Hegel’s treatment of Sophocles’s Antigone exposes a tension in our own landscape between religious and civil autonomy. This tension reflects a deeper tension between unreflective, implicit norms and reflective, explicit norms that can be autonomously endorsed. The tension is, as Hegel recognizes, of particular importance to women. Hegel’s characterization of this tension in light of Antigone is, as H.S. Harris argues, both a more developed and a more fundamental moment in the Phenomenology of Spirit than the moment of Enlightenment autonomy (...) (with its powers of reflective self-critique). Indeed, George Steiner has remarked that, for the German idealists, Antigone exemplifies the very “pivot of consciousness,” so fundamental is the tension that it expresses. I argue that, while Hegel demonstrates the necessity of the modern transition to explicit norms that can be autonomously endorsed, explicit norms nevertheless depend on a background of unreflective norms for their force. Moreover, Hegel uses the conflict between Antigone and Creon to illustrate the tension and mutual dependence between these two types of norms. (shrink)

This paper considers debates around the neoliberal governmentality, and argues for the need to better theorize the specific ethical practices through which such programs of governmentality are carried out. Arguing that much theoretical and empirical work in this area is prone to a “top down” approach, in which governmentality is reduced to an imposing apparatus through which subjectivities are produced, it argues instead for the need to understand the self-production of subjectivities by considering the ethical practices that make (...) up neoliberal governmentality. Moreover, taking Robert T. Kiyosaki’s Rich Dad/Poor Dad as an illustrative case, the point is made that the work of neoliberal governmentality specifically targets the temporalities of conduct, in an attempt to shape temporal orientations in a more entrepreneurial form. Drawing on Foucault’s lecture courses on liberalism and neoliberalism, and Jacques Donzelot’s work on the social, the case is made that neoliberal governmentality exhorts individuals to act upon the residual social temporalities that persist as a trace in the dispositions of neoliberal subjects. Moreover, the paper concludes with a discussion of the potentials for resistance in this relation, understood as temporal counter-conducts within neoliberalism. (shrink)

Ethics in Mental Health-Substance Use aims to explore the comprehensive concerns and dilemmas occurring from mental health and substance use problems, and to inform, develop, and educate by sharing and pooling knowledge, and enhancing expertise, in this fast developing region of ethics and ethical care and practice. This volume concentrates on ethical concerns, dilemmas, and concepts specifically interrelated, as a collation of problem(s) that directly or indirectly affect the life of the individual and family. Whilst presenting (...) a balanced view of what is ethically best practice today, this title challenges concepts and stimulates debate, exploring all aspects of the development in treatment, intervention and care responses, and the adoption of research-led best practice. (shrink)

The substance view is an account of personhood that regards all human beings as possessing instrinsic value and moral status equivalent to that of an adult human being. Consequently, substance view proponents typically regard abortion as impermissible in most circumstances. The substance view, however, has difficulty accounting for certain intuitions regarding the badness of death for embryos and fetuses, and the wrongness of killing them. Jeff McMahan’s time-relative interest account is designed to cater for such intuitions, and (...) so I present a proposal for strengthening the substance view by incorporating McMahan’s account – the Dual-Aspect Account of the morality of killing. I show that it resolves some important issues for the substance view while preserving its central premise of moral equality for all human beings. I then compare the Dual-Aspect Account with McMahan’s Two-Tiered Account of the morality of killing, which he derives from his time-relative interest account. (shrink)

When doing research among vulnerable populations, researchers are obliged to protect their subjects from harm. We will argue that traditional ethical guidelines are not sufficient to do this, since they mainly focus on direct harms that can occur: for example, issues around informed consent, fair recruitment and risk/harm analysis. However, research also entails indirect harms that remain largely unnoticed by research ethical committees and the research community. Indirect harms do not occur during data collection, but in the analysis (...) of the data, and how the data is presented to the scientific and wider societal community. Highly stigmatized research subjects, like substance‐dependent parents, are especially at risk of encountering indirect harm, because the prejudice against them is so persistent. In this paper we discuss two forms of indirect harm. First, researchers have to be aware how their results will be preceived by society. Even when subjects are presented in an objective way, further, out of porportion stigmatization can occur. Researchers sometimes try to counteract this by whitewashing their results, at the risk of downplaying their respondents’ problems. The second risk researchers face is that their own normative judgements influence how they question such parents, report results and interpret statements. Researchers’ own normative judgements may influence the way they present their subjects. This article reviews a broad range of research that exhibits such indirect harms, discussing how and why indirect harms occur and formulating corresponding recommendations on how to prevent them. (shrink)

Philosophers generally agree that meaningful ethical statements are universal in scope. If so, what sense is there to speak about a business ethics particular to Judaism? Just as a Jewish algebra and a Jewish physics are contradictions in terms, so too, is the notion of a particularly Jewish business ethics. The goal of this paper is to deny the above assertion and to explore the potentially unique characteristic of a Jewish business ethics. Ethics, in the final analysis, is not (...) like algebra or physics. Specifically, it is argued here that – in terms of substance – Jewish business ethics differs from secular approaches in three very specific ways. Jewish ethics: (1) recognizes God as the ultimate source of value, (2) acknowledges the centrality of the community, (3) and holds out the promise that men and women (living in community) can transform themselves. We define Jewish ethics as the interpretation of the written and oral Torah to determine what God commands us to be and to do. The paper carefully explores this definition and examines its specific implications for modern business ethics. (shrink)

While solid organ transplantation for patients with substance use issues has attracted ethical discussion, a typology of the ethics themes has not been articulated in the literature. We conducted a scoping review of peer-reviewed literature on solid organ transplantation and substance use published between January 1997 and April 2016. We aimed to identify and develop a typology of the main ethical themes discussed in this literature and to identify gaps worthy of future research. Seventy articles met (...) inclusion criteria and underwent inductive content analysis. Four main ethical themes were identified: (1) personal responsibility; (2) utility; (3) moral character; and (4) fairness. Each theme had multiple sub-themes and there was substantial overlap between themes. This scoping review identified a disproportionate emphasis in the literature regarding personal responsibility, which was referenced by each of the other themes, and a narrow focus on alcohol and liver. We recommend future research further investigate these connections between ethical themes and focus on ethical issues associated with transplants from organ groups other than liver for patients who use substances other than alcohol. (shrink)

Ethical frameworks can support professionals’ decision‐making. Here, we identify two ethical frameworks to analyse the best support for families that struggle with parental substance or alcohol abuse. The first framework, which we call ‘the framework of conflicting interests’, is most prominent in the literature. Here, the interests of parents and children are weighed against each other using the medical ethical principles of respect for autonomy, justice, beneficence, and non‐maleficence. The second framework is most prominent in a (...) series of interviews we conducted with alcohol‐dependent parents and professionals working in addiction care and youth care. This framework aligns more with an ethics of care, and starts with the assumption that the interests of people who are close to each other are often intertwined. This framework does not so much look at conflicting interests, but at relationships and vulnerability. We label this the ethics of care framework. In this article, we show the value of both frameworks and how they can support ethical decision‐making. (shrink)

G.W.F. Hegel focuses his treatment of Sophocles' drama, Antigone , in the Phenomenology of Spirit, on the ideal of mutual recognition. Antigone was punished with death for performing the burial ritual honoring her brother, Polyneices, to whose irreplaceability she attests in her well-known speech of defiance. Hegel argues that Antigone's loss of Polyneices was the irreparable loss of reciprocal recognition. Only in the brother sister relation, Hegel thought, could there be equality in mutual recognition. I argue that this equality cannot (...) be found in a marriage union with a husband or in the public sphere of civil society. Situating Hegel's account of marriage in the Philosophy of Right within the history of marriage and historical literature on the emerging market economy of Hegel's time, I demonstrate that Hegel's perception of equality in the reciprocal recognition of the brother sister relation was a function of both economic realities and his relationship with his sister, Christiane. I show desire in the Phenomenology to be the desire for dominance, and I show the brother sister relation to be free of desire. (shrink)

In this dissertation, I argue that we should reframe the presentation and defense of the program of discourse ethics and deliberative democracy (DEP) in such a way that we make clear its connection to the substantive moral ideas of solidarity, equality and freedom. This program basically says that we should, when we can, determine the validity of the norms regulating our social life through practices of public deliberation. If we want to understand why engaging in public deliberation makes moral sense, (...) or is obligatory, we need to make explicit the connection between the formal procedures of deliberation and our most basic substantive moral ideas of freedom, equality and solidarity. In order to unpack this claim, I construct what I call an expressive-elaboration model of the relation between substance and procedure in public deliberation. According to this model, we should see the two dimensions as working in tandem, in such a way that deliberative procedures are understood as the medium of expression and elaboration of our basic substantive ideas of solidarity, equality and freedom. The three ideas are expressed in the fact and form of deliberation, and elaborated in their changing and specific interpretations as topics and consequences of deliberative practices. To develop this model, I start with a consideration of certain insights of Kant's moral theory, and proceed to bridge the gap between Habermas's more formalistic and Rawls's more substantive neo-Kantian accounts of practical reason. The result is a straightforwardly substantive articulation and defense of the dialogic procedures of DEP based on the recognition of the fact of widespread moral disagreement and a fundamental project of justice demanding that we deal with that condition of disagreement by constructing social arrangements in which we include each other, solidaristically, as free and equal members. This morally substantive defense of DEP referring to the fact of widespread moral disagreement and the fundamental project of justice is different from, and more compelling than, other common, formalistic and prudential defenses of DEP. (shrink)

In this paper, I argue that bioethics suffers from a masculinist approach-what I call “ethical androcentrism.” Despite the genesis of other legitimate approaches to ethics (such as feminist, narrative, and communicative ethics), this masculinist tradition persists. The first part of my paper concerns the problem of ethical androcentrism, and how it is manifest in our typical ways of “doing” bioethics (as teachers, ethicists, policymakers, and medical practitioners). After arguing that bioethics suffers from a masculinist ethic, I consider the (...) case of maternal substance addiction to show how this ethic negatively affects the treatment of pregnant addicts. I argue that by treating maternal substance addiction from an androcentric approach, we fail to serve both pregnant addicts and their fetuses; furthermore, we misrepresent the intentional state of pregnant substance addicts and label them “prenatal abusers.” If maternal substance addiction is to be ethically addressed -- and if pregnant substance addicts are to be effectively treated -- we cannot tacitly accept an androcentric ethic. (shrink)

Aristotle bequeathed to us a powerful metaphysical picture, of substances in which properties inhere. The picture has turned out to be highly problematic in many ways; but it is nevertheless a picture not easy to dislodge. Less obvious are the normative tones implicit in the picture and the way these permeate our system of values, especially when thinking of ourselves and our ambitions, hopes and fears. These have proved, if anything, even harder to dislodge than the metaphysical picture which supports (...) them. This paper first draws out the ethics suggested by a conception of being as individual substances, and finds both inner tensions among these values—expressed in divergent characteristics in the history of philosophy—and a neglect of a significant set of values. Substance metaphysics prefers freedom, independence and autonomy over relational and reciprocal values, which can even be regarded as existentially threatening. A prominent attempt to accommodate both sorts of values without eschewing substantialist metaphysics is briefly considered, before turning to examine an alternative metaphysics and the values it implies. A metaphysics which takes being as becoming, it is argued, supports an ethics centred on relational values, and their associated virtues of care. (shrink)

Few would deny that some central questions in business ethics are normative. But there has been, and remains, much skepticism about the value of traditional philosophical approaches to answering these questions. I have three central aims in this chapter. The first is to defend traditional philosophical approaches to business ethics against the criticism that they are insufficiently practical. The second is to defend the view that the appropriate methodology for pursuing work in business ethics is largely continuous with the appropriate (...) methodology in moral and political philosophy more broadly. And the third is to offer a brief characterization of how we should think about the substance of business ethics, in light of my arguments about its proper aims and methodology. (shrink)

Substance use disorder (SUD) care among women in the sex trade poses multiple ethical challenges. We propose a framework with three lenses—autonomy, power, and place—that can inform and help improve more ethical clinical care for people who trade sex seeking SUD treatment. A relational perspective on autonomy, an analysis of power relations in the clinic, and a geographical analysis can inform how we create space for people with experience in the sex trade in substance use treatment (...) facilities and beyond. We conclude with some practical applications of this framework, all while integrating a composite clinical vignette throughout our analysis. This analysis addresses a clinical and ethical gap in ways to provide better care for women in the sex trade, an understudied and chronically marginalized population deserving of care that meets them where they are. (shrink)

Psychologists providing services to pregnant individuals using substances face a number of complicated ethical dilemmas, however guidance in this area is sparse. This article presents the ethical and legal issues that may arise in working with this population within the framework of the American Psychological Association’s (APA) Ethical Principles of Psychologists and Code of Conduct (2017). The recommendations made are designed to assist psychologists with understanding factors that contribute to substance use during pregnancy, navigating punitive policies (...) and liability risk, and methods to increase access to care for this vulnerable group. (shrink)

Spinoza searched for a language that could help him to create a monistic system of ethics. Latin was in the 17th century a fairly malleable medium of communication. In its philosophical use it was largely a creation of Descartes. Spinoza wanted to use it in a way that would resemble Euclid's treatment of geometry. He needed a language that would clearly and precisely describe the process by which a man could liberate himself from the power of affection that hamper naturaly (...) propensity for social peace and mental equaenimity. He decided to begin by describing nature, which was responsible for man's proclivities and abilities. Consequently he needed a new conception of substance which on the one hand could be definied by some initial axioms, and on the other hand would sufficiently flexible to include various aspects of human thought. It is interesting that when Spinoza had to make a choice between flexibility and content, he resolved to adopt a strict method of reasoning at the cost of the received understanding of substance. It is possible that these linguistic considerations led him to adopt the view that substance is identical with God and as such encompasses all principles of operations of the human mind and premises for the deriving of all fundamental notions popular in his times. (shrink)

There is a long-standing failure to create an ethical culture around substance use disorders (SUDs) or dependence that actively supports people’s recovery efforts. Issues which impede the development of prorecovery environments are complex, but include the far-reaching effects of the social stigma that surrounds SUDs; and the failure to harness relational and social support that allows debates to transcend blaming individual substance users. As part of efforts to create prorecovery environments, it is important to acknowledge that bioethics (...) debate on SUDs is narrow in scope, prioritising topics related to its traditional interests in individual autonomy and novel technologies. As a result, it has not played a significant role in helping to transform the ethical cultures in which substance use recovery takes place. For example, it largely neglects the ethical challenges of developing an empathic, person-centred approach to substance use problems that listens and responds to the voices of clients. It has also participated little in efforts to develop a positive response to reducing the toxic effects of stigma. Indeed, some contributions from the field fan stigma, rather than alleviate it. The aim of this paper is to seed broader ethical debate, in academic literature and lay/professional communities, on how societies should respond to SUDs: steering a course between the critical, but narrow approach of bioethics and the empowerment discourse of evidence-based treatments. (shrink)

As part of an ethics course, health professions students were asked to identify ethical issues and to propose resolutions before and after a class discussion of a case involving confidentiality and substance abuse. Students listed an average of 2.4 issues before and 3.6 issues after the discussion. After discussion 50 per cent of students made explicit changes in their proposed resolution. Opinions varied widely on breaching confidentiality and the responsibility for protecting the patient's health. After the discussion almost (...) 20 per cent of the class felt it was acceptable to breach confidentiality as long as the patient was unaware. Many students identified more with the health care provider than with the patient. The presence of substance abuse altered many students' views on confidentiality. In this experience students were less rigorous in their application of principles, creating an excellent opportunity for teaching through exploration of the complexity of ethical decision-making in a specific case. (shrink)

‘Substance’ (substantia, zelfstandigheid) is a key term of Spinoza’s philosophy. Like almost all of Spinoza’s philosophical vocabulary, Spinoza did not invent this term, which has a long history that can be traced back at least to Aristotle. Yet, Spinoza radicalized the traditional notion of substance and made a very powerful use of it by demonstrating – or at least attempting to demonstrate -- that there is only one, unique substance -- God (or Nature) -- and that all (...) other things are merely modes or states of God. Some of Spinoza’s readers understood these claims as committing him to the view that only God truly exists, and while this interpretation is not groundless, we will later see that this enticing and bold reading of Spinoza as an ‘acosmist’ comes at the expense of another audacious claim Spinoza advances, i.e., that God/Nature is absolutely and actually infinite. But before we reach this last conclusion, we have a long way to go. So, let me first provide an overview of our plan. In the first section of this paper we will examine Spinoza’s definitions of ‘substance’ and ‘God’ at the opening of his magnum opus, the Ethics. Following a preliminary clarification of these two terms and their relations to the other key terms defined at the beginning of the Ethics, we will briefly address the Aristotelian and Cartesian background of Spinoza’s discussion of substance. In the second section, we will study the properties of the fundamental binary relations pertaining to Spinoza’s substance: inherence, conception, and causation. The third section will be dedicated to a clarification of Spinoza’s claim that God, the unique substance, is absolutely infinite. This essential feature of Spinoza’s substance has been largely neglected in recent Anglo-American scholarship, a neglect which has brought about an unfortunate tendency to domesticate Spinoza’s metaphysics to more contemporary views. The fourth section will study the nature of Spinoza’s monism. It will discuss and criticize the interesting yet controversial views of the eminent Spinoza scholar, Martial Gueroult, about the plurality of substances in the beginning of the Ethics; address Spinoza’s claim in Letter 50 that, strictly speaking, it is improper to describe God as “one”; and, finally, evaluate Spinoza’s kind of monism against the distinction between existence and priority monism recently introduced into the contemporary philosophical literature. The fifth and final section will explain the nature, reality, and manner of existence of modes. We therefore have an ambitious plan; let’s get down to business. (shrink)

We examine the relation between worker substance abuse and workplace fraud in a sample of medical doctors. Relative to their peers, we observe that doctors engaging in substance abuse are between 50 and 100 times more likely to commit fraud in a given year. This result is consistent with research suggesting that substance abuse both creates financial pressures and impairs the functioning of cognitive self-regulatory mechanisms. Our results are robust in within-subject tests and between-subject tests, as well (...) as in tests using instrumental variables that exploit exogenous variation in the state-level availability of opioids, a commonly abused substance. (shrink)

In this paper I analyze the most controversial thesis of Aristotelian substantialism, namely, that substances cannot be composed of other substances. I call this position the Mereological Limitation Thesis (MLT). I find MLT valid and defend it. My argument for MLT is a version of the argument from the unicity of substantial form. Every substance can have only one substantial form, thus, if some substances compose the objectO, then what binds them is only a set of their accidental forms (...) (relations) and in the result thereofOis not a substance (Ois not informed by a substantial form). I argue against the relativization of the substantiality of forms to the level of composition by showing that substantial forms must be absolutely identity-independent. In the last section I specify the ontological status of parts of substances and argue that they are spatially distributed bundles of accidents of a compound substance itself. (shrink)

William Smith’s recent article criticises the so-called orthodox approaches to the normative analysis of healthcare resource allocation, associated to the requirement that decision-makers should abide by strictly procedural principles of legitimacy defining a deliberative democratic process. Much of the appeal of Smith’s argument goes down to his awareness of real-world processes and, in particular, to the large gap he identifies between well-led democratic deliberation and the messiness of the process through which the intuitively legitimate Affordable Care Act was created. This (...) reply aims to demonstrate that the ACA provides no counterexample to orthodox views, seizing this opportunity to explore the specific space that the procedural principles populating orthodox accounts are meant to regulate. Neither general questions of healthcare justice concerning, for example, universal access nor, relatedly, the activity of elected politicians falls within the natural scope of application of such principles, revealing a much more complex picture of the interactions between justice and legitimacy as well as substantive and procedural considerations than acknowledged by Smith. In the end, orthodox accounts of healthcare resource allocation turn out to provide a precious fund of theoretical resources for the normative study of administrators, which might be useful well beyond bioethics and health policy. (shrink)

It is useful in an article of this kind to inform the reader of the author’s background, biases, and rationale for the format and content. As a clinically trained psychiatrist and addiction specialist/researcher, my training and experience have led me to best understand the “clinical side” of alcoholism and substance abuse. A large part of my career has been devoted to treating individuals with alcohol use disorders, especially in the context of clinical trials devoted to finding new medications to (...) reduce craving, drinking, and preventing relapse. I also teach professionals about the diagnosis and treatment of alcohol and other substance abuse disorders. While my focus has been mainly on alcohol use disorders, much of what is known about the neuroscience of addiction is applicable to many, if not all, substances of abuse. I have seen the ravages of these diseases, including death, but I more commonly see the milder forms of these diseases that make people’s lives just plain miserable and/or less enjoyable or productive than they would have been without their addiction. (shrink)

Alcohol and substance abuse are prevalent in our society. Advances in neuroscience have led to a clearer understanding of the effects of abused substances on the brain. Clues are now available regarding how a person goes from a “user” to being addicted based on brain chemistry, anatomy, and genetic risk. During this process the person loses at least partial, if not complete, control, over their compulsive substance use. This article attempts to put modern notions of alcohol and (...) class='Hi'>substance abuse and dependency into a societal and cultural context with the hope of reducing the stigma of this illness while shifting the focus a bit more away from criminal solutions to those offered by health care and treatment options. (shrink)

The treatment of pregnant women addicted to drugs provides an especially important and illustrative example of how political and popular demands can successfully challenge professional ethical norms associated with clinical medicine — norms such as confidentiality, patient autonomy, and the right to consent to and to refuse treatment. One increasingly popular policy approach is to limit patient autonomy by coercing women in an attempt to change their behavior, either by involuntary civil commitment or by imprisoning them for drug abuse (...) or child neglect. Thirty-five states have criminally prosecuted women for substance abuse or alcohol use during pregnancy. Other states aggressively use involuntary civil commitment as a means to protect the yet-to-be-born from harm during pregnancy. Medical professionals have been forced to participate in these programs by mandatory reporting requirements. (shrink)

The treatment of pregnant women addicted to drugs provides an especially important and illustrative example of how political and popular demands can successfully challenge professional ethical norms associated with clinical medicine — norms such as confidentiality, patient autonomy, and the right to consent to and to refuse treatment. One increasingly popular policy approach is to limit patient autonomy by coercing women in an attempt to change their behavior, either by involuntary civil commitment or by imprisoning them for drug abuse (...) or child neglect. Thirty-five states have criminally prosecuted women for substance abuse or alcohol use during pregnancy. Other states aggressively use involuntary civil commitment as a means to protect the yet-to-be-born from harm during pregnancy. Medical professionals have been forced to participate in these programs by mandatory reporting requirements. (shrink)

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies, and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and to (...) pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970. CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence. (shrink)

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies, and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and to (...) pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970. CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence. (shrink)

This is a response to Stephen Maitzen’s paper. ‘Moral Conclusions from Nonmoral Premises’. Maitzen thinks that No-Ought-From-Is is false. He does not dispute the formal proofs of Schurz and myself, but he thinks they are beside the point. For what the proponents of No-Ought-From-Is need to show is not that you cannot get SUBSTANTIVELY moral conclusions from FORMALLY non-moral premises but that you cannot get SUBSTANTIVELY moral conclusions from SUBSTANTIVELY non-moral premises. And he believes that he can derive substantively moral (...) conclusions from FORMALLY moral but SUBSTANTIVELY nonmoral premises. However his argument relies on what I call ‘taxonomic essentialism’, the thesis that sentences do not change their semantic characters from context to context or from world to world. In particular, they do not change their META-ETHICAL status from context to context or world to world. If a sentence is non-moral at one world it is non-moral at all the rest. This thesis leads to contradictions (with some propositions as both moral and non-moral) and even if (as is perhaps possible) these contradictions can be avoided, it leads to further consequences that are palpably absurd. Thus It may be possible to derive substantively moral conclusions from premises that are not substantively moral, but if it is, Maitzen has failed to prove the point. (shrink)

In his groundbreaking work of 1969, Spinoza's Metaphysics: An Essay in Interpretation, Edwin Curley attacked the traditional understanding of the substance-mode relation in Spinoza, which makes modes inhere in the substance. Curley argued that such an interpretation generates insurmountable problems, as had been already claimed by Pierre Bayle in his famous entry on Spinoza. Instead of having the modes inhere in the substance Curley suggested that the modes’ dependence upon the substance should be interpreted in terms (...) of (efficient) causation, i.e., as committing Spinoza to nothing over and above the claim that the substance is the (efficient) cause of the modes. These bold and fascinating claims generated one of the most important scholarly controversies in Spinoza scholarship of the past thirty-five years. In this chapter I argue against Curley’s interpretation and attempt to reestablish the traditional understanding of Spinozistic modes as inhering in God and as predicated of God. I also criticize Curley’s philosophical motivation for suggesting this interpretation. I do believe, however, that Curley is right about the existence of an intimate connection between the substance-mode relation and causation in Spinoza. In the next chapter I will study the notion of ‘immanent cause’, which merges efficient causality and inherence. I will clarify the relation between immanent, efficient and material causation, and show where precisely Spinoza diverged from the traditional Aristotelian taxonomy of causes. In the second chapter I also discuss the German Idealists’ view of Spinoza as an ‘acosmist’. Under this interpretation Spinoza was a modern reviver of Eleatic monism, who allegedly asserts the mere existence of God, and denies the reality of the world of particular things. Spinozistic modes - according to this reading - are nothing but passing and unreal phenomena. Though this view of Spinoza as an ‘acosmist’ can be supported by some lines in Spinoza’s thought, I believe it should be rejected since it is not consistent with some of the most central doctrines of the Ethics. In the final part of the second chapter I discuss the relation between modes and the attributes under which they fall, and suggest a terminological distinction between a ‘mode of God’ (i.e., a mode under all attributes) and a ‘mode of an attribute’ (i.e., a mode under a specific attribute), a distinction which can help us avoid some common confusions in the treatment of the issue. (shrink)

Leibniz believed the ‘true concept of substance’ is found in ‘the concept of forces or powers’. Accordingly, he conceived monadic substances as metaphysically primitive forces whose modifications manifest both as monads’ appetitions and perceptions and as derivative forces in monads’ organic bodies. Relationships between substances, and in particular the ethical relationships that hold between rational substances, are also foregrounded by Leibniz’s concept of substances as forces. In section one, we discuss the derivative forces of bodies. In section two, (...) we consider monads’ perceptions and appetitions. Section three attends to ethical aspects of Leibniz’s account, focusing in particular on souls’ representative natures and the correspondence that obtains between perceptions in one and perceptions in all others. In section four, however, I argue that Leibniz’s commitment to the doctrine of the conservation of force makes it impossible for any one substance to pursue its own advantage by increasing its active force without there being a correlative disadvantageous decrease in the active force of substances elsewhere in the universe. While the reconciliatory proposals offered do not entirely remove the tension between Leibniz’s ethics and his physics, they do soften its severity and allow it to be regarded in a more positive light. (shrink)

When a debate is misplaced, new problems are cast in the distorting language of the settled problems of the past while, at the same time, the participants in the debate are assimilated into communities of thought with which they have little in common. The result is that their work, and our response to it, is distorted. This article contends that the polemical debate between James Gustafson (and his followers) and Stanley Hauerwas (and his followers) is just such a misplaced debate. (...) In fact, both can be shown to be Troeltschian historicists, and it is only when this commonality is recognized that their very real and deep differences can be rightly appreciated as emblematic of the true sources of disagreement at the growing edge of the discipline. (shrink)

The purpose of this commentary is to consider circumstances under which it may be ethical to permit patients to use licit substances in rehabilitation contexts. While the content of this commentary may be transferable to other healthcare spaces, our focus on rehabilitation is based on some important distinctions that exist between rehabilitation and acute care spaces.

Though Spinoza's definition of God at the beginning of the Ethics unequivocally asserts that God has infinitely many attributes, the reader of the Ethics will find only two of these attributes discussed in any detail in Parts Two through Five of the book. Addressing this intriguing gap between the infinity of attributes asserted in E1d6 and the discussion merely of the two attributes of Extension and Thought in the rest of the book, Jonathan Bennett writes: Spinoza seems to imply that (...) there are other [attributes] – he says indeed that God or Nature has “infinite attributes.” Surprising as it may seem, there are reasons to think that by this Spinoza did not mean anything entailing that there are more than two attributes. In this paper I will argue that Bennett’s claim is fundamentally wrong and deeply misleading. I do think, however, that addressing Bennett’s challenge will help us better understand Spinoza’s notion of infinity. I will begin by summarizing Bennett’s arguments. I will then turn to examine briefly the textual evidence for and against his reading. Then I will respond to each of Bennett’s arguments, and conclude by pointing out theoretical considerations which, I believe, simply refute his reading. (shrink)

In this book, Carl Cranor utilizes material from ethics, philosophy of law, epidemiology, tort law, regulatory law, and risk assessment to argue that the evidentiary standards for science used in the law to control toxics ought to be ...

An emerging ethical dilemma in light of the opioid crisis, repeat cardiac valve replacements for patients diagnosed with endocarditis from intravenous drug use presents specific challenges to Catholic health care organizations. While secular health care is tasked with the allocation of scarce resources, Catholic institutions must address additional considerations when balancing stewardship of scarce resources, human dignity, and patient accountability. A recent ethics consultation illustrates the issues involved in multiple valve replacements for substance-addicted patients from a Catholic (...) class='Hi'>ethical perspective. The discussion includes policy recommendations and ethical reflections. (shrink)

‘Substance’ (substantia, zelfstandigheid) is a key term of Spinoza’s philosophy. Like almost all of Spinoza’s philosophical vocabulary, Spinoza did not invent this term, which has a long history that can be traced back at least to Aristotle. Yet, Spinoza radicalized the traditional notion of substance and made a very powerful use of it by demonstrating – or at least attempting to demonstrate -- that there is only one, unique substance -- God (or Nature) -- and that all (...) other things are merely modes or states of God. Some of Spinoza’s readers understood these claims as committing him to the view that only God truly exists, and while this interpretation is not groundless, we will later see that this enticing and bold reading of Spinoza as an ‘acosmist’ comes at the expense of another audacious claim Spinoza advances, i.e., that God/Nature is absolutely and actually infinite. But before we reach this last conclusion, we have a long way to go. So, let me first provide an overview of our plan. In the first section of this paper we will examine Spinoza’s definitions of ‘substance’ and ‘God’ at the opening of his magnum opus, the Ethics. Following a preliminary clarification of these two terms and their relations to the other key terms defined at the beginning of the Ethics, we will briefly address the Aristotelian and Cartesian background of Spinoza’s discussion of substance. In the second section, we will study the properties of the fundamental binary relations pertaining to Spinoza’s substance: inherence, conception, and causation. The third section will be dedicated to a clarification of Spinoza’s claim that God, the unique substance, is absolutely infinite. This essential feature of Spinoza’s substance has been largely neglected in recent Anglo-American scholarship, a neglect which has brought about an unfortunate tendency to domesticate Spinoza’s metaphysics to more contemporary views. The fourth section will study the nature of Spinoza’s monism. It will discuss and criticize the interesting yet controversial views of the eminent Spinoza scholar, Martial Gueroult, about the plurality of substances in the beginning of the Ethics; address Spinoza’s claim in Letter 50 that, strictly speaking, it is improper to describe God as “one”; and, finally, evaluate Spinoza’s kind of monism against the distinction between existence and priority monism recently introduced into the contemporary philosophical literature. The fifth and final section will explain the nature, reality, and manner of existence of modes. We therefore have an ambitious plan; let’s get down to business. (shrink)

In this paper, I inspect the grounds for the mature Spinozist argument for substance monism. The argument is succinctly stated at Ethics Part 1, Proposition 14. The argument appeals to two explicit premises: (1) that there must be a substance with all attributes; (2) that substances cannot share their attributes. In conjunction with a third implicit premise, that a substance cannot not have any attribute whatsoever, Spinoza infers that there can be no more than one substance. (...) I begin the inspection with the analysis of the first premise, which is provided in the form of the four proofs of God’s existence in Ethics Part 1, Proposition 11. While demonstrating how Spinoza adopts a progressive approach, where the fourth proof of God’s existence is more successful and persuasive than the third, which is more successful than the second, etc., I also unpack concepts central to Spinoza’s thinking here, including the concepts of reason (ratio) and power (potesta or potentia). I then analyze the second premise of the Spinozist argument for substance monism, as established by Ethics Part 1, Proposition 4 in conjunction with Ethics Part 1, Proposition 5. I take up and respond to the objection attributed to Leibniz that a substance p can have the attributes x and y and a substance q can have the attributes y and z, and thus that substances can share some attributes while remaining distinct. Throughout the study, my attention is focused on the argumentative procedures Spinoza adopts. This yields a close, internalist reading of the text where Spinoza effectively embraces substance monism. In conclusion to this study, I underscore to the originality of Spinoza’s argument for seventeenth century theories of substance. (shrink)

Substance-abusing women are vulnerable to specific kinds of epistemic injustice, including stigmatization and discrimination. This article examines the development of the epistemic agency of female substance abusers by asking: How does the use of a formal discussion protocol in community rehabilitation interaction alleviate epistemic injustice and strengthen the epistemic agency of substance abusers? The data were collected in a Finnish rehabilitation center by videotaping six group discussions between social workers, peer support workers, and rehabilitation clients with (...) class='Hi'>substance abuse problems. Of these data, one recorded group discussion between four female participants—two rehabilitation clients, a peer support worker, and a social adviser—was used in this paper. Using conversational analysis, the findings indicate that, through the collaborative activities of sharing experiential knowledge about substance abuse and discussing the experiences of abuse in the rehabilitation interaction, substance abusers can develop novel ways to strengthen their epistemic agency by enhanced self-awareness. The discussion protocol is an epistemic tool that professionals and clients can learn to use in ethically and epistemologically successful ways in interaction. The use of a discussion protocol is an example of social professionals’ clinical knowledge of intensifying collaboration and sharing experiential knowledge in community rehabilitation and other substance abuse services. (shrink)

The author reviews one of the more intriguing articles in the stem cell research issue of the journal Metaphilosophy (April 2007), “Killing Embryos for Stem Cell Research,” by Jeff McMahan. He begins by recapitulating McMahan’s argument against the proposition that we are essentially individual human organisms. He then turns to two main critiques of the argument. First, he shows that the term “essentially” is insufficiently defined by McMahan and, more important, if we take the typical explication of the concept by (...) modal metaphysicians, then the claim “we are essentially human beings” is true—contrary to McMahan’s argument. Second, the author offers a counterexample to McMahan’s implicit acceptance of the principle that only beings who have developed the capacity for self-consciousness are the proper subjects of moral worth. The author presents a regenerative therapy example to show that McMahan’s commitment on this point is counterintuitive. National Catholic Bioethics Quarterly 8.2 (Summer 2008): 255–264. (shrink)