The traditional common consent argument for the existence of God has largely been abandoned—and rightly so. In this paper, I attempt to salvage the strongest version of the argument. Surprisingly,...

A popular introduction to common consent arguments for belief in God.

various arguments for the existence of God have risen and fallen over the centuries, but the one that has perhaps fallen furthest is the argument from the universal consent of mankind. Put simply, the argument went as follows: near enough everyone, in near enough every nation, in near enough every historical era, has believed in God; therefore, God must exist. Or, as it was summarized in the strikingly Lincolnesque terms of Diderot’s Encyclopédie: “You can fool some of (...) the people, or fool all of them in certain places and certain times, but not all people in all places and in all ages.”1 Universal agreement in the truth of a certain proposition was taken by many as a sufficient demonstration of that truth. This.. (shrink)

The common consent argument claims that widespread belief in God is good evidence for God’s existence. Though taken seriously throughout the history of philosophy, the argument died in the 1800s. Our philosophy of religion textbooks ignore it. In this paper, we hope to resuscitate it drawing upon the demographics of religious belief, the cognitive science of religion, and contemporary epistemology. We develop and defend two common consent arguments, which maintain that widespread belief in a (...) High God is good evidence for theism over metaphysical naturalism. (shrink)

Until recently, epistemology was largely caught in the grips of an epistemically unrealistic radical epistemological individualism on which the beliefs and testimony of others were of virtually no epistemic significance. Thankfully, epistemologists have bucked the individualist trend, acknowledging that one person's belief or testimony that P might offer another person prima facie epistemic reasons – or social evidence as I call it – to believe P. In this paper, I discuss the possibility and conditions under which beliefs and testimony act (...) as social evidence, in particular, beliefs and testimony regarding the existence of God. The epistemic egoist maintains that one must possess positive reasons in favor of other people's reliability or trustworthiness before their beliefs and testimony offer prima facie social evidence. The epistemic universalist, on the other hand, argues that the beliefs of all others are prima facie credible and should be treated accordingly. All this will set up subsequent discussion of the epistemic significance of common consent or widespread belief in God. I show how common consent arguments assume the epistemic universalist's account of the conditions under which the beliefs and testimony of others acquire reason-giving force as social evidence. (shrink)

In this paper, I will explain and motivate the common consent argument for theism. According to the common consent argument it is rational for you to believe that God exists because you know so many other people believe that God exists. Having motivated the argument, I will explain and motivate several pressing objections to the argument and evaluate their probative force. The paper will serve as both an accessible introduction to this (...) class='Hi'>argument as well as a resource for continued research on the topic. (shrink)

In this paper I provide support for the view that at least some forms of adversariality in argumentation are legitimate. The support comes from Aristotle’s theory of illegitimate adversarial argumentation in dialectical contexts: his theory of eristic in his work On Sophistical Refutations. Here Aristotle develops non-epistemic standards for evaluating the legitimacy of dialectical procedures, standards which I propose can be understood in terms of the pragmatic notion of context as common ground. Put briefly, Aristotle makes the answerer’s meaning (...) in giving assent in dialectical contexts the basis for further moves in the game of dialectic. Moves which subvert the answerer’s meaning or do not solicit the answerer’s consent are marked as eristic, i.e. adversarial in a problematic sense. I conclude with remarks on what Aristotle’s theory may teach us about how semantic features relate to the normative evaluation of argumentation. (shrink)

Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received in a lukewarm (...) fashion by most clinicians, many simply rejecting what they commonly refer to as the `myth of informed consent'. The purpose of this book is to defuse this seemingly intractable controversy by offering an efficient and effective operational model of informed consent. This goal is pursued first by reviewing and evaluating, in detail, the agendas, arguments, and supporting materials of its proponents and detractors. A comprehensive review of empirical studies of informed consent is provided, as well as a detailed reflection on the common clinician experience with attempts at informed consent and the exercise of autonomy by patients. In the end, informed consent is recast as a management tool for pursuing clinically and ethically important goods and values that any clinician should see as meriting pursuit. Concurrently, the model incorporates a flexible, anticipatory approach that recognizes that no static, generic ritual can legitimately pursue the quite variable goods and values that may be at stake with different patients in different situations. Finally, efficiency of provision is addressed by not pursuing the unattainable and ancillary. Throughout, the traditional principle of beneficence is appealed to toward articulating an operational model of informed consent as an intervention that is likely to change outcomes at the bedside for the better. (shrink)

Science requires postformal capabilities to compare competing explanations and conceptualize how to coordinate or integrate them. With conflicts thus reconciled, science advances. The Model of Hierarchical Complexity facilitates the coordination of current arguments about intelligence. A cross-species measurement theory of comparative cognition is proposed. It has potential to overcome the lack of a general measurement theory for the science of comparative cognition, and the lack of domain-general mechanisms for evolutionary psychologists. The hierarchical complexity of concepts and debates as well as (...) the new theory are scored, and demonstrate the postformal hierarchical complexity of the proposed theory. (shrink)

The institutionalization of systems of informed consent in market economies has exaggerated rather than minimized the meritocractic effect of such economies. In developing economies, it may help reduce both inherent economic gaps and effects of inherited wealth. In both cases, the highest paid people are those whose performances evidence the highest hierarchical complexity, and lowest paid people have the lowest stages of performance. Society is stratified according to stage of performance. Postformal thought is more likely to develop in graduate (...) level education. Higher education has the effect of further stratifying individuals by stage of performance, rather than equalizing opportunity. (shrink)

According to The Consensus Gentium Argument from the premise: “Everyone believes that God exists” one can conclude that God does exist. In my paper I analyze two ways of defending the claim that somebody’s belief in God is a prima facie reason to believe. Kelly takes the fact of the commonness of the belief in God as a datum to explain and argues that the best explanation has to indicate the truthfulness of the theistic belief. Trinkaus Zagzebski grounds her (...) defence on rationality of epistemic trust in others. In the paper I argue that the second line of reasoning is more promising and I propose its improved version. (shrink)

Substantial efforts have recently been made to reform the physician-patient relationship, particularly toward replacing the `silent world of doctor and patient' with informed patient participation in medical decision-making. This 'new ethos of patient autonomy' has especially insisted on the routine provision of informed consent for all medical interventions. Stronly supported by most bioethicists and the law, as well as more popular writings and expectations, it still seems clear that informed consent has, at best, been received in a lukewarm (...) fashion by most clinicians, many simply rejecting what they commonly refer to as the `myth of informed consent'. The purpose of this book is to defuse this seemingly intractable controversy by offering an efficient and effective operational model of informed consent. This goal is pursued first by reviewing and evaluating, in detail, the agendas, arguments, and supporting materials of its proponents and detractors. A comprehensive review of empirical studies of informed consent is provided, as well as a detailed reflection on the common clinician experience with attempts at informed consent and the exercise of autonomy by patients. In the end, informed consent is recast as a management tool for pursuing clinically and ethically important goods and values that any clinician should see as meriting pursuit. Concurrently, the model incorporates a flexible, anticipatory approach that recognizes that no static, generic ritual can legitimately pursue the quite variable goods and values that may be at stake with different patients in different situations. Finally, efficiency of provision is addressed by not pursuing the unattainable and ancillary. Throughout, the traditional principle of beneficence is appealed to toward articulating an operational model of informed consent as an intervention that is likely to change outcomes at the bedside for the better. (shrink)

Several authors have recently argued that psychotherapy, as it is commonly practiced, is deceptive and undermines patients’ ability to give informed consent to treatment. This ‘deception’ claim is based on the findings that some, and possibly most, of the ameliorative effects in psychotherapeutic interventions are mediated by therapeutic common factors shared by successful treatments, rather than because of theory-specific techniques. These findings have led to claims that psychotherapy is, at least partly, likely a placebo, and that practitioners of (...) psychotherapy have a duty to ‘go open’ to patients about the role of common factors in therapy ; to not ‘go open’ is supposed to unjustly restrict patients’ autonomy. This paper makes two related arguments against the ‘go open’ claim. While therapies ought to provide patients with sufficient information to make informed treatment decisions, informed consent does not require that practitioners ‘go open’ about therapeutic common factors in psychotherapy, and clarity about the mechanisms of change in psychotherapy shows us that the common-factors findings are consistent with, rather than undermining of, the truth of many theory-specific forms of psychotherapy; psychotherapy, as it is commonly practiced, is not deceptive and is not a placebo. The call to ‘go open’ should be resisted and may have serious detrimental effects on patients via the dissemination of a false view about how therapy works. (shrink)

Researchers increasingly rely on large data sets of health information, often linked with biological specimens. In recent years, the argument has been made that obtaining informed consent for conducting records-based research is unduly burdensome and results in ?consent bias.? As a type of selection bias, consent bias is said to exist when the group giving researchers access to their data differs from the group denying access. Therefore, to promote socially beneficial research, it is argued that (...) class='Hi'>consent should be unnecessary. After analyzing the biostatistics evidence and bioethics arguments, the article concludes that (1) claims about the amount of consent bias are overstated; (2) commonly used statistical methods usually can account for consent bias; and (3) any residual effects of consent bias are below an acceptable level of imprecision and constitute a reasonable social cost for conducting ethically responsible research. (shrink)

Informed consent has become one of the central problems in medical ehtics. At first sight, it would seem that no argument can be made against a person's right to be fully aware of the extent, course, and implications of his medical condition. It seems equally obvious that it is the patient's right to participate in, influence, or fully and solely assume the decisions of medical actions that should be undertaken or withheld with regard to his disease. Nevertheless, there (...) are circumstances in which these commonly held assumptions about a patient's rights may not apply. It is the purpose of this report to describe a case where informed consent was deliverately not sought, and to discuss the ethical issues involved. (shrink)

In ‘Psychotherapy, Placebos and Informed Consent’, I argued that the minimal standard for informed consent in psychotherapy requires that ‘patients understand that there is currently no consensus about the mechanisms of change in psychotherapy, and that the therapy on offer…is based on disputed theoretical foundations’, and that the dissemination of this information is compatible with the delivery of many theory-specific forms of psychotherapy (including cognitive behavioural therapy [CBT]). I also argued that the minimal requirements for informed consent (...) do not include information about the role of therapeutic common factors in healing (e.g., expectancy effects and therapist effects); practitioners may discuss the common factors with patients, but they are not part of the ‘core set’ of information necessary to obtain informed consent. In a recent reply, Charlotte Blease criticises these two arguments by claiming they are not supported by empirical findings about the therapeutic common factors. Blease’s response is based on serious misunderstandings of both CBT and what the common factor findings actually find. Nevertheless, addressing the reasons for these misunderstandings is instructive and gives us an opportunity to clarify what, exactly, needs to be explained to patients in order to obtain informed consent for psychotherapy. (shrink)

This paper argues that the provision of effective informed consent by surgical patients requires the disclosure of material information about the comparative clinical performance of available surgeons. We develop a new ethical argument for the conclusion that comparative information about surgeons' performance - surgeons' report cards - should be provided to patients, a conclusion that has already been supported by legal and economic arguments. We consider some recent institutional and legal developments in this area, and we respond to (...) some common objections to the use of report cards on the clinical performance of surgeons. (shrink)

A very common but untested assumption is that potential children would consent to be exposed to the harms of existence in order to experience its benefits. And so, would-be parents might appeal to the following view: Procreation is all-things-considered permissible, as it is morally acceptable for one to knowingly harm an unconsenting patient if one has good reasons for assuming her hypothetical consent—and procreators can indeed reasonably rely on some notion of hypothetical consent. I argue that (...) this view is in error. My argument appeals to a consent-based version of anti-natalism advanced by Seana Valentine Shiffrin. Anti-natalism is the view that it is always wrong to bring people into existence. While, like Shiffrin, I stop short of advocating a thoroughgoing anti-natalism, I nevertheless argue that procreators cannot appeal to hypothetical consent to justify exposing children to the harms of existence. I end by suggesting a more promising route by which this justification might be achieved. (shrink)

Ethical guidelines commonly state that research subjects should have a right to withdraw consent to participate. According to the guidelines we have studied, this right applies also to research on biological samples. However, research conducted on human subjects themselves differs in important respects from research on biological samples. It is therefore not obvious that the same rights should be granted research participants in the two cases. This paper investigates arguments for and against granting a right to withdraw consent (...) to research on biobank samples. We conclude that (1) there are no explicit arguments for such a right in the guidelines we have studied, (2) the arguments against such a right are inconclusive, (3) considerations of autonomy, privacy, personal integrity, and trust in medical research provide sufficient reasons for granting a right to withdraw consent to research on biobank samples, (4) in certain cases, research participants should be allowed to waive this right. (shrink)

The use of medical records in research can yield information that is difficult to obtain by other means. When such records are released to investigators in identifiable form, however, substantial privacy and confidentiality risks may be created. These risks become more common and more serious as medical records move to an electronic format. In 1996, the state of Minnesota enacted legislation with respect to consent requirements for the use of medical records in research. This legislation has been widely (...) criticized because—it is claimed—it creates an unnecessary impediment to research. In this article, we show that these arguments rest upon misinterpretation and/or misrepresentation of the 1996 legislation. A consent requirement had actually been present in Minnesota since 1976 (though codified in a patient rights statute rather than a privacy statute). The 1996 law does not require specific consent, as often claimed, but rather only a general authorization. The campaign against the Minnesota legislation appears to have been motivated by concern with respect to the then impending federal privacy rule. The HIPAA rule, as enacted, is in fact less stringent with respect to consent than the Minnesota consent law. On the other hand, the Minnesota consent law has not been effectively applied or enforced. As we change the way we manage sensitive medical information, new efforts are needed to provide protection against the confidentiality risks in research. Patient consent is an important tool in this regard. New instrumentalities are needed to solicit and document consent. (shrink)

It is widely believed that informed consent must be obtained from a patient for it to be morally permissible to administer to him/her a medical intervention. The same has been argued for the use of neurointerventions administered to criminal offenders. Arguments in favour of a consent requirement for neurointerventions can take two forms. First, according to absolutist views, neurointerventions shouldneverbe administered without an offender’s informed consent. However, I argue that these views are ultimately unpersuasive. The second, and (...) more plausible, form defences of the consent requirement may take are more moderate in that they accept the use of neurointerventions in some cases, but not in others. Based on common rationales for consent in medical interventions, I discuss whether four moderate approaches in defence of the informed consent requirement for medical interventions succeed in establishing that informed consent must be obtained from offenders prior to administering neurointerventions to them. I offer novel critical perspectives on approaches that have already received some attention in the literature, and I critically discuss other approaches to defending informed consent in a medical context that have not yet received due attention. Ultimately, I argue that it is not obvious that any of these considerations support a requirement of offenders’ informed consent to neurointerventions. Lastly, however, I suggest that there is at least one overlooked fact as regards how courts currently employ mandatory neurointerventions, which may support such a requirement. (shrink)

According to Reid, opinions that contradict the principles of common sense are not only false but also absurd. Nature has given us an emotion that reveals the absurdity of an opinion: the emotion of ridicule. An appeal to ridicule in philosophical arguments may easily be discounted as a logical fallacy in the same manner as an appeal to the common consent of people. This essay traces the origins of Reid's defense of ridicule in the works of Addison, (...) Hutcheson, Shaftesbury and Campbell. Reid rejected a non-epistemic view of the sense of ridicule. According to Reid, ridicule includes both a feeling and a particular act of judgment based on the principles of common sense. (shrink)

This chapter examines a common objection to sex robots: the symbolic-consequences argument. According to this argument sex robots are problematic because they symbolise something disturbing about our attitude to sex-related norms such as consent and the status of our sex partners, and because of the potential consequences of this symbolism. After formalising this objection and considering several real-world uses of it, the chapter subjects it to critical scrutiny. It argues that while there are grounds for thinking (...) that sex robots could symbolically represent a troubling attitude toward women (and maybe children) and the norms of interpersonal sexual relationships, the troubling symbolism is going to be removable in many instances and reformable in others. What will ultimately matter are the consequences of the symbolism but these consequences are likely to be difficult to ascertain. This may warrant an explicitly experimental approach to the development of this technology. (shrink)

Using video to facilitate data collection has become increasingly common in health research. Using video in research, however, does raise additional ethical concerns. In this paper we utilize family therapy data to provide empirical evidence of how recording equipment is treated. We show that families made a distinction between what was observed through the video by the reflecting team and what was being recorded onto videotape. We show that all parties actively negotiated what should and should not go ‘on (...) the record’, with particular attention to sensitive topics and the responsibility of the therapist. Our findings have important implications for both clinical professionals and researchers using video data. We maintain that informed consent should be an ongoing process and with this in mind we present some arguments pertaining to the current debates in this field of health-care practice. (shrink)

What is the point of appealing to a social contract? An intuitively plausible answer is that the metaphor functions as a justification for the obligation to obey the law. If I have made a contract to establish a political authority, then I am bound to obey the commands of that authority. In a contract, my agreement creates an obligation to perform. Then only remaining question is what reasons I have to make the agreement in the first place. It would then (...) seem that classical social contract theory is divided between those who understand our reasons to agree as prudential and those who take our reasons to be moral. But this kind of interpretation fails to make sense of Kant’s political theory, which understands our obligation to enter into a civil condition as prior to the appeal to the social contract. The original contract enters into Kant’s theory at a crucially later point, after the creation of specific political institutions. It functions as a way of reconciling these institutions with the idea of rightful coercion, by imposing normative requirements on the political reasoning of legislators and citizens. For Kant, the distinctive feature of normative political reasoning is the notion of a unified will, an idea that was already present at the start of social contract theory in Hobbes, but had yet to be properly clarified. Kant appeals to the original contract not to ground our political obligations, but to explain both the coherence and the necessity of the idea of a common will for political argument. (shrink)

The coronavirus pandemic has brought to public attention a variety of questions long debated in medical ethics, but now given both added urgency and wider publicity. Among these is triage, with its origins in deciding which individual lives are to be saved on a battlefield, but now also concerned with the allocation of scarce resources more generally. On the historical battlefield, decisions about whom to treat first – neither those who would survive without treatment, nor those who would not survive (...) even with treatment, but those who needed treatment to survive – was facilitated by military discipline and the limited effectiveness of treatments available. In the allocation of scarce resources today, by contrast, such decisions are subject to intense public and political scrutiny, and the range of effective treatments available has immeasurably diminished the proportion of ‘those who would not survive even with treatment’. If triage decisions are to be made, they now need to be justified in the arena of public opinion by moral arguments which are also politically persuasive. A number of different aspects of what is required for this endeavour are examined in the first five contributions to this issue of the Journal. In ‘Should age matter in COVID-19 triage? A deliberative study ’1, Kuylen and colleagues report on a deliberative study of public views in the UK, in which participants ‘generally accepted the need for triage but strongly rejected ’fair innings’ and ’life projects’ principles as justifications for age-based allocation,…preferring to maximise the number of lives rather than life years saved’; and concerned that in any resolution ‘utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability’. A similar concern to temper utilitarian considerations, in this case with an Aristotelian view of the common good as ‘the good life for …. (shrink)

A growing number of clinical trials use invasive research procedures to obtain tissue for disease screening and to monitor the effects of drugs. These procedures can be ethically contentious because they often have neither therapeutic nor diagnostic value, and because research participants may not realize this, which could compromise the validity of their consent to the procedure. In the first section of this paper, we describe the burdens, risks, and benefits associated with certain common invasive, nondiagnostic research procedures. (...) We next offer a series of arguments about the general properties of a valid consent for such procedures, and we close by examining what is currently known about consent quality for invasive research procedures when measured against the standards laid out in the second section. We conclude that there is little evidence to either confirm or dispel concerns about participants’ consent quality for protocols involving invasive, nondiagnostic research procedures. (shrink)

The empirical literature seems to indicate that prehistoric humans did not believe in God or anything like God. Why is that so, if God exists? The problem is difficult because their nonbelief was natural: their evolved mind and cultural environment restricted them to concepts of highly limited supernatural agents. Why would God design their mind and place them in their environments only to hide from them? The natural nonbelief of prehistoric humans is much more surprising given theism than naturalism. Thus, (...) it constitutes strong evidence that theism is false, or so Jason Marsh (2013) has argued. The "problem of natural nonbelief" is a debunking argument that invokes the genealogy of religious belief to cast doubt upon theism. In this chapter, we put it to the test. First, we argue on empirical grounds that it is not clear that natural nonbelief was prevalent: the empirical jury is still out on what prehistoric humans believed about gods. Second, we argue that even if natural nonbelief was prevalent, it would not be very surprising given theism. We conclude that natural nonbelief presents no problem for theism. We also turn the tables and suggest that the real problem is the problem of widespread belief in a High God (common consent), which is a problem for naturalism. (shrink)

Biobanks are potential goldmines for genomics research. They have become increasingly common as a means to determine the relationship between lifestyle, environmental exposures and predisposition to genetic disease. More and more countries are developing massive national scale biobanks, including Iceland, the UK and Estonia. Now several large-scale regional and national biobanks are planned in China, such as Shanghai Biobank, which is defined as a key-element in Shanghai's twelfth five-year Development Plan of Science and Technology. It is imperative that the (...) authors who are in charge of the ethical aspect of Shanghai Biobank discuss the ethical aspects of these biobanks up front. Currently there is a great deal of heterogeneity in the approaches to informed consent taken by different countries. In the article, after briefly introducing the biobanks in China, we focus on the three most common approaches: classical informed consent, tiered consent, and one-time general (or blanket) consent, and propose a version of the latter for China, based on compelling arguments. (shrink)

Medical students commonly learn how to administer pelvic exams by practicing on unconscious patients, often without first obtaining explicit consent from patients to do so. While twenty-one states currently have laws that require teaching hospitals to obtain consent from patients to participate in this educational experience, opposition from the medical community has stymied legislative progress. In this paper, I respond to the two most common reasons offered to oppose legislation, which appeal to (1) the educational benefits of (...) these exams, or (2) protecting institutional autonomy. Kantian ideas about autonomy help to illuminate the problematic ways in which these arguments supplant the importance of women’s choices over how their bodies are used while seeking medical treatment. Ultimately, neither argument offers sufficient reason to oppose laws that require explicit consent before administering training pelvic exams. (shrink)

There is a tendency in contemporary jurisprudence to regard political authority and, more particularly, legal intervention in human affairs as having no justification unless it can be defended by what Laing calls the principle of modern liberal autonomy (MLA). According to this principle, if consenting adults want to do something, unless it does specific harm to others here and now, the law has no business intervening. Harm to the self and general harm to society can constitute no justification for legal (...) regulation or prohibition. So pervasive is this understanding of legal intervention in human affairs, that it is common now to encounter arguments in favour of permissive laws on, for example, private drug use, pornography, sexual and reproductive choice, based on the idea that to intervene in these areas would constitute a breach of the liberal ideal. The only alternative to modern liberal autonomy is assumed to be radical oppression, in which the State intervenes in the individual’s life to impose unwarranted measures designed to further its own ends. The legacy of Stalin, Hitler and other modern tyrants has undermined conceptual appeals to the common good. So widespread is this liberal assumption in the Western, English-speaking world that critics of the outlook embodied by MLA are customarily regarded with suspicion and charged with paternalism, narrow-mindedness and intolerance. Laing highlights contradictions inherent in the modern liberal tradition. She argues that there is a certain reliance on the notion of the common good within the natural law tradition that is instructive. According to this view, the common good constitutes a mean between two extremes: on the one hand, contemporary liberalism’s over-insistence on radical individual autonomy and, on the other hand, totalitarianism’s over-emphasis on collective social benefit. There is, I will argue, substantial terrain between the conceptual excesses of modern liberalism and oppressive tyranny that needs to be acknowledged and discussed. (shrink)

The present paper investigates the seventeenth-century debate on whether the agreement of all human beings upon certain notions—designated as the “common” ones—prove these notions to be innate. It does so by focusing on Descartes’ and Locke’s rejections of the philosophy of Herbert of Cherbury, one of the most important early modern proponents of this view. The paper opens by considering the strategy used in Herbert’s arguments, as well as the difficulties involved in them. It shows that Descartes’ 1638 and (...) 1639 reading of Herbert’s On Truth—both the 1633 second Latin edition and Mersenne’s 1639 translation—was instrumental in shaping Descartes’ views on the issue. The arguments of Locke’s Essay opposing Herbert’s case for innatism are thus revealed to be ineffective against the case which Descartes makes for this same doctrine, since Descartes had in fact framed his conception of innateness in opposition to the very same theses as Locke was arguing against. The paper concludes by explaining how two thinkers as antithetical as Locke and Descartes came to agree on at least one point, and a truly crucial one: namely, that universal consent counts as a criterion neither for innatism nor for truth. (shrink)

In an earlier article in this journal I argued that the question of whether heroin addicts can give voluntary consent to take part in research which involves giving them a choice of free heroin does not – in contrast with a common assumption in the bioethics literature – depend exclusively on whether or not they possess the capacity to resist their desire for heroin. In some cases, circumstances and beliefs might undermine the voluntariness of the choices a person (...) makes even if they do possess a capacity for self-control. Based on what I took to be a plausible definition of voluntariness, I argued that the circumstances and beliefs typical of many vulnerable heroin addicts are such that we have good reasons to suspect they cannot give voluntary consent to take part in such research, even assuming their desire for heroin is not irresistible. In a recent article in this journal, Uusitalo and Broers object to this on the grounds that I misdescribe heroin addicts' options set, that the definition of voluntariness on which I rely is unrealistic and too demanding, and, more generally, that my view of heroin addiction is flawed. I think their arguments derive from a misunderstanding of the view I expressed in my article. In what follows I hope therefore to clarify my position. (shrink)

Global justice theorists have given much attention to corporations' purchases of state-owned natural resources controlled by dictators. These resources, the common argument goes, belong to the people rather than to those who exercise effective political power. Dictators who rely on violence to secure their political power and who sell state-owned natural resources without authorisation from their people, or from their people's elected delegates, are therefore violating their peoples' property rights. But many dictatorships also distribute natural resource revenue to (...) the population, and stopping to purchase natural resources from them is therefore likely to produce relative deprivation for the people, even while increasing the chances of the people gaining control over their property. Given these circumstances, can corporations buying the people's natural resources from a distributive dictatorship appeal to the people's consent as justification for such purchases? I consider this question by inspecting three types of consent to which resource corporations might appeal. I show that, under the circumstances of natural resource trade with distributive dictatorships, none of these types of consent can obtain. Hence, resource corporations cannot appeal to popular consent to defend their transactions with distributive dictatorships. (shrink)

The deceased's prior consent to posthumous reproduction is a common requirement in many common law jurisdictions. This paper critically evaluates four arguments advanced to justify the presumption against consent. It is argued that, in situations where death is caused by sudden trauma, not only is there inadequate justification for the presumption against consent, but there are good reasons to reverse the presumption. The article concludes that the precondition of prior consent may be inappropriate in (...) these situations. (shrink)

In this paper I problematise quite a simple assertion: that the two major frameworks used in assessing consent to post-mortem organ donation, presumed consent and informed consent, are procedurally similar in that both are ‘default rules.’ Because of their procedural common characteristic, both rules do exclude marginalized groups from consent schemes. Yet this connection is often overlooked. Contract theory on default rules, better than bioethical arguments, can assist in choosing between these two rules. Applying contract (...) theory to the question of post-mortem organ donation suggests that the default rule should be one that goes against the wishes of the stronger party in consent decisions. (shrink)

A discussão acerca da constituição da autoridade política descrita no Leviathan, especificamente, no contexto do Cap. XVI, configura-se como uma das questões mais proeminentes referente às pesquisas da problemática filosófica e política de Hobbes na atualidade. Relacionado diretamente com a teoria da representação, o fundamento da autoridade evidencia nitidamente uma articulação entre o processo representativo da pessoa artificial com as exigências do argumento contratualista hobbesiano, cuja consequência direta está na configuração da convergência entre a vontade do poder soberano com a (...) vontade particular daqueles que o instituíram. Diante desse pressuposto teórico, propõe-se examinar o processo intrínseco pelo qual a vontade soberana reverte-se de autoridade suficiente para agir em conformidade com a vontade e poder de ação daqueles que consentidamente a autorizaram a este fim. Para tanto, torna-se imprescindível analisar o processo argumentativo pelo qual o filósofo explica a aquisição do direito e consentimento para agir no lugar daquele a quem pertencia tal direito de praticá-la na consecução de uma “ação ou efeito comum” como consequência do processo de representação política, assim como a natureza e determinação da figura teórica da pessoa fictícia ou artificial portadora da unidade das vontades. Baseado nesses elementos torna-se, portanto, possível determinar o fundamento da autoridade, tal como Hobbes pressupõe no Leviathan, tarefa ao qual a presente comunicação objetiva essencialmente a demonstrar.: The discussion about the constitution of political authority described in the Leviathan, specifically in the context of Sec. XVI, configures itself as one of the most prominent issues related to the research of philosophical problems and Hobbes politics today. Directly related to representation theory, the foundation of authority clearly shows a link between the representative process of artificial person with the requirements of the hobbesian’s contractarian argument, which is a direct consequence of the configuration of the convergence between the will of the sovereign power to the will of those particular that instituted. Face of this theoretical assumption, we propose to examine the intrinsic process by which the sovereign will revert is sufficient to comply with the will and power of action of those who consentidamente the authorized authority for this purpose. For this, it is essential to analyze the argumentative process by which the philosopher explains the entitlement and consent to act in place of who owned that right to practice it in achieving "common action or effect" as a result of the process political representation, and the nature and determination of the theoretical concept of fictional or artificial person drive carrier wills. Based on these elements becomes therefore possible to determine the basis of the authority, as Hobbes in the Leviathan assumes, a task to which this article aims primarily to demonstrate. Keys words: Authority, political representation, Unity, will. (shrink)

Biobanks are potential goldmines for genomics research. They have become increasingly common as a means to determine the relationship between lifestyle, environmental exposures and predisposition to genetic disease. More and more countries are developing massive national scale biobanks, including Iceland, the UK and Estonia. Now several large-scale regional and national biobanks are planned in China, such as Shanghai Biobank, which is defined as a key-element in Shanghai's twelfth five-year Development Plan of Science and Technology. It is imperative that the (...) authors who are in charge of the ethical aspect of Shanghai Biobank discuss the ethical aspects of these biobanks up front. Currently there is a great deal of heterogeneity in the approaches to informed consent taken by different countries. In the article, after briefly introducing the biobanks in China, we focus on the three most common approaches: classical informed consent, tiered consent, and one-time general (or blanket) consent, and propose a version of the latter for China, based on compelling arguments. (shrink)

Vaccine mandates can take many forms, and different kinds of mandates can implicate an array of values in diverse ways. It follows that good ethics arguments about particular vaccine mandates will attend to the details of individual policies. Furthermore, attention to particular mandate policies—and to attributes of the communities they aim to govern—can also illuminate which ethics arguments may be more salient in particular contexts. If ethicists want their arguments to make a difference in policy, they should attend to these (...) kinds of empirical considerations. This paper focuses on the most common and contentious vaccine mandate reform in the contemporary United States: the elimination of nonmedical exemptions (NMEs) to school and daycare vaccine mandates. It highlights, in particular, debates about California's Senate Bill 277 (SB277), which was the first successful recent effort to eliminate NMEs in that country. We use media, secondary sources, and original interviews with policymakers and activists to identify and evaluate three ethics arguments offered by critics of SB277: parental freedom, informed consent, and children's rights to care and education. We then turn to one ethics argument often offered by advocates of SB277: harm prevention. We note, however, that three arguments for mandates that are common in the immunization ethics literature—fairness/free-riding, children's rights to vaccination, and utilitarianism—did not play a role in debates about SB277. (shrink)

In the last decade the use of advance directives or living wills has become increasingly common. This paper is concerned with those advance directives in which the user opts for withdrawal of active treatment in a future situation where he or she is incompetent to consent to conservative management but where that incompetence is potentially reversible. This type of directive assumes that the individual is able accurately to determine the type of treatment he or she would have adopted (...) had he or she been competent in this future scenario. The paper argues that this assumption is flawed and provides theoretical and empirical evidence for this. If the assumption is false, and those taking out advance directives do not realise this, then the ethical bases for the use of these advance directives-the maximisation of the individual's autonomy and minimisation of harm-are undermined. The paper concludes that this form of advance directive should be abolished. (shrink)

This article examines theories of ocean rights based on the works of Hugo Grotius and Samuel von Pufendorf. Grotius's object‐centred view uses features of the natural world to justify claims to external objects. I show that Grotius's view is inadequate, because it relies on an outdated claim that oceanic resources are sufficiently abundant for anybody to use. Further, adaptations of his view are wanting, because they either rely on arbitrary distinctions or disregard the values of cultural minorities. Pufendorf's relational view (...) constructs rights through the exercise of human will. While Pufendorf believes that agreements create rights, he also argues that property rights can be unilaterally acquired from the commons without express consent from others. The relational view is a viable alternative to the object‐centred view, because it both delimits territorial claims over the ocean to a ‘modest’ size and also respects cultural variability. A major aim of this article is to present Pufendorf's theory of territorial rights extended over oceans and to demonstrate how it is useful for assessing contemporary disputes. In the final sections, I apply the relational view to Canadian claims to the Northwest Passage, and I also sketch implications for assessing expanding claims to the seabed. (shrink)

Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Our review identified four (...) major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)

This article addresses the relationship between understanding and believing from the cognitive perspective of information-processing. I promote, within the scope of the Critical Discourse Analysis agenda, the relevance of an account of belief-fixation sustained by a combination of argumentative and cognitive insights. To this end, I first argue that discursive strategies fulfilling legitimization purposes, such as evidentials, tap into the same cognitive mechanisms as arguments. I then proceed to examine the idea that the most effective arguments are the ones that (...) manage to obscure or make irrelevant counter-evidence and propose, from a cognitive pragmatic perspective, a formulation of rhetorical effectiveness as a constraint on information-selection taking place at the interpretation stage and decisively influencing the evaluation stage responsible for belief-fixation. (shrink)

The priority monist holds that the cosmos is the only fundamental object, of which every other concrete object is a dependent part. One major argument against monism goes back to Russell, who claimed that pluralism is favoured by common sense. However, Jonathan Schaffer turns this argument on its head and uses it to defend priority monism. He suggests that common sense holds that the cosmos is a whole, of which ordinary physical objects are arbitrary portions, and (...) that arbitrary portions depend for their existence on the existence of the whole. In this paper, we challenge Schaffer’s claim that the parts of the cosmos are all arbitrary portions. We suggest that there is a way of carving up the universe such that at least some of its parts are not arbitrary. We offer two arguments in support of this claim. First, we shall outline semantic reasons in its favour: in order to accept that empirical judgements are made true or false by the way the world is, one must accept that the cosmos includes parts whose existence is not arbitrary. Second, we offer an ontological argument: in order for macro-physical phenomena to exist, there must be some micro-physical order which they depend upon, and this order must itself be non-arbitrary. We conclude that Schaffer’s common sense argument for monism cannot be made to work. (shrink)

The need to protect the public against the spread of communicable disease provides a good example of the need for a commonsense approach to the use of confidential data. Laboratories need to notify different professionals in order to trace the sources of outbreaks of infection and eradicate the cause. It is often not possible to obtain consent from individual patients, given the rapid time scale required. In doing so, however, laboratory staff and others would contravene the Data Protection Act (...) in passing on information without consent. Section 60 of the Health and Social Care Act was designed to overcome barriers to research relying on data accumulated in the past and this type of public health work. But this is proving a sluggish procedure. It is an awkward solution to the problem of data use without specific consent. This problem will be overcome only when the public can have sufficient trust in safeguards that are in place to protect their safety and confidentiality so that these important activities can be pursued without specific informed consent. (shrink)

Background Pragmatic randomized controlled trials are designed to evaluate the effectiveness of interventions in real-world clinical conditions. However, these studies raise ethical issues for researchers and regulators. Our objective is to identify a list of key ethical issues in pragmatic RCTs and highlight gaps in the ethics literature. Methods We conducted a scoping review of articles addressing ethical aspects of pragmatic RCTs. After applying the search strategy and eligibility criteria, 36 articles were included and reviewed using content analysis. Results Our (...) review identified four major themes: 1) the research-practice distinction; 2) the need for consent; 3) elements that must be disclosed in the consent process; and 4) appropriate oversight by research ethics committees. 1) Most authors reject the need for a research-practice distinction in pragmatic RCTs. They argue that the distinction rests on the presumptions that research participation offers patients less benefit and greater risk than clinical practice, but neither is true in the case of pragmatic RCTs. 2) Most authors further conclude that pragmatic RCTs may proceed without informed consent or with simplified consent procedures when risks are low and consent is infeasible. 3) Authors who endorse the need for consent assert that information need only be disclosed when research participation poses incremental risks compared to clinical practice. Authors disagree as to whether randomization must be disclosed. 4) Finally, all authors view regulatory oversight as burdensome and a practical impediment to the conduct of pragmatic RCTs, and argue that oversight procedures ought to be streamlined when risks to participants are low. Conclusion The current ethical discussion is framed by the assumption that the function of research oversight is to protect participants from risk. As pragmatic RCTs commonly involve usual care interventions, the risks may be minimal. This leads many to reject the research-practice distinction and question the need for informed consent. But the function of oversight should be understood broadly as protecting the liberty and welfare interest of participants and promoting public trust in research. This understanding, we suggest, will focus discussion on questions about appropriate ethical review for pragmatic RCTs. (shrink)