This report explores the relationship between philosophy and medicine in the U.K. We note that medical training involves very little formal instruction in philosophy and ethics, and that, with few exceptions, philosophers in the U.K. do not contribute to the instruction of physicians or the philosophy of medicine. However, reviewing the problems arising out of recent developments within scientific medicine we find a pressing need for future philosophical analysis in the following areas: psychiatry, organ transplantation, abortion, euthanasia, experiments on living (...) subjects, consent, confidentiality, the relationship between medicine and political authority, and the provisions for social justice in medicine. (shrink)

BackgroundPalliative sedation and analgesia are employed in patients with refractory and intractable symptoms at the end of life to reduce their suffering by lowering their level of consciousness. The doctrine of double effect, a philosophical principle that justifies doing a “good action” with a potentially “bad effect,” is frequently employed to provide an ethical justification for this practice. Main textWe argue that palliative sedation and analgesia do not fulfill the conditions required to apply the doctrine of double effect, and therefore (...) its use in this domain is inappropriate. Furthermore, we argue that the frequent application of the doctrine of double effect to palliative sedation and analgesia reflects physicians’ discomfort with the complex moral, intentional, and causal aspects of end-of-life care. ConclusionsWe are concerned that this misapplication of the doctrine of double effect can consequently impair physicians’ ethical reasoning and relationships with patients at the end of life. (shrink)

For half a century, Ernest Fortin's scholarship has charmed and educated theologians and philosophers with its intellectual search for the best way to live. Written by friends, colleagues, and students of Fortin, this book pays tribute to a remarkable thinker in a series of essays that bear eloquent testimony to Fortin's influence and his legacy. A formidable commentator on Catholic philosophical and political thought, Ernest Fortin inspired others with his restless inquiries beyond the boundaries of conventional scholarship. With essays on (...) subjects ranging across philosophy, political science, literature, and theology Gladly to Learn and Gladly to Teach reflects the astonishing depth and breadth of Fortin's contribution to contemporary thought. (shrink)

Background In end-of-life situations, the phrase “do everything” is sometimes invoked by physicians, patients, or substitute decision-makers, though its meaning is ambiguous. We examined instances of the phrase “do everything” in the archive of the Ontario Consent and Capacity Board in Canada, a tribunal with judicial authority to adjudicate physician–patient conflicts in order to explore its potential meanings. Methods We systematically searched the CCB’s online public archive from its inception to 2018 for any references to “do everything” in the context (...) of critical care medicine and end-of-life care. Two independent assessors reviewed decisions, collected characteristics, and identified key themes. Results Of 598 cases in the archive, 41 referred to “do everything” in end-of-life situations. The phrase was overwhelmingly invoked by SDMs, typically to advocate for life-prolonging measures that contradicted physician advice. Physicians generally related “doing everything” to describe the interventions they had already performed, using it to recommend focusing on patients’ quality of life. SDMs were generally reluctant to accept death, whereas physicians found prolonging life at all costs to be morally distressing. The CCB did not interpret appeals to “do everything” legally but followed existing laws by deferring to patients’ prior wishes whenever known, or to concepts of “best interests” when not. The CCB generally recommended against life-prolonging measures in these cases, focusing on patients’ “well-being” and “best interests.” Conclusions In this unique sample of cases involving conflict surrounding resuscitation and end-of-life care, references to “do everything” highlighted conflicts over quantity versus quality of life. These appeals were associated with signs of cognitive distress on the behalf of SDMs who were facing the prospect of a patient’s death, whereas physicians identified moral distress related to the prolongation of patients’ suffering through their use of life-sustaining interventions. This divergence in perspectives on death versus suffering was consistently the locus of conflict. These findings support the importance of tools such as the Serious Illness Conversation Guide that can be used by physicians to direct conversations on the patients’ goals, wishes, trade-offs, and to recommend a treatment plan that may include palliative care. Trial Registration Not applicable. (shrink)

For half a century, Ernest Fortin's scholarship has charmed and educated theologians and philosophers with its intellectual search for the best way to live. Written by friends, colleagues, and students of Fortin, this book pays tribute to a remarkable thinker in a series of essays that bear eloquent testimony to Fortin's influence and his legacy. A formidable commentator on Catholic philosophical and political thought, Ernest Fortin inspired others with his restless inquiries beyond the boundaries of conventional scholarship. With essays on (...) subjects ranging across philosophy, political science, literature, and theology Gladly to Learn and Gladly to Teach reflects the astonishing depth and breadth of Fortin's contribution to contemporary thought. (shrink)

Jablonka & Lamb (J&L) reject but memetics can explain human uniqueness and culture (as a product of the ability to imitate) without depending on their slippery notion of symbolism. Modern memes show the beginnings of a division into replicators and vehicles, and the replacement of reconstructive processes with systems of blind copying, variation, and selection.

Dolly is a lamb that was cloned by Dr. Ian Wilmut, a Scottish embryologist. But she is also a Rorschach test. The public response to the production of a lamb by cloning a cultured cell line reflects the futuristic fantasies and Frankenstein fears that have more broadly surrounded research in genetics and especially genetic engineering. Cloning was a term originally applied to a botanical technique of asexual reproduction. But following early experiments in the manipulation of the hereditary and (...) reproductive process during the mid-1960s, the term became associated with human biological engineering. It also became a pervasive theme in horror films and science fiction fantasies. Appearing to promise both amazing new control over nature and terrifying dehumanization, cloning has gripped the popular imagination. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Response to Susan Laird, “Musical Hunger: A Philosophical Testimonial of Miseducation”Estelle R. JorgensenSusan Laird’s lament of her “musical under-education,” her youthful lack of opportunity for the sorts of experiences for which she hungered and its life-long after-effects, and her invocation of hunger as a metaphor for music education raise compelling questions. In a feminized field such as music, particularly piano playing, her hunger is particularly poignant. Also, (...) the notion of “musical taste” takes on new meaning, and the musical, educational, and ethical questions this metaphor evokes reveal its richness as a means of thinking about music education. This metaphor joins others such as Barbara Thayer Bacon’s metaphor of the quilt, Jane Roland Martin’s metaphor of the home, Iris Yob’s metaphor of pilgrimage, Elizabeth Gould’s metaphor of the nomad, Virginia Richardson’s metaphor of the steward, and Randall Allsup’s metaphor of the garage band, each of which illumines music education differently.1 Without one, we miss important insights into the thought and practice of music education; when taken together, they offer a richer view than were we to see music education in terms of one alone. [End Page 75]Although metaphor evokes imaginative thought and practice in music education, it is also limited. As Nelson Goodman aptly puts it, metaphor is a “matter of teaching an old word new tricks” and an “expedition abroad in which associations with one realm are applied in another.”2 Its power lies in its evocative and imaginative quality as it startles and surprises, challenges familiar ways of thinking and doing, and opens new possibilities for how we might think, act, and be differently. Although Laird would not want to literalize musical hunger or equate it with physical hunger—physical and spiritual realms intersect but they are not equivalent—it is possible to freeze a metaphor or literalize the vitality out of it. Testing it systematically, we enter the ground between metaphor and model, or what Iris Yob thinks of as the metaphorical model.3 While metaphor may prompt an intellectual journey, it cannot take us the entire way. In its particularistic and imaginative appeal, it opens reflection though it cannot suffice. A metaphor may also have a dark side. For example, envisaging the teacher’s role as salvific in providing bread for the hungry or preventing gluttony or food addictions may foster a paternalistic view that substitutes the teacher’s view of a student’s long term interests for the student’s directly-known and immediately perceived needs and interests, thereby subverting Laird’s expressed interest in the student’s desires. The educational “sin” of addiction may also be “redeemed” in Schefflerian fashion by pointing to important contributions of musicians who were doubtless excessive in their musical engagements.4 These possibilities suggest that we shall need to examine critically the metaphor and what it means for music education and move beyond the metaphor to its related models of music education.One of the interesting questions that Laird’s metaphor of hunger raises is the possibility of spiritual hunger, especially in a pervasively materialistic world. Matters related to spirituality have been addressed variously by writers in music education, whether it be the “healing” and ecologically-oriented approach of June Boyce-Tillman, the evolutionary and anthropologically grounded holistic approach of Anthony Palmer, the ethically-based approach of David Carr, the introspective and politically-charged writing of Cathy Benedict and Randall Allsup, the feminist perspectives of Elizabeth Gould, Charlene Morton, Roberta Lamb, and Deanne Bogdan, or the religiously grounded work of Iris Yob.5 Notions of spiritual hunger might be seen differently within the various lenses that these writers bring to music education but they all underscore the importance of knowing that goes beyond the literal, utilitarian, generalizable, and vocational to address the life of mind and body that Susanne Langer terms “feeling” and with which the arts, myths, rituals, and religions have to do.6 As such, they rebuke general education that is limited to reading, writing, and arithmetic, and driven by tests, standards, and mandates that often give short shrift to matters of human spirituality. Still, as the recent unanimous resolution in favor of... (shrink)

With the coronavirus outbreak, new and strengthened norms of plastic dependency emerged in the Middle East and North Africa region through the desperate demand for products like face masks and other personal protective equipment, highlighting the tradeoffs between health and the environment. While the rise in demand has been considered as temporary, behavioral barriers and misperceptions might make these norms particularly sticky and hinder society’s ability to transition to a circular economy. Fortunately, behavioral science offers valuable insights about why the (...) current pandemic can actually be a catalyst to create new eco-conscious behaviors. As some behaviors are often strenuous to change and require enforcement through traditional policy solutions, behavioral science offers complementary tools that will make policies more effective. We have an opportunity to start thinking about ways to leverage behavioral insights to create new norms that promote a circular economy while ultimately ensuring proper adherence to hygiene practices to curb the spread of the virus. (shrink)

Why Theories of Concepts Should Not Ignore the Problem of Acquisition.

Confessional modes of self-representation have become crucial in feminist epistemologies that broaden and contextualize the location and production of knowledge. In some versions of confessional feminism, the insertion of “I” is reflective, the product of an uncomplicated notion of experience that shuttles into academic discourse apersonal truth. In contrast to reflective intrusions of the first person, reflexive confessing is primarily a questioning mode that imposes self-vigilance on the process of self positioning.

In this paper I examine the particularist attack on deductive uses of moral principles, reviewing the critiques of the uniformity of moral reasons and impartiality in ethics, looking principally at arguments from Larry Blum, Jonathan Dancy, and Margaret Walker. I defend the action-guiding-ness of moral principles themselves, but consider various ways to accommodate the objections coming fromparticularism. I conclude that one objection to the impartialist theory of value must be conceded without qualification: generalism is unable to account for the unique (...) and irreplaceable value of individual persons. I present an example which supports my view andshows that, in the context of lived experience, replaceability is contradicted. Indeed there may be few constants of value in the narrative of one’s life, as experiences overlay supposed constants with continual new shading, and create even deeper sorts of transformation in valuing. In the end, both particularized moral judgment and the articulation of fact with principle contribute to moral discernment. (shrink)

This article examines two questions pertaining to the extension of infertility treatment to postmenopausal women. First, what concepts and principles of infertility practice apply to assisted reproduction for the postmenopausal patient? Second, what role should these concepts play in the development of an ethical justification for extending women's reproductive lives past the menopausal boundary? The argument offered here supports their claim to infertility services on the basis of the formal principle of justice, which requires that similar cases be treated similarly. (...) The cases of many postmenopausal patients are argued to be relevantly similar to classes of patients who already receive assistance in reproduction. (shrink)

Is the lower rate of kidney transplantation into African Americans medically and ethically justifiable? Or is it a form of racial discrimi nation comparable to if not worse than denial of employment opportunities, housing, and educational opportunities? This essay focusses on the medical problems associated with matching antigens in donors and recipients, and the implications of those problems for social justice.1 Racially discriminatory practices in bank lending, education, and hiring provide a context for understanding how medical criteria treat black recipients (...) unfairly. Although antigen matching is only one aspect of the general problem of finding medically suitable black recipients, it presents an especially interesting challenge for theories of justice, as well as for medical research. (shrink)

Kant objects on principle to any duty of moral self-perfection that would aim at the moral self-perfection of another person. Yet, despite the apparent barrier posed by the introspective technique of self-perfecting effort, I argue that such a duty is both possible and desirable as a part of moral friendship. Through mutual sincere efforts at self-disclosure, we escape the prison of mutual distrust which otherwise characterizes social life and consolidate the very sincerity necessary for moral improvement.

In this paper, I take up the conciliatory-steadfast debate occurring within social epistemology in regards to the phenomenon of peer disagreement. I will argue, because the conciliatory perspective al-lows us to understand argumentation pragmatically—as a method of problem-solving within a community rather than as a method for obtaining the truth—that in most cases, we should not simply agree to disagree.

In this response to David Rondel’s Pragmatist Egalitarianism, I suggest that the disagreement between vertical egalitarians and horizontal egalitarians has deeper roots than Rondel acknowledges. Using feminist egalitarianism as my example, I suggest that this is because Rondel fails to note that horizontal egalitarians do not merely offer an alternative account of the sites of and remedies for inequality than do vertical egalitarians; they also see vertical egalitarianism itself as contributing to inequality. Yet I also contend that, even though the (...) two sides of the vertical-horizontal debate are more divided than Rondel lets on, a pragmatist egalitarianism, because of its emphasis on problem-solving, is still able to circumvent this debate. (shrink)

This book contains diverse and critical reflections on Richard Rorty’s contributions to ethics, an aspect of his thought that has been relatively neglected. Together, they demonstrate that Rorty offers a compelling and coherent ethical vision. The book's chapters, grouped thematically, explore Rorty’s emphasis on the importance of moral imagination, social relations, language, and literature as instrumental for ethical self-transformation, as well as for strengthening what Rorty called "social hope," which entails constant work toward a more democratic, inclusive, and cosmopolitan society (...) and world. -/- Several contributors address the ethical implications of Rorty’s commitment to a vision of political liberalism without philosophical foundations. Others offer critical examinations of Rorty’s claim that our private or individual projects of self-creation can or should be held apart from our public goals of ameliorating social conditions and reducing cruelty and suffering. Some contributors explore hurdles that impede the practical applications of certain of Rorty's ideas. -/- The Ethics of Richard Rorty will appeal to scholars and advanced students interested in American philosophy and ethics. (shrink)

Richard Rorty’s neopragmatism is more similar to the self-described pragmatisms of his contemporaries Jürgen Habermas and Hilary Putnam than it is dissimilar from them. Indeed, the only significant difference between Rorty’s views and those of his interlocutors, and what forms the basis of their many public exchanges, is their respective stances toward the status of epistemic norms. Rorty’s arguments against Habermas’s endorsement of transcendental conditions that ground successful communication, and against Putnam’s contention that there exists a limit conception of truth (...) upon which the possibility for critique depends speak to the very heart of his philosophical differences from the Kantian pragmatisms of Habermas and Putnam. -/- This paper engages in a detailed exploration of the debates between Rorty and Habermas and between Rorty and Putnam over these matters. These debates provide us with a direct route to understanding Rorty’s own views on epistemic norms. That is, the comparison between his own position and those of his fellow neopragmatists throws into sharp relief Rorty’s belief in the radical contingency of epistemic norms. -/- This exploration profits from engaging a feminist lens because feminist critiques, specifically of Habermas’s work, draw attention to the inadequacies of his views that Rorty seeks to correct, inadequacies that can be easily translated to Putnam’s case as well. By approaching this issue from a feminist angle, the paper highlights the dissimilarities in the theoretical positions between Rorty and his contemporaries, and shows why this difference is more significant than it might seem at first blush. The paper concludes with the suggestion that Rorty’s emphasis on the radical contingency of epistemic norms can provide a basis for the kind of revolutionary social, political, and cultural change that is central to much recent feminist theory. (shrink)

Alexandre Gajevic Sayegh presents an intriguing interdisciplinary exploration of climate justice policy issues. He argues the important point that justice must be a key element of any climate regim...

How we assess current calls for vigorous, or “radical”, enhancement through befitting procreative choices depends in part on the plausibility of supporters’ rejecting all substantive ties between their views and earlier eugenics. When denying such connections, today’s advocates of vigorous enhancement routinely emphasize that enhancement decisions would stem from individuals and families, not the state. In a multipronged critique, I show the untenability of transhumanists’ denials.

This book explores an ethical value central to all mental health professions. Although "dignity" appears near the beginning of many codes of ethics, it has been largely unexamined in the professional literature. Potter Stewart famously declared about pornography that we can't define it but we know it when we see it. Likewise with dignity. This book addresses that gap. The book considers the role of dignity as an ethical dimension of practice: in individual psychotherapeutic and psychoanalytic work; in the therapeutic (...) community; and in groups, organizations and nations. It outlines dignity in individual development and families, the role of dignity violations in the understanding and treatment of trauma, and how dignity and its violations can be a powerful force in conflict resolution. The book will also address dignity in relations to specific populations, with chapters on the African-American and the LGBT experiences. Listening, with the question of dignity in mind, offers a fresh non-pathologizing framework for the practitioner. (shrink)

Thomas & Karmiloff- Smith show that the assumption of residual normality does not hold in connectionist simulations, and argue that RN has been inappropriately applied to childhood disorders. We agree. However, we suggest that the RN hypothesis may never have been fully viable, either empirically or computationally.

This article challenges the widespread assumption that Plato’s valuation of medicine remains steady across the corpus. While Plato’s opposition to poetry and sophistry/rhetoric endures, in the Laws he no longer views medicine as a rival concerning phusis and eudaimonia. Why is this dispute laid to rest, even as the others continue? This article argues that the Laws’ developments with a bearing onmedicine stem ultimately from the philosopher-ruler’s disappearance. The deeper appreciation of good medical practice that ensues, combined with an array (...) of sociopolitical mechanisms for detecting injustice, means that the health care setting is no longer—as in the Republic—the crossroads where judgments of the whole person must be made. For the first time, by Plato’s lights, medicine may be a truly self-standing technē. (shrink)

The Animal Ethics Reader is an acclaimed anthology containing both classic and contemporary readings, making it ideal for anyone coming to the subject for the first time. It provides a thorough introduction to the central topics, controversies and ethical dilemmas surrounding the treatment of animals, covering a wide range of contemporary issues, such as animal activism, genetic engineering, and environmental ethics. The extracts are arranged thematically under the following clear headings: Theories of Animal Ethics Nonhuman Animal Experiences Primates and Cetaceans (...) Animals for Food Animal Experimentation Animals and Biotechnology Ethics and Wildlife Zoos and Aquariums Animal Companions Animal Law and Animal Activism Readings from leading experts in the field including Peter Singer, Bernard E. Rollin and Jane Goodall are featured, as well as selections from Tom Regan, Jane Goodall, Donald Griffin, Temple Grandin, Ben A. Minteer, Christine Korsgaard and Mark Rowlands. Classic extracts are well balanced with contemporary selections, helping to present the latest developments in the field. This revised and updated _Third Edition_ includes 31 new readings on a range of subjects, including animal rights, captive chimpanzees, industrial farm animal production, genetic engineering, keeping cetaceans in captivity, animal cruelty, and animal activism. The _Third Edition _also is printed with a slightly larger page format and in an easier-to-read typeface. Featuring contextualizing introductions by the editors, study questions and further reading suggestions as the end of each chapter, this will be essential reading for any student taking a course in the subject. With a new foreword by Bernard E. Rollin. (shrink)