This essay explores some concerns about the quality of informed consent in patients whose autonomy is diminished by fatal illness. It argues that patients with diminished autonomy cannot give free and voluntary consent, and that recruitment of such patients as subjects in human experimentation exploits their vulnerability in a morally objectionable way. Two options are given to overcome this objection: (i) recruit only those patients who desire to contribute to medical knowledge, rather than gain access to experimental treatment, or (ii) (...) provide prospective subjects the choice to participate in standard doubleblind study or receive the experimental treatment. Either option would guarantee that patients in desperate conditions are given a more meaningful choice and a richer freedom, and thus a higher quality of informed consent, than under standard randomized trials. Keywords: autonomy, double-blind trials, prerandomized and randomized trials, informed consent CiteULike Connotea Del.icio.us What's this? (shrink)

In this book the author examines the stubborn philosophical belief in moral responsibility, surveying the philosophical arguments for it, but focusing on the system that supports these arguments: powerful social and psychological factors that hold the belief in moral responsibility firmly in place.--Publisher's description.

In Against Moral Responsibility, Bruce Waller launches a spirited attack on a system that is profoundly entrenched in our society and its institutions, deeply rooted in our emotions, and vigorously defended by philosophers from ancient times to the present. Waller argues that, despite the creative defenses of it by contemporary thinkers, moral responsibility cannot survive in our naturalistic-scientific system. The scientific understanding of human behavior and the causes that shape human character, he contends, leaves no room for (...) moral responsibility. Waller argues that moral responsibility in all its forms--including criminal justice, distributive justice, and all claims of just deserts--is fundamentally unfair and harmful and that its abolition will be liberating and beneficial. What we really want--natural human free will, moral judgments, meaningful human relationships, creative abilities--would survive and flourish without moral responsibility. In the course of his argument, Waller examines the origins of the basic belief in moral responsibility, proposes a naturalistic understanding of free will, offers a detailed argument against moral responsibility and critiques arguments in favor of it, gives a general account of what a world without moral responsibility would look like, and examines the social and psychological aspects of abolishing moral responsibility. Waller not only mounts a vigorous, and philosophically rigorous, attack on the moral responsibility system, but also celebrates the benefits that would result from its total abolition. (shrink)

Autonomy is good for you. A strong sense of competent self-control and effective choice-making promotes both physical and psychological well-being. Loss of autonomous control—and a sense of helplessness—causes depression, increased sensitivity to pain, greater vulnerability to disease, and death. Well established by a wide range of psychological and physiological studies, the positive effects of patient autonomy are well known to competent physicians, nurses, and therapists. Conscientious caregivers are thus moving beyond grudging acceptance of informed consent toward clinical respect for patient (...) autonomy. (shrink)

In this book, Bruce Waller attacks two prevalent philosophical beliefs. First, he argues that moral responsibility must be rejected; there is no room for such a notion within our naturalist framework. Second, he denies the common assumption that moral responsibility is inseparably linked with individual freedom. Rejection of moral responsibility does not entail the demise of individual freedom; instead, individual freedom is enhanced by the rejection of moral responsibility. According to this theory of "no-fault naturalism," no one deserves (...) either blame or reward.In the course of arguing against moral responsibility, Waller critiques major compatibilist arguments-by Dennett, Frankfurt, Strawson, Bennett, Wolf, Hampshire, Glover, Rachels, Sher, and others. In addition, the implications of denying moral responsibility-for individual freedom, for moral judgments and moral behavior, and for social justice-are examined; the supposed dire consequences of the denial of moral responsibility are challenged; and the benefits of denying moral responsibility are described. Author note: Bruce N. Waller, Assistant Professor of Philosophy at Youngstown State University, Youngstown, Ohio, is the author of Critical Thinking: Consider the Verdict. (shrink)

Analogies come in several forms that serve distinct functions. Inductive analogy is a common type of analogical argument, but critical thinking texts sometimes treat all analogies as inductive. Such an analysis ignores figurative analogies, which may elucidate but do not argue; and also neglects a priori arguments by analogy, a type of analogical argument prominent in law and ethics. A priori arguments by analogy are distinctive, but--contrary to the claims of Govier and Sunstein-they are best understood as deductive, rather than (...) a special form of non deductive reasoning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 125-128 [Access article in PDF] Comparing Psychoanalytic and Cognitive-Behavioral Perspectives on Control Bruce N. Waller Keywords freedom, locus of control, psychoanalysis, self-efficacy, volition Cognitive behavioral research on locus of control and self-efficacy has produced an extensive body of empirical results that might prove useful to psychoanalytic researchers endeavoring to strengthen the empirical foundation of psychoanalytic therapy. Cognitive-behaviorists and psychoanalysts share a (...) common interest in the importance of perspectives and belief systems and their impact on individual freedom, and comparative research on therapeutic effectiveness could yield benefits for both therapeutic approaches.Locus of control and self-efficacy are central elements in cognitive-behavioral psychology, and they play an important role in cognitive-behavioral therapy. Although the psychoanalytic approach does not explicitly employ those concepts, psychoanalytic therapists are obviously concerned with problems of effective action and internal obstacles to action. Attention to these two perspectives and their overlapping interests offers potential benefits for both the cognitive-behavioral and the psychodynamic approaches to psychological research and therapy.One potential benefit is the development of useful tools for advancing empirically based research on psychoanalysis. As Lehrer (1999) states, it is advantageous to ground psychoanalysis in "firm empirical evidence whenever possible." Although there have obviously been significant positive steps in that direction (Singer 2003; Weiss 1995, 1988; Weiss and Sampson 1986), psychoanalytic researchers have recognized that one source of difficulty is in finding clearly measurable research objectives and hypotheses (Burgin 2002). Cognitive-behavioral research on locus of control and self-efficacy has produced an extensive body of research using clear measurement standards that could prove useful in the empiricist approach to psychodynamic theories. In particular, those cognitive-behavioral research findings might offer a means of extending empirical investigation of psychodynamic theory in a direction usually regarded as difficult to test empirically: the study of psychoanalytic effectiveness to "change your way of seeing" (Lieberman 1999). Shifting locus of control or efficacy expectations in specific domains (Bandura 1997) [End Page 125] would empirically confirm the effectiveness of psychoanalytic techniques. It might well be that some efficacy expectations are enhanced more effectively by psychodynamic processes than by cognitive-behavioral therapy, or that psychoanalysis is effective in enhancing some specific efficacy expectations but not others. This could potentially extend the empirical examination of psychoanalytic theory as well as provide a base of comparison with cognitive-behavioral therapy techniques.Although self-efficacy enhancement might be a fruitful empirical test for psychodynamic therapy, therapeutic intervention to modify locus of control potentially could be even more productive. Current research indicates that one's orientation toward locus of control is a relatively stable characteristic, although it can be modified (Holyrod et al. 1984; Rotter 1979; Sadow and Hopkins 1993). One reason for locus of control stability may be that the locus of control imposes a perspective on the conceptualization of all one's experiences: from a strong internal locus of control perspective I view failures and successes as largely my own doing, whereas from an external locus perspective even my most effective efforts are seen as events that were outside my control: "I guess it was just my time to do well on a math exam," rather than "My hard work for that exam really paid off." (Lieberman makes this phenomenon quite clear in his excellent discussion of transparency.) Although locus of control is not easily modified, it is important to find effective means of helping subjects to achieve such changes, because research shows that a strong internal locus of control is positively correlated with success in work, sports, studies, marriage, and psychological adjustment (Lefcourt 1981, 1992), as well as with better health care behavior and better health (Bandura 1977; Schorr and Rodin 1982; Schulz 1976; Schulz and Hanusa 1978; Wallston 1993). Those deeply enmeshed in an external locus of control enjoy less real freedom and suffer severe disadvantages.How does one effect a shift in such a basic orientation? Not easily. From a psychoanalytic approach, the key will lie in recognizing and reconceptualizing the beliefs that impede effective action. Cognitive-behaviorists are more likely to... (shrink)

The patient's right to informed consent is grudgingly acknowledged by medical professionals, firmly established in law, and brandished as a shibboleth by most bioethicists. But questions remain concerning genuine patient autonomy, and the doctrine of informed consent offers inadequate answers. In addition to the continuing controversy over what counts as “informed,” the passive acquiescence implied by “consent” seems a pale shadow of genuine autonomy.

Restorative Free Will examines free will as an adaptive capacity that evolved in humans and many other species, and restores free will to species excluded by claims of human uniqueness. Restorative Free Will recognizes the basic biological value of both libertarian and compatibilist elements of free will, and explains how these traditionally opposed accounts of free will capture an essential element of foraging animals' free will.

"Cover" -- "Title" -- "Copyright" -- "Contents" -- "Preface" -- "Acknowledgments" -- "1 Beyond the Moral Responsibility System" -- "2 The Unjust Necessity of Punishment" -- "3 Tychonic Moral Responsibility" -- "4 The Strike-Back Roots of Retributive Justice" -- "5 A Just World, Moral Responsibility, and the Justice of Punishment" -- "6 Does Denying Moral Responsibility Threaten Dignity, Rights, and Innocence?" -- "7 Empirical Examination of Moral Responsibility" -- "8 How Does Belief in Moral Responsibility Undermine Personal Dignity?" -- "9 (...) Efforts to Make Punishment Just" -- "10 Is Therapy an Alternative?" -- "11 The No-Blame System Model" -- "12 No Limits on No-Blame" -- "13 A Universal No-Blame System" -- "14 Conclusion" -- "References. (shrink)

The city of Cork experienced a political odyssey between Easter 1916 and the end of 1918. Wartime policies conceived in London manifested themselves unexpectedly in Cork--The Defence of the Realm Act was used to repress political speech; deficit spending generated massive inflation; mandatory arbitration encouraged workers to join trade unions; food rationing panicked a country scarred by the Potato Famine; and military conscription generated virtual rebellion. As a result, the Cork public increasingly turned against the war. The book examines the (...) political situation in Cork prior to the Easter Rising; local reactions to the rebellion; the rapid creation of the Republican mass movement; the dramatic decline of the Irish Party; the explosion of anti-authority street rioting; the mobilization of women in the independence struggle; disturbances against venereal disease treatments and visiting American sailors; the emergence of radical trade unionism; agitation over the retention of local food supplies; the nationalist mobilization during the Conscription Crisis; and Sinn Féin's triumph in the 1918 General Election. (shrink)

Philosophical tradition demands rational reflection as a condition for genuine moral acts. But the grounds for that requirement are untenable, and when the requirement is dropped morality comes into clearer view as a naturally developing phenomenon that is not confined to human beings and does not require higher-level rational reflective processes. Rational consideration of rules and duties can enhance and extend moral behavior, but rationality is not necessary for morality and (contrary to the Kantian tradition represented by Thomas Nagel) morality (...) cannot transcend its biological roots. Recognizing this helps forge a complementary rather than competitive relation between feminist care-based ethics and rationalistic duty-based ethics. (shrink)

Challenges the deep traditional assumption that autonomy, morality, and moral responsibility are uniquely human characteristics.

Peter Woolcock, in Ruse's Darwinian Meta-Ethics: A Critique, argues that the subjectivist (nonobjectivist) Darwinian metaethics proposed by Michael Ruse (in Taking Darwin Seriously) cannot work, because the illusion of objectivity that Ruse claims is essential to morality breaks down when it is recognized as illusion, and there then remain no good reasons for acknowledging or following moral obligations. Woolcock, however, is mistaken in supposing that moral behaviour requires rational motivation. Ruse's Darwinian metaethical analysis shows why such objective support for morality (...) is neither plausible nor necessary; and when that is recognized, it can also be seen that Ruse's proposed illusion of moral objectivity is superfluous. (shrink)

Moving beyond the retributive system requires clearing away some of the basic assumptions that form the foundation of that system: most importantly, the assumption of moral responsibility, which is held in place by deep and destructive belief in a just world. Efforts to justify moral responsibility typically appeal to some version of self-making, and that appeal is only plausible through limits on inquiry. Eliminating moral responsibility removes a major impediment to deeper inquiry and understanding of the biological, social, and environmental (...) causes of both vicious and virtuous behavior. The resources for moving beyond the moral responsibility are already being developed in social democratic corporatist cultures as well as in workplace management models that nurture commitment and reject blame and shame. Without moral responsibility we must face the unpleasant fact that although punishment is sometimes unavoidable it is always unjust. That unpleasant fact motivates difficult but beneficial changes that minimize both the extent and the severity of punitive measures. (shrink)

Informed consent has passed through three stages. The first paternalistic stage lasted for many centuries: The doctor's diagnosis and healing arts were kept secret, and informing patients was regarded as professionally and ethically wrong. Second came the legal stage, when the right of patients to make informed decisions concerning their own treatment was imposed by the courts and reluctantly tolerated by medical professionals. The third informed consent stage emerged more recently: the general therapy stage. The therapeutic benefits of informed consent (...) have been well established, and informed consent is widely recognized as an important element in sound medical practice. When patients are effectively informed and can exert knowledgeable control over their own treatment decisions and therapy processes, that enhances recovery, strengthens the immune system, promotes better pain tolerance, prevents depression, and encourages patient cooperation and fortitude in treatment, rehabilitation, and preventative procedures. As the medical community has absorbed greater knowledge of this research, informed consent has been recognized as both ethically essential and therapeutically sound: the hallmark of the current general therapy stage of informed consent. (shrink)

Two essential elements of free will—internal locus of control and confident self-efficacy—have been studied extensively by psychologists but neglected by philosophers. As a result of this neglect, philosophers have worked with a distorted view of free will. Existentialists exaggerate internal locus of control while undercutting self-efficacy; most contemporary philosophers have taken both internal locus of control and self-efficacy for granted, ignoring their importance and the problems generated by their absence. By taking advantage of psychological research on internal locus of control (...) and self-efficacy, this paper develops a richer and more realistic account of the value of free choice and the real threats to free will. (shrink)

The debate over free will has pittedlibertarian insistence on open alternativesagainst the compatibilist view that authenticcommitments can preserve free will in adetermined world. A second schism in the freewill debate sets rationalist belief in thecentrality of reason against nonrationalistswho regard reason as inessential or even animpediment to free will. By looking deeperinto what motivates each of these perspectivesit is possible to find common ground thataccommodates insights from all those competingviews. The resulting metacompatibilist view offree will bridges some of the differencesbetween (...) compatibilists and incompatibilists aswell as between rationalists andnonrationalists, and results in a free willtheory that is both more philosophicallyinclusive and more firmly connected tocontemporary research in psychology andbiology. (shrink)

Theories of autonomy divide into two conflicting categories: theories that emphasize freedom to choose among alternatives, and theories that focus on personal authenticity. This conflict can be resolved by recognizing the basic function of natural authenticity, and its deep roots in human and animal behavior. Authenticity functions to keep options open that might be too hastily abandoned. Thus forms a natural symbiotic union with autonomy as alternatives. Human authenticity is a special adaptation, but it is not different in kind from (...) the authenticity of many other species. My naturalistic account of authenticity avoids traditional problems concerning willing addicts and happy slaves and reaffirms the traditional link between authenticity and autonomous choices among alternatives. (shrink)

This book examines a nonconscious and profoundly harmful desire that is almost universally denied: the desire to be a god. Afflicting believers and nonbelievers alike, the desire is manifested in religious myths and throughout the history of philosophy.

People occasionally change their moral beliefs and principles, and they may experience such changes as occurring independently of their wishes. Moral realists argue that this phenomenon of moral conversion is evidence for moral realism, and against noncognitivism. However, contemporary noncognitivists can acknowledge such changes--including changes "against our wills"--and can account for the changes in a simpler and more plausible manner. If moral realism posits real moral facts to account for moral conversion the result will be an extreme and untenable inflation (...) of moral realist ontology. (shrink)