In the debate surrounding the morality and legality of the practices of physician-assisted death and euthanasia, a common logical argument regularly employed against these practices is the “slippery slope argument.” One formulation of this argument claims that acceptance of physician-assisted death will eventually lead down a “slippery slope” into acceptance of active euthanasia, including its voluntary, non-voluntary, and/or involuntary forms, through psychological and social processes that warp a society’s values and moral perspective of a practice over an extended period of (...) time. This formulation is known as the psychological slippery slope argument. This paper analyzes the psychological slippery slope argument as it is applied to the practice of physician-assisted death, and utilizing recent empirical evidence from various nations around the world that practice physician-assisted death and/or euthanasia, the paper argues that employing the psychological slippery slope argument against physician-assisted death is logically fallacious, this kind of slippery slope is unfounded in practice, and thus the psychological slippery slope argument is insufficient on its own to justify continued legal prohibition of physician-assisted death. (shrink)

Volume 20, Issue 7, July 2020, Page 193-195.

In Catholic moral theology, the principle of double effect has been an effective normative tool for centuries, and it can be used to determine the ethicality of actions that contain both good and evil consequences. The principle of double effect is especially useful in end-of-life care, because many end-of-life treatment options inherently have both good and evil conse­quences. The principle of double effect can be used to make both practical and moral distinctions between the acts of euthanasia, physician-assisted suicide, palliative (...) sedation, and the withholding and withdrawal of life-sustaining treatment, which can be classified as either unjustified acts of killing or jus­tifiable acts of allowing to die. (shrink)

Volume 20, Issue 6, June 2020, Page 28-30.

Each year, many young professionals forego advanced education in the traditional doctoral programs of medicine, law, and philosophy in favor of pursuing a PhD or professional doctorate in bioethics or healthcare ethics that is offered by several major institutes of higher education across the United States. These graduates often leverage their degrees into careers within the broader field of bioethics. As such, they represent a growing percentage of professional bioethicists in both academia and healthcare nationwide. Given the significant role that (...) doctoral bioethics programs play in the training of future professional bioethicists, it is imperative that programs conferring bioethics degrees are attuned to the knowledge and skills students will need as they transition to professional positions, especially where this training substantially differs from more traditional doctoral degree tracks. Yet, even given this need, there is nothing in the professional literature regarding doctoral bioethics graduates’ perspectives or the overall efficacy of a bioethics doctorate as compared to more traditional doctoral degree tracks for future professional bioethicists. This paper then gives the perspective of five recent doctoral bioethics graduates on the utility of a bioethics doctorate and areas where the doctorate prepared or underprepared them in their roles as early-career professional bioethicists. (shrink)

While the practice of organ donation after cardiac death has long been trending upwards in acceptance and use, it is still a highly controversial and practically inefficient method of organ procurement. One policy that has recently been proposed to try and alleviate some of the ethical and practical concerns with organ donation after cardiac death is the practice of imminent death organ donation. This type of live organ donation comes in patients at the end of their life who have decided (...) to withdraw life-sustaining treatment, but still want to ensure that their organs are donated and not wasted, which isn't always the case with organ donation after cardiac death. This paper then gives some ethical and practical reflections and recommendations regarding the potential implementation of this controversial practice into regular transplant practice and policy. (shrink)

Volume 20, Issue 2, February 2020, Page 62-64.

In the United States, the field of bioethics has expanded over the last two decades. Several institutions offer graduate-level training at both the masters and doctoral level. However, a lack of published literature on the outcomes of doctoral training in bioethics from the perspective of graduates exists. Researchers conducted an online survey of doctoral students who had finished all doctoral requirements but their dissertation, as well as doctoral graduates, of four US-based institutions to ascertain their perspectives on a number of (...) items regarding their doctoral training and their perception of how that training prepared them for their current role in the workforce. Responses from 34 participants were assessed. Respondents had positive overall views on the utility of a bioethics doctorate and the educational training they received in their respective programs. A number of areas for improvement were identified, including better structured clinical ethics training, greater opportunities for research and publishing, and having the ability to teach during their doctoral program, as well as formal pedagogy training. Greater exposure to clinical ethics consultation during the doctoral program was associated with feeling fully prepared as a clinical ethics consultant. This is the first study to assess the perspectives of bioethics doctoral graduates and ABD students regarding the utility of a bioethics doctorate. Per the perspectives of graduates and ABD students, bioethics doctorates are important and effective to train professional bioethicists. We recommend that a few key changes to these programs’ curricula can further bolster their effectiveness. (shrink)

Propelling Clinical Ethics Forward: A Working Unconference was held from 28-29 April 2022 in Atlanta, Georgia. The event, the third installment in an ongoing series of Clinical Ethics Unconferences, brought together 77 individuals from 40 institutions to exchange innovative practices and collaborate to address issues facing the field of clinical ethics. In this article the authors highlight the five major themes that emerged from the 2022 Unconference, including: (1) tackling new and old problems in clinical ethics practice; (2) evolving models (...) of clinical ethics structure and delivery; (3) defining the scope of clinical ethics work; (4) addressing racism, ableism, and underrepresentation in clinical ethics work; and (5) collecting and utilizing data effectively. The authors also reflect on what was learned from the first three Unconferences and offer suggestions for future Unconferences. (shrink)

This paper is a clinical ethics case study which sheds light on several important dilemmas which arise in providing care to patients from cultures with non-individualistic conceptions of autonomy. Medical professionals face a difficult challenge in determining how to respond when families of patients ask that patients not be informed of bad medical news. These requests are often made for cultural reasons, by families seeking to protect patients. In these cases, the right that patients have to their own medical information (...) in order to make autonomous decisions is in tension with the possibility that patients could hold values that require limiting their autonomy with regard to medical information disclosure, often based on the idea that family should take on difficult decision-making as an act of care. We describe one such case, of an 83-year old Russian woman whose husband requested she not be informed of a new cancer diagnosis. The appropriate response to this request was to ask the patient about her values separately, without disclosing any medical information until her values were clear. This patient indicated she wanted the care team to uphold her husband’s request. This response makes the importance of determining a patient’s values before moving forward with disclosure clear: she would not have wanted to be informed of her cancer. We describe our conversation strategy, which allowed value exploration without disclosure and highlighted that the obligation to respect a patient’s autonomy sometimes includes an obligation to allow a patient to choose to limit their own autonomy. This case also highlights that this kind of conversation prioritizes the patient’s values rather than the family’s or care team’s, centering patients in the way that is ethically appropriate. (shrink)

Demonstrating value is an ongoing process and requirement for institutional survival for ethics programs. Although our ethics program has significantly increased our ethics consultation volume and maintains a robust database that tracks ethics consultation data, these data regarding ethics consultations alone do not accurately represent the program’s overall activities and value to the institution. The roles and responsibilities of clinical ethicists extend beyond clinical ethics consultation, and there are many other ways that clinical ethicists contribute and add value to their (...) institutions. This article describes our ethics program’s early efforts to systematically track ethics program activities outside of ethics consultations as a way to demonstrate additional value to the institution that goes beyond ethics consultation. By systematically tracking activities such as internal ethics education sessions, conference presentations, publications, grants, committee/policy work, and other activities, our ethics program has been able to gather substantial quantitative data that highlight our program’s numerous activities and outreach, both within and outside the institution, that provide additional value to the institution beyond our ethical consultation activities. (shrink)

With the increasing professionalization of clinical ethics, some hospitals and health systems utilize both ethics committees and professional clinical ethicists to address their ethics needs. Drawing upon historical critiques of ethics committees and their own experiences, the authors argue that, in ethics programs with one or more professional clinical ethicists, ethics committees should be dissolved when they fail to meet minimum standards of effectiveness. The authors outline several criteria for assessing effectiveness, describe the benefits of a model that places primary (...) responsibility for ethics work with professional clinical ethicists—the PCE-primary model, and offer suggestions for alternative ethics program structures that empower healthcare professionals to contribute to ethics work in ways more tailored to their strengths and skills while minimizing the shortcomings of ethics committees. (shrink)

Are demands for equality motivated by envy? Nietzsche, Freud, Hayek, and Nozick all thought so. Call this the Envy Objection. For egalitarians, the Envy Objection is meant to sting. Many egalitarians have tried to evade the Envy Objection.. But should egalitarians be worried about envy? In this paper, I argue that egalitarians should stop worrying and learn to love envy. I argue that the persistent unwillingness to embrace the Envy Objection is rooted in a common misunderstanding of the nature of (...) the charge, what it reveals, and what can be said in response to it. I develop what Bernard Williams might call a vindicatory genealogy of envy, thereby allowing us to see that envy, rather than undermining egalitarian intuitions, can in fact play a distinct justificatory role (when it is fitting), which undermines the Envy Objection. (shrink)

1. Sexual Brains and Body Politics 2. Hormones and Hardwiring 3. Making Sense of Brain Organization Studies 4. Thirteen Ways of Looking at Brain Organization 5. Working Backward from “Distinct‘ Groups 6. Masculine and Feminine Sexuality 7. Sexual Orienteering 8. Sex-Typed Interests 9. Taking Context Seriously 10. Trading Essence for Potential.

When our nearest and dearest experience medical crises, we may need to step into caregiving roles. But in doing so, we may find that our new caregiving relationship is actually in tension with the loving relationship that motivated us towards care. What we owe and are entitled to as friends, spouses, and family members, can be different from what we owe and are entitled to as caregivers. For this reason, caregiving carries with it the risk of a type of moral (...) distress that I call “role conflict distress.” Rather than view role conflict distress as a sign that we are falling short, I suggest that it actually speaks to the commitment that we have to the loving relationship that grounds our duty of care. (shrink)

Strawson (1994) and Peacocke (1992) introduced thought experiments that show that it seems intuitive that there is, in some way, an experiential character to mental events of understanding. Some (e.g., Siewert 1998, 2011; Pitt 2004) try to explain these intuitions by saying that just as we have, say, headache experiences and visual experiences of blueness, so too we have experiences of understanding. Others (e.g., Prinz 2006, 2011; Tye 1996) propose that these intuitions can be explained without positing experiences of understanding. (...) Call this the debate between Realism and Anti-Realism about experiences of understanding. This paper aims to advance that debate in two ways. In the first half, I develop more precise characterizations of what Realists and Anti-Realists propose. In the second half, I distinguish the four most plausible versions of Anti-Realism and argue that Realism better explains the target intuition than any of them does. (shrink)

This volume summarizes what we know of early Advaita Vedanta upto the Samkara's pupils, Suresvara, Padmapada, Totaka and Hanstamalaka. An analytical introduction by the editor introduces the reader to the concepts utilized by Gaudapada, Samkaracarya and mandana Misra in expounding and defending the Advaita view. This is followed by summaries of all the authentic Advaita works of these authors, together with those of Suresvara and Padmapada as well as a number of other works which have been attributed to samkara, Totaka (...) and Hastamalaka. This volume is divided into two parts and is enriched with an elaborate introduction discussing briefly the history of the school, its theories of value, language and relations and its metaphysics and epistemology. Contents Preface, Part one: Introduction to the philosophy of advaita vedanta, PART Two: Summaries of Works, Notes, Index. (shrink)

This Element examines Kant's innovative account of labour in his political philosophy and develops an intersectional analysis of Kant. By demonstrating that Kant's analysis of slavery, citizenship, and sex developed in inter-linked ways over several decades, culminating in his development of a 'trichotomy' of Right, the author shows that Kant's normative account of independence is configured through his theory of labour, and is continuous with his anthropological accounts of race and gender, providing a systemic justification for the dependency of women (...) and non-whites embedded in his philosophy of right. By examining Kant's arguments about slavery as intertwined with his account of domestic labour, the author argues that his ultimate rejection of slavery may owe more to his changing conceptualization of labour than to his theory of race, and that his final arguments against slavery rehearse strategies for embedding intersectional patterns of domestic dependence in his account of the rightful state. (shrink)

Psyche and Soma is a multi-disciplinary exploration of the history of understanding of the human mind or soul and its relationship to the body, through the course of more than two thousand years. Thirteen specially commissioned chapters, each written by a recognized expert, discuss such figures as the doctors Hippocrates and Galen, the theologians St Paul, Augustine, and Aquinas, and philosophers from Plato to Leibniz.

In a recent paper published in this journal, Hughes (2019) has argued that Machery’s (2017) Dogmatism Argument is self-defeating. Machery’s (2019) reply involves giving the Dogmatism Argument an inductive basis, rather than a philosophical basis. That is, he argues that the most plausible contenders in the epistemology of disagreement all support the Dogmatism Argument; and thus, it is likely that the Dogmatism Argument is true, which gives us reason to accept it. However, Machery’s inductive argument defines the leading views in (...) terms of their citation counts. But there is no necessary connection between citation counts and truth; it is a truism that many highly cited papers over the past century have turned out to contain false arguments. This inductive information should lead Machery to revise his argument; what Machery (2019) owes—but has failed to provide—is a positive argument for ruling out another plausible contender that Hughes (2019) raises. Without such an account, Machery’s inductive case for the Dogmatism Argument fails. (shrink)

Rules are meant to apply equally to all within their jurisdiction. However, some rules are frequently broken without consequence for most. These rules are only occasionally enforced, often at the discretion of a third-party observer. We propose that these rules—whose violations are frequent, and enforcement is rare—constitute a unique subclass of explicitly codified rules, which we call ‘phantom rules’ (e.g., proscribing jaywalking). Their apparent punishability is ambiguous and particularly susceptible to third-party motives. Across six experiments, (N = 1440) we validated (...) the existence of phantom rules and found evidence for their motivated enforcement. First, people played a modified Dictator Game with a novel frequently broken and rarely enforced rule (i.e., a phantom rule). People enforced this rule more often when the “dictator” was selfish (vs. fair) even though the rule only proscribed fractional offers (not selfishness). Then we turned to third person judgments of the U.S. legal system. We found these violations are recognizable to participants as both illegal and commonplace (Experiment 2), differentiable from violations of prototypical laws (Experiments 3) and enforced in a motivated way (Experiments 4a and 4b). Phantom rule violations (but not prototypical legal violations) are seen as more justifiably punished when the rule violator has also violated a social norm (vs. rule violation alone)—unless the motivation to punish has been satiated (Experiment 5). Phantom rules are frequently broken, codified rules. Consequently, their apparent punishability is ambiguous, and their enforcement is particularly susceptible to third party motives. (shrink)

Reflecting upon the recent growth of interest in feminist ideas of philosophy of science, this book traces the development of the subject within the confines of feminist philosophy. It is designed to introduce the newcomer to the main ideas that form the subject area with a view to equipping students with all the major arguments and standpoints required to understand this burgeoning area of study. Arranged thematically, the book looks at the spectrum of views that have arisen in the debate. (...) It is broadly arranged into sections dealing with concepts such as the notion of value free-science, values, objectivity, point of view and relativism, but also details the many subsidiary ideas that have sprung from these topics. (shrink)

In this paper, I defend the view that self-deception is a moral failure. Instead of saying that self-deception is bad because it undermines our moral character or leads to morally deleterious consequences, as has been argued by Butler, Kant, Smith, and others, I argue the distinctive badness of self-deception lies in the tragic relationship that it bears to our own values. On the one hand, self-deception is motivated by what we value. On the other hand, it prevents us from valuing (...) those things properly. I argue that we owe it ourselves to take seriously our own values, by striving to properly value them. This gives us both prudential and moral reasons to avoid self-deception. (shrink)

I argue that an evolutionary adaptation for bodily mimesis, the volitional use of the body as a representational devise, is the “small difference” that gave rise to unique and yet pre-linguistic features of humanity such as imitation, pedagogy, intentional communication and the possibility of a cumulative, representational culture. Furthermore, it is this that made the evolution of language possible. In support for the thesis that speech evolved atop bodily mimesis and a transitional multimodal protolanguage, I review evidence for the extensive (...) presence of sound-symbolism in modern languages, for its psychological reality in adults, and for its contribution to language acquisition in children. On a meta-level, the argument is that dividing human cognitive-semiotic evolution into a sequence of stages is crucial for resolving classical dichotomies concerning human nature and language, which are both natural and cultural, both continuous with and discontinuous from those of animals. (shrink)

Although COVID-19 vaccines are free and readily available in the United States, many healthcare workers remain unvaccinated, potentially exposing their patients to a life-threatening pathogen. This paper reviews the ethical and legal factors surrounding patient requests to limit their care teams exclusively to vaccinated providers. Key factors that shape policy in this area include patient autonomy, the rights of healthcare workers, and the duties of healthcare institutions. Hospitals must also balance the rights of interested parties in the context of logistical (...) constraints, equity, and public health considerations. (shrink)

The ‘black box problem’ is a long-standing talking point in debates about artificial intelligence. This is a significant point of tension between ethicists, programmers, clinicians and anyone else working on developing AI for healthcare applications. However, the precise definition of these systems are often left undefined, vague, unclear or are assumed to be standardised within AI circles. This leads to situations where individuals working on AI talk over each other and has been invoked in numerous debates between opaque and explainable (...) systems. This paper proposes a coherent and clear definition for the black box problem to assist in future discussions about AI in healthcare. This is accomplished by synthesising various definitions in the literature and examining several criteria that can be extrapolated from these definitions. There are no data in this work. (shrink)

What does everyone in the modern world need to know? Renowned psychologist Jordan B. Peterson's answer to this most difficult of questions uniquely combines the hard-won truths of ancient tradition with the stunning revelations of cutting-edge scientific research. Humorous, surprising and informative, Dr. Peterson tells us why skateboarding boys and girls must be left alone, what terrible fate awaits those who criticize too easily, and why you should always pet a cat when you meet one on the street. What (...) does the nervous system of the lowly lobster have to tell us about standing up straight (with our shoulders back) and about success in life? Why did ancient Egyptians worship the capacity to pay careful attention as the highest of gods? What dreadful paths do people tread when they become resentful, arrogant and vengeful? Dr. Peterson journeys broadly, discussing discipline, freedom, adventure and responsibility, distilling the world's wisdom into 12 practical and profound rules for life. [This book] shatters the modern commonplaces of science, faith and human nature, while transforming and ennobling the mind and spirit of its readers. (shrink)

About 6% of women in the world live in countries that ban all abortions, and 34% in countries that only allow abortion to preserve maternal life or health. In the USA, over the last decades—even before Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion—various states have sought to restrict abortion access. Often times, this legislation has been advanced based on legislators’ personal moral values. At the bedside, in contrast, provision of abortion care should adhere to the (...) normative principles of medical ethics and reproductive justice, centreing patients and their individual reproductive intentions and desires. Abortion regulations, through their influence on patients and providers, may facilitate or impede such ethical care at the bedside. In this paper, we present a framework to model how abortion legislation should fit into the patient–provider relationship and to clarify the dynamics by which legislation may affect healthcare encounters. Our proposed framework serves as a tool to analyse the ethical impact of abortion regulations. We propose a model for assessing abortion policies based not on legislators’ or advocates’ individual moral claims, but on the shared, normative framework of clinical medical ethics. Through contrasting case studies, we demonstrate how a robust normative ethical framework can recentre patients and their reproductive needs. Our model is one way to account for—and safeguard—patients’ diverse viewpoints and needs in the development of abortion policy, and it can serve to ground narratives for advocacy by healthcare workers and their professional organisations. (shrink)