The following description is based upon an actual case in which a patient initiated legal action after suffering a complication subsequent to an invasive diagnostic procedure performed by a senior fellow. Named as codefendants were the senior fellow, attending physician, and the hospital. Because any hospital with house staff is potentially vulnerable to similar litigation, Ethics Committees at Work is addressing the questions raised by this dilemma.

In 1924The Classical Quarterlypublished a note by Alexander Haggerty Krappe titled ‘Euripides’Alcmaeonand the Apollonius Romance’. Drawing attention to the obscure origins of the ancient Greek and Roman novels in general and pointing out the scholarly agreement on the role love plays in both the ancient novels and Euripidean tragedy, Krappe observed that ‘Euripides was drawn upon for whole episodes in order to enrich the plot of the [ancient] novel’. Krappe then goes on in his note to attribute the plot of (...) Euripides' lostAlcmaeonas a source of inspiration for one of the major episodes of theHistoria Apollonii Regis Tyri. Today, this reliance of the ancient novels on Euripides is generally recognized, but, curiously, Krappe, while identifying an episode from the lostAlcmaeon, failed to identify a clear plot-borrowing from another extant Euripidean play, theAlcestis. (shrink)

Arthur W. H. Adkins's writings have sparked debates among a wide range of scholars over the nature of ancient Greek ethics and its relevance to modern times. Demonstrating the breadth of his influence, the essays in this volume reveal how leading classicists, philosophers, legal theorists, and scholars of religion have incorporated Adkins's thought into their own diverse research. The timely subjects addressed by the contributors include the relation between literature and moral understanding, moral and nonmoral values, and the contemporary meaning (...) of ancient Greek ethics. The volume also includes an essay from the late Adkins himself illustrating his methodology in an analysis of the "Speech of Lysias" in Plato's _Phaedrus_. _The Greeks and Us_ will interest all those concerned with how ancient moral values do or do not differ from our own. Contributors include Arthur W. H. Adkins, Stephanie Nelson, Martha C. Nussbaum, Paul Schollmeier, James Boyd White, Bernard Williams, and Lee Yearley. Commentaries by Wendy Doniger, Charles M. Gray, David Grene, Robert B. Louden, Richard Posner, and Candace Vogler. (shrink)

: When may a physician legitimately offer enrollment in a randomized clinical trial (RCT) to her patient? Two answers to this question have had a profound impact on the research ethics literature. Equipoise, as originated by Charles Fried, which we term Fried's equipoise (FE), stipulates that a physician may offer trial enrollment to her patient only when the physician is genuinely uncertain as to the preferred treatment. Clinical equipoise (CE), originated by Benjamin Freedman, requires that there exist a state of (...) honest, professional disagreement in the community of expert practitioners as to the preferred treatment. FE and CE are widely understood as competing concepts. We argue that FE and CE offer separable and, in themselves, incomplete justifications for the conduct of clinical trials. FE articulates conditions under which the fiduciary duties of physician to patient may be upheld in the conduct of research. CE sets out a standard for the social approval of research by institutional review boards. Viewed in this way, FE and CE are not necessarily competing notions, but rather address complementary moral concerns. (shrink)

Commodification and Secondary Rationalization.

Franklin G. Miller and colleagues have stimulated renewed interest in research ethics through their work criticizing clinical equipoise. Over three years and some twenty articles, they have also worked to articulate a positive alternative view on norms governing the conduct of clinical research. Shared presuppositions underlie the positive and critical dimensions of Miller and colleagues' work. However, recognizing that constructive contributions to the field ought to enjoy priority, we presently scrutinize the constructive dimension of their work. We argue that it (...) is wanting in several respects. (shrink)

When may a physician enroll a patient in clinical research? An adequate answer to this question requires clarification of trust-based obligations of the state and the physician-researcher respectively to the patient-subject. The state relies on the voluntarism of patient-subjects to advance the public interest in science. Accordingly, it is obligated to protect the agent-neutral interests of patient-subjects through promulgating standards that secure these interests. Component analysis is the only comprehensive and systematic specification of regulatory standards for benefit-harm evaluation by research (...) ethics committees (RECs). Clinical equipoise, a standard in component analysis, ensures the treatment arms of a randomised control trial are consistent with competent medical care. It thus serves to protect agent-neutral welfare interests of the patient-subject. But REC review occurs prior to enrolment, highlighting the independent responsibility of the physician-researcher to protect the agent-relative welfare interests of the patient-subject. In a novel interpretation of the duty of care, we argue for a “clinical judgment principle” which requires the physician-researcher to exercise judgment in the interests of the patient-subject taking into account evidence on treatments and the patient-subject‘s circumstances. (shrink)

Paul Thompson’s excellent book, From Field to Fork: Food Ethics for Everyone, argues that contemporary food ethics persistently ignores the nature and actual impact of GMOs, Concentrated Animal Feeding Operations, food aid to developing countries, and more. On Thompson’s view, such philosophical analyses must incorporate empirical knowledge. Additional strengths of Thompson’s book: its attention to quality-of-life issues, its openness to the concerns of the marginalized, and its emphasis on the interconnectedness of problems in food ethics. I raise one area (...) of disagreement with Thompson: his treatment of GMOs is, I argue, insufficiently skeptical. I suggest a three-fold revision of the book’s treatment of the precautionary principle, and I levy an additional argument against GMOs, the Inductive Argument. Using the herbicide Roundup as a case study of the ways in which industry urges the use of technologies that have not been fully vetted or monitored, I argue that products originally seen as safe often turn out instead to be harmful to the environment and health. Significant inductive experience with similar cases gives people additional reason to be even more suspicious of GMOs than Thompson suggests. (shrink)

The Spirit of the Soil challenges environmentalists to think more deeply and creatively about agriculture. Paul B. Thompson identifies four `worldviews' which tackle agricultural ethics according to different philosophical priorities; productionism, stewardship, economics and holism. He examines current issues such as the use of pesticides and biotechnology from these ethical perspectives. This book achieves an open-ended account of sustainability designed to minimise hubris and help us to recapture the spirit of the soil.

The global food system exhibits dizzying complexity, with interaction among social, economic, biological, and technological factors. Opposition to the first generation of plants and animals transformed through rDNA-enabled gene transfer has been a signature episode in resistance to the forces of industrialization and globalization in the food system. Yet agricultural scientists continue to tout gene technology as an essential component in meeting future global food needs. An ethical analysis of the debate over gene technologies reveals the details that matter. On (...) the one hand, alternative regimes for institutionalizing gene technology could mitigate injustices suffered by politically marginalized and economically disadvantaged actors in the food system, especially smallholding farmers in less industrialized economies. On the other hand, GMO opposition has been singularly effective in mobilizing citizens of affluent countries against policies and practices that lie at the heart of these same injustices. As part of the roundtable, “Ethics and the Future of the Global Food System,” this essay argues that charting a middle course that realizes the benefits of gene technology while blocking its use in the perpetration of unjust harms may require a more detailed grasp of intricacies in the food system than even motivated bystanders are willing to develop. (shrink)

Presents a collection of essays written over a period of 15 years by agricultural ethicist Paul B. Thompson. The essays address the practical application of ethics to agriculture in a world faced with issues of increased yield, threatened environment, and the disappearance of the family farm.

In lieu of an abstract, here is a brief excerpt of the content:Excited DeliriumWhat’s Psychiatry Got to do With It?Paul B. Lieberman, MDIf in life we are surrounded by death, so too in the health of our intellect by madness.—WittgensteinDelirium is a medical syndrome defined as “a relatively acute decline in cognition that fluctuates over hours or days” whose primary manifestation is a deficit of attention. It is common, estimated to occur in 10% to more than 50% of hospitalized (...) patients, with higher prevalence rates among people in nursing homes and at the end of life. It is often fatal, with a mortality rate in the hospital estimated to be 25% to 33%. Caused by a wide variety of conditions and frequently difficult to diagnose, it lacks characteristic postmortem pathology (Josephson & Miller 2018)‘Excited delirium,’ as Byju and Friesen forcefully argue (Byju & Friesen, 2023), is, if nothing else, an excuse. The ‘diagnosis’ has not been empirically validated and remains controversial (American Psychiatric Association, 2020). And while delirium is usually treated by internists and emergency medicine physicians, psychiatrists should also be concerned about the misuse of a putative medical diagnosis and join actively in discussion about it. For one thing, patients mis-diagnosed with this condition, as Byju and Friesen’s examples suggest, may actually have another psychiatric condition and, so, be people for whose safety we should advocate. Moreover, the kinds of police interventions which Byju and Friesen document as involving excited delirium also befall patients with other psychiatric problems in whom the issue of delirium does not arise.There are at least two broad ways in which psychiatrists are qualified and obligated to engage with this issue. As physicians, we should join our medical colleagues in carefully but persistently telling the scientific, medical truth. As psychiatrists, we should bring psychiatric knowledge into the discussion, for example, by explaining what can happen when people who do not, apparently, have a diagnosable mental disorder interact under stress with other people who, apparently, do.Delirium is a clinical diagnosis, made when characteristic signs and symptoms are present which should not be made ‘by exclusion’ when, as may happen, other causes are not found. There is no evidence of delirium in any of the three clinical descriptions Byju and Friesen provide. Perhaps such evidence exists which is not in their brief reports, but these three people appear to have had, either, another psychiatric condition, such as psychosis or drug intoxication, or perhaps no [End Page 353] diagnosis at all. Psychiatrists are particularly wellpositioned to make this point since patients with mental health problems are often misdiagnosed when they seek medical attention and are told, and treated as if, “it’s all (“just”!) psychological.”Excited delirium, if it exists, is fatal in 10% of cases (Gonin, Beysard, Hersin, & Carron, 2018) and, although this is lower than the rate for delirium in general, it is still high. Medical personnel must be available to evaluate and ensure the safety of patients in custody.The potential conflict between protecting the patient and protecting the public should not be overstated. Although physical trauma and excessive administration of medications, including ketamine 500 mg IV (Orhurhu, Vashicht, Claus, & Cohen, 2023) can be lethal, mechanical restraint by itself is not (Chieze et al., 2019; Gleerup et al., 2019): something else is necessary, such as asphyxiation (Evans, Wood, & Lambert, 2003). Nor is restraint necessary in many cases in which ‘de-escalation’ techniques can be equally effective (Garriga et al., 2016; Fernández-Costa, 2020). Perhaps these points are best made by law enforcement leaders—and they have been—but psychiatrists can add that safe management of potential violence can be provided for agitated people with psychiatric conditions.Although it is not clear what kind of strength ‘superhuman’ strength might be (certainly not medical), relative imperviousness to pain is clinically described. Its locus classicus is Beecher’s observation, during World War II, that injured soldiers awaiting return home from the front, required lower than usual doses of analgesics (Beecher, 1946). And it’s a common experience, scientifically confirmed, that physical trauma may not become painful until sometime after the injury (Melzack, Wall, & Ty, 1982). But pain is a warning. Its absence is not a license, but a caution... (shrink)

In this paper I argue that Bolzano's concept of deducibility and Tarski's concept of logical consequence differ with respect to their philosophical intent. I distinguish between epistemic and ontic approaches to logic, and argue that Bolzano's deducibility presupposes an epistemic approach, while Tarski's logical consequence presupposes an ontic approach.

Critically analyzes and revitalizes agrarian philosophy by tracing its evolution. Today, most historians, philosophers, political theorists, and scholars of rural America take a dim view of the agrarian ideal that farmers and farming occupy a special moral and political status in society. Agrarian rhetoric is generally seen as special pleading on the part of farmers seeking protection from labor reform and environmental regulation while continuing to receive direct payments and subsidies from the public till. Agrarianism should not be viewed as (...) a set of immutable claims about farming and political order, but as a tradition of moral and political philosophy that has evolved and deepened over the centuries. Agrarian naturalism--the belief that culture and conduct are conditioned by nature because they are of a piece with nature--becomes pragmatic naturalism, giving way to a new set of puzzles about how we are to understand the rural landscape and our responsibilities for its use. The agrarian idea that personality and sociability are integrated with the material transformation of the landscape can serve as the basis for a new, pragmatically grounded ethic of natural resources and rural development. The essays in this volume critically analyze and revitalize agrarian philosophy by tracing its evolution in the classical American philosophy of key figures such as Franklin, Jefferson, Emerson, Thoreau, Dewey, and Royce. Three chapters address the belief that farming peoples develop moral virtue and a taste for democracy as it evolved in the American context, and four examine how a reconstitution of agrarian themes might invigorate our nation's thinking on environment, food, and rural development policy. The Agrarian Roots of Pragmatism will be of broad interest to scholars of American philosophy, rural history, history of ideas, geography, and agricultural or natural resource policy. (shrink)

Philosophical food ethics or deliberative inquiry into the moral norms for production, distribution and consumption of food is contrasted with food ethics as an international social movement aimed at reforming the global food system. The latter yields an activist orientation that can become embroiled in self-defeating impotency when the complexity and internal contradictions of the food system are more fully appreciated. However, recent work in intersectionality offers resources that are useful to both philosophical and activist food ethics. For activists, intersectionality (...) provides a way to preserve and strengthen the meaningfulness of protest and resistance, even in the face of complexity and uncertain outcomes. For philosophers, intersectionality chastens the tendency to regard moral problems as inherently solvable, and provides a way use tensions inherent in food system reform as a source of ethical insight. (shrink)

The canonical function game is a game of length ω1 introduced by W. Hugh Woodin which falls inside a class of games known as Neeman games. Using large cardinals, we show that it is possible to force that the game is not determined. We also discuss the relationship between this result and Σ22 absoluteness, cardinality spectra and Π2 maximality for H(ω2) relative to the Continuum Hypothesis.

Flores and Johnson (Ethics 93 No. 3 (1983) pp. 537, 545.) offer a solution to the problem of individual and collective responsibility which obscures the fundamental requirement for responsibility ascriptions, namely, moral agency. Close attention to matters of individual and collective agency provides a simple yet defensible criterion for establishing when an individual is and isn't responsible for the untoward consequences of a collective act.

Mainstream environmental ethics grew out of an approach to value that was rooted in a particular conception of rationality and rational choice. As weaknesses in this approach have become more evident, environmental philosophers have experimented with both virtue ethics and with pragmatism as alternative starting points for developing a more truly ecological orientation to environmental philosophy. However, it is possible to see both virtue ethics and pragmatism as emerging from older philosophical traditions that are here characterized as “agrarian.” Agrarian philosophy (...) stresses the role of nature, soil and climate in the formation of moral character as well as social and political institutions. As such, reaching back to the agrarian tradition may provide a way to move forward with both virtue oriented themes as well as pragmatist themes in developing ecological ethics. (shrink)

Abstract Critics of The Agrarian Vision: Sustainability and Environmental Ethics (Lexington: 2010, University Press of Kentucky) have difficulties with its commitment to agrarian philosophy, and have also suggested that the program described there needs more elaboration of how sustainability might be pursued, especially in its social dimensions. The book draws upon agrarian philosophy to argue that habit and material practice are an appropriate and vital focus of ethics. Attention to habit and material practice will counterbalance an overemphasis on intentions and (...) outcomes in contemporary environmental philosophy. It is in this sense that agrarianism contributes to an ethic of sustainability by showing how contemporary food practices—the culture of the table—might contribute to an enabling sense of community solidarity. The book does not advocate a return to once vibrant agrarian traditions. Content Type Journal Article Category Articles Pages 1-10 DOI 10.1007/s10806-011-9329-z Authors Paul B. Thompson, WK Kellogg Professor of Agricultural, Food and Community Ethics, Department of Philosophy, Michigan State University, 503 South Kedzie Hall, East Lansing, MI 48824-1032, USA Journal Journal of Agricultural and Environmental Ethics Online ISSN 1573-322X Print ISSN 1187-7863. (shrink)

Issues of social justice underlie the clamour for greater gender balance in top-management. The present study reveals that pursuit of such social justice is also value-enhancing in relation to the longer-run performance of initial public offerings stocks, especially where female board members are unencumbered by family-connection with other directors. This study examines the economic benefits of board gender diversity for state- and privately controlled firms in the Hong Kong IPO market. Gender board diversity is much less common in state-run IPO (...) firms. Within the subset of privately controlled IPO firms, distinction exists between entities that accommodate family-connected board officers and those that do not. Specifically, this study focuses on family-ties between board members. This issue allows for finer-grained assessment of family influence on firm performance. Stronger post-listing stock, return-on-assets and sales-on-assets performance arise in privately controlled firms without family-connected board members and in state-run entities. Gender diversity thus serves as a positive, but only when female director presence is untrammelled by family associations between directors. However, there is little evidence of a link between female board representation and IPO underpricing. Relative to state-backed issuers, privately controlled firm boards accommodate more women, younger officers and a broader mix of nationalities, but appear more-inclined to unify CEO and chair positions. Board duality, the fraction of independent directors and directors’ age and nationality exhibit little relation with initial and aftermarket stock returns. In prescriptive terms, minority investors gain from the inclusion of female directors, especially when IPO firm directors are unencumbered by family-affiliation with other board members. Results therefore add to the clarion of calls for greater female board presence. (shrink)

Bryan Norton’s 2005 book Sustainability describes a pragmatic approach to environmental philosophy that stresses philosophy’s role as one of mediating between scientific and ordinary language. But on two topics, Norton’s approach is not pragmatic enough. In the case of his discussion of risk, he accedes to a scientific notion that fails to acknowledge the way that ordinary usage of the word risk involves pragmatic links to human action and moral responsibility. With respect to the word sustainability, his analysis fails to (...) acknowledge important scientific work that characterizes the functional integrity of system cycling, opting instead for usage grounded either in economic accounting or in an even less substantive sense of a broad social movement for environmental improvement. On each of these topics, adherence to the pragmatic orientation of Norton’s philosophy results in a different analysis of the concepts in question. (shrink)

Risk communication poses a challenge to ordinary norms of truth-telling because it can easily mislead. Analyzing this challenge in terms of a systematic divergence between expertise and public attitudes fails to recognize how two specific features of the concept of risk play a role in managing daily affairs. First, evaluating risk always incorporates an estimate of the reliability of information. Since risk communication is an effort at providing information, audiences will naturally and appropriately incorporate their assessment of the reliability of (...) the risk communicator into their assessment of the risk as such. Second, one conceptual and grammatical feature of the concept of risk is to categorize experience as non-routine and demanding further deliberation. That is, the whole point of calling something a risk can be to distinguish it from activities or phenomena that need no further attention. Risk communications that stress relative comparisons of measured probabilities and expected utilities can be inconsistent with both features of our concept of risk. At best they mislead; at worst they undermine our society’s capacity to cope with risk. While there are no simple answers to these two conundrums, technical experts should bear them in mind when communicating with the broader public. (shrink)

This chapter attempts to derive, define, and specify norms governing the relationship between physician-researcher and patient-subject, and to explore their interconnection. It argues that rooting the relationship between physician-researcher and patient-subject in a normative theory of trust is promising. It enables the derivation, definition, and specification of norms governing the relationship and appreciation of their interconnection.

The Filter Dichotomy says that every uniform nonmeager filter on the integers is mapped by a finite-to-one function to an ultrafilter. The consistency of this principle was proved by Blass and Laflamme. A medial limit is a universally measurable function from [Formula: see text] to the unit interval [0, 1] which is finitely additive for disjoint sets, and maps singletons to 0 and ω to 1. Christensen and Mokobodzki independently showed that the Continuum Hypothesis implies the existence of medial limits. (...) We show that the Filter Dichotomy implies that there are no medial limits. (shrink)

Replies to commentaries on my 2012 article ‘Synthetic Biology Needs a Synthetic Bioethics,’ note that I do not, in fact, call for some ‘new’ kind of ethics. The focus then and now is on integrating questions that relate to distributive justice and environmental quality more faithfully into the topics that have come to preoccupy mainstream bioethics as institutionalized in medical schools and medical research institutions.

Four strands of research in the philosophy of technology have made important contributions to environmental philosophy. First, critical theory of technology emphasizes the environmentally exploitative tendencies of capitalist technological innovation. Second, phenomenologyhas examined how technologies shapeperception and orientation to the world with implications for our treatment of and regard for nature. Third, concurrent with the environmental movement itself, an empirical turn in philosophy of technology resulting in philosophers focusing their attention on particular tools and techniques. Empirical studies have emphasized environmentally (...) significant technologies. Finally, work inspired by philosophy of science has adopted scientific reasoning and methods in environmental policy with tools such as risk analysis and environmental impact assessment. These four strands of work have often merged with the work of sociologists, geographers, and political theorists interested in the connections between science and democracy. (shrink)

Open-source communities that focus on content rely squarely on the contributions of invisible strangers in cyberspace. How do such communities handle the problem of trusting that strangers have good intentions and adequate competence? This question is explored in relation to communities in which such trust is a vital issue: peer production of software (FreeBSD and Mozilla in particular) and encyclopaedia entries (Wikipedia in particular). In the context of open-source software, it is argued that trust was inferred from an underlying ‘hacker (...) ethic’, which already existed. The Wikipedian project, by contrast, had to create an appropriate ethic along the way. In the interim, the assumption simply had to be that potential contributors were trustworthy; they were granted ‘substantial trust’. Subsequently, projects from both communities introduced rules and regulations which partly substituted for the need to perceive contributors as trustworthy. They faced a design choice in the continuum between a high-discretion design (granting a large amount of trust to contributors) and a low-discretion design (leaving only a small amount of trust to contributors). It is found that open-source designs for software and encyclopaedias are likely to converge in the future towards a mid-level of discretion. In such a design the anonymous user is no longer invested with unquestioning trust. (shrink)

After centuries of neglect, the ethics of food are back with a vengeance. Justice for food workers and small farmers has joined the rising tide of concern over the impact of industrial agriculture on food animals and the broader environment, all while a global epidemic of obesity-related diseases threatens to overwhelm modern health systems. An emerging worldwide social movement has turned to local and organic foods, and struggles to exploit widespread concern over the next wave of genetic engineering or nanotechnologies (...) applied to food. Paul B. Thompson's book applies the rigor of philosophy to key topics in the first comprehensive study explore interconnections hidden deep within this welter of issues. Bringing to bear more than thirty years of experience working closely with farmers, agricultural researchers and food system activists, he explores the eclipse of food ethics during the rise of nutritional science, and examines the reasons for its sudden re-emergence in the era of diet-based disease. Thompson discusses social injustice in the food systems of developed economies and shows how we have missed the key insights for understanding food ethics in the developing world. His discussions of animal production and the environmental impact of agriculture break new ground where most philosophers would least expect it. By emphasizing the integration of these issues, Thompson not only brings a comprehensive philosophical approach to moral issues in the production, processing, distribution, and consumption of food -- he introduces a fresh way to think about practical ethics that will have implications in other areas of applied philosophy. (shrink)