Moral conflicts occur in theories that involve more than one principle. I examine basic ways of dealing with moral dilemmas in medical ethics and in ethics generally, and propose a different approach based on a principle I call the "mutuality principle". It is offered as an addition to Tom Beauchamp and James Childress' principlism. The principle calls for the mutual enhancement of basic moral values. After explaining the principle and its strengths, I test it by way of an examination of (...) three responses—in the recent Festschrift for Dr Raanon Gillon—to a case involving parental refusal of a blood transfusion. The strongest response is the one that comes closest to the requirements of the mutuality principle but yet falls short. I argue that the mutuality principle provides an explicit future orientation in principlism and gives it greater moral coherence. (shrink)

Philosophy is experiencing a resurgence of property (PD) and generic substance dualism (SD). One important argument for SD that has played a role in this resurgence is some version of a modal argument. Until recently, premise (3) of the argument (Possibly, I exist, and no wholly physical objects exist.) has garnered most of the attention by critics. However, more recently, the focus has also been on (2) (Wholly physical objects are essentially, wholly, and intrinsically physical and wholly spiritual substances are (...) essentially, wholly, and intrinsically immaterial.). Andrew Bailey has provided one of the best criticisms of (2) on offer. In what follows, I present and clarify one form of the argument and defend premise (2) by responding to important defeaters proffered by Andrew Bailey and his contingent physicalism. (shrink)

Context The conduct of medical research led by Northern countries in developing countries raises ethical questions. The assessment of research protocols has to be twofold, with a first reading in the country of origin and a second one in the country where the research takes place. This reading should benefit from an independent local ethical review of protocols. Consequently, ethics committees for medical research are evolving in Africa. Objective To investigate the process of establishing ethics committees and their independence. Method (...) Descriptive study of 25 African countries and two North American countries. Data were recorded by questionnaire and interviews. Two visits of ethics committee meetings were conducted on the ground: over a period of 3 months in Kigali (Rwanda) and 2 months in Washington DC (USA). Results 22 countries participated in this study, 20 from Africa and two from North America. The response rate was 80%. 75% of local African committees developed into national ethics committees. During the last 5 years, these national committees have grown on a structural level. The circumstances of creation and the general context of underdevelopment remain the major challenges in Africa. Their independence could not be ensured without continuous training and efficient funding mechanisms. Institutional ethics committees are well established in USA and in Canada, whereas ethics committees in North America are weakened by the institutional affiliation of their members. Conclusion The process of establishing ethics committees could affect their functioning and compromise their independence in some African countries and in North America. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Being and Freedom: On Late Modern Ethics in Europe by John SkorupskiJ. P. MessinaJohn Skorupski. Being and Freedom: On Late Modern Ethics in Europe. Oxford: Oxford University Press, 2021. Pp. 560. Hardcover, $130.00.John Skorupski's Being and Freedom traces the development of modern ethics in France, Germany, and England, as set in motion by two great revolutions: the French Revolution and Kant's methodological revolution in the Critique of Pure (...) Reason. I begin this review by offering [End Page 714] a brief summary of the book (which consists of eight lengthy chapters, an introduction, and a brief conclusion). I then raise some interpretive worries and offer an overall assessment.In chapter 1, Skorupski reminds us that the French Revolution, a physical struggle between opposing factions, was also a battleground of ideas. In opposing the ancien régime, revolutionaries took aim at the "Catholic-feudal order" (27). Underlying this order was an ethical view, "holism," according to which a person lives well through excellent performance of community roles assigned by family, state, and church. When individual interests conflict with these social roles, the latter take precedence. Revolutionaries (partially inspired by Rousseau) railed against this. On their view, persons were born for freedom, not the chains of traditional life. To realize such freedom demanded a radical democratic state. Here, too, fidelity to the ethical whole (the Republic) sometimes required sacrifices on the part of individuals. But in a properly constituted republic, these sacrifices would be self-imposed requirements of the general will.As revolution turned to terror and blood became the regular currency of sacrifice, critics like Guizot saw the ancien régime's parochialism as a symptom of a larger problem with its underlying ethics, one it shared with the radicals aligned against it: its commitment to holism. Holism says that some social entities have a good not reducible to the good of their members. Additionally, these social wholes have their own rights that sometimes override individual rights (28, 59). These features make it easy for holist orders to justify sacrificing individuals for collective goods. If this is the disease, individualism of the sort associated with Kantian ethics can seem to be the cure.Chapter 2 argues that the new critical philosophy resulting from Kant's "Copernican" Revolution is a mixed bag. On the one hand, Kant offers no good reason for positing a noumenal world and locating freedom there (77–79). On the other hand, there is lasting promise in the idea that morality follows from each person's individual autonomy. And yet, in the end, Kant's arguments fail here, too. For deriving morality from autonomy requires an explicit commitment to impartiality, which does not follow from autonomy (83–102). And, even when suitably modified, Kant's ethical principles risk emptiness if they fail to take content from our relationships and social roles (112, 148). Unfortunately, Kant suggests that doing so would perpetrate heteronomy, making such emptiness inevitable (102).By chapter 3, the tension between holist and individualist conceptions of ethics has become Skorupski's central leitmotif. On the one hand, individualists are well positioned to resist oppression and terror. On the other hand, individualism risks atomism and alienation from our attachments and feelings. Such alienation leads Schiller to reject Kant's views on freedom and virtue (161). For our author, this is as it should be.Skorupski next turns to Fichte. Although Fichte takes a step away from transcendental idealism by making intellectual intuition the hallmark of our subjectivity (173), he agrees with Kant that morality follows from autonomy. Indeed, for Fichte, autonomy commits us to striving for full self-sufficiency, which appears to court a similar atomism. Yet this impression is corrected when Fichte turns to politics. There, Fichte grounds rights (as permissible demands) in mutual recognition (182–83). This positions him to see the state and the family as ethical wholes (187–88), pointing away from Kantian individualism back toward holism.Hegel takes these steps away from Kant to their logical conclusion. As Skorupski explains in chapter 4, Hegel argues that the individualist systems grounded in autonomy and abstract right (Moralität) mark but stages on the way to moral... (shrink)

Do we still have a Cartesian mind-body problem? Folk wisdom has it that Descartes is responsible for there being a mind-body problem. Nonetheless, the same folk wisdom has it that the mind-body problem is still with us. Discovering the culprit and his modus operandi has not apparently enabled us to neutralize his mischief. How can that be? Perhaps it is because the mind-body problem we have now is not the infamous one of Cartesian origins.

Objectives: The objective of this study is to investigate the relationship between a physician’s subjective mortality prediction and the level of confidence with which that mortality prediction is made.Design and participants: The study is a prospective cohort of patients less than 18 years of age admitted to a tertiary Paediatric Intensive Care Unit at a University Children’s Hospital with a minimum length of ICU stay of 10 h. Paediatric ICU attending physicians and fellows provided mortality risk predictions and the level (...) of confidence associated with these predictions on consecutive patients at the time of multidisciplinary rounds within 24 hours of admission to the paediatric ICU. Median confidence levels were compared across different ranges of mortality risk predictions.Results: Data were collected on 642 of 713 eligible patients . Mortality predictions greater than 5% and less than 95% were made with significantly less confidence than those predictions 95%. Experience was associated with greater confidence in prognostication.Conclusions: We conclude that a physician’s subjective mortality prediction may be dependent on the level of confidence in the prognosis; that is, a physician less confident in his or her prognosis is more likely to state an intermediate survival prediction. Measuring the level of confidence associated with mortality risk predictions may therefore be important because different levels of confidence may translate into differences in a physician’s therapeutic plans and their assessment of the patient’s future. (shrink)

J. P. Telotte _A Distant Technology: Science Fiction Film and the Machine Age_ Hanover, NH: Wesleyan University Press, 1999 ISBN 0-8195-6346-3 218 pages.

Despite Vancil’s (1979) proclamation over twenty years ago that topoi have been abandoned in argument theory, this essay contends that topoi should have a vital role in contemporary argumentation theory. Four key areas are identified where topoi are (or can be) essential tools for argumentation: Locating argument, building argument, development of critical thinking, and argument pedagogy. As a result, teachers and students of argument can both benefit from a (re)discovery of topoi.

Concerns about censorship have once again reached a fever pitch across the liberal West. In other historical periods, such concerns may have marked reactions to book bans and burnings. Often, they followed prosecutions and subsequent jailtime for things spoken or written. During the Red Scare, they were the hushed response to chilling state-sponsored watch-lists and employer-supported blacklists designed to ensure victory against communism. Against this history, complaints about the new censorship appear differently. With respect to the new censorship, there are (...) no books burnings, no prosecutions, no laws or committees. Indeed, there is no coercive state involvement at all. With a few notable exceptions, complaints about censorship in the 21st-century West are complaints about the behavior of private parties: social groups, employers, media conglomerates, social media platforms, and search engines. -/- To better understand the concerns surrounding nonstate interference with speech, Private Censorship offers an account of censorship, as well as an assessment of the ethical and political issues it raises across contexts. J.P. Messina asks and variously answers questions like: what should we think when employees get fired for things they say and how might patterns of such firings create a climate of fear inimical to free inquiry? When is it appropriate for social media firms to deplatform users, and what does it mean for our democracy that those in charge of such decisions are often wealthy Silicon Valley executives? Do search engines act as massive gatekeepers to information in troubling ways, and how might they be constrained, if they do? Along the way, Messina casts a critical eye on many popular proposals for responding to these complaints. Unlike these popular approaches, Private Censorship foregrounds the importance of rights to property, association, and free expression for thinking well about 21st-century censorship concerns. (shrink)

In their thought-provoking article, Sedlakova and Trachsel (2023) defend the view that the status—both epistemic and ethical—of Conversational Artificial Intelligence (CAI) used in psychotherapy is complicated. While therapeutic CAI seems to be more than a mere tool implementing particular therapeutic techniques, it falls short of being a “digital therapist.” One of the main arguments supporting the latter claim is that even though “the interaction with CAI happens in the course of conversation… the conversation is profoundly different from a conversation with (...) a human therapist” (Sedlakova and Trachsel 2023, 8). In particular, unlike a human therapist, CAI cannot help its users gain new insight and self-understanding (Sedlakova and Trachsel 2023). We agree that currently available therapeutic CAI cannot be considered a “digital therapist,” however, we think that the issue surrounding the acquisition of new self-understanding in the interaction with therapeutic CAI is more complicated than Sedlakova and Trachsel suggest. (shrink)

Neologicists have sought to ground mathematical knowledge in abstraction. One especially obstinate problem for this account is the bad company problem. The leading neologicist strategy for resolving this problem is to attempt to sift the good abstraction principles from the bad. This response faces a dilemma: the system of ‘good’ abstraction principles either falls foul of the Scylla of inconsistency or the Charybdis of being unable to recover a modest portion of Zermelo–Fraenkel set theory with its intended generality. This article (...) argues that the bad company problem is due to the ‘static’ character of abstraction on the neologicist's account and develops a ‘dynamic’ account of abstraction that avoids both horns of the dilemma. 1 Introduction2ion Reconstructed3 From Bad to Worse4 Abstraction Reconceived5 Bad Company Made GoodA AppendixA.1SemanticsA.2LogicA.3ConsistencyA.4Strength. (shrink)

The concept of civil society has once again emerged as a viable mechanism for developing and sustaining deliberative democracy. However, an essential component of many strategies to sustain civil society appears lacking, especially when we see the growing cynicism and apathy among citizens. What is missing is a strategy for training or encouraging citizens to participate more fully in civil society. The skills of advocacy can, at least in part, help renew civic activism. Thus, the role of advocacy will be (...) explored as a potential way to resuscitate civil society. (shrink)

Objectives: To determine the effects of risk and payment on subjects’ willingness to participate, and to examine how payment influences subjects’ potential behaviours and risk evaluations.Methods: A 3 × 3 , between subjects, completely randomised factorial design was used. Students enrolled at one of five US pharmacy schools read a recruitment notice and informed consent form for a hypothetical study, and completed a questionnaire. Risk level was manipulated using recruitment notices and informed consent documents from hypothetical biomedical research projects. Payment (...) levels were determined using the payment models evaluated by Dickert and Grady as a guide. Five dependent variables were assessed in the questionnaire: willingness to participate, willingness to participate with no payment, propensity to neglect to tell about restricted activities, propensity to neglect to tell about negative effects, and risk rating.Results: Monetary payment had positive effects on respondents’ willingness to participate in research, regardless of the level of risk. However, higher monetary payments did not appear to blind respondents to the risks of a study. Payment had some influence on respondents’ potential behaviours regarding concealing information about restricted activities. However, payment did not appear to have a significant effect on respondents’ propensity to neglect to tell researchers about negative effects.Conclusions: Monetary payments appear to do what they are intended to do: make subjects more willing to participate in research. Concerns about payments blinding subjects to risks could not be substantiated in the present study. However, the findings do raise other concerns—notably the potential for payments to diminish the integrity of a study’s findings. Future research is critical to make sound decisions about the payment of research subjects. (shrink)

The ‘decapitation gambit’ holds that, if physical decapitation normally entails the death of the human being, then physiological decapitation, evident in cases of total brain failure, entails the death of the human being. This argument has been challenged by Franklin Miller and Robert Truog, who argue that physical decapitation does not necessarily entail the death of human beings and that therefore, by analogy, artificially sustained human bodies with total brain failure are living human beings. They thus challenge the current neurological (...) criterion for determining death and argue for a return to the traditional criterion of the irreversible loss of circulation and respiration. In this paper, I defend the decapitation gambit and total brain failure as a criterion for determining death against Miller and Truog's criticism. (shrink)

Not long ago, one of us has clarified and defended a bare particular theory of individuation. More recently, D. W. Mertz has raised a set of objections against this account and other accounts of bare particulars and proffered an alternative theory of individuation. He claims to have shown that 'the concept of bare particulars, and consequently substratum ontology that requires it, is untenable.' We disagree with this claim and believe there are adequate responses to the three arguments Mertz raises against (...) bare particulars. To substantiate this assertion, we clarify the nature of bare particulars as individuators, state Mertz's objections, and respond to them. We conclude that Mertz has failed to show that bare particular theory is untenable. (shrink)