Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

Responding to research indicating unsettling results with regard to the ability of University students to recognize and reflect on questions of morality, this paper aims to discuss these issues and to introduce a promising mode of ethics instruction for overcoming such challenges. The Curricular Ethics Bowl (CEB) is a method of ethics education and assessment for a wide range of students and is a descendent of the Medical Ethics Bowl (MEB) (Merrick et al., “Introducing the Medical Ethics Bowl”). We seek (...) in this article to show the similarities of CEB to MEB and to distinguish this model from the Intercollegiate Ethics Bowl (ICEB) sponsored by the Association for Professional and Practical Ethics (Landenson 2001). The CEB institutionalizes this mode of ethics education at the program, rather than at the individual course level, and shows advantages over other ethics curricula. (shrink)

Responding to research indicating unsettling results with regard to the ability of University students to recognize and reflect on questions of morality, this paper aims to discuss these issues and to introduce a promising mode of ethics instruction for overcoming such challenges. The Curricular Ethics Bowl (CEB) is a method of ethics education and assessment for a wide range of students and is a descendent of the Medical Ethics Bowl (MEB) (Merrick et al., “Introducing the Medical Ethics Bowl”). We seek (...) in this article to show the similarities of CEB to MEB and to distinguish this model from the Intercollegiate Ethics Bowl (ICEB) sponsored by the Association for Professional and Practical Ethics (Landenson 2001). The CEB institutionalizes this mode of ethics education at the program, rather than at the individual course level, and shows advantages over other ethics curricula. (shrink)

In his new book the eminent Kant scholar Henry Allison provides an innovative and comprehensive interpretation of Kant's concept of freedom. The author analyzes the concept and discusses the role it plays in Kant's moral philosophy and psychology. He also considers in full detail the critical literature on the subject from Kant's own time to the present day. In the first part Professor Allison argues that at the centre of the Critique of Pure Reason there is the foundation (...) for a coherent general theory of rational agency. The second part employs this account of rational agency as a key to understanding Kant's concept of moral agency and associated moral psychology. The third part focuses on Kant's attempt to ground both moral law and freedom in the Groundwork and the Critique of Practical Reason. This is a major contribution to the interpretation of Kant which will be of special interest to scholars and graduate students of Kant's moral theory. (shrink)

Hester Goodenough Gelber is Associate Professor of Religious Studies, Stanford University.

Introduction to healthcare ethics committees / D. Micah Hester and Toby Schonfeld -- Brief introduction to ethics and ethical theory / D. Micah Hester and Toby Schonfeld -- Ethics committees and the law / Stephen Latham -- Cultural and ...

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

The behavior of some nightlife-setting patrons would be unacceptable in workplaces or public settings and could cause distress to other patrons. This quantitative study determined 381 young Australian’s descriptive and personal norms regarding four types of sexual behavior. Participants’ personal norms were that these behaviors are wrong, but they reported that the behaviors are common in a nightlife setting. Behaviors such as these could theoretically be prevented by modifying patrons’ descriptive norms with evidence that their beliefs are contrary to individuals’ (...) personal norms of acceptable behavior in nightlife settings. (shrink)

Although there are many different moral arguments concerning the use of Best Interests in neonatal decision-making, there seems in practice a firm commitment to application of the concept. And yet, there is still little reflection given by practitioners about what employing a Best Interest determination means in infant care. The following lays out a comprehensive taxonomy of interest-sources in order to provide for more robust considerations of what constitutes best interests of/for neonates.

Is conceptual engineering feasible? Answering that question requires a theory of semantic change, which is sometimes thought elusive. Fortunately, much is known about semantic change as it occurs in the wild. While usage is chaotic and complex, changes in a word’s use can produce changes in its meaning. There are several under-appreciated empirical constraints on how meanings change that stem from the following observation: word use finely reflects equilibrium between various communicative pressures. Much of the relevant work in linguistics has (...) employed the methods of empirical pragmatics and diachronic semantics. In this way, the study of meaning change can be brought to bear on the conceptual engineer’s normative project. The picture that emerges tells against the sorts of engineering projects most likely to appeal to philosophers. Some may stand to succeed, but they have significantly different contours than the typical ones. (shrink)

abstractPosthumanism can be understood as a position that de-prioritizes or rescinds the privilege of the human in some way – frequently by attempting to think humanity as one element of a wider ecology of interdependent forces. This paper argues that one can be on the side of the human without neglecting the assemblages of which we are all a part – by conceiving of humanity as a site of nascent potential for sapience + care – an alienated understanding of a (...) complex world combined with the will to engage in the reparative processes of tending to it. (shrink)

This landmark book is now reissued in a new edition that has been vastly rewritten and updated to respond to recent Kantian literature. It includes a new discussion of the Third Analogy, a greatly expanded discussion of Kant’s _Paralogisms, _and entirely new chapters dealing with Kant’s theory of reason, his treatment of theology, and the important Appendix to the Dialectic. _Praise for the earlier edition: _ “Probably the most comprehensive and substantial study of the Critique of Pure Reason written by (...) any American philosopher.... This is a splendid book.”—Lewis White Beck “This masterful study... will most certainly join the canon of required reading for future interpreters of Kant’s theoretical philosophy. Superbly organized and lucidly written.”—Garrett Green, _Journal of Religion_. (shrink)

This CQ department is dedicated to bringing noted bioethicsts together in order to debate some of the most perplexing contemporary bioethics issues. You are encouraged to contact department editor, D. Micah Hester, UAMS/Humanities, 4301 W. Markham St. #646, Little Rock, AR 72205, with any suggestions for debate topics and interlocutors you would like to see published herein.

This CQ department is dedicated to bringing noted bioethicists together in order to debate some of the most perplexing contemporary bioethics issues. You are encouraged to contact “The Great Debates” department editor, D. Micah Hester, UAMS/Humanities, 4301 W. Markham St., #646, Little Rock, AR 72205, with any suggestions for debate topics and interlocutors you would like to see published herein.

Contemporary feminist theory is at an impasse: the project of reformulating concepts of self and social identity is thwarted by an association between identity and oppression and victimhood. In Sacrificial Logics, Allison Weir proposes a way out of this impasse through a concept of identity which depends on accepting difference. Weir argues that the equation of identity with repression and domination links "relational" feminists like Nancy Chodorow, who equate self-identity with the repression of connection to others, and poststructuralist feminists (...) like Judith Butler, who view any identity as a repression of nonidentity and difference. Through readings of Chodorow, Butler, Jessica Benjamin, Luce Irigaray, Jacqueline Rose and Julia Kristeva, Weir analyzes the relation of theories of self-identity to theories of women's identity, social identity, the identity of meaning in language and feminist solidarity. Drawing particularly on the work of Julia Kristeva, she argues for a reformulation of self-identity as a capacity to participate in a social world, and sketches a model of a self-identity which depends on a capacity to accept nonidentity, difference and connections to others. (shrink)

Organ procurement presents several ethical concerns (from what constitutes acceptable criteria for death to issues involved in specifically designating to whom an organ can be given), but none is more central than the concern for what are appropriate means for acquiring organs. The following discussion attempts a different perspective on the issue of organ procurement by arguing that, rather than appealing to our charitable consciences or our pocketbooks, relinquishing our organs after death in this day and age is, in fact, (...) obligatory for most people. Each of us is pressed by the growing demand for our organs should we die ?rightly,? and that desperate need has risen to such a level that not to release our organs for transplantation would constitute a serious moral wrong. (shrink)

Applying the framework proposed by Jeffery et al. to nonhuman primates moving in multilayer arboreal and terrestrial environments, we see that these animals must generate a mosaic of many bicoded spaces in order to move efficiently and safely through their habitat. Terrestrial light detection and ranging (LiDAR) technology and three-dimensional modelling of canopy movement may permit testing of Jeffery et al.'s framework in natural environments.

How can we think about identities in the wake of feminist critiques of identity and identity politics? Allison Weir rethinks conceptions of individual and collective identities in relation to freedom.

Every one of us will die, and the processes we go through will be our own - unique to our own experiences and life stories. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions, healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so (...) that their dying processes embody their life stories. He discusses three types of end-of-life patient populations - adults with decision-making capacity, adults without capacity, and children - to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients. (shrink)

Canonical defenders of the principle of sufficient reason (PSR), such as Leibniz and Spinoza, are metaphysical foundationalists of one stripe or another. This is curious since the PSR—which says that everything has a ground, cause, or explanation—in effect, denies fundamental entities. In this paper, I explore the apparent inconsistency between metaphysical foundationalism and approaches to metaphysical system building that are driven by a commitment to the PSR. I do so by analyzing how Indian Buddhist philosophers arrive at foundationalist and anti-foundationalist (...) positions motivated by implicit commitments to different versions of the PSR. I begin by introducing the Buddhist principle of dependent origination (pratītyasamutpāda) as a proto-PSR that is restricted to causal explanation. Next, I show how Vasubandhu’s Sautrāntika Abhidharma metaphysics is shaped by a qualified commitment to both causal and metaphysical grounding versions of the PSR. I then reveal how Nāgārjuna’s Madhyamaka metaphysics is driven by an unrestricted and exceptionless commitment to causal and metaphysical grounding versions of the PSR. Finally, I consider how Nāgārjuna’s account may put him in a unique position to respond to a common contemporary objection to the PSR from necessitarianism. I conclude by addressing a competing interpretation on which Nāgārjuna is best understood as an anti-rationalist rather than an uber-rationalist, as I characterize him. (shrink)

When I classify Fluffy as a cat, I appear to do so out of an appreciation of a prior metaphysical fact, namely, that she has a nature or essence common to creatures we classify as cats. Locke turns this picture on its head. Our actual practices of naming and sorting individuals into kinds proceed according to ideas in the mind. As Locke puts it, species (kinds) are ‘the Workmanship of the Understanding,’ not the workmanship of nature, because their essences consist (...) in abstract ideas, or ‘nominal essences,’ we make. Many take Locke to mean that the observable similarities and differences between things leave it undetermined how we are to group and distinguish them, so that classification is, and must be, a matter of convention. And while Locke never denies that individuals have real essences, it is argued that knowledge of them would not reveal natural boundaries, either. On this influential reading, nature does not draw boundaries between kinds, and she makes this fact apparent to us. I argue that Locke’s claim that nature does not determine the ‘Boundaries of the Species of Things’ should be understood as the claim that nature does not draw the variable boundaries set out in the nominal essences we make. Differences in our nominal essences reflect differences in speakers’ knowledge of external ‘standards,’ which we latch on to by way of their ‘leading’ qualities, which present the mind with a limited number of unique and highly salient bases for classification. On my reading, nature may very well draw boundaries of her own. (shrink)

Governments are increasingly inviting patient organizations to participate in healthcare policymaking. By inviting POs that claim to represent patients, representation comes into being. However, little is known about the circumstances under which governments accept POs as patient representatives. Based on the analysis of relevant legislation, this article investigates the criteria that self-help organizations, a special type of PO, must fulfil in order to be accepted as patient representatives by governments in Austria and Germany. Thereby, it aims to contribute to the (...) discussion on the role of governments in steering SHOs. There are different degrees of regulation. Governments in both countries not only formulate explicit criteria for SHOs with respect to patient representation but also guide SHOs representing patients through implicit criteria for associations. We discuss the findings against concepts of responsiveness, authorization, and accountability. Our findings indicate that governmental steering is not negative per se as indicated by previous research but—depending on legislative criteria—can promote transparency and democratic quality in patient representation. (shrink)

Patient organizations increasingly play an important role in health care decision-making in Western countries. The Netherlands is one of the countries where this trend has gone furthest. In the literature some problems are identified, such as instrumental use of patient organizations by care providers, health insurers and the pharmaceutical industry. To strengthen the position of patient organizations government funding is often recommended as a solution. In this paper we analyze the ties between Dutch government and Dutch patient organizations to learn (...) more about the effects of such a relationship between government and this part of civil society. Our study is based on official government documents and existing empirical research on patient organizations. We found that government influence on patient organizations has become quite substantial with government influencing the organizational structure of patient organizations, the activities these organizations perform and even their ideology. Financing patient organizations offers the government an important means to hold them accountable. Although the ties between patient organizations and the government enable the former to play a role that can be valued as positive by both parties, we argue that they raise problems as well which warrant a discussion on how much government influence on civil society is acceptable. (shrink)

This landmark book is now reissued in a new edition that has been vastly rewritten and updated to respond to recent Kantian literature.

Since the decade of the 1970s, and particularly since the first successful test-tube baby in 1978, the development and use of assisted reproductive technologies have grown exponentially. Would-be parents—including those in so-called traditional male-female marriages, unmarried adults, postmenopausal women, and same-sex partnerships—who just over 20 years ago had no recourse for their fertility issues can now pursue their desires to have children with at least a partial, if not, total, genetic and/or biological relationship. Ovulation-stimulating medications, artificial insemination using the sperm (...) of a husband or unrelated donor, in vitro fertilization with embryo transfer, intracytoplasmic sperm injection, and gamete and zygote intrafallopian transfers are but a few of a host of treatment options ranging in complexity, invasiveness, and expense. And on the horizon are genetic techniques such as cloning—which was once considered “pure” science fiction but in 1997 became what some call an inevitability, with the development of mammalian cloning in the form of the now-famous Dolly the sheep. (shrink)

In April of 2001 I published a brief commentary in the journal Academic Medicine questioning the current character and functioning of the National Residency Matching Program. The purpose of the article was to stimulate a rethinking of process. At 50 years old, the environment through which the match operates has changed, and as such I thought it time to ask ourselves whether or not the match, its algorithm, and, more important, the values it manifests might well need an overhaul.

Scholars have explored the influence of the field of cybernetics on scientific thought and disciplines. However, from the inception of the field, ‘‘cyberneticians’’ had explicitly envisioned applications reaching beyond the purview of scientific disciplines; cybernetics was remarkable for its portability and potential application in a wide variety of contexts. This article explores connections between cybernetics and experimental music from 1950-1980, which was a period of experimentation with electronic techniques in recording, composition, and sound production and manipulation. Examples include musicians, engineers, (...) instrument builders, composers, and scientists in collaboration with musicians who invoked cybernetic themes in their work. These uses of cybernetics were more diverse than accounts of cybernetics within the sciences suggest, presenting a major difficulty in addressing cybernetics as a homogeneous or monolithic discourse. In particular, cybernetic discourse in music often exhibited themes of openness and indeterminacy, rather than the ‘‘command and control’’ of the ‘‘closed world.’’. (shrink)

The form of Western mainstream film is the crux of its ideological efficiency: by using established formal techniques, films ensure audiences un- derstand that aesthetic decisions support and clarify the narrative to ensure maximum spectatorial satisfaction. However, some films exploit their formal aesthetics in order to prevent clarification, thwarting satisfaction in favour of viewing practices that can be considered perverse in that they withhold, suspend or obstruct immediate pleasure. Contemporary Western filmmaking in the mid-1990s witnessed the emergence of a distinct (...) group of filmmakers and films that, in the popular discourse of cinematic criticism, were together coded as “difficult” or “perverse.” These films were, as a result of the characteristics we identify below, situated obliquely in relation to the larger economic and artistic struc- tures of a commercially oriented “mainstream” cinema. Included in this new form of cinematic production were films from directors such as Tim Burton: Edward Scissorhands ; David Cronenberg: eXistenZ ; David Fincher: Se7en ; Peter Greenaway: The Baby of Maçon ; David Lynch: Lost Highway ; Quentin Tarantino: Pulp Fiction and Lars von Trier: Breaking the Waves . Whilst Western cinema as a whole has a long history of exploring “difficult” or “perverse” material within the overt or covert content of narrative, plot and story, such films demonstrate a particular relationship between the content being explored and the specific formal characteristics utilised in the delivery of that content. Thus where previous examples would utilise standardised formal techniques as a way of both delivering and containing the difficult or objectionable material, the films instead offer instances where the material of the narrative content seems to bleed backwards, affecting the form and rendering the very materiality of the film itself suspect and problematic. (shrink)

Horizontal gene transfer (HGT) is a major mechanism responsible for the spread of antibiotic resistance. Conversely, it is often assumed that antibiotics promote HGT. Careful dissection of the literature, however, suggests a lack of conclusive evidence supporting this notion in general. This is largely due to the lack of well‐defined quantitative experiments to address this question in an unambiguous manner. In this review, we discuss the extent to which HGT is responsible for the spread of antibiotic resistance and examine what (...) is known about the effect of antibiotics on the HGT dynamics. We focus on conjugation, which is the dominant mode of HGT responsible for spreading antibiotic resistance on the global scale. Our analysis reveals a need to design experiments to quantify HGT in such a way to facilitate rigorous data interpretation. Such measurements are critical for developing novel strategies to combat resistance spread through HGT. -/- . (shrink)

This book constitutes one of the most important contributions to recent Kant scholarship. In it, one of the pre-eminent interpreters of Kant, Henry Allison, offers a comprehensive, systematic, and philosophically astute account of all aspects of Kant's views on aesthetics. The first part of the book analyses Kant's conception of reflective judgment and its connections with both empirical knowledge and judgments of taste. The second and third parts treat two questions that Allison insists must be kept distinct: the (...) normativity of pure judgments of taste, and the moral and systematic significance of taste. The fourth part considers two important topics often neglected in the study of Kant's aesthetics: his conceptions of fine art, and the sublime. (shrink)

Henry E. Allison presents an analytical and historical commentary on Kant`s transcendental deduction of the pure concepts of the understanding in the Critique of Pure Reason. He argues that, rather than providing a new solution to an old problem, it addresses a new problem, and he traces the line of thought that led Kant to the recognition of the significance of this problem in his 'pre-critical' period. In addition to the developmental nature of the account of Kant`s views presented (...) here, two distinctive features of Allison's reading of the deduction are a defense of Kant`s oft criticized claim that the conformity of appearances to the categories must be unconditionally rather than merely conditionally necessary and an insistence that the argument cannot be separated from Kant`s transcendental idealism. (shrink)

According to Madhyamaka Buddhist philosophers, everything depends for its existence on something else. But what would a world devoid of fundamentalia look like? In this paper, I argue that the anti-foundationalist “neither-one-nor-many argument” of the Indian Mādhyamika Śrīgupta commits him to a position I call “metaphysical indefinitism.” I demonstrate how this view follows from Śrīgupta’s rejection of mereological simples and ontologically independent being, when understood in light of his account of conventional reality. Contra recent claims in the secondary literature, I (...) clarify how the Madhyamaka metaphysical dependence structure is not a straightforward infinitism since it does not honor strict asymmetry or transitivity. Instead, its dependence relations are irreflexive and extendable, admitting of dependence chains of indefinite (though not actually infinite) length and dependence loops of non-zero length. Yet, the flexible ontology of Śrīgupta's Madhyamaka can accommodate a contextualist account of asymmetry and support a revisable theory of conventional truth, delivering significant payoffs for the view, including the capacity to accommodate developments in scientific explanation. (shrink)

This chapter presents an overview of the life, work, and philosophical contributions of Śāntarakṣita (c. 725–788), who is known for his synthesis of Nāgārjuna’s Madhyamaka with elements of the Dignāga-Dharmakīrti tradition of logic and epistemology. His two most important independent treatises, the Compendium of True Principles (Tattvasaṃgraha) and the Ornament of the Middle Way (Madhyamakālaṃkāra), are characterized by an emphasis on the indispensable role of rational analysis on the Buddhist path as well as serious and systematic engagement with competing Buddhist (...) and non-Buddhist schools of thought. Śāntarakṣita employs a pedagogical-rhetorical device of provisionally adopting what he deems to be successively more rational views to reject less rational ones. Using this approach, in the Ornament of the Middle Way, he recommends a gradual path to arrive at an understanding of the Madhyamaka ultimate truth by incorporating Yogācāra idealist ontology into his presentation of conventional truth. In this same text, he presents an influential iteration of the neither-one-nor-many argument for the Madhyamaka ultimate truth, the emptiness of intrinsic nature—i.e., the universal negation of ontologically independent being—leaving a lasting and significant impact on both Indian and Tibetan Madhyamaka Buddhist philosophy. (shrink)

According to a dominant view of stigma, a person is stigmatized within a community if sufficiently many people within that community hold a bad view of her. I call this the 'Bad View Model'. In this paper, I argue against the Bad View Model on the grounds that such beliefs are neither necessary nor sufficient for stigma, and that the account cannot explain the distinctive phenomenology of stigma, including certain vulnerabilities to shame. I then develop an alternative that explains these (...) features of stigma, which I call the 'Shaming Model'. On this view, a person is stigmatized within a community if she is shamed by members of that community, and this is explained by their belief that she has deviated from some social norm and/or standard. (shrink)

So considered, Hume is viewed as a naturalist, whose project in the first three parts of the first book of the Treatise is to provide an account of the ...

There’s a common line of reasoning which supposes that the phenomenal unity of conscious experience is grounded in a mind-like simple subject. To the contrary, Mādhyamika Buddhist philosophers like Śrīgupta (seventh–eighth century) argue that any kind of mental simple is incoherent and thus metaphysically impossible. Lacking any unifying principle, the phenomenal unity of conscious experience is instead an unfounded illusion. In this paper, I present an analysis of Śrīgupta’s "neither-one-nor-many argument" against mental simples and show how his line of reasoning (...) is driven by a set of implicit questions concerning the nature of and relation between consciousness and its intentional object. These questions not only set the agenda for centuries of intra-Buddhist debate on the topic, but they are also questions to which any defender of unified consciousness or a simple subject of experience arguably owes responses. (shrink)

Originally published in 1773 in two volumes, and now reissued here together in one, this work by the writer Hester Chapone, a renowned proponent of female education, contains advice delivered in the form of letters to her niece. The first volume deals primarily with matters of religion and morality, while the second volume addresses questions of behaviour and schooling. Unusually for self-improvement books of this era, Chapone recommends that a young woman should have a rigorous education in a wide (...) variety of subjects, including ancient history and geography, as well as instruction in ladylike deportment and mastery of household matters. She exhorts young ladies to avoid vanity and other vices through devoted study of scripture, and writes of the importance of choosing worthy and sensible friends who can be trusted to offer good advice. Chapone's posthumously published works, in two volumes, are also reissued in this series. (shrink)