The recent Minnesota case of In re Emergency Guardianship of Albert Barnes illustrates an emerging class of cases where a dispute between a family proxy and a hospital over “medical futility” requires legal resolution. The case was further complicated by the patient’s spouse who fraudulently claimed to be the patient’s designated health care proxy and who misrepresented the patient’s previously expressed treatment preferences. Barnes demonstrates the degree of significant administrative and institutional support to the health care team, ethics consultants, and (...) futility committees that is required when a futility dispute escalates to the need for judicial resolution. An institutional futility policy, especially one that is endorsed by other regional medical centers and organizations, is an important foundation for a hospital that seeks judicial support in a dispute over medical futility in end of life care. (shrink)

My path to bioethics was a long and uncharted one. My journey, through a rich and varied career and three postgraduate degrees, reflects the evolving narrative of both my own life and the field of bioethics.

Preface by Daniel C. Dennett Beginning with a general theory of function applied to body organs, behaviors, customs, and both inner and outer representations, ...

This collection of essays serves both as an introduction to Ruth Millikan’s much-discussed volume Language, Thought, and Other Biological Categories and as an extension and application of Millikan’s central themes, especially in the philosophy of psychology. The title essay discusses meaning rationalism and argues that rationality is not in the head, indeed, that there is no legitimate interpretation under which logical possibility and necessity are known a priori. In other essays, Millikan clarifies her views on the nature of mental (...) representation, explores whether human thought is a product of natural selection, examines the nature of behavior as studied by the behavioral sciences, and discusses the issues of individualism in psychology, psychological explanation, indexicality in thought, what knowledge is, and the realism/antirealism debate. Table of Contents Preface Acknowledgments Introduction 1 In Defense of Proper Functions 2 Propensities, Exaptations, and the Brain 3 Thoughts without Laws 4 Biosemantics 5 On Mentalese Orthography, Part 1 6 Compare and Contrast Dretske, Fodor, and Millikan on Teleosemantics 7 What Is Behavior? A Philosophical Essay on Ethology and Individualism in Psychology, Part 1 8 The Green Grass Growing All Around: A Philosophical Essay on Ethology and Individualism in Psychology, Part 2 9 Explanation in Biopsychology 10 Metaphysical Antirealism? 11 Truth Rules, Hoverflies, and the Kripke-Wittgenstein Paradox 12 Naturalist Reflections on Knowledge 13 The Myth of the Essential Indexical 14 White Queen Psychology; or, The Last Myth of the Given References Index. (shrink)

There are no "special sciences" in Fodor's sense. There is a large group of sciences, "historical sciences," that differ fundamentally from the physical sciences because they quantify over a different kind of natural or real kind, nor are the generalizations supported by these kinds exceptionless. Heterogeneity, however, is not characteristic of these kinds. That there could be an univocal empirical science that ranged over multiple realizations of a functional property is quite problematic. If psychological predicates name multiply realized functionalist properties, (...) then there is no single science dealing with these: human psychology, ape psychology, Martian psychology and robot psychology are necessarily different sciences. (shrink)

This paper begins with a response to Josh Gert’s challenge that ‘on a par with’ is not a sui generis fourth value relation beyond ‘better than’, ‘worse than’, and ‘equally good’. It then explores two further questions: can parity be modeled by an interval representation of value? And what should one rationally do when faced with items on a par? I argue that an interval representation of value is incompatible with the possibility that items are on a par (a mathematical (...) proof is given in the appendix). I also suggest that there are three senses of ‘rationally permissible’ which, once distinguished, show that parity does distinctive practical work that cannot be done by the usual trichotomy of relations or by incomparability. In this way, we have an additional argument for parity from the workings of practical reason. (shrink)

Citizenship and its education is again gaining importance in many countries. This paper uses England as its primary example to develop a Habermasian perspective on this issue. The statutory requirements for citizenship education in England imply that significant attention be given to the moral and social development of the learner over time, to the active engagement of the learner in community and to the knowledge skills and understanding necessary for political action. This paper sets out a theoretical framework that offers (...) a perspective on learning suitable for these far-reaching aims. We argue that schools need to shift from the currently dominant discourse of accountability to incorporate a discourse of care in order to make room for an effective and appropriate pedagogy for citizenship. Habermas’s social theory gives us a theoretical framework that properly locates schools within the lifeworld as part of civil society. Schools should therefore attend to hermeneutical and emancipatory concerns, not only to strategic interests. We put these in the context of Habermas’s social theory to paint an alternative vision learning for citizenship education which is based in developing the dispositions, values and attitudes necessary for lifelong learning with a view to developing ongoing communicative action. (shrink)

The demand for bodily parts such as organs is increasing, and individuals in certain circumstances are responding by offering parts of their bodies for sale. Is there anything wrong in this? Kant had arguments to suggest that there is, namely that we have duties towards our own bodies, among which is the duty not to sell parts of them. Kant's reasons for holding this view are examined, and found to depend on a notion of what is intrinsically degrading. Rom Harré's (...) recent revision of Kant's argument, in terms of an obligation to preserve the body's organic integrity, is considered. Harré's view does not rule out all acts of selling, but he too ultimately depends on a test of what is intrinsically degrading. Both his view and Kant's are rejected in favour of a view which argues that it does make sense to speak of duties towards our own bodies, grounded in the duty to promote the flourishing of human beings, including ourselves. This provides a reason for opposing the sale of bodily parts, and the current trend towards the market ethic in health care provision. (shrink)

This paper explores the ways in which postdoctoral life scientists engage in supervision work in academic institutions in Austria. Reward systems and career conditions in academic institutions in most European and other OECD countries have changed significantly during the last two decades. While an increasing focus is put on evaluating research performances, little reward is attached to excellent performances in mentoring and advising students. Postdoctoral scientists mostly inhabit fragile institutional positions and experience harsh competition, as the number of available senior (...) positions is small compared to that of young scientists striving for an academic career. To prevail in this competition, publications and mobility are key. Educational work is rarely rewarded. Nevertheless, postdocs play a key role in educating PhD students, as overburdened senior scientists often pass on practical supervision duties to their postdoctoral fellows. This paper shows how under these conditions, postdocs reframe the students they supervise as potential resources for co-authored publications. What might look like a mutually beneficial solution at a first glance, in practice implies the subordination of the values of education to the logic of production, which marginalizes spaces primarily devoted to education. The author argues that conflicts like this are indicative of broader changes in the cultural norms of science and academic citizenship, rendering community-oriented tasks such as education work less attractive to academic scientists. Since education and supervision work are central cornerstones of any functioning higher education and research system, this could have negative repercussions for the long-term development of academic institutions. (shrink)

Interdisciplinarity is often framed as crucial for addressing the complex problems of contemporary society and for achieving new levels of innovation. But while science policy and institutions have provided a variety of incentives for stimulating interdisciplinary work throughout Europe, there is also growing evidence that some aspects of the academic system do not necessarily reward interdisciplinary work. In this study, we explore how mid-career researchers in an environmental science research center in Sweden relate to and handle the distinct forms of (...) uncertainty that arise from conflicting institutional and policy impulses. Our material suggests that interdisciplinary academics are often confronted with and at times themselves operate with a surprisingly dichotomous, value-laden view of their research practice. Disciplinarity is primarily associated with the ideals of scientific rigor, while interdisciplinarity becomes conflated with application-oriented work and a lack of ‘theory.’ We also draw attention to the underlying practical dynamics that reproduce this tension and entangle it with the very process of academic socialization. Specifically, we analyze the ambivalent consequences of the various work-arounds that researchers rely on to carve out opportunities for ongoing interdisciplinary research within heterogeneous funding landscapes. These tactics turn out to be undermined by the overriding normative power of formal career incentives at universities, which continue to emphasize the ideals of the individual high-performing academic who publishes in disciplinary journals and attracts the most selective grants. Under such circumstances, the work-arounds themselves become an insidious mechanism that allows researchers to stay in academia but systematically marginalizes their voices and epistemic ambitions in the process. (shrink)

This is the second edition of a highly successful and well-received textbook on the responsible conduct of biomedical and health science research. It is aimed at faculty and graduate students in health science and biomedical science programs. In addition those on National Institute of Health research grants, administrators at universities, academic health centers, and medical and graduate schools will find the book a useful resource. The structure of the book remains the same as the first edition. Each chapter offers an (...) overview together with important primary documents and case studies concerned with core ethical issues underlying responsible research. The major changes from the first edition include new chapters providing overviews of each topic, several new published articles added to the readings, revised case studies along with an essay on how they can be used, as well as further readings and web addresses that will serve as invaluable sources of reference. (shrink)

Moral sceptics maintain that there are no objective moral values, or that there is no moral knowledge, or no moral facts, or that what looks like a statement which makes a moral judgment is not really a statement and does not have a truth-value. All of this is rather, unclear because all of it is negative. It will be necessary to remove some of this unclarity because my aim in this paper is to establish a proposition which may be summarized (...) by saying: even if there are no objective moral values in one sense, there are objective moralvalues in another sense, and the latter values are good enough to do some of the jobs that objective values in the first sense would have done. A useful analogy might be that of a person who has lost her hand and has been given a prosthesis. In one sense the prosthesis is not as real as the hand, in another sense it is just as real ; most importantly, the person can do with the prosthesis enough of what she could do with the hand to make do. (shrink)

The biggest contemporary challenge to democratic legitimacy gravitates around the crisis of democratic representation.

Lifelong learning is something which one does for oneself that no one else can do for one: it is a public and personal human activity, rather than private or individualistic. One of the features of the education system is the paucity of a language for learning as process and participative experience. Personalised learning requires a sense of the worth-whileness of 'being a learner' - a virtue in the 21st century. A sense of one's own worth as a person is essential (...) to understanding one's identity as a learner. Research suggests the human capacity to learn can be understood as a form of consciousness which is characterised by particular values, attitudes and dispositions, with a lateral and a temporal connectivity. This 'consciousness' has several dimensions which are all related to becoming a person, with a learning identity. They also enable the learner to become aware of and appropriate what is of worth and map onto the sorts of core values that learning communities espouse. Awareness of self and of one's own worth as a person is a necessary condition for 'becoming a learner' and for identifying and engaging with 'what is of worth'. Furthermore, a sense of self as a learner is formed in relationship, and understood as one learns to tell one's own story, as a participant in the conversation of the learning community. Character is the way in which we refer to that quality of personhood in which there is rooted the capacity to change and learn over time. (shrink)

The Hebrew text On the Heavens and the World, ascribed to Ibn S, is an interesting and intriguing composition. It dates from the 13th century and was quite influential. It is not a translation of any text of Ibn S known to us, but is related to the Latin De celo et mundo, which appears in the 1508 Venice edition of translations of Ibn S. The Latin and Hebrew texts differ widely and the relation between them is far from being (...) clear. Both are in sixteen chapters, the titles of the chapters are the same, but the texts are only roughly similar. The Hebrew text often offers short, incomplete summaries of the Latin arguments. On the other hand it includes many passages which have no parallel in the Latin. There are two possible explanations of the perplexing relationship between the two texts: either that there was more than one version of the Latin text, or that the translator, Shlomo ben Moshe of Laguiri wrote a kind of paraphrase. The paper shows that the second explanation is correct and offers a preliminary study of the sources and the aims of the Hebrew text. (shrink)

I sketch in miniature the whole of my work on the relation between language and thought. Previously I have offered closeups of this terrain in various papers and books, and I reference them freely. But my main purpose here is to explain the relations among the parts, hoping this can serve as a short introduction to my work on language and thought for some, and for others as a clarification of the larger plan.

In lieu of an abstract, here is a brief excerpt of the content:A Defense of Fundamental Principles and Human Rights: A Reply to Robert Baker *Ruth Macklin (bio)AbstractThis article seeks to rebut Robert Baker’s contention that attempts to ground international bioethics in fundamental principles cannot withstand the challenges posed by multiculturalism and postmodernism. First, several corrections are provided of Baker’s account of the conclusions reached by the Advisory Committee on Human Radiation Experiments. Second, a rebuttal is offered to Baker’s (...) claim that an unbridgeable moral gap exists between Western individualism and non-Western communalism. In conclusion, this article argues that Baker’s “nonnegotiable primary goods” cannot do the work of “classical human rights” and that the latter framework is preferable from both a practical and a theoretical standpoint.Robert baker has written two interesting and thoughtful essays in support of his theory of international bioethics (Baker 1998a & b). Both essays are rich in content and comprehensive in scope. In the first of the two, “Multiculturalism, Postmodernism, and the Bankruptcy of Fundamentalism”—hereafter, “Multiculturalism”—Baker argues that attempts to ground international bioethics in fundamental principles cannot withstand the challenges posed by multiculturalism and postmodernism. As one of the bioethicists whose writings are the object of Baker’s critique, I undertake in this reply first, to elaborate my own position and to comment on related aspects of Baker’s thesis. 1 Next, I offer some corrections of Baker’s account of the conclusions reached by the Advisory Committee on Human Radiation Experiments, of which I was a member. Finally, I compare Baker’s “nonnegotiable [End Page 403] primary goods” with “classical human rights” and conclude that the latter framework is preferable from both a practical and a theoretical standpoint.In his second essay, “The Negotiable and the Non-Negotiable”—hereafter, “The Negotiable”—Baker puts forth a positive theory designed to meet the challenges of multiculturalism and postmodernism and, at the same time, to justify transcultural and transhistorical moral judgments. Baker (1998a, p. 203) describes his theoretical model as an effort “to validate the conception of international bioethics as a continually renegotiated moral order.” Although I find Baker’s proposal intriguing, I believe his rejection of fundamental principles can result in an unacceptable ethical relativism. To abandon “classical human rights,” along with the fundamental moral principles from which they derive, opens the door to all forms of cultural oppression in the name of “the most fundamental of all human rights, the right to define primacy for oneself” (Baker 1998b, p. 246). Alternatively, one can view Baker’s “nonnegotiable primary goods” as virtually equivalent to classical human rights, but much more difficult to identify, both theoretically and practically.Moral FundamentalismThe difference between my defense of universal moral principles and Baker’s critique rests, at least in part, on an interpretation of what is meant by “moral fundamentalism.” (I must confess to a distaste for the ‘ism’ because of the connotations and consequences of fundamentalism in other spheres.) Baker (1998a, p. 203) defines “moral fundamentalism” as the position “that certain basic or fundamental moral principles are accepted in all eras and cultures and thus are universally applicable to agents and actions in any era or culture.” A central feature of this definition is the requirement that all eras and cultures accept these fundamental moral principles. By this definition, the position I embrace does not count as “moral fundamentalism,” because I maintain that certain fundamental moral principles ought to be binding on all cultures or societies even if those cultures or societies do not accept them. 2 Universal acceptance is not a necessary condition for universal applicability.Part of the problem with Baker’s (and probably also my own) analysis is that it shifts constantly and imperceptibly back and forth between a variety of concepts: “moral principles,” “ethical standards,” “morality,” and “moral judgments.” In one instance, Baker (1998a, p. 209) notes my citation of a remark of Ruth Benedict (1934) that “morality differs in [End Page 404] every society.” That is what Ruth Benedict wrote; but nowhere did she specify that she had moral principles in mind. Indeed, her complete sentence reads as follows: “Morality differs in every society and is a convenient term for socially approved habits” (Benedict 1934, emphasis added... (shrink)

A seemingly plausible application of Bayesian decision-theoretic reasoning to determine one's rational degrees of belief yields a paradoxical conclusion: one ought to jettison one's intermediate credences in favour of more extreme (opinionated) ones. I discuss various attempts to solve the paradox, those involving the acceptance of the paradoxical conclusion, and those which attempt to block its derivation.

The universalist argument that all children should be educated in inclusive mainstream schools, irrespective of their difficulties or disabilities, is traced to the claims that special schools and disability ‘labels’ are inherently humiliating, and that no decent society tolerates inherently humiliating institutions. I ask whether there is a sound reason for a child to feel humiliated by special schools/disability ‘labels’ as such, and find none. Empirically, some do and some do not find these humiliating, and it is argued that the (...) failure to address the multiple ‘realities’ of disability and learning difficulty is responsible for the policy impasse in this area. (shrink)

A cardinal rule of academic research with human participants is to protect their confidentiality. While there are limits to confidentiality, universities and researchers will make strenuous efforts...

Las traducciones al inglés de la obra de Karl Jaspers no han sido hasta el momento uniformes en su elección de la terminología técnica. Esta interpretación especializada de la Introducción de Jaspers a su obra seminal "The Great Philosophers" ("Los Grandes Filósofos", nota de la traductora) se mantiene fiel al texto original en alemán tanto como es posible, protegiendo sus expresiones idiomáticas culturales, la estructura compleja de la oración y los matices particulares, con la condición de que la claridad de (...) la comunicación se conserve. Los contenidos sustanciales y la significación de este texto, cuyo principal tema es la grandeza, se bosquejan aquí. La comunicación con los grandes filósofos puede aportar una visión de su pensamiento, haciendo posible el trascender hacia una posible Existenz auténtica. (shrink)