This paper responds to the commentaries from Stacy Carter and Alan Cribb. We pick up on two main themes in our response. First, we reflect on how the process of setting standards for empirical bioethics research entails drawing boundaries around what research counts as empirical bioethics research, and we discuss whether the standards agreed in the consensus process draw these boundaries correctly. Second, we expand on the discussion in the original paper of the role and significance of the concept of (...) ‘integrating’ empirical methods and ethical argument as a standard for research practice within empirical bioethics. (shrink)

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

As John McMillan notes in January’s editorial, 1 many countries are reflecting on how they responded to the COVID-19 pandemic, what went wrong and how responses to such system shocks can be better managed in the future. However, while it is tempting to think that the COVID-19 pandemic is over and that what is now needed is a reflection on how countries could have responded better, some of the underlying issues and problems COVID-19 both highlighted and created are still with (...) us. The legacy of the pandemic has continued particularly for healthcare workers at all levels, who have had to continue providing services with little time to rest and reflect and with new ‘shocks’ to the systems to cope with. For example, in England, industrial action by junior doctors has put already fragile systems under pressure, and the issues that staff are campaigning about remain unaddressed. Many of... (shrink)

People should be allowed to decide how and where they wish to be tested for HIV without there being a formal requirement for pretest counsellingIn his paper, Ethics of HIV testing in general practice without informed consent, Fraser argues that pretest counselling and informed consent are pillars of the ethical conduct of HIV testing. In my response I want to look critically at these contentions. While I will agree with Fraser that it is always necessary to get informed consent from (...) a patient for an HIV test I will argue that an emphasis on pretest counselling as a prerequisite for testing can actually undermine a patient’s autonomy, the very principle that informed consent seeks to promote.This response will start with an analysis of Case Two as this highlights the fundamental importance of informed consent. It will then go on to look at Case One and show how the special application of informed consent in the field of HIV testing can, in certain circumstances, lead to a reduction in patient autonomy.CASE TWOIn Fraser’s second case a 43 year old married clergyman presented with a recurrent infection of his little toe and the preliminary lab reports queried Kaposi’s sarcoma. The general practitioner thought that because of the patient’s lifestyle there was little risk of HIV infection, “suggesting the possibility of HIV, when it is unexpected and the risk low, can in itself cause anxiety and distress”. On these grounds the GP did not call the patient in for an HIV test.Some might argue that the GP should have tested the clergyman. This could have been done in one of two ways: by seeking his explicit consent for an HIV test, or by getting blanket consent for a range of tests, including HIV, without HIV being explicitly mentioned. …. (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.

Humans, like other primates, are intensely social creatures. One of the major functions of our brains must be to enable us to be as skilful in social interactions as we are in our interactions with the physical world. Furthermore, any differences between human brains and those of our nearest relatives, the great apes, are likely to be linked to our unique achievements in social interaction and communication rather than our motor or perceptual skills. Unique to humans is the ability to (...) mentalise, that is to perceive and communicate mental states, such as beliefs and desires. A key problem facing science is to uncover the biological mechanisms underlying our ability to read other minds and to show how these mechanisms evolved. To solve this problem we need to do experiments in which people interact with one another rather than behaving in isolation. Such experiments are now being conducted in increasing numbers and many of the leading exponents of such experiments have contributed to this volume. 'The Neuroscience of Social Interactions' will be an important step in uncovering the biological mechanisms underlying social interactions - undoubtedly one of the major programmes for neuroscience in the 21st century. (shrink)

Clark acknowledges but resists the indirect mind–world relation inherent in prediction error minimization (PEM). But directness should also be resisted. This creates a puzzle, which calls for reconceptualization of the relation. We suggest that a causal conception captures both aspects. With this conception, aspects of situated cognition, social interaction and culture can be understood as emerging through precision optimization.

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.

Humans have been shown capable of performing many cognitive tasks using information of which they are not consciously aware. This raises questions about what role consciousness actually plays in cognition. Here, we explored whether participants can learn cue-target contingencies in an attentional learning task when the cues were presented below the level of conscious awareness, and how this differs from learning about conscious cues. Participants’ manual (Experiment 1) and saccadic (Experiment 2) response speeds were influenced by both conscious and unconscious (...) cues. However, participants were only able to adapt to reversals of the cue-target contingencies (Experiment 1) or changes in the reliability of the cues (Experiment 2) when consciously aware of the cues. Therefore, although visual cues can be processed unconsciously, learning about cues over a few trials requires conscious awareness of them. Finally, we discuss implications for cognitive theories of consciousness. (shrink)

A key question for cognitive theories of reasoning is whether logical reasoning is inherently a sentential linguistic process or a process requiring spatial manipulation and search. We addressed this question in an event-related fMRI study of syllogistic reasoning, using sentences with and without semantic content. Our findings indicate involvement of two dissociable networks in deductive reasoning. During content-based reasoning a left hemisphere temporal system was recruited. By contrast, a formally identical reasoning task, which lacked semantic content, activated a parietal system. (...) The two systems share common components in bilateral basal ganglia nuclei, right cerebellum, bilateral fusiform gyri, and left prefrontal cortex. We conclude that syllogistic reasoning is implemented in two distinct systems whose engagement is primarily a function of the presence or absence of semantic content. Furthermore, when a logical argument results in a belief–logic conflict, the nature of the reasoning process is changed by recruitment of the right prefrontal cortex. (shrink)

In this paper we examine the functional anatomy of volition, as revealed by modern brain imaging techniques, in conjunction with neuropsychological data derived from human and non-human primates using other methodologies. A number of brain regions contribute to the performance of consciously chosen, or ‘willed', actions. Of particular importance is dorsolateral prefrontal cortex , together with those brain regions with which it is connected, via cortico-subcortical and cortico-cortical circuits. That aspect of free will which is concerned with the voluntary selection (...) of one action rather than another critically depends upon the normal functioning of DLPFC and associated brain regions. Disease, or dysfunction, of these circuits may be associated with a variety of disorders of volition: Parkinson's disease, ‘utilization’ behaviour, ‘alien’ and ‘phantom’ limbs, and delusions of ‘alien control’ . Brain imaging has allowed us to gain some access to the pathophysiology of these conditions in living patients. At a philosophical level, the distinction between ‘intentions to act', and ‘intentions in action’ may prove particularly helpful when addressing these complex disturbances of human cognition and conscious experience. The exercise and experience of free will depends upon neural mechanisms located in prefrontal cortex and associated brain systems. (shrink)

The distinction between bottom-up and top-down control of action has been central in cognitive psychology, and, subsequently, in functional neuroimaging. While the model has proven successful in describing central mechanisms in cognitive experiments, it has serious shortcomings in explaining how top-down control is established. In particular, questions as to what is at the top in top-down control lead us to a controlling homunculus located in a mythical brain region with outputs and no inputs. Based on a discussion of recent brain (...) imaging experiments, we argue for the need to factor the interaction between the experimenter and the experimental participant into a realistic understanding of top-down control. We suggest these interactions involve a ‘sharing of scripts’ for perception and action that may be described as ‘top-top processes.’ We thereby expand the understanding of the homunculus to include elements of social cognition. This conceptual reconfiguration may grant some sort of asylum for a—not very omnipotent—homunculus. (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)

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)

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.

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.

Causation: A Realist Approach Traditional empiricist accounts of causation and laws of nature have been reductionist in the sense of entailing that given a complete specification of the non-causal properties of and relations among particulars, it is therefore logically determined both what laws there are and what events are causally related. It is argued here, however, that reductionist accounts of causation and of laws of nature are exposed to decisive objections, and thus that the time has come for empiricists to (...) break with that tradition. -/- The basic goal of this book, therefore, is to set out and defend realistic accounts of those concepts. In the case of causal relations, for example, Tooley maintains that causation is basically a matter of theoretical relations between states of affairs that underlie and explain relative frequencies. He also argues that such an approach avoids the objections that tell against reductionist accounts and that it does so without making causal relations epistemologically inaccessible. (shrink)

Mentalizing refers to our ability to read the mental states of other agents and engages many neural processes. The brain's mirror system allows us to share the emotions of others. Through perspective taking, we can infer what a person currently believes about the world given their point of view. Finally, the human brain has the unique ability to represent the mental states of the self and the other and the relationship between these mental states, making possible the communication of ideas.

Over the last 20 years the comparator model for delusions of control has received considerable support in terms of empirical studies. However, the original version clearly needs to be replaced by a model with a much greater degree of sophistication and specificity. Future developments are likely to involve the specification of the role of dopamine in the model and a generalisation of its explanatory power to the whole range of positive symptoms. However, we will still need to explain why symptoms (...) can be so variable and we still do not understand the origin of the most mysterious symptom of all: thought insertion. (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)

Patients with delusions of control are abnormally aware of the sensory consequences of their actions and have difficulty with on-line corrections of movement. As a result they do not feel in control of their movements. At the same time they are strongly aware of the action being intentional. This leads them to believe that their actions are being controlled by an external agent. In contrast, the normal mark of the self in action is that we have very little experience of (...) it. Most of the time we are not aware of the sensory consequences of our actions or of the various subtle corrections that we make during the course of goal-directed actions. We know that we are agents and that we are successfully causing the world to change. But as actors we move through the world like shadows glimpsed only occasional from the corner of an eye. (shrink)

Autism provides a model for exploring the nature of self‐consciousness: self‐consciousness requires the ability to reflect on mental states, and autism is a disorder with a specific impairment in the neurocognitive mechanism underlying this ability. Experimental studies of normal and abnormal development suggest that the abilities to attribute mental states to self and to others are closely related. Thus inability to pass standard ‘theory of mind’ tests, which refer to others’ false beliefs, may imply lack of self‐consciousness. Individuals who persistently (...) fail these tests may, in the extreme, be unable to reflect on their intentions or to anticipate their own actions. In contrast, individuals with high‐functioning autism or Asperger syndrome often possess a late‐acquired, explicit theory of mind, which appears to be the result of effortful learning. An experimental study with three people with Asperger syndrome suggested that level of performance on standard theory of mind tasks was strongly related to the ability to engage in introspection. Qualitative differences in the introspections of high‐functioning people with autism are also reflected in autobiographical accounts which may give a glimpse of what it is like to be autistic. (shrink)

edition (unseen), $12.95. traditions, bringing into being new modes of understanding. Paper Anthropology, and particularly ethnography, is torn between two quests, one to capture the diversity of social life and the other to discover universal principles structuring that diversity. Jackson examines these quests within the context of ethnographic fieldwork, focusing on the relationship between ethnographers and the people they study. He is concerned with defining the anthropological project as something more than the projection of the anthropologist's traditions and concerns onto (...) an alien culture. Rather, he would have the project open a genuine dialogue between people from different cultures or Annotation copyrighted by Book News, Inc., Portland, OR. (shrink)

Like any discipline, bioethics is a developing field of academic inquiry; and recent trends in scholarship have been towards more engagement with empirical research. This ‘empirical turn’ has provoked extensive debate over how such ‘descriptive’ research carried out in the social sciences contributes to the distinctively normative aspect of bioethics. This paper will address this issue by developing a practical research methodology for the inclusion of data from social science studies into ethical deliberation. This methodology will be based on a (...) naturalistic conception of ethical theory that sees practice as informing theory just as theory informs practice – the two are symbiotically related. From this engagement with practice, the ways that such theories need to be extended and developed can be determined. This is a practical methodology for integrating theory and practice that can be used in empirical studies, one that uses ethical theory both to explore the data and to draw normative conclusions. (shrink)

Michael G. Titelbaum presents a new Bayesian framework for modeling rational degrees of belief—the first of its kind to represent rational requirements on agents who undergo certainty loss.

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion. We conducted a systematic review (...) of ethical arguments asking, “What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?” We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000–2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection. Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, “moral reasons” contained the largest number of narrow reasons. The reasons and their associated mentions in this category outnumber those in the sum of the other three categories. We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals. (shrink)