Choice is probably one of the most often discussed areas in bioethics, alongside the related concepts of informed consent and autonomy. It is generally, prima facie, portrayed as a good thing. In healthcare, the 2000s saw the UK Prime Minister Tony Blair pursue the ‘Choice Agenda’ where, ‘As capacity expands, so choice will grow. Choice will fundamentally change the balance of power in the NHS.’1 In a consumerist society giving consumers more choice is seen as desirable. However, choice is not (...) a good in itself, giving people more choice in certain situations can be problematic: i.e. consumerism drives economic growth and this has a detrimental effect on the environment; and increasing the range of choices a patient is offered is often not the best way to improve the quality of healthcare provision.2 The assumptions behind the valuing of choice need careful unpacking and this Issue of the Journal of Medical Ethics includes papers that explore choice in a number of areas. This Issue's Editor’s choice is Tom Walker’s ‘The Value of Choice’,3 which puts forward a suggestion for the importance of the symbolic value of choice. There are a number of ways of categorising the value of choice in healthcare. One account sees choice as valuable because it is by choosing that individuals make their life their own. Another account sees choice as valuable for instrumental reasons, people are generally, assuming they are sufficiently informed, the best judge of their own best interests. Walker argues for an additional third reason, the symbolic value of choice, originally proposed by Scanlon. This sees choice as valuable because being given the option to choose, whether or not one takes it up, not the act of choosing is what makes choice valuable. Being offered the option to choose has a …. (shrink)

Regan provides the theoretical framework that grounds a responsible pro-animal rights perspective, and ultimately explores how asking moral questions about other animals can lead to a better understanding of ourselves.

“Applied ethics” has been the major growth area in North American philosophy in the last decade, yet a robust confidence and enthusiasm over its promise is far from universal in academic philosophy. It is considered nonphilosophical in West Germany, and has largely failed to penetrate British departments of philosophy. Whether it has any intellectually or pedagogically redeeming value is still widely debated in North America, where many who have tried to teach some area of applied ethics for the first time (...) have seen their courses grind to a halt in unresolvable quandaries, practical exigencies, or unavailable technical information. Consequently, some departments are at war over whether to hire or confer tenure on those who teach these subjects. Many also remain unconvinced that philosophical generalizations or theories can play any significant role in applied contexts. They may even doubt both that applied ethics is really ethics and that philosophy should accomodate this creature in its curriculum. (shrink)

An argument is examined and defended for extending basic moral rights to animals which assumes that humans, including infants and the severely mentally enfeebled, have such rights. It is claimed that this argument proceeds on two fronts, one critical, where proposed criteria of right-possession are rejected, the other constructive, where proposed criteria are examined with a view to determining the most reasonable one. This form of argument is defended against the charge that it is self-defeating, various candidates for the title, (...) 'most reasonable criterion of right-possession', are critically examined, and it is argued that this criterion is to be found in the notion of inherent value: What underlies the ascription of rights to any given x is that x has value logically independently of anyone's valuing x; thus, to treat x as if x had value only if or as it served one's interests, etc., is to violate x 's rights. It is argued that many animals, owing to their being subjects of a life that is more or less valuable for them logically independently of the interests of others, can satisfy this criterion and therefore have certain basic moral rights, if humans, including the severely mentally enfeebled, do. Finally, the question, What basic moral rights do animals have? is explored. (shrink)

The frequency of death from miscarriage is very high, greater than the number of deaths from induced abortion or major diseases.Berg (2017, Philosophical Studies 174:1217–26) argues that, given this, those who contend that personhood begins at conception (PAC) are obliged to reorient their resources accordingly—towards stopping miscarriage, in preference to stopping abortion or diseases. This argument depends on there being a basic moral similarity between these deaths. I argue that, for those that hold to PAC, there are good reasons to (...) think that there is no such similarity. There is a morally relevant difference between preventing killing and letting die, giving PAC supporters reasons to prioritize reducing abortion over reducing miscarriage. And the time-relative interest account provides a morally relevant difference in the badness of death of miscarriages and deaths of born adults, justifying attempts to combat major diseases over attempts to combat miscarriage. I consider recent developments in the literature and contend that these new arguments are unsuccessful in establishing moral similarities between deaths from miscarriage and abortion, and deaths from miscarriage and disease. (shrink)

It is generally held that doctors and researchers have an obligation to obtain informed consent. Over time there has been a move in relation to this obligation from a requirement to disclose information to a requirement to ensure that that information is understood. Whilst this change has been resisted, in this article I argue that both sides on this matter are mistaken. When investigating what information is needed for consent to be informed we might be trying to determine what information (...) a person would need in order to consent at all, or we might be trying to determine what information a person needs in order to make an informed choice about whether or not to consent. I argue that the obligation to ensure understanding only applies to information generated by the first type of enquiry; but that much of the information generally thought necessary in order for consent to be informed is only required if our concern is with the second type of enquiry. For this reason it is neither the case that doctors and researchers should ensure all the information they provide is understood, nor is it the case that their only obligation is to disclose it. (shrink)

There is widespread agreement that it would be both morally and legally wrong to treat a competent patient, or to carry out research with a competent participant, without the voluntary consent of that patient or research participant. Furthermore, in medical ethics it is generally taken that that consent must be informed. The most widely given reason for this has been that informed consent is needed to respect the patient’s or research participant’s autonomy. In this article I set out to challenge (...) this claim by considering in detail each of the three most prominent ways in which ‘autonomy’ has been conceptualized in the medical ethics literature. I will argue that whilst these accounts support the claim that consent is needed if the treatment of competent patients, or research on competent individuals, is to respect their autonomy, they do not support the claim that informed consent is needed for this purpose. (shrink)

Argues that there is a puzzle about how our own thick concepts, which motivate us simply because they are our own, can be legitimated in any stronger sense than that, from a perspective which is not an “insider perspective.”.

The notion of a D-ring, generalizing that of a differential or a difference ring, is introduced. Quantifier elimination and a version of the Ax-Kochen-Eršov principle is proven for a theory of valued D-fields of residual characteristic zero.

Technological developments in the sphere of artificial intelligence (AI) inspire debates about the implications of autonomous weapon systems (AWS), which can select and engage targets without human intervention. While increasingly more systems which could qualify as AWS, such as loitering munitions, are reportedly used in armed conflicts, the global discussion about a system of governance and international legal norms on AWS at the United Nations Convention on Certain Conventional Weapons (UN CCW) has stalled. In this article we argue for the (...) necessity to adopt legal norms on the use and development of AWS. Without a framework for global regulation, state practices in using weapon systems with AI-based and autonomous features will continue to shape the norms of warfare and affect the level and quality of human control in the use of force. By examining the practices of China, Russia, and the United States in their pursuit of AWS-related technologies and participation at the UN CCW debate, we acknowledge that their differing approaches make it challenging for states parties to reach an agreement on regulation, especially in a forum based on consensus. Nevertheless, we argue that global governance on AWS is not impossible. It will depend on the extent to which an actor or group of actors would be ready to take the lead on an alternative process outside of the CCW, inspired by the direction of travel given by previous arms control and weapons ban initiatives. (shrink)

On December 15, 2011, a final report was issued by the Committee on the Use of Chimpanzees in Biomedical and Behavioral Research, which had been convened by the U. S. Institute of Medicine (IOM) in collaboration with National Research Council (NRC) of the National Academies. Within a month of its release, this report was designated by Wired Science one of the “top scientific discoveries of 2011” (Wired Science Staff 2011). The ad hoc Committee responsible for this report was formed at (...) the request of the National Institutes of Health (NIH) in response to congressional inquiry that had been prompted by expressions of public concern.1 The issues addressed in the report are profoundly ethical, despite NIH’s .. (shrink)

In a health service with limited resources we must make decisions about who to treat first. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don't know in a particular (...) case that the illness is self-inflicted, that it seems that all illness is self-inflicted in the sense used in my argument, and finally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like fire-fighters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections. (shrink)

This sense of attributability, or internality, is the quarry in many of Frankfurt's articles, and it has proved to be an elusive one. In this paper I want to explore, in a tentative fashion, the question of why we should be interested in finding this quarry. It seems to me that there are at least two quite distinct kinds of reason for this concern, and that when they are distinguished the problem may look less difficult than it has seemed.

In the relatively short time since 2006—when Theoretical Medicine and Bioethics published an issue on moral issues relevant to the use of nonhuman animals in research [1]—significant changes have occurred for nonhuman animals in many quarters. Public sentiment, new policy initiatives, and scientific studies of nonhuman animals’ capacities have all influenced the ways in which nonhuman animals are perceived and treated in research. Today, a large body of information is available for use in decision making about the acceptability of using (...) nonhuman animals in research. The articles in this issue assess how moral argument and empirical studies stand to guide animal research policies and practices in future years.Many in bioethics have come to regard issues of animal research as a subfield of research ethics, bringing it closer to human research ethics. Animal ethics, like public health ethics, has struggled for recognition in bioethics. As the contributions to this issue show, some in bioe. (shrink)

In a recent article, Fabian Freyenhagen argues that we should understand first-generation Frankfurt School critical theory (in particular, the work of Adorno and Horkheimer) as being defined by a kind of ‘linguistic turn’ analogous to one present in the later Wittgenstein. Here, I elaborate on this hypothesis – initially by calling it into question, by detailing Herbert Marcuse’s extensive criticisms of Wittgenstein (and other analytic philosophers of language) in One-Dimensional Man. While Marcuse is harshly critical of analytic ordinary language philosophy, (...) he is much more sympathetic to a different sort of ordinary language philosophy, which he unpacks with reference to Karl Kraus. I show how, by getting Marcuse’s criticisms of Wittgenstein and other analytic philosophers, and lauding of Kraus, into view, we can better understand the first generation of the Frankfurt School as having practised a sort of ‘non-quietistic’ philosophical therapy (that may or may not have been the sort of thing that Wittgenstein himself had in mind). (shrink)

In Rationality and the Genetic Challenge: Making People Better? Matti Häyry provides a clear and informed discussion and analysis of a number of competing answers to the above questions. Häyry describes three main perspectives on the morality of prenatal genetic diagnosis , the “restrictive,” “moderate,” and “permissive” views, and his analysis illuminates that these views can be distinguished in terms of their different “rationalities”—their respective understanding of what counts as a reasonable choice for parents to make in light of PGD.

Ulysses contracts are a method by which one person binds himself by agreeing to be bound by others. In medicine such contracts have primarily been discussed as ways of treating people with episodic mental illnesses, where the features of the illness are such that they now judge that they will refuse treatment at the time it is needed. Enforcing Ulysses contracts in these circumstances would require medical professionals to override the express refusal of the patient at the time treatment is (...) required, something that is generally problematic both ethically and legally. In this paper I will argue that despite appearances Ulysses contracts can make it the case that treating a patient in such circumstances is an instance of treating him with his consent, although safeguards are needed to ensure that this is the case. Given the potential benefits to patients I further argue that modified Ulysses contracts should be made legally enforceable. (shrink)

In this paper, I argue for two principles to determine the temporal interpretation of modal sentences in English, given a theory in which modals are interpreted against double conversational backgrounds and an ontology in which possible worlds branch towards the future, The Disparity Principle requires that a modal sentence makes distinctions between worlds in the modal base. The Non- disparity Principle requires that a modal sentence does not make distinctions on the basis of facts settled at speech time. Selection of (...) the modal base will set these principles against each other, or allow for their cooperative interaction. For a root modal base, there is a conflict and disparity wins. The resulting interpretation is future. For a non-root modal base, the principles cooperate. Non-disparity determines a non-future interpretation and disparity requires the sentence to go beyond what is known by the speaker. (shrink)

It is a particular pleasure to be able to participate in this symposium in honor of Amartya Sen. We agree on a wide range of topics, but I will focus here on an area of relative disagreement. Sen is much more attracted to consequentialism than I am, and the main topic of my paper will be the particular version of consequentialism that he has articulated and the reasons why he is drawn to this view.

Knobe reports that subjects' judgments of whether an agent did something intentionally vary depending on whether the outcome in question was seen by them as good or as bad. He concludes that subjects' moral views affect their judgments about intentional action. This conclusion appears to follow only if different meanings of “intention” are overlooked.

This paper argues for the importance of a passive form of embodiment for educational purposes to capture tacit environmental influences. G. Buck’s account of learning as experience is put in discussion with psychological approaches to reveal the limitation of what psychology can achieve, especially when it comes to situated experiences within educational environments. As a solution to overcome this problem a concept of passive embodiment is developed that allows for a body that is receptive to multisensory environmental influences. Böhme’s concept (...) of atmospheres in relation to Schmitz’ New Phenomenology provide a theoretical framework to understand how these situated experiences are evoked by certain situations. This allows for a new understanding of passive, embodied experiences within educational environments by incorporating the tacit influences of the setting. (shrink)

This text develops students' ability to philosophise and learn about philosophy and education. It challenges readers to use philosophy as a tool within education and as a set of theories to understand education by developing solutions to problems as they occur within practice. Assuming no pre-existing philosophical background, this book explores topics such as: the limits of a religious-based education; the desire for 'alternative facts' or 'truths'; and the struggle in the teacher-student relationship. This book will support all those on (...) Education, Childhood or Youth Studies courses in developing a critical perspective and understanding the true value of philosophy within education. (shrink)