Wexler and Sullivan (2023) recommend integration as a guiding principle for translational neuroethics. We agree that collaboration between neuroethicists and other professionals can advance the fie...

Volume 19, Issue 11, November 2019, Page 42-44.

Shared decision-making is a well-recognized model to guide decision-making in medical care. However, the shared decision-making concept can become exceedingly complex in adolescent patients with varying degrees of autonomy who have most of their medical decisions made by their parents or legal guardians. The complexity increases further in ethically difficult situations such as terminal illness. In contrast to the typical patient-physician dyad, shared decision-making in adolescents requires a decision-making triad that also includes the parents or guardians. The multifactorial nature of (...) these cases can overwhelm treatment teams, with minimal guidance on how to best approach the patient–parents–physician dynamic in an ethically appropriate manner. Estimated time left to live is the paramount ethical consideration for such cases with respect to shared decision-making. This paper offers a sliding scale to serve as a grounding reference for clinicians who care for terminally ill adolescents and hospital ethics committee members for initiating and guiding the ethical discussion for these patients. This paper also elucidates several other ethically salient features inherent to many of these cases, including quality of life, treatability of disease, cultural influences, among others. Yet how each of these variables is weighed is dependent upon the specific circumstances of each individual case. Ultimately, shared decision-making in adolescent patients with terminal illnesses must be a collaborative and ongoing process that thoughtfully weighs the values and ethical responsibilities of the patient, parents, and physician to ideally reconcile differences and come to a consensus on the best management option for each individual patient. (shrink)

Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical (...) cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward. (shrink)

Miller synthesizes Karen Horney's model of submission, aggression and withdrawal, Jean Baker Miller's concept of relational being, Julia Kristeva's idea of psychic space, and Kelly Oliver's notions on social support to advance a penetrating analysis of the fiction of Paule Constant.

A critical evaluation of Rawlsian and Habermasian paradigms of political philosophy that offers an interpretation and defense of Habermas's theory of law and ...

Editor's suggested further reading in BioEssaysA new paradigm in cell therapy for diabetes: Turning pancreatic α‐cells into β‐cells Abstract.

Over the past decade, we have witnessed some early signs of progress in the battle against international bribery and corruption, a problem that throughout the history of commerce had previously been ignored. We present a model that we then use to assess progress in reducing bribery. The model components include both hard law and soft law legislation components and enforcement and compliance components. We begin by summarizing the literature that convincingly argues that bribery is an immoral and unethical practice and (...) that the economic harm it causes falls most heavily on those least able to absorb it. The next section summarizes the main provisions of anti-bribery legislation including the Foreign Corrupt Practices Act (FCPA), the Organization for Eco nomic Development's Convention on Combating Bribery of Foreign Officials in International Business Transactions, the United Nations Convention Against Corruption and the laws of selected countries. We conclude this section with a discussion of the "moral imperialism" argument for not imposing Western laws and values on other cultures. The next section focuses on the roles played by NGOs including Transparency International (TI), the World Economic Forum (WEF), and the International Chamber of Commerce. We review trends in enforcement and prosecution, including a review of the United States' enforcement processes, mechanisms for cross-border legal assistance, a discussion of the distinctive nature of FCPA cases, and an assessment of what the future holds for enforcement. The final section focuses on compliance processes for corporations aimed at reducing the risk of FCPA and related violations. This section also addresses the ethics of gift giving and "grease" payments. The article concludes with a summary and suggestions for further research. Throughout the article, we reference important bribery cases and include comments from several authorities who are on the front lines of the battle against international bribery. (shrink)

This article surveys recent developments in the epistemology of modality.

Developing a simple test to identify swiftly neonates with sepsis who carry the genetic variant which means that one dose of the recommended antibiotic, gentamicin, will cause the child to become profoundly deaf looks like an admirable objective. The baby needs antibiotics and needs them within 1 hour of admission to the neonatal intensive care unit. Conventional genetic tests take much longer to yield results. The test being trialled produces results in 25 min; a baby who carries the variant can (...) be treated with a different antibiotic. All the test requires is a gentle swab of the baby’s inner cheek. Babies can be treated for potentially fatal sepsis without the risk that the drugs designed to save their lives will cost them their hearing. Parents and healthcare staff are relieved of worry—a great idea? PALOH is not a trial of the safety or efficacy of the test, only to assess how feasible it will be to carry out this test in a busy NICU, without disrupting the care of the baby. A tiny painless ‘scrape’ will take a sample of DNA—what’s the fuss about? Several other invasive and painful procedures will be carried out without a fuss.1 The problem is DNA. Genetic information must be safeguarded from falling into the wrong hands. In section 45 of Human Tissue Act 2004, Parliament legislated to prohibit non-consensual DNA testing.1 It fits uncomfortably in a statute designed to regulate retention and uses of human material, after revelations that organs and tissue from the …. (shrink)

It is widely assumed that sense perception cannot deliver knowledge of nonactual (metaphysical) possibilities. We are not supposed to be able to know that a proposition p is necessary or that p is possible (if p is false) by sense perception. This paper aims to establish that the role of sense perception is not so limited. It argues that we can know lots of modal facts by perception. While the most straightforward examples concern possibility and contingency, others concern necessity and (...) impossibility. The possibility of a perceptual route to some modal knowledge is not as radical as it may at first sound. On the contrary, acknowledging it has benefits. (shrink)

The moral/conventional task has been widely used to study the emergence of moral understanding in children and to explore the deficits in moral understanding in clinical populations. Previous studies have indicated that moral transgressions, particularly those in which a victim is harmed, evoke a signature pattern of responses in the moral/conventional task: they are judged to be serious, generalizable and not authority dependent. Moreover, this signature pattern is held to be pan‐cultural and to emerge early in development. However, almost all (...) the evidence for these claims comes from studies using harmful transgressions of the sort that primary school children might commit in the schoolyard. In a study conducted on the Internet, we used a much wider range of harm transgressions, and found that they do not evoke the signature pattern of responses found in studies using only schoolyard transgressions. Paralleling other recent work, our study provides preliminary grounds for skepticism regarding many conclusions drawn from earlier research using the moral/conventional task. (shrink)

The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and ‘anticipatory triage’ likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public’s moral intuitions. Our study aimed to explore general public views in the UK on (...) the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public. Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected ‘fair innings’ and ‘life projects’ principles as justifications for age-based allocation. They were also wary of the ‘maximise life-years’ principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This ‘triad’ of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. (shrink)

This essay examines the work of Nancy Fraser and Seyla Benhabib, two philosophers who have demonstrated that feminist theorists can usefully draw upon both postmodernism and the critical theory tradition, with which Fraser and Benhabib are more clearly associated. I argue that each theorist claims the universal ideals and normative judgements of modernism, and the contextualism, particularity, and skepticism of postmodernism. I do this by revisiting each of their positions in the now well-known Feminist Contentions exchange, by examining the diverse (...) ways in which they reconcile universalism and difference, and by exploring each theorist's critique of the Habermasian public sphere. (shrink)

Challenges to the exercise of the basic socio-economic rights of half the global population give rise to some of the most pressing issues today. This timely book focuses on world poverty, providing a systematic exposition of the evolving legal responsibility of the international community of states to cooperate in addressing the structural obstacles that contribute to this injustice. This book analyzes the approach, contribution, and current limitations of the international law of human rights to the manifestations of world poverty, inviting (...) the reader to rethink human rights, and, in particular, the framing of responsibilities that are essential to their contemporary protection. (shrink)

The epistemology of modality has focused on metaphysical modality and, more recently, counterfactual conditionals. Knowledge of kinds of modality that are not metaphysical has so far gone largely unexplored. Yet other theoretically interesting kinds of modality, such as nomic, practical, and ‘easy’ possibility, are no less puzzling epistemologically. Could Clinton easily have won the 2016 presidential election—was it an easy possibility? Given that she didn’t in fact win the election, how, if at all, can we know whether she easily could (...) have? This paper investigates the epistemology of the broad category of ‘objective’ modality, of which metaphysical modality is a special, limiting case. It argues that the same cognitive mechanisms that are capable of producing knowledge of metaphysical modality are also capable of producing knowledge of all other objective modalities. This conclusion can be used to explain the roles of counterfactual reasoning and the imagination in the epistemology of objective modality. (shrink)

While best known for the immensely popular and controversial novel Uncle Tom's Cabin, Harriet Beecher Stowe is also the author of an extensive body of additional work on American culture and politics. Playing many roles--journalist, pamphleteer, novelist, preacher, and advisor on domestic affairs--Stowe used the written word as a vehicle for religious, social, and political commentaries, often leavening them with entertainment in order to reach a broad audience. She had a profound effect on American culture, not because her ideas were (...) unique, but because they were common. What made her so radical was that she insisted on putting her ideas into action. The Oxford Harriet Beecher Stowe Reader offers a focused collection of Stowe's writings from the 1830s through the 1860s. Illustrating her broad range, rhetorical strategies, and cultural designs on the world, it is ideal for courses in nineteenth-century American literature, women's literature, and American history. The volume collects those selections best suited for classroom use, reprinting many pieces here for the first time. Editor Joan D. Hedrick provides a substantial introduction that assesses Stowe's vital impact on nineteenth-century American literature, politics, and culture. The readings are divided into three sections: Early Sketches, Antislavery Writings, and Domestic Culture and Politics. Early Sketches presents the finest writing of Stowe's literary apprenticeship. Antislavery Writings includes Uncle Tom's Cabin in its entirety, placing it in the context of Stowe's considerable and often-overlooked body of other antislavery writings. This section also includes a generous selection from A Key To Uncle Tom's Cabin, a companion volume to the novel. Domestic Culture and Politics shows the scope of Stowe's thinking on the Victorian home, for which she was a major propagandist. The inclusion here of "The True Story of Lady Byron's Life," an exposé of male debauchery and incest at the core of a nineteenth-century home, represents Stowe's willingness to tackle the most challenging political and social issues of her time. (shrink)

This paper examines "moderate modal skepticism", a form of skepticism about metaphysical modality defended by Peter van Inwagen in order to blunt the force of certain modal arguments in the philosophy of religion. Van Inwagen’s argument for moderate modal skepticism assumes Yablo's (1993) influential world-based epistemology of possibility. We raise two problems for this epistemology of possibility, which undermine van Inwagen's argument. We then consider how one might motivate moderate modal skepticism by relying on a different epistemology of possibility, which (...) does not face these problems: Williamson’s (2007: ch. 5) counterfactual-based epistemology. Two ways of motivating moderate modal skepticism within that framework are found unpromising. Nevertheless, we also find a way of vindicating an epistemological thesis that, while weaker than moderate modal skepticism, is strong enough to support the methodological moral van Inwagen wishes to draw. (shrink)

Epistemology -- Power I -- Power II -- Subjectivity -- Resistance -- Critique -- Ethics.

If reification is the projection of a false, thing-like appearance onto society, what is de-reifying critique supposed to reveal? After distinguishing between versions of reification based on a social ontology of will from those that think of the social as a normatively constituted domain, I argue that Lukács’ work on reification fudges this distinction through his account of class. I then turn to the debate between Schmitt and Kelsen, where the will-versus-norm issue is central. I argue that the consonance between (...) ideas about reification and will-based theories like Schmitt’s is superfcial, as the latter relies on identifcation with authority for its account of normativity, making Kelsen’s ideas about normativity stemming from an orientation toward intersubjective process more convivial. I note, however, that norm-based accounts are less amenable to radical change than will-based ones, making the link between dereification and radical politics less direct than is often thought. (shrink)

Knowledge closure is the claim that, if an agent S knows P, recognizes that P implies Q, and believes Q because it is implied by P, then S knows Q. Closure is a pivotal epistemological principle that is widely endorsed by contemporary epistemologists. Against Knowledge Closure is the first book-length treatment of the issue and the most sustained argument for closure failure to date. Unlike most prior arguments for closure failure, Marc Alspector-Kelly's critique of closure does not presuppose any (...) particular epistemological theory; his argument is, instead, intuitively compelling and applicable to a wide variety of epistemological views. His discussion ranges over much of the epistemological landscape, including skepticism, warrant, transmission and transmission failure, fallibilism, sensitivity, safety, evidentialism, reliabilism, contextualism, entitlement, circularity and bootstrapping, justification, and justification closure. As a result, the volume will be of interest to any epistemologist or student of epistemology and related subjects. (shrink)

There are three primary aims of the book. The first, set out in the book's introduction, is to explain how two fairly recent developments in philosophy, externalism and modalism, provide the basis for a promising account of knowledge - an account that achieves anti-skeptical results and avoids Gettier-style counterexamples that are based on an agent having warranted beliefs that are merely luckily true. Epistemological externalism is the thesis that not all the factors that make a true belief a case of (...) knowledge need to be cognitively accessible or "internal" to the agent. Modalism, as the author construes it, is the use of possible worlds talk in clarifying what would or might be the case and what is necessarily so." "The second objective is to work through the different modalized epistemologies extant in the literature, assessing their strengths and weaknesses, with a view toward constructing a working theory. Finally, the author proposes the theory that knowledge is reliably formed, sensitive true belief, and defends the theory against objections."--Jacket. (shrink)

Debates regarding clinical ethicists’ scope of practice are not novel and will continue to evolve. Rapid changes in healthcare delivery, outcomes, and expectations have necessitated flexibility in clinical ethicists’ roles whereby hospital-based clinical ethicists are expected to be woven into the institutional fabric in a way that did not exist in more traditional relationships. In this article we discuss three emerging roles: the ethicist embedded in the interdisciplinary team, the ethicist with an expanded educational mandate, and the ethicist as a (...) therapeutic presence in the patient care space. Such expanded capacities offer more robust, positive contributions to institutional culture, stakeholders’ relationships, and patient-centered care. (shrink)

Epistemic luck has been the focus of much discussion recently. Perhaps the most general knowledge-precluding type is veritic luck, where a belief is true but might easily have been false. Veritic luck has two sources, and so eliminating it requires two distinct conditions for a theory of knowledge. I argue that, when one sets out those conditions properly, a solution to the generality problem for reliabilism emerges.

This book sets out first to explain how two fairly recent developments in philosophy, externalism and modalism, provide the basis for a promising account of knowledge, and then works through the different modalized epistemologies extant in the literature, assessing their strengths and weaknesses. Finally, the author proposes the theory that knowledge is reliably formed, sensitive true belief, and defends the theory against objections.

The sensitivity principle is a compelling idea in epistemology and is typically characterized as a necessary condition for knowledge. This collection of thirteen new essays constitutes a state-of-the-art discussion of this important principle. Some of the essays build on and strengthen sensitivity-based accounts of knowledge and offer novel defences of those accounts. Others present original objections to sensitivity-based accounts and offer comprehensive analysis and discussion of sensitivity's virtues and problems. The resulting collection will stimulate new debate about the sensitivity principle (...) and will be of great interest and value to scholars and advanced students of epistemology. (shrink)

An increasing number of scientists and doctors are concerned that new laws are inhibiting ethical research. This paper argues that this is not the case. Laws do not inhibit medical progress. Misunderstanding the law may do so.

Emerging from the intersection of the virtual world with the real."--BOOK JACKET.

Hellenistic philosophy concerns the thought of the Epicureans, Stoics, and Skeptics, the most influential philosophical groups in the era between the death of Alexander the Great and the defeat of the last Greek stronghold in the ancient world. The Routledge Handbook of Hellenistic Philosophy provides accessible yet rigorous introductions to the theories of knowledge, ethics, and physics belonging to each of the three schools. It explores the fascinating ways in which interschool rivalries shaped the philosophies of the era, and offers (...) unique insight into the relevance of Hellenistic views to issues today, such as environmental ethics, consumerism, and bioethics. Eleven countries are represented among the Handbook's thirty-five authors, whose chapters were written specifically for this volume and are organized thematically into six sections: I. The people, history, and methods of Epicureanism, Stoicism, and Skepticism. II. Earlier philosophical influences on Hellenistic thought, such as Aristotle, Socrates, and Presocratics. III. The soul, perception, and knowledge. IV. God, fate, and the primary principles of nature and the universe. V. Ethics, political theory, society, and community. VI. Hellenistic philosophy's relevance to contemporary life. Spanning from the ancient past to the present, this Handbook aims to show that Hellenistic philosophy has much to offer all thinking people of the twenty-first century. (shrink)

Argument that full grounds modally entail what they ground.

For healing the land and human relationships to land are a step toward healing a troubled relationship, borne of a history, which is painful for native people and shameful for settlers. Protection...

Prisoners are legally categorized as a vulnerable group for the purposes of medical research, but their vulnerability is not limited to the research context. Prisoner-patients may experience lower standards of care, fewer options for treatment, violations of privacy, and the use of inappropriate surrogates as a result of their status. This case study highlights some of the ways in which a prisoner-patient’s vulnerable status impacted the care he received. The article argues the following: (1) Prisoner-patients are entitled to the same (...) quality of care as all other patients, and healthcare providers should be vigilant to ensure that the stigma of incarceration does not influence care decisions. (2) Options for treatment should reflect what is most medically appropriate in the hospital or other healthcare setting, even when not all treatments would be available in the correctional setting. (3) The presence of guards at the bedside requires that additional measures be taken to protect the privacy and confidentiality of prisoner-patients. (4) When endof-life decisions must be made for an incapacitated patient, prison physicians are not well placed to act as surrogate decision makers, which heightens the obligations of the healthcare professionals in the hospital to ensure an ethically supportable process and outcome. Therefore, healthcare professionals should provide extra protection for those prisoner-patients who do not have decision-making capacity, by utilizing a robust process for decision making such as those used for incapacitated patients without surrogates, rather than relying solely on prison physicians as surrogates. (shrink)

Displays of eye movements may convey information about cognitive processes but require interpretation. We investigated whether participants were able to interpret displays of their own or others' eye movements. In Experiments 1 and 2, participants observed an image under three different viewing instructions. Then they were shown static or dynamic gaze displays and had to judge whether it was their own or someone else's eye movements and what instruction was reflected. Participants were capable of recognizing the instruction reflected in their (...) own and someone else's gaze display. Instruction recognition was better for dynamic displays, and only this condition yielded above chance performance in recognizing the display as one's own or another person's. Experiment 3 revealed that order information in the gaze displays facilitated instruction recognition when transitions between fixated regions distinguish one viewing instruction from another. Implications of these findings are discussed. (shrink)

Jonathan Vogel has recently argued that counterfactual reliabilism cannot account for higher‐level knowledge that one's belief is true, or not false. His particular argument for this claim is straightforward and valid. Interestingly, there is a parallel argument, based on an alternative but plausible reinterpretation of the main premise in Vogel's argument, which squares CR with higher‐level knowledge both that one's belief is true and that one's belief is not false. I argue that, while Vogel's argument reveals the incompatibility of CR (...) and knowledge of certain higher‐level propositions, it does not establish the general claim that CR is incompatible with knowledge that any of one's beliefs is true, or not false. (shrink)

Drawing out literal and metaphorical meanings of 'foreignness' this wide-ranging volume offers much to scholars of postcolonial, gender, and cultural studies seeking new approaches to the study of alterity.