In this article I argue that there is a sense in which logic is empirical, and hence open to influence from science. One of the roles of logic is the modelling and extending of natural language reasoning. It does so by providing a formal system which succeeds in modelling the structure of a paradigmatic set of our natural language inferences and which then permits us to extend this structure to novel cases with relative ease. In choosing the best system of (...) those that succeed in this, we seek certain virtues of such structures such as simplicity and naturalness (which will be explained). Science can influence logic by bringing us, as in the case of quantum mechanics, to make natural language inferences about new kinds of systems and thereby extend the set of paradigmatic cases that our formal logic ought to model as simply and naturally as possible. This can alter which structures ought to be used to provide semantics for such models. I show why such a revolution could have led us to reject one logic for another through explaining why complex claims about quantum mechanical systems failed to lead us to reject classical logic for quantum logic. (shrink)

People with learning disability sometimes display challenging behaviour. This can be managed by use of antipsychotic medication or behavioural therapy or both. There is no solid evidence, however, that these therapies are safe and effective. A randomised controlled trial of antipsychotic medication has been proposed to deliver such evidence. However, this presents difficult issues in the ethics of research with learning disabled people. In particular, is a trial the most efficient and fairest way to evaluate practice in this area? This (...) paper reviews the clinical situation, gives the rationale for the trial, and analyses the ethical arguments for and against such a trial. (shrink)

Frances Kamm's characteristically subtle paper in response to Michael Sandel is an intriguing intervention in the long-standing and increasingly frustrating debate over the morality of enhancement...

Frances Kamm's characteristically subtle paper in response to Michael Sandel is an intriguing intervention in the long-standing and increasingly frustrating debate over the morality of enhancement...

The book deepens our understanding of Arendt's conception of the role of violence in her political theory. But it also uses her work as a provocation to think about how we might engage with, build on, or criticize contemporary ideas of the political that have drawn on Arendtian themes-notably via the notion of "agonal" or "agonistic" politics as theorized in recent years by thinkers such as Chantal Mouffe and Bonnie Honig-and how we can read Arendt in different ways to challenge (...) or further our understanding of the political. (shrink)

The plot thickens--in novels and our lives--forcing us from the fairy tale into a bewildering, even heartbreaking narrative. We look at the god we're holding, and find it too fragile, too brittle to meet reality. Cling tighter? Move on godless? In fact, rejecting a god image (or as C. S. Lewis puts it, allowing God to smash our limited god) opens space for deeper faith in the midst of painful life experience. In OMG, Mary Ellen Ashcroft invites readers to (...) look over her shoulder as she traces her god growth, beginning with a capricious childhood god. The loving savior who embraced her when she was eighteen, followed her into strict fundamentalism, while the god she met in an Anglican seminary shocked her by caring more about poverty than a seven-day creation, but then called her to a South Africa tipping toward revolution. An interweaving of narrative theology and creative nonfiction, OMG invites readers to grow into deeper faith, retelling their stories in the light of the biblical one, dropping inadequate gods to grasp a mysterious, awesome one. (shrink)

The empirical turn in bioethics has been widely discussed by philosophical medical ethicists and social scientists. The focus of this discussion has been almost exclusively on methodological issues in research, on the admissibility of empirical evidence in rational argument, and on the possible superiority of empirical methods for permitting democratic lay involvement in decision-making. In this paper I consider how the collection of qualitative and quantitative social research evidence plays its part in the construction of social order, and how this (...) creates certain paradoxes for the normative ideal of a public bioethics. The analysis in this paper is based on Foucauldian ideas, and on recent work in the history of the human sciences. The paper closes with some open questions for theoretical work in the sociology and philosophy of bioethics. (shrink)

Regulation and governance of medical research is frequently criticised by researchers. In this paper, we draw on Everett Hughes’ concepts of professional licence and professional mandate, and on contemporary sociological theory on risk regulation, to explain the emergence of research governance and the kinds of criticism it receives. We offer explanations for researcher criticism of the rules and practices of research governance, suggesting that these are perceived as interference in their mandate. We argue that, in spite of their complaints, researchers (...) benefit from the institutions of governance and regulation, in particular by the ways in which regulation secures the social licence for research. While it is difficult to answer questions such as: “Is medical research over-regulated?” and “Does the regulation of medical research successfully protect patients or promote ethical conduct?”, a close analysis of the social functions of research governance and its relationship to risk, trust, and confidence permits us to pose these questions in a more illuminating way. (shrink)

Evidence based medicine has been a topic of considerable controversy in medical and health care circles over its short lifetime, because of the claims made by its exponents about the criteria used to assess the evidence for or against the effectiveness of medical interventions. The central epistemological debates underpinning the debates about evidence based medicine are reviewed by this paper, and some areas are suggested where further work remains to be done. In particular, further work is needed on the theory (...) of evidence and inference; causation and correlation; clinical judgment and collective knowledge; the structure of medical theory; and the nature of clinical effectiveness. (shrink)

This book defends a form of ethical intuitionism, according to which (i) there are objective moral truths; (ii) we know some of these truths through a kind of immediate, intellectual awareness, or "intuition"; and (iii) our knowledge of moral truths gives us reasons for action independent of our desires. The author rebuts all the major objections to this theory and shows that the alternative theories about the nature of ethics all face grave difficulties.

Bioethics has been subject to considerable social criticism in recent years. One criticism that has caused particular discomfort in the bioethics community is that bioethicists, because of the way their work is funded, are involved in profound conflicts of interest that undermine their title to be considered independent moral commentators on developments in biomedicine and biotechnology. This criticism draws its force from the assumption that bioethics is, or ought to be, a type of normative social criticism. Versions of this criticism (...) come from both the political left and right. For instance, such criticisms include allegations that bioethics is inherently socially conservative, that it is inherently “pro-technology”, that it lays spurious claims to moral and social authority and expertise, that its focus on autonomy links it to neoliberal theories of choice, and that it is an ideological mystification of real social relationships and political power. This commentary paper analyses the problem of bioethical conflict of interest, and argues that the types of conflict of interest facing bioethics are inherent to the role of “public intellectual” that bioethicists generally wish to assume. The paper defends this conception of the role of the bioethicist, arguing that bioethicists should be interested and openly so. (shrink)

The first edition of The Scientific Background to Modern Philosophy took the dialogue of science and philosophy from Aristotle through to Newton. This second edition adds eight chapters, taking the dialogue through the Enlightenment and up to Darwin. This anthology is an attempt to help bridge the gap between the history of science and the history of philosophy.

Part I: The representation of life -- Can life be given a real definition? -- The representation of the living individual -- The representation of the life-form itself -- Part II: Naive action theory -- Types of practical explanation -- Naive explanation of action -- Action and time -- Part III: Practical generality -- Two tendencies in practical philosophy -- Practices and dispositions as sources of the goodness of individual actions -- Practice and disposition as sources of individual action.

Francis Fukuyama, in his Our Posthuman Future, and Gregory Stock, in his Redesigning Humans, present competing versions of the biomedical future of human beings, and debate the merits of more or less stringent regimes of regulation for biomedical innovation. In this article, these positions are shown to depend on a shared discourse of market liberalism, which limits both the range of ends for such innovation discussed by the authors, and the scope of their policy analyses and proposals. A proper evaluation (...) of the human significance and policy imperatives for biomedical innovation needs to be both more utopian in its imagination, and more sophisticated in its political economy. In essence, the Fukuyama/Stock debate tells us more about current US political ideology than it does about the morality of human genetic and biopsychological engineering. (shrink)

ABSTRACT Medicines that are vital for the saving and preserving of life in conditions of public health emergency or endemic serious disease are known as essential medicines. In many developing world settings such medicines may be unavailable, or unaffordably expensive for the majority of those in need of them. Furthermore, for many serious diseases (such as HIV/aids and tuberculosis) these essential medicines are protected by patents that permit the patent‐holder to operate a monopoly on their manufacture and supply, and to (...) price these medicines well above marginal cost. Recent international legal doctrine has placed great stress on the need to globalise intellectual property rights protections, and on the rights of intellectual property rights holders to have their property rights enforced. Although international intellectual property rights law does permit compulsory licensing of protected inventions in the interests of public health, the use of this right by sovereign states has proved highly controversial. In this paper I give an argument in support of states’ sovereign right to expropriate private intellectual property in conditions of public health emergency. This argument turns on a social contract argument for the legitimacy of states. The argument shows, further, that under some circumstances states are not merely permitted compulsory to license inventions, but are actually obliged to do so, on pain of failure of their legitimacy as sovereign states. The argument draws freely on a loose interpretation of Thomas Hobbes's arguments in his Leviathan, and on an analogy between his state of War and the situation of public health disasters. (shrink)

Since the inception of the Human Genome Project, human genetics has frequently been conducted through big science projects, combining academic, state and industrial methods, interests and resources. The legitimacy of such projects has been linked to national prestige and images of the nation, the purity of scientific endeavour, the entrepreneurial spirit, medical progress and the public health. A key complication in these discourses is that large-scale genetic research has yet to show major results when considered in terms of the objectives (...) used to legitimate investment and social support for these projects. The main area showing promise at present is the developing field of pharmacogenetics, which is now attracting major industry and government investment. Sociological, ethical and philosophical study of human genetic sample-based research and pharmacogenetics has developed in parallel with inquiry in the biological and biomedical sciences. This paper introduces a symposium on the ethical and social aspects of this field of biomedical research. (shrink)

Virtually all philosophers agree that for a belief to be epistemically justified, it must satisfy certain conditions. Perhaps it must be supported by evidence. Or perhaps it must be reliably formed. Or perhaps there are some other "good-making" features it must have. But does a belief's justification also require some sort of awareness of its good-making features? The answer to this question has been hotly contested in contemporary epistemology, creating a deep divide among its practitioners. Internalists, who tend to focus (...) on scientific or theoretical beliefs as the ideal, insist that such awareness is required for justification. Externalists, who think children's ordinary beliefs in obvious facts are paradigm cases of justified belief, say it isn't required. Michael Bergmann's book offers a decisive refutation of internalism and a sustained defense of externalism. (shrink)

When denial of medical treatment is being used as a lever to move people out of the country, ethicists and healthcare professionals should speak out.An ugly feature of political life throughout the Western world, and beyond, is the suspicion towards, and maltreatment of, migrants from poor to rich countries. People who would otherwise be horrified at being labelled racist nevertheless find it acceptable to support practices which can range from stigmatisation to confinement in brutalising conditions in “reception” and “removal” centres.1–5An (...) hour spent searching through government and NGO websites concerned with the treatment of asylum seekers and refugees in developed world countries is an hour well spent – but profoundly depressing. This is not only because of the frankly Orwellian language used by the governments of the UK and Australia , or because of the conditions and treatment meted out, but also because of the apparent support these practices have among the voting public. In the pointedly optimistic reports of Her Majesty’s Inspector of Prisons, for example, one can find praise for the fact …. (shrink)

A patient's informed consent is required by the Nuremberg code, and its successors, before she can be entered into a clinical trial. However, concern has been expressed by both patients and professionals about the beneficial or detrimental effect on the patient of asking for her consent. We examine advantages and drawbacks of popular variations on consent, which might reduce the stress on patients at the point of illness. Both informed and uninformed responses to particular trials, and trials in general, are (...) discussed. The selection by doctors of patients, to whom entry to trials will be offered, is explored. (shrink)

In this paper I examine the ways in which the concept of “public interest” is used in biomedical policymaking to justify the preemption or overruling of decisions made by individuals about their own, their family's, or group interests in the field of healthcare. I discuss six variants of public-interest justification, before going on to consider a concrete example, the use of personal health data in health services management and medical research. I distinguish between the global public interest and particular public (...) interests and consider critically how the global public interest can be said to arise from private interests. I show that there is always room for the private individual to defeat appeals to public interest on moral grounds, and hence that public interest cannot have overriding moral force. Hence, public-interest claims need to be considered as political appeals about competing claims and conceptions of justice, rather than as shortcuts to defining the universal solidary interest. (shrink)

Externalist theories of justification create the possibility of cases in which everything appears to one relevantly similar with respect to two propositions, yet one proposition is justified while the other is not. Internalists find this difficult to accept, because it seems irrational in such a case to affirm one proposition and not the other. The underlying internalist intuition supports a specific internalist theory, Phenomenal Conservatism, on which epistemic justification is conferred by appearances.

The editors of the symposium hope it will provide a balanced appraisal of evidence based medicine.This symposium is devoted to evidence based medicine and the ethical issues it raises. Since Sir Archie Cochrane’s seminal Nuffield Provincial Hospitals Trust lectures in 1972 and their publication as the Rock Carling monograph for that year, Effectiveness and Efficiency: Random Reflections on Health Services, the idea that medical interventions and health services should be evaluated and selected on the basis of the most reliable evidence (...) available for their effectiveness and cost effectiveness has become very widely accepted.1,2 This widespread acceptance has not been complete, and it sometimes seems that there are as many critics of EBM as advocates. Whereas the importance of randomised trial evidence, critical appraisal, meta-analysis, and systematic review …. (shrink)

Evaluation of the potential of a cocaine vaccine requires a detailed understanding of the intended and unintended social consequences of its use. Prospective technology assessment is always difficult, but in the case of treatment and prevention of cocaine addiction we need to understand not only the neuroscience and pharmacology of cocaine addiction, but also social attitudes to drug use and addiction, the social context of drug use, and the factors which make drug use a rational strategy for an addict and (...) make treatment seeking or relapse more or less likely. By considering different scenarios related to differing levels of effectiveness of the vaccine, the authors argue that vaccination will be at best a useful adjunct to existing methods of treatment, rather than a substitute for them. (shrink)

At the University of Sheffield during 2011 and 2012, a leading group of philosophers, psychologists, and others gathered to explore the nature and significance of implicit bias. The two volumes of Implicit Bias and Philosophy emerge from these workshops. Each volume philosophically examines core areas of psychological research on implicit bias as well as the ramifications of implicit bias for core areas of philosophy. Volume I: Metaphysics and Epistemology is comprised of two parts: “The Nature of Implicit Attitudes, Implicit Bias, (...) and Stereotype Threat,” and “Skepticism, Social Knowledge, and Rationality.” The first part contains chapters examining the relationship between implicit attitudes and “dual process” models of the mind; the role of affect in the formation and change of implicit associations; the unity (or disunity) of implicit attitudes; whether implicit biases are mental states at all; and whether performances on stereotype-relevant tasks are automatic and unconscious or intentional and strategic. The second part contains chapters examining implicit bias and skepticism; the effects of implicit bias on scientific research; the accessibility of social stereotypes in epistemic environments; the effects of implicit bias on the self-perception of members of stigmatized social groups as rational agents; the role of gender stereotypes in philosophy; and the role of heuristics in biased reasoning. (shrink)

In this engaging and spirited text, Michael Lynch argues that truth does matter, in both our personal and political lives. He explains that the growing cynicism over truth stems in large part from our confusion over what truth is.

Background Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. Objective To describe UK mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Design Thematic content analysis. Subjects National and local news coverage in newspapers, news media targeted at health-care providers and popular websites between January (...) 2005 and February 2010. Setting UK mass media. Results The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health-care provider interests dominated favourable coverage; oppo- sition came from rival politicians, taxpayersÕ representatives, certain charities and from some journalists themselves. Conclusions Those promoting incentive schemes for people who might be regarded as ÔundeservingÕ should plan a media strategy that anticipates their public reception. (shrink)

Dignity plays a central role in current thinking about law and human rights, but there is sharp disagreement about its meaning. Combining conceptual precision with a broad historical background, Michael Rosen puts these controversies in context and offers a novel, constructive proposal. “Penetrating and sprightly...Rosen rightly emphasizes the centrality of Catholicism in the modern history of human dignity. His command of the history is impressive...Rosen is a wonderful guide to the recent German constitutional thinking about human dignity...[Rosen] is in (...) general an urbane and witty companion, achieving his aim of accessibly written philosophy.” —Samuel Moyn, The Nation “[An] elegant, interesting and lucid exploration of the concept of dignity...Drawing on classical, liberal and Catholic traditions, Rosen hopes to rehabilitate dignity to its rightful place near the centre of moral thought...Rosen's admirable book deserves wide attention from political theorists, jurisprudes and political philosophers.” —Simon Blackburn, Times Higher Education “Dignity deserves to be widely read, not only for its intrinsic interest, but also as a corrective to the habit of discussing such topics in abstraction from their social context. Whether or not one agrees with Rosen's arguments, there can be no doubt he has widened our horizons.” —Rae Langton, Times Literary Supplement. (shrink)

Bioethics should update its conception of the geneThe 25th of April marks the 50th anniversary of the publication in Nature of the letter by James Watson and Francis Crick announcing their solution to the structure of deoxyribose nucleic acid .1 By that time, much was known about the role of chromosomes in inheritance, the contribution of DNA to chromosome structure, and the chemistry of DNA.2 The gene concept itself was also well established by then; the principal scientific problem became to (...) specify what genes were in molecular terms and how they functioned in the cell during ordinary function and cell division.The importance of the solution of the structure of DNA was twofold. First, it gave insight into finding a mechanism for DNA replication, as the authors recognised in this famous sentence:"It has not escaped our notice that the specific pairing we have postulated immediately suggests a copying mechanism for the genetic material.3 … ". (shrink)

In this paper three models of teaching and learning medical ethics are discussed critically, the traditional and revised vocational models, and the patient-centred model. The autonomy-oriented patient-centred ethics of Beauchamp and Childress is rejected in favour of a hermeneutic practical ethics. A performative conception of ethics teaching is recommended as the most appropriate model for use in the theory and practice of ethics pedagogy.

Deputy Editor Richard Ashcroft introduces four papers on drugs and autonomyIn this symposium we bring together four papers which consider novel approaches to the use and response to what are popularly known as “drugs”. The language available here is not altogether helpful—the drugs discussed have very different pharmacological effects, social acceptability, long and short term psychological effects, medical uses, and legal status.1 Arguably, the way these three drugs are considered as constituting a unified medical field can only be understood (...) as a rather specific social and historical phenomenon, rather than being based on a coherent concept of “drugs”. Nevertheless a major part of international health and foreign policy turns on this social construction, and as doctors, ethicists, or policy makers we are obliged to work within this social reality, even as we criticise its basis.2A central consideration in all four papers is the role …. (shrink)

Professor Robertson sketches an elegant framework for policy evaluation and regulation of the use of preimplantation genetic diagnosis for various medical, medical related, and non-medical purposes. In criticism of his position, I argue that the distinction between policy and ethics upon which his argument relies is highly unstable, and the approach taken to ethical evaluation of particular parental interests leaves open many issues which the policy approach would hope to exclude. In conclusion I argue that while his position ultimately fails, (...) the onus is on his critics to come up with a viable and satisfying alternative. (shrink)

Since the inception of the Human Genome Project, human genetics has frequently been conducted through big science projects, combining academic, state and industrial methods, interests and resources. The legitimacy of such projects has been linked to national prestige and images of the nation, the purity of scientific endeavour, the entrepreneurial spirit, medical progress and the public health. A key complication in these discourses is that large-scale genetic research has yet to show major results when considered in terms of the objectives (...) used to legitimate investment and social support for these projects. The main area showing promise at present is the developing field of pharmacogenetics, which is now attracting major industry and government investment. Sociological, ethical and philosophical study of human genetic sample-based research and pharmacogenetics has developed in parallel with inquiry in the biological and biomedical sciences. This paper introduces a symposium on the ethical and social aspects of this field of biomedical research. (shrink)

Teaching medical ethics and law to medical students has been a requirement for all medical schools in the United Kingdom since the General Medical Council’s Tomorrow’s Doctors guidance on medical curricular reform of 1992. All United Kingdom medical schools now have at least some medical ethics and law in their curricula and most have a person appointed primarily to be responsible for this teaching. Since the publication in the Journal of Medical Ethics in 1998, volume 24, pages188–192, of a consensus (...) statement on a core curriculum in medical ethics and law for medical students, most medical schools have gradually come to conform to this as the benchmark for the content of such teaching. There remains, however, a great diversity in the approaches taken to ensuring that learning this content takes place. A wide range of strategies have …. (shrink)