Spinal muscular atrophy (SMA) is the most common genetic disease that causes infant mortality. Its treatment and prevention represent the paradigmatic example of the ethical dilemmas of 21st‐century medicine. New therapies (nusinersen and AVXS‐101) hold the promise of being able to treat, but not cure, the condition. Alternatively, genomic analysis could identify carriers, and carriers could be offered in vitro fertilization and preimplantation genetic diagnosis. In the future, gene editing could prevent the condition at the embryonic stage. How should these (...) different options be evaluated and compared within a health system? In this paper, we discuss the ethical considerations that bear on the question of how to prioritize the different treatments and preventive options for SMA, at a policy level. We argue that despite the tremendous value of what we call ‘ex‐post’ approaches to treating SMA (such as using pharmacological agents or gene therapy), there is a moral imperative to pursue ‘ex‐ante’ interventions (such as carrier screening in combination with prenatal testing and preimplantation genetic diagnosis, or gene editing) to reduce the incidence of SMA. There are moral reasons relating to autonomy, beneficence and justice to prioritize ex‐ante methods over ex‐post methods. (shrink)

Although rapid genomic sequencing (RGS) is improving care for critically ill children with rare disease, it also raises important ethical questions that need to be explored as its use becomes more widespread. Two such questions relate to the degree of consent that should be required for RGS to proceed and whether it might ever be appropriate to override parents’ decisions not to allow RGS to be performed in their critically ill child. To explore these questions, we first examine the legal (...) frameworks on securing consent for genomic sequencing and how they apply to the specific context of RGS for critically ill children. We then use a tool from clinical ethics, the Zone of Parental Discretion, to explore two case studies and identify under which circumstances it might be appropriate for parental refusal of RGS to be overridden. We argue that RGS may be a context where, in addition to assessing the complexity of the test offered, it is ethically appropriate to consider an effect on patient outcomes when deciding the degree of consent required. We also suggest that there are some contexts where it may be ethically justified to perform RGS, even when it is actively against the wishes of the parents. More work is needed to examine exactly how ‘time-sensitive’ exceptions to current guidance on consent for genomic sequencing could be formulated and operationalised for RGS for critically ill-children. (shrink)

There appears to be a tension between two commitments in liberalism. The first is that citizens, as rational agents possessing dignity, are owed a justification for principles of justice. The second is that members of society who do not meet the requirements of rational agency are owed justice. These notions conflict because the first commitment is often expressed through the device of the social contract, which seems to confine the scope of justice to rational agents. So, contractarianism seems to ignore (...) the justice claims of the severely cognitively impaired. To solve this problem, Martha Nussbaum proposes the capabilities approach. The justifiability condition, on this approach, is met by the idea of overlapping consensus. This essay argues that overlapping consensus cannot meet liberalism’s justifiability condition, nor is it more inclusive of the cognitively impaired. Therefore, we have reason to retain the contract device and look for another way to ensure that liberalism respects the justice claims of all. (shrink)

Abstract:While the medical ethics literature has well explored the harm to patients, families, and the integrity of the profession in failing to disclose medical errors once they occur, less often addressed are the moral and professional obligations to take all available steps to prevent errors and harm in the first instance. As an expanding body of scholarship further elucidates the causes of medical error, including the considerable extent to which medical errors, particularly in diagnostics, may be attributable to cognitive sources, (...) insufficient progress in systematically evaluating and implementing suggested strategies for improving critical thinking skills and medical judgment is of mounting concern. Continued failure to address pervasive thinking errors in medical decisionmaking imperils patient safety and professionalism, as well as beneficence and nonmaleficence, fairness and justice. We maintain that self-reflective and metacognitive refinement of critical thinking should not be construed as optional but rather should be considered an integral part of medical education, a codified tenet of professionalism, and by extension, a moral and professional duty. (shrink)

Existing justifications for exclusionary rules and stays of proceedings in response to pre-trial wrongdoing by police officers and prosecutors are often thought to be counter-productive or disproportionate in their consequences. This article begins to explore whether the concept of standing to blame can provide a fresh justification for such responses. It focuses on a vice related to standing—hypocrisy—and a related vice concerning inconsistent blame. It takes seriously the point that criminal justice agencies, although all part of the State, are in (...) real terms separated from each other, and analyses the so-called separation thesis (or theses). It concludes that hypocrisy and inconsistent blame arguments could plausibly justify exclusion and stays only in relation to lower-level offending, and even there only indirectly. This is in the sense that exclusion and stays are expressions of judicial frustration with other bodies for their failure to take pre-trial wrongdoing seriously. (shrink)

Conflicts of interest pose special problems for the professions. Even the appearance of a conflict of interest can undermine essential trust between professional and public. This volume is a comprehensive and accessible guide to the ramifications and problems associated with important issue. It contains fifteen new essays by noted scholars and covers topics in law, medicine, journalism, engineering, financial services, and others.

The standard theory of logic programming is not applicable to Prolog programs even not to pure code. Modifying the theory to take account of reality more is the motivation of this article. For this purpose we introduce the ℓ-completion and the inductive extension of a logic program. Both are first-order theories in a language with operators for success, failure and termination of goals. The ℓ-completion of a logic program is a sound and complete axiomatization of the Prolog depth-first search under (...) certain natural conditions; the inductive extension of the ℓ-completion is a suitable theory for proving termination and equivalence of pure Prolog programs with negation. (shrink)

This paper discusses the views of Wheeler and LaFollette on the right to bear arms. It argues, with LaFollette and against Wheeler that the right to bear arms is derivative and not a fundamental right. My argument pivots on the idea that Wheeler's account of what makes a right fundamental is too broad.

Despite the immense societal importance of ethically designing artificial intelligence, little research on the public perceptions of ethical artificial intelligence principles exists. This becomes even more striking when considering that ethical artificial intelligence development has the aim to be human-centric and of benefit for the whole society. In this study, we investigate how ethical principles are weighted in comparison to each other. This is especially important, since simultaneously considering ethical principles is not only costly, but sometimes even impossible, as developers (...) must make specific trade-off decisions. In this paper, we give first answers on the relative importance of ethical principles given a specific use case—the use of artificial intelligence in tax fraud detection. The results of a large conjoint survey suggest that, by and large, German respondents evaluate the ethical principles as equally important. However, subsequent cluster analysis shows that different preference models for ethically designed systems exist among the German population. These clusters substantially differ not only in the preferred ethical principles but also in the importance levels of the principles themselves. We further describe how these groups are constituted in terms of sociodemographics as well as opinions on artificial intelligence. Societal implications, as well as design challenges, are discussed. (shrink)

Kant claims that persons have a perfect duty to respect themselves. I argue, first, that Kant’s argument for the duty of self-respect commits him to an implausible view of the nature of self-respect: he must hold that failures of self-respect are either deliberate or matter of self-deception. I argue, second, that this problem cannot be solved by understanding failures of self-respect as failures of rationality because such a view is incompatible with human psychology. Surely it is not irrational for people, (...) especially members of oppressed groups, to view themselves as having diminished moral worth. (shrink)

I explore a distinction that is philosophically significant but rarely a cynosure. The distinction is betvveen fallacies and logical errors, and I approach it by advancing overlooked albeit deleterious logical errors that are not fallacies but that fall squarely within the purview of Critical Thinking if not also Informal Logic. One key claim to emerge is that these logical errors -- just as basic and thought-impeding as the fallacies -- demand that we take a hard look at what is and (...) what should be guiding our activity in teaching such courses. Another is that although philosophers appeal to the notion of logical error in their explications of fallacies, the former notion is anything but clear and indeed usually explained in terms of the latter. Yet another is that the distinction illustrates why the oft encountered “false premise or bad inference” account of how thinking can go bad is oversimplified. (shrink)

The essay challenges the de facto dichotomy between the discipline of logic and the activity of social criticism, i.e., it provides an illustrated reminder to philosophers that the gulf between these two areas of philosophy is not quite as wide as our curriculum andspecialization designations tend to suggest. Social criticism plays some necessary roles in certain branches of logic, and the second-order accounting of the contents of these branches leads back to social criticism. These points suggest an adjusted conception of (...) logic that would, among other things, render phrases such as “applying logic to social criticism” as misleading since certain branches of logic would not even coherently exist apart from social criticism. The lead illustrations are the identification of basic, pervasive, and thought-impeding logical errors that have been missed by numerous logic texts, and the assessment of contemporary academic logic as properly a quest for communal sanity that lies caught between communal insanity and communal mendacity. (shrink)

We show the adequacy of axioms and proof rules for strict and lazy functional programs. Our basic logic comprises a huge part of what is common to the two styles of functional programming. The logic for call-by-value is obtained by adding the axiom that says that all variables are defined, whereas the logic for call-by-name is obtained by adding the axiom that postulates the existence of an undefined object for each type. To show the correctness of the axiomatization we do (...) not use denotational semantics and the adequacy of the evaluation of programs with respect to the semantics. Instead we use the standard term models based on call-by-value and call-by-name evaluation. We introduce a new method to prove on the syntactical level the monotonicity of the evaluation of functional programs with unbounded recursion. The direct method yields results concerning the proof-theoretic strength of the axiomatization. As a side result we obtain a syntactical proof of the context lemma for simply typed lambda terms with recursion. (shrink)

Because contractarians see justice as mutual advantage, they hold that justice can be rationally grounded only when each can expect to gain from it. John Rawls seems to avoid this feature of contractarianism by fashioning the parties to the contract as Kantian agents whose personhood grounds their claims to justice. But Rawls also endorses the Humean idea that justice applies only if people are equal in ability. It would seem to follow from this idea that dependent persons (such as the (...) disabled) lack claims of justice. It appears, then, that the Kantian and Humean themes in Rawls conflict. I present a reading of Rawls that resolves this tension between the Kantian and Humean themes. The first theme, I argue, allows Rawls to maintain that persons as such are owed justice regardless of their ability to engage in social cooperation. The second theme, I argue, allows him to retain Hume's connection between justice and reciprocity, but confines the reciprocity condition to relations among nondependents. I conclude that Rawls's approach permits him to rebut recent criticisms leveled by disability theorists and others who claim that his theory excludes dependents. (shrink)

I argue that Roger Ascham was a more vehement Protestant that is ordinarily assumed. Inheriting from the Reformation notions of apocalypse, Catholic witchcraft, and mass demonic possession, Ascham teaches English eloquence primarily so that students might defend themselves against the Devil's and Rome's rhetoric before the world ends, for the sake of their own salvation as well as England’s. More broadly, I demonstrate that scholars require a neglected theological category—eschatology—in order adequately to discuss the rise of modern English eloquence.

Recklessness involves unreasonable/unjustified risk-taking. The argument here is that recklessness in the criminal law is best understood as nevertheless containing an element of reasonableness. To be reckless, on this view, the defendant must reasonably believe that she is exposing others to a risk of harm. If the defendant’s belief about the risk being imposed by her conduct is unreasonable, she should not be considered reckless. This point is most important in relation to offences of endangerment where recklessness sets the outer (...) limits of criminal liability. (shrink)

Judith Butler’s recent work is exemplary of the trend in contemporary theory to consider ethics. Her deliberation over ethical questions, and the place of ethics in intellectual work, has undeniably intensified since September 11. This article will demonstrate, however, that this is a rendering explicit of what has always been implicit in her work. Rather than perceiving the ethical dimension of Butler’s writings in her increasing interest in thinkers such as Emmanuel Levinas and Hannah Arendt, I contend that it is (...) in her sustained interest in Hegel, and specifically in Hegelian recognition, that her work can be read as engaged with ethical concerns. This article highlights the growing critical concern with the prevalence of recognition in ethical theory and questions the possibility of theorising ethics outside of the recognition-paradigm. (shrink)

DieVorlesung über Moralphilosophie aus den 1770er Jahren ist eine wichtige Erläuterung und Ergänzung zur Grundlegung der Metaphysik der Sittenvon 1785. Die Neuedition der so genannten Menzer-Vorlesung präsentiert diese Vorlesung auf dem aktuellen Stand der Forschung. Zugrunde gelegt ist die Nachschrift Kaehler, die seit 1997 zum Kant-Archiv in Marburg gehört. Abgeglichen ist der Text mit mehreren Handschriften des Archivs der Berlin-Bandenburgischen Akademie der Wissenschaften und der Staatsbibliothek Berlin. Ein Anhang mit textkritischem Apparat und Erläuterungen zu Literatur und Personen sowie eine Einleitung (...) von Manfred Kühn erschließen die Vorlesung für alle, die sich für die Kant'sche Philosophie der Ethik interessieren. (shrink)

Kants Metaphysische Anfangsgründe der Rechtslehre galten seit ihrem Erscheinen 1797 als mehr oder weniger verunglücktes Alterswerk. Bernd Ludwigs Untersuchung beansprucht dagegen, in ihrem ersten Teil den Nachweis zu führen, daß der problematische Zustand der Schrift nicht etwa den nachlassen den Geisteskräften des Autors zuzuschreiben ist, sondern sich vielmehr einer verunglücken Drucklegung verdankt: Zum Druck gelangte ein Manuskript, in dem nicht nur einzelne Textpassagen falsch angeordnet waren, sondern das auch Vorarbeiten enthielt, die für den Druck gar nicht vorgesehen waren. Anhand von (...) philologischen Indikatoren läßt sich eine Version rekonstruieren, die der von Kant intendierten Textgestalt weitgehend entspricht, ihr zumindest aber wesentlich näher kommt als der Druck von 1797. Im zweiten Teil wird in Gestalt eines analytischen Kommentars feingliedrig die Kantische Argumentation rekonstruiert und auf diesem Wege aufgezeigt, daß das wiederhergestellte Werk tatsächlich die über dreißig Jahre währende Arbeit Kants an seiner Rechtsphilosophie erfolgreich zum Abschluß gebracht hat. Spuren nachlassender Geisteskräfte sind dabei nicht auszumachen. Vielmehr erweist sich Kant als Autor, der traditionelle Lehrstücke des Naturrechts souverän an seine kritische Grundlegung der praktischen Philosophie anschließt. (shrink)

According to Catharine MacKinnon, pornography itself subordinates women by ranking women as inferior to men and legitimating acts of violence and discrimination against us. As such, pornography is directly implicated in women's diminished moral and civil status. It follows that pornography is not a form of speech, but rather an action, and so does not deserve first amendment protection. I argue that MacKinnon does not adequately support her claim that pornography is an action but instead shows that it is harmful (...) speech. While this might be grounds for limiting it, MacKinnon does not adequately support the view that pornography is especially harmful in comparison to other sorts of misogynist and sexist speech. Hence we lack reasons to limit pornography alone. (shrink)

A central strand in philosophical debate over the just distribution of resources attempts to juggle three competing imperatives: helping those who are worst off, helping those who will benefit the most, and then – beyond this – determining when to aggregate such ‘worst off’ and ‘benefit’ claims, and when instead to treat no such claim as greater than that which any individual by herself can exert. Yet as various philosophers have observed, ‘we have no satisfactory theoretical characterization’ as to how (...) to weigh each of the three imperatives against one another, we find it ‘difficult to state... precise or comprehensive conclusions’, and we do not yet have a ‘metric for integrating the three measures’. In what follows, I offer an approach to weighing the three criteria against one another that yields resolutions – in Hard Cases of the ‘saving one infant's life versus replacing ten elderly people's hips’ sort – that are cardinally definitive, intuitively satisfactory and theoretically justified. (shrink)

This article explores the development of therapeutic psychological techniques for emotional management as exemplified by Albert Ellis’s development of rational therapy (RT) in the 1950s and 1960s. A precursor to contemporary Cognitive Behavioral Therapy (CBT), rational therapy conceptualized emotion as manageable through scientific self-narration. The article examines how Ellis’s immersion in media techniques and forms accessible to a general audience shaped his focus on a new language for clinical practice inspired by behaviorist principles, and how much this ‘clarified’ language exemplifies (...) the application of ‘high modernist ideology’ to the treatment of the postwar American psychological subject. (shrink)

This article provides a philosophical account of love in relation to contemporary Marxist and post-structuralist conceptions of politics. Shifting the emphasis away from both the ontological question, “what is love?,” and the epistemological question, “how do we acquire certainty about love?,” this article advances a pedagogical question: how might love enable us to learn? To answer this question we turn to the work of Michael Hardt and Antonio Negri, and Gilles Deleuze and Félix Guattari. After examining the tensions between ontological (...) and ideological conceptions of love, we explore Hardt and Negri’s work on love as part of the affective labour of the “multitude.” We then trace the development of Deleuze’s early work on love as an apprenticeship to signs to his later exploration of love in relation to multiplicity. In doing so, this article seeks to renovate the concept of love itself, framing it in terms of difference rather than merging and unity, and locating it outside the confines of the heterosexual couple and nuclear family. (shrink)