Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical (...) students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless. (shrink)

When attempting to answer the question, in the context of clinical healthcare, one might be tempted to leap to either of two rather obvious, but seemingly contradictory conclusions. On the one hand, we might have a general impression of religion not making much of a distinctive and clear difference, at least in the actions and outcomes of most cases of clinical interaction. Those of us in the bioethics world of discourse are likely to think only of the less common cases (...) of Christian Scientists, Jehovah's Witnesses, Orthodox Jews, or certain religious groups who seem to the majority of the population to hold especially sectarian, if not beliefs about medical matters. The so-called mainstream religious groups do not get much attention because they largely don't cause much trouble ; they have learned to bracket their religious commitments from at least any professional settings ; or they don't hold views entailing consequences any different from those of most nonbelieving, generally upright individuals. Furthermore, although religious believers may have some distinctive views, these views don't often noticeably manifest themselves in distinctive or significant ways. (shrink)

The biotechnology industry's intellectual property claims contribute to a subtle but not insignificant encroachment of commodification within health care. Drawing on the conceptual framework of Margaret Jane Radin, I argue that patent claims on human biological materials may commodify that with which our personhood and individuality is intertwined but that such commodification is broad and incomplete. Patents on nonhuman biological organisms contribute to a more materialistic understanding of them but do not significantly change our relationship to them. The systemic effects (...) of biotechnology's commodification within health care are various and may compromise the goal of good health. The morally problematic aspects of patent claims entail certain obligations to inhibit commodification from becoming more egregious, but on balance, those aspects are currently insufficient to justify denying the benefits the patent system promotes. (shrink)

Book reviewed in this article: Theological Voices in Medical Ethics. Edited by Allen Verhey and Stephen E. Lammers.

Book reviewed in this article: Theological Voices in Medical Ethics. Edited by Allen Verhey and Stephen E. Lammers.

As medical science continues its rapid advances, questions are raised that have more to do with theology than with technology: Where is God when I am hurt or suffering? What role does God play in my healing? "Pain Seeking Understanding" examines how believers and nonbelievers alike wrestle with questions of faith when confronted with pain and suffering that medicine alone cannot treat. Margaret Mohrmann and Mark Hanson call upon fellow experts in the fields of medicine, ethics, theology, and (...) pastoral care to help them weave the complex story of faith and science working together to ease suffering -- and to help broaden our understanding of God's role in suffering and healing. (shrink)

The UK government has recently committed to adopting a new policy—dubbed ‘Martha’s Rule’—which has been characterised as providing patients the right to rapidly access a second clinical opinion in urgent or contested cases. Support for the rule emerged following the death of Martha Mills in 2021, after doctors failed to admit her to intensive care despite concerns raised by her parents. We argue that framing this issue in terms of patient rights is not productive, and should be avoided. Insofar as (...) the ultimate goal of Martha’s Rule is the provision of a clinical service that protects patient safety, an approach that focuses on the obligations of the health system—rather than the individual rights of patients—will better serve this goal. We outline an alternative approach that situates rapid clinical review as part of a suite of services aimed at enhancing and protecting patient care. This approach would make greater progress towards addressing the difficult systemic issues that Martha’s Rule does not, while also better engaging with the constraints of clinical practice. (shrink)

In recent decades cognitive science has revolutionised our understanding of the workings of the human mind. Philosophy has made a major contribution to cognitive science and has itself been hugely influenced by its development. This dynamic book explores the philosophical significance of cognitive science and examines the central debates that have enlivened its history. In a wide-ranging and comprehensive account of the topic, philosopher M.J. Cain discusses the historical origins of cognitive science and its philosophical underpinnings; the nature and role (...) of representations in cognition; the architecture of the mind and the modularity thesis; the nature of concepts; knowledge of language and its acquisition; perception; and the relationship between the brain and cognition. Cain draws upon an extensive knowledge of empirical developments and their philosophical interpretation. He argues that although the field has generated some challenging new views in recent years, many of the core ideas that initiated its birth are still to be taken seriously. Clearly written and incisively argued, The Philosophy of Cognitive Science will appeal to any student or researcher interested in the workings of the mind. (shrink)

Since the start of the twenty-first century, the political mainstream has been shifting to the right. The liberal orthodoxy that took hold in the West as a reaction to the Second World War is breaking down. In Europe, populist political parties have pulled the mainstream in their direction; in America, a series of challenges to the Republican mainstream culminated in the 2016 election of Donald Trump. In Key Thinkers of the Radical Right, sixteen expert scholars explain sixteen thinkers, providing an (...) introduction to their life and work, a guide to their thought, and an explanation of their work's reception. The chapters focus on thinkers who are widely read across the political right in both Europe and America, such as Julius Evola, Alain de Benoist, and Richard B. Spencer. Featuring classic, modern, and emerging thinkers, this selection provides a good representation of the intellectual right and avoids making political or value judgments. In an increasingly polarized political environment, Key Thinkers of the Radical Right offers a comprehensive and unbiased introduction to the thinkers who form the foundation of the radical right. (shrink)

Aristotle sets the horizons of our inquiry: What is it when we say we know something? And is the object of knowledge a universal or particular [tode ti] object? Aristotle's critique of Plato's theory of form/Forms in light of his notion of actuality has generated a variety of topics that frame our inquiry: "Understanding Eidos as Form in the Works of Aristotle as Plato's Critical Student"; "Aristotle on Plato's Forms as Causes"; "Notes on the Relationship between Plato's Parmenides and Aristotle's (...) Metaphysics Alpha"; "'Separate' and 'Inactive'? Aristotle's Most Challenging Critique of Plato's 'Forms'"; "Too Much Unity in a City Is Destructive of the City: Aristotle against Plato's Unification Project of the Polis"; "Aristotle on the Soul as Actuality"; "Delphic Piety in the De Anima of Alexander of Aphrodisias"; "Aristotle and Plotinus: Act and Potency and the Two Acts"; and "Al-Fārābīon Habit and Imagination." Here, the Peripatetic readings of form and actuality are parsed from the precipice of historical, analytic, and continental approaches to the mind/language/object problem, with advocacy of the importance of Aristotle's contribution to this inquiry for the present age. (shrink)

This book is a new interpretation of Schelling's path-breaking 1809 treatise on freedom, the last major work published during his lifetime. The treatise is at the heart of the current Schelling renaissance—indeed, Heidegger calls it "one of the most profound works of German, thus of Western, philosophy." It is also one of the most demanding and complex texts in German Idealism. By tracing the problem of ground through Schelling's treatise, this book provides a unified reading of the text, while unlocking (...) the meaning of its most challenging passages through clear, detailed analysis. This analysis shows how Schelling's implicit distinction between senses of ground is the key to his project of constructing a system that can satisfy reason while accommodating objects that seem to defy rational explanation—including evil, the origins of nature, and absolute freedom. This allows Schelling to unite reason and mystery, providing a rich model for philosophizing about freedom and evil today. (shrink)

Although current educational priorities tend to avoid strong moral positions, one of the world's most venerable yet persistently influential moral traditions not only lays out a number of major moral principles but also incorporates them into its pedagogy. Confucius teaches us about the importance of seeking knowledge, learning how to learn, applying ancient wisdom to contemporary situations, valuing virtue over material gain, following the Golden Rule, and living by our principles. He also has ways of assessing his own students' progress (...) in these matters. Confucius' pedagogy is an interesting model to consider and contrast with contemporary models. This chapter introduces these principles and assessments from the Analects and draws out some comparisons to and contrasts with two alternative theories in western moral thought, Augustine and John Dewey. -/- The accepted version of the paper is included here. Pagination does not match the published version. (shrink)

This volume brings together a set of critical essays on the thought of Professor Doctor H. Tristram Engelhardt Jr., Co-Founding Editor of the Philosophy and Medicine book series. Amongst the founders of bioethics, Professor Engelhardt, looms large. Many of his books and articles have appeared in multiple languages, including Italian, Romanian, Portuguese, Spanish, and Chinese. The essays in this book focus critically on a wide swath of his work, in the process elucidating, critiquing, and/or commending the rigor and reach of (...) his thought. This volume compasses analyses of many different aspects of Engelhardt's work, including social and political philosophy, biopolitics, the philosophy of medicine, and bioethics. It brings together internationally known scholars to assess key elements of Engelhardt's work. (shrink)

In studies of early Christian thought, 'philosophy' is often a synonym for 'Platonism', or at most for 'Platonism and Stoicism'. Nevertheless, it was Aristotle who, from the sixth century AD to the Italian Renaissance, was the dominant Greek voice in Christian, Muslim and Jewish philosophy. Aristotle and Early Christian Thoughtis the first book in English to give a synoptic account of the slow appropriation of Aristotelian thought in the Christian world from the second to the sixth century. Concentrating on the (...) great theological topics - creation, the soul, the Trinity, and Christology - it makes full use of modern scholarship on the Peripatetic tradition after Aristotle, explaining the significance of Neoplatonism as a mediator of Aristotelian logic. While stressing the fidelity of Christian thinkers to biblical presuppositions which were not shared by the Greek schools, it also describes their attempts to overcome the pagan objections to biblical teachings by a consistent use of Aristotelian principles, and it follows their application of these principles to matters which lay outside the purview of Aristotle himself. This volume offers a valuable study not only for students of Christian theology in its formative years, but also for anyone seeking an introduction to the thought of Aristotle and its developments in Late Antiquity. by a consistent use of Aristotelian principles, and it follows their application of these principles to matters which lay outside the purview of Aristotle himself. This volume offers a valuable study not only for students of Christian theology in its formative years, but also for anyone seeking an introduction to the thought of Aristotle and its developments in Late Antiquity. (shrink)

Examines the political significance of ideas about happiness through the work of utilitarian philosophers William Thompson and Jeremy Bentham. Happiness is political. The way we think about happiness affects what we do, how we relate to other people and the world around us, our moral principles, and even our ideas about how society should be organized. Utilitarianism, a political theory based on hedonistic and individualistic ideas of happiness, has been dominated for more than two-hundred years by its founder, Jeremy Bentham. (...) In Happiness, Democracy, and the Cooperative Movement, Mark J. Kaswan examines the work of William Thompson, a friend of Bentham’s who nonetheless offers a very different utilitarian philosophy and political theory based on a different conception of happiness, but whose work has been largely overlooked. Kaswan reveals the importance of our ideas about happiness for our understanding of the basic principles and nature of democracy, its role in society and its character as a social institution. In what is the closest examination of Thompson’s political theory to date, Kaswan moves from philosophy to theory to practice, starting with conceptions of happiness before moving to theories of utility, then to democratic theory, and finally to practice in the first detailed account of how Thompson’s ideas laid the foundations for the cooperative movement, which is now the world’s largest democratic social movement. Mark J. Kaswan is Assistant Professor of Government at the University of Texas at Brownsville and J. Robert Beyster and Michael W. Huber Fellow, Rutgers University School of Management and Labor Relations. (shrink)

Traditionalism is a shadowy philosophy that has influenced much of the twentieth century and beyond: from the far-right to the environmental movement, from Sufi shaykhs and their followers to Trump advisor and right-wing provocateur Steve Bannon. It is a worldview that rejects modernity and instead turns to mystical truth and tradition as its guide. Mark Sedgwick, one of the world's leading scholars of Traditionalism, presents a major new analysis, pulling back the curtain on the foundations of Traditionalist philosophy, its (...) major proponents-René Guénon, Julius Evola, and Frithjof Schuon-and their thought. One of Traditionalism's fundamental pillars is perennialism, the idea that beneath all the different forms of religion there lies one single timeless and esoteric tradition. A second is the view that everything is getting worse, rather than better, over time, leading to the Traditionalist critique of modernity. Sedgwick details Traditionalism's unique ideas about self-realization, religion, politics, and many other spheres. Traditionalism provides an expansive guide to this important school of thought-one that is little-known and even less understood-and shows how pervasive these ideas have become. (shrink)

This book analyses some of the key problems explored in Paul Virilio's theorising on war and security.Virilio is one of the most challenging and provocative critics of technology, war and globalisation. While many commentators focus on the new possibilities for mobility and communication in an interconnected world, Virilio is interested in the role that technology and security play in the shaping of our bodies and how we come to see the world -- what he terms the 'logistics of perception'. Security, (...) Technology and Global Politics explores Virilio's work in this area, with each chapter using examples from popular culture -- from video games and on-line graphic novels, to films from around the world - as a starting point from which the author goes on to develop a critical engagement with Virilio's work. One of the key themes that emerge from this analysis is the importance of the idea of 'disappearance' -- the aesthetics of disappearance or the politics of disappearance. The book argues that the politics of disappearance provides a disturbing and insightful introduction to the key questions posed by politics of security in the twenty-first century.This book will be of much interest to students of critical security studies, political theory, sociology, political geography, cultural studies and IR in general. (shrink)

In a recent article in this journal Professor Tibor Machan defends advertising from those who find that it is ‘anything but honorable’. According to Machan advertising is not merely honorable, but also natural, a virtual paradigm of cooperative behavior, and an essential component of human well-being. ‘If human life is a value, advertising is a value. It is a positive good.’ Machan concedes that sometimes people exposed to advertising make foolish choices, but that is explained by their lack of prudence, (...) not any fault of advertisers. He also appeals to our sense of fair play: advertisers are like us – people trying to earn a living, and even issues a veritable cri de coeur: Who among us hasn't tried to promote a book we've written? (shrink)

This paper defends an in principle understanding of the authority of persons over themselves and, in consequence, argues for significant limits on morally permissible state authority. It also defends an account of the limits of permissible state action that distinguishes between the ability of persons to convey authority to common projects and what may be judged virtuous, good, safe, or proper to do. In terms of organ transplantation policy, it concludes that it is morally acceptable, and should be legally permissible, (...) for individuals to sell one of their kidneys while living, pocketing the cash to use as that person sees fit to advance their own understanding of their own best interests. Morally objectionable policy proposals, I argue, are not those that encourage individuals to sell a redundant kidney while living or families to sell the organs of a recently deceased loved one, but those that seek coercively to confiscate the organs of the recently deceased. Recognizing the authority of persons over themselves, and their ability to convey moral authority to common projects, including the sale of human organs for transplantation, would shed light on the medical marketplace and clarify public policy, while increasing the efficiency and effectiveness of procuring human organs for transplantation. (shrink)

The legal basis of informed consent in Texas may on first examination suggest an unqualified affirmation of persons as the source of authority over themselves. This view of individuals in the practice of informed consent tends to present persons outside of any social context in general and outside of their families in particular. The actual functioning of law and medical practice in Texas, however, is far more complex. This study begins with a brief overview of the roots of Texas law (...) and public policy regarding informed consent. This surface account is then contrasted with examples drawn from the actual functioning of Texas law: Texas legislation regarding out-of-hospital do-not-resuscitate (DNR) orders. As a default approach to medical decision-making when patients lose decisional capacity and have failed to appoint a formal proxy or establish their wishes, this law establishes a defeasible presumption in favor of what the law characterizes as “qualified relatives” who can function as decision-makers for those terminal family members who lose decisional capacity. The study shows how, in the face of a general affirmation of the autonomy of individuals as if they were morally and socially isolated agents, space is nevertheless made for families to choose on behalf of their own members. The result is a multi-tier public morality, one affirming individuals as morally authoritative and the other recognizing the decisional standing of families. (shrink)

This paper defends an in principle understanding of the authority of persons over themselves and, in consequence, argues for significant limits on morally permissible state authority. It also defends an account of the limits of permissible state action that distinguishes between the ability of persons to convey authority to common projects and what may be judged virtuous, good, safe, or proper to do. In terms of organ transplantation policy, it concludes that it is morally acceptable, and should be legally permissible, (...) for individuals to sell one of their kidneys while living, pocketing the cash to use as that person sees fit to advance their own understanding of their own best interests. Morally objectionable policy proposals, I argue, are not those that encourage individuals to sell a redundant kidney while living or families to sell the organs of a recently deceased loved one, but those that seek coercively to confiscate the organs of the recently deceased. Recognizing the authority of persons over themselves, and their ability to convey moral authority to common projects, including the sale of human organs for transplantation, would shed light on the medical marketplace and clarify public policy, while increasing the efficiency and effectiveness of procuring human organs for transplantation. (shrink)

The essays in this issue of The Journal of Medicine and Philosophy explore an innovative voucher program for encouraging kidney donation. Discussions cluster around a number of central moral and political/theoretical themes: What are the direct and indirect health care costs and benefits of such a voucher system in human organs? Do vouchers lead to more effective and efficient organ procurement and allocation or contribute to greater inequalities and inefficiencies in the transplantation system? Do vouchers contribute to the inappropriate commodification (...) of human body parts? Is there a significant moral difference between such a voucher system and a market in human organs for transplantation? This paper argues that while kidney vouchers constitute a step in the right direction, fuller utilization of market-based incentives, including, but not limited to, barter exchanges, would save more lives and further reduce human suffering. (shrink)

Organ procurement policy from the recently deceased recasts families into gatekeepers of a scarce medical resource. To the frustration of organ procurement teams, families do not always authorize organ donation. As a result, efforts to increase the number of organs available for transplantation often seek to limit the authority of families to refuse organ retrieval. For example, in some locales if a deceased family member has satisfied the legal conditions for first-person prior assent, a much looser and easier standard to (...) satisfy than informed consent, organ retrieval may proceed despite the family’s objections. Some countries have replaced voluntary consent to organ donation with forms of organ conscription. Often referred to under the misnomer “presumed consent,” such policies legalize the harvesting of organs at death, unless individuals exercise official options to opt out. As this article explores, however, there are good grounds for affirming the authority of the family to consent to or to deny organ donation on behalf of recently deceased family members, as well as to reject first-person assent and “presumed consent” policies of organ procurement. Insofar as individuals have failed clearly and competently to provide informed consent to organ donation, moral authorization for the use of the person and his body ought to be grounded on the foundational authority of the family, rather than the state’s supposed interests in obtaining organs for transplantation. (shrink)

Jerry Fodor is one of the most important philosophers of mind in recent decades. He has done much to set the agenda in this field and has had a significant influence on the development of cognitive science. Fodor's project is that of constructing a physicalist vindication of folk psychology and so paving the way for the development of a scientifically respectable intentional psychology. The centrepiece of his engagement in this project is a theory of the cognitive mind, namely, the computational (...) theory of mind, which postulates the existence of a language of thought. Fodor: Language, Mind and Philosophy is a comprehensive study of Fodor's writings. Individual chapters are devoted to each of the major issues raised by his work and contain extensive discussion of his relationships to key developments in cognitive science and to the views of such philosophical luminaries as Dennett, Davidson and Searle. (shrink)

This paper challenges the foundational claim that the human family is no more than a social construction. It advances the position that the family is a central category of experience, being, and knowledge. Throughout, the analysis argues for the centrality of the family for human flourishing and, consequently, for the importance of sustaining family-oriented practices within social policy, such as more family-oriented approaches to consent to medical treatment. Where individually oriented approaches to medical decision-making accent an ethos of isolated personal (...) autonomy family-oriented approaches acknowledge the central social and moral reality of the family. I argue that the family ought to be appreciated as more than a mere network of personal relations and individual undertakings; the family possesses a being that is social and moral such that it realizes a particular structure of human good and sustains the necessary conditions for core areas of human flourishing. Moreover, since the family exists as a nexus of face-to-face relationships, the consent of persons, including adults, to be members of a particular family, subject to its own respective account of family sovereignty, is significantly more amply demonstrated than the consent of citizens to be under the authority of a particular state. As a result, in the face of a general Western bioethical affirmation of the autonomy of individuals, as if adults and children were morally and socially isolated agents, this paper argues that social space must nevertheless be made for families to choose on behalf of their own members. (shrink)

This paper critically explores key aspects of the gulf between traditional Christian bioethics and the secular moral reflections that dominate contemporary bioethics. For example, in contrast to traditional Christian morality, the established secular bioethics judges extramarital sex acts among consenting persons, whether of the same or different sexes, as at least morally permissible, affirms sexual freedom for children to develop their own sexual identity, and holds the easy availability of abortion and infanticide as central to the liberty interests of women. (...) Secular bioethics seeks to separate children from the authority of their parents, placing children themselves as in authority to make their own judgments about appropriate lifestyle choices, including sexual behaviors. As I argue, however, absent God, there exists no standpoint outside of our own cultural sociohistorically conditioned understanding from which to communicate any deeper perspective of reality or the bioethics that such a perspective would secure. Consequently, rather than discerning moral truth, secular bioethics merely affirms its own particular cultural sociohistorically conditioned ideological perspective. It is a social and political worldview bereft of definitive moral foundation, independent moral authority, or unambiguous content. (shrink)

This study explores the ways in which adolescents, even so-called “mature minors”, lack adequate development of the intellectual, affective, and emotional capacities necessary morally to consent to medical research on their own behalf. The psychological and neurophysiological data regarding brain maturation supports the conclusion that adolescents are qualitatively different types of agents than mature adults. They lack full adult maturity and personal agency. As a result, in addition to the usual requirements for IRB approval, one or both parents, or a (...) legal guardian, should provide informed consent for minor children to participate in medical research. (shrink)

Several axiom systems for preference among acts lead to a unique probability and a state-independent utility such that acts are ranked according to their expected utilities. These axioms have been used as a foundation for Bayesian decision theory and subjective probability calculus. In this article we note that the uniqueness of the probability is relative to the choice of whatcounts as a constant outcome. Although it is sometimes clear what should be considered constant, in many cases there are several possible (...) choices. Each choice can lead to a different "unique" probability and utility. By focusing attention on statedependent utilities, we determine conditions under which a truly unique probability and utility can be determined from an agent's expressed preferences among acts. Suppose that an agent's preference can be represented in terms of a probability P and a utility U.That is, the agent prefers one act to another iff the expected utility of that act is higher than that of the other. There are many other equivalent representations in terms of probabilities Q, which are mutually absolutely continuous with P, and state-dependent utilities V, which differ from U by possibly different positive affine transformations in each state of nature. We describe an example in which there are two different but equivalent state-independent utility representations for the same preference structure. They differ in which acts count as constants. The acts involve receiving different amounts of one or the other of two currencies, and the states are different exchange rates between the currencies. It is easy to see how it would not be possible for constant amounts of both currencies to have simultaneously constant values across the differentstates. Savage (1954, sec. 5.5) discovered a situation in which two seemingly equivalent preference structures are represented by different pairs of probability and utility. He attributed the phenomenon to the construction of a "small world." We show that the small world problem is just another example of two different, but equivalent, representations treating different actsas constants. Finally, we prove a theorem (similar to one of Karni 1985) that shows how to elicit a unique state-dependent utility and does not assume that there are prizes with constant value. To do this, we define a new hypothetical kind of act in which both the prize to be awarded and the state of nature are determined by an auxiliary experiment. (shrink)

This book focuses on the social psychology of belief systems and how they influence perceptions of reality. These belief systems, from politics to religion to science, shape one¿s thoughts and views, but also can be the cause of conflict and disagreement over values, particularly when they are enacted in political policies. ¿ In¿Belief Systems and the Perceptions of Reality, editors Bastiaan Rutjens and Mark Brandt examine the social psychological effects at the heart of the conflict, by bringing together contributions (...) under five themes: Motivated Reasoning; Inequality; Threat; Scientists Interpreting Science; and People Interpreting Science. This book aims to create a more integrated understanding of reality perception and its connection with belief systems, viewed through the lens of social psychology. ¿ The synthesis of expert contributors as well as the literature around social psychology and belief systems makes this a unique resource for students, researchers and academics in behavioural and social sciences, as well as activists and journalists working in this political field. (shrink)