General practitioners (GPs) have to negotiate a range of challenges when they suspect child abuse or neglect. This article details findings from a Delphi exercise that was part of a larger study exploring the conflicts of interest that arise for UK GPs in safeguarding children. The specific objectives of the Delphi exercise were to understand how these conflicts of interest are seen from the perspectives of an expert panel, and to identify best practice for GPs. The Delphi exercise involved four (...) iterative rounds with questionnaires completed by an expert panel. Results from each round were distilled and findings sent to panel members until consensus was reached. Panel members shared insights regarding their understanding of conflicts of interest in relation to GPs and safeguarding children and responses when conflicts of interests arise. Findings suggested a broader understanding of conflicts of interest (intrapersonal, interpersonal, interprofessional and interagency), the importance of professional judgement in uncertain situations when both action and inaction have potentially negative consequences and the importance of trust. The Delphi exercise was an effective means to bring together a wide range of professional and disciplinary perspectives on a complex topic. Findings caution against the oversimplification of the conceptual and practical issues, emphasise the importance of professional judgement, and support the development of open and trusting relationships with families and among professionals in health and social care agencies. (shrink)

The narrative approach to identity has developed as a sophisticated philosophical response to the complexities and ambiguities of the human, lived situation, and is not – as has been naively suggested elsewhere – the imposition of a generic form of life or the attempt to imitate a fictional character. I argue that the narrative model of identity provides a more inclusive and exhaustive account of identity than the causal models employed by mainstream theorists of personal identity. Importantly for ethical subjectivity, (...) the narrative model gives a central and irreducible role to the first-person perspective. I will draw the connection between narrative identity and ethical subjectivity by way of an exposition of work by Paul Ricoeur and Marya Schechtman, and a brief consideration of Korsgaard’s work on practical identity and normative ethics. I argue that the first-person perspective – the reflective structure of human consciousness – arises from human embodiment, and therefore the model of identity required of embodied consciousness is more complex and irreducibly first-personal than that provided in a causal account. What is required is a self-constitution model of identity: a narrative model of identity. (shrink)

In this essay I take issue with Derek Parfit's reductionist account of personal identity.Parfit is concerned to respond to what he sees as flaws in the conception of the role of 'person' in self-interest theories. He attempts to show that the notion of a person as something over and above a totality of mental and physical states and events (in his words, a 'further fact'), is empty, and so, our ethical concerns must be based on something other than this. My (...) objections centre around the claim that Parfit employs an impoverished conception of 'life'. Parfit misconceives the connection between 'I' and one's body, and, so, despite his rejection of a metaphysical conception of 'self', remains within the logic of Cartesianism. What Parfit and other reductionists call an 'impersonal' perspective, I shall call the third-person perspective: a perspective which one in general may take. Against Parfit I shall offer a more complex conception of 'self' through the concept of 'bodily perspective'. I emphasize the irreducible ambiguities of human embodiment in order to show the presuppositions and the limitations of Parfit's view. Of interest is the conception of time and the model of continuity that is appropriate to an embodied subject's life. I employ Paul Ricoeur's concept of 'human time' to argue that the reflective character of human experience demands a model of temporality and continuity that differs significantly from the one Parfit employs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:746 BOOK REVIEWS they he systematic, well-founded, inter-subjective, free, and critical. Unfortunately for the argument, such criteria require a theory of the good as well as of the true. No survey of the literature alone will yield these criteria; reasoned decisions about larger matters must be made. Vroom's inability to decide the meta-questions about truth and goodness is less significant in his final chapter on inter-religious dialogue, where he (...) looks for a schema of mutual understanding rather than for norms of successful communication. The stress on family resemblance helps him to avoid two mistakes. First is the idea that all religions are variations on one universal human activity, a position made untenable by the multitude of concerns embraced by every religious tradition and the absence of any one integrating feature. The second mistake he escapes is the belief that every religion is a unit having no overlap with any other and that consequently dialogue is impossible. Religions and the Truth traces the major world traditions so carefully that the overlap is obvious, hut it also makes clear that the overlap is various and fluctuating. Vroom has made a major contribution to the understanding of religion and to the conversation of religious people. My one wish is that he had been brave enough to take a stand on the basic philosophical questions and that he had set in motion an interaction between these questions and his detailed analysis of religion. An investigation of these deepest and richest quests for the true, the good, and the beautiful would result in an even better view of religion. La SaUe University Philadelphia, Pa. MICHAEL J. KERLIN Persons and Personal Identity: A Contemporary Inquiry. Edited by ARTHUR PEACOCKE AND GRANT GILLETT. Ian Ramsey Centre Publication, no. 1. Oxford: Basil Blackwell, 1987. Pp. ix + 222. $39.95 (cloth). This hook contains thirteen papers given at a seminar series and workshop on " Conceptions of the Person and Their Ethical Implications " held under the aegis of the Ian Ramsey Centre in Oxford, Eng· land, in 1985-86. The Ian Ramsey Centre, founded in 1985 and based at St. Cross College in Oxford, is directed by Arthur Peacocke, one of the editors of this hook. The Centre has as its aim " the interdiscipli· nary study of both ethical problems arising from scientific and medical research and practice and the underlying philosophical and theological BOOK REVIEWS 747 issues" (p. vii). The range of contributions to this volume shows that this aim is being taken seriously. Five contributions are by philos· ophers, three by theologians, and one each by a chemist, a psychologist, a psychiatrist, a literary critic, and a legal theorist. In addition, some of the papers have appended to them a partial record of the discussions they prompted, and the participants in these discussions represent a still broader range of disciplines. One of the chief strengths of this collection is thus the unusually wide spectrum of iITtellectual interests it covers. This is also its weakness; diversity can easily become disjointedness. The dominant tone of the collection nevertheless is philosophical, and the parameters of the philosophical debate are set by the first two con· tributions. In the first, Peter Atkins presents a radically scientistic materialism as the only possible view of what human persons are. Science, he claims, is omnicompetent and simple; purposelessness and chaos are fundamental in the cosmos; and physicalist reductionism. is capable of explaining everything. Atkins attempts to show, in the body of his paper, that these claims are true by offering a physicalist explanation of qualia and intentionality. Atkins's paper is remarkable both for the fervor of its rhetoric and the implausibility of its conclusions: any position that is not radically scientistic and physicalist is dismissed as sentimental wishful thinking (p. 13). But Atkins never establishes that nonphysicalist explanations of some phenomena are made less plau· sible by the fact that physicalist explanations can also be offered. Richard Swinburne, in the second paper, gives us the opposite end of the philosophical spectrum. He argues that if it is logically possible that I, as a conscious person, can exist without a body, then it follows that I have a soul (see... (shrink)

In _Matter and Consciousness_, Paul Churchland presents a concise and contemporary overview of the philosophical issues surrounding the mind and explains the main theories and philosophical positions that have been proposed to solve them. Making the case for the relevance of theoretical and experimental results in neuroscience, cognitive science, and artificial intelligence for the philosophy of mind, Churchland reviews current developments in the cognitive sciences and offers a clear and accessible account of the connections to philosophy of mind. For (...) this third edition, the text has been updated and revised throughout. The changes range from references to the iPhone's "Siri" to expanded discussions of the work of such contemporary philosophers as David Chalmers, John Searle, and Thomas Nagel. Churchland describes new research in evolution, genetics, and visual neuroscience, among other areas, arguing that the philosophical significance of these new findings lies in the support they tend to give to the reductive and eliminative versions of materialism. Matter and Consciousness, written by the most distinguished theorist and commentator in the field, offers an authoritative summary and sourcebook for issues in philosophy of mind. It is suitable for use as an introductory undergraduate text. (shrink)

Paul Moser's book defends what has been an unfashionable view in recent epistemology: the foundationalist account of knowledge and justification. Since the time of Plato philosophers have wondered what exactly knowledge is. This book develops a new account of perceptual knowledge which specifies the exact sense in which knowledge has foundations. The author argues that experiential foundations are indeed essential to perceptual knowledge, and he explains what knowledge requires beyond justified true beliefs. In challenging prominent sceptical claims that we (...) have no justified beliefs about the external world, the book outlines a theory of rational belief. (shrink)

Birds, beasts, and creeping things swarm throughout the Bible's pages. Despite their prevalence, most biblical scholars have viewed them merely as metaphors, passive objects, or background embellishment to the human experience. This collection seeks to move beyond this traditional view of biblical animals by engaging the growing interdisciplinary field of animal studies. Contributors Peter Joshua Atkins, Jared Beverly, William P. Brown, Margaret Cohen, Jacob R. Evers, Michael J. Gilmour, William "Chip" Gruen, Dong Hyeon Jeong, Brian Fiu Kolia, Anne Létourneau, (...) Robert R. MacKay, Suzanna R. Millar, Timothy J. Sandoval, Robert Paul Seesengood, Ken Stone, Brian James Tipton, Arthur W. Walker-Jones, and Jaime L. Waters showcase the breadth and depth of inquiry that animal studies can foster in biblical studies as well as what animal studies can gain from a more rigorous engagement with biblical texts. Together the essays offer an animal hermeneutic that supports the flourishing of all creatures. (shrink)

Paul Snowdon; XI*—Perception, Vision and Causation, Proceedings of the Aristotelian Society, Volume 81, Issue 1, 1 June 1981, Pages 175–192, https://doi.org/10.

In this influential study of central issues in the philosophy of science, Paul Horwich elaborates on an important conception of probability, diagnosing the failure of previous attempts to resolve these issues as stemming from a too-rigid conception of belief. Adopting a Bayesian strategy, he argues for a probabilistic approach, yielding a more complete understanding of the characteristics of scientific reasoning and methodology. Presented in a fresh twenty-first-century series livery, and including a specially commissioned preface written by Colin Howson, illuminating (...) its enduring importance and relevance to philosophical enquiry, this engaging work has been revived for a new generation of readers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 65.1 (2004) 155-157 [Access article in PDF] In Memoriam John F. Callahan John Francis Callahan, Professor Emeritus of Philosophy and Classics at Georgetown University, died 14 July 2003 after open-heart surgery performed 6 June and was buried with full military honors 17 September at Arlington National Cemetery. His funeral Mass at the Old Post Chapel was concelebrated by his old friend and former (...) colleague, Father Edward W. Bodnar, S.J., who had also concelebrated a memorial Mass in the Jesuit Chapel at Georgetown 5 August.John served on the Board of Editors and the Board of Directors of the Journal of the History of Ideas from 1970 until his death and was Vice-President from 1985. Throughout thirty-three years, during which he never missed a meeting until the last, he devoted unstinted time and energy to the affairs of the Journal, rigorously scrutinizing every problem, from matters of editorial policy through changes in leadership, location, and membership on the Editorial Board to proposals for expenditures and questions of format and style. He was a meticulous reader of manuscripts and applied the most stringent standards to his consideration of both content and modes of expression. No mistake in Greek typography escaped his vigilance. He brought to the annual meetings a distinctive elegance and an unusual sense of collegiality that derived both from his devotion to the Journal itself and from his long friendship with some of the older members of the Board, such as Paul Kristeller and Richard McKeon.John was a life member of the American Philological Association (since 1940) and served with distinction from 1976 to 1986 as its delegate to the International Federation of Classical Studies (FIEC), attending its meetings in Budapest and Helsinki. A scholar of exceptionally wide-ranging interests, he was best known for his studies of the concept of time in ancient philosophy and his critical edition of Gregory of Nyssa, De oratione dominica et De beatitudinibus, which he completed at Dumbarton Oaks after he retired from Georgetown.Born in Chicago 13 May 1912, he began the study of Greek and Latin at St. Ignatius Prep, where he was also introduced to opera, a lifelong passion, by one of his Jesuit teachers. He received the A.B. in 1933 and the A.M. in 1934 from Loyola University, Chicago, which on Founder's Day, 1965, honored him with an award for distinguished contributions to classical scholarship. He received the Ph.D. in 1940 from the University of Chicago, where he studied with Richard McKeon and Werner Jaeger, the two principal, very different influences on his approach to philosophy and philology. Henry Prescott and Carl Darling Buck were two other members of that fabulous generation of classical scholars at Chicago who made a lasting impression on him. His interest in Plautus, Greek and Roman linguistics, and comparative grammar continued throughout his life, contributing to what a former colleague at Dumbarton Oaks has described as an uncanny ability to penetrate beneath the surface of the classical languages, to "peer into their deep structure."John was a Teaching Fellow at the University of Chicago, 1936-37, Instructor at Loyola University, 1937-40, Visiting Instructor, Harvard University, 1940-41, Assistant Professor, Loyola University, 1941-43, Associate Professor and Professor of Classics and Philosophy, Georgetown University, from 1946 until he retired in 1978, and Project Director at Dumbarton Oaks, Harvard University, 1977-86. He served in the United States Navy from 1943 to 1946, working in Naval Communications. He rarely [End Page 155] spoke of his part in breaking the Japanese code, but often referred to such comrades in arms as Sam Atkins and Richmond Lattimore, who like him returned to teaching as soon as World War II was over.John's teaching was enriched by his research, which was supported by a notable succession of fellowships, from the Rockefeller Foundation in 1947, the Ford Foundation for the Advancement of Education, 1953-54, the Fulbright Commission, 1953-55, the Guggenheim Foundation, 1958-59, and the National Endowment for the Humanities, 1967. He... (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.

Like nature itself, modern economic life is driven by relentless competition and unbridled selfishness. Or is it? Drawing on converging evidence from neuroscience, social science, biology, law, and philosophy, Moral Markets makes the case that modern market exchange works only because most people, most of the time, act virtuously. Competition and greed are certainly part of economics, but Moral Markets shows how the rules of market exchange have evolved to promote moral behavior and how exchange itself may make us more (...) virtuous. Examining the biological basis of economic morality, tracing the connections between morality and markets, and exploring the profound implications of both, Moral Markets provides a surprising and fundamentally new view of economics--one that also reconnects the field to Adam Smith's position that morality has a biological basis. Moral Markets, the result of an extensive collaboration between leading social and natural scientists, includes contributions by neuroeconomist Paul Zak; economists Robert H. Frank, Herbert Gintis, Vernon Smith, and Bart Wilson; law professors Oliver Goodenough, Erin O'Hara, and Lynn Stout; philosophers William Casebeer and Robert Solomon; primatologists Sarah Brosnan and Frans de Waal; biologists Carl Bergstrom, Ben Kerr, and Peter Richerson; anthropologists Robert Boyd and Michael Lachmann; political scientists Elinor Ostrom and David Schwab; management professor Rakesh Khurana; computational science and informatics doctoral candidate Erik Kimbrough; and business writer Charles Handy. (shrink)

Values of Beauty discusses major ideas and figures in the history of aesthetics from the beginning of the eighteenth century to the end of the twentieth century. The core of the book features Paul Guyer's essays on the epochal contribution of Immauel Kant, and sets Kant's work in the context of predecessors, contemporaries, and successors including David Hume, Alexander Gerard, Archibald Alison, Arthur Schopenhauer, and John Stuart Mill All of the essays emphasize the complexity rather than isolation of our (...) aesthetic experience of both nature and art; and the interconnection of aesthetic values such as beauty and sublimity on the one hand, and prudential and moral values on the other. Guyer emphasizes that the idea of the freedom of the imagination as the key to both artistic creation and aesthetic experience has been a common thread throughout the modern history of aesthetics, although the freedom of the imagination has been understood and connected to other forms of freedom in a variety of ways. (shrink)

We introduce proof nets and sequent calculus for the multiplicative fragment of non-commutative logic, which is an extension of both linear logic and cyclic linear logic. The two main technical novelties are a third switching position for the non-commutative disjunction, and the structure of order variety.

(2002). Clarifying the Ethics of Clinical Research: A Path toward Avoiding the Therapeutic Misconception. The American Journal of Bioethics: Vol. 2, No. 2, pp. 22-23.

Rawls says in Political Liberalism that “the focus of an overlapping consensus is [more likely to be] a class of liberal conceptions” than a single one. In conceding that members of the well-ordered society are unlikely to live up to justice as fairness, Rawls would seem to have conceded that they are also unlikely to live autonomously. This is exactly the conclusion some commentators have drawn. I contend that the likelihood of “reasonable pluralism about justice” does not have the implication (...) for Rawls’s project that it is said to have: political autonomy remains available even when such pluralism obtains. (shrink)

In Being and Time Heidegger gives an account of the distinctive features of human existence, in an attempt to answer the question of the meaning of being. He finds that underlying all of these features is what he calls 'original time'. In this clear and straightforward introduction to the text, Paul Gorner takes the reader through the work, examining its detail and explaining the sometimes difficult language which Heidegger uses. The topics which he covers include being-in-the-world, being-with, thrownness and (...) projection, truth, authenticity, time and being, and historicity. His book makes Being and Time accessible to students in a way that conveys the essence of Heidegger's project and remains true to what is distinctive about his thinking. (shrink)

Causal decision theory attends to probabilities used to obtain an option's expected utility but for completeness should also attend to utilities of possible outcomes. A suitable formula for an option's expected utility uses a certain type of conditional utility.

This essay explores the mutual reinforcements between socioeconomic precarity and right-wing populism, and then envisions a politics that contests Trumpism through workers’ organizations that create alternatives to predominant patterns of subject formation through work. I first revisit my recent critique of precarity, which initiates a new method of critical theory informed by Paulo Freire’s political pedagogy of popular education. Reading migrant day laborers’ commentaries on their work experiences alongside critical accounts of today’s general work culture, this “critical-popular” procedure yields a (...) conception of precarity with two defining characteristics. First, precarity is socially bivalent: it singles out specific groups for especially harsh treatment even as it pervades society. Second, precarity constitutes subjects through contradictory experiences of time in everyday work-life, exacerbated by insoluble dilemmas of moral responsibility. Antonio Vásquez-Arroyo’s conception of “political literacy” and Bridget Anderson’s notion of “migrantizing the citizen,” in turn, help us understand how precaritization blocks workers from developing the critical dispositions toward time needed for democratic citizenship. This analysis then makes it possible to elucidate, in dialogue with Daniel Martinez-HoSang and Joseph Lowndes, how precaritized worker-citizenship facilitates the cross-class and multiracial appeal of Trumpism’s white supremacist discourse of national economic decline and resurgence, while normalizing the temporal affects of shock and violence characteristic of Trumpism, as theorized by Lia Haro and Romand Coles. Day laborers’ worker centers, I argue, refunction precaritized time, regenerate political literacy, and migrantize the citizen. A large-scale alternative to right-wing populism thus could emerge if the worker center network were expanded throughout the economy. (shrink)

Amongst traditionally-available frameworks within which end-of-life decisions in Intensive Care Units (ICU) are situated, we favour Ordinary versus Extra-ordinary care distinctions as the most helpful. Predicated on this framework, we revisit the concepts of personhood and autonomy. We argue that a full account of personhood locates its foundation in relationships with others, rather than merely in “rationality”. A full account of autonomy also recognises relationships with others, as well as the actual reality of the patient’s situation-in-the-world. The fact that, when (...) critically ill, the patient may no longer be able to take an active role in decision-making does not bring about the end of their personhood, or of their autonomy. Because the patient’s autonomy is intimately linked to their relationships with others, once critical illness supervenes, respect for their autonomy devolves to those others with whom the patient is in relationship. In practical application, this means that there must be a dialogue, as the end-of-life of the critically-ill patient in ICU comes into view. Such dialogue should be grounded on this understanding in order to conform best to moral philosophical principles. Ideally the dialogue will involve all those with whom the patient is in relationship and, practical difficulties within an ICU notwithstanding, will aim to be inclusive, non-coercive and reflective as it seeks to maximise the good of the patient in their unique context. (shrink)

Genomic research—including whole genome sequencing and whole exome sequencing—has a growing presence in contemporary biomedical investigation. The capacity of sequencing techniques to generate results that go beyond the primary aims of the research—historically referred to as “incidental findings”—has generated considerable discussion as to how this information should be handled—that is, whether incidental results should be returned, and if so, which ones.Federal regulations governing most human subjects research in the United States require the disclosure of “the procedures to be followed” in (...) the research as part of the informed consent process. It seems reasonable to assume—and indeed, many commentators have concluded—that genomic investigators will be expected to inform participants about, among other procedures, the prospect that incidental findings will become available and the mechanisms for dealing with them. Investigators, most of whom will not have dealt with these issues before, will face considerable challenges in framing meaningful disclosures for research participants.To help in this task, we undertook to identify the elements that should be included in the informed consent process related to incidental findings. We did this by surveying a large number of genomic researchers (n = 241) and by conducting in‐depth interviews with a smaller number of researchers (n = 28) and genomic research participants (n = 20). Based on these findings, it seems clear to us that routine approaches to informed consent are not likely to be effective in genomic research in which the prospect of incidental findings exists. Ensuring that participants’ decisions are informed and meaningful will require innovative approaches to dealing with the consent issue. We have identified four prototypical models of a consent process for return of incidental findings. (shrink)

In this wide-ranging interdisciplinary work, Paul W. Kahn argues that political order is founded not on contract but on sacrifice. Because liberalism is blind to sacrifice, it is unable to explain how the modern state has brought us to both the rule of law and the edge of nuclear annihilation. We can understand this modern condition only by recognizing that any political community, even a liberal one, is bound together by faith, love, and identity.Putting Liberalism in Its Place draws (...) on philosophy, cultural theory, American constitutional law, religious and literary studies, and political psychology to advance political theory. It makes original contributions in all these fields. Not since Charles Taylor's The Sources of the Self has there been such an ambitious and sweeping examination of the deep structure of the modern conception of the self.Kahn shows that only when we move beyond liberalism's categories of reason and interest to a Judeo-Christian concept of love can we comprehend the modern self. Love is the foundation of a world of objective meaning, one form of which is the political community. Arguing from these insights, Kahn offers a new reading of the liberalism/communitarian debate, a genealogy of American liberalism, an exploration of the romantic and the pornographic, a new theory of the will, and a refoundation of political theory on the possibility of sacrifice.Approaching politics from the perspective of sacrifice allows us to understand the character of twentieth-century politics, which combined progress in the rule of law with massive slaughter for the state. Equally important, this work speaks to the most important political conflicts in the world today. It explains why American response to September 11 has taken the form of war, and why, for the most part, Europeans have been reluctant to follow the Americans in their pursuit of a violent, sacrificial politics. Kahn shows us that the United States has maintained a vibrant politics of modernity, while Europe is moving into a postmodern form of the political that has turned away from the idea of sacrifice. Together with its companion volume, Out of Eden, Putting Liberalism in Its Place finally answers Clifford Geertz's call for a political theology of modernity. (shrink)

In Out of Eden, Paul W. Kahn offers a philosophical meditation on the problem of evil. He uses the Genesis story of the Fall as the starting point for a profound articulation of the human condition.

: Responding to the paper by Miller and Joffe, we review the development of the concept of therapeutic misconception (TM). Our concerns about TM's impact on informed consent do not derive from the belief that research subjects have poorer outcomes than persons receiving ordinary clinical care. Rather, we believe that subjects with TM cannot give an adequate informed consent to research participation, which harms their dignitary interests and their abilities to make meaningful decisions. Ironically, Miller and Joffe's approach ends up (...) largely embracing the very position that they inaccurately attribute to us: the belief that, with some exceptions, it is only the prospect of poorer outcomes that should motivate efforts to dispel TM. In the absence of empirical studies on the steps required to dispel TM and the impact of such procedures on subject recruitment, it is premature to surrender to the belief that TM must be widely tolerated in clinical research. (shrink)

The aim of this review is to show the fruitfulness of using images of facial expressions as experimental stimuli in order to study how neural systems support biologically relevant learning as it relates to social interactions. Here we consider facial expressions as naturally conditioned stimuli which, when presented in experimental paradigms, evoke activation in amygdala–prefrontal neural circuits that serve to decipher the predictive meaning of the expressions. Facial expressions offer a relatively innocuous strategy with which to investigate these normal variations (...) in affective information processing, as well as the promise of elucidating what role the aberrance of such processing might play in emotional disorders. (shrink)

Horror stories attached to some recent retailing events concerning Hoover, Ratners and others raise questions about a company’s ethical concern, whether it be part of its marketing strategy or ‘thrust upon it’. If ethics is to have a place in retail strategy that place is better focused around performance at an operational level rather than at the level of promotion or publicity. The author is Professor of Retailing at Nottingham Business School, Nottingham Trent University, Nottingham NG1 4BU, U.K. e‐mail: smm3whysapt@ntu.ac.uk.

There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice still requires (...) interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research. (shrink)

The Theaetetus is one of the most widely studied of any of the Platonic dialogues because its dominant theme concerns the significant philosophical question, what is knowledge? In this book Paul Stern provides a full-length treatment of its political character in relationship to this dominant theme. He argues that this approach sheds significant light on the distinctiveness of the Socratic way of life, with respect to both its initial justification and its ultimate character. More specifically, he argues that Socrates' (...) revolutionary decision to subject political life to philosophic reflection, the decision that leads directly to his trial and execution, is based on his awareness of the elusiveness of comprehensive knowledge and the implications of that elusiveness for the validity of philosophic inquiry. This view of Socrates' rationale has important consequences for our understanding of political philosophy and of the validity of the life of reason itself. (shrink)

The object of this paper is to throw light on the reciprocal exchanges between legal philosophy and the theory of speech acts (as developed by Austin and Searle). The first part concerns the contributions to legal philosophy made by the theory of speech acts with a view to developing new perspectives. The second part deals with the contributions of legal philosophy to speech act theory.

An agent's options in a decision problem are best understood as the decisions that the agent might make. Taking options this way eliminates the gap between an option's adoption and its execution.

In lieu of an abstract, here is a brief excerpt of the content:Examining the Ethics of Human Subjects ResearchPaul S. Appelbaum (bio)The work of the Advisory Committee on Human Radiation Experiments confirms once again the value of combining empirical and normative approaches to problems in clinical and research ethics. The Committee, like its predecessor, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, spent relatively modest sums of money gathering targeted data to inform (...) its deliberations. The results of the Committee’s research, which are discussed by Nancy Kass and Jeremy Sugarman in this issue of the Kennedy Institute of Ethics Journal, enhance our understanding of the current ethical status of human subjects research, helping to focus attention on areas of particular concern, and lay the basis for future research and policy development.My comments here focus on the two major empirical studies conducted by the Committee—the Research Proposal Review Project and the Subject Interview Study. I will underscore just a few of the primary findings from these studies, consider their limitations, and explore their implications. Readers interested in the details of the studies should consult the Committee’s Final Report (ACHRE 1995), on which I rely in part and which provides additional information on the methodology and findings of the studies.Research Proposal Review ProjectWhat can be learned from the Committee’s review of 125 federally-funded human research studies? In answering that question, one cannot ignore the irony inherent in the Committee’s decision to review documents related to institutional review board (IRB) consideration of the selected protocols. The single most frequent complaint about the current system for protecting human subjects is that IRBs focus almost exclusively on review of consent forms and other research documents, as if they bore some close relationship to what actually transpires between investigators and potential research subjects. Only a small number of studies examine the research consent process. Nevertheless, existing data strongly [End Page 283] suggest that subject recruitment often involves an extended process of courtship, during which the information contained in consent forms is only a small part of the information passed between investigators and subjects (Benson, Roth, and Winslade 1985; Lidz et al. 1984).Indeed, the second of the Committee’s studies—the Subject Interview Study, which is discussed below—appears to confirm these findings. In-depth interviews with 99 individuals who reported that they were former or current research subjects suggest that “[f]or many, the decision to participate seemed to have been made before the consent form was given to them, and they signed it almost as a formality” (ACHRE 1995 [GPO, p. 742; Oxford, p. 471]). 1 Why, then, did the Committee focus its attention on documents that in many cases seem to play only a tangential role in the consent process? As is the case with IRBs around the country, the answer appears to be that consent forms and related documents are the only easily available window on consent transactions. In addition, under the current system, consent forms constitute the part of the process that IRBs can influence most easily. Consequently, it suits almost everyone’s needs—except perhaps those of the research subjects—to pretend that they reflect what actually transpires in the recruitment process. To the Committee’s credit, it was well aware of this dilemma. Nonetheless, it struggled to wring valid lessons from these limited data in its Final Report.Perhaps the most interesting finding from the Research Proposal Review Project is just how poor so many consent forms are. Given the disproportionate emphasis that many IRBs place on the content of the forms, one would expect that investigators by now would have learned to design documents that meet objective standards of adequacy, such as those applied by the Committee. Indeed, except in the most unusual circumstances, doing so would virtually guarantee that the IRB will ask no further questions about subject recruitment procedures. Although the data justify the inference that many investigators do not yet understand which information is essential to communicate to potential subjects, nor have learned how to do so effectively, they also force us to a still more radical conclusion. If the IRBs were doing their jobs, the Committee... (shrink)