[David Charles] Aristotle, it appears, sometimes identifies well-being with one activity, sometimes with several, including ethical virtue. I argue that this appearance is misleading. In the Nicomachean Ethics, intellectual contemplation is the central case of human well-being, but is not identical with it. Ethically virtuous activity is included in human well-being because it is an analogue of intellectual contemplation. This structure allows Aristotle to hold that while ethically virtuous activity is valuable in its own right, the best life available for (...) humans is centred around, but not wholly constituted by, intellectual contemplation. /// [Dominic Scott] In Nicomachean Ethics X 7-8, Aristotle distinguishes two kinds of eudaimonia, primary and secondary. The first corresponds to contemplation, the second to activity in accordance with moral virtue and practical reason. My task in this paper is to elucidate this distinction. Like Charles, I interpret it as one between paradigm and derivative cases; unlike him, I explain it in terms of similarity, not analogy. Furthermore, once the underlying nature of the distinction is understood, we can reconcile the claim that paradigm eudaimonia consists just in contemplation with a passage in the first book requiring eudaimonia to involve all intrinsic goods. (shrink)

In _ Psychiatry in the Scientific Image, _Dominic Murphy looks at psychiatry from the viewpoint of analytic philosophy of science, considering three issues: how we should conceive of, classify, and explain mental illness. If someone is said to have a mental illness, what about it is mental? What makes it an illness? How might we explain and classify it? A system of psychiatric classification settles these questions by distinguishing the mental illnesses and showing how they stand in relation to one (...) another. This book explores the philosophical issues raised by the project of explaining and classifying mental illness. Murphy argues that the current literature on mental illness -- exemplified by the Diagnostic and Statistical Manual of Mental Disorders -- is an impediment to research; it lacks a coherent concept of the mental and a satisfactory account of disorder, and yields too much authority to commonsense thought about the mind. He argues that the explanation of mental illness should meet the standards of good explanatory practice in the cognitive neurosciences, and that the classification of mental disorders should group symptoms into conditions based on the causal structure of the normal mind. (shrink)

Images have power - for good or ill. They may challenge us to see things anew and, in widening our experience, profoundly change who we are. The change can be ugly, as with propaganda, or enriching, as with many works of art. Sight and Sensibility explores the impact of images on what we know, how we see, and the moral assessments we make. Dominic Lopes shows how these are part of, not separate from, the aesthetic appeal of images. His book (...) will be essential reading for anyone working in aesthetics and art theory, and for all those intrigued by the power of images to affect our lives. '...tightly focused and carefully argued... an exceptionally interesting contribution to the philosophy of art: it contains subtle, concise, and convincing discussions of a number of difficult concepts and contentious doctrines... lucid and meticulous'. (shrink)

Les Arts et les Images se veut une introduction aux principaux terrains d’investigation de Dominic McIver Lopes, philosophe canadien contemporain, figure incontournable de l’esthétique et de la philosophie de l’art en langue anglaise au cours des vingt dernières années. Il ouvre une réflexion sur les méthodes employées en esthétique et philosophie de l’art aujourd’hui, qu’on soit un philosophe dit « analytique » ou bien « continental », Lopes cherchant à penser le lien entre les deux traditions. -/- À travers leur (...) textes respectifs, Laure Blanc-Benon, Jacques Morizot et Frédéric Pouillaude instaurent un dialogue avec Dominic McIver Lopes, sur plusieurs de ses livres : Understanding Pictures (1996), ouvrage de référence sur la question philosophique des images et de la représentation, Beyond Art (2014), livre qui traite de la question classique au XXe siècle de la définition de l’œuvre d’art, et Four Arts of Photography (2016) dans lequel Dominic Lopes met en avant une nouvelle philosophie de la photographie. À ce dialogue s’ajoutent trois textes de Lopes inédits en français, portant sur la méthode de l’esthétique et de la philosophie de l’art et également sur la question de la beauté et de la valeur esthétique. (shrink)

Certain representations are bound in special ways to our sensory capacities; consider, for instance, pictures, sound recordings, and the various forms of mental sensory imagery. What do these representations have in common, and what makes them different from representations of other kinds? Dominic Gregory employs novel ideas on perceptual states and sensory perspectives to explain the special nature of the contents of distinctively sensory representations. The book contains extensive discussions of e.g. perceptual imagination, pictorial representation, and memories.

Given its brevity, Plato's Meno covers an astonishingly wide array of topics: politics, education, virtue, definition, philosophical method, mathematics, the nature and acquisition of knowledge and immortality. Its treatment of these, though profound, is tantalisingly short, leaving the reader with many unresolved questions. This book confronts the dialogue's many enigmas and attempts to solve them in a way that is both lucid and sympathetic to Plato's philosophy. Reading the dialogue as a whole, it explains how different arguments are related to (...) one another and how the interplay between characters is connected to the philosophical content of the work. In a new departure, this book's exploration focuses primarily on the content and coherence of the dialogue in its own right and not merely in the context of other dialogues, making it required reading for all students of Plato, be they from the world of classics or philosophy. (shrink)

Why me? -- Sticks and stones -- Hammer of God -- God is great -- The problem of atheists -- Guardian angels -- Nations under God -- God knows.

For centuries, philosophers have identified beauty with what brings pleasure. Dominic McIver Lopes challenges this interpretation by offering an entirely new theory of beauty - that beauty engages us in action, in concert with others, in the context of social networks - and sheds light on why aesthetic engagement is crucial for quality of life.

There is not one but many ways to picture the world--Australian "x-ray" pictures, cubish collages, Amerindian split-style figures, and pictures in two-point perspective each draw attention to different features of what they represent. Understanding Pictures argues that this diversity is the central fact with which a theory of figurative pictures must reckon. Lopes advances the theory that identifying pictures' subjects is akin to recognizing objects whose appearances have changed over time. He develops a schema for categorizing the different ways pictures (...) represent--the different kinds of meaning they have--and argues that that depiction's epistemic value lies in its representational diversity. He also offers a novel account of the phenomenology of pictorial experience, comparing pictures to visual prostheses like mirrors and binoculars. (shrink)

In recent years, there has been a wide-ranging debate about the neo-republican principle of non-domination. Neo-republicans argue that domination is a capacity for one to intentionally use arbitrary power to interfere in someone’s life. Critics of neo-republicanism argue that this definition of freedom as non-domination precludes a structural analysis of domination, which would explain and critique the ways in which societies produce structural domination unintentionally. The article focuses on capitalism’s labor process and its labor markets. (...) It argues that critics are correct to think that the neo-republican principle of non-domination has an insufficient scope, but that an alternative account of structural domination should still support the neo-republican idea that agency must be involved. Otherwise, we might simply fail to explain the social processes that reproduce structural domination. What is needed is to explain how the labor process creates incentives for agents to intentionally produce structures that have unintended, yet dominating effects, and in turn, how the intentions of agents are conditioned by their social positions. Domination is thus agential and structural. (shrink)

The COVID-19 coronavirus pandemic raises a host of challenging ethical questions at every level of society. However, some of the most acute questions relate to decision making in intensive care. The problem is that a small but significant proportion of patients develop severe viral pneumonitis and respiratory failure. It now seems likely that the number of critically ill patients will overwhelm the capacity of intensive care units within many health systems, including the National Health Service in the UK. The experience (...) of Northern Italy—a couple of weeks ahead of the UK, suggests that it will simply not be possible to provide mechanical ventilation to every patient who might need it. When the crunch comes, the unpalatable question facing clinicians is which patient to save. There are some obvious strategies to avoid or reduce the problem—through measures to increase intensive care capacity, and via society-level interventions to reduce the spread of the virus. These are vitally important, but unfortunately they are unlikely to prevent the problem of demand outstripping supply from occurring. What, then, should clinicians do? How should they allocate the scarce resource of intensive care—particularly over the coming weeks as the crisis escalates? There are different values at stake in triage decisions, but at a basic level the key values are those of benefit and …. (shrink)

This paper argues that social media companies’ power to regulate communication in the public sphere illustrates a novel type of domination. The idea is that, since social media companies can partially dictate the terms of citizens’ political participation in the public sphere, they can arbitrarily interfere with the choices individuals make qua citizens. I contend that social media companies dominate citizens in two different ways. First, I focus on the cases in which social media companies exercise direct control over (...) political speech. They exercise quasi-public power over citizens because their regulation of speech on social media platforms implies the capacity to arbitrarily interfere with citizens’ democratic contestation in the political system. Second, companies’ algorithmic governance entails the capacity to interfere with citizens’ choices about what mode of discursive engagement they endorse in their relationships with fellow citizens. By raising the cost of deliberative engagement, companies narrow citizens’ choice menu. (shrink)

In cognitive science, creative ideas are defined as original and feasible solutions in response to problems. A common proposal is that creative ideas are generated across dedicated cognitive pathways. Only after creative ideas have emerged, they can be enacted to solve the problem. We present an alternative viewpoint, based upon the dynamic systems approach to perception and action, that creative solutions emerge in the act rather than before. Creative actions, thus, are as much a product of individual constraints as they (...) are of the task and environment constraints. Accordingly, we understand creative motor actions as functional movement patterns that are new to the individual and/or group and adapted to satisfy the constraints on the motor problem at hand. We argue that creative motor actions are promoted by practice interventions that promote exploration by manipulating constraints. Exploration enhances variability of functional movement patterns in terms of either coordination or control solutions. At both levels, creative motor actions can emerge from finding new and degenerate adaptive motor solutions. Generally speaking, we anticipate that in most cases, when exposed to variation in constraints, people are not looking for creative motor actions, but discover them while doing an effort to satisfy constraints. For future research, this paper achieves two important aspects: it delineates how adaptive (movement) variability is at the heart of (motor) creativity, and it sets out methodologies toward stimulating adaptive variability. (shrink)

Ethical discussions about medical treatment for seriously ill babies or children often focus on the ‘value of life’ or on ‘quality of life’ and what that might mean. In this paper, I look at the other side of the coin—on the value of death, and on the quality of dying. In particular, I examine whether there is such a thing as a good way to die, for an infant or an adult, and what that means for medical care. To do (...) that, I call on philosophy and on personal experience. However, I will also make reference to art, poetry and music. That is partly because the topic of mortality has long been reflected on by artists as well as philosophers and ethicists. It is also because, as we will see, there may be some useful parallels to draw. (shrink)

Dominic Scott compares the Republic and Nicomachean Ethics from a methodological perspective. He argues that Plato and Aristotle distinguish similar levels of argument in the defence of justice, and that they both follow the same approach: Plato because he thinks it will suffice, Aristotle because he thinks there is no need to go beyond it.

Death and grief in the ancient world -- Predictions and disability in Rome.

Paraconsistent responses to vagueness are often thought to represent a revision of logical theory that is too radical to be defensible. The paracomplete logic of supervaluationism, SpV, is not only taken to be more conservative but is also commonly said to 'preserve classical logic'. This chapter argues that this is wrong on both counts. The paraconsistent logic SbV, or subvaluationism, is no less conservative than SpV nor more so. In the end both logics offer equally compelling theoretical approaches to vagueness. (...) Each approach is also equally objectionable, with neither providing an adequate account of vagueness, but this criticism arises from a feature shared by each approach that is independent of their paracompleteness or paraconsistency per se. For all that has been said, a paraconsistent approach, and the associated recourse to truth-value gluts, remains a contender in accounting for vagueness. (shrink)

Imagine that we are considering whether our healthcare system (or insurer) should fund treatment or procedure X. One factor that may be cited is that of so-called ‘medical necessity’. The claim would be that treatment X should be eligible for funding if it is medically necessary, but ineligible if this does not apply. Similarly, (and relevant to the debates in this special issue), if considering whether a particular treatment should be ethically and/or legally permitted, we may wish to distinguish between (...) cases where the treatment is medically necessary, and those were it is not. But what do we mean by this concept? Here I will propose and briefly defend one plausible and practical definition. (shrink)

In response to the looming environmental crisis, many have recommended lists of environmental virtues. As a result, environmental ethics has been enriched by new virtue terms, such as ecological sensitivity or kinship with nature, and with new applications of older terms, such as benevolence or care. But how do we know which of these are genuine virtues? Although this question is important, it is difficult to answer for two reasons. First, we might think of 'nature' in a variety of ways, (...) each of which presupposes ethical beliefs about the relationship between humans and the nonhuman world. Second, environmental virtue terms seem far less clear than our more familiar virtues, which calls into question both their intelligibility and usefulness as normative concepts. I respond to both problems by considering the environmental virtue of care for nature, and one plausible examplar of this quality, US nature writer and conservationist Rachel Carson. I claim that Carson's example illuminates this virtue, and that care for nature is one environmental virtue we have reason to recognise. While this account might seem vulnerable to a kind of relativism stemming from particular conceptions of nature, I claim that the threat of cultural variation need not shake our reflective confidence in recognising some ways of thinking about nature as excellent. (shrink)

This paper develops a domination-based practice-dependent approach to justice, according to which it is practices of systemic domination which can be said to ground demands from justice. The domination-based approach developed overcomes the two most important objections levelled to alternative practice-dependent approaches. First, it eschews conservative implications and hence is immune to the status quo objection. Second, it is immune to the redundancy objection, which doubts whether empirical facts and practices can really play an irreducible role in (...) grounding justice. In theorising dominating practices in terms of practices of social power, a domination-based approach makes justice dependent on factual information in three ways: First, the principle of non-domination is indeterminate and can only be spelled out by taking into view particular contexts of domination. Second, the principle of non-domination is conditional on the existence of practices of social power. Third, social power possesses a structural ontology – to know whether A has social power over B we need to turn to social rules distributing agents' higher order status of normative authority towards each other. This explains in what way practices of social power – and of domination – are both factual and normative practices and hence how such practices are non-redundant in grounding justice. (shrink)

There are not enough solid organs available to meet the needs of patients with organ failure. Thousands of patients every year die on the waiting lists for transplantation. Yet there is one currently available, underutilized, potential source of organs. Many patients die in intensive care following withdrawal of life-sustaining treatment whose organs could be used to save the lives of others. At present the majority of these organs go to waste.In this paper we consider and evaluate a range of ways (...) to improve the number and quality of organs available from this group of patients. Changes to consent arrangements (for example conscription of organs after death) or changes to organ donation practice could dramatically increase the numbers of organs available, though they would conflict with currently accepted norms governing transplantation.We argue that one alternative, Organ Donation Euthanasia, would be a rational improvement over current practice regarding withdrawal of life support. It would give individuals the greatest chance of being able to help others with their organs after death. It would increase patient autonomy. It would reduce the chance of suffering during the dying process. We argue that patients should be given the choice of whether and how they would like to donate their organs in the event of withdrawal of life support in intensive care.Continuing current transplantation practice comes at the cost of death and prolonged organ failure. We should seriously consider all of the alternatives. (shrink)

Cooperation towards public goods relies on credible threats of punishment to deter cheats. However, punishing is costly, so it remains unclear who incurred the costs of enforcement in our evolutionary past. Theoretical work suggests that human cooperation may be promoted if people believe in supernatural punishment for moral transgressions. This theory is supported by new work in cognitive psychology and by anecdotal ethnographic evidence, but formal quantitative tests remain to be done. Using data from 186 societies around the globe, I (...) test whether the likelihood of supernatural punishment—indexed by the importance of moralizing “high gods”—is associated with cooperation. (shrink)

Vagueness, Logic and Ontology explores various responses to the philosophical problems generated by vagueness and its associated paradox - the sorites paradox. Hyde argues that the theoretical space in which vagueness is sometimes ontologically grounded and modelled by a truth-functional logic affords a coherent response to the problems posed by vagueness. Showing how the concept of vagueness can be applied to the world, Hyde's ontological account proposes a substantial revision of orthodox semantics, metaphysics and logic. This book will be of (...) particular interest to readers in philosophy, linguistics, cognitive science and geographic information systems. (shrink)

In this paper, we explore three separate questions that are relevant to assessing the prudential value of life in infants with severe life-limiting illness. First, what is the value or disvalue of a short life? Is it in the interests of a child to save her life if she will nevertheless die in infancy or very early childhood? Second, how does profound cognitive impairment affect the balance of positives and negatives in a child’s future life? Third, if the life of (...) a child with life-limiting illness is prolonged, how much suffering will she experience and can any of it be alleviated? Is there a risk that negative experiences for such a child will remain despite the provision of palliative care? We argue that both the subjective and objective components of well-being for children could be greatly reduced if they are anticipated to have a short life that is affected by profound cognitive impairment. This does not mean that their overall well-being will be negative, but rather that there may be a higher risk of negative overall well-being if they are expected to experience pain, discomfort, or distress. Furthermore, we point to some of the practical limitations of therapies aimed at relieving suffering, such that there is a risk that suffering will go partially or completely unrelieved. Taken together, these considerations imply that some life-prolonging treatments are not in the best interests of infants with severe life-limiting illness. (shrink)

On 24 July 2017, the long-running, deeply tragic and emotionally fraught case of Charlie Gard reached its sad conclusion. Following further medical assessment of the infant, Charlie’s parents and doctors finally reached agreement that continuing medical treatment was not in Charlie’s best interests. Life support was subsequently withdrawn and Charlie died on 28 July 2017.Box 1 ### Case summary and timeline21–23 Charlie Gard was born at full term, apparently healthy, in August 2016. At a few weeks of age his parents (...) noticed early signs of muscle weakness. At 2 months of age, he was admitted to Great Ormond Street Hospital with poor feeding, failure to thrive and respiratory failure. He was admitted to intensive care, where investigations led to the diagnosis of a rare severe mitochondrial disorder – infantile onset encephalomyopathic mitochondrial DNA depletion syndrome. The specific genetic form of MDDS in Charlie Gard had previously been reported in approximately 15 infants, with typical clinical features including early onset, rapid progression and death in infancy.24 By that point, Charlie was paralysed and unable to breathe without respiratory support. He was found to have congenital deafness, and his heart, liver and kidneys were affected by the disorder. Doctors felt that Charlie’s prognosis was extremely poor. In early 2017, Charlie’s parents identified an experimental treatment, previously used in a different form of MDDS, which they hoped might benefit Charlie. In mouse models of a myopathic form of MDDS, early supplementation with deoxypryrimidine nucleosides apparently bypasses the genetic defect and leads to a reduction in the biochemical defect and in the severity of the clinical phenotype.25 26 Doctors at GOSH initially planned to use nucleoside treatment in Charlie, but in January he developed evidence of electrical seizures, and clinicians became convinced that treatment, both continued intensive care and the requested …. (shrink)

Abstract:Discussions of conscientious objection (CO) in healthcare often concentrate on objections to interventions that relate to reproduction, such as termination of pregnancy or contraception. Nevertheless, questions of conscience can arise in other areas of medicine. For example, the intensive care unit is a locus of ethically complex and contested decisions. Ethical debate about CO usually concentrates on the issue of whether physicians should be permitted to object to particular courses of treatment; whether CO should be accommodated. In this article, I (...) focus on the question of how clinicians ought to act: should they provide or support a course of action that is contrary to their deeply held moral beliefs? I discuss two secular examples of potential CO in intensive care, and propose that clinicians should adopt a norm of conscientious non-objection (CNO). In the face of divergent values and practice, physicians should set aside their personal moral beliefs and not object to treatment that is legally and professionally accepted and provided by their peers. Although there may be reason to permit conscientious objections in healthcare, conscientious non-objection should be encouraged, taught, and supported. (shrink)

When is it permissible to allow a newborn infant to die on the basis of their future quality of life? The prevailing official view is that treatment may be withdrawn only if the burdens in an infant's future life outweigh the benefits. In this paper I outline and defend an alternative view. On the Threshold View, treatment may be withdrawn from infants if their future well-being is below a threshold that is close to, but above the zero-point of well-being. I (...) present four arguments in favor of the Threshold View, and identify and respond to several counterarguments. I conclude that it is justifiable in some circumstances for parents and doctors to decide to allow an infant to die even though the infant's life would be worth living. The Threshold View provides a justification for treatment decisions that is more consistent, more robust, and potentially more practical than the standard view. (shrink)

Decisions about providing life-sustaining treatments for extremely premature infants born after preterm labor are complex, contested, and fraught. They are medically uncertain—the outcome of embark...

Life-sustaining treatment is sometimes withdrawn or withheld from critically ill newborn infants with poor prognosis. Guidelines relating to such decisions place emphasis on the best interests of the infant. However, in practice, parental views and parental interests are often taken into consideration.In this paper I draw on the example of newborn infants with severe muscle weakness (for example spinal muscular atrophy). I provide two arguments that parental interests should be given some weight in decisions about treatment, and that they should (...) be given somewhat more weight in decisions about newborns than for older children. Firstly, the interests of the infant and of parents intersect, and are hard to separate. Parents’ views about treatment may be relevant to an assessment of the infant’s interests, and they may also affect those interests. Secondly, the interests of the infant in her future are relatively reduced by her developmental immaturity. In some situations parents’ welfare interests outweigh those of the infant. However, I argue that this would not justify treatment limitation except in the setting of severe impairment. (shrink)

In the case that triggered this round-table discussion there are three separate factors that contribute to moral uncertainty.1 First, the infant, baby T, is extremely premature with suspected brain injury and potentially poor prognosis. Second, the gestational mother is critically unwell herself and her outlook is guarded. Third, as linked commentaries make clear, the legal status of the intended parents is complex and ambiguous.2 3 Any of these factors on their own would be enough to generate ethical complexity and distress (...) in the neonatal intensive care unit. The combination of the three is likely to be highly stressful for all concerned.4 Commentaries on the case emphasise the complex legal questions and the potential need to involve the court. One resource that is not mentioned is the potential value of clinical ethics input in such a case. This is complementary to the need for legal advice. Its aim would be to help think through the specifically ethical, rather than legal questions. There are several things that I would aim to clarify if chairing a clinical ethics discussion on the case. First, it may be useful to draw on the concept of the …. (shrink)

Jennifer Radden argues that delusions play an important role in modernist epistemology, which is preoccupied with the justification and evaluation of beliefs. Another theme running through the book is the importance of culture for attribution of delusion. Beliefs that look delusional will not be treated as pathological if they are expressions of religious views or other culturally acceptable forms of life. It is hard to see why cultural acceptability should play a role in the modernist project of justification. I suggest (...) that we think less about a philosophical project of justification and turn our attention instead to commonsense judgements of the circumstances in which we see a belief as evidence of underlying pathology. I discuss cases in which unjustified beliefs are nonetheless treated as phenomena that are consistent with our views of how healthy human beings act, and suggest that alongside folk psychology we should acknowledge a folk epistemology that embraces such instances. I suggest that delusions are beliefs that folk epistemology treats as inexplicable, and that this approach solves some of the puzzles that Radden identifies as growing out of the modernist epistemic project. (shrink)

Sometimes dictators are benevolent. Sometimes masters are kind and gentle to their slaves. John Adams was a pretty good "husband" to Abigail Adams. But it seems like there’s something very wrong with being a dictator or a master or a spouse with the power that John Adams had over Abigail Adams in late 18th Century America. A theory of domination tries to pinpoint what’s distinctive about dictatorship and mastery and traditional husbanding, and what is distinctively wrong with such—even the (...) benevolent, kind, gentle, and pretty good varieties. -/- There has been a lot of thinking about domination over the last twenty-five or so years. This is due largely to the efforts of republican political philosophers, who have used domination and its absence — nondomination — as the primary moving part in their conceptions of freedom. Even so, perhaps because domination has often appeared in a supporting role for the analysis of other concepts, conceptualizing domination itself is still a fairly nascent endeavor. -/- Accounts of domination need at least two movements. First, domination is a subset of a social phenomenon with—at least more or less—unobjectionable varieties. Maybe this social phenomenon is power; maybe it’s the capacity to interfere with choice; maybe something else. Whatever it is, it’s plausible to think it’s not always bad. Sometimes it’s perfectly alright to have power over someone else; sometimes there’s nothing wrong with the capacity to interfere with someone’s choices. (For example, if what you’d rather do is go after your neighbor with a meat-axe, it’s a good thing if someone is in a position to interfere with you, or if your choice situation can be worsened, so that charging next door, axe in hand, without having to worry about a lengthy prison sentence is not among your options.) The first task of a theory of domination is to specify exactly what this broader social phenomenon is. -/- Next we need to figure out what gives domination its negative moral valence, and thus sets it apart from that broader social phenomenon. Republicans usually say that what makes domination morally problematic is its arbitrariness. Frank Lovett claims that domination is instantiated in a social relationship between A and B only if A is permitted to exercise power over B arbitrarily (2010, 120). Philip Pettit, until recently, claimed that domination is a capacity for arbitrary interference. Marilyn Friedman calls it “arbitrary interference in someone’s choices…”(2008, 265). If that’s right, and arbitrariness is the difference maker between forms of social power that aren’t domination and those that are, we need a story about what arbitrariness is. -/- Such are the two essential tasks of conceptualizing domination. I offer here what I think are important course-corrections for recent attempts to complete them. In §1 I set out some desiderata for a useful conception of domination before sketching the elements of earlier attempts I think we can’t do without. §2 addresses the problem of “cheap domination”. This is the problem of identifying ordinary, innocuous human interactions with anything we call domination. I don’t think we should do this, but some of the most influential accounts of domination on offer nowadays — in particular, Lovett’s and Pettit’s — have this result. Instead, I contend that only certain forms of social power can underwrite domination, and try to provide a principled way of identifying what these forms are like. Finally, in §3, I address the nature of arbitrariness. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:From Báñez with Love:A Response to a Response by Taylor Patrick O'NeillJames Dominic Rooney O.P.From where I stand, the traditional options of Molinism and Báñezianism seem logically exhaustive possible accounts of the way in which God can cause people to love him, under the influence of grace, while at the same time being able to affirm that those people remain free. Either God's giving efficacious grace to an individual (...) is such as to cause that individual to act a certain way, merely in virtue of giving that grace to that individual, or it is not. If that grace is not intrinsically efficacious, then you need to explain the way in which God can cause an action by giving grace which does not require grace to be intrinsically efficacious. On the latter front, Molinists aim to affirm that human beings are free even while acting under the influence of God's grace, and hold that God's grace is not such as to make it that one could not have done otherwise. They explain this by appeal to counterfactual truths about what human beings would do, metaphysically prior to and independent of God's subsequent decisions to give or withhold grace. These "counterfactuals of freedom" are central to Molinist accounts of freedom, since the truth of these counterfactuals alone secures the fact that human beings are acting freely even when God gives them grace and causes them to perform certain actions. Those human beings could have acted otherwise. Conversely, since God knows these truths, he can use them in order to give grace to an individual at those times when he knows it will be efficacious.To me, the Molinist view is a non-starter. What these truths consist in, what grounds them, how God uses them—I find the critiques compelling [End Page 675] and Molinist answers to these questions metaphysically problematic.1 I am committed to finding a Báñezian solution, therefore, to the riddle. From my perspective, the mystery of predestination invites confusion ultimately because the issue is a subtle philosophical, not a theological, problem. The resolution to the riddle of grace and free will can come only through an adequate account of the nature of human freedom. And I remain unsatisfied by a lack of philosophical clarity among Báñezian authors on the nature of freedom. In a recent paper, I therefore posed a problem for Báñezianism that resembles what is called the "grounding problem" for Molinism: where do the truths about alternative possibilities come from? And I illustrated the problem in the context of the account of grace given by one famous defender of the view, Fr. Réginald Garrigou-Lagrange, whose work in turn was recently promoted by Taylor Patrick O'Neill.In short, Garrigou-Lagrange appears to accept that there need to be alternative possibilities if human action is to be free. He gives an accounting of those possibilities as follows. On one side, when I sin, Garrigou-Lagrange argues that God's denial of efficacious grace, even though this denial occurs prior to anything I do or could have done, does not necessitate my sin because I performed the sin by means of my normally operating volitional and intellectual capacities (which God merely refrained from interfering in), and I had alternative possibilities provided by the possibility of God providing efficacious grace. Then, on the other, when I do good, he appeals at many points to non-culpable "defects" regarding my intellectual or volitional capacities as grounding those alternative possibilities that I could have sinned even when acting under efficacious grace. In both cases, my acts are still metaphysically contingent. However, neither case provides a sufficient grounding for alternative possibilities (I argued), because I had no relevant control over God's decision to deny efficacious grace, nor were those "defects" in light of which I could have sinned under my control. Instead, I argued that Garrigou-Lagrange's account of humans having alternative possibilities for action would be successful only if there were facts about what I would have done under sufficient grace, truths prior to and independent of God's decision to give efficacious... (shrink)

Ethical analyses, professional guidelines and legal decisions support the equivalence thesis for life-sustaining treatment: if it is ethical to withhold treatment, it would be ethical to withdraw the same treatment. In this paper we explore reasons why the majority of medical professionals disagree with the conclusions of ethical analysis. Resource allocation is considered by clinicians to be a legitimate reason to withhold but not to withdraw intensive care treatment. We analyse five arguments in favour of non-equivalence, and find only relatively (...) weak reasons to restrict rationing to withholding treatment. On the contrary, resource allocation provides a strong argument in favour of equivalence: non-equivalence causes preventable death in critically ill patients. We outline two proposals for increasing equivalence in practice: (1) reduction of the mortality threshold for treatment withdrawal, (2) time-limited trials of intensive care. These strategies would help to move practice towards more rational treatment limitation decisions. (shrink)

The claim that workers are subject to structural domination in the labor market is a central contention of the recent radical turn in republican political theory, but it remains undertheorized. Two core components—the claim that workers have “no reasonable alternative” to selling their labor to capitalists and the relevance of exposure to potential interference in such cases—remain unclear. Without a more precise specification of the conditions of structural domination, it is difficult to assess how well republican prescriptions minimize (...) it. I develop a revised defense of the central claim through an analysis of these components. I clarify what it is to have reasonable alternatives in the labor market but show that holding such options is insufficient to avoid structural domination. I argue that the dependence at the heart of structural domination can be constituted multifariously and develop an additional criterion directed at capturing such dependence in production. (shrink)

Decisions about allocation of limited healthcare resources are frequently controversial. These decisions are usually based on careful analysis of medical, scientific and health economic evidence. Yet, decisions are also necessarily based on value judgements. There may be differing views among health professionals about how to allocate resources or how to evaluate existing evidence. In specific cases, professionals may have strong personal views (contrary to professional or societal norms) that treatment should or should not be provided. Could these disagreements rise to (...) the level of a conscientious objection? If so, should conscientious objections to existing allocation decisions be accommodated? In the first part of this paper, I assess whether resource allocation could be a matter of conscience. I analyse conceptual and normative models of conscientious objection and argue that rationing could be a matter for conscience. I distinguish between negative and positive forms: conscientious non-treatment and conscientious treatment. In the second part of the paper, I identify distinctive challenges for conscientious objections to resource allocation. Such objections are almost always inappropriate. (shrink)

Can love really be considered another form of technology? Dominic Pettman says it can - although not before carefully redefining technology as a cultural challenge to what we mean by the "human" in the information age. Using the writings of such important thinkers as Giorgio Agamben, Jean-LucNancy, and Bernard Stiegler as a springboard, Pettman explores the "techtonic" movements of contemporary culture, specifically in relation to the language of eros. Highly ritualized expressions of desire - love, in other words - always (...) reveal an era's attitude toward what it means to exist as a selfamong others. For Pettman, the articulation of love is a technique of belonging: a way of responding to the basic plurality of everyone's identity, a process that becomes increasingly complex as the forms of mediated communication, from cell phone and text messaging to the mass media, multiply andmesh together.Wresting the idea of love from the arthritic hands of Romanticism, Pettman demonstrates the ways in which this dynamic assemblage - "the stirrings of the soul" - have always been a matter of tools, devices, prosthetics, and media. Love is, after all, something we make. And, love, this book argues,is not eternal, but external. (shrink)

Accession Number: ATLA0001788471; Hosting Book Page Citation: p 26-43.; Physical Description: diag, table ; Language(s): English; Issued by ATLA: 20130825; Publication Type: Essay.

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Controversial cases in medical ethics are, by their very nature, divisive. There are disagreements that revolve around questions of fact or of value. Ethical debate may help in resolving those disagreements. However, sometimes in such cases, there are opposing reasonable views arising from deep-seated differences in ethical values. It is unclear that agreement and consensus will ever be possible. In this paper, we discuss the recent controversial case of Vincent Lambert, a French man, diagnosed with a vegetative state, for whom (...) there were multiple court hearings over a number of years. Both family and health professionals were divided about whether artificial nutrition and hydration should be withdrawn and Lambert allowed to die. We apply a ‘dissensus’ approach to his case and argue that the ethical issue most in need of scrutiny is different from the one that was the focus of attention. (shrink)