Julian Wuerth offers a radically new interpretation of major themes in Kant's philosophy. He explores Kant's ontology of the mind, his transcendental idealism, his account of the mind's powers, and his theory of action, and goes on to develop an original, moral realist account of Kant's ethics.

Seasonal influenza kills many hundreds of thousands of people every year. We argue that the current pandemic has lessons we should learn concerning how we should respond to it. Our response to the COVID-19 not only provides us with tools for confronting influenza; it also changes our sense of what is possible. The recognition of how dramatic policy responses to COVID-19 were and how widespread their general acceptance has been allowed us to imagine new and more sweeping responses to influenza. (...) In fact, we not only can grasp how we can reduce its toll; this new knowledge entails new responsibilities to do so. We outline a range of potential interventions to alter social norms and to change structures to reduce influenza transmission, and consider ethical objections to our proposals. (shrink)

In 2011 the English Court of Protection ruled that it would be unlawful to withdraw artificial nutrition and hydration from a woman, M, who had been in a minimally conscious state for 8 years. It was reported as the first English legal case concerning withdrawal of artificial nutrition and hydration from a patient in a minimally conscious state who was otherwise stable. In the absence of a valid and applicable advance decision refusing treatment, of other life-limiting pathology or excessively burdensome (...) suffering, the judgement makes it clear that the obligation on health professionals falls strongly in favour of preserving life. Although the Court sought to limit the judgement as closely as possible to the facts of the case, it is likely to have a significant impact on life-sustaining treatment decisions for people in states of low awareness. This paper outlines the main legal features of the judgement. (shrink)

This book will provide a cutting-edge, theoretically innovative, and analytically detailed response to significant developments occurring in the fields of indigenous governance.

In The Gift Relationship, Richard Titmuss argued that the practice of altruistic blood donation fosters social solidarity while markets in blood erode it. This paper considers the implications of this line of argument for the organ market debate. I defend Titmuss’ arguments against a number of criticisms and respond to claims that Titmuss’ work is not relevant to the context of live donor organ transplantation. I conclude that Titmuss’ arguments are more resilient than many advocates of organ markets suggest, and (...) more relevant to the debate than is commonly appreciated. (shrink)

Hughes offers a consequentialist response to our rejection of accommodation of conscientious objection in medicine. We argue here that his compromise proposition has been tried in many jurisdictions and has failed to deliver unimpeded access to care for eligible patients. The compromise position, entailing an accommodation of conscientious objection provided there is unimpeded access, fails to grasp that the objectors are both determined not to provide services they object to as well as to subvert patient access to the objected to (...) services. Unpredictable future developments in drug R&D and resulting treatment and prevention options in medicine make the compromise position unrealistic. (shrink)

The exponential rise in transgender self-identification invites consideration of what constitutes an ethical response to transgender individuals’ claims about how best to promote their well-being. In this paper, we argue that ‘accepting’ a claim to medical transitioning in order to promote well-being would be in the person’s best interests iff at the point of request the individual is correct in their self-diagnosis as transgender (i.e., the distress felt to reside in the body does not result from another psychological and/or societal (...) problem) such that the medical interventions they are seeking will help them to realise their preferences. If we cannot assume this—and we suggest that we have reasonable grounds to question an unqualified acceptance in some cases—then ‘acceptance’ potentially works against best interests. We propose a distinction between ‘acceptance’ and respectful, in-depth exploration of an individual’s claims about what promotes their well-being. We discuss the ethical relevance of the unconscious mind to considerations of autonomy and consent in working with transgender individuals. An inquisitive stance, we suggest, supports autonomous choice about how to realise an embodied form that sustains well-being by allowing the individual to consider both conscious and unconscious factors shaping wishes and values, hence choices. (shrink)

In 2002, I wrote an editorial in this Journal arguing that it was time to review the structure and function of ethics committees in the USA, Australia and the UK.1 This followed the deaths of Ellen Roche and Jesse Gelsinger, which were at least in significant part due to the poor functioning of research ethics committees in the USA.2 In the case of Ellen Roche, it was the failure to require a systematic review of the existing literature which led to (...) her death. Iain Chalmers and I had previously documented in 1996 the failure of ethics committees to require systematic review.3 In 1998, at the time of revising the previous guidelines and forming the first Australian National Statement on Research Ethics, I made a public submission to the Australian Health Ethics Committee arguing that the new guidelines for RECs should include a person with skills in conducting systematic reviews of the literature and that the requirement to have a religious representative on the committee be replaced with the requirement to have an ethicist. Neither of these changes was made. I argued, ‘It is time to ask whether institutional RECs should be abandoned in favour of expert committees that cover many institutions—suprainstitutional specialist committees. Supraregional specialist ethics committees could specialise—for example, in genetic research, cancer clinical trials, dermatology, respiratory physiology and each of the specialist areas of medical research. An example of such a committee is provided by the Thoracic Society of Australia and New Zealand research ethics committee, which reviews multicentre trials of respiratory drugs’.4 Around that time, I was involved ‘at the coal face’ as Chair of the Department of Human Services Ethics Committee in Victoria. In a public presentation, I arguedThere are two philosophical views of what ethics review is. On the …. (shrink)

Context: A central motivation behind various embodied, extended, and enactive (4E) approaches to cognition is to ground our understanding of minds and cognition within the biological structures that give rise to life. Because of this, their advocates often claim a natural kinship with dynamical and developmental systems theories. However, these accounts also explicitly or implicitly privilege individual organisms in ways that contrast with many of the insights of systems and developmental systems approaches to biology. Problem: The prioritization of individual organisms (...) within 4E approaches to cognition contrasts with the default entangled structure of biological systems associated with cognitive agency. We provide means for 4E cognitive science to move beyond an individual-centred view of cognitive agency. Method: We first identify and problematize individual-centredness within various predominant 4E approaches by comparison with biological research and developmental systems theory. Subsequently, we offer conceptual resources from the field of ecological research for understanding cognitive agency beyond the predominant focus on individual organisms. Results: Cognitive agency may be understood without privileging individual organisms by reading nonequilibrium maintenance in terms of a dynamic differentiation instead of individual organismic autonomy. This form of organizational structure corresponds to the notion of sympoiesis from ecological research. Implications: Approaching cognitive agency without privileging individual organisms should be invaluable to advocates of 4E cognition seeking to ground notions of cognition and mind within contemporary biological research. Constructivist content: We seek to expand upon existing constructivist perspectives on the organizing principles of cognitive agency, such as sensorimotor embodiment and autopoiesis, arguing that meta-organismic cognitive agents (including humans) embody distributed relations beyond the privileging of individual organisms. Key words: 4E cognition, autopoiesis, cognitive agency, developmental systems theory, enactivism, extended mind thesis, holobionts, sympoeisis. (shrink)

When we applied for the editorship of the JME 7 years ago, we said that we considered the JME to be the most important journal in medicine. The most profound questions that health professionals face are not scientific or technical, but ethical. Our enormous scientific and medical progress already outstrips our capability to provide treatment. Life can be prolonged at enormous cost, sometimes far beyond the point that the individual appears to be gaining a net benefit from that life. Science (...) can tell us how to achieve something, but it cannot tell us whether we should achieve that end—whether it is good. For that, we need ethics. Ethics grows in importance as our technology creates new possibilities. Where there are no options, there are no ethical questions. However, once there are options, there arise pressing questions about whether to pursue them. We require values and principles to decide how to use medicine and science. During the last 7 years, issues like the creation of brain organoids, human non-human chimeras, mitochondrial transfer, gene editing of embryos and in vitro gametogenesis have grown in prominence. These raise deep questions about moral status and how it should be determined, the limits of modification of humans, and what is good in life. As editors of the JME, we are proud of our small contribution to thinking about these challenges. We are grateful to the hard work of our associate editors and administrative staff, but there is still much more to do. During our term as editors, we have published papers from diverse perspectives, on a wide range of topics. We have seen vigorous debate within the pages of the journal and have often sought to deliberately encourage that debate …. (shrink)

We might worry that our seamless reliance on AI systems makes us prone to adopting the strange errors that these systems commit. One proposed solution is to design AI systems so that they are not phenomenally transparent to their users. This stops cognitive extension and the automatic uptake of errors. Although we acknowledge that some aspects of AI extension are concerning, we can address these concerns without discouraging transparent employment altogether. First, we believe that the potential danger should be put (...) into perspective – many unreliable technologies are unlikely to be used transparently precisely because they are unreliable. Second, an agent who transparently employs a resource may also reflect (opaquely) on its reliability. Finally, agents can rely on a process transparently and be yanked out of their transparent use when it turns unreliable. When an agent is responsive to the reliability of their process in this way, they have epistemically integrated it, and the beliefs they form with it are formed responsibly. This prevents the agent from automatically incorporating problematic beliefs. Responsible (and transparent) use of AI resources – and consequently responsible AI extension – is hence possible. We end the paper with several design and policy recommendations that encourage epistemic integration of AI-involving belief-forming processes. (shrink)

Controversial cases in medical ethics are, by their very nature, divisive. There are disagreements that revolve around questions of fact or of value. Ethical debate may help in resolving those disagreements. However, sometimes in such cases, there are opposing reasonable views arising from deep-seated differences in ethical values. It is unclear that agreement and consensus will ever be possible. In this paper, we discuss the recent controversial case of Vincent Lambert, a French man, diagnosed with a vegetative state, for whom (...) there were multiple court hearings over a number of years. Both family and health professionals were divided about whether artificial nutrition and hydration should be withdrawn and Lambert allowed to die. We apply a ‘dissensus’ approach to his case and argue that the ethical issue most in need of scrutiny is different from the one that was the focus of attention. (shrink)

At the University of Pretoria the author, a practical theologian, experiences a fruitful soil for the development of an interdisciplinary process. He referred to concrete examples of cooperation, but used the article to reflect on best practices for the interdisciplinary dialogue. He came to the conclusion that it probably made more sense to talk of Practical-theological alternatives rather than to describe the subject in a single fixed manner of understanding and action. Our goal should rather be to open up the (...) boundaries between Practical Theology, Human, Social and Natural Sciences. (shrink)

In this paper I consider, in connection with dementia, two views of the person. One view of the person is derived from Locke and Parfit. This tends to regard the person solely in terms of psychological states and his/her connections. The second view of the person is derived from a variety of thinkers. I have called it the situated-embodied-agent view of the person. This view, I suggest, more readily squares with the reality of clinical experience. It regards the person as (...) embedded in a history and culture. The human person is also an embodied agent. I contend that this view encourages a more appropriate approach towards the ethical issues that arise in dementia and towards people with dementia. (shrink)

Dementia affects millions of people throughout the world. Thinking through Dementia offers a critique of the main models used to understand dementia-the biomedical, neuropsychological, and social constructionist. It discusses clinical issues and cases, together with philosophical work that might help us to better understand and treat this illness.

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The recent tragic and widely publicised death of Jesse Gelsinger in a gene therapy trial has many important lessons for those engaged in the ethical review of research. One of the most important lessons is that ethics committees can give too much weight to ensuring informed consent and not enough attention to minimising the harm associated with participation in research. The first responsibility of ethics committees should be to ensure that the expected harm associated with participation is reasonable. Jesse was (...) an 18-year-old man with a mild form of ornithine transcarbamylase (OTC) deficiency, a disorder of nitrogen metabolism. His form of the disease could be controlled by diet and drug treatment. On September 13 1999 a team of researchers lead by James Wilson at the University of Pennsylvania's Institute for Human Gene Therapy (IHGT) injected 3.8 X 1013 adenovirus vector particles containing a gene to correct the genetic defect. He was the eighteenth and final patient in the trial. The virus particles were injected directly into the liver. He received the largest number of virus particles in a gene therapy trial.1 Four days later he was dead from what was probably an immune reaction to the virus vector. This was the first death directly attributed to gene therapy. It resulted in worldwide publicity, an independent investigation, the Federal Drug Administration (FDA) suspending all trials at the IHGT, an FDA, and a senate subcommittee investigation. At a special public meeting at the National Institutes of Health (NIH) in December 1999, James Wilson, also the director of the IHGT, said they still did not understand fully what had gone wrong.2 Even though a massive dose had been used, only 1% of transferred genes reached the target cells. (None of the patients in the trial showed significant gene expression. Art …. (shrink)

Duas formulações oferecidas por Leibniz de seu princípio de causalidade são examinadas, e a incompatibilidade, segundo Leibniz, do princípio com a possibilidade de causas indiferentes com respeito a seus efeitos é considerada. Acompanhamos o desenvolvimento de sua teoria da escolha a partir de suas teses sobre causalidade e indiferença. Por fim, procuramos explicar por que Leibniz sustentava que sua teoria de escolha não exclui a liberdade. Some remarks about causality, choice and freedom in Leibniz Abstract Two statements of Leibniz’ principle (...) of causality are discussed, and their alleged incompatibility with there being causes which are indifferent with respect to their effects is considered. We follow the development of his theory of choice on the basis of his views on causality and indifference. Finally, we attempt to explain why Leibniz maintained that his theory of choice does not rule out freedom. (shrink)

Opponents of destructive embryo research, such as embryo rightists, as well as proponents accept that natural reproduction is permissible. There is an alternative to natural reproduction—to remain childless. John Harris began this series of articles by asking, what does a commitment to the permissibility of natural reproduction entail? Harris has argued that a commitment to the permissibility of natural reproduction entails a commitment to the permissibility of destructive embryo research. Julian Savulescu has denied this. However, there are significant areas (...) in which our views have converged. (shrink)

Sen’s Liberal paradox describes a conflict between weak Pareto, minimal liberalism, and either transitivity or a best element over a domain of individual preferences. This paper examines variants of that paradox with varying amounts of unconditional preferences. We define a notion of unconditional preferences under which, in the absence of Pareto, there can be no cycles. We then define a stronger condition, that makes an individual’s preferences for her own private attributes independent of all other attributes. Under this assumption, there (...) can be no cycles with or without Pareto. We also show there exists a social decision function satisfying those conditions. We then determine the probability of a cycle assuming a much weaker independence condition that does not restrict the domain. This probability converges to one as the number of non-private attributes within the social states increases. Finally, we use simulations to determine the probability that liberalism and Pareto conflict with best elements, maximal elements, and transitivity separately. (shrink)

Dementia is an illness that raises important questions about our own attitudes to illness and aging. It also raises very important issues beyond the bounds of dementia to do with how we think of ourselves as people--fundamental questions about personal identity. Is the person with dementia the same person he or she was before? Is the individual with dementia a person at all? In a striking way, dementia seems to threaten the very existence of the self.LThis book brings together philosophers (...) and practitioners to explore the conceptual issues that arise in connection with this increasingly common illness. Drawing on a variety of philosophers such as Descartes, Lock, Hume, Wittgenstein, the authors explore the nature of personal identity in dementia. They also show how the lives and selfhood of people with dementia can be enhanced by attention to their psychological and spiritual environment. Throughout, the book conveys a strong ethical message, arguing in favor of treating people with dementia with all the dignity they deserve as human beings. The book covers a range of topics, stretching from talk of basic biology to talk of a spiritual understanding of people with dementia. Accessibly written by leading figures in psychiatry and philosophy, the book presents a unique and long overdue examination of an illness that features in so many of our lives. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 62.1 (2001) 121-140 [Access article in PDF] The Rhetoric of Modal Equivocacy in Cartesian Transubstantiation Julian Bourg Everyday language, in which words are not defined, is a medium in which nobody can express himself unequivocally. Robert Musil 1René Descartes's attempt to explain Eucharistic transubstantiation has long been understood as a dramatically significant moment in his tightrope walk across the medieval-to-modern divide. 2 (...) Modeled on the Last Supper in the New Testament, the Eucharistic rite had been explained in the Catholic tradition after the twelfth century in the scholastic philosophical language of substance and accident. 3 As the Council of Trent reaffirmed in 1551, this transubstantiation was a conversion "of the whole substance of the bread into the substance of the Body and of the whole substance of the wine into the substance of His blood... the appearances [speciebus] only of the bread and wine remaining." 4 Christ was [End Page 121] held to be "truly, really, and substantially contained under the species of those sensible things," under what still appeared to be bread and wine. 5Descartes's dilemma was that on one hand he was dead set against the hylomorphic theory of substance and accident, and on the other hand he found himself obliged by some of his interlocutors to comment on transubstantiation. It was a balancing act that pleased no one for very long, since despite his sometimes eager discussions of the Eucharist, he was not, as he admitted, "a theologian by profession." 6 The putative heterodoxy of Cartesian transubstantiation was principally responsible for his works being placed on the Index of Prohibited Books in 1663 and for his thought being banned from schools under Louis XIV in 1671. 7 His treatment of the Eucharistic question also distressed others in the seventeenth and early eighteenth centuries, such as Thomas Hobbes and Isaac Newton, who were unhappy that Descartes had bothered with such a theological non-issue. 8 For the many post-seventeenth-century advocates of a proto-secular Descartes as the godfather of modern philosophy, Cartesian transubstantiation has proved similarly inconvenient.The indisputable connections between Descartes and his scholastic forerunners, exemplified by the Eucharistic question, service a basic question of contemporary Cartesian scholarship. As Émile Boutroux put it, how was new wine poured from old bottles? 9 Accepting as axiomatic that there was something both radical and original in the Cartesian project but without falling back on pieties about his turn toward the modern subject, we must ask how Descartes put forth novel claims in conceptual language regarded by his contemporaries as resonant, if not consonant, with the scholastic intellectual culture of Catholic Reform France. More precisely, setting aside the not-very-defensible position that such language was merely incidental to Cartesian thought (a position that dehistoricizes Descartes as a precocious Enlightener), the dilemma then becomes explaining how original positions were elaborated within scholastic language. One important task is accounting for what Descartes did with that vocabulary--how he pointed words and concepts in new and surprising directions. The Eucharist becomes crucial in this perspective. [End Page 122]Though the question of Cartesian transubstantiation has been discussed for some time, the topic is worth revisiting again in light of two themes, rhetoric and the Cartesian theory of modes. My argument is that Descartes used one particular scholastic term, "mode," in equivocal ways and that this equivocation was in multiple senses rhetorical. This rhetoric coalesced and came to the fore around the Eucharist because, given the intellectual-political climate of the Catholic Reformation, the stakes of transubstantiation were so high. That Descartes used certain scholastic terms in equivocal or ambiguous ways should come as no surprise. Of interest, though, is the fact that by definition "mode" meant many things. This ambiguous term facilitated ambiguous intellectual positions about the Eucharist that allowed Descartes more generally (no matter what he "really" intended) to skirt between an orthodoxy that represented the past and an originality, not without dangers in his time, that seem to gesture toward our day. Foregrounded with regard to... (shrink)

What is the meaning of life? It is a question that has intrigued the great philosophers--and has been hilariously lampooned by Monty Python. Indeed, the whole idea strikes many of us as vaguely pompous, a little absurd. Is there one profound and mysterious meaning to life, a single ultimate purpose behind human existence? In What's It All About?, Julian Baggini says no, there is no single meaning. Instead, Baggini argues meaning can be found in a variety of ways, in (...) this life. He succinctly breaks down six answers people commonly suggest when considering what life is all about--helping others, serving humanity, being happy, becoming successful, enjoying each day as if it were your last, and "freeing your mind." By reducing the vague, mysterious question of meaning to a series of more specific (if thoroughly unmysterious) questions about what gives life purpose and value, he shows that the quest for meaning can be personal, empowering, and uplifting. If the meaning of life is not a mystery, if leading meaningful lives is within the power of us all, then we can look around us and see the many ways in which life can have purpose. We can see the value of happiness while accepting it is not everything. We can see the value of success, without interpreting that too narrowly. We can see the value of seizing the day as well as helping others lead meaningful lives. We can recognize the value of love, as perhaps the most powerful motivator of all. Illustrating his argument with the thoughts of many of the great philosophers and examples drawn from everyday life, Baggini convincingly shows that the search for meaning is personal and within the power of each of us to find. (shrink)

Achievement test differences between boys and girls and between young men and young women, mostly favoring males, extend far beyond mathematics. Such pervasive differences, illustrated here, may require an explanatory theory broader than Geary's.

Documentary has undergone a marked revival in recent art, following a long period in which it was a denigrated and unfashionable practice. This has in part been led by the exhibition of photographic and video work on political issues at Documenta and numerous biennials and, since the turn of the century, issues of injustice, violence and trauma in increasing zones of conflict. Aesthetically, documentary is now one of the most prominent modes of art-making, in part assisted by the linked transformation (...) and recuperation of photography and video by the gallery and museum world. Unsurprisingly, this development, along with the close attention paid to photojournalism and mainstream documentary-making in a time of crisis, has been accompanied by a rich strain of theoretical and historical writing on documentary. This anthology provides a definitive historical context for documentary, exploring its roots in modernism and its critique under postmodernism; it surveys current theoretical thinking about documentary; and it examines a wide range of work by artists within, around or against documentary through their own writings and interviews. (shrink)

This introduction expounds educational problems that arise from transnational migration. It argues that it is high time to critically analyze normative issues of and in education under conditions of globalization because dominant approaches in normative philosophy of education tend to suffer from both a nationalist bias and a sedentary bias. The contributions to this special issue address normative problems pertaining to migration-related education from a variety of ethical and philosophical perspectives, including analytic applied ethics, continental philosophy, care ethics, Hegelian philosophy, (...) the capability approach and theories of distributive justice. They discuss the education of both citizens and migrants in the receiving society as well as in the country of origin, focusing on ethical issues pertaining to access to education as well as to the content of educational programs. (shrink)

Animals obviously cannot have a right of free speech or a right to vote because they lack the relevant capacities. But their right to life and to be free of exploitation is no less fundamental than the corresponding right of humans, writes Julian H. Franklin. This theoretically rigorous book will reassure the committed, help the uncertain to decide, and arm the polemicist. Franklin examines all the major arguments for animal rights proposed to date and extends the philosophy in new (...) directions. _Animal Rights and Moral Philosophy_ begins by considering the utilitarian argument of equal respect for animals advocated by Peter Singer and, even more favorably, the rights approach that has been advanced by Tom Regan. Despite their merits, both are found wanting as theoretical foundations for animal rights. Franklin also examines the ecofeminist argument for an ethics of care and several rationalist arguments before concluding that Kant's categorical imperative can be expanded to form a basis for an ethical system that includes all sentient beings. Franklin also discusses compassion as applied to animals, encompassing Albert Schweitzer's ethics of reverence for life. He concludes his analysis by considering conflicts of rights between animals and humans. (shrink)