Natural death act legislation which is intended to assist patients who wish to refuse or limit medical treatment may actually erode patients' rights. By use of a 'living will' the legislation intends to extend the patients' role in decision-making to the time when patients can no longer speak for themselves. However, the legislation erodes and constricts the right of refusal. The erosion is the result of two sets of conditions found in the legislation. The first requires that the patient be (...) qualified and certified by others before interventions can be withdrawn or withheld. The second delineates the physical condition which must be present before a living will can be followed. Patients have had to seek the assistance of the courts to enforce their common law rights of refusal of treatment against these requirements. Legislation is needed, but greater care must be taken to avoid the creation of a Kafkaesque legal nightmare for those we intend to assist. (shrink)

I will attempt to do two things in this paper.In Part I) I will show that H.A. Prichard failed to appreciate the limitations of the application of the ‘“ought” implies “can”’ principle. Where the ‘can’ is not the ‘can’ of physical impossibility the principle is false; the principle can be shown to be false when it is read this way by an examination of the role of excuses, which is not that of removing obligations. Part II) demonstrates how the misapplication (...) of the ‘“ought” implies “can”’ principle is utilized in a chain of confusion: a confusion of excuses and justifications with respect to obligations and a confusion of the relation between obligations and blameworthiness. (shrink)

I will attempt to do two things in this paper.In Part I) I will show that H.A. Prichard failed to appreciate the limitations of the application of the ‘“ought” implies “can”’ principle. Where the ‘can’ is not the ‘can’ of physical impossibility the principle is false; the principle can be shown to be false when it is read this way by an examination of the role of excuses, which is not that of removing obligations. Part II) demonstrates how the misapplication (...) of the ‘“ought” implies “can”’ principle is utilized in a chain of confusion: a confusion of excuses and justifications with respect to obligations and a confusion of the relation between obligations and blameworthiness. (shrink)

Laymen and philosophers alike find it counterintuitive to consent to the assertion that “it is sometimes right not to follow the requirements of morality”. This may be because the conventions of ordinary language do much to encourage the view that “morally ought to do” functions as an equivalent for “what one ought to do all things considered”. In this paper I will argue against such an equivalence and attempt to shake the holders of the prevailing view, that moral reasons are (...) always overriding, from their dogmatism. The primary theses of this paper are (1) there is no acceptable ordering of reasons for acting--not between types of reasons nor within the category of moral reasons, and (2) moral reasons are not unconditional or unexceptionable.The body of this paper will include a discussion of various versions of the prevailing view (that reasons do have an order with moral reasons as overriding all reasons). I will make some brief remarks about several forms of simplification or reductionism which provide fertile ground for the prevailing view, specifically (a) efforts to transform ‘the all things considered ought’ into a ‘moral ought’ and (b) three efforts to offer a single principle as the basis of moral reasoning. Then I will attempt to reveal flaws in two contemporary expressions of the prevailing view; those of D.Z. Phillips and Kurt Baier. The bulk of my efforts will be directed at demonstrating the conditionality and overrideability of moral reasons. In the process I will also attempt to illuminate the attractiveness of the, if I am correct, mistaken but prevailing view. And finally a moral will be drawn. (shrink)

Laymen and philosophers alike find it counterintuitive to consent to the assertion that “it is sometimes right not to follow the requirements of morality”. This may be because the conventions of ordinary language do much to encourage the view that “morally ought to do” functions as an equivalent for “what one ought to do all things considered”. In this paper I will argue against such an equivalence and attempt to shake the holders of the prevailing view, that moral reasons are (...) always overriding, from their dogmatism. The primary theses of this paper are (1) there is no acceptable ordering of reasons for acting--not between types of reasons nor within the category of moral reasons, and (2) moral reasons are not unconditional or unexceptionable.The body of this paper will include a discussion of various versions of the prevailing view (that reasons do have an order with moral reasons as overriding all reasons). I will make some brief remarks about several forms of simplification or reductionism which provide fertile ground for the prevailing view, specifically (a) efforts to transform ‘the all things considered ought’ into a ‘moral ought’ and (b) three efforts to offer a single principle as the basis of moral reasoning. Then I will attempt to reveal flaws in two contemporary expressions of the prevailing view; those of D.Z. Phillips and Kurt Baier. The bulk of my efforts will be directed at demonstrating the conditionality and overrideability of moral reasons. In the process I will also attempt to illuminate the attractiveness of the, if I am correct, mistaken but prevailing view. And finally a moral will be drawn. (shrink)

Après avoir présenté et expliqué la notion de cognition distribuée, je situerai l'analyse qu'elle permet au sein des sciences cognitives et de la sociologie. Mes buts sont de montrer en quoi la théorie de la cognition distribuée contribue aux théories de la psychologie et de la sociologie, et réciproquement comment les théories de la sociologie et de la psychologie peuvent être recrutées pour expliquer l'existence de systèmes de cognition distribuée. La troisième section de ce chapitre est centrée sur les relations (...) entre psychologie et théorie de la cognition distribuée. Elle montre que la sociologie de la cognition distribuée béné à être une sociologie cognitive de la cognition distribuée. La quatrième partie continue cet argument, mais en soulignant les phénomènes typiquement sociologique qui interviennent dans la constitution et l'évolution des systèmes de cognition distribuèe. (shrink)

Our knowledge of the human brain and the influence of pharmacological substances on human mental functioning is expanding. This creates new possibilities to enhance personality and character traits. Psychopharmacological enhancers, as well as other enhancement technologies, raise moral questions concerning the boundary between clinical therapy and enhancement, risks and safety, coercion and justice. Other moral questions include the meaning and value of identity and authenticity, the role of happiness for a good life, or the perceived threats to humanity. Identity and (...) authenticity are central in the debate on psychopharmacological enhancers. In this paper, I first describe the concerns at issue here as extensively propounded by Carl Elliott. Next, I address David DeGrazia’s theory, which holds that there are no fundamental identity-related and authenticity-related arguments against enhancement technologies. I argue, however, that DeGrazia’s line of reasoning does not succeed in settling these concerns. His conception of identity does not seem able to account for the importance we attach to personal identity in␣cases where personal identity is changed through enhancement technology. Moreover, his conception of authenticity does not explain the reason why we find inauthentic values objectionable. A broader approach to authenticity can make sense of concerns about changes in personal identity by means of enhancement technologies. (shrink)

Studying institutions as part of the research on cultural evolution prompts us to analyze one very important mechanism of cultural evolution: institutions do distribute cultural variants in the population. Also, it enables relating current research on cultural evolution to some more traditional social sciences: institutions, often seen as macro-social entities, are analyzed in terms of their constitutive micro-phenomena. This article presents Sperber’s characterization of institutions, and then gives some hints about the set of phenomena to which it applies.

Comment témoigner d’une espérance religieuse dans le droit contemporain ? Par l’obéissance et l’humilité de l’inculturation, ou par l’objection et la résistance propre au signe de contradiction ? Si les périodes barbares du XXe siècle ont relancé l’analyse théologique de la tension entre ces deux voies, qu’en est-il aujourd’hui des contextes apparemment pacifiés de nos droits démocratiques ? Si le moment juridique y colonise progressivement la société, c’est au nom de sa nature de « droit commun » qu’il estime acquérir (...) de sa prétention croissante à la « neutralité ». À cet égard, la prise de parole religieuse dans l’espace public est aujourd’hui vivement débattue. Il serait cependant erroné de n’y viser que le seul moment de l’élaboration formelle de la loi. Cette prise de parole peut aussi viser les modalités d’application et de mise en contexte du droit. Cet article entend montrer l’importance de ce nouveau moment pour une prise de parole religieuse, entendue comme une troisième voie : celle de l’attestation évangélique au cœur de la pratique du droit. (shrink)

Humans massively depend on communication with others, but this leaves them open to the risk of being accidentally or intentionally misinformed. To ensure that, despite this risk, communication remains advantageous, humans have, we claim, a suite of cognitive mechanisms for epistemic vigilance. Here we outline this claim and consider some of the ways in which epistemic vigilance works in mental and social life by surveying issues, research and theories in different domains of philosophy, linguistics, cognitive psychology and the social sciences.

This article examines what happens when local gender rights activism is taken up by international allies and appropriators, using case studies of activism in Saudi Arabia and India. The relationship between local and transnational activists is shaped by histories of Euro-Americans writing about the gendered organisation of Eastern societies. In an economic system where nongovernmental activist groups compete for donor support, political causes are commodities with value, and value is generated through representations (e.g. of patriarchal oppression). These representations of the (...) sexuality and gender organisation of other societies are fetishes in the Marxian sense, essential to the commodity-cause that generates value in circulation. These representations gain value through the accretion of cultural images and texts that adhere to the cause, e.g. the stereotype of the violent brown man and oppressed woman. Such images in the cultural repository allow transnational consumers to make sense of issues they are called to support. But such images also reify stereotypes that activists seek to undermine, even at the same time that these representations generate an international audience. We analyse this process and identify strategies for how transnational allies can show solidarity without overshadowing or devaluing the voices of local activists, with primary focus on the case of activism against male guardianship laws in Saudi Arabia. (shrink)

Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese (...) parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks. (shrink)

This paper provides a series of reflections on making the case to senior leaders for the introduction of clinical ethics support services within a UK hospital Trust at a time when clinical ethics committees are dwindling in the UK. The paper provides key considerations for those building a case for clinical ethics support within hospitals by drawing upon published academic literature, and key reports from governmental and professional bodies. We also include extracts from documents relating to, and annual reports of, (...) existing clinical ethics support within UK hospitals, as well as extracts from our own proposal submitted to the Trust Board. We aim for this paper to support other ethicists and/or health care staff contemplating introducing clinical ethics support into hospitals, to facilitate the process of making the case for clinical ethics support, and to contribute to the key debates in the literature around clinical ethics support. We conclude that there is a real need for investment in clinical ethics in the UK in order to build the evidence base required to support the wider introduction of clinical ethics support into UK hospitals. Furthermore, our perceptions of the purpose of, and perceived needs met through, clinical ethics support needs to shift to one of hospitals investing in their staff. Finally, we raise concerns over the optional nature of clinical ethics support available to practitioners within UK hospitals. (shrink)