There is currently no consensus from the relevant stakeholders regarding the operational and construct definitions of child assent for research. As such, the requirements for assent are often construed in different ways, institutionally disparate, and often conflated with those of parental consent. Development of a standardized operational definition of assent would thus be important to ensure that investigators, institutional review boards, and policy makers consider the assent process in the same way. To this end, we describe a Delphi study that (...) provided consensus from a panel of expert stakeholders regarding the definitions of child assent for research. Based on current guidelines, a preliminary definition of assent was generated and sent out for review to a Delphi panel including pediatric bioethicists and researchers, Institutional Review Board members, parents, and individuals with regulatory/legal expertise. For each subsequent review, the process of summarizing and revising responses was repeated until consensus was achieved. Panelists were also required to rank order elements of assent that they believed were most important in defining the underlying constructs of the assent process. In providing these rankings, panelists were asked to frame their responses in the contexts of younger and adolescents/older children in non-therapeutic and therapeutic trials. Summary rankings of the most important identified elements were then used to generate written construct definitions which were sent out for iterative reviews by the expert panel. Consensus regarding the operational definition was reached by 14/18 of the panel members. Seventeen panelists agreed with the definitions of capacity for assent, elements of disclosure for younger children, and the requirements for meaningful assent, respectively. Fifteen members agreed with the elements of disclosure for adolescents/older children. It is hoped that this study will positively inform and effect change in the way investigators, regulators, and IRBs operationalize the assent process, respect children’s developing autonomy, and in concert with parental permission, ensure the protection of children who participate in research. (shrink)

Informed consent is central to the bioethical principle of respect for persons, a process that involves a discussion between the physician and patient with disclosure of information sufficient to allow the patient to make an informed decision about her or his care. However, despite the importance of informed consent in clinical practice, the process is often ritualized, perfunctory, and performed by individuals with little or no training in the consent process. This article discusses the lack of medical students’ and residents’ (...) training in informed consent and questions the practice of allowing untrained residents and surrogates to obtain consent from patients. (shrink)

What is the basis for arguing that a volunteer army exploits citizens who lack civilian career opportunities? How do we determine that a doctor who has sex with his patients is exploiting them? In this book, Alan Wertheimer seeks to identify when a transaction or relationship can be properly regarded as exploitative--and not oppressive, manipulative, or morally deficient in some other way--and explores the moral weight of taking unfair advantage. Among the first political philosophers to examine this important topic (...) from a non-Marxist perspective, Wertheimer writes about ordinary experience in an accessible yet philosophically penetrating way. He considers whether it is seriously wrong for a party to exploit another if the transaction is consensual and mutually advantageous, whether society can justifiably prohibit people from entering into such a transaction, and whether it is wrong to allow oneself to be exploited. Wertheimer first considers several contexts commonly characterized as exploitive, including surrogate motherhood, unconscionable contracts, the exploitation of student athletes, and sexual exploitation in psychotherapy. In a section outlining his theory of exploitation, he sets forth the criteria for a fair transaction and the point at which we can properly say that a party has consented. Whereas many discussions of exploitation have dealt primarily with cases in which one party harms or coerces another, Wertheimer's book focuses on what makes a mutually advantageous and consensual transaction exploitive and analyzes the moral and legal implications of such exploitation. (shrink)

Drawing upon ancient Hindu philosophy, the author explores the human psyche and the importance of personal identity.

Actualists who believe in possible worlds typically regard them as "abstract" objects of some special sort. For example, Alvin Plantinga takes worlds to be maximal possible states-of-affairs, all of which "exist", as actualism requires, but only one of which "obtains". Views like Plantinga's run into difficulty in the interpretation of statements of "iterated" modality, statements about what is "possible" for individuals that "could" exist but that do not actually exist. These statements seem to require the existence of "singular" states-Of-affairs that (...) have nonactual individuals as constituents, a requirement that is incompatible with actualism. One can try to avoid the troublesome singular states-of-affairs by introducing "unexemplified individual essences" and maintaining that these are the true constituents of the required states-of-affairs, rather than the nonactual possibles themselves. However, serious arguments are raised against this employment of individual essences. (shrink)

First published in 1991. Routledge is an imprint of Taylor & Francis, an informa company.

Ethics and Values in Psychotherapy examines the ways in which the ethical convictions of both therapist and client contribute to the practical process of psychotherapy. Practitioners are increasingly focusing on the issue of their extensive--and often problematic--ethical influence on clients as they attempt to agree on guidelines and standards for professional practice. Alan C. Tjeltveit argues that any discussion of ethical practice in psychotherapy must be carried out in connection with traditional ethical theories. The author draws on scientific, clinical, (...) and philosophical approaches to address issues such as: the role of therapy in society; the goals and outcomes of psychotherapy; techniques and practices; the existence and operation of values; and the intellectual and social context in which therapy takes place. This comprehensive study is a significant contribution to the debate on the ethical character of psychotherapy. (shrink)

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

Over 100 years ago, Frances Galton began the empirical study of autobiographical memory by devising a technique in which he explored the capacity for a cue word to elicit the recollection of events from earlier life (Galton, 1883). After a century of neglect, the topic began to re-emerge, stimulated by the work of Robinson (1976) using the technique on groups of normal subjects, by Crovitz’s work on its application to patients with memory deficits (Crovitz & Schiffman, 1974), and by the (...) detailed diary study of her own autobiographical memory carried out by Marigold Linton (Linton, 1975). This early wave of interest was focused by Rubin’s edited book on the topic (Rubin, 1986) which captured a broad and growing interest in autobiographical memory. This trend was reflected very strongly in the submissions to the second conference on Practical Aspects of Memory, in which the study of autobiographical memory represented one of the major strands (Gruneberg, Morris & Sykes, 1988), featuring prominently in both the opening and concluding addresses (Baddeley, 1988; Neisser, 1988). (shrink)

A conception of the relation between reasons for belief, justified belief, and knowledge is outlined on which a belief is justified, in the sense of being well‐founded, only if there is an adequate reason to believe it, reasons to believe something are constituted by truths, and a reason to believe something justifies one in believing it only if it is constituted by a truth or truths that one knows. It is argued that, contrary to initial appearances, perceptual justification does not (...) pose a problem for this view. The discussion touches upon the relation between believing for reasons and reflective knowledge. (shrink)

Let φ be a monadic second order sentence about a finite structure from a class K which is closed under disjoint unions and has components. Compton has conjectured that if the number of n element structures has appropriate asymptotics, then unlabelled (labelled) asymptotic probabilities ν(φ) (μ(φ) respectively) for φ always exist. By applying generating series methods to count finite models, and a tailor made Tauberian lemma, this conjecture is proved under a mild additional condition on the asymptotics of the number (...) of single component K-structures. Prominent among examples covered, are structures consisting of a single unary function (or partial function) and a fixed number of unary predicates. (shrink)

The integration of technology in care is core business in nursing and this role requires that we must understand and use technology informed by evidence that goes much deeper and broader than actions and behaviours. We need to delve more deeply into its complexity because there is nothing minor or insignificant about technology as a major influence in healthcare outcomes and experiences. Evidence is needed that addresses technology and nursing from perspectives that examine the effects of technology, especially related to (...) increasing demands for efficiency, the relationship of technology to nursing and caring, and a range of philosophical questions associated with empowering people in their healthcare choices. Specifically, there is a need to confront in practice the ways technique influences care. Technique is the creation of a kind of thinking that is necessary for contemporary healthcare technology to develop and be applied in an efficient and rational manner. Technique is not an entity or specific thing, but rather a way of thinking that seeks to shape and organize nursing activity, and manage efficiently individual difference(s) in care. It emphasizes predetermined causal relationships, conformity, and sameness of product, process, and thought. In response is needed a radical vision of nursing that attempts in a real sense to ensure we meet the needs of individuals and their community. Activism and advocacy are needed, and a willingness to create a certain detachment from the imperatives that technique demands. It is argued that our responsibility as nurses is to respond in practice to the errors, advantages, difficulties, and temptations of technology for the benefit of those who most need our assistance and care. (shrink)

In 1964, the American Medical Association invited liberal theologian Abraham Joshua Heschel to address its annual meeting in a program entitled “The Patient as a Person” [1]. Unsurprisingly, in light of Heschel’s reputation for outspokenness, he launched a jeremiad against physicians, claiming: “The admiration for medical science is increasing, the respect for its practitioners is decreasing. The depreciation of the image of the doctor is bound to disseminate disenchantment and to affect the state of medicine itself” [1, p. 35]. Heschel’s (...) reference to “disenchantment” suggests that he may have been familiar with the work, or at least the outlook, of sociologist Max Weber, whose 1917 address “Science as a Vocation” portrays the modern world as disenchanted by the progress of rationalism. Heschel’s life’s vocation had been to uncover the inner meaning of religious faith and to translate that faith into principled action. Heschel saw disenchantment not as an inescapable aspect of modern life but rather as the byproduct of physicians’ conscious choices to seek worldly success and material comfort. Yet, because of their privileged position as witnesses to human vulnerability, physicians possess an obligation to develop their own personhood, to re-enchant medicine, and through medicine to spark a positive transformation in all of modern life. As Heschel says, “The doctor must realize the supreme nobility of his vocation, to cultivate a taste for the pleasures of the soul. … The doctor is a major source of moral energy affecting the spiritual texture and substance of the entire society” [1, pp. 34, 38]. While Heschel’s conception of the physician’s role is romanticized and idealized, changes in the organization and practice of medicine have validated his concerns. (shrink)

In a recent article, van Fraassen has taken issue with the use to which Perrin’s experiments on Brownian motion have been put by philosophers, especially those defending scientific realism. He defends an alternative position by analysing the details of Perrin’s case in its historical context. In this reply, I argue that van Fraassen has not done the job well enough and I extend and in some respects attempt to correct his claims by close attention to the historical details.

In his newly updated version of The Anatomy of a Constitutional Law Case, Alan F. Westin provides a documentary portrait of historically important constitutional law case, 'Youngstown Sheet & Tube Co. v. Sawyer, ' from its rise in a bargaining dispute in the steel industry during 1952 to the aftermath of its decision by the United States Supreme Court. Westin has added to his classic book additional materials and personal commentaries collected since the work was first published. The new (...) information covers what went on within the Truman administration, what went on within the Supreme Court when analyzing and resolving issues that come before it. Westin includes selections from transcripts, briefs and other official proceedings, adds notes describing each phase of the constitutional process, and a section of commentary and questions relating this case to others. (shrink)

In the popular folklore three-score-years-and-ten is treated as a fair innings for people, and thereby serves as an informal reference point for judgements about distributive justice within a community. But length of life alone is an insufficient basis for such judgements - a person's health-related quality-of-life also needs to be taken into account. If one of the objectives of public policy is to reduce inequalities in lifetime health, it will be demonstrated that this is very likely to require systematic discrimination (...) against the older members of a community. The notion of community solidatity will also be tested, because a decision will need to be made as to whether the same fair innings applies to all members of the community, or whether some are entitled to more than others. The strength of the fair innings principle is that it brings these issues to the fore in a systematic way which should ais their resolition in a practical context. (shrink)

The paper is a response to William Newman’s rebuttal of a critique of his account of the origins of modern chemistry by Alan Chalmers. A way in which the nature of science can be illuminated by history of science is identified and an account of how this can be achieved in the context of a study of the work of Boyle defended in the face of Newman’s criticism. Texts from the writings of Boyle that are cited by Newman as (...) posing problems for Chalmers’ thesis are interpreted as in fact supporting it. (shrink)

The book provides a novel theory of the criminal law that focuses, not on when it is appropriate to blame and make suffer an individual character, but on when it is legitimate to deprive a free agent of its liberty and on how it is possible to reconcile punishment with individual freedom.

This paper aims to elucidate the meanings of the concept of modernity, highlighting its contradictory core and the theoretical and practical implications of this contradiction. To this end, we turn to the works of the German philosopher Immanuel Kant (1724-1804), as a paradigmatic intellectual expression of modernity, insofar as the author highlights notions that seem central to understanding the specificity of his time, which are brought together in his reflections on history and human progress, in the context of the enlightenment (...) that is struggling to become effective. We believe it is possible to extract from these reflections an idea of utopia which, although it needs to be cleansed of certain idealistic excesses, ends up representing a perspective that dialogues with Critical Theory, notably with Theodor Adorno (1903-1969). Although he demonstrates the bankruptcy and limits of the philosophical categories that authors such as Kant used to think about modernity, he doesn't discard the concepts in question, but rather puts them under tension, ultimately aiming to unveil the prospects for emancipation from the administered world, which, in the final analysis, have always been present at the heart of modern thought. (shrink)

It is argued that reasonable partiality allows an agent to attach value to particular objects of attachment via recognition of the value of the holding of that relation between agent and object. The reasonableness of partiality is ensured by a background context set by the agent's virtues, notably justice. It is argued that reasonable partiality is the only view that is compatible with our best account of the nature of self-knowledge. That account rules out any instrumental relationship between moral demands (...) and moral character, but that familiar claim is given an unfamiliar explanation. Instrumentality depends on a prior objectification of the self and it is that kind of objectification that, in the ethical case, represents a form of ethical evasion. Self-knowledge is transparent, incomplete and essentially connected with first person endorsement. The transparency condition is that knowledge of one's state of mind is "taken" transparently to its object. More specifically, ethical transparency is the feature that my virtues do not exhibit themselves to me in self-knowledge, but take me transparently to the way in which they saliently represent the world as containing evaluative properties calling for various forms of response. It is concluded that reasonable partiality grounded in the nature of the virtues is the only reflective account of morality compatible with the most plausible account of the nature of self-knowledge. The demands of impartiality are incompatible with a condition of having a personal point of view, namely, that a self can stand in a non-alienated relation to itself via its capacity for self-knowledge. (shrink)

This book is the companion to Difference and Disavowal: The Trauma of Eros (Stanford University Press, 2000), which dealt with the psychoanalytic clinical problem of resistance to interpretation. The key to this resistance is the unconscious registration and repudiation (disavowal) of the reality of difference. The surprising generality of this resistance intersects with Nietzsche's, Heidegger's, and Derrida's understanding of how and why difference is in general the “unthought of metaphysics.” All three see metaphysics engaged with a “registration and repudiation of (...) difference,” and all three rethink interpretation in relation to this question. The synthesis of these theories of interpretation and difference provides the philosophical foundations for a new thinking of how interpretation functions, and is a critical intersection of deconstruction and psychoanalysis. (shrink)

This article compares the dialectics of Fredric Jameson and Roy Bhaskar. From a dialectical critical-realist standpoint, it argues that Jameson’s approach in his recent collection Valences of the Dialectic sits uncomfortably between Hegelian and Marxist presuppositions. This is seen in the way he configures the relation between thinking and being, and it leads to an alliance with poststructuralist thinking in which real negativity is denied. In consequence, his thought is caught between a critique of the present and the impossibility of (...) thinking real change within it. (shrink)

We often consider semantic-pragmatic properties of language independently of each other. In actual texts, however, the properties frequently interact. For this reason a robust theory should allow us to account not only for semantic-pragmatic properties in isolation, but also for the ways in which they are combined. This is especially important for the understanding of literary texts because the exploitation of semantic-pragmatic properties is characteristic of literary language. This article argues that it is possible to account systematically for the occurrence (...) of metaphorical \literal poetic ambiguity in terms of the interaction of such properties. Using the notion of conceptual domains and subdomains, the article proposes two necessary conditions and shows how the interaction of these conditions allows for a simple account of metaphorical/literal ambiguity. The article concludes by suggesting that examining the ways in which basic semantic-pragmatic principles of language are used in literature to create poetic effects offers us another path in understanding the poetic, one which neither equates poetic effects with a distinct poetic language, as do many formalists, nor reduces the exploration of the poetic to the properties of everyday language, as cognitivists often have. (shrink)

Cowan's revisiting of the magic number is very timely and the case he makes for a more moderate number than seven is persuasive. It is also appropriate to frame his case within a theoretical context, since this will influence what evidence to include and how to interpret it. He presents his model however, as a contrast to the working memory model of Baddeley. I suggest that this reflects a misinterpretation of our model resulting in a danger of focusing attention on (...) pseudo-problems rather than genuine disparities between his approach and my own. (shrink)

Bioethics as politics -- Bioethics and the politics of expectations -- Engendering consent : bioethics and biobanks -- Missing the big picture : bioethics and stem cell research -- Testing times : bioethics and "do-it-yourself" genetics -- Governing uncertainty : the politics of nanoethics -- Beyond bioethics.

The fundamental causal concept in Chisholm's theory of agency is that of causally contributing to, a generic concept covering both event-causal contributors and agent-causal contributors. Chisholm's elucidation of agent-causation is explored and defended against objections. It is then argued that Chisholm's ontology, in particular in its treatment of the concept of an evert, generates difficulties for his theory of agency oi which two are explored: that it is hard to reconcile with Chisholm's own apparent analysis of the distinction between intentional (...) and unintentional actions; and that it entails that every causal contributing has an infinite set of causal contributors, which is in conflict with the principle that any set of nonredundant conditions that are jointly sufficient for the occurrence of an event are so by the nature of things, and not by virtue of some further event. (shrink)

The rapid development of biobanks internationally reflects the considerable expectations attached to the exploitation of genetics knowledge. However, establishing consent and legitimacy for the new generation of biobanks is not without its challenges because they tend to be prospective in nature, involving the collection of DNA, personal medical and lifestyle data generally held over a very long period of time for unspecified research purposes. Thus far, biobanks have tended to be established ahead of wide-ranging debate about their broad implications. Making (...) specific reference to the 'engagement' processes employed by UK Biobank during its establishment phase, this article focuses on the politics of 'public engagement'. It examines the context of arguments for 'public engagement', drawing attention to how particular approaches to 'engagement' within biobank projects may serve to limit debate on substantive questions arising from their development. Unless biobanks' 'engagements' substantially involve publics in deliberations about their development, it is argued, publics are likely to become distrustful of projects and perhaps resist other similar population-based health initiatives in the future. (shrink)

In several recent articles, Michael Wreen has given a plausible account of the structure of ad baculum argument and argued that it is neither inherently fallacious nor even commonly so. He has also, arguing mainly in terms of examples, attempted to show that a number of common assumptions about the ad baculum are incorrect. Most controversially, he argues that the ad baculum is not essentially dialectical and that it does not essentially involve threatening. I argue that the genuineness of his (...) examples as cases of ad baculum is doubtful, except insofar as they do at least implicitly have these features. I argue further that the stock cases used by Copi and other textbook writers extensionally define the ad baculum, which is a strategy already familiar to students from ordinary life, which is essentially first personlsecondperson, and which does essentially involve a threat. (shrink)

This essay argues that critical realism provides a philosophical perspective from which to talk about good and evil. It draws on dialectical critical realism’s meta-ethics of freedom and solidarity, and the different grades of freedom identified there: from the basic spontaneity in agency to the possibility of a fully flourishing, eudaimonic social condition. It argues that evil acts can be understood as those which fundamentally deny basic human freedom (spontaneity) and solidarity, and that good acts are those which affirm human (...) flourishing and solidarity. It draws upon Hannah Arendt’s depiction of what was morally evil in the Holocaust, and recent English criminal trials involving mercy killing to depict the good. It suggests that moral framing in terms of good and evil lies beyond the terms in which modern law thinks of human actions. (shrink)