unfeasible. I provide reasons for thinking that these conditions will often hold. (shrink)

Proponents of permitting living kidney sales often argue as follows. Many jobs involve significant risks; people are and should be free to take these risks in exchange for money; the risks involved in giving up a kidney are no greater than the risks involved in acceptable hazardous jobs; so people should be free to give up a kidney for money, too. This paper examines this frequently invoked but rarely analysed analogy. Two objections are raised. First, it is far from clear (...) that kidney sales and dangerous jobs involve comparable risks on an appropriately broad comparison. Second, and more importantly, even if they do involve comparable risks it does not follow that kidney sales must be permitted because dangerous jobs are. The analogy assumes that kidney sales are banned for paternalistic reasons. But there may be other, non-paternalistic reasons for the ban. And paternalists, too, can consistently defend the ban even if kidney sales are no riskier than occupations that they find acceptable. Soft paternalists may want to protect would-be vendors from harms that they have not voluntarily chosen. Egalitarian hard paternalists may want to protect already badly off vendors from further worsening their situation. For neither species of paternalist is the size of the risk prevented decisive. I conclude that the analogy with dangerous jobs, while rhetorically powerful, pulls little real argumentative weight. Future debates on living kidney sales should therefore proceed without it. (shrink)

We propose a principle of sustainability to complement established principles used for justifying healthcare resource allocation. We argue that the application of established principles of equal treatment, need, prognosis and cost-effectiveness gives rise to what we call negative dynamics: a gradual depletion of the value possible to generate through healthcare. These principles should therefore be complemented by a sustainability principle, making the prospect of negative dynamics a further factor to consider, and possibly outweigh considerations highlighted by the other principles. We (...) demonstrate how this principle may take different forms, and show that a commitment to sustainability is supported by considerations internal to the ethical principles already guiding healthcare resource allocation. We also consider two objections. The first of these, we argue, is either based on implausible assumptions or begs the question, whereas the second can be adequately accommodated by the principle we propose. (shrink)

What, if anything, is wrong with taking advantage of people’s unjust circumstances when they both benefit from and consent to the exchange? The answer, some believe, is that such exchanges are wrongfully exploitative. I argue that this answer is incomplete at best, and I elaborate a different one: to take advantage of injustice is to become complicit in its reproduction. I also argue that the case for third-party interference with mutually beneficial and consensual exchanges, while normally considered weak, is strengthened (...) once these exchanges are understood as implicated in broader unjust structures. (shrink)

Antibiotic resistance is widely recognized as a major threat to public health and healthcare systems worldwide. Recent research suggests that pollution from antibiotics manufacturing is an important driver of resistance development. Using Sweden as an example, this article considers how industrial antibiotic pollution might be addressed by public actors who are in a position to influence the distribution and use of antibiotics in high-income countries with publicly funded health systems. We identify a number of opportunities for these actors to incentivize (...) industry to increase sustainability in antibiotics production. However, we also show that each alternative would create tensions with other significant policy goals, necessitating trade-offs. Since justifiable trade-offs require ethical consideration, we identify and explore the main underlying normative issues, namely, the weighing of local versus global health interests, the weighing of present versus future health interests, and the role of individualistic constraints on the pursuit of collective goals. Based on this analysis, we conclude that the actors have weighty principled reasons for prioritizing the goal of addressing pollution, but that translating this stance into concrete policy requires accommodating significant pragmatic challenges. (shrink)

Parker’s article is a welcome attempt to address the importance of environmental sustainability in the realm of clinical ethics.1 We support the recent movement to seriously consider the environmental impact of healthcare institutions in bioethics.2 3 Still, we find two partly linked weaknesses of Parker’s analysis and guideline suggestion. These relate to a need in ‘green’ bioethics to see beyond the normal healthcare ethical focus on health-related values related to individual patients, and to primarily adopt institutional ways of framing central (...) decision problems. Traditional bioethics applies a restricted scope of values to assess clinical decisions: primarily health-related patient well-being (including life) and patient autonomy. If a decision improves (or, as in Parker’s inhaler case, maintains) a patient’s health-related well-being, this supports it. However, if a decision improves a patient’s non health-related well-being, say, winning a beauty contest or securing a job by having cosmetic surgery, it is not supported. And so on. This idea of healthcare as, in Michael Walzer’s classic terminology, a separate ‘sphere of justice’ has two interrelated limitations: it reflects a bias towards individual patients over other people, and it restricts the scope of values allowed to influence healthcare ethical judgements. These limitations appear once we see that the issue addressed by Parker can be framed either as prescription decisions taken by individual doctors against the background of …. (shrink)

The concept of exploitation and potentially exploitative real-world practices are the subject of increasing philosophical attention. However, while philosophers have extensively debated what exploitation is and what makes it wrong, they have said surprisingly little about what might be required to remediate it. By asking how the consequences of exploitation should be addressed, this article seeks to contribute to filling this gap. We raise two questions. First, what are the victims of exploitation owed by way of remediation? Second, who ought (...) to remediate? Our answers to these questions are connected by the idea that exploitation cannot be fully remediated by redistributing the exploiter's gain in order to repair or compensate the victim's loss. This is because exploitation causes not only distributive but also relational harm. Therefore, redistributive measures are necessary but not sufficient for adequate remediation. Moreover, this relational focus highlights the fact that exploitative real-world practices commonly involve agents other than the exploiter who stand to benefit from the exploitation. Insofar as these third parties are implicated in the distributive and relational harms caused by exploitation, there is, we argue, good reason to assign part of the burden of remediation to them. (shrink)

Journal of Social Philosophy, EarlyView.

Human consumption of pharmaceuticals often leads to environmental release of residues via urine and faeces, creating environmental and public health risks. Policy responses must consider the normative question how responsibilities for managing such risks, and costs and burdens associated with that management, should be distributed between actors. Recently, the Polluter Pays Principle (PPP) has been advanced as rationale for such distribution. While recognizing some advantages of PPP, we highlight important ethical and practical limitations with applying it in this context: PPP (...) gives ambiguous and arbitrary guidance due to difficulties in identifying the salient polluter. Moreover, when PPP does identify responsible actors, these may be unable to avoid or mitigate their contribution to the pollution, only able to avoid/mitigate it at excessive cost to themselves or others, or excusably ignorant of contributing. These limitations motivate a hybrid framework where PPP, which emphasizes holding those causing large-scale problems accountable, is balanced by the Ability to Pay Principle (APP), which emphasizes efficiently managing such problems. In this framework, improving wastewater treatment and distributing associated financial costs across water consumers or taxpayers stand out as promising responses to pharmaceutical pollution from human use. However, sound policy depends on empirical considerations requiring further study. (shrink)

Bioethics, Volume 35, Issue 7, Page 688-695, September 2021.

This study is a contribution to the bioethical debate about new and possibly emerging reproductive technologies. Its point of departure is the intuition, which many people seem to share, that using such technologies to select non-disease traits – like sex and emotional stability - in yet unborn children is morally problematic, at least more so than using the technologies to avoid giving birth to children with severe genetic diseases, or attempting to shape the non-disease traits of already existing children by (...) environmental means, like education. The study employs philosophical analysis for the purpose of making this intuition intelligible and judging whether it is justified. Different ways in which the moral problems posed by reproductive technologies are often framed in bioethical debates are criticised as inadequate for this task. In particular, it is argued that the intuition cannot fully be made sense of in terms of harm to the children that such technologies help create. The study attempts to elaborate an alternative to that broadly consequentialist approach, by drawing on Martin Heidegger’s philosophy of technology, Hans Jonas’s ethics, and Aristotle’s practical philosophy, as it has been received and developed in the hermeneutical tradition. It is suggested that reproductive choices, unlike decisions for already born children, are characterised by a peculiar one-sidedness: the future child appears to the parents as something wholly theirs to decide about, not as a concrete other with whom they must interact in a responsive and attuned way. This is problematic because it means that such choices cannot call upon the particularised moral understanding only gained in interpersonal encounters. In particular, it makes them easily shaped by various tendencies, to which parents are always susceptible, to relate to children in instrumentalising ways, and at risk of reinforcing such tendencies. However, this does not mean that all uses of reproductive technologies are equally troubling. When selecting against severe disease the parents can rely on a widely shared illness experience to escape the dangers that one-sidedness involves. It is concluded that the intuition under discussion, thus explicated and in some ways qualified, makes sense morally. (shrink)

Medical therapy, research and technology enable us to make our bodies, or parts of them, available to others in an increasing number of ways. This is the case in organ, tissue, egg and sperm donation as well as in surrogate motherhood and clinical research. Bringing together leading scholars working on the ethical, social and cultural aspects of such bodily exchanges, this cutting-edge book develops new ways of understanding them. Bodily Exchanges, Bioethics and Border Crossing both probes the established giving and (...) selling frameworks for conceptualising bodily exchanges in medicine, and seeks to develop and examine another, less familiar framework: that of sharing. A framework of sharing can capture practices that involve giving up and giving away part of one's body, such as organ and tissue donation, and practices that do not, such as surrogacy and research participation. Sharing also recognizes the multiple relationalities that these exchanges can involve and invites inquiry into the context in which they occur. In addition, the book explores the multiple forms of border crossing that bodily exchanges in medicine involve, from the physical boundaries of the body to relational borders - as can happen in surrogacy - to national borders and the range of ethical issues that these various border-crossings can give rise to. Engaging with anthropology, sociology, philosophy, and feminist and postcolonical perspectives, this is an original and timely contribution to contemporary bioethics in a time of increasing globalization. It will be of use to students and researchers from a range of humanities and social science backgrounds as well as medical and other healthcare professionals with an interest in bioethics. (shrink)

Randomized and double-blind clinical trials are widely regarded as the most reliable way of studying the effects of medical interventions. According to received wisdom, if a new drug or treatment is to be accepted in clinical practice, its safety and efficacy must first be demonstrated in such trials. For ethical and scientific reasons, it is generally considered necessary to monitor a trial in various ways as it proceeds and to analyze data as they accumulate. Monitoring and interim analyses are often (...) conducted by a so-called data monitoring committee (DMC), a group of experts independent of both sponsors and investigators. On the basis of DMC recommendations, sponsors sometimes decide to discontinue trials .. (shrink)

The target article challenges the increasingly popular portrayal of living kidney sale as potentially a mutually beneficial arrangement, capable not only of saving or improving the lives of patients in need of transplants but also of significantly benefiting poor vendors. Carefully reviewing the literature on harms to vendors in illegal kidney markets and in Iran’s legal market, Koplin argues that many of these harms would persist in the sort of legal regulated system that kidney sale advocates envision. This is an (...) important argument. The kidney sales debate has been skewed in favor of permitting sales by a simplified view of the potential harms involved and excessive optimism about the capacity of regulation to prevent these harms. The article counterbalances these tendencies and thus considerably weakens the case for allowing sales. Nonetheless, some market proponents might remain unconvinced. I shall suggest that in addition to the lessons that Koplin draws from existing kidney markets, there is yet another one, which casts further doubt on the advisability of allowing kidney sales. (shrink)

Many countries are now implementing human papillomavirus vaccination. There is disagreement about who should receive the vaccine. Some propose vaccinating both boys and girls in order to achieve the largest possible public health impact. Others regard this approach as too costly and claim that only girls should be vaccinated. We question the assumption that decisions about human papillomavirus vaccination policy should rely solely on estimates of overall benefits and costs. There are important social justice aspects that also need to be (...) considered. Policy makers should consider how to best protect individuals who will remain unvaccinated through no fault of their own. This is especially important if these individuals are already disadvantaged in other ways and if vaccinating other people increases their risk of infection. (shrink)

A common argument in favor of using reprogenetic technologies to enhance children goes like this: parents have always aimed at enhancing their children through upbringing and education, so why not use new tools to accomplish the same goal? But reprogenetics differs significantly from good childrearing and education, in its means, if not its ends.

Human papillomavirus (HPV) infection is the world’s most common sexually transmitted infection. It is a prerequisite for cervical cancer, the second most common cause of death in cancer among women worldwide, and is also believed to cause other anogenital and head and neck cancers. Vaccines that protect against the most common cancer-causing HPV types have recently become available, and different countries have taken different approaches to implementing vaccination. This paper examines the ethics of alternative HPV vaccination strategies. It devotes particular (...) attention to the major arguments for and against one strategy: voluntary, publicly funded vaccination for all adolescent boys and girls. This approach seems attractive because it would protect more people against cervical cancer and other HPV-related cancers than less inclusive alternatives, without the sacrifice of autonomy that a comparably broad compulsory programme would require. Also, the herd immunity that it would likely generate would protect those who remain unvaccinated, a major advantage from a justice perspective. However, there is a possibility that a HPV vaccination programme targeting all adolescents of both sexes is not considered sufficiently cost-effective. Also, it might pose more difficulties for achieving informed consent than comparable vaccination programmes against other diseases. Ultimately, society’s choice of HPV vaccination strategy requires careful consideration not only of the values at stake but also of available and emerging scientific evidence. (shrink)

The idea of paying donors in order to make more human bodily material available for therapy, assisted reproduction, and biomedical research is notoriously controversial. However, while national and international donation policies largely oppose financial incentives they do not treat all parts of the body equally: incentives are allowed in connection to the provision of some parts but not others. Taking off from this observation, I discuss whether body parts differ as regards the ethical legitimacy of incentives and, if so, why. (...) I distinguish two approaches to this issue. On a ”principled” approach, some but not all body parts are inherently special in a way that proscribes payment. On a ”pragmatic” approach, the appropriateness of payment in relation to a specific part must be determined through an overall assessment of e.g. the implications of payment for the health and welfare of providers, recipients, and third parties, and the quality of providers’ consent. I argue that the first approach raises deep and potentially divisive questions about the good life, whereas the second approach invokes currently unsupported empirical assumptions and requires difficult balancing between different values and the interests of different people. This does not mean that any attempt to distinguish between body parts in regard to the appropriateness of payment necessarily fails. However, I conclude, any plausible such attempt should either articulate and defend a specific view of the good life, or gather relevant empirical evidence and apply defensible principles for weighing goods and interests. (shrink)

Jules Salomone-Sehr argues that an activity is cooperative if and only if, roughly, it consists of several participants’ actions that are (i) coordinated for a common purpose (ii) in ways that do not undermine any participant’s agency. He argues that guidance by shared intention is neither necessary nor sufficient for cooperation. Thereby, he claims to “topple an orthodoxy of shared agency theory." In response, we argue that Salomone-Sehr’s account captures another notion of cooperation than the sociopsychological notion shared agency theory (...) has focused on. Furthermore, we argue that Salomone-Sehr’s interpretation of (ii) is too demanding; it implausibly makes cooperation incompatible with exploitation. (shrink)

Biomedical research on human subjects involves exposing individuals to risks and burdens for the benefit of others, and therefore raises concerns about exploitation. While the concept of exploitation has received significant attention in recent research ethical literature, its relevance and implications in this area remain unclear and contested. This chapter explains how this concept is nonetheless important for understanding the ethical complexities of human subject research and the proper design of subject protections. The chapter provides an overview of research practices (...) often thought to raise exploitation concerns and introduces philosophical exploitation theory, focusing on aspects relevant to research ethics. Against this background, the obligations of non-exploitation held by researchers, sponsors, and third parties such as ethics committees and regulators are outlined. The chapter ends by considering how exploitative research in the past can be retroactively remediated. (shrink)

In the present paper it is argued that genetic interventions on human embryos are in principle permissible if they promote the health of the persons that these embryos will one day become and impermissible if they compromise their health. This so called health-intervention principle is reached by, inter alia, rejecting alternative approaches to the problem of the permissibility of genetic intervention. The health-intervention principle can be interpreted in different ways depending on how the notion of health is understood. The central (...) part of the paper is an attempt to find a concept of health which is such that it makes the health-intervention principle normatively plausible. For this purpose I examine two influential competing theories of health: Cristopher Boorse’s biostatistical theory of health and Lennart Nordenfelt’s welfare theory of health. I argue that the health-intervention principle is more plausible if health is understood in the latter sense, although it is not ruled out that the principle may be given an even more plausible explication in terms of some other notion of health. (shrink)

The term “exploitation” is notoriously hard to define. Yet it is frequently invoked to frame moral concerns about clinical research. Recently, a group of influential authors have proposed a so-called nonexploitation framework for the ethics of randomized controlled trials that appears to address these concerns. This article challenges one basic assumption of that framework: the idea that nonexploitation in research requires participants to be protected from excessive risks, which are understood to be risks that are not outweighed by the benefits (...) that the research is expected to lead to. Examples of exploitation in other contexts show that this idea has highly counterintuitive implications. The result is that the nonexploitation framework obscures concerns about exploitation in biomedical research, rather than clarifying them. (shrink)

We proposed adding a sustainability principle to the operational ethical principles guiding public healthcare resources allocation decisions. All our commentators acknowledge our core message: healthcare needs to pay attention to the future. They also strengthen our proposal by offering support by luck egalitarian and Rawlsian arguments, and helpfully point out ambiguities and gaps requiring attention in the further development of the proposal, and its practical implementation.

Actually possible and conceivable future uses of preimplantation genetic diagnosis (PGD) and germ-line genetic intervention in assisted reproduction seem to offer increasing possibilities of choosing the kind of persons that will be brought to existence. Many are troubled by the idea of these technologies being used for enhancement purposes. How can we make sense of this worry? Why are our thoughts about therapeutic genetic interventions and non-genetic enhancement (for instance education) not accompanied by the same intuitive uneasiness? I argue that (...) the concepts of autonomy and freedom of choice, typically invoked to delimit the morally acceptable uses of reproductive technologies, cannot fully answer these questions. Instead, I suggest that an alternative answer might begin with reflections on the notion of interfering with nature. Drawing on Martin Heidegger’s critique of modern technology and Hans Jonas’s moral philosophy, I outline an argument that attempts to capture what might be particularly troubling about the idea of “designing” future persons. At the core of the argument is the suggestion that enhancing selections and modifications on embryos might be bound up with an instrumentalising, non-responsive perspective on the future persons into which they are intended to grow. (shrink)

John Rawls’s ‘just savings’ principle is among the better-known attempts to outline how we should balance the claims of the present with the claims of the future generations on resources. A central element of Rawls’s approach involves endorsing a sufficientarian approach, where our central obligation is to ensure ‘the conditions needed to establish and to preserve a just basic structure’.1 This engaging paper by Christian Munthe, Davide Fumagalli and Erik Malmqvist (‘the authors’) does not explicitly mention Rawls’s work (...) on this issue.2 Still, there are parallels in their aim to generate a ‘sustainability principle’ for healthcare systems. The authors defend the broadening of our focus to the relations between rounds—particularly, how decisions in one period can affect our choice range in the next, whereas current principles for allocating healthcare resources operate within ‘allocation rounds’. Where Rawls is concerned about future generations, the authors’ concern is with future sets of patients. Our present decisions may generate system ‘dynamics’ which are either positive—where ‘more resources per health need’ become available—or negative—where (otherwise justified) decisions taken now leave us with less bang for our buck in the future. The paper’s important and compelling central claim is that we have an obligation …. (shrink)

Logical pluralism is the view that there is more than one correct logic. Most logical pluralists think that logic is normative in the sense that you make a mistake if you accept the premisses of a valid argument but reject its conclusion. Some authors have argued that this combination is self-undermining: Suppose that L1 and L2 are correct logics that coincide except for the argument from Γ to φ, which is valid in L1 but invalid in L2. If you accept (...) all sentences in Γ, then, by normativity, you make a mistake if you reject φ. In order to avoid mistakes, you should accept φ or suspend judgment about φ. Both options are problematic for pluralism. Can pluralists avoid this worry by rejecting the normativity of logic? I argue that they cannot. All else being equal, the argument goes through even if logic is not normative. (shrink)

C. S. Lewis is one of the most beloved Christian apologists of the twentieth century; David Hume and Bertrand Russell are among Christianity’s most important critics. This book puts these three intellectual giants in conversation with one another on various important questions: the existence of God, suffering, morality, reason, joy, miracles, and faith. Alongside irreconcilable differences, surprising areas of agreement emerge. Curious readers will find penetrating insights in the reasoned dialogue of these three great thinkers.

Erik Wielenberg has presented an objection to divine command theory (DCT) alleging that DCT has the troubling implication that psychopaths have no moral obligations. Matthew Flannagan has replied to Wielenberg’s argument. Here, I defend the view that, despite Flannagan’s reply, the psychopath objection presents a serious problem for the versions of DCT defended by its most prominent contemporary advocates — Robert Adams, C. Stephen Evans, and William Lane Craig.

Gerald Harrison identifies two Euthyphro-related concerns for divine command theories and makes the case that to the extent that these concerns make trouble for divine command theories they also make trouble for non-naturalistic moral realism and naturalistic moral realism. He also offers responses to the two concerns on behalf of divine command theorists. I show here that the parity thesis does not hold for the most commonly discussed version of divine command theory. I further argue that his responses to the (...) two concerns fail. Finally, I draw on some of Harrison’s ideas to identify an advantage that non-naturalistic moral realism has over divine command theories and naturalistic moral realism. (shrink)

Marxism: Crisis or Renewal? It has become commonplace nowadays to speak of a crisis— and even of the end— of Marxism. This dire forecast can hardly be ...

There are several theses in political science that are usually explicitly called ‘laws’. Other theses are generally thought of as laws, but often without being explicitly labelled as such. Still other claims are well-supported and arguably interesting, while no one would be tempted to call them laws. This situation raises philosophical questions: which theses deserve to be called laws and which not? And how should we decide about this? In this paper we develop and motivate a strategy for thinking about (...) laws in political science which integrates two core concepts: spatio-temporal stability and social mechanisms. The proposed strategy is a set of guidelines that political scientists can use to reflect on and argue about specific cases within their discipline, not a clear-cut demarcation criterion. We defend and motivate this strategy and apply it to two cases (one with respect to state repression, one about parliamentary elections). After we have developed and motivated our strategy for political science, we show that our proposal is relevant for other disciplines in the social sciences. We explain how our views fit into critical realism and embed them in the debate on laws in general philosophy of science and in the philosophy of the social sciences. (shrink)

It is often argued that it does not matter morally whether biomedical interventions treat or prevent diseases or enhance nondisease traits; what matters is whether and how much they promote well-being. Therapy and enhancement both promote well-being, the argument goes, so they are not morally distinct but instead continuous. I provide three reasons why this argument should be rejected when it is applied to choices concerning the genetic makeup of future people. First, it rests on too simple a conception of (...) the badness of disease. Second, it wrongly assumes that disease avoidance and enhancement can proceed with similar accuracy. Third, it overlooks that disease avoidance tends to be more urgent than enhancement from the point of view of distributive justice. Although none of these reasons establishes a firm therapy-enhancement distinction, they show that a continuum model is not an attractive alternative. (shrink)

In everyday life we often act adequately, yet without deliberation. For instance, we immediately obtain and maintain an appropriate distance from others in an elevator. The notion of normativity implied here is a very basic one, namely distinguishing adequate from inadequate, correct from incorrect, or better from worse in the context of a particular situation. In the first part of this paper I investigate such ‘situated normativity’ by focusing on unreflective expert action. More particularly, I use Wittgenstein’s examples of craftsmen (...) (tailors and architects) absorbed in action to introduce situated normativity. Situated normativity can be understood as the normative aspect of embodied cognition in unreflective skillful action. I develop Wittgenstein’s insight that a peculiar type of affective behaviour, ‘directed discontent’, is essential for getting things right without reflection. Directed discontent is a reaction of appreciation in action and is introduced as a paradigmatic expression of situated normativity. In the second part I discuss Wittgenstein’s ideas on the normativity of what he calls ‘blind’ rule-following and the ‘bedrock’ of immediate action. What matters for understanding the normativity of (even ‘blind’) rule-following, is not that one has the capacity for linguistic articulation or reflection but that one is reliably participating in a communal custom. In the third part I further investigate the complex relationships between unreflective skillful action, perception, emotion, and normativity. Part of this entails an account of the link between normativity at the level of the expert’s socio-cultural practice and the individual’s situated and lived normativity. (shrink)

One can (for the most part) formulate a model of a classical system in either the Lagrangian or the Hamiltonian framework. Though it is often thought that those two formulations are equivalent in all important ways, this is not true: the underlying geometrical structures one uses to formulate each theory are not isomorphic. This raises the question of whether one of the two is a more natural framework for the representation of classical systems. In the event, the answer is yes: (...) I state and sketch proofs of two technical results—inspired by simple physical arguments about the generic properties of classical systems—to the effect that, in a precise sense, classical systems evince exactly the geometric structure Lagrangian mechanics provides for the representation of systems, and none provided by Hamiltonian. The argument not only clarifies the conceptual structure of the two systems of mechanics, but also their relations to each other and their respective mechanisms for representing physical systems. It also shows why naïvely structural approaches to the representational content of physical theories cannot work. [Lagrange] grasped that he had gained a method of stating dynamical truths in a way, which is perfectly indifferent to the particular methods of measurement employed in fixing the positions of the various parts of the system. Accordingly, he went on to deduce equations of motion, which are equally applicable whatever quantitative measurements have been made, provided that they are adequate to fix positions. The beauty and almost divine simplicity of these equations is such that these formulae are worthy to rank with those mysterious symbols which in ancient times were held directly to indicate the Supreme Reason at the base of all things. (Whitehead [1948], p. 63)1. Introduction2.Classical Systems3. The Possible Interactions of a Classical System and the Structure of Its Space of States4. Classical Systems Are Lagrangian5. Classical Systems Are Not Hamiltonian6. How Lagrangian and Hamiltonian Mechanics Represent Classical Systems7. The Conceptual Structure of Classical Mechanics. (shrink)

The author analyzes the inner structure of the philosophy of the Tractatus rather than its relation to the views of other philosophers.

In cognitive science, long-term anticipation, such as when planning to do something next year, is typically seen as a form of ‘higher’ cognition, requiring a different account than the more basic activities that can be understood in terms of responsiveness to ‘affordances,’ i.e. to possibilities for action. Starting from architects that anticipate the possibility to make an architectural installation over the course of many months, in this paper we develop a process-based account of affordances that includes long-term anticipation within its (...) scope. We present a framework in which situations and their affordances unfold, and can be thought of as continuing a history of practices into a current situational activity. In this activity affordances invite skilled participants to act further. Via these invitations one situation develops into the other; an unfolding process that sets up the conditions for its own continuation. Central to our process account of affordances is the idea that engaged individuals can be responsive to the direction of the process to which their actions contribute. Anticipation, at any temporal scale, is then part and parcel of keeping attuned to the movement of the unfolding situations to which an individual contributes. We concretize our account by returning to the example of anticipation observed in architectural practice. This account of anticipation opens the door to considering a wide array of human activities traditionally characterized as ‘higher’ cognition in terms of engaging with affordances. (shrink)

There are important structural similarities in the way that animals and humans engage in unreflective activities, including unreflective social interactions in the case of higher animals. Firstly, it is a form of unreflective embodied intelligence that is ‘motivated’ by the situation. Secondly, both humans and non-human animals are responsive to ‘affordances’ (Gibson 1979); to possibilities for action offered by an environment. Thirdly, both humans and animals are selectively responsive to one affordance rather than another. Social affordances are a subcategory of (...) affordances, namely possibilities for social interaction offered by an environment: a friend’s sad face invites comforting behavior, a person waiting for a coffee machine can afford a conversation, and an extended hand affords a handshake. I will review recent insights in the nature of the bodily intentionality characteristic of unreflective action. Such ‘motor intentionality’ can be characterized as “our direct bodily inclination to act in a situated, environmental context” (Kelly 2005, p. 106). Standard interpretations of bodily intentionality see grasping an object as the paradigmatic example of motor intentionality. I will discuss the implications of another, novel perspective that emphasizes the importance of unreflective switches from one activity to another (Rietveld 2004) and understands bodily intentionality in terms of adequate responsiveness to a field of relevant affordances. In the final section I will discuss some implications for cognitive neuroscientists who use empirical findings related to the ‘mirror neuron system’ as a starting point for a theory of motor intentionality and social cognition. (shrink)