'The law imposes the duty of care: but the standard of care is a matter of medical judgment'. So says Lord Scarman, outlining the hitherto accepted 'Bolam' standard, in his recent speech in the House of Lords decision of Sidaway v Bethlem Royal Hospital, reflecting earlier judicial dicta suggesting that it is for the medical profession rather than the courts to determine whether or not a medical practitioner has achieved the required standard of care (1). It is suggested here that (...) this concept is bad in principle, and that the weight of judicial authority is against it. (shrink)

Immediately after the publication of Darwin's book on the origin of species, Engels, having familiarized himself with it, wrote to Marx on December 12, 1859: "All in all, Darwin, whom I am reading right now, is superb. Teleology had hitherto not yet been destroyed in one of its aspects, and now this has been done. Moreover, hitherto there has never been so sweeping an attempt to prove historical development in nature, especially with such success." Soon Marx enlarged upon the evaluation (...) of Darwinism. In his letter of December 19, 1860, he commented that this theory "provides a foundation in natural history for our views." It is therefore no accident that Engels, in developing the principles of dialectical materialism and problems of the dialectics of nature, interested himself so deeply and comprehensively in the theory of evolution. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Dogs and MonstersObservations on the Evacuation of Afghanistan and the Intersection of Human Rights and the AnthropoceneK. M. Ferebee (bio)On August 28, 2021, former Royal Marine and charity worker Pen Farthing was evacuated from Afghanistan with almost two hundred dogs and cats that his Kabul animal charity, Nowzad Dogs, had rescued. The role of the British government in this evacuation remains hotly contested: At the time, the British Ministry (...) of Defence tweeted (Fig. 1) that Farthing's escape had been assisted by the British military, but Farthing later disputed this claim and argued that his rescue was not the result of high-level intervention in the British government. In January 2022 controversy erupted around the emergence of documents suggesting that Prime Minister Boris Johnson had lied to Parliament about the personal role that he played in just such an intervention. Notably, Nowzad's Afghan staff members were not evacuated alongside Farthing and the animals, though they would eventually escape to Pakistan. Following Farthing's escape, the British government failed to evacuate hundreds of British citizens and residents (Merriman and Ghouri), as well as many more Afghans who had worked on behalf of British forces. The Nowzad Dogs evacuation became a site of symbolic struggle over Britain's respect (or lack thereof) for human rights. "What a story to tell the world: Britain values dogs more than Afghan people," the headline of an opinion piece in the Guardian (Hinsliff) read.The story of Nowzad Dogs is interesting to me not only as a tale of human-nonhuman relations, but also because I was, at the time it occurred, volunteering within the Afghan aid community to assist relatives of a friend, British Afghans who had been visiting Kabul when the government [End Page 52] collapsed. The family repeatedly asked for assistance from the British Foreign, Commonwealth and Development Office—assistance that never appeared. Ultimately, due to the generosity of donors and the coordination of a volunteer team, the family was able to flee to Pakistan, where they boarded a commercial flight to London. This case was a particularly stark and powerful illustration of the negotiations of rights and value that took place during and following the evacuation. It seemed nonsensical, in August 2021, to suppose that British citizens, including British children (the family I worked with included a six- and an eleven-year-old who were British citizens), would be abandoned while Afghan dogs had their rights prioritized. As I hope to demonstrate here, however, such an incident becomes comprehensible and even logical when it is understood as part of a specifically Anthropocene manifestation of subjectivity.Upendra Baxi suggests that 1948's Universal Declaration of Human Rights (UDHR) marks a broad shift from the era of "modern" (42) human rights (which began with the American and French Revolutions) to the era of "contemporary" (42) human rights. His periodization links these eras in human rights to shifts in the ideology of capitalism and empire. The "modern" era of human rights, he writes, "signals a whole variety of ideological 'justifications' for colonization and world domination" and "provides a register of major development in industrial capitalism" (42), while the "contemporary" era of human rights "is based on the premise of radical self-determination" (46). Such a periodization also brings human rights into close alignment with the Anthropocene, which is rooted in the capitalist-colonial Enlightenment and Industrial Revolution, yet often dated most concretely to the circa-1950 shift that some (such as J. R. McNeill and Peter Engelke) label the "Great Acceleration." Indeed, one could reasonably appropriate Baxi's terms and speak of "modern" and "contemporary" Anthropocenes mapped identically onto the global timeline.I propose to use the 2021 Afghan evacuation as a site from which to explore how human rights and the Anthropocene have together coproduced certain forms of subjectivity that are essential for the continued smooth functioning of world-ecological capitalism. These new forms of subjectivity are necessary to sustain the important fiction of individual [End Page 53] agency and value and conceal the ways in which the Anthropocene moment renders this fiction meaningless. Ultimately, I paint a picture of an Anthropocene without any human agency at all. I want... (shrink)

This paper raises the questions: 'What do we expect from nursing ethics?' and 'Is the literature of nursing ethics any different from that of medical ethics?' It is suggested that rather than develop nursing ethics as a separate field writers in nursing ethics should take a lead in making the patient the central focus of health care ethics. The case is made for empirical work in health care ethics and it is suggested that a good way of setting about this (...) is to ask practising nurses about the real ethical problems they encounter. (shrink)

If George Eliot is a determinist, how can she justify judging her characters on moral grounds? The most influential discussion of her determinism concludes that she believed one overcomes its depressing effects by understanding it. But this view is contradicted by her assertion that free will is a “practical” necessity, even a necessary fiction. Kantian moral theory is strongly present in her work as is shown by her use of Kantian terms, but it is grounded nonmetaphysically. Rationality and the will (...) are essential if one is to feel free to choose. Her concept of whole self in relation to moral choice has links with Bergsonian theory. (shrink)

This monograph aims to mathematically codify the notion of "moral systems" and define a sensible distance between them. It consists of three parts, aimed at an audience with varying interests and mathematical backgrounds. The first part steers philosophical, formally defining moral systems and several related concepts. The second part studies black box algorithms, including questions of inference and metric construction. The third part explores the technical construction of metrics amongst conditional probability distributions.

Although science supplies medicine's “gold standard,” knowledge exercised in the care of patients is, like moral knowing, a matter of narrative, practical reason. Physicians draw on case narrative to store experience and to apply and qualify the general rules of medical science. Literature aids in this activity by stimulating moral imagination and by requiring its readers to engage in the retrospective construction of a situated, subjective account of events. Narrative truths are provisional, uncertain, derived from narrators whose standpoints are always (...) situated, particular, and uncertain, but open to comparison and reinterpretation. Reading is thus a model for knowing in both morality and clinical medicine. While principles remain essential to bioethics and science must always inform good clinical practice, the tendency to collapse morality into principles and medicine into science impoverishes both practices. Moral knowing is not separable from clinical judgment. While ethics must be open to discussion and interpretation by patients, families, and society, it is nevertheless substantively and epistemologically an inextricable part of a physician's clinical practice. (shrink)

Medical ethics, principles, persons, and perspectives is discussed under three headings: History, Theory, and Practice. Under Theory, the author will say something about some different approaches to the study and discussion of ethical issues in medicine—especially those based on principles, persons, or perspectives. Under Practice, the author will discuss how one perspectives based approach, hermeneutics, might help in relation first to everyday ethical issues and then to public controversies. In that context some possible advantages of moving from controversy to conversation (...) will be explored; and that will then be illustrated with reference to a current controversy about the use of human embryos in stem cell therapy research. The paper begins with history, and it begins in the author’s home city of Edinburgh. (shrink)

Narrative ethics taps into an inherent human need to tell our own stories centred on our own moral values and to have those stories heard and acknowledged. However, not everyone’s words are afforded equal power. The use of narrative ethics in bioethical decision-making is problematized by a disparity in whose stories are told, whose stories are heard, and whose stories are believed. Here, I conduct an analysis of narrative ethics through a critical theory lens to show how entrenched patterns of (...) narrative neglect in medicine are harming not only our capacity to make use of narrative ethics but also our capacity to deliver effective healthcare. To illustrate this point, I use three examples where the patient’s gender affects how their stories unfold: autism, weight, and pain management. From these, I argue that the use of narrative ethics without the application of a critical theory lens risks the exacerbation of what Miranda Fricker refers to as “testimonial injustice,” the prima facie harm experienced by individuals whose credibility is undermined by others’ prejudices. Finally, I suggest that narrative ethics can be a powerful tool for mitigating oppressive practices in medicine if we couple it with critical analysis that enables us to understand the power dynamics at play in storytelling. (shrink)

Mark Coeckelbergh (Int J Soc Robot 1:217–221, 2009) argues that robot ethics should investigate what interaction with robots can do to humans rather than focusing on the robot’s moral status. We should ask what robots do to our sociality and whether human–robot interaction can contribute to the human good and human flourishing. This paper extends Coeckelbergh’s call and investigate what it means to live with disembodied AI-powered agents. We address the following question: Can the human–AI interaction contribute to our moral (...) development? We present an empirically informed philosophical analysis of how the AI personal assistant Siri changes its users’ way of life, based on the responses obtained from 20 semi-directive individual interviews with Siri users. We identify changes in the users’ social interaction associated with the adoption of Siri. These changes include: (1) the indirect effect of reducing opportunities of human interaction, (2) the second-order effect of diminished expectations toward each other in a community, and (3) the acquired preference to obtain hassle-free interaction with Siri over human interaction. We examine them in relation to concerns that are voiced in the current debates over the rise of AI, namely the suspicion that humans could become overly reliant on AI (Danaher 2019) and the worry that social AI could impede on moral development (Fröding and Peterson, Ethics Inf Technol 23:207–214, 2012; Li, Ethics Inf Technol 23:543–550, 2021). We analyze the ethical costs that come from these changes in light of virtue ethics and address potential objections along the way. We end by offering directions for thinking about how to live with AI personal assistant while preserving favorable conditions for moral development. (shrink)

Ḥaydar al-Harawī (d. 825/after 1427) was a significant scholar from Khorasan who migrated to the Ottoman lands. A distinguished student of al-Taftazanī, he earned high regard from Mehmed I and received patronage from him. al-Harawī dedicated his commentary on al-Zamakhsharī’s al-Kashshāf to Mehmed I with exaggerated expressions of praise and provided significant details about his biography in the introduction of the work. After spending many years in Ottoman lands, al-Harawī established contact with Shahrukh, the son of Timur. He rewrote the (...) introduction of Sharḥ al-Kashshāf and ded- icated the work to Shahrukh. This new patronage relationship is evident in the second version of the introduction, where not only the dedication part but also the content was rearranged concerning the new patron’s identity. Important biographical details not found in the first version are included in the second version, making it a crucial source for al-Harawī’s biography. This article brings the second version of the introduction to light for the first time, constructing al-Harawī’s biography by compiling information from both versions. While no specific dates are provided in either version, the duration of al-Harawi’s stay in certain cities is mentioned. Gaps in the narrative were filled based on histori- cal events, allowing for accurate dating of approximately forty years of al-Harawī’s life, from Sarakhs through Shiraz, Tabriz, Shirvan, Bursa, Edirne, and back to Khorasan. This comprehensive overview sheds light on the relationship between scholars and rulers, the influence of political developments on scholarly life, and the intellectual world of a scholar dedicated to the pursuit of knowledge. (shrink)

For much of human history the idea of a right to life has not seemed self-evident. The credibility of the idea appears to depend on a particular kind of intuition concerning the nature of the world. In this paper, the kind of intuition involved is related to the idea of a covenant, illustrated by that of marriage. The paper concludes by suggesting that talk about responsibilities may be more fruitful than talk about rights.

Drawing on the family resemblance between quantum physics and Eastern wisdom identified by Niels Bohr, this article brings insights from Buddhism and Daoism to the task of enhancing our understanding of the significance of Alexander Wendt’s argument for a quantum-based social science. Five areas of overlap between his argument and Eastern wisdom are explored: vitalism and the idea that life goes “all the way down”; the dependence of consciousness on both subjectivity and relationality; the ethical significance of language; the notion (...) of “changing the past”; and the importance of leaders. The family resemblances between Wendt’s perspective and those available in Daoism and Buddhism are remarkable. (shrink)

Objective To study how doctors care for their patients, both medically and as fellow humans, through observing their conduct in patient–doctor encounters. Design Qualitative study in which 101 videotaped consultations were observed and analysed using a Grounded Theory approach, generating explanatory categories through a hermeneutical analysis of the taped consultations. Setting A 500-bed general teaching hospital in Norway. Participants 71 doctors working in clinical non-psychiatric departments and their patients. Results The doctors were concerned about their patients' health and how their (...) medical knowledge could be of service. This medical focus often over-rode other important aspects of the consultations, especially existential elements. The doctors actively directed the focus away from their patients' existential concerns onto medical facts and rarely addressed the personal aspects of a patient's condition, treating them in a biomechanical manner. At the same time, however, the doctors attended to their patients with courteousness, displaying a polite and friendly attitude and emphasising the relationship between them. Conclusions The study suggests that the main failing of patient–doctor encounters is not a lack of courteous manners, but the moral offence patients experience when existential concerns are ignored. Improving doctors' social and communication skills cannot resolve this moral problem, which appears to be intrinsically bound to modern medical practice. Acknowledging this moral offence would, however, be the first step towards minimising the effects thereof. (shrink)