Book reviewed in this article: Philosophy in Medicine: Conceptual and Ethical Problems in Medicine and Psychiatry. By Charles M. Culver and Bernard Gert. Psychiatric Ethics. Edited by Sidney Block and Paul Chodoff. Man, Mind, and Morality: The Ethics of Behavior Control. By Ruth Macklin.

After surveying and criticizing some earlier definitions of "disease", we propose that a general term--malady--be used to represent what all diseases, illnesses, injuries, etc., have in common. We define a malady as the suffering, or increased risk of suffering an evil in the absence of a distinct sustaining cause. We discuss the key terms in the definition: evil, distinct sustaining cause, and increased risk. We show that the role of abnormality is to clarify these terms rather than to be used (...) directly in the definition of malady. (shrink)

In his article 'Specifying, balancing and interpreting bioethical principles' (Richardson, 2000), Henry Richardson claims that the two dominant theories in bioethics - principlism, put forward by Beauchamp and Childress in Principles of Bioethics , and common morality, put forward by Gert, Culver and Clouser in Bioethics: A Return to Fundamentals - are deficient because they employ balancing rather than specification to resolve disputes between principles or rules. We show that, contrary to Richardson's claim, the major problem with principlism, either (...) the original version, or the specified principlism of Richardson, is that it conceives of morality as being composed of free-standing principles, rather than as common morality conceives it, as being a complete public system, composed of rules, ideals, morally relevant features, and a procedure for determining when a rule can be justifiably violated. (shrink)

Although the definition of a mental disorder has remained essentially the same from Diagnostic and Statistical Manual of Mental Disorder, Third Edition, Revised (DSM-III-R) through DSM-IV to DSM-IV-TR, the account of the paraphilias has changed continually. Although the definition in all the DSMs explicitly rules out deviant sexual behavior as sufficient for labeling someone as having a mental disorder, deviant sexual behavior counts as sufficient for all the paraphilias in DSM-III-R. In DSM-IV, the account of all the paraphilias is made (...) consistent with the definition. In DSM-IV-TR, mere deviant sexual behavior is not sufficient for being classified as having a paraphilia, but immoral deviant sexual behavior is. Thus, in DSM-IV-TR, only those paraphilias that involve immoral deviant sexual behavior are inconsistent with the definition, but deviant sexual behavior by itself does not count as a mental disorder. (shrink)

Coercion is commonly said to invalidate consent, and that is always true if the source of the coercion is the physician. However, if it is a family member who coerces the patient to consent, the resultant consent may be quite valid and treatment should proceed.

Derek Parfit, Joseph Raz, and T. M. S canlon, among others, all hold that reasons for action are provided by facts about those actions. They also hold that the fact that an action would promote or achieve the object of an agent's desire is not one of the relevant facts, and does not provide a reason. Rather, the facts that provide reasons are typically facts about valuable states of affairs that the action is likely to bring about, or valuable properties (...) that the action itself will instantiate. For this reason it is appropriate to call Parfit, Raz, and Scanlon "value-based" theorists about reasons for action. In contrast to value-based theorists, there is a strong current of contemporary theorizing, starting with Bernard Williams, that can be called "desire-based." Desire-based theorists argue that practical reasons should be understood in terms of the desires of the agents who are said to have those reasons. (shrink)

Medical decision making relies heavily on the notion of the quality of a person's life in providing a reason to utilize one therapy over another or to withhold certain therapies altogether. The concept of quality of life, however, lacks clear definition as well as consensus on its constitutive elements. ;Chapter one engages a basic controversy in the literature: whether 'quality of life' should be understood as a subjective concept, or whether objective "lists" can help us assess a person's quality of (...) life. Chapter two examines whether anthropological data might provide guidance. While it is often argued that anthropological data supports relativism, John Finnis argues that anthropological data supports universalism which, in turn, bolsters objectivist claims. I argue that anthropological data may plausibly be interpreted to support either subjective or objective accounts, and thus, does not settle our approach to quality of life. ;Chapter Three examines objective list theories, in particular those of Bernard Gert and John Finnis. I find Gert's account to be problematic because it seems incomplete. Finnis's criteria, too, seems ultimately indefensible. Thus, I conclude that while objectivist claims may offer insight into human values and motivations, existing accounts are flawed. Chapter Four examines subjective accounts of quality of life. I focus on "preference satisfaction" accounts. While these accounts provide intuitively plausible descriptions, they fall victim to a host of difficulties. Perhaps the best example of this is the "fleeting preferences" problem, which undermines our confidence in making life-and-death decisions on the basis of quality of life considerations. ;The concluding chapter offers that much progress can be made by understanding quality of life in terms of finding meaning in life. Thus, the quality of one's life is determined by how much purpose and meaning is found in that life. While this notion is not without its problems, it does capture the complex elements of the kinds of cases in which we are particularly interested, and combines some of the best features of both the objective and subjective accounts. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.3 (2003) 189-192 [Access article in PDF] Is There a Common Morality? Robert M. VeatchSenior EditorOne of the most exciting and important developments in recent ethical theory—especially bioethical theory—is the emergence of the concept of "common morality." Some of the most influential theories in bioethics have endorsed the notion using it as the starting point of their systems. This issue of the Journal is (...) devoted to these developments.The core idea of a common morality is that all humans—at least all morally serious humans—have a pretheoretical awareness of certain moral norms. The claim is that normal humans intuit or in some other way know that there is something wrong with things like lying or breaking promises or killing people. These purportedly universally shared insights can provide the raw data from which ethical theories are constructed. As such, they are perhaps analogous to the raw sense data that are relied on in the natural sciences to launch the construction of scientific theories and accounts of the nature of reality. Some common morality theorists suggest an analogy between the natural and the moral sciences.In the natural sciences there is a widely shared belief that some raw sensory data are perceived by all normal humans and provide the basis for the construction of various scientific theories. For example, it is widely believed that all normal humans looking at the top light on a traffic signal perceive something that in English is called "red." Of course, different cultures will use different language to describe this experience. They may parse the boundaries differently (varying on the exact borderline between red and orange), provide widely differing accounts of why the experience of "red" occurs, and eventually generate significantly different theoretical formulations to explain the experience of redness. Moreover, some individuals may look at that top light of the traffic signal and not see color at all. One generally, however, does not account for this by denying there is any objective, generally shared basis for the experience that produces a sensation of redness in normal people. One simply explains the experience of the one who fails to see color by positing a defect in perception, called "color-blindness."Some moral theorists suggest that something analogous happens when humans look at the moral scene. The claim is that all normal humans in all places and cultures "see" certain moral requiredness. They see that some behaviors are, in some sense, generally wrong; that other behaviors are generally right; that [End Page 189] some character traits are generally praiseworthy, others blameworthy. No sophisticated common morality theorist denies that, as with color-blindness, there may be occasional outliers who for one reason or another fail to intuit or perceive these simple, abstract moral norms. Certainly, people in different cultures will define the terms differently, will recognize different limits on the norms, and will construct different theories to account for their experience. The primitive idea that there is something generally wrong with killing other humans will be articulated very differently in different cultures—some referring to the "sacredness of life;" others to a duty not to kill, a right to life, or a prohibition on killing the innocent. Some may extend the insight to a duty to prolong living, others limit it merely to a prohibition of direct, active killing. Some may endorse more exceptions—for killing of unjust aggressors, for killing in just war, for killing in self-defense; others, such as pacifists, will be much more stingy in doling out exceptions. Certainly, people at different times and places will articulate the norms in different language and embed them in different theories. The basic claim of common morality theorists, however, is that there is some primitive, pretheoretical insight that is shared by all normal, morally serious persons.Recently, the notion of a common morality has served as a starting point for bioethical theories as diverse as Bernard Gert, Charles Culver, and Danner Clouser's Bioethics: A Return to Fundamentals (1997) and the latest edition of Tom Beauchamp and James Childress's Principles of Biomedical Ethics... (shrink)

In this essay, I advance an argument against the expansion and acceptance of postmodern metaphysical antirealist ideologies in the development of nursing theory in North America. I suggest mystical theoretical explanations of care, the rejection of empirical epistemology, and a return to divinity in nursing represent an intellectual dead end, as these ideas do little to help resolve real‐world health issues and also negate the need for the academic discrimination of bad ideas. I examine some of the philosophical foundations of (...) nursing theory and deconstruct some of the more preternatural theories that have become established as the dominant conventional wisdom in the academy. It is argued that this can be characterized as a form of self‐deception, and overall has had a negative impact on advancement of the nursing profession and public health care. Reasons behind the widespread acceptance of these irrational theoretical stances in nursing and the ongoing support for mystical therapeutic interventions are explored. (shrink)

Two years ago in two articles in a thematic issue of this journal the three of us engaged in a critique of principlism. In a subsequent issue, B. Andrew Lustig defended aspects of principlism we had criticized and argued against our own account of morality. Our reply to Lustig's critique is also in two parts, corresponding with his own. Our first part shows how Lustig's criticisms are seriously misdirected. Our second and philosophically more important part picks up on Lustig's challenge (...) to us to show that our account of morality is more adequate than principlism. In particular we show that recognition of morality as public and systematic enables us to provide a far better description of morality than does principlism. This explains why we adopt the label “Dartmouth Descriptivism.”. (shrink)

This book sets out to present Kant as a theological thinker. His critical philosophy was not only destructive of "natural" theology, with its attempt to prove devine existence by logical argument, it also left no room for "revelation" in the traditional sense. Yet Kant himself, who was brought up in Lutheran pietism, certainly believed in God, and could fairly be described as a religious man. But he held that religion can be based only on the moral consciousness, and in his (...) last major work, "Religion within the Limits of Reason Alone"ódiscussed here in detailóhe interpreted Christianity purely in terms of moral symbolism. (shrink)

Overgeneralization -- Vague definition -- Post hoc, propter hoc -- False analogy -- Partial selection of the evidence -- Groupthink -- Scams, deceptions, ruses, swindles, hoaxes and gaslights -- Begging the question -- The logic of Alice.

Esprit, l’un des mots clés des Pensées, reçoit chez Pascal deux significations : la raison et le souffle intérieur. Si l’esprit en tant que mens rationalis appartient au deuxième ordre, l’esprit en tant que mens spiritualis relève du troisième ordre. Deux dualismes se croisent dans la distinction pascalienne des trois ordres : le premier de nature philosophique, cartésienne, oppose le premier ordre, voué au corps, et les deuxième et troisième ordres, voués à la mens ; le second, de nature éthico-religieuse, (...) oppose le premier et le deuxième ordres, ordres de la cupidité, au troisième ordre, celui de la charité. Au-dessus de l’esprit/raison se tient l’esprit/amour. Pascal tisse, au sein du troisième ordre, un lien entre l’esprit et le cœur. Dans la notion de spiritus cordialis, d’esprit cordial, se situe l’apport essentiel de l’auteur des Pensées.« Esprit », one of the key-words of Pascal’s Pensées, has two meanings according to Pascal : i.e. reason and interior creative inspiration. If esprit as mens rationalis belongs to the second order, esprit as mens spiritualis refers to the third order. Two dualisms cross themselves within the Pascalian distinction of three orders. The former – of a philosophical nature, i.e. Cartesian – opposes the first order, devoted to the body and the second and third order devoted to the mens ; the latter – of an ethico-religious nature – opposes both the first and second order, i.e. the orders of cupidity to the third order, i.e. that of charity. The esprit as love rests above the esprit as reason. Pascal weaves, amid the third order a link between the esprit and the heart. The major contribution of the author of the Pensées rests in the concept of spiritus cordialis. (shrink)

This Major Reference series brings together a wide range of key international articles in law and legal theory. Many of these essays are not readily accessible, and their presentation in these volumes will provide a vital new resource for both research and teaching. Each volume is edited by leading international authorities who explain the significance and context of articles in an informative and complete introduction.

The conference did not target only the U.S. Christian right for opposing such things as stem cell research. It challenged every faith community that believes a human being is more than just one more biological product. The weekend of Aug. 7 was organized by the World Transhumanist Association. In 2005 its conference will be in Caracas, Venezuela, where this small band of transhumanists will continue to challenge all larger faith communities to review what they have to say about a "brave (...) new world" that would carry us far beyond the engineered manipulations that seemed so distant when Aldous Huxley wrote in 1932 about creating babies in test tubes. (shrink)