In lieu of an abstract, here is a brief excerpt of the content:President’s Council on BioethicsEdmund D. Pellegrino (bio) and F. Daniel Davis (bio)Approximately two weeks before what was to have been its final meeting, the White House dissolved the President’s Council on Bioethics by terminating the appointments of its 18 members. The letters of dismissal, dated 10 June 2009, informed the members that their service on the Council would end with the close of business the next day.The Council’s (...) term was set to expire on 30 September 2009. After President Obama’s election in November and during the transition, we were advised to proceed on the assumption that the Council would be permitted to cease on that date. Reasons for the abrupt move to disband the Council are unknown. We have accepted the fact that we Council members served at the pleasure of the President and that he simply exercised his rightful prerogative. No explanation is therefore required.Some observers have speculated that the action was retaliatory. They related to the fact that several members of the Council disagreed with the President’s stem cell policy in a signed statement published in the Hastings Center’s Bioethics Forum. Others have speculated that the move was pre-emptive. At its final meeting, scheduled for 25–26 June, the Council was set to sign-off on two of its final publications. One was a comprehensive report on the ethics of organ transplantation, and the other a white paper entitled Health Care and the Common Good. The aim was immediately to release the latter as a contribution to the intensifying debate about health care reform. Health Care and the Common Good could well have aided rather than impeded the President’s drive to better control health care costs and achieve universal coverage. The Council report attempted to ground both goals in the ethical framework of, as the title indicates, the common good of all Americans.In his letter terminating the members’ appointments, Assistant to the President for Presidential Personnel Don Gips said that the President “recognizes the values of having a commission of experts in bioethical issues to provide objective and non-ideological bioethics advice to his administration.” Gips went on to say that the President is “currently rethinking the purposes and goals of such a bioethics commission, and is carefully considering a revitalized mission and mandate.” And, [End Page 309] responding to media enquiries, White House press officer Reid Cherlin explained that the President’s Council was terminated because it was a “philosophically leaning advisory group” and, according to a New York Times account by Nicholas Wade, “because it favored discussion over developing a shared consensus.” As for the ultimate outcome of the President’s “rethinking,” Cherlin indicated that President Obama will appoint a new commission with the mandate of offering “practical policy options” in bioethics.In the light of our experiences with the Council, we leave it with hopes that certain questions of national importance will be addressed. In light of the nature of federal advisory commissions, what is or are the proper roles of a national bioethics commission? If the aim is to provide advice and counsel to the President or, perhaps to the U. S. Congress, is that advice best rendered as a group consensus or as an in-depth exploration of the inevitably conflicting ethical perspectives on a given issue? How should such a commission be constituted—with what sorts of individuals? And what is the nature of the expertise that they individually and collectively bring to the commission’s functions? If the commission is to promote public debate and discussion, how exactly should it go about that task? And how is the efficacy of a commission to be assessed? Such questions inevitably lead us deep into contested territory, as the experience of this Council has shown: into the intersections of politics, religion, and science and into the relations between practice and theory—between policy and what some seem to deride as “philosophy.” Indeed, policy without an underlying philosophy is an edifice without a foundation; philosophy without policy is a foundation without an edifice.At the last meeting of the Council in March 2009, we launched a discussion of these questions with the... (shrink)

This paper investigates what choices teachers made and what rationales they offered related to the inclusion and exclusion of primary source photographs for a hypothetical unit about the U.S. Civil...

This Handbook offers a broad yet unified treatment of many philosophical issues connected with climate change, ranging from foundational puzzles to detailed applications. It extends to many branches of philosophy that are relevant to the understanding of the premises and implications of the impacts of climate change on human and nonhuman life on Earth. More specifically, the handbook examines the scientific accounts of climate change as well as its causes. It explores the tools offered by social sciences and humanities to (...) study the societal premises and impacts of climate change as well as delving deeper into the ethical and political issues connected with and resulting from climate change. By doing so, it puts it all in an ecological and historical context. In addition, the book offers solutions to some important philosophical puzzles and problems, and indicates paths of interaction between philosophy and other disciplines. The discussion about climate change and the mitigation/adaptation policies spans many areas and levels – from abstract science and philosophy to current on-the-ground politics. However, climate change is also a great a philosophical puzzle. Indeed, its existential and practical relevance can be thought to largely derive from the philosophical complications it engenders. Climate change is applied philosophy par excellence. Preventing dangerous anthropogenic climate change needs very good philosophy applied to concrete and specific practical issues. Climate change is an area where scholars from very different provenances should cooperate on equal terms, having in view a common, and really important, purpose – contribute to preventing great burdens and even the extinction of humankind and the destruction of hospitable and valuable non-human nature. (shrink)

At the center of medical morality is the healing relationship. It is defined by three phenomena: the fact of illness, the act of profession, and the act of medicine. The first puts the patient in a vulnerable and dependent position; it results in an unequal relationship. The second implies a promise to help. The third involves those actions that will lead to a medically competent healing decision. But it must also be good for the patient in the fullest possible sense. (...) The physician cannot fully heal without giving the patient an understanding of alternatives such that he or she can freely arrive—together with the physician—at a decision in keeping with his or her personal morality and values. In today's pluralistic society, universal agreement on moral issues between physicians and patients is no longer possible. Nevertheless, a reconstruction of professional ethics based on a new appreciation of what makes for a true healing relationship between patient and physician is both possible and necessary. (shrink)

This response to Kevin WildesÕs article in the previous issue of the Kennedy Institute of Ethics Journal addresses several major points of disagreement between Pellegrino and Wildes regarding the nature and scope of a philosophy of medicine, in particular how it is derived and by what method of philosophical enquiry it is best pursued.

Book reviewed in this article: For the Patient's Good: The Restoration of Beneficence in Health Care. By Edmund D. Pellegrino and David C. Thomasma.

Fifty years ago, 23 Nazi physicians were defendants before a military tribunal in Nuremberg, charged with crimes against humanity. During that trial, the world learned of their personal roles in human experimentation with political and military prisoners, mass eugenic sterilizations, state-ordered euthanasia of the and the program of genocide we now know as the Holocaust. These physicians, and their colleagues who did not stand trial, were universally condemned in the free world as ethical pariahs. The term became the paradigm for (...) total defection from the most rudimentary elements of medical morality. The caduceus literally became the instrument of the swastika. (shrink)

Richard Lamm is an eloquent and insistent advocate for healthcare reform. In his paper, he argues that if reform is to be effective, a radical metamorphosis in the values underlying our present system must take place. “New realities” have made the “old values” unsustainable. Unless they are replaced by “new values,” we face a future of disastrous overspending, gross inequities in accessibility, poorer health for many, and more expensive dying.

In 1991, Diane Wood Middlebrook, a professor of English at Stanford University, published a biography of the poet Anne Sexton in which, among other things, she used as source material some 300 tapes of Sexton's psychotherapeutic sessions with her psychiatrist, Dr. Martin Orne. After some years of reluctance and with the concurrence of Sexton's daughter and literary executor, Linda Gray Sexton, Orne released the tapes to Professor Middlebrook. Middlebrook's picture of Sexton drew heavily on the tapes, supplemented by scrapbooks, letters, (...) photos, clippings, unpublished poems, and hospital records. (shrink)

A decade ago, we reviewed the field of clinical ethics; assessed its progress in research, education, and ethics committees and consultation; and made predictions about the future of the field. In this article, we revisit clinical ethics to examine our earlier observations, highlight key developments, and discuss remaining challenges for clinical ethics, including the need to develop a global perspective on clinical ethics problems.

Observing averted eye gaze results in the automatic allocation of attention to the gazed-at location. The role of the orientation of the face that produces the gaze cue was investigated. The eyes in the face could look left or right in a head-centred frame, but the face itself could be oriented 90 degrees clockwise or anticlockwise such that the eyes were gazing up or down. Significant cueing effects to targets presented to the left or right of the screen were found (...) in these head orientation conditions. This suggests that attention was directed to the side to which the eyes would have been looking towards, had the face been presented upright. This finding provides evidence that head orientation can affect gaze following, even when the head orientation alone is not a social cue. It also shows that the mechanism responsible for the allocation of attention following a gaze cue can be influenced by intrinsic object-based (i.e. head-centred) properties of the task-irrelevant cue. (shrink)

In the history of science, the birth of classical chemistry and thermodynamics produced an anomaly within Newtonian mechanical paradigm: force and acceleration were no longer citizens of new cited sciences. Scholars tried to reintroduce them within mechanistic approaches, as the case of the kinetic gas theory. Nevertheless, Thermodynamics, in general, and its Second Law, in particular, gradually affirmed their role of dominant not-reducible cognitive paradigms for various scientific disciplines: more than twenty formulations of Second Law—a sort of indisputable intellectual wealth—are (...) conceived after 1824 Sadi Carnot’s original statement and a multitude of entropy functions are proposed after 1865 Clausius’ former definition. Furthermore, at the end of nineteenth century, thermodynamics extended its cognitive domain to chemistry. Mainly thanks to Gibbs, a brand new discipline—chemical thermodynamics or physical chemistry—gradually affirmed its role inside the scientific community. This paper reports the former results of collaborative research program in the History and Epistemology of Science as well as Nature of Science Teaching aimed at retracing the foundations of the physical chemistry. Specifically, the research is structured in three parts: historical-epistemic reflections on fundamental thermodynamic concepts and principles—such as reversible process, heat, temperature, thermal equilibrium and Clausius’ Second Law—that play a structural role inside modern physical chemistry; panoramic overview on the entropy, whose polysemy makes it one of the most demanding concepts for scholars, teachers and students while approaching thermodynamics; conceptualization of chemical equilibrium as complex entity according to the dual epistemological approach offered by Gibbs’ thermodynamic model and the kinetic standpoint by Guldberg and Waage. In particular, the present work details an original reading of thermodynamic principles with the aim of setting forth a rationalized multidisciplinary substrate whereon the foundational concepts of reversible process and thermal equilibrium can be set. (shrink)

In the history of science, the birth of classical chemistry and thermodynamics produced an anomaly within Newtonian mechanical paradigm: force and acceleration were no longer citizens of new cited sciences. Scholars tried to reintroduce them within mechanistic approaches, as the case of the kinetic gas theory. Nevertheless, Thermodynamics, in general, and its Second Law, in particular, gradually affirmed their role of dominant not-reducible cognitive paradigms for various scientific disciplines: more than twenty formulations of Second Law—a sort of indisputable intellectual wealth—are (...) conceived after 1824 Sadi Carnot’s original statement and a multitude of entropy functions are proposed after 1865 Clausius’ former definition. Furthermore, at the end of nineteenth century, thermodynamics extended its cognitive domain to chemistry. Mainly thanks to Gibbs, a brand new discipline—chemical thermodynamics or physical chemistry—gradually affirmed its role inside the scientific community. This paper reports the former results of collaborative research program in the History and Epistemology of Science as well as Nature of Science Teaching aimed at retracing the foundations of the physical chemistry. Specifically, the research is structured in three parts: historical-epistemic reflections on fundamental thermodynamic concepts and principles—such as reversible process, heat, temperature, thermal equilibrium and Clausius’ Second Law—that play a structural role inside modern physical chemistry; panoramic overview on the entropy, whose polysemy makes it one of the most demanding concepts for scholars, teachers and students while approaching thermodynamics; conceptualization of chemical equilibrium as complex entity according to the dual epistemological approach offered by Gibbs’ thermodynamic model and the kinetic standpoint by Guldberg and Waage. In particular, the present work details an original reading of thermodynamic principles with the aim of setting forth a rationalized multidisciplinary substrate whereon the foundational concepts of reversible process and thermal equilibrium can be set. (shrink)

The ventromedial prefrontal cortex (VMPFC) is crucial for moral behavior, yet the mechanism through which the VMPFC promotes moral behavior remains unclear. In this article, we emphasize that moral choice is often intertemporal, requiring foregoing short-term gains in favor of future outcomes of larger value. We propose that the VMPFC may be necessary for mental time travel (MTT), a cognitive process enabling vivid preexperiencing of future outcomes. By providing anticipated outcomes that inform decisions, MTT may promote farsighted, moral behaviors.