Accounts of the value of patient choice in contemporary medical ethics typically focus on the act of choosing. Being the one to choose, it is argued, can be valuable either because it enables one to bring about desired outcomes, or because it is a way of enacting one’s autonomy. This paper argues that all such accounts miss something important. In some circumstances, it is having the opportunity to choose, not the act of choosing, that is valuable. That is because in (...) many situations whether one has, or is denied, that opportunity conveys how one is seen. In particular, it conveys whether or not one is seen as an equal and competent member of society. Adequately recognising this fact has implications for what healthcare professionals should do, ones that require a move away from the current focus on autonomy. The paper draws out these implications by focusing on patients who may struggle to be recognised as competent and equal members of society, and whose autonomy may thus itself sometimes be in question. (shrink)

There is widespread agreement that it would be both morally and legally wrong to treat a competent patient, or to carry out research with a competent participant, without the voluntary consent of that patient or research participant. Furthermore, in medical ethics it is generally taken that that consent must be informed. The most widely given reason for this has been that informed consent is needed to respect the patient’s or research participant’s autonomy. In this article I set out to challenge (...) this claim by considering in detail each of the three most prominent ways in which ‘autonomy’ has been conceptualized in the medical ethics literature. I will argue that whilst these accounts support the claim that consent is needed if the treatment of competent patients, or research on competent individuals, is to respect their autonomy, they do not support the claim that informed consent is needed for this purpose. (shrink)

It is generally held that doctors and researchers have an obligation to obtain informed consent. Over time there has been a move in relation to this obligation from a requirement to disclose information to a requirement to ensure that that information is understood. Whilst this change has been resisted, in this article I argue that both sides on this matter are mistaken. When investigating what information is needed for consent to be informed we might be trying to determine what information (...) a person would need in order to consent at all, or we might be trying to determine what information a person needs in order to make an informed choice about whether or not to consent. I argue that the obligation to ensure understanding only applies to information generated by the first type of enquiry; but that much of the information generally thought necessary in order for consent to be informed is only required if our concern is with the second type of enquiry. For this reason it is neither the case that doctors and researchers should ensure all the information they provide is understood, nor is it the case that their only obligation is to disclose it. (shrink)

In a health service with limited resources we must make decisions about who to treat first. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don't know in a particular (...) case that the illness is self-inflicted, that it seems that all illness is self-inflicted in the sense used in my argument, and finally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like fire-fighters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections. (shrink)

Around the world, the population is ageing in ways that pose new challenges for healthcare providers. To date these have mostly been formulated in terms of challenges created by increasing costs, and the focus has been squarely on life-prolonging treatments. However, this focus ignores the ways in which many older people require life-enhancing treatments to counteract the effects of physical and mental decline. This paper argues that in doing so it misses important aspects of what justice requires when it comes (...) to older people. (shrink)

Ulysses contracts are a method by which one person binds himself by agreeing to be bound by others. In medicine such contracts have primarily been discussed as ways of treating people with episodic mental illnesses, where the features of the illness are such that they now judge that they will refuse treatment at the time it is needed. Enforcing Ulysses contracts in these circumstances would require medical professionals to override the express refusal of the patient at the time treatment is (...) required, something that is generally problematic both ethically and legally. In this paper I will argue that despite appearances Ulysses contracts can make it the case that treating a patient in such circumstances is an instance of treating him with his consent, although safeguards are needed to ensure that this is the case. Given the potential benefits to patients I further argue that modified Ulysses contracts should be made legally enforceable. (shrink)

People often have a strong intuitive sense that we ought to rescue those in serious need, even in cases where we could produce better outcomes by acting in other ways. It has become common in such cases to refer to this as the Rule of Rescue. Within the medical field this rule has predominantly been discussed in relation to decisions about whether to fund particular treatments. Whilst in this setting the arguments in favour of the Rule of Rescue have generally (...) been found to be unconvincing, there are some reasons for thinking that it may have more of a role to play at the clinical level. In this article we examine three lines that such reasoning might take. In each case we argue that the reasons given do not support the adoption of a Rule of Rescue in clinical practice. (shrink)

Within medical ethics it is widely agreed both that it would be morally wrong to give a competent patient medical treatment without his consent, and that for his agreement to treatment to constitute valid consent it needs to meet certain criteria. In illustrating why these requirements are needed it is common to use treatments that involve a healthcare professional doing something to the patient's body—for example, performing surgery, giving an injection, or taking a blood sample or swab (see, for example, (...) Manson 2007, 299;... (shrink)

It is relatively uncontroversial that some public health policies are paternalistic. Furthermore, that they are paternalistic is often taken to show that they are morally wrong. In this article I challenge this position. The article starts by arguing that given standard definitions of paternalism it is unclear why such policies count as paternalistic. Whilst it might appear that they impose restrictions on what individuals can, or cannot, do for their own good, this is not the case. The reason for this (...) is that whilst public health policies focus on achieving benefits at a population or group level, the imposition is made at the level of the individual. If we are to retain the idea that such policies are paternalistic we must characterize them in such a way that both the benefit and imposition are at the same level: either that of the individual or that of the group. I argue that in many cases moving to the group level is the only plausible option. However, if we move to the group level, the features that make a policy paternalistic will not, unlike in those cases where paternalism is targeted at an individual, make the policy morally wrong. (shrink)

Psychological altruism (being motivated by the needs of others) has a tendency to produce behaviour that is costly in evolutionary terms. How, then, could the capacity for psychological altruism evolve? One suggestion is that it is the result of sexual selection. There are, however, two problems that face such an account: first, it is not clear that the resulting behaviour would be altruistic in the relevant sense, and second, it does not seem to fit with key features of our actual (...) helping behaviour. I will argue that both of these problems can be avoided if we adopt a modular account of desire formation. (shrink)

Healthcare ethics has to date had very little to say about the treatment of chronic illness. That is problematic. Chronic illness differs from other illnesses in that: 1. in most cases it cannot be cured; 2. patients can live with it for many years; and 3. its day to day management is typically carried out, not by healthcare professionals, but by the patient and/or members of their family. These features problematise key distinctions that underlie much existing work in healthcare ethics (...) — including those between beneficence and autonomy, between treatment and prevention, and between the recipient and provider of treatment. They also raise ethical questions that have not to date been addressed in any detail — including what healthcare professionals should do when patients are managing their illness poorly, or when changes occur that affect their patients. For these reasons chronic illness provides a lens through which to challenge the adequacy of existing approaches to healthcare ethics, exposing the gaps and false assumptions built into them. In doing so it also provides the materials to build a more philosophically adequate account of healthcare professionals’ moral obligations than exists to date. Providing such an account is the aim of this monograph. (shrink)

Researchers working on drug addiction may, for a variety of reasons, want to carry out research which involves giving addicts their drug of choice. In carrying out this research consent needs to be obtained from those addicts recruited to participate in it. Concerns have been raised about whether or not such addicts are able to give this consent. Despite their differences, however, both sides in this debate appear to be agreed that the way to resolve this issue is to determine (...) whether or not addicts have irresistible cravings for drugs – if they do, then they cannot consent to this type of research; if they do not, then they can. This I will argue is a mistake. Determining whether or not addicts can say 'No' to offers of drugs will not help us to make much progress here. Instead we need to look at the various ways in which different types of research may undermine an addict's competence to give consent. What we will find is that the details of the research make a big difference here and that, as such, we need to steer a course between, on the one hand, painting all addicts as being unable to consent to research which involves providing them with drugs, and, on the other, maintaining that there are no problems in obtaining consent from addicts to take part in such research. (shrink)

We are living through a demographic transition from a world in which there were lots of young people and very few older adults to one in which the numbers in these age groups are becoming more evenly balanced. One reason for this is that more of us are living into our seventies, eighties, nineties, and beyond. That is the good news. Unfortunately, the chance of developing chronic illnesses (including diabetes, arthritis, and dementia) is typically higher for people in these older (...) age groups than for those who are younger. Because we do not know how to cure these illnesses, many of us will spend at least some of this extra time with one or more chronic illness. While we are more likely than in the past to live into older age, we are likely to be living with illness when we get there. That raises a challenge: how should we respond to this change? (shrink)

Worldwide populations are aging with economic development as a result of public health initiatives and advances in therapeutic discoveries. Since 1850, life expectancy has advanced by 1 year for every four. Accompanying this change is the rapid development of anti‐aging science. There are three schools of thought in the field of aging science. One perspective is the life course approach, which considers that aging is a good and natural process to be embraced as a necessary and positive aspect of life, (...) where the aim is to improve the quality of existing lifespan and “compress” morbidity. Another view is that aging is undesirable, and that rejuvenation and indeed immortality are possible since the biological basis of aging is understood, and therefore, strategies are possible for engineering negligible senescence. Finally, a hybrid approach is that life span can be extended by anti‐aging medicines but with uncertain effects on health. While these advances offer much promise, the ethical perspectives are seldom discussed in cross‐disciplinary settings. This article discusses some of the key ethical issues arising from recent advances in biogerontology. (shrink)

Plato Tom Angier -- Aristotle Timothy Chappell -- Stoics Jacob Klein -- Aquinas Vivian Boland O.P -- Hume Peter Millican -- Kant Ralph Walker -- Hegel Kenneth Westphal -- Marx Sean Sayers -- Mill Krister Bykvist -- Nietzsche Ken Gemes and Christoph Schuringa -- Macintyre David Solomon.

Lycambes, the most famous of Archilochus' whipping boys, is everywhere upstaged in the surviving iambic texts and testimonia. This paper seeks to reconstruct something of Lycambes' voice and its role in the Archilochean tradition. I begin with a reconsideration of Archilochus' “first epode” and argue that Lycambes is styled as an older public rival to Archilochus who questions the role of the poet's iambos. The preliminary results of this section are then strengthened by drawing upon two relevant episodes in the (...) later ancient reception of Archilochean poetics: the sniping between Aristophanes and his older rival Cratinus and the Mnesiepes Inscription's tale of the uproar surrounding Archilochus' first performance. Lycambes emerges from this study as a character constructed to question the value and status of the iambist within the social space of contemporary Paros. As such, his criticisms afford Archilochus the opportunity to trumpet his claim to the very cultural capital that Lycambes strives to deny him. More than just a private enemy, Lycambes raises aesthetic and ethical debates that can still be heard throughout the iambographic tradition. (shrink)

We dedicate this book to John Thibaut. He was mentor and personal friend to one of us, and his work had a profound intellectual influence on both of us. We were both strongly influenced by Thibaut's insightful articulation of the importance to psychology of the concept of pro cedural justice and by his empirical work with Laurens Walker in reactions to legal institu demonstrating the role of procedural justice tions. The great importance we accord the Thibaut and Walker (...) work is evident throughout this volume. If anyone person can be said to have created an entire field of inquiry, John Thibaut created the psychological study of procedural justice. (To honor Thibaut thus in no sense reduces our recognition of the contributions of his co-worker, Laurens Walker, in the creation of the field. We are as certain that Walker would endorse our statement as we are that Thibaut, with characteristic modesty, would demur from it. ) Even to praise Thibaut in this fashion falls short of recognizing all of his contributions to procedural justice. Not only did he initiate the psy chological study of the topic, he also built much of the intellectual foun dation upon which the study of procedural justice rests. Thibaut's work with Harold Kelley (1959; Kelley & Thibaut, 1978) created a social psy chological theory of interdependence that, among many other applica tions, serves as the basis for one of the major models of the psychology of procedural justice. (shrink)

An introduction to Gila Walker’s translation of Michel Mourlet’s “On a Misunderstood Art (1959).”.

In this new study the authors examine a range of theories about the state of nature in seventeenth- and eighteenth-century England, considering the contribution they made to the period's discourse on sovereignty and their impact on literary activity. Texts examined include Leviathan, Oceana, Paradise Lost, Discourses Concerning Government, Two Treatises on Government, Don Sebastian, Oronooko, The New Atalantis, Robinson Crusoe, Dissertation upon Parties, David Simple, and Tom Jones. The state of nature is identified as an important organizing principle for narratives (...) in the century running from the Civil War through to the second Jacobite Rebellion, and as a way of situating the author within either a reactionary or a radical political tradition. The Discourse of Sovereignty provides an exciting new perspective on the intellectual history of this fascinating period. (shrink)

This book review essay discusses Principles of Animal Research Ethics (2020), by Tom L. Beauchamp and David DeGrazia.

More than twenty years after its original publication, The Case for Animal Rights is an acknowledged classic of moral philosophy, and its author is recognized as the intellectual leader of the animal rights movement. In a new and fully considered preface, Regan responds to his critics and defends the book's revolutionary position.

It is an important feature of creatures like us that our various motivations compete for control over our behaviour, including mental behaviour such as imagining and attending. In large part, this competition is adjudicated by the stimulation of affect — the intrinsically pleasant or unpleasant aspects of experience. In this paper I argue that the motivation-affect system controls a sub-type of attention called 'alerting attention' to bring various goals and stimuli to consciousness and thereby prioritize those contents for action. This (...) view allows me to flesh out the global workspace theory of consciousness, as well as some of the phenomenal characteristics of conscious experience. (shrink)

Willie James Jennings contends that the goal of whiteness is the creation and preservation of segregated space. For Jennings, whiteness, as well as upholding perceived notions of white normativity, is a way of being in the world, an imagined reality made real by our movement in physical space which destroys the identity-forming connections between communities and land. In this article I bring together Pope Francis’s reflections on the globalised economy in Laudato Si’ with the critiques of James H. Cone and (...) Jennings to demonstrate the horrific harm of whiteness on marginalised people groups and the land itself. To resist the building project of whiteness, therefore, requires attention to our relationship with land. At this point I turn more readily to the land of England, offering the beginnings of a theology of place given the substantial land holdings of the Church of England. I close by asking whether the Church of England can be trusted to use its land to dismantle whiteness given its troubling colonial history in relation to land use. (shrink)

To understand Self-Representationalism you need to understand its family. Self-Representationalism is a branch of the Meta-Representationalist family, and according to theories in this family what distinguishes conscious mental representations from unconscious mental representations is that conscious ones are themselves the target of a mental meta¬-representational state. A mental state M1 is thus phenomenally conscious in virtue of being suitably represented by some mental state M2. What distinguishes the Self-Representationalist branch of the family is the claim that M1 and M2 must (...) be the same token mental state, so a mental state is phenomenally conscious in virtue of suitably representing itself. This Self-Representationalist branch of the family divides into further branches, giving us specific implementations of the Self-Representationalist approach. But before asking whether we should adopt Self-Representationalism, and in what form, we should reflect on why Meta-Representationalism is an attractive family in the first place. After all, Self-Representationalist theories trade on their family name, claiming to deliver on the promises that drive the Meta-Representationalist approach. The two most important promises of Meta-Representationalism are: a) the promise of capturing the transitivity of consciousness and; b) the promise of rendering consciousness naturalisable. I discuss each in turn. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The author argues that uploading does preserve personal identity, at least identity of a certain sort. The fact that we are assuming that computers are capable of embodying all the same type of properties necessary for personal identity means that we can make use of the equivalency thesis. There are two reasons for invoking the equivalency thesis. The first is so that we are not misled by a new form of racism: substratism. The second is that it makes directly relevant (...) an enormous amount of philosophical effort that has gone into exploring the possibility of carbonto‐ carbon transfers. He examines an alternative explanation to somaticism for why people might be reluctant to use Parfit's Teletransporter, namely, fear of the unknown. Finally, the author talks about the type/token (TT) account of personal identity and then see whether the no‐branching argument has any traction against it. (shrink)

Abstract Temporal Externalism is the view that future events can contribute to determining the present content of our thoughts and utterances. Two objections to Temporal Externalism are discussed and rejected. The first is that Temporal Externalism has implausible consequences for the epistemology of biology and other taxonomic sciences (Brown, 2000). The second is that it is committed to implausible claims about dispositions.

If we were to connect two individuals’ brains together, how would this affect the individuals’ conscious experiences? In particular, it is possible for two people to share any of their conscious experiences; to simultaneously enjoy some token experiences while remaining distinct subjects? The case of the Hogan twins—craniopagus conjoined twins whose brains are connected at the thalamus—seems to show that this can happen. I argue that while practical empirical methods cannot tell us directly whether or not the twins share conscious (...) experiences, considerations about the locality of content processing in the brain entails that they most likely do so. (shrink)

How wrong is it to deceive someone into sex by lying, say, about one's profession? The answer is seriously wrong when the liar's actual profession would be a deal breaker for the victim of the deception: this deception vitiates the victim's sexual consent, and it is seriously wrong to have sex with someone while lacking his or her consent.

Mark Walker argues for Skeptical-Dogmatism-the view that we should disbelieve our cherished philosophical views, such as beliefs about what makes for a good life, religious beliefs, and political beliefs. To not disbelieve one's preferred views in these contested matters is hubristic.

There are reasons to be skeptical of the claim that philosophy and science are making progress toward the complete truth of the universe and our place in it. I discuss two different kinds of skeptical worries about justifying contemporary philosophical and scientific beliefs. Widespread philosophical disagreement leads to a suspicion that most philosophers are probably wrong. In science there is more agreement, but science has not justified some of its basic assumptions including the use of Occam's Razor for theory selection. (...) Worse, noetic skepticism questions whether humans even have the cognitive capacity for understanding the complete truth. We do not believe that children or apes have that capacity, so the question naturally arises within both philosophy and science as to whether we have reason to believe that adult humans are adequately equipped. Finally, I propose a scientific experiment to put this type of skepticism to the test. (shrink)

This book moves away from the frameworks that have traditionally guided ethical decision-making in the Western clinical setting, towards an inclusive, non-coercive and, reflective dialogic approach to moral decision-making. Inspired in part by Jürgen Habermas's discourse theory of morality and principles of communicative action, the book offers a proportionist approach as a way of balancing out the wisdom in traditional frameworks, set in the actual reality of the clinical situation at hand. Putting this approach into practice requires having a conversation, (...) a dialogue or a discourse, with collaboration amongst all the stakeholders. The aim of the dialogue is to reach consensus in the decision, via mutual understanding of the values held by the patient and others whom they see as significant. This book aims to underscore the moral philosophical foundations for having a meaningful conversation. Life and Death Decision in the Clinical Setting is especially relevant in our contemporary era, characterised medically by an ever-increasing armamentarium of life-sustaining technology, but also by increasing multiculturalism, a multiplicity of faiths, and increasing value pluralism. (shrink)

Fast‐forward two hundred years to the opening sequence of Alien: Resurrection where United Systems Military (USM) science officers aboard the Auriga are toying with her DNA—salvaged from frozen blood samples on Fiorina 161—to try to create a cloned version of the alien queen that was growing inside her at the time of her death. The absurd is what links the two— Ripley's desire to make some sense out of her troubling existence and the fact that the world is unable to (...) offer her any such sense. French essayist, Albert Camus, repeatedly stresses this point in different, sometimes rather poetic, ways throughout his classic essay, “The Myth of Sisyphus”. Ripley‐8 has one messed‐up and confusing life. When Camus talks about philosophical suicide, he is really talking about an irrational “leap of faith”. Ripley and Call are both artificial creations living a similar sort of existence. (shrink)

This chapter offers a complete account of Aristotle’s underexplored treatment of the virtue of wittiness (eutrapelia) in Nicomachean Ethics IV.8. It addresses the following questions: (1) What, according to Aristotle, is this virtue and what is its structure? (2) How do Aristotle’s moral psychological views inform Aristotle’s account, and how might Aristotle’s discussions of other, more familiar virtues, enable us to understand wittiness better? In particular, what passions does the virtue of wittiness concern, and how might the virtue (and its (...) attendant vices) be related to the virtue of temperance (and its attendant vices)? (3) How does wittiness, as an ethical virtue, benefit its possessor? (4) How can Aristotle resolve some key tensions that his introducing a virtue of wittiness apparently generates for his ethics? In addition to exploring these questions, this chapter challenges some commonly accepted accounts of Aristotle’s views on the nature of the laughable. (shrink)

In this essay we critically evaluate the progress that has been made in solving the problem of meaning in artificial intelligence (AI) and robotics. We remain skeptical about solutions based on deep neural networks and cognitive robotics, which in our opinion do not fundamentally address the problem. We agree with the enactive approach to cognitive science that things appear as intrinsically meaningful for living beings because of their precarious existence as adaptive autopoietic individuals. But this approach inherits the problem of (...) failing to account for how meaning as such could make a difference for an agent’s behavior. In a nutshell, if life and mind are identified with physically deterministic phenomena, then there is no conceptual room for meaning to play a role in its own right. We argue that this impotence of meaning can be addressed by revising the concept of nature such that the macroscopic scale of the living can be characterized by physical indeterminacy. We consider the implications of this revision of the mind-body relationship for synthetic approaches. (shrink)