"Canada, like other industrial nations, is undergoing widespread social change at a faster pace than ever before. Many features of our basic institutions are being transformed and some of the values on which they were based are being weakened or swept away to be replaced by others. As this Royal Commission indicated in its first report, Challenges and Choices, the scope and implications of these changes call "into question basic assumptions, values, and institutions at every level of society, from the (...) shop floor to the cabinet room, to the international economic system," but while many values change, others endure."--. (shrink)

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation... (shrink)

The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encounters.

To judge from the rash of recent law review articles, it is a miracle that research with human subjects in the U.S. continues to draw breath under the asphyxiating heel of the rent-seeking, creativity-stifling, jack-booted bureaucrethics that is the current system of research ethics oversight and review. Institutional Review Boards, sometimes called Research Ethics Committees, have been accused of perpetrating “probably the most widespread violation of the First Amendment in our nation's history,” resulting in a “disaster, not only for academics, (...) but for the whole nation.” One member of the President's Council on Bioethics went so far as to assert, “There has been no greater damage to academic freedom in the United States in my lifetime. And my lifetime encompasses McCarthy and it encompasses political correctness, both.” Locked in the bureaucratic “iron cage” of IRB oversight, critics charge that researchers have been transformed into a vulnerable, exposed population, subject to domination, that has been likened in one case to a kind of “Tuskegee in reverse.”. (shrink)

This paper provides a retrospective and prospective overview of TU Delft’s approach to engineering ethics education. For over twenty years, the Ethics and Philosophy of Technology Section at TU Delft has been at the forefront of engineering ethics education, offering education to a wide range of engineering and design students. The approach developed at TU Delft is deeply informed by the research of the Section, which is centered around Responsible Research and Innovation, Design for Values, and Risk Ethics. These (...) theoretical approaches are premised on the notion that technologies are inherently value-laden, and as such contain the possibility of fostering or hindering moral values. Each of these approaches encourages students to take a proactive attitude with respect to their projects and profession, thinking creatively about – and taking responsibility for – how to both prevent harm and do good via the technologies they help develop. To explain how this is put into practice, this paper sketches a brief history of ethics teaching at TU Delft, outlines current activities, and presents future plans for Bachelor and Master’s level engineering ethics education at TU Delft. (shrink)

BackgroundProfessional guidelines have addressed ethical dilemmas posed by a few types of nontraditional procreative arrangements, but many questions arise regarding how providers view and make decisions about these and other such arrangements.MethodsThirty-seven ART providers and 10 patients were interviewed in-depth for approximately 1 h each. Interviews were systematically analyzed.ResultsProviders faced a range of challenges and ethical dilemmas concerning both the content and the process of decisions about requests for unconventional interfamilial and other reproductive combinations. Providers vary in how they respond (...) — what they decide, who exactly decides, and how — often undergoing complex decision-making processes. These combinations can involve creating or raising the child, and can shift over time — from initial ART treatment through to the child’s birth. Patients’ requests can vary from fully established to mere possibilities. Arrangements may also be unstable, fluid, or unexpected, posing challenges. Difficulties emerge concerning not only familial but social, combinations. These arrangements can involve blurry and confusing roles, questions about the welfare of the unborn child, and unanticipated and unfamiliar questions about how to weigh competing moral and scientific concerns — e.g., the autonomy of the individuals involved, and the potential risks and benefits. Clinicians may feel that these requests do not “smell right”; and at first respond with feelings of “yuck,” and only later, carefully and explicitly consider the ethical principles involved. Proposed arrangements may, for instance, initially be felt to involve consanguineous individuals, but not in fact do so. Obtaining and verifying full and appropriate informed consent can be difficult, given implicit familial and/or cultural expectations and senses of duty. Social attitudes are changing, yet patients’ views of these issues may also vary, based on their cultural backgrounds.ConclusionsThese data, the first to examine how clinicians make decisions about unconventional reproductive arrangements, highlight several critical ethical questions and ambiguities, and variations in clinicians’ responses. While several professional guidelines exist, the current data highlight additional challenges, and have vital implications for improving future guidelines, practice, education and research.Trial registrationNot applicable. (shrink)

In this paper I seek to reconsider wilderness against recent critiques that portray it as necessarily contributing to a separation between nature and society. By examining the historical and contemporary contexts for designating wilderness areas in the United States, I propose that these wilderness lands and their particular constraints on the use of certain technologies may in fact present integrative, open spaces for considering how to live ethical, technological lives in contemporary society. An examination of actual wilderness practices illustrates how (...) wilderness regulations may support a more democratic politics of technology and help develop an ethic grounded in fairness, humility, and restraint. (shrink)

Research shows that a high majority of parents receiving prenatal diagnosis of intellectual disability terminate pregnancy. They have reasons for rejecting a child with intellectual disabilities—these reasons are, most commonly, beliefs about quality of life for it or them. Without a negative evaluation of intellectual disability, their choice makes no sense. Disability-based abortion has been critiqued through virtue ethics for being inconsistent with admirable moral character. Parental selectivity conflicts with the virtue of acceptingness and exhibits the vice of wilfulness. In (...) this paper I claim that, beyond failures of moral virtue, disability abortion often involves failures of epistemic virtue on the part of parents. I argue two things: parents believe something false, or at least contested, about life with intellectual disability—and they do so because they are not epistemically conscientious. I first explain why a central motivation for disability abortion—that it prevents harm to the child—is mistaken. I next give a brief account of intellectual virtue and culpable ignorance. I then indicate why many parents fail to be intellectually virtuous when choosing to terminate pregnancy. I focus on elimination of intellectual disability and have little to say about physical and sensory impairments. (shrink)

The role of imagery in encoding event-based prospective memories has yet to be fully clarified. Herein, it is argued that imagery augments a cue-to-context association that supports event-based prospective memory performance. By this account, imagery encoding not only improves prospective memory performance but also reduces interference to intention-related information that occurs outside of context. In the current study, when lure words occurred outside of the appropriate responding context, the use of imagery encoding strategies resulted in less interference (...) when compared with a standard event-based intention condition. This difference was eliminated when participants were not given a specific context to associate their intention . These results support a cue-to-context association account of how imagery operates in certain event-based prospective memory tasks. (shrink)

Poverty has traditionally been conceived of as a state of deprivation. To be poor is to lack something essential to human flourishing. How that something is understood—in terms of welfare, resources, or capabilities—and how it is measured—in absolute terms or relative to a social standard—has been the subject of much debate within the development literature. In this paper, I put forward an account of poverty rooted in the philosophy of action. I argue that poverty essentially involves being in a context (...) in which a reasonable agent’s future-directed agency is systemically undermined. Centering this dimension of poverty allows us to attend to aspects of poverty that are easily overlooked on existing accounts. (shrink)

Après avoir élaboré son projet qui consiste à modifier la Nature et l'Humanité, la technoscience passe à l'action et ravage les domaines complexes du sacré. Afin de prévenir une crise générale apportant le désagrément de l'imminence terreur apocalyptique, l'Afrique engage un procès fondé sur les valeurs africaines en partant du principe selon lequel l'humanité est un patrimoine appartenant à tous les hommes, à toutes les générations et à toutes les races.

Responding to bivalent stimuli slows subsequent performance. In prospective memory research, prospective memory targets can be considered as bivalent stimuli because they typically involve features relevant for both the prospective memory task and the ongoing task. The purpose of this study was to investigate how responding to a prospective memory target slows subsequent performance. In two experiments, we embedded the prospective memory task in a task-switching paradigm and we manipulated the degree of task-set overlap between (...) the prospective memory task and the ongoing task. The results showed consistent after-effects of responding to prospective memory targets. The specific trajectory of the slowing depended on the amount of task-set overlap. These results demonstrate that responding to prospective memory targets results in after-effects, a so far neglected cost on ongoing task performance. (shrink)

Previously we reported a three-factor structure for hallucinations accompanying sleep paralysis . These earlier analyses were, however, based on retrospective accounts. In a prospective study, 383 individuals reported individual episodes online providing further evidence for the three-factor structure as well as clearer conceptually meaningful relations among factors than retrospective studies. In addition, reports of individual episodes permitted a more fine-grained analysis of the internal structure of factors to assess predictions based on the hypothesis that a sensed or felt presence (...) is a core experience affecting other SP hallucinations. Results were generally consistent with this hypothesis. In particular, associations among, and temporal stability of, sensory hallucinations were largely explained by their common association with FP. The findings are consistent with REM initiation of a threat activated vigilance system with pervasive effects on the SP experience and suggest a potential model for the thematic organization of nightmares and dreams more generally. (shrink)

SummaryAs part of a prospective controlled study of the psychosomatic effects of elective tubal sterilization, 138 women were questioned about their menstrual functioning before sterilization, and again 6 months and 12 months post-operatively, using standardized interviewing procedures. Adverse changes, including increased menstrual loss, shorter menstrual cycles and greater use of pads or tampons were reported by sterilized subjects at both of the post-operative interviews. Control subjects reported several comparable effects, although adverse changes overall were reported more commonly by sterilized (...) women than by control subjects. However, many of the reported changes appeared to be related to pre-operative contraceptive methods, although consistent increases in use of pads or tampons were found in women who had pre-operatively used neither the pill nor the IUD. (shrink)

In this chapter, I offer a constructivist account of practical reasoning as both generative and transformative in response to calls from philosophers as diverse as Iris Murdoch and Gilbert Harman, who have urged the development of a more nuanced picture of reasoning that incorporates revisionary and revelatory changes in viewpoint. Within this context, I describe sensitivity to facts as a form of emotional engagement that is also partially constitutive of facts. I consider both the epistemological and ontological aspects of this (...) claim. From an epistemological point of view, my claim is that agents strengthen their discernment of relevant facts through emotional engagement. From an ontological point of view, my claim is that, through emotional engagement, agents alter their immediate relationship to objects, changing not only “what matters” but also the “facts of the matter”. To an important extent, then, facts are inseparable from the subjective concerns of the agent. This is not to say that there are no subject-independent facts of the matter, nor that objects are mere projections of an agent’s sensibility onto the cold, colorless canvass of valueless reality. Rather, my claim is that the ontological boundary between facts and values—and the normative status of facts—are both internal to the practical perspective, defined by an agent’s particular concerns and within shared practices of mutual recognition. The most relevant implications of the constructivist view are found at the level of prospective rationality, that is, within the temporal dimension of rationality. Emotional engagement fosters changes in perspective, but this should not be read as simply arbitrary fluctuations. Despite being perspectival, such changes are applied to a subject-independent field, which gains further intelligibility through the agent’s altered relationship to those circumstances. By examining the dynamics of such changes, we acquire a more nuanced theoretical vocabulary to help make sense of the prospective dimension of practical reasoning within which ordinary agents are engaged. (shrink)

(2001). How Should IVF Programs Handle Initial Disclosure of Information to Prospective Ovum Donors? The American Journal of Bioethics: Vol. 1, No. 4, pp. 23-25.

This study examined people’s ability to predict and postdict their performance on an event-based prospective memory task. Using nonfocal cues, one group of participants predicted their success at finding animal words and a different group predicted their ability to find words with a particular syllable in it. The authors also administered a self-report questionnaire on everyday prospective and retrospective memory failures. Based on the different strategies adopted by the two groups and correlations among the dependent variables, the authors (...) concluded that people do have a basic awareness of their prospective memory abilities, but that this awareness is far from accurate. The importance of metamemory concerning one’s prospective memory is discussed in terms of how it influences the strategies that people might choose for actually completing their various everyday intentions. (shrink)

La responsabilité du fait d’autrui a fait l’objet de mutations successives tout au long du xx e siècle, soit que les régimes légaux aient été adaptés et façonnés afin de garantir une réparation automatique de leurs dommages aux victimes, soit que le juge ait fait usage de son pouvoir créateur pour inventer de nouveaux régimes de responsabilité pour répondre aux évolutions sociales et aux nouveaux enjeux indemnitaires. Si la tendance est globalement à l’objectivation de la responsabilité du fait d’autrui, des (...) incohérences sont apparues qui s’expliquent par le mode de création du droit jurisprudentiel, par petites touches, au gré des besoins exprimés dans les prétoires. À l’heure de réécrire le code civil, les promoteurs de la réforme promettent de nouvelles métamorphoses. Ils ne se sont pas bornés à importer la jurisprudence mais se sont assignés la mission plus ambitieuse de restituer à la responsabilité du fait d’autrui sa cohérence perdue, tout en garantissant un équilibre entre la responsabilité encourue par le civilement responsable et l’importance de l’autorité exercée sur autrui. Pour servir cet objectif, les projet et proposition de réforme précisent la nature de la responsabilité du fait d’autrui et se prononcent en faveur d’un régime dual de responsabilité du fait d’autrui. Cette étude envisage les conséquences théoriques et pratiques de la réforme à venir et propose des pistes de réflexion pour remédier aux inconvénients qu’elle pourrait induire. (shrink)

Background The often poor prognosis associated with cancer necessitates empowering patients to express their care preferences. Yet, the prevalence of Advance Directives (AD) among oncology patients remains low. This study investigated oncologists' perspectives on the interests and challenges associated with implementing AD. Methods A French national online survey targeting hospital-based oncologists explored five areas: AD information, writing support, AD usage, personal perceptions of AD's importance, and respondent's profile. The primary outcome was to assess how frequently oncologists provide patients with information (...) about AD in daily clinical practice. Additionally, we examined factors related to delivering information on AD. Results Of the 410 oncologists (50%) who responded to the survey, 75% (n = 308) deemed AD relevant. While 36% (n = 149) regularly inform patients about AD, 25% (n = 102) remain skeptical about AD. Among the respondents who do not consistently discuss AD, the most common reason given is the belief that AD may induce anxiety (n = 211/353; 60%). Of all respondents, 90% (n = 367) believe patients require specific information to draft relevant AD. Physicians with experience in palliative care were more likely to discuss AD (43% vs 32.3%, p = 0.027). Previous experience in critical care was associated with higher levels of distrust towards AD (31.5% vs 18.8%, p = 0.003), and 68.5% (n = 281) of the respondents expressed that designating a “person of trust” would be more appropriate than utilizing AD. Conclusion Despite the perceived relevance of AD, only a third of oncologists regularly apprise their patients about them. Significant uncertainty persists about the safety and relevance of AD. (shrink)

What I most appreciate about H. Theixos and S. B. Jamil’s article, “The Bad Habit of Bearing Children,” is their basic scrutiny of unreflective procreation. Bearing biological children is not a bad habit in the way that smoking is a bad habit. There is nothing intrinsically harmful to a parent’s health in bearing a biological child.Nor is bearing biological children a bad habit in the way that biting one’s nails is a bad habit. There is nothing socially unacceptable in bearing (...) biological children; on the contrary, for married couples at least, it is largely a social expectation. Bearing biological children is a bad habit precisely because it is often done out of habit, rather than as the result of conscious and .. (shrink)

ABSTRACTObjective: This study was designed to improve our understanding of prospective memory changes in ageing, and to identify the cognitive correlates of PM decline, using a virtual environment, to provide a more realistic assessment than traditional laboratory tasks.Design: Thirty-five young and 29 older individuals exposed to a virtual town were asked to recall three event-based intentions with a strong link between prospective and retrospective components, three event-based intentions with a weak link, and three time-based intentions. They also underwent (...) retrospective episodic memory, executive functions, binding in working memory, processing speed, and time estimation assessments.Results: Older individuals recalled fewer intentions than young adults. While age-related PM decline affected the recall of both prospective and retrospective components, the recall of the latter seemed more challenging for older individuals when the link was weak. This PM decline was linked to an age-related decline... (shrink)

As artificial intelligence becomes more sophisticated and robots approach autonomous decision-making, debates about how to assign moral responsibility have gained importance, urgency, and sophistication. Answering Stenseke’s (2022a) call for scaffolds that can help us classify views and commitments, we think the current debate space can be represented hierarchically, as answers to key questions. We use the resulting taxonomy of five stances to differentiate—and defend—what is known as the “blank check” proposal. According to this proposal, a person activating a robot could (...) willingly make themselves answerable for whatever events ensue, even if those events stem from the robot’s autonomous decision(s). This blank check solution was originally proposed in the context of automated warfare (Champagne & Tonkens, 2015), but we extend it to cover all robots. We argue that, because moral answerability in the blank check is accepted voluntarily and before bad outcomes are known, it proves superior to alternative ways of assigning blame. We end by highlighting how, in addition to being just, this self-initiated and prospective moral answerability for robot harm provides deterrence that the four other stances cannot match. (shrink)