Derk Pereboom's Four-Case Argument is among the most famous and resilient manipulation arguments against compatibilism. I contend that its resilience is not a function of the argument's soundness but, rather, the ill-gotten gain from an ambiguity in the description of the causal relations found in the argument's foundational case. I expose this crucial ambiguity and suggest that a dilemma faces anyone hoping to resolve it. After a thorough search for an interpretation which avoids both horns of this dilemma, I conclude (...) that none is available. Rather, every metaphysically coherent interpretation invites either a hard- or soft-line reply to Pereboom's argument. I then consider a recharacterization of the dilemma which seems to clear the way for the defence of a revised Four-Case Argument. I address this rejoinder by identifying a still more fundamental problem shared by all viable interpretations of the manipulation cases, showing that each involves a type of manipulation which undermines the victim's agency. Because this diagnosis supports a soft-line reply to every viable interpretation of the argument and can be endorsed by any compatibilist, I consider it the final piece of the Soft-line Solution to the Four-Case Argument. Finally, I suggest a new taxonomy of manipulation arguments, arguing that none that employs the suppressive variety of manipulation found in Pereboom's argument offers a threat to compatibilism. -/- (For direct download option, search Kristin M. Mickelson, Soft-line Solution). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Teaching Medieval Christian Contemplation: An Ethical Dilemma?Kristine T. UtterbackBy its very nature, contemplative pedagogy would seem to be a more solitary undertaking than many other forms of pedagogy. We are asking our students to go inward, producing a special kind of engagement unlike any other teaching methods I employ. For me, teaching in the only four-year state university in Wyoming, where I have never encountered anyone else who employs (...) contemplative pedagogy, that already solitary undertaking becomes even more solitary—to the point of isolation. That was one of the reasons that having an opportunity to appear on a panel with others who use contemplative pedagogy provided a rare and treasured opportunity to discuss what I do and to learn from others. I had such an opportunity at the November 2012 American Academy of Religion (AAR) Annual Meeting. At the session titled “Contemplative Pedagogy: Pitfalls and Potentials” organized by the Society for Buddhist-Christian Studies, I described my contemplative pedagogy course titled Medieval Christian Contemplation in History and Practice. The panel members and the engaged audience combined to create a lively and thought-provoking discussion.All four of the panelists, including myself, had contributed to the collection of essays edited by Judith Simmer-Brown and Fran Grace, Meditation and the Classroom,1 and we all use contemplative pedagogy in our teaching. In my case, I teach specific Christian contemplative methods to help my students gain a connection with medieval people by using some of the same practices that they did. In the discussion that followed the presentations, an audience member questioned whether these Christian contemplative methods are appropriately taught to all comers—something that would not have been deemed appropriate by the medieval teachers of these methods. I should add that the question spoke to a much larger issue than my course and the ten or fifteen students I teach in a semester, but he raised an interesting and important point, which I will discuss below. Before I address the potential dilemma my questioner elicited, and my argument that other considerations override it, let me provide context for that discussion by describing what, why, and how I teach twenty-first century students medieval contemplative practices.When I teach medieval history, I struggle to help my students get a “feel” for a world very different from their own. The problems of understanding a world far removed from twenty-first-century Americans is obvious, since I can neither bring [End Page 53] a medieval peasant to class nor take field trips to living medieval sites, and almost every medieval assumption about the world differs radically from ours. In 1999, when I saw a call for proposals from the Center for Contemplative Mind in Society, for Contemplative Practice in Teaching Fellowships, I realized that contemplative practices might offer my students first-person experiences of an important dimension of medieval life: spirituality. Although I had no evidence to support this, it seemed to me that what practitioners experienced a millennium or more ago and what someone experiences today doing the same thing might have a great deal in common. When I applied for the fellowship, I had never heard of contemplative pedagogy, so I viewed my endeavor primarily as experiential learning, but as I have taught the course and learned about contemplative pedagogy, the contemplative focus has joined and to some extent subsumed the experiential one.By the time I received the fellowship, I had already been practicing Christian Centering Prayer for several years. This is a modern contemplative practice based on the teachings of the anonymous author of a medieval classic, The Cloud of Unknowing. I was intrigued by the challenge of developing a course that combined the history of medieval Christian contemplative practice with experiential and, later, contemplative learning. Since receiving the grant, I have offered the course Medieval Christian Contemplation in History and Practice several times; it is cross-listed in both the Religious Studies and the History Departments. Pedagogically I want to allow the students to experience the Middle Ages in some small but real way. I have an additional personal hope, shared with the students but certainly not required, that they might find these practices rewarding enough... (shrink)

To answer tantalizing questions such as whether animals are moral or how morality evolved, I propose starting with a somewhat less fraught question: do animals have normative cognition? Recent psychological research suggests that normative thinking, or ought-thought, begins early in human development. Recent philosophical research suggests that folk psychology is grounded in normative thought. Recent primatology research finds evidence of sophisticated cultural and social learning capacities in great apes. Drawing on these three literatures, I argue that the human variety of (...) social cognition and moral cognition encompass the same cognitive capacities and that the nonhuman great apes may also be normative beings. To make this argument, I develop an account of animal social norms that shares key properties with Cristina Bicchieri's account of social norms but which lowers the cognitive requirements for having a social norm. I propose a set of four early developing prerequisites implicated in social cognition that make up what I call naïve normativity: the ability to identify agents, sensitivity to in-group/out-group differences, the capacity for social learning of group traditions, and responsiveness to appropriateness. I review the ape cognition literature and present preliminary empirical evidence supporting the existence of social norms and naïve normativity in great apes. While there is more empirical work to be done, I hope to have offered a framework for studying normativity in other species, and I conclude that we should be open to the possibility that normative cognition is yet another ancient cognitive endowment that is not human-unique. (shrink)

Derk Pereboom's Four-Case Argument is among the most famous and resilient manipulation arguments against compatibilism. I contend that its resilience is not a function of the argument's soundness but, rather, the ill-gotten gain from an ambiguity in the description of the causal relations found in the argument's foundational case. I expose this crucial ambiguity and suggest that a dilemma faces anyone hoping to resolve it. After a thorough search for an interpretation which avoids both horns of this dilemma, I conclude (...) that none is available. Rather, every metaphysically coherent interpretation invites either a hard- or soft-line reply to Pereboom's argument. I then consider a recharacterization of the dilemma which seems to clear the way for the defence of a revised Four-Case Argument. I address this rejoinder by identifying a still more fundamental problem shared by all viable interpretations of the manipulation cases, showing that each involves a type of manipulation which undermines the victim's agency. Because this diagnosis supports a soft-line reply to every viable interpretation of the argument and can be endorsed by any compatibilist, I consider it the final piece of the Soft-line Solution to the Four-Case Argument. Finally, I suggest a new taxonomy of manipulation arguments, arguing that none that employs the suppressive variety of manipulation found in Pereboom's argument offers a threat to compatibilism. (shrink)

Childhood obesity has become a central concern in many countries and a range of policies have been implemented or proposed to address it. This co-authored book is the first to focus on the ethical and policy questions raised by childhood obesity and its prevention. -/- Throughout the book, the authors emphasize that childhood obesity is a multi-faceted phenomenon, and just one of many issues that parents, schools and societies face. They argue that it is important to acknowledge the resulting complexities (...) and not to think in terms "single-issue" policies. -/- After first reviewing some of the factual uncertainties about childhood obesity, the authors explore central ethical questions. What priority should be given to preventing obesity? To what extent are parents responsible? How should we think about questions of stigma and inequality? In the second part of the book, the authors consider key policy issues, including the concept of the 'obesogenic environment,' debates about taxation and marketing, and the role that schools can play in obesity prevention. -/- The authors argue that political debate is needed to decide the importance given to childhood obesity and how to divide responsibilities for action. These debates have no simple answers. Nonetheless, the authors argue that there are reasons for hope. There are a wide range of opportunities for action. Many of these options also promise wider social benefits. (shrink)

Psychologists distinguish between intentional systems which have beliefs and those which are also able to attribute beliefs to others. The ability to do the latter is called having a 'theory of mind', and many cognitive ethologists are hoping to find evidence for this ability in animal behaviour. I argue that Dennett's theory entails that any intentional system that interacts with another intentional system (such as vervet monkeys and chess-playing computers) has a theory of mind, which would make the distinction all (...) but meaningless. This entailment should not be accepted; instead, Dennett's position that intentional behaviour is best predictable via the intentional stance should be rejected in favour of a pluralistic view of behaviour prediction. I introduce an additional method which humans often use to predict intentional and non-intentional behaviour, which could be called the inductive stance. (shrink)

Great hope has been placed on biobank research as a strategy to improve diagnostics, therapeutics and prevention. It seems to be a common opinion that these goals cannot be reached without the participation of commercial actors. However, commercial use of biobanks is considered morally problematic and the commercialisation of human biological materials is regulated internationally by policy documents, conventions and laws. For instance, the Council of Europe recommends that: “Biological materials should not, as such, give rise to financial gain”. (...) Similarly, Norwegian legislation reads: “Commercial exploitation of research participants, human biological material and personal health data in general is prohibited”. Both articles represent kinds of common moral intuitions. A problem, however, is that legislative documents are too vague and provide room for ample speculation. Through the use of focus group interviews with Norwegian biobank donors, we have tried to identify lay intuitions and morals regarding the commercial use of biobanks. Our findings indicate that the act of donation and the subsequent uses of the samples belong to two different spheres. While concerns around dignity and commodification were present in the first, injustice and unfairness were our informants’ major moral concerns in the latter. Although some opposition towards commercial actors was voiced, these intuitions show that it is possible to render commercial use of biobanks ethically acceptable based on frameworks and regulations which hinder commodification of the human body and promote communal benefit sharing. (shrink)

IntroductionDeep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in “last resort” intervention scenarios such as DBS for refractory conditions.ObjectiveThis study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.Materials and (...) MethodsSemi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, transcribed, and coded.ResultsUsing thematic content analysis, four major themes from clinician interviews and five major themes from caregiver interviews related to hopes and expectations were identified. Clinicians expressed concerns about caregiver false hopes (86%, 25/29) and desperation (68.9%, 20/29) in light of DBS being a last resort. As a result, 68.9% of clinicians (20/29) expressed that they intentionally tried to lower caregiver expectations about DBS outcomes. Clinicians also expressed concern that, on the flip side, unrealistic pessimism drives away some patients who might otherwise benefit from DBS (34.5%, 10/29). Caregivers viewed DBS as the last option that they had to try (61.3%, 27/44), and 73% of caregivers (32/44) viewed themselves as having high hopes but reasonable expectations. Fewer than half (43%, 19/44) expressed that they struggled setting outcome expectations due to the uncertainty of DBS, and 50% of post-DBS caregivers (14/28) expressed some negative feelings post treatment due to unmet expectations. 43% of caregivers (19/44) had experiences with clinicians who tried to set low expectations about the potential benefits of DBS.ConclusionThoughtful clinician-stakeholder discussion is needed to ensure realistic outcome expectations. (shrink)

The long Nineteenth Century spans a host of important philosophical movements: romanticism, idealism, socialism, Nietzscheanism, and phenomenology, to mention a few. Hegel, Schopenhauer, Kierkegaard, Nietzsche, and Marx are well-known names from this period. This, however, was also a transformative period for women philosophers in German-speaking countries and contexts. Their works are less well-known, yet offer stimulating and path-breaking contributions to nineteenth-century thought. In this period, women philosophers explored a wide range of philosophical topics and styles. Throughout the movements of romanticism, (...) idealism, socialism, and phenomenology, women philosophers helped shape philosophy's agenda and provided unique approaches to existential, political, aesthetic, and epistemological questions. While during the Nineteenth Century women continued to be (largely) excluded from formal education and positions, they developed ways of philosophizing that was accessible, intuitive, and activist in spirit. The present volume makes available to English-language readers--often for the first time--the works of nine significant women philosophers, with the hope of stimulating further interest in and scholarship on their works. The Editors' introductions offer a comprehensive introduction to the contributions of women philosophers in the period, but also to individual figures and movements. The translations are furnished with explanatory footnotes and are designed to be accessible to students as well as scholars. (shrink)

This article explores affectivity, temporality, and their interrelation in patients who contracted COVID-19 during the first wave of the pandemic in Sweden and with symptoms indicative of post-COVID-19 Condition (PCC) that remained one year after the infection. It offers a qualitative phenomenological philosophy analysis, showing how being ill with acute COVID-19 and with symptoms indicative of PCC can entail a radically altered self-world relation. We identify two examples of pre-intentional (existential) feelings: that of listlessness and that of not being able (...) to sense what is real and not real, both of which, in different ways, imply a changed self-world relation. We offer an analysis of intentional feelings: how the fear of not “returning” to one’s previous self and the hope of such a return weave together the present and the absent, as well as the past and the future, in ways that make the future appear as constricted, disquieting, or lost. We argue that a phenomenological differentiation among experiences of living with symptoms indicative of PCC—through attention to the way intentional affectivity and pre-intentional affectivity help shape the embodied self’s attunement to the world—is apt to yield a better understanding of the variations within these experiences and contribute to clinical practice. (shrink)

Howard Zinn's A People's History of the United States is a polarizing historical survey that has become a common subject of social studies curricular battles. This mixed methods study uses survey data and interviews with teachers who frequently assign the book to understand who uses this text and why. Findings reveal that the text has functional, pedagogical, and political appeal for teachers who are committed to including multiple perspectives and critiquing historical narratives. That these teachers are not primarily animated by (...) Zinn's intention for the text to inspire students’ participation in social movements should undermine critics’ fears of indoctrination and sloppy history teaching, but may disappoint supporters of the text hoping for more critical pedagogical motivations. (shrink)

HLDING A‐G and HEGGDAL K. Nursing Inquiry 2012; 19: 345–356 Patients’ experiences of health transitions in pulmonary rehabilitationPeople who live with chronic obstructive pulmonary disease (COPD) experience major changes in health. Coping with the illness and caring for themselves places extensive demands on them. Thus, pulmonary rehabilitation (PR) is recommended as a means to facilitate healthy transitions in everyday life with COPD. This study explores the experience of patients with COPD in terms of their transitions in health during and after (...) PR. The research was inspired by interpretive phenomenology. Thirty‐three individual qualitative interviews were conducted with eighteen patients recruited from Norwegian PR units. A thematic analysis of the interviews was performed. The interviewees described participation in PR as a time of increasing awareness of opportunities for health and well‐being with strengthened hope. The year following PR was dominated by their ongoing challenge to acknowledge limitations and explore opportunities in everyday life. Continuation of healthy transitions was facilitated by peer and professional support. The study highlights the personal resources that patients with COPD have access to in order to promote their own health. The study also highlights their vulnerability during illness and rehabilitation. The findings critique time‐limited PR and support the current trends towards patient‐centred rehabilitation efforts that incorporate user involvement and self‐management education. (shrink)

Education and cognition research today generally recognize the tri-dimensional nature of reasoning processes as involving cognitive, social and emotional phenomena. However, there is so far no theoretical framework articulating these three dimensions from a descriptive perspective. This paper aims at presenting a first model of how group emotions work in collective reasoning, and specifies their social and cognitive functions. This model is inspired both from a multidisciplinary literature review and our extensive previous empirical work on an international corpus of videotaped (...) student debates. The cognitive function of emotions is defined in reference to the process of schematization and associated emotional framing. On the other hand, the social function of emotions refers to recognition-oriented behaviors that correspond to engagement into specific types of group talk, implying specific politeness rules or face-preservation systems. We believe that our multi-dimensional and multi-level approach to group reasoning, which mostly employs a linguistic perspective, can be applied to a diversity of contexts. We hope it will serve as a basis for further discussion on the role of emotions in reasoning among the interdisciplinary community of argumentation studies. (shrink)

The field of second language acquisition (SLA) is by nature of its subject a highly interdisciplinary area of research. Learning a (foreign) language, for example, involves encoding new words, consolidating and committing them to long-term memory, and later retrieving them. All of these processes have direct parallels in the domain of human memory and have been thoroughly studied by researchers in that field. Yet, despite these clear links, the two fields have largely developed in parallel and in isolation from one (...) another. The present article aims to promote more cross-talk between SLA and memory science. We focus on foreign language (FL) attrition as an example of a research topic in SLA where the parallels with memory science are especially apparent. We discuss evidence that suggests that competition between languages is one of the mechanisms of FL attrition, paralleling the interference process thought to underlie forgetting in other domains of human memory. Backed up by concrete suggestions, we advocate the use of paradigms from the memory literature to study these interference effects in the language domain. In doing so, we hope to facilitate future cross-talk between the two fields and to further our understanding of FL attrition as a memory phenomenon. (shrink)

In this discussion piece, eight scholars in geography, urban planning, and agri-food studies from the United States (US) and France engage in a bi-national comparison to deepen our collective understanding of food and land justice. We specifically contextualize land justice as a critical component of food justice in both the US and France in three key areas: access to land for cultivation, urban agriculture, and non-agricultural forms of food provisioning. The US and France are interesting cases to compare, considering the (...) differences and similarities in their colonial and agricultural histories, persistent and systemic race and class-based inequities in land access, and the roles of public bodies and social movements. In this paper, we synthesize literature, share reflections, and offer directions for future scholarship, including a broader comparative research agenda. An important difference we found is in the degree of scholarly attention to race and how it mediates access to land. We also observe that few scholars articulate a clear definition of justice in their work, nor do they share a common justice framework. We hope that this paper contributes to a more robust food and land justice framework for the use of scholars, practitioners and activists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Women Philosophers in the Long Nineteenth Century: The German Tradition ed. by Kristin Gjesdal and Dalia NassarAlison StoneKristin Gjesdal and Dalia Nassar, editors. Women Philosophers in the Long Nineteenth Century: The German Tradition. Oxford: Oxford University Press, 2021. Pp. 336. Hardback, $99.00."How plausible, [Dalia Nassar and I] kept asking, is it that women published philosophy in the early modern period and then simply ceased to think and (...) publish philosophy in the nineteenth century?" remarked Kristin Gjesdal recently (interview with Richard Marshall, 3:16am [blog], https://www.3-16am.co.uk/articles/gadamer-herder-and-the-womenphilosophers-of-the-long-nineteen-cent ury?c=end-times-series). Not plausible at all—yet this is what historians of women in philosophy often seem to have assumed, judging by the remarkably small amount of scholarship on nineteenth-century women philosophers compared with those of the early modern period or the twentieth century. Eileen O'Neill, for instance, claims that it was "not a particularly friendly century for women philosophers" (1). In fact, as Gjesdal and Nassar observe, women were "significant contributors" to the "thriving intellectual cultures in German-speaking countries" at this time (1). Gjesdal and Nassar contrast Germanic countries to France and Britain in this regard, yet I would add that nineteenth-century Britain too had a vibrant print and periodical culture that created openings for women philosophers such as Harriet Martineau, Anna Jameson, Frances Power Cobbe, and many others. The broader point remains: the nineteenth century has only seemed empty of women philosophers because we have not yet investigated the women thinkers of this period or challenged the canons and narratives from which they have been excluded.Recognizing German women philosophers is particularly important because the vast majority of scholarship on the nineteenth century focuses on the German tradition. Consequently, unless we recover the work of German-speaking women, we will never change the narrative about this period. This makes the present anthology invaluable for both teaching and research. Edited by Gjesdal and Nassar, it contains new translations, nearly all by Anna Ezekiel, of texts by historical German-speaking women philosophers.Regarding teaching, many courses on post-Kantian European philosophy include no women until Beauvoir or Arendt. Such courses typically cover Fichte, Hegel, Marx, Schopenhauer, Nietzsche, Husserl, and Heidegger. The editors have clearly designed this volume to enable instructors easily to bring women into such courses, by providing extracts—of suitable lengths for teaching—from women affiliated respectively with German idealism and Romanticism (Germaine de Staël, Karoline von Günderrode, and Bettina von Arnim), Marxism (Clara Zetkin, Rosa Luxemburg), Nietzscheanism (Hedwig Dohm, Lou Salomé), and phenomenology (Edith Stein, Gerda Walther). Some of these women are already well-known as political activists, as with Luxemburg and Zetkin, or under the elastic heading of "writers," as with Staël and von Arnim. But this collection presents these women's writings in a new light, showcasing their philosophical side. After all, we have learned to read Marx and Nietzsche philosophically: why not extend the same courtesy to Staël or Luxemburg?For researchers, this collection will likewise be invaluable. Post-Kantian European philosophy has been slow to respond to the wider questioning and broadening of the traditional philosophical canon. It remains sadly common for narratives of nineteenth-century German philosophy to discuss men only—a position that this book makes untenable. [End Page 336] Hopefully it will galvanize philosophers to integrate these women into the historiography of the post-Kantian tradition at last.In the introduction, the editors helpfully contextualize the selected writings, arguing that these women's exclusion from academic institutions led them to philosophize in ways that spoke to general audiences, connected with lived experience, and addressed practical and political concerns. In short, these women did a type of philosophy that was not purified but socially engaged, and can be a model for us today. Thereafter the book consists of sections on nine women philosophers, ordered chronologically. Each section begins with an editorial introduction to the philosopher and her interests, ideas, writings, and interlocutors.The writings included from Staël—whose work spans the period from the French Revolution into Romanticism—are "On Women Writers" from... (shrink)

I attempt first to disentangle three aspects of Kant’s distinction between perfect and imperfect duty. There is the central distinction between principles of duty contrary to that which is contradictory in conception/consistent in conception but contradictory in will. There is also a distinction between essential and non-essential duties: those which cannot, or occasionally can, be passed over consistent with the requirements of morality. Finally, there is a distinction between duties that exhibit a scalar aspect – degrees of goodness or virtue (...) – and duties that do not. My aim is to show how these distinct considerations can be reconciled as aspects of a single distinction, and I conclude that the remarkable complexity of Kant’s perfect/imperfect distinction is actually a strength, rather than a weakness. (shrink)

Observations of animals engaging in apparently moral behavior have led academics and the public alike to ask whether morality is shared between humans and other animals. Some philosophers explicitly argue that morality is unique to humans, because moral agency requires capacities that are only demonstrated in our species. Other philosophers argue that some animals can participate in morality because they possess these capacities in a rudimentary form. Scientists have also joined the discussion, and their views are just as varied as (...) the philosophers’. Some research programs examine whether animals countenance specific human norms, such as fairness. Other research programs investigate the cognitive and affective capacities thought to be necessary for morality. There are two sets of concerns that can be raised by these debates. They sometimes suffer from there being no agreed upon theory of morality and no clear account of whether there is a demarcation between moral and social behavior; that is, they lack a proper philosophical foundation. They also sometimes suffer from there being disagreement about the psychological capacities evident in animals. Of these two sets of concerns—the nature of the moral and the scope of psychological capacities—we aim to take on only the second. In this chapter we defend the claim that animals have three sets of capacities that, on some views, are taken as necessary and foundational for moral judgment and action. These are capacities of care, capacities of autonomy, and normative capacities. Care, we argue, is widely found among social animals. Autonomy and normativity are more recent topics of empirical investigation, so while there is less evidence of these capacities at this point in our developing scientific knowledge, the current data is strongly suggestive. (shrink)

A scholarly edition of letters by Anne, Viscountess Conway, Henry More, and their friends. The edition presents an authoritative text, together with an introduction, commentary notes, and scholarly apparatus.

The societal and ethical implications of artificial intelligence (AI) have sparked discussions among academics, policymakers and the public around the world. What has gone unnoticed so far are the likewise vibrant discussions in China. We analyzed a large sample of discussions about AI ethics on two Chinese social media platforms. Findings suggest that participants were diverse, and included scholars, IT industry actors, journalists, and members of the general public. They addressed a broad range of concerns associated with the application of (...) AI in various fields. Some even gave recommendations on how to tackle these issues. We argue that these discussions are a valuable source for understanding the future trajectory of AI development in China as well as implications for global dialogue on AI governance. (shrink)

ZusammenfassungEntscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (shrink)

Journal of Social Philosophy, EarlyView.

Abstract:Human and animal research both operate within established standards. In the United States, criticism of the human research environment and recorded abuses of human research subjects served as the impetus for the establishment of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, and the resulting Belmont Report. The Belmont Report established key ethical principles to which human research should adhere: respect for autonomy, obligations to beneficence and justice, and special protections for vulnerable individuals and (...) populations. While current guidelines appropriately aim to protect the individual interests of human participants in research, no similar, comprehensive, and principled effort has addressed the use of (nonhuman) animals in research. Although published policies regarding animal research provide relevant regulatory guidance, the lack of a fundamental effort to explore the ethical issues and principles that should guide decisions about the potential use of animals in research has led to unclear and disparate policies. Here, we explore how the ethical principles outlined in the Belmont Report could be applied consistently to animals. We describe how concepts such as respect for autonomy and obligations to beneficence and justice could be applied to animals, as well as how animals are entitled to special protections as a result of their vulnerability. (shrink)

Lifelong smokers lose on average a decade of life vis-à-vis non-smokers. Globally, tobacco causes about 5–6 million deaths annually. One billion tobacco-related deaths are predicted for the 21st century, with about half occurring before the age of 70. In this paper, we consider a complete ban on the sale of cigarettes and find that such a ban, if effective, would be justified. As with many policy decisions, the argument for such a ban requires a weighing of the pros and cons (...) and how they impact on different individuals, both current and future. The weightiest factor supporting a ban, we argue, is the often substantial well-being losses many individuals suffer because of smoking. These harms, moreover, disproportionally affect the disadvantaged. The potential gains in well-being and equality, we argue, outweigh the limits a ban places on individuals’ freedom, its failure to respect some individuals’ autonomous choice and the likelihood that it may, in individual cases, reduce well-being. (shrink)

Trust relations in the health services have changed from asymmetrical paternalism to symmetrical autonomy-based participation, according to a common account. The promises of personalized medicine emphasizing empowerment of the individual through active participation in managing her health, disease and well-being, is characteristic of symmetrical trust. In the influential Kantian account of autonomy, active participation in management of own health is not only an opportunity, but an obligation. Personalized medicine is made possible by the digitalization of medicine with an ensuing increased (...) tailoring of diagnostics, treatment and prevention to the individual. The ideal is to increase wellness by minimizing the layer of interpretation and translation between relevant health information and the patient or user. Arguably, this opens for a new level of autonomy through increased participation in treatment and prevention, and by that, increased empowerment of the individual. However, the empirical realities reveal a more complicated landscape disturbed by information ‘noise’ and involving a number of complementary areas of expertise and technologies, hiding the source and logic of data interpretation. This has lead to calls for a return to a mild form of paternalism, allowing expertise coaching of patients and even withholding information, with patients escaping responsibility through blind or lazy trust. This is morally unacceptable, according to Kant’s ideal of enlightenment, as we have a duty to take responsibility by trusting others reflexively, even as patients. Realizing the promises of personalized medicine requires a system of institutional controls of information and diagnostics, accessible for non-specialists, supported by medical expertise that can function as the accountable gate-keeper taking moral responsibility required for an active, reflexive trust. (shrink)

It feels like there’s two of you inside—like there’s another half of you, which is my anorexia, and then there’s the real K [own name], the real me, the logic part of me, and it’s a constant battle between the two. The anorexia almost does become part of you, and so in order to get it out of you I think you do have to kind of hurt you in the process. I think it’s almost inevitable. We came to the (...) concept of authenticity belatedly, one might say. We had been talking to people who had a diagnosis of anorexia nervosa about their experiences of living with their condition, and though we had not raised issues of authenticity or identity ourselves, they often did. They struggled with questions of .. (shrink)

In the middle of the 19th century a new value began to appear in Western Europe - the belief that (in the words of Matthew Arnold) 'the exercise of a creative activity is the true function of man'. This book gives an account of the stages by which, and the reasons why, this development occurred at that time. In so doing it reveals a historical puzzle, for the main factors which can be seen to have given rise to the new (...) value - mainly scientific, technological, economic and political - were not reflected in the value itself, for that was applied almost exclusively to artistic and cultural activity. John Hope Mason sets out to explain this puzzle by showing how throughout European history there have been two radically different views of the creative attribute. An early example of one view was the character of Prometheus in Greek mythology; influential examples of the second were the figures of God the Creator in Judaeo-Christian theology and the neo-Platonic One in Hellenistic philosophy. The book shows how the contrast represented by those figures informed discussions of genius in the 18th century and indicates why the notion of creativity which came to prevail then assimilated it with purely aesthetic and moral concerns. Combining a broad perspective with a close analysis of key figures - from Adam Smith, Rousseau and Kant, to Arnold, Marx and Nietzsche - this book casts a new light on a central value of the modern world. (shrink)

Important advances in biomedical and behavioral research ethics have occurred over the past few decades, many of them centered on identifying and eliminating significant harms to human subjects of research. Comprehensive attention has not been paid to the totality of harms experienced by animal subjects, although scientific and moral progress require explicit appraisal of these harms. Science is a public good and the prioritizing within, conduct of, generation of, and application of research must soundly address questions about which research is (...) morally defensible and valuable enough to support through funding, publication, tenure, and promotion. Likewise, educational pathways of re-imagined science are critical. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation study. (...) Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

We describe the teaching programme in ethics, law and communication skills for clinical medical students which is being developed as part of the Oxford Practice Skills Project. These three elements of practice are approached in an integrated teaching programme which aims to address everyday clinical practice. The role of a central value of patient-centred health care in guiding the teaching is described. Although the final aim of the teaching is to improve actual practice, we have found three 'sub-aims' helpful in (...) the development of the programme. These sub-aims are: increasing students' awareness of ethical issues; enhancing their analytical thinking skills, and teaching specific knowledge. (shrink)

Next SectionMaking threats and offers to patients is a strategy used in community mental healthcare to increase treatment adherence. In this paper, an ethical analysis of these types of proposal is presented. It is argued (1) that the primary ethical consideration is to identify the professional duties of care held by those working in community mental health because the nature of these duties will enable a threat to be differentiated from an offer, (2) that threatening to act in a way (...) that would equate with a failure to uphold the requirements of these duties is wrong, irrespective of the benefit accrued through treatment adherence and (3) that making offers to patients raises a number of secondary ethical considerations that need to be judged on their own merit in the context of individual patient care. The paper concludes by considering the implications of these arguments, setting out a pathway designed to assist community mental healthcare practitioners to determine whether making a specific proposal to a patient is right or wrong. (shrink)

Conway characterizes freedom in apparently contradictory ways. She describes God as the most free, yet he is necessitated to act perfectly due to his wisdom and goodness. Created beings, by contrast, sin. They are not necessitated to do so. This suggests that Conway has a binary account of freedom: divine freedom is a matter of being necessitated by wisdom and goodness, whereas creaturely freedom consists in indifference, understood as a power to act, or not act. Despite the apparently conflicting remarks, (...) I argue that Conway has a single account of freedom as spontaneity. Conway defines spontaneity in terms of causing one’s own action independent of external causes. I suggest that spontaneity is more precisely understood as an intrinsic power aimed at the good in Conway’s metaphysics, and that this account of freedom can combine necessity and contingency. Rather than a binary, Conway offers an account of freedom in creation that has it on a continuum with divine freedom. (shrink)

This richly illustrated book focuses on the life and work of British photographer Frederick H. Evans (1853-1943).

This paper aims to resolve an unremarked-upon tension between Anne Conway’s commitment to the moral responsibility of created beings, or creatures, and her commitment to emanative, constant creation. Emanation causation has an atemporal aspect according to which God’s act of will coexists with its effect. There is no before or after, or past or future in God’s causal contribution. Additionally, Conway’s constant creation picture has it that all times are determined via divine emanation. Creaturely agency, by contrast, is fundamentally temporal, (...) occurring successively over time. It is unclear how creatures can count as emanative causes, which coexists with its effect, given that their agency is limited by time, proceeding from before to after, or past to future. Conway’s account of divine justice in the progress of time, however, requires that creatures are causally responsible. That is, moral responsibility requires causal responsibility. I propose that Conway’s distinction between vital motion and local motion enables a resolution of the tension. Vital motion contributes an atemporal aspect to creaturely agency so that creatures can count as secondary emanative causes. (shrink)

Alternative food movements work to create more environmentally and economically sustainable food systems, but vary widely in their advocacy for social, racial and environmental justice. However, even those food justice activists explicitly dedicated to equity must respond to the unintended consequences of their work. This paper analyzes the work of activists in Oakland, CA, who have increasingly realized that their gardens, health food stores and farm-to-table restaurants play a role in what scholars have called green gentrification, the upscaling of neighborhoods (...) through the creation of environmental amenities. Gentrification has had grave consequences for the low-income communities of color that food justice activists seek to serve. Activists are reflexive about this dynamic, and have developed strategies to push back against displacement. Most commonly, non-profit organizations and individual social entrepreneurs found businesses that seek to raise the profile of people of color in the trendy Oakland food scene while employing long-term residents in well-paying, green jobs. However, while these efforts are an essential component of a broader agenda to create both food justice and development without displacement, even these relatively high paying “good food jobs” cannot keep up with escalating rents. For this reason, we also highlight the direct action and policy-oriented strategies engaged by a smaller number of food justice activists, and argue that these are necessary compliments to a market-based approach. (shrink)

History has demonstrated the necessity of protecting research participants. Research ethics are based on a concept of asymmetry of power, viewing the researcher as powerful and potentially dangerous and establishing ethics committees as external agencies in the field of research. We argue in favour of expanding this perspective on relationships of power to encompass the ethics committees as one among several actors that exert power and that act in a relational interplay with researchers and participants. We employ Michel Foucault’s ideas (...) of power as an omnipresent force which is dynamic and unstable, as well as the notion that knowledge and power are inextricably intertwined. The article discusses how research ethics committees may affect academic freedom. In addition it is pointed out that research participants could be harmed — not only by unfortunate research practices, but also by being subjected to the protective efforts of ethics monitoring bodies. (shrink)

I address the usefulness of thinking about a human right to subsistence within conceptions of human rights grounded in ordinary moral reasoning. I argue that that natural rights should be understood as rights in rem, with their dynamism constrained by the requirements of justification and their scope constrained by the distinction between perfect and imperfect duty. I then suggest that many of the most pressing demands which the moral significance of subsistence needs create are plausibly imperfect duties, and so cannot (...) correlate to a natural right to subsistence. This restricts the helpfulness of a human right to subsistence in our reasoning about what we owe to others. (shrink)

Most studies into the performance of socially responsible investment vehicles have focused on the performance of sustainable or socially responsible mutual funds. This research has been complemented recently by a number of studies that have examined the performance of sustainable investment indices. In both cases, the majority of studies have concluded that the returns of socially responsible investment vehicles have either underperformed, or failed to outperform, comparable market indices. Although the impact of sustainable indices to date has been limited, the (...) recent launch of sustainable indices by Dow Jones and FTSE suggests that more attention is being paid to the subject by financial markets, investors, and companies. This development raises a number of important issues which are reviewed in this article: (a) the performance of indices compared with their benchmark indices; (b) the methodologies employed in compiling the indices; and (c) the impact of the indices on companies and the investment community. The article concludes with a number of suggestions for areas that merit future research. (shrink)