This book offers a complete rethink of the institutional limits and possibilities of deliberative democracy and legitimacy. Examining several unresolved problems at the core of deliberative democratic theory, this volume will be vital reading for deliberative democratic theorists and public policy makers.

Social responsibility on the part of business has various meanings, to some of which English law is more favourable than others. But the law could be changed. The author is a Solicitor and Lecturer in Law in the University of Bristol. His Corporate Power and Responsibility: Issues in the Theory of Company Law has recently been published by Oxford University Press.

Social responsibility on the part of business has various meanings, to some of which English law is more favourable than others. But the law could be changed. The author is a Solicitor and Lecturer in Law in the University of Bristol. His Corporate Power and Responsibility: Issues in the Theory of Company Law has recently been published by Oxford University Press.

While euthanasia and assisted suicide have been the subject of continuing public debate, few studies have examined the attitudes of relevant patient groups. This study systematically reviews the research literature on patients’ attitudes from 1989 to 2003, to i) identify the number of studies, ii) evaluate study methods and measures, and iii) examine prevalence of favourable attitudes. A systematic search was undertaken across five databases. Methods of the 21 studies identified varied considerably. General support for euthanasia and assisted suicide was (...) substantial across patient groups, with lower support for these as a personal option. The cancer / terminally ill / palliative care patient group had the lowest median general support for euthanasia (60% [IQ1=47, IQ3=65]) and assisted suicide (50% [IQ1=38, IQ3=71]), while the general/older/younger patient group had the lowest median personal preference for these (18% [IQ1=14, IQ3=27]). The effect of question context on level of support was unclear, due to the variety and number of contexts used across questions. There is still work that needs to be done in this controversial area before any robust conclusions can be made concerning the attitudes of patients to euthanasia and assisted suicide, and the adoption of a minimum set of standard questions would enhance this work. (shrink)

Objectives: The aims of this study were to: (1) investigate patients’ views on euthanasia and physician-assisted suicide (PAS), and (2) examine the impact of question wording and patients’ own definitions on their responses. Design: Cross-sectional survey of consecutive patients with cancer. Setting: Newcastle (Australia) Mater Hospital Outpatients Clinic. Participants: Patients over 18 years of age, attending the clinic for follow-up consultation or treatment by a medical oncologist, radiation oncologist or haematologist. Main Outcome Measures: Face-to-face patient interviews were conducted examining attitudes (...) to euthanasia and PAS. Results: 236 patients with cancer (24% participation rate; 87% consent rate) were interviewed. Though the majority of participants supported the idea of euthanasia, patient views varied significantly according to question wording and their own understanding of the definition of euthanasia. Conclusions: Researchers need to be circumspect about framing and interpreting questions about support of ‘euthanasia’, as the term can mean different things to different people, and response may depend upon the specifics of the question asked. (shrink)

The theme of this paper is a philosophical theory of communication; more specifically, a theory about the understanding of language. It is an old theory, whose classical exponent was John Locke, and in the form that Locke expounded it the theory is now generally rejected by philosophers. But it is far from being a mere museum piece. The view about language that Locke put forward was a plausible one, and it has continued to be put forward in various forms. (...) My main concern here is with a very recent version of the theory, contained in a book published early in 1975; however, it will be helpful to begin with a brief account of Locke's version. This is not only classical, but is also simple and clear, and as such it may serve as a useful stepping-stone towards an understanding of the more modern version. (shrink)

Deep brain stimulation (DBS) is an effective treatment for the debilitating motor symptoms of Parkinson’s disease and other neurological disorders. However, clinicians and commentators have noted that DBS recipients have not necessarily experienced the improvements in quality of life that would be expected, due in large part to what have been described as the ‘psychosocial’ impacts of DBS. The premise of this paper is that, in order to realise the full potential of DBS and similar interventions, clinical services need (...) to be arranged in such a way that these psychosocial dimensions are recognised and managed. Our starting point is that the psychosocial effects of DBS ‘in the field’ present us with analytically-useful disruptions: they disturb and foreground deeply held assumptions relating to the individual, health and its treatment, and which in a crude form manifest as the myth of technological solutionism within health care. Drawing on scholarship in medical sociology and science and technology studies (STS), we argue that DBS brings to the fore the relational dimensions of personhood, and demonstrates the emotional and social turmoil that can result if the relational dimensions of personhood are ignored by clinical services. In light of this, we argue that DBS should be implemented within a regime of care. Drawing on ethnographic research of a paediatric DBS clinical service, we provide an example of a regime of care, and conclude by reflecting on what other DBS services might learn from this paediatric service. (shrink)

This study seeks to understand the subjective experience or lived world typical of patients with Parkinson’s disease. It uses qualitative methodology, grounded in a hermeneutic-phenomenological perspective, to consider lived experience in a small sample of 7 individuals. The analysis identified four themes that appear to be characteristic of the experience of PD: A) Denial, B) Emotion and symptom expression, C) Volitional and spontaneous action, and D) Alteration of temporal perspective. Concepts from existential-phenomenological philosophy were used to reflect upon these (...) themes to achieve a synthetic account of the subjective experience of PD. The findings of the study are compared to other findings in the phenomenological literature, and suggestions for further research are posed. (shrink)

Dysregulation of genes that control cell‐cycle progression and DNA repair is a hallmark of tumorigenesis. It is becoming increasingly apparent, however, that these defects also contribute to degeneration of post‐mitotic neurons under certain conditions. The gene for ataxia‐telangiectasia mutated (ATM) is a prototype for this dual mechanism of action, with loss‐of‐function mutations causing not only selective degeneration of cerebellar neurons but also increased susceptibility to breast cancer and hematologic malignancy. Increased dosage of amyloid precursor protein in Down syndrome (trisomy 21) (...) predisposes to dementia of Alzheimer type and may also contribute to acute leukemia and transient myeloproliferative disorder. The gene parkin, loss‐of‐function mutations in which account for about half of cases of early‐onset Parkinson disease, has been identified as a candidate tumor suppressor gene by several groups. Parkin is deleted or downregulated in several tumor types, and its re‐expression sensitizes derivative cell lines to inhibitors of cell‐cycle progression. The overlap of molecular pathways implicated in cancer and neurodegeneration challenges long‐held notions about differentiated cellular states and may open the door to novel therapeutic approaches to both groups of disorders. BioEssays 30:719–727, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

The decision to initiate invasive, first-in-human trials involving Parkinson’s disease presents a vexing ethical challenge. Such studies present significant surgical risks, and high degrees of uncertainty about intervention risks and biological effects. We argue that maintaining a favorable riskbenefit balance in such circumstances requires a higher than usual degree of confidence that protocols will lead to significant direct and/or social benefits. One critical way of promoting such confidence is through the application of stringent evidentiary standards for preclinical studies. We (...) close with a series of recommendations for strengthening the internal and external validity of preclinical studies, reducing their tendency toward optimism and publication biases, and improving the knowledge base used to design and evaluate preclinical studies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:FDA Releases Draft Guidance on Regulation of Genetically Engineered AnimalsJohn P. Gluck (bio) and Mark T. Holdsworth (bio)On 18 September 2008, the U.S. Food and Drug Administration (FDA) issued a draft set of guidelines for those involved in developing genetically engineered animals with heritable recombinant DNA (rDNA) constructs and is requesting comment from industry and the public about their content. The document does not impose new regulations but details (...) how existing laws and regulations apply to genetically engineered (GE) animals and offers advice to developers on how to negotiate the laws in the most efficient and productive manner. The draft guidance document is not legally enforceable at this juncture, but the guidelines are recommendations reflecting the FDA's "current thinking on a topic."The modification of GE animals being developed for commercialization, which are the focus of the document, fall into six categories: modifications intended to (1) enhance food quality—e.g., faster growing fish and meats with better nutritional profiles; (2) improve animal health via increased resistance to disease—e.g., mastitis in dairy cattle and Bovine Spongiform Encephalopathy (BSE); (3) create so-called "biopharm" animals capable of producing therapeutic products such as insulin, clotting factors, and tissues for human transplantation; (4) reduce the barriers to human animal interaction—e.g., hypoallergenic pets; (5) develop valid animal models of human disease—e.g., Parkinson's disease, Lesh-Nyhan's syndrome, and cancer; and (6) improve production of industrial or consumer products such as fiber. The timing of the guidelines coincides with the FDA's belief in an expected boon in the number of GE animals approaching the stage of commercialization.The FDA's involvement in the approval process emerges from the new animal drug provisions of the Federal Food Drug and Cosmetic Act and the definition of what constitutes a drug. The Act defines a new animal drug as "an article (other than food) intended to affect the structure or any function of the body of... animals." A rDNA construct intended to affect the structure or function of an animal meets the definition of a new animal drug, regardless of whether the resulting GE animals are intended for human food or the production of pharmaceuticals or any other substances. [End Page 393]Before proceeding to a review of the draft guidelines, it is important briefly to set the controversies around GE animals in historical and ethical context.The Ethical DebateFrom its inception, the intentional genetic modification or genetic engineering of molecules, plants, and animals by the techniques of gene splicing has consistently elicited strong responses from both the scientific community and the public. There are some data to suggest that although the concerns of scientists fall primarily into the category of possible biohazards, those of the public also reflect great concern about the intrinsic moral issues, such as whether there is something fundamentally wrong with this line of work, making it a form of forbidden knowledge (see, e.g., Gaskell 1997). When news of Paul Berg's attempts in 1970 to graft the primate tumor virus (SV 40) onto the intestinal tract bacteria Escherichia coli for the purpose of studying how normal cells may be transformed into cancerous cells was shared with colleagues, he was strongly encouraged to reflect on the potential public health risks if somehow the altered bacteria broke containment and entered the environment. Thanks to Berg's leadership, these concerns soon resulted in conferences held in Asilomar, California, and New Hampton, New Hampshire, where the ethical responsibilities of microbiologists involved in this research were discussed. These initial discussions resulted in what has come to be known as "The Moratorium Letter" (Shattuck 1996) published in the journal Science in 1974. This letter, signed by 11 leaders in the field, actually recommended restrictions on several types of experiments that were considered to be particularly risky and stated "that adherence to our major recommendations will entail postponement or possibly abandonment of certain types of scientifically worthwhile experiments" (Berg 1974). An international conference on the issues came to similar conclusions about the need for a research moratorium for the sake of public safety. Recommendations arising from conference participants led to the formation of the National Institutes... (shrink)

Online personalized genetic testing services offer accessible and convenient options for satisfying personal curiosity about health and obtaining answers about one’s genetic provenance. They are especially attractive to healthy people who wish to learn about their future risk of disease, as Paul Mason’s case study of “Jordan” illustrates. In this response, we consider how online genetic testing services are used by people diagnosed with a common neurodegenerative disease, Parkinson’s disease, to gain a sense of certainty regarding the future.

On both sides of the debate on the use of embryos in stem cell research, and in reproductive technologies more generally, rhetoric and symbolic images have been evoked to influence public opinion. Human embryos themselves are described as either “very small human beings” or “small clusters of cells.” The intentions behind the use of these phrases are clear. One description suggests that embryos are already members of our community and share with us a right to life or at least respectful (...) treatment, whereas the other focuses on the differences between embryos and adult human beings with normal capacities, that is, their lack of sentience and of personal identity. The research on stem cells has been nicknamed “Frankenstein science” or presented as “research that could stop Parkinson disease.” Again, one description reminds us of scary science-fiction scenarios where the scientist is guilty of “playing God,” whereas the other description highlights the worth and potential benefits of the research outcomes. (shrink)

The phenomenological effects of deep brain stimulation (DBS) on the self of the patient remains poorly understood and under described in the literature, despite growing evidence that a significant number of patients experience postoperative neuropsychiatric changes. To address this lack of phenomenological evidence, we conducted in-depth, semistructured interviews with 17 patients with Parkinson's disease who had undergone DBS. Exploring the subjective character specific to patients' experience of being implanted gives empirical and conceptual understanding of the potential phenomenon of DBS-induced (...) self-estrangement. Our study concluded that (1) the more patients preoperatively felt alienated by their illness, the more they experienced postoperative self-estrangement, and (2) the notion of self-estrangement seems to exist in association with certain common qualitative characters, namely, loss of control, which reflects a deteriorative estrangement, and distorted perception of capacities, which reveals a restorative estrangement. These findings indicate that subjective self-reports help us to understand some aspects of the potential phenomenon of DBS-induced self-estrangement. (shrink)

Northoff's target article presents a unifying theory of the pathophysiology of catatonia, as compared to Parkinson's disease. We address two arguments in particular that do not appear justified by available evidence: (1) The physiological basis of catatonia is the breakdown of right hemisphere prefrontal-parietal cortical connectivity, and (2) Dysfunction in this system results in specific deficits in termination of action.

While explaining a large proportion of any variance, accounts of the speed and accuracy of targetting movements use techniques (e.g., log transforms) that typically reduce variability before ''explaining'' the data. Therefore the predictive power of such accounts are important. We consider whether Plamondon's model can account for kinematics of targetting movements of clinical populations.

Recently it has been hypothesized that apoptotic cell death is involved in several neuropathological conditions including Parkinson's disease (PD). Initial morphological studies assessing the presence of apoptosis in Parkinsonian brain tissues yielded mixed results. Based on more recent studies in human PD brains as well in animal and cell culture models of the disease, a picture is emerging, however, that strongly suggests that many of the molecular players thought to participate in this type of neuronal cell death are active (...) in the disease. The task of researchers in the field is now to deduce how these players may be interacting with one another to bring about cell death in PD and to design effective therapies to interfere with these processes. BioEssays 23:640–646, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

Though the revised edition of A Theory of Justice, published in 1999, is the definitive statement of Rawls's view, so much of the extensive literature on Rawls's theory refers to the first edition. This reissue makes the first edition once again available for scholars and serious students of Rawls's work.

John MacFarlane explores how we might make sense of the idea that truth is relative. He provides new, satisfying accounts of parts of our thought and talk that have resisted traditional methods of analysis, including what we mean when we talk about what is tasty, what we know, what will happen, what might be the case, and what we ought to do.

For this second edition, the editors have returned to Austin's original lecture notes, amending the printed text where it seemed necessary.

Much as we would like to conceive empirical thought as rationally grounded in experience, pitfalls await anyone who tries to articulate this position, and ...

What psychological and philosophical significance should we attach to recent efforts at computer simulations of human cognitive capacities? In answering this question, I find it useful to distinguish what I will call "strong" AI from "weak" or "cautious" AI. According to weak AI, the principal value of the computer in the study of the mind is that it gives us a very powerful tool. For example, it enables us to formulate and test hypotheses in a more rigorous and precise fashion. (...) But according to strong AI, the computer is not merely a tool in the study of the mind; rather, the appropriately programmed computer really is a mind, in the sense that computers given the right programs can be literally said to. (shrink)

Normative requirements are often overlooked, but they are central features of the normative world. Rationality is often thought to consist in acting for reasons, but following normative requirements is also a major part of rationality. In particular, correct reasoning – both theoretical and practical – is governed by normative requirements rather than by reasons. This article explains the nature of normative requirements, and gives examples of their importance. It also describes mistakes that philosophers have made as a result of confusing (...) normative requirements with reasons. (shrink)

This book is the one to put into the hands of those who have been over-impressed by Austin 's critics....[Warnock's] brilliant editing puts everybody who is concerned with philosophical problems in his debt.

This new edition of the classic Contemporary Theories of Knowledge has been significantly updated to include analyses of the recent literature in epistemology.

This study provides a comprehensive reinterpretation of the meaning of Locke's political thought. John Dunn restores Locke's ideas to their exact context, and so stresses the historical question of what Locke in the Two Treatises of Government was intending to claim. By adopting this approach, he reveals the predominantly theological character of all Locke's thinking about politics and provides a convincing analysis of the development of Locke's thought. In a polemical concluding section, John Dunn argues that liberal and (...) Marxist interpretations of Locke's politics have failed to grasp his meaning. Locke emerges as not merely a contributor to the development of English constitutional thought, or as a reflector of socio-economic change in seventeenth-century England, but as essentially a Calvinist natural theologian. (shrink)

This is a selection of essays on moral responsibility that represent the major components of John Martin Fischer's overall approach to freedom of the will and moral responsibility. The collection exhibits the overall structure of Fischer's view and shows how the various elements fit together to form a comprehensive framework for analyzing free will and moral responsibility. The topics include deliberation and practical reasoning, freedom of the will, freedom of action, various notions of control, and moral accountability. The essays (...) seek to provide a foundation for our practices of holding each other (and ourselves) morally and legally accountable for our behavior. A crucial move is the distinction between two kinds of control. According to Fischer, "regulative control" involves freedom to choose and do otherwise ("alternative possibilities"), whereas "guidance control" does not. Fischer contends that guidance control is all the freedom we need to be morally responsible agents. Further, he contends that such control is fully compatible with causal determinism. Additionally, Fischer argues that we do not need genuine access to alternative possibilities in order for there to be a legitimate point to practical reasoning. Fischer's overall framework contains an argument for the contention that guidance control, and not regulative control, is associated with moral responsibility, a sketch of a comprehensive theory of moral responsibility (that ties together responsibility for actions, omissions, consequences, and character), and an account of the value of moral responsibility. On this account, the value of exhibiting freedom (of the relevant sort) and thus being morally responsible for one's behavior is a species of the value of artistic self-expression. (shrink)

John Hyman explores central problems in philosophy of action and the theory of knowledge, and connects these areas of enquiry in a new way. His approach to the dimensions of human action culminates in an original analysis of the relation between knowledge and rational behaviour, which provides the foundation for a new theory of knowledge itself.

This anthology is a thorough introduction to classic literature for those who have not yet experienced these literary masterworks. For those who have known and loved these works in the past, this is an invitation to reunite with old friends in a fresh new format. From Shakespeare's finesse to Oscar Wilde's wit, this unique collection brings together works as diverse and influential as The Pilgrim's Progress and Othello. As an anthology that invites readers to immerse themselves in the masterpieces of (...) the literary giants, it is must-have addition to any library. (shrink)