This is the first of two companion articles drawn from a larger project, provisionally entitled Undisciplining Moral Epistemology. The overall goal is to understand how moral claims may be rationally justified in a world characterized by cultural diversity and social inequality. To show why a new approach to moral justification is needed, it is argued that several currently influential philosophical accounts of moral justification lend themselves to rationalizing the moral claims of those with more social power. The present article explains (...) how discourse ethics is flawed just in this way. The article begins by identifying several conditions of adequacy for assessing reasoning practices designed to achieve moral justification and shows that, when used in contexts of cultural diversity and social inequality, discourse ethics fails these conditions. It goes on to argue that the failure of discourse ethics is rooted in its reliance on a broader conception of moral epistemology that is invidiously idealized. It concludes by pointing to the need to rethink both the mission and the method of moral epistemology. (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

The death of Jesse Gelsinger in 1999 during a gene therapy trial raised many questions about the ethical review of medical research. Here, the author argues that the principle of justice is interpreted too narrowly and receives insufficient emphasis and that what we permit in terms of bodily invasion affects the value we place on individuals. Medical research is a societally supported activity. As such, the author contends that justice requires that invasive medical research demonstrates sufficiently compelling societal benefit. Many (...) consider this societal benefit to be self evident. However, medical research is a complex activity; it yields new treatments but also creates financial rewards and affects health resource allocation. As research evolves into a multibillion pound, multinational enterprise, justice requires a much broader analysis of societal benefit. Without such evaluation we risk undermining the value of bodily integrity and of research participants. (shrink)

Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...) ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)

Precision Medicine has become a common label for data-intensive and patient-driven biomedical research. Its intended future is reflected in endeavours such as the Precision Medicine Initiative in the USA. This article addresses the question whether it is possible to discern a new ‘medical cosmology’ in Precision Medicine, a concept that was developed by Nicholas Jewson to describe comprehensive transformations involving various dimensions of biomedical knowledge and practice, such as vocabularies, the roles of patients and physicians and the conceptualisation of disease. (...) Subsequently, I will elaborate my assessment of the features of Precision Medicine with the help of Michel Foucault, by exploring how precision medicine involves a transformation along three axes: the axis of biomedical knowledge, of biomedical power and of the patient as a self. Patients are encouraged to become the managers of their own health status, while the medical domain is reframed as a data-sharing community, characterised by changing power relationships between providers and patients, producers and consumers. While the emerging Precision Medicine cosmology may surpass existing knowledge frameworks; it obscures previous traditions and reduces research-subjects to mere data. This in turn, means that the individual is both subjected to the neoliberal demand to share personal information, and at the same time has acquired the positive ‘right’ to become a member of the data-sharing community. The subject has to constantly negotiate the meaning of his or her data, which can either enable self-expression, or function as a commanding Superego. (shrink)

“A New Budget of Paradoxes” will be a section of our Journal devoted to the pathological. It is not mere amusement. The old “Budget of Paradoxes,” edited by Augustus De Morgan is our model both for choice of material and for humaneness toward the Don Quixotes of Thought.

Organic chemists have been able to develop a robust, theoretical understanding of the phenomena they study; however, the primary theoretical devices employed in this field are not mathematical equations or laws, as is the case in most other physical sciences. Instead it is diagrams, and in particular structural formulas and potential energy diagrams, that carry the explanatory weight in the discipline. To understand how this is so, it is necessary to investigate both the nature of the diagrams employed in organic (...) chemistry and how these diagrams are used in the explanations of the discipline. I will begin this paper by characterizing some of the major ways that structural formulas used in organic chemistry. Next I will present a model of the explanations in organic chemistry and describe how both structural formulas and potential energy diagrams contribute to these explanations. This will be followed by several examples that support my abstract account of the role of diagrams in the explanations of organic chemistry. In particular, I will consider both the appeal to ‘hyperconjugation’ in the explanation of alkene stability and how the idea of ‘ring strain’ was developed to explain the relative stability of cyclic compounds. (shrink)

After first defending dualism against epiphenomenalism and other theories which would render survival impossible, the author discusses what would be admissible evidence either for a discarnate life after death or for reincarnation. He then presents some evidence for both beliefs.--W. L. M.

Subtitled "A Study in Comparative Philosophy," the concept of man in Greek, Jewish, Chinese, and Indian cultures is briefly outlined.--W. L. M.

A massive series of meticulous clarifications and arguments is marshalled to attempt to refute, first, the doctrine that all relations are "internal", next, the claims that coherence is the sole criterion of the nature of truth, and finally, the theory of degrees of truth and falsity. The author's great familiarity with the literature of the coherence theorists proves almost a drawback: he prefers to cite texts extensively, but must then acknowledge important differences among them. There is little in the way (...) of a constructive alternative theory of truth, but the criticism is formidable.--W. L. M. (shrink)

A careful analysis of the relevant passages. The good is both a cause and a quality; as a quality, it is used only in reference to moveable things. Aristotle's treatment here is seen to differ from that in the Ethics.--W. L. M.

This seems destined, quite naturally and justly, to become a standard group of selections. Included are Chappell's meaty Introduction, My Own Life, Of the Standard of Taste, the Dialogues, and large portions of the Treatise and the two Inquiry's. Where Chappell feels that the Treatise and especially the first Inquiry overlap, he favors the passages from the Treatise. Among the notable exclusions from the latter are most of the discussion of space and time and the better part of Book II, (...) Part II. What is probably most controversial and unfortunate is the editor's omission of all but three sections in "Of Justice and Injustice".--W. L. M. (shrink)

Kateb poses as a defender of an actually attainable utopia and considers some recent attacks on this idea. He finds flaws in various arguments against any use of violence in attaining utopia, denies that utopian government need be highly authoritarian or machine-guided, and shows the immorality of certain "aesthetic" objections to life in utopia. While condemning theories of indeterminism, he sympathizes with expressions of hostility to utopian psychologists, such as B. F. Skinner, who would like "conditioning" to supersede older forms (...) of being virtuous. The author makes good use of a wide range of works in philosophy and the social sciences, maintains a high level of argumentation, and displays great respect for most of his anti-utopian opponents.--W. L. M. (shrink)

A leading British historian brings considerable philosophical insight to bear in criticizing the cult of facts, treatments of great men in isolation from their societies, and the view that historians should make moral judgments upon their subjects. His esteem for Collingwood and other idealists is tempered by a warning against their excessive subjectivism. Carr upholds the reality of historical causation, and the belief in some progress.--W. L. M.

Philosophy of science is the organized expression of a growing intent among philosophers and scientists to clarify, perhaps unify, the programs, methods and results of the disciplines of philosophy and of science. The examination of fundamental concepts and presuppositions in the light of the positive results of science, systematic doubt of the positive results, and a thorough-going analysis and critique of logic and of language, are typical projects for this joint effort. It is not necessary to be committed to a (...) belief that science and philosophy are or should be one, or else that “never the twain shall meet.” If anything, there is to be expected a wholesome regard for the value of established science in furnishing a foil for philosophy and a check on its old extravagances. This does not mean that even the best-established science may not be subject to most devastating criticism by analysis of its foundations. In fact, despairing of the philosophy of the schools, science has done it largely for itself. The theories of gravitation, atomicity, electro-magnetism, evolution, relativity and quanta have all arisen through drastic revisions of complacent fundamental “truths.”. (shrink)

The Teubner edition of Festus de Verborum Significatu had scarcely appeared when Professor Anspach announced his discovery of a MS. of Isidore's Etymologies with some Scholia taken from Festus. Last Easter, in the limited time at my disposal, I transcribed from the MS. the greater part of this Isidore Commentary and, later, received a transcript of the remainder from Abbe Liebaert some weeks before his death. Although hampered by the deficiencies of our University Library, I am unwilling to keep this (...) new evidence any longer from students of Festus. (shrink)