This essay lays the groundwork for a novel conception of autonomy that may be called “effective autonomy”—a conception designed to be genuinely action guiding in bioethics. As empirical psychology research on the heuristics and biases approach shows, decision making commonly fails to correspond to people’s desires because of the biases arising from bounded cognition. People who are classified as autonomous on contemporary philosophical accounts may fail to be effectively autonomous because their decisions are uncoupled from their autonomous desires. Accordingly, continuing (...) attempts to value patient autonomy must go beyond existing philosophical conceptions of autonomy to consider the background conditions of human decision making. (shrink)

Epistemic trust is an unacknowledged feature of medical knowledge. Claims of medical knowledge made by physicians, patients, and others require epistemic trust. And yet, it would be foolish to define all epistemic trust as epistemically responsible. Accordingly, I use a routine example in medical practice to illustrate how epistemically responsible trust in medicine is trust in epistemically responsible individuals. I go on to illustrate how certain areas of current medical practice of medicine fall short of adequately distinguishing reliable and unreliable (...) processes because of a failure to systematically evaluate health outcomes. I conclude by articulating the devastating obstacles to the consilience assumption, which takes intellectual character as the standard for epistemic responsibility. (shrink)

1The opinions contained in this article are those of the authors and should not be construed as policies of the American Medical Association.

Conflicts of interest represent one of the defining problems of our time, and yet a clear definition of what constitutes a conflict of interest remains elusive. To move us closer to resolving this problem, this article first reviews and critiques attempts to define conflicts of interest, and, second, uses these critiques to ground a more conceptually consistent and practically useful definition. This definition builds on, but also breaks away from Michael Davis’s definition of conflicts of interest. Specifically, it articulates and (...) defends defining conflicts of interest in terms of their threat to good judgment but does so in the broadest terms. Defining it in this way expands the domain of conflicts of interest, but also avoids unnecessary conceptual distractions and practical difficulties. (shrink)

This paper is split into two parts. The first half analyzes conflicts of interests’ effects on judgment, the harms these effects threaten, and our current policies and practices for handling conflicts of interest. This analysis relies on scholarship in several fields, most prominently psychology, all of which have reasons to worry about conflicts of interest. This analysis will show that our current classifications of conflicts of interest and our current strategies for handling conflicts of interest are confusing, of dubious benefit, (...) or both. The second half provides some tools for helping us to limit or avoid the harms of conflicts of interest. These simple tools focus on how we think about and classify conflicts of interest. Specifically, I recommend beginning to classify conflicts of interest in a new way: as either severable or systemic. These new classifications are not intended to be heavy conceptual machinery, but simple and valuable tools. These new classifications, even though they are not meant to be exhaustive or comprehensive, help delineate tractable strategies and help determine the distribution of responsibilities for addressing specific conflicts of interest. (shrink)

The criminal law presently distinguishes between actions and omissions, and only rarely proscribes failures to avert consequences that it would be an offense to bring about. Why? In recent years it has been persuasively argued by both Glover and Bennett that, celeris paribus, omissions to prevent a harm are just as culpable as are actions which bring that harm about. On the other hand, and acknowledging that hitherto “lawyers have not been very successful in finding a rationale for it,” Tony (...) Honoré has sought to defend the law's differential treatment. He proposes a “distinct-duties theory” that in addition to the general duties we owe to everyone, we also owe distinct duties to a more limited collection of people and associations, specified by features of our relationship with them. Where a distinct duty holds, breach by omission may well be no better than breach by positive action. But absent a distinct duty, omissions, per Honoré, are less culpable. They are mere failures to intervene and improve or rectify things, whereas actions are positive interventions which make things worse. And, thus, the law has good reason to differentiate between them. (shrink)

Aristotle's definition of the soul should be interpreted as: 'the soul is the entelechy of a natural body that serves as its instrument'.

In 1956, a few writings of Wittgenstein that he didn't publish in his lifetime were revealed to the public. These writings were gathered in the book Remarks on the Foundations of Mathematics (1956). There, we can see that Wittgenstein had some discontentment with the way philosophers, logicians, and mathematicians were thinking about paradoxes, and he even registered a few polemic reasons to not accept Gödel’s incompleteness theorems.

When should we make use of the criminal law? Suppose that a responsible legislature seeks to enact a morally justifiable range of criminal prohibitions. What criteria should it apply when deciding whether to proscribe conduct? Crimes, Harms, and Wrongs is a philosophical analysis of the nature, significance, and ethical limits of criminalisation. The authors explore the scope and moral boundaries of harm-based prohibitions, proscriptions of offensive behaviour, and 'paternalistic' prohibitions aimed at preventing self-harm. Their aim is to develop guiding principles (...) for these various grounds of state prohibition, including an analysis of the constraints and mediating factors that weigh for and against criminalisation. Both authors have written extensively in the field. In Crimes, Harms, and Wrongs they have reworked a number of well-known essays and added several important new essays to produce an integrated, accessible, philosophically-sophisticated account that will be of great interest to legal academics, philosophers, and advanced students alike"--Provided by publisher. (shrink)

A. P. Martinich's The Two Gods of Leviathan appeared in 1992, and J. R. Collins's The Allegiance of Thomas Hobbes in 2005. Martinich offered a revisionist interpretation of Thomas Hobbes's religious commitments. He rebuked the conventional view that Hobbes was an atheist and placed him within particular traditions of reformed Christian theology. Collins's book strongly differed from these conclusions, and reasserted Hobbes's hostility to traditional Christianity as part of a general contextualization of his writings within the period of the English (...) Revolution. The following exchange between Martinich and Collins was first aired in 2007 as a debate at the Southwestern Political Science Association's Annual Conference. (shrink)

The book opens with a description of the smooth transition from Newtonian to Einsteinian behaviour from electrons as their energy is progressively increased, ...

Après les traités 38, 50 et 25, les Éditions du Cerf récidivent avec un nouveau titre, le traité 20 Sur la dialectique. Il faut toutefois aborder ce livre d’une manière toute spéciale, car il se distingue radicalement des autres parutions de cette collection. L’auteur, Vladimir Jankélévitch, s’est en effet éteint à Paris en 1985, à l’âge de quatre-vingt-deux ans. Le travail qu’on offre au public prend donc la forme d’un hommage posthume à ce philosophe français dont les publications s’étendent sur (...) cinquante ans, de 1924 à 1974. C’est précisément sa toute première composition d’importance, celle de 1924 lors de son diplôme d’études supérieures, qui s’ajoute désormais à l’ensemble de ses écrits et permettra de voir à quel état d’élévation se trouvait alors sa pensée du haut de ses vingt ans. L’édition moderne qu’on en propose respecte autant que possible l’original manuscrit. Par exemple, toutes les annotations que fit Émile Bréhier en marge du travail de son étudiant apparaissent au bas des pages. Même les quelques erreurs de langage subsistent dans leur intégralité. Nos attentes doivent alors s’ajuster au type de travail qu’on s’apprête à lire. En tant que relique et témoignage d’une intelligence en plein développement, il prend une tout autre tangente que les ouvrages plus matures qu’a écrits P. Hadot sur les traités 38 et 50. La division de la recherche en introduction, traduction et commentaire, si constante d’un livre à l’autre, s’évanouit dans le traité Sur la dialectique. On n’y trouve aucune traduction et seulement un commentaire plus ou moins suivi sur la seconde moitié du traité. Le lecteur fera bien de se munir au préalable de son édition de Plotin chez Les Belles Lettres, afin de se rafraîchir au besoin la mémoire sur le traité I, 3. (shrink)

It is often alleged that an agent is morally responsible in a liability sense for a transgression just in case s/he deserves a negative interpersonal response for that transgression, blaming responses such as resentment and indignation being paradigms. Aside from a few exceptions, guilt is cited in recent discussions of moral responsibility, if at all, as merely an effect of being blamed, or as a reliable indicator of moral responsibility, but not itself an explanation of moral responsibility. In this paper, (...) I argue that an agent is morally responsible in a liability sense for a transgression just in case s/he deserves to feel moral guilt for that transgression. I argue that this alternative view offers all that the predominant blame-focused view offers, while also solving some puzzling features of moral responsibility. Specifically, it offers a compelling way to reconcile conflicting intuitions about the suberogatory, and allows those who do not understand what Darwall calls ‘second-personal’ reasons to be morally responsible for their immoral acts. (shrink)

I argue that four-dimensionalism and the desire satisfaction account of well-being are incompatible. For every person whose desires are satisfied, there will be many shorter-lived individuals (‘person-stages’ or ‘subpersons’) who share the person’s desires but who do not exist long enough to see those desires satisfied; not only this, but in many cases their desires are frustrated so that the desires of the beings in whom they are embedded as proper temporal parts may be fulfilled. I call this the frustrating (...) problem for four-dimensionalism. In the first half of the paper I lay the groundwork for understanding the frustrating problem, and then in the second half, I will examine six possible responses to the frustrating problem on behalf of the four-dimensionalist, (i) the Parfit (1984) inspired claim that identity is not what matters, (ii) the personal pronoun revisionism of Noonan (2010), (iii) the indirect concern account of Hudson (2001), (iv) the sensible stages account of Lewis (1986), (v) a multiple-concepts account of desire satisfaction, and (vi) a No Desire View according to which subpersons have no mental states and thus no desires to frustrate. I argue that none of these solutions will help the four-dimensionalist; she does better to reject the desire satisfaction theory, while the defender of the desire satisfaction theory does better to reject four-dimensionalism. (shrink)

BackgroundAs moral case deliberations (MCDs) have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how ‘impact of MCD’ should be conceptualized for future research.MethodsA multiple-case study was conducted in a care organization for people with (...) intellectual disabilities and/or acquired brain injury, by observing MCD sessions as ‘cases’, followed by interviews with health care professionals concerning the follow-up to these cases, and a focus group with involved MCD facilitators. A conceptual scheme concerning the possible impact formed the basis for analysis: (1) individual moral awareness; (2) the actions of health care professionals; (3) collaboration among health care professionals; (4) the concrete situation of the client; (5) the client’s quality of care and life; (6) the organizational and policy level.ResultsAccording to interviewees, their moral awareness and their collaboration, both among colleagues and with clients’ relatives, improved after MCD. Perceived impact on client situation, quality of care/life and the organizational level varied among interviewees or was difficult to define or link to MCD. Three aspects were added to the conceptual scheme concerning the impact of MCD: (a) preparations and expectations prior to the MCD session; (b) a translational step between the conclusions of the MCD session and practical events in the following period, and (c) collaboration with clients’ relatives. A negative impact of MCD was also found on misunderstandings among participants and disappointment about lack of follow-up.ConclusionsConcretizing and conceptualizing the ‘impact’ of MCD is complicated as many factors play a role either before or during the transition from MCD to practice. It is important to consider ‘impact’ in a broad sense and to relate it to the goals and context of the MCD in question. Future studies in this field should pay additional attention to the preparations, content and process involved in ethics support, including clients’ and relatives’ experiences. (shrink)

As the United States is currently prosecuting two wars, it is important to consider whether those wars, and the resulting noncombatantcasualties, can be morally justified. Such consideration can be initiated by considering some of Alan Donagan’s work in his book The Theory of Morality. In that book Donagan sets out to develop, as a philosophical system, that part of the common morality according to the Hebrew-Christian tradition, which does not depend on any theistic beliefs. According to that tradition it is (...) sometimes morally permissible to resort to war. This poses a problem because also part of the tradition is a near absolute prohibition on harming innocent people. Since innocent people die in war, there is a tension here.Donagan claims that this problem can be solved by assigning the blame for some such deaths to the aggressor, thereby permitting (some) resorts to war. This paper shows that this solution is inadequate; and defends a more plausible (and more traditional) justification for some innocent deaths. This justification is consistent with the system Donagan develops, and thus may have application in the consideration of the justification of the two wars currently being prosecuted by the United States. (shrink)

The relation between Church and state is nowadays at stake. This article concerns the relation between Church and state from an ecclesiastical and canonical point of view. It makes clear, how the ecclesiastical doctrine reacts to social developments in relation to the national state in order to safeguard the independence of the Church. The 19th century ecclesiastical doctrine on the Church as a societas perfecta reacts on doctrines on the national states, which claimed absolute sovereignty and by that subordinated the (...) Church to the civil government and civil law. With societas perfecta doctrine the Church defends its sovereignty in the domain of the spiritual good of men. In this way the Church defines and protects its divine origin and independence from the national state. In the first half of the 20th century the democratic and constitutional national states were developed, which acknowledges religious freedom on a constitutional level as a human and a civil right. Because of this progress the Second Vatican Council could formulate its doctrine on religious freedom based on the traditional ecclesiastical teaching of the freedom of the religious act. By then, the independence of the Church is founded and defended on the freedom of the Church, which is guaranteed in national states, which acknowledge religious freedom as a human and civil right. Although one can say that there is discontinuity in the ecclesiastical teaching on the Church as a societas perfecta and the ecclesiastical doctrine on religious freedom, there exists also continuity, because both ecclesiastical doctrines intend to safeguard the independence of the Church in human society. (shrink)

This article is based on a discussion held in Athens in April 2002, in the framework of a research visit, supported by the National Technical University of Athens, among the following participants: Alexander Pavlovits Ogurtsov (APO), Svetlena Sergeevna Neretina (SSN), and Michalis Assimakopoulos (MA) who translated and annotated the Russian text. The later wishes to thank his Russian teachers in philosophy, E.A. Mamchur and language, A.A. Nekrasova The translation was reviewed and emended by E.M. Swiderski, editor of SEET.Svetlana Neretina is (...) senior researcher in the Institute of Philosophy of the Russian Academy of Sciences (RAS), doctor of philosophy, titled professor for medieval philosophy, author of: The Conceptualism of Peter Abelard (1994), Believing Reason (1995), Tropes and Concepts (1999), Time of Culture (2000, with A. Ogurtsov), articles and translations on Philosophy of culture, email, [email protected]. (shrink)

Thomas Hobbes is recognized as one of the fathers of modern philosophy and political theory. In his own time he was as famous for his work in physics, geometry, and religion. He associated with some of the greatest writers, scientists, and politicians of his age. Martinich has written a complete and accessible biography of Hobbes. The book takes full account of the historical and cultural context in which Hobbes lived, drawing on both published and unpublished sources. It will be a (...) great resource for philosophers, political theorists and historians of ideas. The clear, crisp prose style will also ensure that the book appeals to general readers with an interest in the history of philosophy, the rise of modern science and the English Civil War. (shrink)