The Covid‐19 pandemic has concentrated bioethics attention on the “lifeboat ethics” of rationing and fair allocation of scarce medical resources, such as testing, intensive care unit beds, and ventilators. This focus drives ethics resources away from persistent and systemic problems—in particular, the structural injustices that give rise to health disparities affecting disadvantaged communities of color. Bioethics, long allied with academic medicine and highly attentive to individual decision‐making, has largely neglected its responsibility to address these difficult “upstream” issues. It is time (...) to broaden our teaching, research, and practice to match the breadth of the field in order to help address these significant societal inequities and unmet health needs. (shrink)

Age discrimination, particularly in the context of performance evaluation decisions, has been a source of major concern and litigation for organizations in the past, and indications are that this area will pose serious challenges in the future. The present study attempted to delve more deeply into the process by which manifest age discrimination operates in the performance evaluation process. A conceptualization was proposed and tested which suggested that age-related influences on performance ratings operate through interpersonal distance and political influence of (...) subordinates. Results demonstrated some support for this conceptualization. (shrink)

Cheating through the use of illegal performance enhancements (such as doping) is a persistent problem in sport. It has been suggested that one response to this problem is to separate sport into two parallel leagues. One league would resemble sport as it is currently practised ? i.e. with restrictions on use of particular enhancements ? and the other would not possess these restrictions, allowing those that wish to use currently illegal enhancements to do so. In this paper I articulate the (...) ?two leagues? proposal further and subject it to critical scrutiny. The proposal fails. It does so by failing to address conceptual confusion regarding enhancement use in sport; by replicating in the new league the current problems associated with enhancement-based cheating; and by creating new problems. In an attempt to revive it I describe other possible justifications for the proposal, based on its promotion of personal autonomy, and rights-based justifications. These fail, with the exception of a group right claiming provision of the enhanced league as a participatory good. I conclude that this latter use of the proposal is the only sensible one, but it nevertheless faces significant obstacles. (shrink)

"The fixed person for fixed duties, who in older societies was such a godsend, in the future ill be a public danger." Twenty years ago, a single legal metaphor accurately captured the role that American society accorded to physicians. The physician was "c- tain of the ship." Physicians were in charge of the clinic, the Operating room, and the health care team, responsible - and held accountabl- for all that happened within the scope of their supervision. This grant of responsibility (...) carried with it a corresponding grant of authority; like the ship's captain, the physician was answerable to no one regarding the practice of his art. However compelling the metaphor, few would disagree that the mandate accorded to the medical profession by society is changing. As a result of pressures from a number of diverse directions - including technological advances, the development of new health professionals, changes in health care financing and delivery, the recent emphasis on consumer choice and patients' rights - what our society expects phy- cians to do and to be is different now. The purpose of this volume is to examine and evaluate the conceptual foundations and the moral imp- cations of that difference. Each of the twelve essays of this volume assesses the current and future validity of the "captain of the ship" metaphor from a different perspective. The essays are grouped into four sections. In Section I, Russell Maulitz explores the physician's role historically. (shrink)

Two treatises on memory which have come down to us from antiquity are Aristotle’s “On memory and recollection” and Plotinus’ “On perception and memory” ; the latter also wrote at length about memory in his “Problems connected with the soul”. In both authors memory is treated as a ‘modest’ faculty: both authors assume the existence of a persistent subject to whom memory belongs; and basic cognitive capacities are assumed on which memory depends. In particular, both theories use phantasia to explain (...) memory. Aristotle takes representations to be changes in concrete living things which arise from actual perception. To be connected to the original perception the representation has to be taken as a copy of the original experience ‑ this is the way Aristotle defines memory at the end of his investigation. Plotinus does not define memory: he is concerned with the question of what remembers. This is of course the soul, which goes through different stages of incarnation and disincarnation. Since the disembodied soul can remember, so he does not have Aristotle’s resources for explaining the continued presence of representations as changes in the concrete thing. Instead, he thinks that when acquiring a memory we acquire a capacity in respect of the object of the memory, namely to make it present at a later time. (shrink)

The three important target articles make a strong case for regarding racism as a public health crisis. Each calls for advocacy by the bi...

This essay presents a contextualist defense of the role of narrative and metaphor in the articulation of environmental ethical theories. Both the intelligibility and persuasiveness of ecocentric concepts and arguments presuppose that proponents of these ideas can connect with the narratives and metaphors guiding the expectations and interpretations of their audiences. Too often objectivist presuppositions prevent the full contextualization of environmental ethical arguments. The result is a disembodied environmental discourse with diminished influence on citizens and policy makers. This essay is (...) a pragmatist call for more philosophical attention to locating speakers, audiences, and meanings in more intelligible "discursive spaces." © 1999 Elsevier Science Inc. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Aristotle's "Parva Naturalia" culminates in definitions of the stages of the life cycle, from the generation of a new living thing up to death. This book provides a detailed reading of the end of the "Parva Naturalia" and shows how it completes the investigation into life begun in the "De Anima".

"This collection of essays owes its inception to a symposium held in Munich 8-10th September 2003"--P. [i].

In Menciusiia6 all humans are said to have ‘a heart that does not bear the suffering of others’. I argue that this statement is illustrated, rather than proven, by the example of our reaction to a child about to fall into a well. This illustration can be located at the most basic level of ethical universals : basic ethical training; further steps in a ladder of reflection are universal reflection on ethical norms themselves, which may finally be related universally to (...) non‐ethical concerns. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

Open peer commentary on the article “The Autopoiesis of Social Systems and its Criticisms” by Hugo Cadenas & Marcelo Arnold. Upshot: The authors claim that it is justified to extend the concept of autopoiesis from its biological origin to other disciplines, predominately those that have a social character. However, the authors do not lay strong enough conceptual grounds to justify this extension of autopoiesis because it is unclear what concept of autopoiesis it is that would achieve this objective, or why (...) the concept of autopoiesis itself should be crucial to this endeavor. (shrink)

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

Bioethics needs an expanded moral vision. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, and (...) greater appreciation of the profound health implications of global warming. (shrink)

W. E. Hocking has written recently that Whitehead's descriptive generalization of concrete fact, namely, his actual occasion, is “… not a term of description in the direct sense. It is an hypothesis. It cannot be kept in place by pointing to its presence as a datum: it can only hold its own if it proves to be a valuable conceptual tool.” I further advance the thesis that all generality is hypothetical, and holds it own only if it proves to be (...) conceptually useful. This is in accord with Whitehead's statement, the full implications of which have not been taken seriously enough, that metaphysical categories are not dogmatic statements of the obvious; they are tentative formulations of the ultimate generalities. But when these tentative formulations prove conceptually useful or are conceptually employed, they lose their “hypothetical air,” and often pass into what Whitehead calls a false state of “sober obviousness:”“An old established metaphysical system gains a false air of adequate precision from the fact that its words and phrases have passed into current literature. Thus propositions expressed in its language are more easily correlated to our flitting intuitions into metaphysical truth. When we trust these verbal statements and argue as though they adequately analysed meaning, we are led into difficulties which take the shape of negations of what in practice is presupposed. But when they are proposed as first principles they assume an unmerited air of sober obviousness.”. (shrink)

Ren in the Lunyu is often taken to be virtue; if virtue is taken to be excellence as performing a function, as Plato understands it, this is not persuasive. Nor is it easy to show how ren encompasses or implies all other virtues. Ren is furthermore ambiguous—it is used both in a wide sense and specifically as benevolence; in fact there are at least six accounts of what ren is in the Lunyu. This ambiguity cannot be made harmless by use (...) of speech act theory, since commands, for example, require satisfaction conditions for them to be comprehensible. I conclude on a skeptical note: how ren is to be understood as virtue, if at all, remains unclear. (shrink)

Diogenes Laertius relates the tale that Aristotle, upon being reproached for giving alms to a debased fellow, replied, ‘It was not his character, but the man, that I pitied.’ Some such reply is equally apt in apology for a paper paying homage to an idea long discredited in the philosophical world, Aristotle's theory of Place. I have been moved, not indeed by the apparent character of Aristotle's theory, for that is easily reproached, but by what has proved for the philosophical (...) tradition of infinite worth, what we may call the theory's ‘latent virtue’. There is a danger, of course, as hard-headed philologists and commentators are always reminding us, that in attending to this latent virtue we may be paying sentimental homage to the dead. Thus it will be important that we first carefully and coldly examine the overt character of the Aristotelian doctrine before attempting to justify any philosophical compassion felt in its presence. More than likely in such a disinterested inquiry it will be found that our ‘debased fellow’ is a good deal more of a man than the modern reformers have allowed. (shrink)

The volume presents essays on the philosophical explanation of the relationship between body and soul in antiquity from the Presocratics to Galen. The title of the volume alludes to a phrase found in Plato, Aristotle and Plotinus, referring to aspects of living behaviour involving both body and soul, and is a commonplace in ancient philosophy, dealt with in very different ways by different authors.