Volume 19, Issue 6, June 2019, Page 19-21.

Many diseases and disease symptoms still lack effective treatment. At the same time, certain controversial Schedule I drugs, such as heroin and cannabis, have been reputed to have considerable therapeutic potential for addressing significant medical problems. Yet, there is a paucity of U.S. clinical studies on the therapeutic uses of controlled drugs. For example, people living with HIV/aids experience a variety of disease- and medication-related symptoms. Their chronic pain is intense, frequent, and difficult to treat. Nevertheless, clinical trials of compassionate (...) management for their chronic symptoms, which should be a research priority, are stymied. Stakeholders’ Views on Barriers to Research on Controlled Substances Evelyn Rhodes, Michael Andreae, Tyler Bourgiose, Debbie Indyk, Rosamond Rhodes, and Henry Sacks We employed qualitative methods to develop an understanding of the barriers to research on potential therapeutic uses of Schedule I drugs so that they might be addressed. We elicited the perspectives of key stakeholder groups that would be involved in such studies: people living with HIV/aids, clinicians, and members of institutional review boards. As we identified obstacles to research, we found that all of the stakeholder groups arrived at the same conclusion, that clinical research on the therapeutic potential of these drugs is ethically required. (shrink)

We examine the ethical, social, and regulatory barriers that may hinder research on therapeutic potential of certain controversial controlled substances like marijuana, heroin, or ketamine. Hazards for individuals and society and potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of these substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may, however, limit research on their considerable therapeutic potential. We review (...) the surprisingly sparse literature and address the particular ethical concerns pertinent to research with illicit and addictive substances, such as undue inducement, informed consent, therapeutic misconception, and risk to participants, researchers, and institutions. We consider the perspectives of key research stakeholders and explore whether they may be infected with bias. We conclude by proposing an empirical research agenda to provide an evidentiary basis for ethical reasoning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:84 Reviews THE WAYS OF THE WITTGENSTEINS ACCORDING TO A WAUGH Richard Henry Schmitt U. of Chicago Chicago, il 60637, usa [email protected] AlexanderWaugh. TheHouseofWittgenstein:aFamilyatWar. London: Bloomsbury, 2008. Pp. 366. isbn: 0-7475-9185-7. £20.00 (hb). New York: Doubleday, 2009. Pp. 333. isbn: 0-385-52060-3. us$28.95 (hb). Ezach family is happy and unhappy in its own ways. This is hardly surprising zgiven that the family lies at the crossroad of so much (...) human experience. It is the scene for playing out genetics and for working through the rearing and civilizing of children, both nature and nurture. In economic life it constitutes the primary unit, the household. Despite Tolstoy’s ideal, none can ever be com­ pletely happy for every member all the time. And, there is no reason to think that basically happy families are any more the same than unhappy ones. But then none can ever be completely unhappy; or rather, when a family is com­ pletely unhappy it is unlikely that it will remain one. One other factor, however, intrudes on this picture: we tend to be more interested in bad or scandalous news than good. Vicarious experience brings catharsis, possibly helpful in a way. Yet, as the German language recognizes with the word “Schadenfreudez”, we can experience joy at someone else’s sorrow, despite the questions it raises about our empathy. Alexander Waugh is himself the member of a famous family. He has written December 2, 2009 (5:28 pm) E:\CPBR\RUSSJOUR\TYPE2901\russell 29,1 060 red.wpd E:\CPBR\RUSSJOUR\TYPE2901\russell 29,1 060 red.wpd Reviews 85 its “autobiography” in Fathers and Sons,1 where he is principally concerned with his father Auberon (“Bron”), his grandfather Evelyn, his great-uncle Alec, and his great-grandfather Arthur. Given the family documentation at his disposal and the span of generations, that book covers enough territory, in enough detail, to give us some sense of Waugh family character. You learn what it was like to grow up in the family, down to the odour of Uncle Auberon Herbert’s cologne, “smelling like Cleopatra in her barge on her way to meet Antony for the Wrst time” according to Bron (p. 370, paperback ed.), and the family suspicion that this uncle may have been the illegitimate son of Hilaire Belloc (p. 276). The fathers and sons, from Arthur down to Alexander, all wrote for a living, witty, stylish prose, and sometimes poetry. They especially liked writing about each other in letters, essays, and novels, often to each other in public letters and dedications; and as a consequence Alexander’s book is rich, amusing, intimate, and a bit indiscrete. Arthur’s turn-of-the-century avoidance of emotion in sentimentality grew outmoded, but it was replaced in the family business with newer models, with more Xash and cynicism. When it came to Alexander’s fa­ ther Bron, he was known for his talent at vituperation, and got into verbal and legal scrapes with C. P. Snow and Bertrand Russell among others (p. 407), which led to his getting sacked but only made his journalism more widely read and more valuable to publishers. In Alexander’s disclosure of his family history, there is a sureness of touch that comes from working within his ken. Waugh studied music, and worked as a music critic. In his easy, self-depreci­ ating way, he told an interviewer for The Wall Street Journalz that he got the idea to write this book because of “the most appalling boil on my right index Wnger”. This curtailed his routine enjoyment at the piano, “But then as I sat down and pressed a chord with my left hand I thought of Paul Wittgenstein. I knew about the concerto that Ravel composed for him and I knew that he was Ludwig’s brother. He was bound to have an interesting story.”2 With access to some Witt­ genstein family papers through one of Paul Wittgenstein’s daughters, he began. But a biography of the one-armed pianist soon turned into this “family history”, in part because of the author’s previous success with his own family, but also... (shrink)

I am going to be discussing a mode of moral responsibility that anglophone philosophers have largely neglected. It is a type of responsibility that looks to the future rather than the past. Because this forward-looking moral responsibility is relatively unfamiliar in the lexicon of analytic philosophy, many of my locutions will initially strike many readers as odd. As a matter of everyday speech, however, the notion of forward-looking moral responsibility is perfectly familiar. Today, for instance, I said I would be (...) responsible for watching my nieces while they swam. Neglecting this responsibility would have been a moral fault. When people marry, they undertake responsibilities, of moral import, of fidelity and mutual support. When people have children, they accrue moral responsibilities to feed, rear, and educate them. Not all forward-looking responsibilities are moral. While finishing this essay, I have had to keep an eye on a number of my administrative responsibilities, and, while reading it, you may well be occasionally distracted by some of your own. The notion of a responsibility that we accrue or take on, to look out for some range of concerns over some range of the future, is, then, perfectly familiar. Because this common notion of forward-looking responsibility has not been integrated into recent moral theory, however, my philosophical discussion of it will initially seem strange. (shrink)

Frances Kamm has for some time now been a foremost champion of non-consequentialist ethics. One of her most powerful non-consequentialist themes has been the idea of inviolability. Morality's prohibitions, she argues, confer on persons the status of inviolability. This thought helps articulate a rationale for moral prohibitions that will resist the protean threat posed by the consequentialist argument that anyone should surely be willing to violate a constraint if doing so will minimize the overall number of such violations. As Kamm (...) put it in a 1992 article, ‘If morality permitted minimizing violations of persons by violating other persons, then each of those saved as well as those persons used to save others would be less inviolable. It is the permission, not any actual violation of persons, that makes this so.’ Now, as thus baldly asserted, this claim borders on the conclusory. It is almost as if the claim were that morality conferred on persons the following status: that of being protected from consequentialism. One wants to hear in what inviolability consists, in more detail, so that we can understand it independently of the negation of consequentialism. And there is also an opposite problem: if inviolability is a good, then why can't consequentialism take it into account? Hence, one also wants to hear why this would not be the case. (shrink)

Henry S. Richardson is Professor of Philosophy at Georgetown University. From 2008-18, he was the editor of Ethics. His previous books include Practical Reasoning about Final Ends, Democratic Autonomy, and Moral Entanglements. He has held fellowships sponsored by the Alexander von Humboldt Foundation, the National Endowment for the Humanities, and the University Center for Human Values at Princeton University.

Henry Richardson argues that we can determine our ends rationally. He constructs a rich and original theory of how we can reason about our final goals. Richardson defuses the counter-arguments for the limits of rational deliberation, and develops interesting ideas about how his model might be extended to interpersonal deliberation of ends, taking him to the borders of political theory. Along the way Richardson offers illuminating discussions of, inter alia, Aristotle, Aquinas, Sidgwick, and Dewey, as well as the work (...) of several contemporary philosophers. (shrink)

The philosopher Henry Richardson's short book is a defense of a position on a neglected topic in medical research ethics. Clinical research ethics has been a longstanding area of study, dating back to the aftermath of the Nazi death-camp doctors and the Tuskegee syphilis study. Most ethical regulations and institutions have developed in response to those past abuses, including the stress on obtaining informed consent from the subject. Richardson points out that that these ethical regulations do not address one (...) of the key dilemmas faced by medical researchers -- whether or not they have obligations towards subjects who need care not directly related to the purpose of the study, termed 'ancillary care obligation'. (shrink)

Henry Richardson argues that we can determine our ends rationally. He constructs a rich and original theory of how we can reason about our final goals. Richardson defuses the counter-arguments for the limits of rational deliberation, and develops interesting ideas about how his model might be extended to interpersonal deliberation of ends, taking him to the borders of political theory. Along the way Richardson offers illuminating discussions of, inter alia, Aristotle, Aquinas, Sidgwick, and Dewey, as well as the work (...) of several contemporary philosophers. (shrink)

Researchers do not owe their subjects the same level of care that physicians owe patients, but they owe more than merely what the research protocol stipulates. In keeping with the dynamics of the relationship between researcher and subject, they have limited but substantive fiduciary obligations.

The notion that it is useful to specify norms progressively in order to resolve doubts about what to do, which I developed initially in a 1990 article, has been only partly assimilated by the bioethics literature. The thought is not just that it is helpful to work with relatively specific norms. It is more than that: specification can replace deductive subsumption and balancing. Here I argue against two versions of reliance on balancing that are prominent in recent bioethical discussions. Without (...) meaning to address the substance or the overall merits of either view I criticize, I attack Gert, Culver and Clouser's implicit reliance on some overall dimension of balancing as a basis of resolving conflicts among norms and Beauchamp and Childress's residual acceptance of 'justified balancing'. The former authors' description of resolving conflicts depends upon a type of value commensurability that (as they otherwise seem to admit) does not obtain, while the latter authors' role for justified balancing would be better served by continued specification. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Measurement, Pleasure, and Practical Science in Plato's Protagoras HENRY S. RICHARDSON 1. INTRODUCTION TOWARDS THE END OF THE PROTAGORAS Socrates suggests that the "salvation of our life" depends upon applying to pleasures and pains a science of measurement (metr$tik~techn~).Whether Plato intended to portray Socrates as putting forward sincerely the form of hedonism that makes these pleasures and pains relevant has been the subject of a detailed and probably (...) interminable debate, to which this paper will not directly contribute. By contrast, it seems to be supposed by almost all who have written on the topic that this hedonism, whoever is espousing it, puts forward pleasure as a single, homogeneous yardstick of value to serve as the basis of a supremely simple standard of choice. This standard simply directs one to seek the maximal amount of pleasure. The underlying supposition is that the hedonism put forward in the Protagorasallows one to define a maximum because all goods are commensurable. But, as I shall emphasize in the sequel, hedonism does not imply commensurability, nor does commensurability imply hedonism. The interpretive thesis of this essay is that the common presumption that the dialogue's hedonism carries commensurability with it has impeded our ability to understand the Protagor~'s relation to the other dialogues, and has distorted the fundamental purpose of Socrates's practical science. These matters are of more than textual interest. My reasons for trying to remain neutral as to the longstanding debate about attributing the dialogue's hedonism are not limited to wanting to avoid quagmires and remove confusions that have resulted from unwarranted interpretive assumptions. To many, the Protagorasis of tremendous importance as an early articulation of a calculative ideal for ethical or practical decisionmaking, whether or not Plato or Socrates was committed to that ideal. Looking [7] 8 JOURNAL OF THE HISTORY OF PHILOSOPHY 28:1 JANUARY x99 o back at the Protagorasfrom our twentieth-century perspective encourages the expectation that we might find there some argument for the crucial features of such a calculative ideal, as we have come to understand it. One such feature, prominent especially in the classical utilitarians, is that of the commensurability of goods, which in turn allows the precise definition of a maximizing rule. If the Protagoraspresented a calculative conception involving commensurability, then we might expect to find in the dialogue some argumentfor the rational necessity of commensurability. My claim will be that since there is no compelling evidence that the idea of commensurability is found in the dialogue, there is'hardly likely to be an argument for it there. In fact, it is of philosophical interest to see how far the arguments against weakness of will and for the unity of virtue (whoever is making them) can proceed without relying upon commensurability; This way of putting the philosophical points at issue here underlines the relative modesty of what I am claiming about commensurability. I argue that there is nothing in the dialogue that requires us to see commensurability as part of its hedonism, that the arguments proceed without relying upon commensurability, and that in some respects the problem of understanding the relationship of the Protagorasto Plato's other dialogues is eased if we refrain from attributing any commensurability here. I will show that a clearer picture of what is doing the argumentative work in the last secdon of the dialogue will result if we thus separate commensurability from hedonism, and that an illuminatingly different way of understanding the role of the science of measurement is thereby suggested. None of this amounts to a compelling argument that the idea of commensurability is not to be found in the dialogue. Rather, my case simply undermines the positive reasons for finding the idea there. Apart from the greater clarity which separating hedonism and commensurability allows, this modest negative case links up with the deeper philosophical moti,~ation I have mentioned by casting cold water on any hopes that the Protagorascould be made to yield an argument specifically linking commensurability to rationality. In one respect, my interpretive strategy is akin to that of commentators who have attempted to ease the tension between the Protagorasand the Gorgias by arguing that the form of hedonism... (shrink)

Recent work on incidental fndings, concentrating on the difcult problems posed by the ambiguous results often generated by high-tech medicine, has proceeded largely independently from recent work on medical researchers' ancillary-care obligations, the obligations that researchers have to deal with diseases or conditions besides the one(s) under study. This paper contends that the two topics are morally linked, and specifcally that a sound understanding of ancillary-care obligations will center them on incidental fndings. The paper sets out and defends an understanding (...) of ancillary-care obligations, which is based on the idea that when participants signed up for a study they may — independently of their beliefs and expectations and of those of the researchers — be taken to have partially entrusted certain aspects of their health into the researchers' hands. This partial-entrustment model of ancillary-care obligations, in turn, has substantive implications for how to deal ethically with incidental fndings; for instance, it suggests that researchers have no moral obligation to hunt for incidental fndings. (shrink)

David Estlund’s Democratic Authority develops a novel doctrine of “normative consent,” according to which the nonconsent of those with a duty to consent is null. This article suggests that this doctrine can be defended by confining it to contexts involving consent to an authority, which raise distinctive normative challenges, but argues that Estlund’s attempt to deploy the doctrine fails, for it does not provide convincing reasons to think that citizens have any duty to consent. In closing, the article suggests that (...) the doctrine of normative consent might yet do some useful work in a quite different theoretical setting. (shrink)

Moral reasoning is individual or collective practical reasoning about what, morally, one ought to do. Philosophical examination of moral reasoning faces both distinctive puzzles — about how we recognize moral considerations and cope with conflicts among them and about how they move us to act — and distinctive opportunities for gleaning insight about what we ought to do from how we reason about what we ought to do.

A two-volume set. Print edition available in cloth only. Awarded the Nicholas Hoare/Renaud-Bray Canadian Philosophical Association Book Prize, 2001 From the Preface: _Hegel's Ladder_ aspires to be... a ‘literal commentary’ on _Die Phänomenologie des Geistes_.... It was the conscious goal of my thirty-year struggle with Hegel to write an explanatory commentary on this book; and with its completion I regard my own ‘working’ career as concluded.... The prevailing habit of commentators... is founded on the general consensus of opinion that whatever (...) else it may be, Hegel’s _Phenomenology_ is not the logical ‘Science’ that he believed it was. This is the received view that I want to overthrow. But if I am right, then an acceptably continuous chain of argument, paragraph by paragraph, ought to be discoverable in the text. (shrink)

Frances Kamm has for some time now been a foremost champion of non-consequentialist ethics. One of her most powerful non-consequentialist themes has been the idea of inviolability. Morality's prohibitions, she argues, confer on persons the status of inviolability. This thought helps articulate a rationale for moral prohibitions that will resist the protean threat posed by the consequentialist argument that anyone should surely be willing to violate a constraint if doing so will minimize the overall number of such violations. As Kamm (...) put it in a 1992 article, ‘If morality permitted minimizing violations of persons by violating other persons, then each of those saved as well as those persons used to save others would be less inviolable. It is the permission, not any actual violation of persons, that makes this so.’ Now, as thus baldly asserted, this claim borders on the conclusory. It is almost as if the claim were that morality conferred on persons the following status: that of being protected from consequentialism. One wants to hear in what inviolability consists, in more detail, so that we can understand it independently of the negation of consequentialism. And there is also an opposite problem: if inviolability is a good, then why can't consequentialism take it into account? Hence, one also wants to hear why this would not be the case. (shrink)

Martha Nussbaum has powerfully argued in Frontiers ofJustice and elsewhere that John Rawls’s sort of social-contract theory cannot usefully be deployed to deal with issues pertaining to justice for the disabled. To counter this claim, this article deploys Rawls’s sort of social-contract theory in order to deal with issues pertaining to justice for the disabled—or, since, as Nussbaum stresses, we all have some degree of disability—for the severely disabled. In this way, rather than questioning one by one Nussbaum’s interpretive claims (...) about Rawls’s view, one can simply see how the Rawlsian framework can work in application to this issue. Following Rawls’s lead, the paper utilizes the idealized “initial choice situation” as an analytic and comparative device for examining alternative principles of justice, developing three different interpretations of the initial choice situation that each correspond to a different set of principles that apply to people of all levels of disability. One of these sets of principles is a simple extension of Rawls’s, one is very close to what Nussbaum herself recommends, and the third is a kind of hybrid. In this way, it is shown not only that Rawls’s social-contract device can usefully be applied to these issues, but also that it is helpful for exploring the deep commitments underlying each of these competing sets of principles. (shrink)

Sittlichkeit seduces: Hegel’s third category of Right, intended to synthesize impartially derived rights with a subjectively centered morality of the good, understandably piques the hopes of his modern readers. How could it not? Sittlichkeit, Ethical Life, holds out the prospect of so much that we still seek. It promises to reconcile welfare and autonomy while guaranteeing concrete content for their product. By combining legal duty with a place for conscience and freedom, it could solve a central problem of politics. Most (...) broadly, Sittlichkeit would graft Enlightenment individualism onto a more Aristotelian conception of social order, merging the benefits of ancient virtue and modern liberty. Who would not want to have their cake and eat it in this way? (shrink)

I am grateful to Professor Wheatley for his note, [3], on my analysis of interrogatives, [1]. His comments bring out very clearly a number of considerations that deserve our closest attention. For example, he shows that if we can classify interrogatives as true and false—as I proposed to do—then we can properly inquire about what sentences contradict them, and what sentences are contingently or logically equivalent to them. Furthermore, he shows that, on my analysis, no indirect question can contradict any (...) other indirect question and he accordingly, and correctly, looks for such contradictories among declarative sentences. Finally, he notes, [3], p. 54, that in my article, I have treated only inquisitive questions and have said nothing about deliberative or practical questions. While practical questions demand a different kind of treatment than that which Wheatley speculatively, albeit very tentatively, extrapolates for me, still these questions do form a kind of interrogative that did not get any attention in my article. (shrink)