Due to new developments in prenatal testing and therapy the fetus is increasingly visible, examinable and treatable in prenatal care. Accordingly, physicians tend to perceive the fetus as a patient and understand themselves as having certain professional duties towards it. However, it is far from clear what it means to speak of a patient in this connection. This volume explores the usefulness and limitations of the concept of ¿fetal patient¿ against the background of the recent seminal developments in prenatal or (...) fetal medicine. It does so from an interdisciplinary and international perspective. Featuring internationally recognized experts in the field, the book discusses the normative implications of the concept of ¿fetal patient¿ from a philosophical-theoretical as well as from a legal perspective. This includes its implications for the autonomy of the pregnant woman as well as its consequences for physician-patient-interactions in prenatal medicine. (shrink)

BackgroundEthics consultation is recognized as an opportunity to share responsibility for difficult decisions in prenatal medicine, where moral intuitions are often unable to lead to a settled decision. It remains unclear, however, if the general standards of ethics consultation are applicable to the very particular setting of pregnancy.Main textWe sought to analyze the special nature of disagreements, conflicts and value uncertainties in prenatal medicine as well as the ways in which an ethics consultation service (ECS) could possibly respond to them (...) and illustrated our results with a case example. Ethics facilitation and conflict mediation, currently, have no broadly consented normative framework encompassing prenatal diagnosis and therapy as well as reproductive choice to draw on. Even so, they can still be helpful instruments for ethically challenging decision-making in prenatal medicine provided two additional rules are respected: For the time being, ECSs should (a) refrain from issuing content-heavy recommendations in prenatal medicine and (b) should not initiate conflict mediations that would involve the pregnant woman or couple as a conflict party.ConclusionIt seems to be vital that ethics consultants as well as health care professionals acknowledge the current limitations and pitfalls of ethics consultation in prenatal medicine and together engage in the advancement of standards for this particularly complex setting. (shrink)

Discussion of a “duty to recontact” emerged as technological advances left professionals considering getting back in touch with patients they had seen in the past. While there has been much discussion of the duty to recontact as a matter of theory and ethics, there has been rather little empirically based analysis of what this “duty” consists of. Drawing on interviews with 34 professionals working in, or closely with, genetics services, this paper explores what the “duty to recontact” means for healthcare (...) professionals involved in genetics. Using a discourse analytic framework, the paper identifies three system generated discourses on recontact (governance, legal and responsibilizing discourses) and three lifeworld discourses (situating recontact as a formal duty; more loosely as an obligation; and as a personal sense of responsibility). In summary, the paper shows that the “duty” to recontact involves a complex interplay of system responsibilities with professional duties, responsibilities and obligations. (shrink)

Contributions to this study are drawn both from health professionals engaged in genetic counselling and from observers and critics with backgrounds in law, philosophy, biology, and the social sciences. This diversity will enable health professonals to examine their activities with a fresh eye, and will help the observer-critic to understand the ethical problems that arise in genetic counselling practice, rather than in imaginary encounters. Most examinations of the ethical issues raised by genetics are concerned in a broad sense with the (...) application of new technology to human reproduction. This volume focuses on genetic counselling and screening as such, providing valuable insights for the health professional, social scientist, philosopher, lawyer, and bioethicist. (shrink)

Non-invasive prenatal testing is an emerging form of prenatal genetic testing that provides information about the genetic constitution of a foetus without the risk of pregnancy loss as a direct result of the test procedure. As with other prenatal tests, information from NIPT can help to make a decision about termination of pregnancy, plan contingencies for birth or prepare parents to raise a child with a genetic condition. NIPT can also be used by women and couples to test purely ‘for (...) information’. Here, no particular action is envisaged following the test; it is motivated entirely by an interest in the result. The fact that NIPT can be performed without posing a risk to the pregnancy could give rise to an increase in such requests. In this paper, we examine the ethical aspects of using NIPT ‘purely for information’, including the competing interests of the prospective parents and the future child, and the acceptability of testing for ‘frivolous’ reasons. Drawing on several clinical scenarios, we claim that arguments about testing children for genetic conditions are relevant to this debate. In addition, we raise ethical concerns over the potential for objectification of the child. We conclude that, in most cases, using NIPT to test for adult-onset conditions, carrier status or non-serious traits presenting in childhood would be unacceptable. (shrink)

The paper by Mand et al raises important questions about the predictive genetic testing of children. They focus on those claims made by professionals that are open to empirical enquiry and give too little weight to those claims that do not require empirical support. The authors remind us that some commentators oppose empirical enquiry because of the concern that gathering evidence of the consequences of such testing may itself be harmful or unethical. They respond by asserting that the relevant research (...) questions are ‘eminently testable’ but fail to discuss the challenges of such research, including the questions of timescale, consent or the nature of the data whose collection (they assert) would resolve the perceived difficulties with the genetic testing of children. They conclude that empirical research is required without resolving the weighty arguments against predictive testing of young children or explaining how the evidence they wish to collect could overcome the force of the arguments that favour caution. (shrink)

The paper by Bowman-Smart et al. (2023) on noninvasive prenatal genetic testing (NIPT) for non-medical traits aims to set out the case for and the case against such testing. In response to their pa...

Contributions to this study are drawn both from health professionals engaged in genetic counselling and from observers and critics with backgrounds in law, philosophy, biology, and the social sciences. This diversity will enable health professonals to examine their activities with a fresh eye, and will help the observer-critic to understand the ethical problems that arise in genetic counselling practice, rather than in imaginary encounters. Most examinations of the ethical issues raised by genetics are concerned in a broad sense with the (...) application of new technology to human reproduction. This volume focuses on genetic counselling and screening as such, providing valuable insights for the health professional, social scientist, philosopher, lawyer, and bioethicist. (shrink)

This chapter contains sections titled: Information Management: Confidentiality, Autonomy and Non‐Directiveness Predictive Genetic Testing Childhood Genetic Testing Genetic Screening Informed Consent to Screening Newborn Screening Carrier Screening Prenatal Screening Susceptibility Screening Further Information Management Goals of Genetic Screening: Public Health vs Individual Choice Conclusion References Further reading.

The article reconsiders the nature and location of science in the development of genetic classification. Drawing on field studies of medical genetics, we explore how patient categorization is accomplished in between the clinic and laboratory. We focus on dysmorphology, a specialism concerned with complex syndromes that impair physical development. We show that dys-morphology is about more than fitting patients into prefixed diagnostic categories and that diagnostic process is marked by moments of uncertainty, ambiguity, and deferral. We describe how different forms (...) of evidence are brought into play and how patterns of physical features are identified as genetic or not. We suggest that clinical categorical work helps articulate the genetic as an emergent domain of medical classification and that moments of ambiguity and deferral create an imperative space that helps legitimate the need for more technoscience, and consequently, more clinical judgment with which to fix the genetic future. (shrink)

The prevention, treatment and management of disease are closely linked to how the causes of a particular disease are explained. For multi-factorial conditions, the causal explanations are inevitably complex and competing models may exist to explain the same condition. Selecting one particular causal explanation over another will carry practical and ethical consequences that are acutely relevant for health policy. In this paper our focus is two-fold; the different models of causal explanation that are put forward within current scientific literature for (...) the high and rising prevalence of the common complex conditions of coronary artery disease and type 2 diabetes mellitus ; and how these explanations are taken up within national health policy guidelines. We examine the causal explanations for these two conditions through a systematic database search of current scientific literature. By identifying different causal explanations we propose a three-tier taxonomy of the most prominent models of explanations: evolutionary, lifecourse, and lifestyle and environment. We elaborate this taxonomy with a micro-level thematic analysis to illustrate how some explanations are semantically and rhetorically foregrounded over others. We then investigate the uptake of the scientific causal explanations in health policy documents with regard to the prevention and management recommendations of current National Service Frameworks for CAD and T2D. Our findings indicate a lack of congruence between the complexity and frequent overlap of causal explanations evident in the scientific literature and the predominant focus on lifestyle recommendations found in the mainstream health policy documents. (shrink)

Brains, it has recently been argued, are essentially prediction machines. They are bundles of cells that support perception and action by constantly attempting to match incoming sensory inputs with top-down expectations or predictions. This is achieved using a hierarchical generative model that aims to minimize prediction error within a bidirectional cascade of cortical processing. Such accounts offer a unifying model of perception and action, illuminate the functional role of attention, and may neatly capture the special contribution of cortical processing to (...) adaptive success. This target article critically examines this approach, concluding that it offers the best clue yet to the shape of a unified science of mind and action. Sections 1 and 2 lay out the key elements and implications of the approach. Section 3 explores a variety of pitfalls and challenges, spanning the evidential, the methodological, and the more properly conceptual. The paper ends (sections 4 and 5) by asking how such approaches might impact our more general vision of mind, experience, and agency. (shrink)

Mindware: An Introduction to the Philosophy of Cognitive Science invites readers to join in up-to-the-minute conceptual discussions of the fundamental issues, problems, and opportunities in cognitive science. Written by one of the most renowned scholars in the field, this vivid and engaging introductory text relates the story of the search for a cognitive scientific understanding of mind. This search is presented as a no-holds-barred journey from early work in artificial intelligence, through connectionist (artificial neural network) counter-visions, and on to neuroscience, (...) artificial life, dynamics, and robotics. The journey ends with some wide-ranging and provocative speculation about the complex coadaptive dance between mind, culture, and technology. Each chapter opens with a brief sketch of a major research tradition or perspective, followed by short yet substantial critical discussions dealing with key topics and problems. Ranging across both standard philosophical territory and the landscape of cutting-edge cognitive science, Clark highlights challenging issues in an effort to engage readers in active debate. Topics covered include mental causation; machine intelligence; the nature and status of folk psychology; the hardware/software distinction; emergence; relations between life and mind; the nature of perception, cognition, and action; and the continuity (or otherwise) of high-level human intelligence with other forms of adaptive response. Numerous illustrations, text boxes, and extensive suggestions for further reading enhance the text's utility. Helpful appendices provide background information on dualism, behaviorism, identity theory, consciousness, and more. An exceptional text for introductory and more advanced courses in cognitive science and the philosophy of mind, Mindware is also essential reading for anyone interested in these fascinating and ever-changing fields. (shrink)

A biblical approach to reconciling God’s sovereignty with creaturely responsibility should avoid the extremes of global occasionalism and completely autonomous creatures. This paper evaluates the standard intermediary solutions offered by conservationists and concurrentists. It argues that while each contributes insights which a satisfactory account should retain, none is fully adequate. Even Leibniz’s sophisticated response, which accounts for providence, miracles, and moral responsibility, unacceptably abridges creaturely power to implement decisions. My alternative proposal seeks to explain how creatures can retain full responsibility (...) for their actions even though God reserves the right to override creaturely power with His greater power. (shrink)

In "Mathematical Truth", Paul Benacerraf articulated an epistemological problem for mathematical realism. His formulation of the problem relied on a causal theory of knowledge which is now widely rejected. But it is generally agreed that Benacerraf was onto a genuine problem for mathematical realism nevertheless. Hartry Field describes it as the problem of explaining the reliability of our mathematical beliefs, realistically construed. In this paper, I argue that the Benacerraf Problem cannot be made out. There simply is no intelligible problem (...) that satisfies all of the constraints which have been placed on the Benacerraf Problem. The point generalizes to all arguments with the structure of the Benacerraf Problem aimed at realism about a domain meeting certain conditions. Such arguments include so-called "Evolutionary Debunking Arguments" aimed at moral realism. I conclude with some suggestions about the relationship between the Benacerraf Problem and the Gettier Problem. (shrink)

To what extent are the subjects of our thoughts and talk real? This is the question of realism. In this book, Justin Clarke-Doane explores arguments for and against moral realism and mathematical realism, how they interact, and what they can tell us about areas of philosophical interest more generally. He argues that, contrary to widespread belief, our mathematical beliefs have no better claim to being self-evident or provable than our moral beliefs. Nor do our mathematical beliefs have better claim (...) to being empirically justified than our moral beliefs. It is also incorrect that reflection on the "genealogy" of our moral beliefs establishes a lack of parity between the cases. In general, if one is a moral antirealist on the basis of epistemological considerations, then one ought to be a mathematical antirealist as well. And, yet, Clarke-Doane shows that moral realism and mathematical realism do not stand or fall together -- and for a surprising reason. Moral questions, insofar as they are practical, are objective in a sense that mathematical questions are not. Moreover, the sense in which they are objective can be explained only by assuming practical anti-realism. One upshot of the discussion is that the concepts of realism and objectivity, which are widely identified, are actually in tension. Another is that the objective questions in the neighborhood of questions of logic, modality, grounding, and nature are practical questions too. Practical philosophy should, therefore, take center stage. (shrink)

Since Freud's earliest psychoanalytic theorisation around the beginning of the twentieth-century, the concept of the unconscious has exerted an enormous influence upon psychoanalysis and psychology, literary, critical and social theory. Yet prior to Freud, the concept of the unconscious already possessed a complex genealogy in nineteenth-century German philosophy and literature, beginning with the aftermath of Kant's Critical Philosophy and the origins of German Idealism, and extending into the discourses of Romanticism and beyond. Despite the many key thinkers who contributed to (...) the Germanic discourses on the unconscious, the English speaking world remains comparatively unaware of this heritage and its influence upon the origins of psychoanalysis. Bringing together a collection of experts in the fields of German Studies, Continental Philosophy, the History and Philosophy of Science, and the History of Psychoanalysis, this volume examines the various theorisations, representations and transformations undergone by the concept of the unconscious in nineteenth-century German thought"--Provided by publisher. (shrink)

Ranging across both standard philosophical territory and the landscape of cutting-edge cognitive science, Mindware: An Introduction to the Philosophy of Cognitive Science, Second Edition, is a vivid and engaging introduction to key issues, research, and opportunities in the field.Starting with the vision of mindware as software and debates between realists, instrumentalists, and eliminativists, Andy Clark takes students on a no-holds-barred journey through connectionism, dynamical systems, and real-world robotics before moving on to the frontiers of cognitive technologies, enactivism, predictive coding, and (...) the extended mind. Throughout, he highlights challenging issues in an effort to engage students in active debate. Each chapter opens with a brief sketch of a major research tradition or perspective, followed by concise critical discussions dealing with key topics and problems. (shrink)

Galen Strawson has published several versions of an argument to the effect that moral responsibility is impossible, whether determinism is true or not. Few philosophers have been persuaded by the argument, which Strawson remarks is often dismissed “as wrong, or irrelevant, or fatuous, or too rapid, or an expression of metaphysical megalomania.” I offer here a two-part explanation of why Strawson’s argument has impressed so few. First, as he usually states it, the argument is lacking at least one key premise. (...) The premise in question concerns the very point on which Strawson and many of his contemporary opponents disagree. Strawson will persuade these opponents only when he convinces them of the truth of this crucial premise. Second, Strawson employs a striking conception of responsibility that has not generally been remarked upon. Many might accept that responsibility so conceived is impossible. But there is very different conception of responsibility that appears of great importance to us. To be thoroughly convincing, Strawson will have to show either that this second conception is inadequate or that his argument goes through even given this alternative conception. (shrink)

This book discusses the problem of mathematical knowledge, and its broader philosophical ramifications. It argues that the problem of explaining the (defeasible) justification of our mathematical beliefs (‘the justificatory challenge’), arises insofar as disagreement over axioms bottoms out in disagreement over intuitions. And it argues that the problem of explaining their reliability (‘the reliability challenge’), arises to the extent that we could have easily had different beliefs. The book shows that mathematical facts are not, in general, empirically accessible, contra Quine, (...) and that they cannot be dispensed with, contra Field. However, it argues that they might be so plentiful that our knowledge of them is intelligible. The book concludes with a complementary ‘pluralism’ about modality, logic and normative theory, highlighting its revisionary implications. Metaphysically, pluralism engenders a kind of perspectivalism and indeterminacy. Methodologically, it vindicates Carnap’s pragmatism, transposed to the key of realism. (shrink)

It is commonly suggested that evolutionary considerations generate an epistemological challenge for moral realism. At first approximation, the challenge for the moral realist is to explain our having many true moral beliefs, given that those beliefs are the products of evolutionary forces that would be indifferent to the moral truth. An important question surrounding this challenge is the extent to which it generalizes. In particular, it is of interest whether the Evolutionary Challenge for moral realism is equally a challenge for (...) mathematical realism. It is widely thought not to be. In this paper, I argue that the Evolutionary Challenge for moral realism is equally a challenge for mathematical realism. Along the way, I substantially clarify the Evolutionary Challenge, discuss its relation to more familiar epistemological challenges, and broach the problem of moral disagreement. The paper should be of interest to ethicists because it places pressure on anyone who rejects moral realism on the basis of the Evolutionary Challenge to reject mathematical realism as well. And the paper should be of interest to philosophers of mathematics because it presents a new epistemological challenge for mathematical realism that bears, I argue, no simple relation to Paul Benacerraf's familiar challenge. (shrink)

Part I: The 'explanatory gap'. 1. Why take morality to be objective? -- 2. The gap opens: evolution and our capacity for moral knowledge -- Part II: Secular responses. 3. Alternatives to realism: Simon Blackburn and Allan Gibbard -- 4. Procedures and reasons: Tim Scanlon and Christine Korsgaard -- 5. Natural goodness: Philippa Foot's moral objectivism -- 6. Natural goodness and 'second nature': John McDowell and David Wiggin -- Part III: Theism. 7. From goodness to God: closing the explanatory gap (...) -- 8. Purpose without theism? Axiarchism and Neoplatonism. (shrink)

Let F be a fact in virtue of which an agent, S, is blameworthy for performing an act of A-ing. We advance a slightly qualified version of the following thesis: -/- (Reason) F is (at some time) a reason for S to feel guilty (to some extent) for A-ing. -/- Leaving implicit the qualification concerning extent, we claim as well: -/- (Desert) S's having this reason suffices for S’s deserving to feel guilty for A-ing. -/- We also advance a third (...) thesis connecting desert of feeling guilty with the fittingness of this response. -/- In light of our three theses, we address several claims that have been made regarding responsibility and desert. We take issue with the divorce of desert from responsibility. We find acceptable a claim regarding blameworthiness and reason to induce guilt, and we defend the idea that it is noninstrumentally good that one who is blameworthy be subject to a fitting feeling of guilt. We argue against a view on which desert of blame has a teleological dimension. (shrink)

Philosophical theories of agency have focused primarily on actions and activities. But, besides acting, we often omit to do or refrain from doing certain things. How is this aspect of our agency to be conceived? This book offers a comprehensive account of omitting and refraining, addressing issues ranging from the nature of agency and moral responsibility to the metaphysics of absences and causation. Topics addressed include the role of intention in intentional omission, the connection between negligence and omission, the distinction (...) between doing and allowing, and the distinction in law between act and omission. (shrink)

This is a three-part exchange on the relationship between belief and credence. It begins with an opening essay by Roger Clarke that argues for the claim that the notion of credence generalizes the notion of belief. Julia Staffel argues in her reply that we need to distinguish between mental states and models representing them, and that this helps us explain what it could mean that belief is a special case of credence. Roger Clarke's final essay reflects on the (...) compatibility of the previously discussed views with dualist and monist interpretations of our mental states and our ways of modeling them. (shrink)

This a general account of the school of Mo-tzu, its social basis as a movement of craftsmen, its isolated place in the Chinese tradition, and the nature of its later contributions to logic, ethics, and science. It assesses the relation of Mohist thinking to the structure of the Chinese language, and grapples with the textual dynamics of later Mohist writings, particularly in regard to grammar and style, technical terminology, the use and significance of stock examples, and overall organization. Includes edited (...) and annotated Chinese text with an English translation and commentary, a glossary, and a photographic reproduction of the unemended text from the Taoist Patrology. (shrink)

It is argued that reliance on the testimony of others cannot be viewed as reliance on a kind of evidence. Speech being essentially voluntary, the speaker cannot see his own choice of words as evidence of their truth, and so cannot honestly offer them to others as such. Rather, in taking responsibility for the truth of what he says, the speaker offers a guarantee or assurance of its truth, and in believing him the hearer accepts this assurance. I argue that, (...) contrary to appearances, this account is compatible with the hearer acquiring knowledge, and in fact throws interesting light on the idea of knowledge. -/- . (shrink)

Every time we think ahead, we are crafting a story. Every daily plan—and every political vision, social movement, scientific hypothesis, business proposal, and technological breakthrough—starts with “what if?” Linking causes to effects, considering hypotheticals and counterfactuals, asking how other people will react: these are the essence of narrative. So why do we keep overlooking story’s importance to intelligence in favor of logic? This book explains how and why our brains think in stories. Angus Fletcher, an expert in neuroscientific approaches (...) to narrative, identifies this capacity as “storythinking.” He demonstrates that storythinking is fundamental to what makes us human. Artificial intelligence can perform symbolic logic, rational deduction, and mathematical calculation, but it is incapable of deliberating in narrative. Drawing on new research in neuroscience and narrative theory, Fletcher explores the nature of imagination, innovation, and creativity. He provides concise answers to big questions: How does storythinking work? Why did it evolve? How can it misfire? What problems can it solve? Revealing the significance of storythinking from science to business to philosophy, this book also provides ways for readers to harness its power to script better tomorrows. (shrink)

This paper proposes a roughly Aristotelian account of powers ontology. In doing so, the paper uses the distinction found in Aristotle between four analogous senses of potency to explain causation and the existence-essence distinction in substances. On this basis, the paper offers some justification in support of the claims that powers and dispositions are the truth-makers of categorical properties and that categorical properties are ontologically dependent upon powers and dispositions.

This chapter contains sections titled: Introduction 1. Heidegger's Phenomenology 2. Heidegger on Teaching/Learning 3. Authenticity and the Phenomenon of Teaching Conclusion Notes References.

本书是一部极具可读性与权威性的中国古代思想史,一部具有哲学的原创性、敏锐与深刻洞察的著作,是作者在汉学、语言学和哲学交汇处卓越学识的顶点,内容着重在先秦的哲学史。.

Skilled activity, such as shaving or dancing, differs in important ways from many of the stock examples that are employed by action theorists. Some critics of the causal theory of action contend that such a view founders on the problem of skilled activity. This paper examines how a causal theory can be extended to the case of skilled activity and defends the account from its critics.

This book presents a provocative new interpretation of what is arguably Nietzsche's most important and most difficult work, Beyond Good and Evil.

Despite its central position in the history of European and Christian thought on the protection of human dignity, the virtue of mercy is currently a problematic and under-developed concept in business ethics, compared to related ideas of care, compassion or philanthropy. The aim of this article is to argue for its revival as a core principle of ethical business practice. The article is conceptual in method. An overview is provided of the scope of contemporary business ethics research on related topics (...) and clarifies some of the similarities and differences between mercy and popular terms, such as compassion and prosocial behaviour. The question is then explored as to why mercy has so little traction in business ethics. Some of the history of the idea of mercy in European and Anglophone philosophy is discussed, from Anselm and Aquinas to the present day, showing how discourse on mercy came to be split into a wider concept of the prevention and alleviation of suffering (_misericordia_) and a narrower one of clemency or leniency. Aquinas’s wide concept of the virtue of _misericordia_ is developed as the basis for a principle of mercy, which is applicable directly to corporations. The practical implications of this for standards of corporate behaviour towards employees and other stakeholders are then considered through the introduction of a ‘vulnerability grid’. The grid offers a critical contrast to other analysis tools, such as stakeholder power-interest matrices. Cases drawn from empirical studies are used to illustrate application of the grid and to challenge some common assumptions of stakeholder theory. (shrink)