This is the first textbook of surgical ethics. It is a practical, clinically comprehenive, well-organized guide to ethical issues in surgical practice, research, and education written by leading figures in surgery and bioethics. The authors cover the surgeon-patient relationship, the full range of surgical patients, surgical education and research, and surgery and managed care. Their chapters are not abstract discussions of ethical principles; rather, they connect directly with the everyday concerns of practicing surgeons.

Moral psychology studies the features of cognition, judgement, perception and emotion that make human beings capable of moral action. Perspectives from feminist and race theory immensely enrich moral psychology. Writers who take these perspectives ask questions about mind, feeling, and action in contexts of social difference and unequal power and opportunity. These essays by a distinguished international cast of philosophers explore moral psychology as it connects to social life, scientific studies, and literature.

Following Jacques Hadamard, applied mathematicians typically investigate their models in the form of well-set problems, which actually consist of a family of applicational circumstances that vary in specific ways with respect to their initial and boundary values. The chief motive for investigating models in this wider manner is to avoid the improper behavioral conclusions one might reach from the consideration of a more restricted range of cases. Suitable specifications of the required initial and boundary variability typically appeal to previously established (...) experimental conclusions as to how the target system will behave under a range of eternally applied manipulations of the form “If the conditions pertaining to S were altered in manner M, internal features X would/would not alter”. In his investigations of causal reasoning within other parts of science, our first author has emphasized the conceptual importance of counterfactuals of this nature, for which he was been often criticized by authors of a self-styled “metaphysical” inclination. The purpose of this note is to argue, pace these objections, that closely analogous considerations have long been part of the practice of investigating differential equation models in a sensible way. (shrink)

Just health: meeting health needs fairly is an ambitious book, in which Norman Daniels attempts to bring together in a single framework all his work on health and justice from the past 25 years. One major aim is to reconcile his earlier work on the special moral importance of healthcare with his later work on the social determinants of health. In his earlier work, Daniels argued that healthcare is of special moral importance because it protects opportunity. In this later work, (...) Daniels argues that the social determinants of health (which in fact tend to have a larger effect on health outcomes than healthcare does) should also be considered special. This paper argues that it is a mistake to base a theory of justice for health on the claim that health (or the social determinants of health) are "special", for three reasons. First, once we realise that health is to a large part socially determined by features such as distribution of income, which are also of independent importance for justice, we cannot talk about a theory of justice for health in isolation from an overall theory of justice. Second, when we are trying to work out the place of health in a general theory of justice, being told that health (or the social determinants of health) is special is unhelpful. The relevant starting point should rather be whether health matters in a fundamental way for justice, or whether it matters merely for the effects it has on those goods which are of fundamental importance for justice. Third, treating the social determinants of health as special would in fact be counterproductive in terms of the broad approach to justice Daniels favours. (shrink)

The objective of the present text is to develop a reflection about the value of human life in today’s society bringing into focus the contrasting perspectives of the ordinary and the extraordinary of life. For that purpose, we emphasize the conception of the Catholic Church from the Second Vatican Council that suggests an attitude of a Pilgrim Church which longs for dialogue with human beings in their ordinary life (we intend to rescue the positive sense of the term "ordinary"), in (...) disadvantage of the triumphalist vision which gives priority to the great deeds of history. In that sense, we establish a dialogue with the literal work Crime and Punishment (1866) by Fyodor Dostoyevsky whose protagonist Raskolnikov reveals himself through the contemporary dilemma between being and not being extraordinary in the eyes of the society. His moral conscience is tested after a crime he committed. The apex of this revelation takes place after the reading of the Gospel relating to the resurrection of Lazarus shared with Sonia, a flagrant sinner, an ordinary in the eyes of the society represented in the work. In fact, how it happens in the painful passage of Raskolnikov, God makes himself known through the other in borderline situations and we take him into account through the experience which a man of faith realizes when discovering Him to be present. The presence of God in the world is surely not to be understood in the sphere of the extraordinary, what matters is the experience of refuge when we are seduced by the faith. (shrink)

Historian James H. Jones published the first edition of Bad Blood, the definitive history of the Tuskegee Syphilis Experiment, in 1981. Its clear-eyed examination of that research and its implications remains a bioethics classic, and the 30-year anniversary of its publication served as the impetus for the reexamination of research ethics that this symposium presents. Recent revelations about the United States Public Health Service study that infected mental patients and prisoners in Guatemala with syphilis in the late 1940s (...) in order to determine the efficacy of treatment represent only one of the many attestations to the persistence of ongoing, critical, and underaddressed issues in research ethics that Bad Blood first explored. Those issues include, but are not limited to: the complex and contested matters of the value of a given research question, the validity of the clinical trial designed to address it, and the priorities of science. (shrink)

This work argues that philosophy is not just useful, but vital, for thinking coherently about priorities in health policy and public policy.

Comprehensive Biomedical Research Centre and Centre for Philosophy, Justice and Health, UCL, First Floor, Charles Bell House, 67–73 Riding House Street, London W1W 7EJ, UK. Tel.: +44 (0)20 7679 9417; Fax: +44 (0)20 7679 9426; Email: james-gs.wilson{at}ucl.ac.uk ' + u + '@' + d + ' '//--> . Abstract This paper aims to shed some light on the difficulties we face in constructing a generally acceptable normative framework for thinking about public health. It argues that there are three (...) factors that combine to make theorising about public health difficult, and which when taken together defeat simplistic top-down and bottom-up approaches to the design of public health policies. The first factor is the problem of complex systems, namely that the distribution of health both affects and is affected by the distribution of other goods. The second is the difficulty of defining the goals of public health: we still need to get clear about what we should mean by health in this context, and what the goals of public health should be. The third is that we stand in need of an account of how important health is relative to the importance of other goods that a just society should be trying to secure for its citizens. The paper argues that these problems should lead us to abandon the search for a ‘one-size fits all’ normative framework for thinking about public health. Rather, different approaches will be appropriate at different levels of abstraction. CiteULike Connotea Del.icio.us What's this? (shrink)

The infant mortality rate in Liberia is 50 times higher than it is in Sweden, whilst a child born in Japan has a life expectancy at birth of more than double that of one born in Zambia. 1 And within countries, we see differences which are nearly as great. For example, if you were in the USA and travelled the short journey from the poorer parts of Washington to Montgomery County Maryland, you would find that ‘for each mile travelled life (...) expectancy rises about a year and a half. There is a twenty-year gap between poor blacks at one end of the journey and rich whites at the other’. (Marmot, 2004, p.2). There are two types of questions which it is important to ask about inequalities in health such as these. The first are social scientific questions about the extent of inequalities in health and the factors which are causally responsible for these inequalities. Examples of social scientific questions to ask might be: how do infant mortality rates in the UK differ according to social class? What is the difference in life expectancy between Japanese who emigrate to the US and those who remain in Japan? Why do civil servants in higher ranked jobs tend to live longer than civil servants in lower ranked jobs? The second type are normative questions about the reasons we have to care about inequalities in health. Important normative questions to answer are: which inequalities in health should we care about (all inequalities or merely some of them)? When is an inequality in health unjust? How should we weigh our concern for equality in health against other factors such as maximising the.. (shrink)

Equal Justice: Fair Legal Systems in an Unfair World, by Wilmot-SmithFrederick. Cambridge, MA: Harvard University Press, 2019. Pp. 256.

Democracy establishes relationships of political equality, ones in which citizens equally share authority over what they do together and respect one another as equals. But in today's divided public square, democracy is challenged by political thinkers who disagree about how democratic institutions should be organized, and by antidemocratic politicians who exploit uncertainties about what democracy requires and why it matters. Democratic Equality mounts a bold and persuasive defense of democracy as a way of making collective decisions, showing how equality of (...) authority is essential to relating equally as citizens. James Lindley Wilson explains why the US Senate and Electoral College are urgently in need of reform, why proportional representation is not a universal requirement of democracy, how to identify racial vote dilution and gerrymandering in electoral districting, how to respond to threats to democracy posed by wealth inequality, and how judicial review could be more compatible with the democratic ideal. What emerges is an emphatic call to action to reinvigorate our ailing democracies, and a road map for widespread institutional reform. Democratic Equality highlights the importance of diverse forms of authority in democratic deliberation and electoral and representative processes—and demonstrates how that authority rests equally with each citizen in a democracy. (shrink)

The research project described in this report represents one of the most extensive studies of character education ever undertaken, including over 10,000 students and 255 teachers in schools across England, Scotland, Northern Ireland and Wales. Research techniques consisted of a mixture of surveys, moral dilemmas and semi-structured interviews. This report explores: - The current situation in character education, both in the UK and internationally - How developed British students are with respect to moral character and the extent to which they (...) are able to understand and apply moral virtues, especially those aged 14 and 15 - How teachers in the UK understand their role in terms of students’ moral and character development - What helps or hinders the development of children’s characters according to teachers in UK schools. (shrink)

Book reviewed in this article: On Human Nature. By Edward O. Wilson.

Resnik’s argument relies upon an undefended and unjustified overvaluation of liberty. First, he overlooks some important arguments in favour of restrictions to liberty, and his consideration of the two he does review is unfair; second his account grossly overestimates the autonomy of our food choices; and lastly his mechanism for balancing liberty against other concerns involves an illicit double counting of the weight of individual liberty.

When we talk about intellectual property, it is often implicitly assumed that we are talking about private intellectual property. However, private property and the idea of private ownership do not exhaust the possibilities for accounts of ownership and of property. There are other ways that ownership can operate, such as common property. A resource is common property if its use is ‘governed by rules whose point is to make them available for use by all or any members of the society.’.

The "New Atheist" movement of recent years has put the science-versus-religion controversy back on the popular cultural agenda. Anti-religious polemicists are convinced that the application of the new sciences of the mind to religious belief gives them the final weapons in their battle against irrationality and superstition. What used to be a trickle of research papers scattered in specialized scientific journals has now become a torrent of books, articles, and commentary in the popular media pressing the case that the cognitive (...) science of religion can finally fulfill the enlightenment dream of shrinking religion into insignificance, if not eliminating it altogether. James W. Jones argues that these claims are demonstrably false. He notes that cognitive science research is religiously neutral; it can be deployed in many different ways in relation to the actual belief in and practice of religion: to undermine it, to simply study it, and to support it. These different approaches, Jones suggests, reflect the background assumptions and viewpoints brought to the interpretation of the data. The goal of this book is not to defend either a general religious outlook or a particular religious tradition, but to make the case that while there is much to learn from the cognitive scientific study of religion, attempts to use it to "explain" religion are exaggerated and misguided. Drawing on scientific research and logical argument Can Science Explain Religion? directly confronts the claims of these debunkers of religion, providing an accessibly written, persuasive account of why they are not convincing. (shrink)

The pandemic significantly raised the stakes for the translation of bioethics insights into policy. The novelty, range and sheer quantity of the ethical problems that needed to be addressed urgently within public policy were unprecedented and required high‐bandwidth two‐way transfer of insights between academic bioethics and policy. Countries such as the United Kingdom, which do not have a National Ethics Committee, faced particular challenges in how to facilitate this. This paper takes as a case study the brief career of the (...) Ethics Advisory Board (EAB) for the NHS Covid‐19 App, which shows both the difficulty and the political complexity of policy‐relevant bioethics in a pandemic and how this was exacerbated by the transience and informality of the structures through which ethics advice was delivered. It analyses how and why, after EAB's demise, the Westminster government increasingly sought to either take its ethics advice in private or to evade ethical scrutiny of its policies altogether. In reflecting on EAB, and these later ethics advice contexts, the article provides a novel framework for analysing ethics advice within democracies, defining four idealised stances: the pure ethicist, the advocate, the ethics arbiter and the critical friend. (shrink)

Although Leibniz characterised himself in the “New Essays” as a “Platonic” as opposed to a “Democritean” philosopher, his intellectual relationship with the most famous of the Renaissance Neoplatonists, Marsilio Ficino, has received little attention. Here we review what can be thus far established regarding Leibniz’s acquaintance with portions of Ficino’s Opera omnia of 1576. We compare Ficino’s disenchantment with the atomistic materialism of Lucretius, which he had favoured in his youth, and his turn to Platonism for inspiration, with Leibniz’s own (...) reported disenchantment with Gassendi’s Epicurean atomism and his invention of a vitalistic monadology that, despite Leibniz’s reservations regarding Ficinian magic, resembles Ficinian nature philosophy in number of striking respects. (shrink)

There is a need to better understand how individuals in different religious groups construct and maintain their worldviews. This study explores how religious practices, beliefs, and relationships create and sustain the worldviews of five British Muslims. Semi-structured interviews were inductively analyzed using interpretative phenomenological analysis (IPA) to idiographically explore the participants’ lived experiences. This analysis developed multiple subordinate themes that formed two superordinate themes: “Submitting to Allah” and “Being a British Muslim.” The participants’ experiences of being raised in Muslim families (...) strongly shaped their beliefs and they each strongly identify themselves as both Muslim and British. These important relationships taught them to follow the teachings of the Qur’an and to live their lives in submission to God. The analysis suggests the belief that the Qur’an is the authoritative and enduring revelation of God to mankind provided the core of their worldview and that this belief had far-reaching implications for every aspect of their lives. Their social relationships and religious practices both continually affirmed this fundamental belief in their sacred text and created a social reality in which the participants experienced God and submitted to the will of Allah. The combination of many different religious practices, social relationships, and personal experiences imbued the Qur’an with the power and authority to shape the participants’ lives and sustained their religious community. The participants’ intratextually fundamentalist approach to the Qur’an helped them create coherent worldviews that were filled with meaning and purpose. (shrink)

Philosophy & Public Affairs, Volume 50, Issue 2, Page 169-201, Spring 2022.

This collection of essays focuses on the concepts of tolerance and intolerance as it commemorates the life of James Parkes - the man who pioneered the study of antisemitism and Jewish-non-Jewish relations. The essays analyse many different examples of antisemitism, ambivalence and philosemitism.

In this chapter we argue that the four principles of medical ethics -- beneficence, non-maleficence, respect for autonomy and justice (Beauchamp & Childress, 2001; Gillon, 1985), a new Family Interest Principle (introduced below) and a consideration of ‘capacity’ provide a reasoned practice guide for work with mothers experiencing health problems, focussing here on mental health when a parent is a patient. Our concern is the relationship of the clinician with a parent and through the parent their child. Ethics of service (...) provision or services planning (e.g. Culyer, 2001; McLachlan, 2005; see also Newbigging and Paul, chapter xxx), or the provision of other services (e.g. education, child protection) although intensely relevant to this area are not addressed in this chapter nor will we deal with the complex aspects of medical ethics relating to the treatment of children (Baines, 2008). We use the term ‘parent’ to refer to any adult person who fulfils a substantive parental role with a child. Defining what counts as a family will in certain circumstances be contentious. There are diverse patterns of family arrangements that may be influenced by cultural, political economic and temporal factors. For the purposes of our discussion, we define a family in terms of its role in childrearing, as a group of at least one adult and at least one child, living together in long term relationships on an ongoing basis with vested interest in the well being of each of the family members. (shrink)

In The Market Experience, Robert Lane restates the central criticism of economic views of human satisfaction?namely, that they define welfare as utility and, in practice if not in theory, use money as the measure of utility, while in reality utility (or welfare) ought to be defined as happiness. In exploring the implications of this noneconomic definition for our assessment of markets, Lane summarizes the evidence about how people assess their own happiness more successfully than he clarifies the meaning of that (...) word. Since increases in income above a certain minimum do not increase happiness, work must be made more meaningful. (shrink)

This paper reflects on the relationship between theory and practice in bioethics, by using various concepts drawn from debates on innovation in healthcare research—in particular debates around how best to connect up blue skies ‘basic’ research with practical innovations that can improve human lives. It argues that it is a mistake to assume that the most difficult and important questions in bioethics are the most abstract ones, and also a mistake to assume that getting clear about abstract cases will automatically (...) be of much help in getting clear about more complex cases. It replaces this implicitly linear model with a more complex one that draws on the idea of translational research in healthcare. On the translational model, there is a continuum of cases from the most simple and abstract to the most concrete and complex. Insights need to travel in both directions along this continuum—from the more abstract to the more concrete and from the more concrete to the more abstract. The paper maps out some difficulties in moving from simpler to more complex cases, and in doing so makes recommendations about the future of bioethics. (shrink)

Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that research should be treated as a (...) special case. First, research typically involves the imposition of risk on people who do not benefit from this risk imposition. Second, research depends on public trust. Third, the complexity of the moral decision making required favors ethics committees as a regulative solution for research. (shrink)

Ours is an age full of desires but impoverished in its understanding of where those desires lead—an age that claims mastery over the world but also claims to find the world as a whole absurd or unintelligible. In The Vision of the Soul, James Matthew Wilson seeks to conserve the great insights of the western tradition by giving us a new account of them responsive to modern discontents. The western— or Christian Platonist—tradition, he argues, tells us that man (...) is an intellectual animal, born to pursue the good, to know the true, and to contemplate all things in beauty. Wilson begins by reconceiving the intellectual conservatism born of Edmund Burke’s jeremiad against the French Revolution as an effort to preserve the West’s vision of man and the cosmos as ordered by and to beauty. After defining the achievement of that vision and its tradition, Wilson offers an extended study of the nature of beauty and the role of the fine arts in shaping a culture but above all in opening the human intellect to the perception of the form of reality. Through close studies of Theodor W. Adorno and Jacques Maritain, he recovers the classical vision of beauty as a revelation of truth and being. Finally, he revisits the ancient distinction between reason and story-telling, between mythos and logos, in order to rejoin the two. Story-telling is foundational to the forms of the fine arts, but it is no less foundational to human reason. Human life in turn constitutes a specific kind of form—a story form. The ancient conception of human life as a pilgrimage to beauty itself is one that we can fully embrace only if we see the essential correlation between reason and story and the essential convertibility of truth, goodness and beauty in beauty. By turns a study in fundamental ontology, aesthetics, and political philosophy, Wilson’s book invites its readers to a renewal of the West’s intellectual tradition. (shrink)

Geographic definitions of constituency—the set of voters eligible to vote for a representative—have been criticized by theorists and reformers as undermining democratic values. I argue, in response, that there is no categorical (or even generally applicable) reason sounding in political equality to reject geographic districts. Geographic districting systems are typically flexible enough that, when properly designed, and matched with an appropriate electoral system, they can satisfy the requirements of political equality. More generally, I argue that it is a mistake to (...) evaluate the egalitarian character of constituency definitions in isolation from the political decision-making process as a whole. While it is conceptually important that we can detach constituency definition from other features of electoral systems, when it comes to normative and evaluative judgment, we ought to judge holistically. When we do so, we will rarely find general reasons to prefer one type of constituency definition to another. Geographic districts may offer benefits of logistical convenience and information circulation, even given the existence of advanced information technology. The best reason to reject geographic districts is their liability to anti-democratic abuse. Their defensibility in any given polity thus depends on how feasible it is to protect against such abuses while retaining a geographic districting system. (shrink)