Quality-adjusted life years (QALYs) are used to determine how to allocate resources to health programmes or to treatments within those programmes in order to gain maximum utility from those limited, shared healthcare resources. However, if we use those same population- based QALYs when faced with individual treatment decisions we may act unjustly in relation to that individual or in relation to the wider population. A treatment with a population-based incremental cost-effectiveness ratio beyond our willingness to pay threshold may be denied (...) to a patient even if, for that particular patient, the QALYs gained for the cost would fall within that threshold. When considering individual cases, it is proposed that we should take an individualised approach to the cost of treatment and response to treatment (‘individualised QALYs’) and a personalised approach to the valuation of health states (‘personalised QALYs’). Only if we do this, can we maximise utility and give the patient a fair opportunity to benefit. Individualised and personalised QALYs also allow us to express patient choice and religious treatment preferences in terms of utility. Individualised and personalised QALYs are explored in the context of individual funding requests in the National Health Service. In preference to the concept of ‘clinical exceptionality’, individualised and personalised QALYs provide the potential for better and more consistent decisions and improved utility. Rather than treating unequal patients as if they were equal, individualised and personalised QALYs promote fair and unequal access to resources for some of our most unequal patients. Potential challenges are also considered. (shrink)

Warwick Heale has recently defended the notion of individualized and personalized Quality-Adjusted Life Years in connection with health care resource allocation decisions. Ordinarily, QALYs are used to make allocation decisions at the population level. If a health care intervention costs £100,000 and generally yields only two years of survival, the cost per QALY gained will be £50,000, far in excess of the £30,000 limit per QALY judged an acceptable use of resources within the National Health Service in the (...) United Kingdom. However, if we know with medical certainty that a patient will gain four extra years of life from that intervention, the cost per QALY will be £25,000. Heale argues fairness and social utility require such a patient to receive that treatment, even though all others in the cohort of that patient might be denied that treatment. Likewise, Heale argues that personal commitments of an individual, that determine how they value a life-year with some medical intervention, ought to be used to determine the value of a QALY for them. I argue that if Heale’s proposals were put into practice, the result would often be greater injustice. In brief, requirements for the just allocation of health care resources are more complex than pure cost-effectiveness analysis would allow. (shrink)

[Michael Tye] Externalism about thought contents has received enormous attention in the philosophical literature over the past fifteen years or so, and it is now the established view. There has been very little discussion, however, of whether memory contents are themselves susceptible to an externalist treatment. In this paper, I argue that anyone who is sympathetic to Twin Earth thought experiments for externalism with respect to certain thoughts should endorse externalism with respect to certain memories. /// [Jane Heal] Tye claims (...) that an externalist should say that memory content invoking natural kind concepts floats free of the setting where the memory is laid down and is at later times determined by the context in which the memory is revived. His argument assumes the existence of 'slow switching' of the meaning of natural kind terms when a person is transported from Earth to Twin Earth. But proper understanding of natural kind terms suggests that slow switching (contrary to what is often presupposed) is likely never to be completed. Hence the situation of a person unknowingly transported to Twin Earth is not that his memories switch content but rather that he gets two natural kinds confused. (shrink)

Moran rightly links performance of speech acts to instituting second‐personal normative relations. He also maintains that an audience's recognition of the speaker's intention in speaking is sufficient for the speaker's success in doing the speech act intended. The claim is true on some ways of understanding speech act verbs, but false on others. This complexity of speech act verbs can be explained by seeing how speech acts need to be understood in the context of shared life and cooperative action.

With A Theory of General Ethics Warwick Fox both defines the field of General Ethics and offers the first example of a truly general ethics. Specifically, he develops a single, integrated approach to ethics that encompasses the realms of interhuman ethics, the ethics of the natural environment, and the ethics of the built environment. Thus Fox offers what is in effect the first example of an ethical "Theory of Everything."Fox refers to his own approach to General Ethics as the (...) "theory of responsive cohesion." He argues that the best examples in any domain of interest--from psychology to politics, from conversations to theories--exemplify the quality of responsive cohesion, that is, they hold together by virtue of the mutual responsiveness of the elements that constitute them. Fox argues that the relational quality of responsive cohesion represents the most fundamental value there is. He then develops the theory of responsive cohesion, central features of which include the elaboration of a "theory of contexts" as well as a differentiated model of our obligations in respect of all beings. In doing this, he draws on cutting-edge work in cognitive science in order to develop a powerful distinction between beings who use language and beings that do not.Fox tests his theory against eighteen central problems in General Ethics--including challenges raised by abortion, euthanasia, personal obligations, politics, animal welfare, invasive species, ecological management, architecture, and planning--and shows that it offers sensible and defensible answers to the widest possible range of ethical problems. (shrink)

In this book I advance an argument concerning the nature of the deep ecology approach to ecophilosophy. In order to advance this argument in as thorough a manner as possible, I present it within the context of a comprehensive overview of the writings on deep ecology.

ABSTRACT In 1929 and 1934–1935, the physical anthropologist Harry L. Shapiro voyaged in the South Seas on the Mahina-I-Te-Pua and the Zaca, measuring mixed-race islanders, including the descendants of the Bounty mutineers on Pitcairn Island. His research in Polynesian hybridity reflects the growing cultural and scientific investment of the United States in the Pacific during this period. Shapiro's oceanic adventures and intimate encounters prompted him to discount typological speculation and emphasize instead the liberal Boasian program in physical anthropology, giving him (...) the confidence to refigure his evaluations of racial difference. The seaborne investigatory enterprise came to influence U.S. racial thought, adding impetus to the condemnation of racism in science. On his return from the South Seas, Shapiro tried to get his fellow physical anthropologists to issue a manifesto opposing the harnessing of their science to racial discrimination and prejudice. (shrink)

Homo sapiens is entering a vital era in which the human-technology link is an inexorable trend. In this paper a look is taken as to how and why this is coming about and what exactly it means for both the posthuman species Homo technologicus and its originator Homo sapiens. Clearly moral and ethical issues are at stake. Different practical experimentation results that relate to the theme are described and the argument is raised as to why and how this can be (...) regarded as a new species. A picture is taken of the status of cyborgs as it stands today but also how this will change in the near future, as the effects of increased technological power have a more dramatic influence. An important ultimate consideration is whether Homo technologicus will act in the best interests of Homo sapiens or not. This paper concludes that the answer is clear. (shrink)

'if AI is outside your field, or you know something of the subject and would like to know more then Artificial Intelligence: The Basics is a brilliant primer.' - Nick Smith, Engineering and Technology Magazine November 2011 Artificial Intelligence: The Basics is a concise and cutting-edge introduction to the fast moving world of AI. The author Kevin Warwick, a pioneer in the field, examines issues of what it means to be man or machine and looks at advances in robotics (...) which have blurred the boundaries. Topics covered include: how intelligence can be defined whether machines can 'think' sensory input in machine systems the nature of consciousness the controversial culturing of human neurons. Exploring issues at the heart of the subject, this book is suitable for anyone interested in AI, and provides an illuminating and accessible introduction to this fascinating subject. (shrink)

In this article, a practical look is taken at some of the possible enhancements for humans through the use of implants, particularly into the brain or nervous system. Some cognitive enhancements may not turn out to be practically useful, whereas others may turn out to be mere steps on the way to the construction of superhumans. The emphasis here is the focus on enhancements that take such recipients beyond the human norm rather than any implantations employed merely for therapy. This (...) is divided into what we know has already been tried and tested and what remains at this time as more speculative. Five examples from the author’s own experimentation are described. Each case is looked at in detail, from the inside, to give a unique personal experience. The premise is that humans are essentially their brains and that bodies serve as interfaces between brains and the environment. The possibility of building an Interplanetary Creature, having an intelligence and possibly a consciousness of its own, is also considered. (shrink)

The era of the Cyborg is now upon us. This has enormous implications on ethical values for both humans and cyborgs. In this paper the state of play is discussed. Routes to cyborgisation are introduced and different types of Cyborg are considered. The author's own self-experimentation projects are described as central to the theme taken. The presentation involves ethical aspects of cyborgisation both as it stands now and those which need to be investigated in the near future as the effects (...) of increased technological power have a more dramatic influence. An important feature is the potential for cyborgs to act against, rather than for, the interests of humanity. (shrink)

There has recently been considerable discussion of the relative merits of deep ecology and ecofeminism, primarily from an ecofeminist perspective. I argue that the essential ecofeminist charge against deep ecology is that deep ecology focuses on the issue of anthropocentrism (i.e., human-centeredness) rather than androcentrism (i.e., malecenteredness). I point out that this charge is not directed at deep ecology’s positive or constructive task of encouraging an attitude of ecocentric egalitarianism, but rather at deep ecology's negative or critical task of dismantling (...) anthropocentrism. I outline a number of problems that can attend not only the ecofeminist critique of deep ecology, but also comparable critiques that proceed from a broad range of social and political perspectives. I then proceed to argue that deep ecology’s concem with anthropocentrism is entirely defensible-and defensible in a way that should be seen as complementing and expanding the focus of radical social and political critiques rather thanin terms of these approaches versus deep ecology. (shrink)

In responding to perceived crises—such as the COVID-19 pandemic—in routinized ways, contemporary bioethics can make us prisoners of the proximate. Rather, we need bioethics to recognize and engage with complex configurations of global ecosystem degradation and collapse, thereby showing us paths toward co-inhabiting the planet securely and sustainably. Such a planetary health ethics might draw rewardingly on Indigenous knowledge practices or Indigenous philosophical ecologies. It will require ethicists, with other health professionals, to step up and become public advocates for environmental (...) sustainability. The COVID-19 pandemic should be seen as opening a portal to planetary health ethics or ecologized bioethics. (shrink)

D. N. Rodowick _Reading the Figural, or, Philosophy after the New Media_ Durham: Duke University Press, 2001 ISBN 0-8223-2711-2 276 pp.

Much has been written in recent years on environmental ethics relating to the more general 'natural' environment but little specifically written about ethics of the built environment. Ethics and the Built Environment responds to this need and offers a debate on the ethical dimension of building in all its forms from a variety of disciplinary perspectives and approaches. This book should be of interest to architects, students of building and building design, environmentalists, politicians and general readers with an interest in (...) ethics. (shrink)

_With Nature_ provides new ways to think about our relationship with nature in today’s technologically mediated culture. Warwick Mules makes original connections with German critical philosophy and French poststructuralism in order to examine the effects of technology on our interactions with the natural world. In so doing, the author proposes a new way of thinking about the eco-self in terms of a careful sharing of the world with both human and non human beings. _With Nature_ ultimately argues for a (...) poetics of everyday life that affirms the place of the human-nature relation as a creative and productive site for ecological self-renewal and redirection. (shrink)

This paper looks at some of the different practical cyborgs that are realistically possible now. It firstly describes the technical basis for such cyborgs then discusses the results from experiments in terms of their meaning, possible applications and ethical implications. An attempt has been made to cover a wide variety of possibilities. Human implantation and the merger of biology and technology are important factors here. The article is not intended to be seen as the final word on these issues, but (...) rather to give an initial overview. Most of the experiments described are drawn from the author’s personal experience over the last 15 years. (shrink)

During the cold war, Frank Fenner and Francis Ratcliffe studied mathematically the coevolution of host resistance and parasite virulence when myxomatosis was unleashed on Australia’s rabbit population. Later, Robert May called Fenner the “real hero” of disease ecology for his mathematical modeling of the epidemic. While Ratcliffe came from a tradition of animal ecology, Fenner developed an ecological orientation in World War II through his work on malaria control —that is, through studies of tropical medicine. This makes Fenner at least (...) a partial exception to other senior disease ecologists in the region, most of whom learned their ecology from examining responses to agricultural challenges and animal husbandry problems in settler colonial society. Here I consider the local ecologies of knowledge in southeastern Australia during this period, and describe the particular cold-war intellectual niche that Fenner and Ratcliffe inhabited. (shrink)

The parsimonious consideration of research into food sharing among chimpanzees suggests that the type of social regulation found among our closest genetic relatives can best be understood as a form of morality. Morality is here defined from a naturalistic perspective as a system in which self-aware individuals interact through socially prescribed, psychologically realistic rules of conduct which provide these individuals with an awareness of how one ought to behave. The empirical markers of morality within chimpanzee communities and the traditional moral (...) traits to which they correspond are (1) self-awareness/agency; (2) calculated reciprocity/obligation; (3) moralistic aggression/blame; and (4) consolation/empathy. (shrink)

In this paper a look is taken at the relatively new area of culturing neural tissue and embodying it in a mobile robot platform—essentially giving a robot a biological brain. Present technology and practice is discussed. New trends and the potential effects of and in this area are also indicated. This has a potential major impact with regard to society and ethical issues and hence some initial observations are made. Some initial issues are also considered with regard to the potential (...) consciousness of such a brain. (shrink)

In an essay published in 1918, Walter Benjamin sets forth a task that will concern him for the rest of his life: The task of a future epistemology is to find for knowledge the sphere of total neutrality in regards to concepts of both subject and object; in other words, it is to discover the autonomous, innate sphere of knowledge in which this concept in no way continues to designate the relation between two metaphysical entities. (‘‘The Coming Philosophy’’ 104) Benjamin (...) seeks an ‘‘autonomous, innate sphere of knowledge’’ that bypasses the Kantian dualism of subject and object to ‘‘form a pure and systematic continuum of experience’’ (105). He wants to break down the relation between subject and object that has led to the ossification of experience in fixed modes of life, in order to develop a theoretical thinking that ‘‘grasps the world as such as an undivided whole’’. (shrink)

In an essay published in 1918, Walter Benjamin sets forth a task that will concern him for the rest of his life: The task of a future epistemology is to find for knowledge the sphere of total neutr...

A discussion of whiteness as an “ethos” or “relational category” in bioethics, drawing on examples from medical and historical research.

The interest of F. Macfarlane Burnet in host–parasite interactions grew through the 1920s and 1930s, culminating in his book, Biological Aspects of Infectious Disease, often regarded as the founding text of disease ecology. Our knowledge of the influences on Burnet’s ecological thinking is still incomplete. Burnet later attributed much of his conceptual development to his reading of British theoretical biology, especially the work of Julian Huxley and Charles Elton, and regretted he did not study Theobald Smith’s Parasitism and Disease until (...) after he had formulated his ideas. Scholars also have adduced Burnet’s fascination with natural history and the clinical and public health demands on his research effort, among other influences. I want to consider here additional contributions to Burnet’s ecological thinking, focusing on his intellectual milieu, placing his research in a settler society with exceptional expertise in environmental studies and pest management. In part, an ‘‘ecological turn’’ in Australian science in the 1930s, derived to a degree from British colonial scientific investments, shaped Burnet’s conceptual development. This raises the question of whether we might characterize, in postcolonial fashion, disease ecology, and other studies of parasitism, as successful settler colonial or dominion science. (shrink)

What happens to twentieth-century race science when we relocate it to the Global South? North Atlantic debates have dominated the conceptual history of race. Yet there is suggestive evidence of a “southern” or antipodean racial distinctiveness. We can find across the Southern Hemisphere greater interest in racial plasticity, environmental adaptation, mixing or miscegenation, and blurring of racial boundaries; endorsement of biological absorption of indigenous populations; and consent to the formation of new or blended races. Once we recognize the Global South (...) as a site of knowledge making, and not just data extraction, the picture of race science in the twentieth century changes. Once situated, or displaced, the conventional North Atlantic history of race science in the twentieth century comes to seem exceptional—and no longer normative. (shrink)

Recent philosophy of mind has had a mistaken conception of the nature of psychological concepts. It has assumed too much similarity between psychological judgments and those of natural science and has thus overlooked the fact that other people are not just objects whose thoughts we may try to predict and control but fellow creatures with whom we talk and co-operate. In this collection of essays, Jane Heal argues that central to our ability to arrive at views about others' thoughts is (...) not knowledge of some theory of the mind but rather an ability to imagine alternative worlds and how things appear from another person's point of view. She then applies this view to questions of how we represent others' thoughts, the shape of psychological concepts, the nature of rationality and the possibility of first person authority. This book should appeal to students and professionals in philosophy of mind and language. (shrink)

This chapter contains sections titled: References and Further Reading.

In this paper, I argue that we need to re-address the issue of freedom as it relates to democracy and critical practice. My argument is drawn out of Derrida's deconstructive reading of Jean-Luc Nancy's The Experience of Freedom which proposes freedom in ontological terms as an experience of indeterminate openness that must be thought prior to any freedom of the self. I show how Derrida's reading of Nancy's text is itself a re-enactment of the freedom that Derrida finds wanting in (...) Nancy's text, but which, by that very fact, affirms the power of critique in its capacity to think freely. The urgency of the thought of freedom is not something that can be avoided, but is itself the fact of critique in its thinking of democracy as a possibility, as something that might come about, as distinct from an already accomplished idea. To think in this way is, I argue, a matter of virtue, that is, of being free, as the virtue of critique and its capacity to act decisively, thereby bringing something forth by risking what it already is, in the absolute possibility of it not being. (shrink)