A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to.

The Association of American Medical Colleges (AAMC) is urging academic medical centers to ban pharmaceutical detailing. This policy followed from a consideration of behavioral and neuroeconomics research. I argue that this research did not warrant the conclusions drawn from it. Pharmaceutical detailing carries risks of cognitive error for physicians, as do other forms of information exchange. Physicians may overcome such risks; those determined to do so may ethically engage in pharmaceutical detailing. Whether or not they should do so is a (...) prudential judgment about which reasonable people may disagree. The AAMC's ethical condemnation of detailing is unwarranted and will subvert efforts to maintain a realm of physician discretion in clinical work that is increasingly threatened in our present practice environment. (shrink)

Contemporary accounts of medical ethics and professionalism emphasize the importance of social justice as an ideal for physicians. This ideal is often specified as a commitment to attaining the universal availability of some level of health care, if not of other elements of a “decent minimum” standard of living. I observe that physicians, in general, have not accepted the importance of social justice for professional ethics, and I further argue that social justice does not belong among professional norms. Social justice (...) is a norm of civic rather than professional life; professional groups may demand that their members conform to the requirements of citizenship but ought not to require civic virtues such as social justice. Nor should any such requirements foreclose reasonable disagreement as to the content of civic norms, as requiring adherence to common specifications of social justice would do. Demands for any given form of social justice among physicians are unlikely to bear fruit as medical education is powerless to produce this virtue. (shrink)

Medical academics are increasingly bringing critical race theory (CRT) or its corollaries to their discourse, to their curricula, and to their analyses of health and medical treatment disparities. The author argues that this is an error. The author considers the history of CRT, its claims, and its current presence in the medical literature. He contends that CRT is inimical to usual academic modes of inquiry and has obscured rather than aided the analysis of social and medical treatment disparities. Remedies for (...) racism suggested by CRT advocates will not work and some of them will make things worse. Academic medicine should avoid the embrace of CRT and should maintain an allegiance to rigorous empirical inquiry and to treating patients not as essentialized ethnic group members but as individual human beings in need of care. (shrink)

The dispute over professional conscientious objection presumes a picture of medicine as a practice governed by rules. This rule-based conception of medical practice is identifiable with John Rawls’s conception of social practices. This conception does not capture the character of medical practice as experienced by practitioners, for whom it is a sensibility or “form of life” rather than rules. Moreover, the sensibility of medical practice as experienced by physicians is at best neutral, and at worst hostile, to the demands of (...) those who would override physician conscientious objection to the provision of currently contested services. That being so, calls for overriding physician conscientious objection are much more demanding of the medical profession than they appear in light of Rawls’s view. As such overriding may entail the forcible transformation of medicine’s form of life, the author contends that it would be more prudent to provide contested services by circumventing the medical profession than by compelling it. (shrink)

Opponents of physician-assisted suicide (PAS) maintain that physician withdrawal-of-life-sustaining-treatment cannot be morally equated to voluntary active euthanasia. PAS opponents generally distinguish these two kinds of act by positing a possible moral distinction between killing and allowing-to-die, ceteris paribus. While that distinction continues to be widely accepted in the public discourse, it has been more controversial among philosophers. Some ethicist PAS advocates are so certain that the distinction is invalid that they describe PAS opponents who hold to the distinction as in (...) the grip of ‘moral fictions’. The author contends that such a diagnosis is too hasty. The possibility of a moral distinction between active euthanasia and allowing-to-die has not been closed off by the argumentative strategies employed by these PAS advocates, including the contrasting cases strategy and the assimilation of doing and allowing to a common sense notion of causation. The philosophical debate over the doing/allowing distinction remains inconclusive, but physicians and others who rely upon that distinction in thinking about the ethics of end-of-life care need not give up on it in response to these arguments. (shrink)

Medical work is increasingly being subjected to objective assessment as those who pay for it seek to grasp the quality of that work and how best to improve it. While objective measures have a role in the assessment of health care, I argue that this role is currently overestimated and that no human practice such as medicine can be fully comprehended by objective assessment. I suggest that the character of practices, in which formalizations are combined with judgment, requires that valid (...) assessment involve the perspective of the skilled practitioner. Relying exclusively on objective measures in assessing health care will not only distort our assessments of it but lead to damage as the incentives of health care workers are directed away from the important aspects of their work that are not captured by objective measures. (shrink)

In spite of ethical analyses assimilating the palliative deactivation of pacemakers to commonly accepted withdrawings of life-sustaining therapy, many clinicians remain ethically uncomfortable with pacemaker deactivation at the end of life. Various reasons have been posited for this discomfort. Some cardiologists have suggested that reluctance to deactivate pacemakers may stem from a sense that the pacemaker has become part of the patient’s “self.” The authors suggest that Daniel Sulmasy is correct to contend that any such identification of the pacemaker is (...) misguided. The authors argue that clinicians uncomfortable with pacemaker deactivation are nevertheless correct to see it as incompatible with the traditional medical ethics of withdrawal of support. Traditional medical ethics is presently taken by many to sanction pacemaker deactivation when such deactivation honors the patient’s right to refuse treatment. The authors suggest that the right to refuse treatment applies to treatments involving ongoing physician agency. This right cannot underwrite patient demands that physicians reverse the effects of treatments previously administered, in which ongoing physician agency is no longer implicated. The permanently indwelling pacemaker is best seen as such a treatment. As such, its deactivation in the pacemaker-dependent patient is best seen not as withdrawal of support but as active ending of life. That being the case, clinicians adhering to the usual ethical analysis of withdrawal of support are correct to be uncomfortable with pacemaker deactivation at the end of life. (shrink)

(2010). Response to Open Peer Commentaries on “The Pitfalls of Deducing Ethics from Economics: Why the Association of American Medical Colleges is Wrong About Pharmaceutical Detailing”. The American Journal of Bioethics: Vol. 10, No. 1, pp. W1-W3.

Suggestions that academic medicine is systemically racist are increasingly common in the medical literature. Such suggestions often rely upon expansive notions of systemic racism that are deeply controversial. The author argues for an empirical concept of systemic racism and offers a counter argument to a recent suggestion that academic medicine is systemically racist in its treatment of medical trainees: Anderson et al.’s (Academic Medicine, 98(8S), S28–S36, 2023) “The Long Shadow: a Historical Perspective on Racism in Medical Education.” Contra the authors (...) of “The Long Shadow,” the author argues that racial performance disparities in medical education cannot be validly attributed to racism without careful empirical confirmation; he further argues that standards of assessment in medical education cannot be properly deemed racist merely because minority trainees are disproportionately disadvantaged by them. Furthermore, the history of medicine and society in the Anglo-European West is not, as argued by the authors of “The Long Shadow,” best viewed as one long tale of racial oppression culminating in the present day pervasive racism of academic medicine in the United States. Racism is a deplorable stain on our history and our present but it is not the historical essence of Christianity, European civilization, Western medicine, or contemporary academic medical institutions. (shrink)

Since patient autonomy became a prominent theme in medical ethics in the 1970s and 1980s, it has had a troubled reputation among many physicians, to whom claims for its importance in medical decision making seem unrealistic and even undesirable. Of course the discussion has moved on since the early days in which informative or interpretive models of medical decision-making—in which physicians provided information and helped patients clarify and express preferences that then determined decisions—were contrasted with usual medical practice characterized as (...) paternalism: physicians telling patients what to do and patients acquiescing in physician direction. The... (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 15-17, March 2012.

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The 14 chapters in Ethics at the End of Life: New Issues and Arguments, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters--written (...) by a team of experts--survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

May lethal autonomous weapons systems—‘killer robots ’—be used in war? The majority of writers argue against their use, and those who have argued in favour have done so on a consequentialist basis. We defend the moral permissibility of killer robots, but on the basis of the non-aggregative structure of right assumed by Just War theory. This is necessary because the most important argument against killer robots, the responsibility trilemma proposed by Rob Sparrow, makes the same assumptions. We show that the (...) crucial moral question is not one of responsibility. Rather, it is whether the technology can satisfy the requirements of fairness in the re-distribution of risk. Not only is this possible in principle, but some killer robots will actually satisfy these requirements. An implication of our argument is that there is a public responsibility to regulate killer robots ’ design and manufacture. (shrink)

In this paper, I explore the question of whether the expected consequences of holding a belief can affect the rationality of doing so. Special attention is given to various ways in which one might attempt to exert some measure of control over what one believes and the normative status of the beliefs that result from the successful execution of such projects. I argue that the lessons which emerge from thinking about the case ofbelief have important implications for the way we (...) should think about the rationality of a number of other propositional attitudes,such as regret, desire, and fear. Finally,I suggest that a lack of clarity with respect to the relevant issues has given rise to a number of rather serious philosophical mistakes. (shrink)

In this paper, I explore the question of whether the expectedconsequences of holding a belief can affect the rationality ofdoing so. Special attention is given to various ways in whichone might attempt to exert some measure of control over whatone believes and the normative status of the beliefs thatresult from the successful execution of such projects. I arguethat the lessons which emerge from thinking about the case ofbelief have important implications for the way we should thinkabout the rationality of a (...) number of other propositional attitudes,such as regret, desire, and fear. Finally,I suggest that a lack of clarity with respect to the relevant issueshas given rise to a number of rather serious philosophical mistakes. (shrink)

Today there is a thriving 'emotions industry' to which philosophers, psychologists and neuroscientists are contributing. Yet until two centuries ago 'the emotions' did not exist. In this path-breaking study Thomas Dixon shows how, during the nineteenth century, the emotions came into being as a distinct psychological category, replacing existing categories such as appetites, passions, sentiments and affections. By examining medieval and eighteenth-century theological psychologies and placing Charles Darwin and William James within a broader and more complex nineteenth-century setting, (...) class='Hi'>Thomas Dixon argues that this domination by one single descriptive category is not healthy. Overinclusivity of 'the emotions' hampers attempts to argue with any subtlety about the enormous range of mental states and stances of which humans are capable. This book is an important contribution to the debate about emotion and rationality which has preoccupied western thinkers throughout the eighteenth and nineteenth centuries and has implications for contemporary debates. (shrink)

Intuitions based on the first-person perspective can easily mislead us about what is and is not conceivable.1 This point is usually made in support of familiar reductionist positions on the mind-body problem, but I believe it can be detached from that approach. It seems to me that the powerful appearance of contingency in the relation between the functioning of the physical organism and the conscious mind -- an appearance that depends directly or indirectly on the first- person perspective -- must (...) be an illusion. But the denial of this contingency should not take the form of a reductionist account of consciousness of the usual type, whereby the logical gap between the mental and the physical is closed by conceptual analysis -- in effect, by analyzing the mental in terms of the physical. (shrink)

Thomas Hobbes (1588-1679) was an English philosopher, remembered today for his work on political philosophy. His 1651 book Leviathan established the foundation for most of Western political philosophy from the perspective of social contract theory. He also contributed to a diverse array of fields, including history, geometry, physics of gases, theology, ethics, general philosophy, and political science. He was one of the main philosophers who founded materialism. He visited Florence in 1636 and later was a regular debater in philosophic (...) groups in Paris, held together by Marin Mersenne. Hobbes's first area of study was an interest in the physical doctrine of motion and physical momentum. Despite his interest in this phenomenon, he disdained experimental work as in physics. He built a good reputation in philosophic circles and in 1645, he was chosen with Descartes, Gilles de Roberval and others, to referee the controversy between John Pell and Longomontanus over the problem of squaring the circle. His other works include: The Elements of Law Natural and Politic (1640) and De Cive (The Citizen): Philosophical Rudiments Concerning Government and Society (1651). (shrink)

Thomas Wheatland examines the influence of the Frankfurt School, or Horkheimer Circle, and how they influenced American social thought and postwar German sociology.

DIVBased on a series of lectures delivered in 1840, Thomas Carlyle’s On Heroes, Hero-Worship, and the Heroic in History considers the creation of heroes and the ways they exert heroic leadership. From the divine and prophetic to the poetic to the religious to the political, Carlyle investigates the mysterious qualities that elevate humans to cultural significance. By situating the text in the context of six essays by distinguished scholars that reevaluate both Carlyle’s work and his ideas, David Sorensen and (...) Brent Kinser argue that Carlyle's concept of heroism stresses the hero’s spiritual dimension. In Carlyle’s engagement with various heroic personalities, he dislodges religiosity from religion, myth from history, and truth from “quackery” as he describes the wondrous ways in which these “flowing light-fountains” unlock the heroic potential of ordinary human beings. /div. (shrink)

According to the analysis of intentional action that Michael Bratman has dubbed the 'Simple View', intending to x is necessary for intentionally x-ing. Despite the plausibility of this view, there is gathering empirical evidence that when people are presented with cases involving moral considerations, they are much more likely to judge that the action (or side effect) in question was brought about intentionally than they are to judge that the agent intended to do it. This suggests that at least as (...) far as the ordinary concept of intentional action is concerned, an agent need not intend to x in order to x intentionally. (shrink)

According to the analysis of intentional action that Michael Bratman has dubbed the ‘Simple View’, intending toxis necessary for intentionallyx‐ing. Despite the plausibility of this view, there is gathering empirical evidence that when people are presented with cases involving moral considerations, they are much more likely to judge that the action (or side effect) in question was brought about intentionally than they are to judge that the agent intended to do it. This suggests that at least as far as the (...) ordinary concept of intentional action is concerned, an agent need not intend toxin order toxintentionally. (shrink)

This book presents a radical and intuitive argument against the notion that intentional action, agency and autonomy are features belonging only to humans. Using evidence from research into the minds of non-human animals, it explores the ways in which animals can be understood as individuals who are aware of themselves, and the consequent basis of our moral obligations towards them. The first part of this book argues for a conception of agency in animals that admits to degrees among individuals and (...) across species. It explores self-awareness and its various levels of complexity which depend on an animals’ other mental capacities. The author offers an overview of some established theories in animal ethics including those of Peter Singer, Tom Regan, Bernard Rollin and Lori Gruen, and the ways these theories serve to extend moral consideration towards animals based on various capacities that both animals and humans have in common. The book concludes by challenging traditional Kantian notions of rationality and what it means to be an autonomous individual, and discussing the problems that still remain in the study of animal ethics. (shrink)

Albert Einstein was the most influential physicist of the twentieth century. Less well-known is that fundamental philosophical problems, such as concept formation, the role of epistemology in developing and explaining the character of physical theories, and the debate between positivism and realism, played a central role in his thought as a whole. Thomas Ryckman shows that already at the beginning of his career, at a time when the twin pillars of classical physics, Newtonian mechanics and Maxwell’s electromagnetism, were known (...) to have but limited validity, Einstein sought to advance physical theory by positing certain physical principles as secure footholds. That philosophy produced his greatest triumph, the general theory of relativity, and his greatest failure, an unwillingness to accept quantum mechanics. This book shows that Einstein’s philosophy grew from a lifelong aspiration for a unified theoretical representation encompassing all physical phenomena. It also considers how Einstein’s theories of relativity and criticisms of quantum theory have shaped the course of twentieth-century philosophy of science. Including a chronology, glossary, chapter summaries, and suggestions for further reading, _Einstein_ is an ideal introduction to this iconic figure in twentieth-century science and philosophy. It is essential reading for students of philosophy of science, and also suitable for those working in related areas such as physics, history of science, or intellectual history. (shrink)

Thomas Williams presents the most extensive collection of John Duns Scotus's work on ethics and moral psychology available in English. This accessible and philosophically informed translation includes extended discussions on divine and human freedom, the moral attributes of God, and the relationship between will and intellect.

Evolution and ethics. Prolegomena (1894).--Evolution and ethics (1893).--Science and morals (1886).--Capital, the mother of labour (1890).--Social diseases and worse remedies (1891): Preface. The struggle for existence in human society. Letters to the Times. Legal opinions. The articles of war of the Salvation Army.

Though it enjoys widespread support, the claim that perceptual experiences possess nonconceptual content has been vigorously disputed in the recent literature by those who argue that the content of perceptual experience must be conceptual content. Nonconceptualism and conceptualism are often assumed to be well-defined theoretical approaches that each constitute unitary claims about the contents of experience. In this paper I try to show that this implicit assumption is mistaken, and what consequences this has for the debate about perceptual experience. I (...) distinguish between two different ways that nonconceptualist proposals about perceptual content can be understood: as claims about the constituents that compose perceptual contents or as claims about whether a subject’s undergoing experiences with those contents requires them to possess the concepts that characterize those contents. I maintain that these ways of understanding conceptualism and nonconceptualism are orthogonal to one another. This is revealed by the conceptual coherence of positions in which the contents of experiences have both conceptual and nonconceptual features; positions which possess their own distinctive sources of philosophical motivation. I argue that the fact that there is a place in conceptual space for such positions, and that there may be good reason for theorists to adopt them, creates difficulties for both the central argument for nonconceptualism and the central argument for conceptualism. I set out each of these arguments; the Argument from Possession-Independence and the Epistemically-Driven Argument. I then try to show how the existence of mixed positions about perceptual content derived from a clear distinction between compositional and possessional considerations constitutes a significant obstacle for those arguments as they stand. The takehome message of the paper is that unless one clearly acknowledges the distinction between issues about the composition of perceptual content and issues about how subject’s capacities to undergo certain experiences relates to their possession of concepts one runs the risk of embracing unsatisfying philosophical arguments in which conclusions relevant to one conception of nonconceptual and conceptual content are grounded on arguments that concern only the other; arguments that cannot, in themselves, sustain them. (shrink)

Rhetoric is widely regarded by both its detractors and advocates as a kind of antithesis to reason. In this book Thomas B. Farrell restores rhetoric as an art of practical reason and enlightened civic participation, grounding it in its classical tradition—particularly in the rhetoric of Aristotle. And, because prevailing modernist world views bear principal responsibility for the disparagement of rhetorical tradition, Farrell also offers a critique of the dominant currents of modern humanist thought. Farrell argues that rhetoric is not (...) antithetical to reason but is a manner of posing and answering questions that is distinct from the approaches of analytic and dialectical reason. He develops this position in a number of ways: through a series of bold reinterpretations of Aristotle's _Rhetoric_; through a detailed appraisal of traditional rhetorical concepts as seen in modern texts from the Army-McCarthy hearings to Edward Kennedy's memorial for his brother, Mario Cuomo's address on abortion, Betty Friedan's _Feminine Mystique_, and Vaclav Havel's inaugural address; and through a fresh appraisal of theories on the character of language and discourse found in contemporary philosophy, literary criticism, anthropology, deconstructionism, Marxism, and especially in Habermas's critical theory of communicative action. (shrink)

This book analyzes iconic British children's literature through the lens of formal educational theory, policy, and practice. Examining themes like growth mindset and project-based learning alongside educational philosophers like Plato, Rousseau, and Dewey, the author sheds new light on children’s classics from Alice in Wonderland to Harry Potter.