This book provides an analysis of the debate surrounding cultural diversity, and attempts to reconcile the seemingly opposing views of "ethical imperialism," the belief that each individual is entitled to fundamental human rights, and cultural relativism, the belief that ethics must be relative to particular cultures and societies. The author examines the role of cultural tradition, often used as a defense against critical ethical judgments. Key issues in health and medicine are explored in the context of cultural diversity: the physician-patient (...) relationship, disclosing a diagnosis of a fatal illness, informed consent, brain death and organ transplantation, rituals surrounding birth and death, female genital mutilation, sex selection of offspring, fertility regulation, and biomedical research involving human subjects. Among the conclusions the author reaches are that ethical universals exist, but must not be confused with ethical absolutes. The existence of ethical universals is compatible with a variety of culturally relative interpretations, and some rights related to medicine and health care should be considered human rights. Illustrative examples are drawn from the author's experiences serving on international ethical review committees and her travels to countries in Africa, Asia, and Latin America, where she conducted educational workshops and carried out out her own research. (shrink)

This paper takes a sideways look at the controversial topic of educational assessment, raising the question: what place should the success/failure distinction have in an effective and humane educational system? Though the experience of failure may undermine the self-esteem that is conducive to learning, its possibility is clearly important educationally. Instead of asking whether teachers should be truthful about children’s achievements or dishonestly promote their self-esteem, we need to recognise a certain logical indeterminacy about what young children can do. Given (...) this, it is reasonable to presume in favour of many of their capacities rather than against them, for this is how children develop the confidence to act. This includes the confidence to fail as well as the confidence to succeed. It is argued that both are crucial for learning. (shrink)

Recent discussions of genomics and international justice have adopted the concept of ‘global public goods’ to support both the view of genomics as a benefit and the sharing of genomics knowledge across nations. Such discussion relies on a particular interpretation of the global public goods argument, facilitated by the ambiguity of the concept itself. Our aim in this article is to demonstrate this by a close examination of the concept of global public goods with particular reference to its use in (...) the context of genomic databases. We contend that the argument for construing genomics as a global public good depends on seeing it as a natural good by focusing on features intrinsic to genomics knowledge. We shall argue that social and political arrangements are relevant and that recognising this opens the door to construing the use of global public goods language as a strategic one. (shrink)

By whatever general principles and mechanisms animal behavior is governed, human behavior control rides piggyback on top of the same or very similar mechanisms. We have reflexes. We can be conditioned. The movements that make up our smaller actions are mostly caught up in perception-action cycles following perceived Gibsonian affordances. Still, without doubt there are levels of behavior control that are peculiar to humans. Following Aristotle, tradition has it that what is added in humans is rationality ("rational soul"). Rationality, however, (...) can be and has been characterized in many different ways. I am going to speculate about two different kinds of cognitive capacities that we humans seem to have, each of which is at least akin to rationality as Aristotle described it. The first I believe we share with many other animals, the second perhaps with none. Since this session of the conference on rational animals has been designated a "brainstorming" session, I will take philosopher's license, presenting no more than the softest sort of intuitive evidence for these ideas. (shrink)

A large literature has grown up around the proposed use of 'weak measurements' to allegedly provide information about hidden ontological features of quantum systems. This paper attempts to clarify the fact that 'weak measurements' are simply strong measurements on one member of an entangled pair, and that all such measurements thus effect complete disentanglement of the pair. The only thing 'weak' about them is that the correlation established via the entanglement does not correspond to eigenstates of the 'weakly measured observable' (...) for the component system that is subject to the weak measurement. It is observed that complete disentanglement always occurs, whether post-­‐selection is performed before or after the pointer detection. Assertions in the literature that weak measurements leave a system negligibly disturbed are therefore inaccurate, and claims based on those assertions need to be critically reassessed. (shrink)

This paper claims that liberal moral education is predicated on an inadequate conception of the roots of moral disposition and agency. It advances a view of modernity in which social and material conditions, whilst not comprising an ‘iron cage’, nevertheless give momentum to some trends in social (and individual) development, and place others at a discount. Thus a moral education which seeks to assure an open future through individual cognitive emancipation risks exacerbating processes inimical to its aims. This is illustrated (...) with reference to the socio-economic conditions of contemporary liberal capitalism and to broader features of modernity. Implications are sketched for the emancipatory aims of education, the role of the school in moral development, the scope of education theory, and the development of critical social theory and social practices. (shrink)

In this paper, I examine the possibility of accounting for the rationality of belief-formation by utilising decision-theoretic considerations. I consider the utilities to be used by such an approach, propose to employ verisimilitude as a measure of cognitive utility, and suggest a natural way of generalising any measure of verisimilitude defined on propositions to partial belief-systems, a generalisation which may enable us to incorporate Popper's insightful notion of verisimilitude within a Bayesian framework. I examine a dilemma generated by the decision-theoretic (...) procedure and consider an adequacy condition (immodesty) designed to ameliorate one of its horns. Finally, I argue in a sceptical vein that no adequate verisimilitude measure can be used decision-theoretically. (shrink)

Fallibilism is an attractive epistemological position, avoiding the Scylla of rationalism, and the Charybdis of scepticism. Acknowledging, on the one hand, human imperfection, yet claiming that science and rational inquiry are possible. Fallibilism is a thesis, but equally importantly – an epistemological recommendation. that we should never be absolutely sure of anything. My aim in this paper is to drive a wedge between the thesis and the recommendation. The (eminently plausible) doctrine, I shall argue, cannot be used to ground the (...) epistemological prescription for caution. (shrink)

In the dyadic and triadic sharing of emotions, intentions, and behaviors in families, interactive synchrony is important to the early life experiences that contribute to the development of cultural cognition. This synchrony likely depends on neurobiological circuits, currently under study with brain imaging, that involve attention, stress response, and memory.

This book is in fact a kind of mosaic, composed from both a concluding act and an act of commencement.

Teachers need grounded ethical confidence: an intellectual virtue analogous to courage. I distinguish this from SCAA's notion of teacher confidence, based on the ‘authority of consensus’. Such a notion is challenged by Wittgenstein's later philosophy. I argue that confidence in authority is deferential rather than intellectual, which is not what we want for teachers. As courage (according to Aristotle) is a mean between vices, grounded ethical confidence is a mean between tendencies to excessive and insufficient doubt (forms of ‘not knowing (...) one's way about’ philosophically.) It is the virtue of thinking well ethically, and knowing that one thinks well. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Informed Consent and Clinical ResearchRuth Faden (bio)Informed consent is a powerful symbol of the commitment and impact of the new, interdisciplinary field of biomedical ethics that the Kennedy Institute has been so instrumental in developing. In the early years of biomedical ethics, there was considerable discussion about the nature of the doctor-patient relationship, about how it ought to be structured, and about how competing values within that relationship ought (...) to be accommodated. By the 1970s and 1980s, the answer was for all practical purposes in. Biomedical ethics was engaged in a clearly reformist project, in step with the values of the times, to right a wrongful imbalance of power and control between physicians and patients.The agenda was clear—to establish the moral authority of the patient to participate in medical decision making by placing respect for the autonomy of patients on the moral map of the medical community. The chief strategy that biomedical ethics adopted to accomplish this agenda was, of course, informed consent. Theories of autonomous action as well as informed consent were intentionally crafted to advance this reformist agenda.In this paper, I examine how the theory of informed consent has fared in one particular realm of “the clinic” where, arguably, there has been considerable success. This is the realm of clinical research; research at the bedside where the patient is also the subject.I rely heavily on the work of President Clinton’s Advisory Committee on Human Radiation Experiments, which I chaired. The Advisory Committee was established in response to exposés in the press about alleged secret experiments during World War II and the Cold War in which patients had been injected with plutonium without their apparent knowledge or consent. As part of its work, the Advisory Committee undertook an oral history project in which we interviewed eminent physicians about the norms and practices of human research in the 1940s and 1950s.Drawing on these interviews, I argue here for two seemingly inconsistent conclusions. First, that the ethical standards for clinical research have changed dramatically in the last 50 years—particularly with respect to informed consent. Second, that despite these important changes, the human dynamics of clinical research in many respects remain unchanged.How the World of Clinical Research Has ChangedDuring the forties and fifties, duties to obtain informed consent, whether for treatment or for research, were simply not part of the doctor-patient experience. [End Page 356]As one physician told us:In 1945, ‘50, the doctor... was king or queen. It never occurred to a doctor to ask for consent for anything. Doctors weren’t in the habit of telling the patients anything (either). They were in charge and nobody questioned their authority.(Advisory Committee on Human Radiation Experiments 1996, p. 83)This unquestioned authority extended to all decisions about the management of the patient, including whether patients were to receive experimental therapies or otherwise become the subjects of research or experimentation. Physicians were trained to be concerned with risk, and harm, and benefit, in keeping with the Hippocratic tradition. But in most institutions, the permission to try something new and to take unknown risks came, not from the patient, but from the chairman of the department.In part, this broad license reflected the very newness of scientifically grounded medical practice. In the forties and fifties, many potentially therapeutic interventions were newly discovered and in this sense considered experimental, or at least innovative. The level of uncertainty about whether a treatment would work was generally high, whether the treatment was part of a research project or not. Moreover, the formalizing of medical science at the bedside was itself still in its infancy—it was not until 1948 that the first modern clinical trial in which patients were randomized to different treatment and control groups was reported in the literature. Much of the research of this period was informal and unsystematic.Thus, it is not surprising that the physician’s authority to make treatment decisions extended to treatments that were innovative or experimental, regardless of whether these innovative treatments were the subject of formal scientific investigation. What is perhaps more surprising is that physicians often acted the same way—that... (shrink)

: Arguments for efficiency in health care delivery have been used to support some level of withholding of information about available treatment options from patients in managed care systems. To the extent that such arguments prevail, they may necessitate changes in the established understanding of and commitment to informed consent and the disclosure of information to patients.

Feminist theory and the politics of life -- Nonhuman nostalgia -- Embryos -- Alphabets -- Conclusion.

The AIDS epidemic calls for an ethical analysis of conflicting obligations surrounding HIV-infected psychiatric patients and confidentiality, as well as issues that go beyond confidentiality. Although laws pertaining to HIV infection have been enacted in a number of states, these statutes leave much discretion to health professionals. The ethical principle known as "the harm principle" can permit disclosure of confidential information and detention or isolation of psychiatric patients who pose a threat of infecting other patients. From an ethical point of (...) view, however, the circumstances under which traditional protections may be weakened or abandoned remain limited. (shrink)

Though active in the arts herself, Dr. Richards (psychology, Saybrook Graduate School, San Francisco; psychiatry, Harvard Medical School; McLean Hospital, Belmont, Massachusetts) views creativity more broadly and as essential to survival. As someone who helped break new ground in the assessment of creativity in the general population, she introduces 13 chapters in which interdisciplinary thinkers probe the "originality of everyday life" in individual and societal contexts. Perspectives range from Piaget's developmental stages and the more positive aspects of television viewing to (...) chaos theory and Zen Buddhism. In integrating these views, the editor enumerates the benefits of living creatively. (shrink)

Theorists have debated whether our ability to understand sarcasm (pertaining here to verbal irony) is principally determined by the context or by properties of the comment itself. The current research investigated an alternative view that broadens the focus on the comment itself, suggesting that mitigating a highly positive concept by using negation generates sarcastic interpretations by default. In the current study, pretests performed on the target utterances presented in isolation established their default interpretations; novel affirmative phrases (e.g., He is the (...) best lawyer) were interpreted literally, whereas equally novel negative counterparts (e.g., He isn’t the best lawyer) were interpreted sarcastically. In Experiment 1 (an eye-tracking study), prior context biased these utterances toward literal or sarcastic interpretations. Results showed that target utterances were easier to process in contexts supporting their default interpretations, regardless of affirmation/negation. Results from a second eye-tracking experiment suggested that readers’ tendency to interpret negative phrases sarcastically is related to their own tendency to use malicious humor. Our findings suggest that negation leads to certain ambiguous utterances receiving sarcastic interpretations by default and that this process may be further intensified by personality factors. (shrink)

The type of research known as cluster randomized trials raises ethical questions not readily answered within the standard understanding of research ethics. What distinguishes a CRT is that it randomizes at the level of social groups rather than at the level of individual research participants: in a CRT, the regimen under study might be assigned to a village, hospital, or school. The organizational schemes of CRTs raise an assortment of fundamental ethical problems. In certain CRTs, the question of whether it (...) is possible to obtain individual informed consent is central. Also, if the intervention is offered at the level of a sizable social group, there is usually no realistic possibility for individuals to opt out of the trial. Other ethical questions raised by CRTs have to do with identifying the subjects of research, and indeed with whether “research” is occurring at all. (shrink)

What I learned from you and what helped me in the ensuing years to find my way around in reality without selling my soul to it the way people in earlier times sold their souls to the devil is that the only thing of importance is not philosophies but the truth, that one has to live and think in the open and not in one's own little shell, no matter how comfortably furnished it is, and that necessity in whatever form (...) is only a will-o'-the-wisp that tries to lure us into playing a role instead of attempting to be a human being.On YouTube, you can find a recording of Flannery O'Connor reading "A Good Man Is Hard to Find." It is fun to hear the audience erupt in laughter when O'Connor, in her thick southern accent, has... (shrink)