Darwin’s classic ‘Origin of Species’ (Darwin 1859) described forces of selection acting upon individuals, but there remains a great deal of controversy about what exactly the status and definition of a biological individual is. Recently some authors have argued that the individual is dispensable – that an inability to pin it down is not problematic because little rests on it anyway. The aim of this paper is to show that there is a real problem of biological individuality, and an urgent (...) need to arbitrate over the current plethora of solutions to it. (shrink)

One of the major aims of this article is to provide the theoretical account of mindfulness provided by the systematic Abhidharma epistemology of conscious states. I do not claim to present the one true version of mindfulness, because there is not one version of it in Buddhism; in addition to the Abhidharma model, there is, for example, the nondual Mahāmudrā tradition. A better understanding of a Buddhist philosophical framework will not only help situate meditation practice in its originating tradition, but (...) it will also clarify a Buddhist perspective on consciousness. In this article, I present the Abhidharma account of mindfulness—as explicated in the Abhidharmakośa, the root text for the Abhidharma tradition—and the theoretical model of the mind that underlies its practice. Abhidharma–Yogācara model of the mind, I believe, contains critical philosophical insights relevant to contemporary concerns while at the same time placing mindfulness meditation in its proper philosophical context. (shrink)

What makes something a part of my body, for moral purposes? Is the body defined naturalistically: by biological relations, or psychological relations, or some combination of the two? This paper approaches this question by considering a borderline case: the status of prostheses. I argue that extant accounts of the body fail to capture prostheses as genuine body parts. Nor, however, do they provide plausible grounds for excluding prostheses, without excluding some paradigm organic parts in the process. I conclude by suggesting (...) that embodiment is moralized all the way down: to be a body part is to be the sort of thing that ought to be protected, in a certain way, by social practices. (shrink)

In the UK and beyond, Down's syndrome screening has become a universal programme in prenatal care. But why does screening persist, particularly in light of research that highlights pregnant women's ambivalent and problematic experiences with it? Drawing on an ethnography of Down's syndrome screening in two UK clinics, Thomas explores how and why we are so invested in this practice and what effects this has on those involved. Informed by theoretical approaches that privilege the mundane and micro practices, discourses, materials, (...) and rituals of everyday life, Down's Syndrome Screening and Reproductive Politics describes the banal world of the clinic and, in particular, the professionals contained within it who are responsible for delivering this programme. In so doing, it illustrates how Down's syndrome screening is 'downgraded' and subsequently stabilised as a 'routine' part of a pregnancy. Further, the book captures how this routinisation is deepened by a systematic, but subtle, framing of Down's syndrome as a negative pregnancy outcome. By unpacking the complex relationships between professionals, parents, technology, policy, and clinical practice, Thomas identifies how and why screening is successfully routinised and how it is embroiled in both new and familiar debates surrounding pregnancy, ethics, choice, diagnosis, care, disability, and parenthood. The book will appeal to academics, students, and professionals interested in medical sociology, medical anthropology, science and technology studies, bioethics, genetics, and/or disability studies. (shrink)

In this article, we sketch how theoretical neuroethics can clarify the concept of autonomy. We hope that this can both serve as a model for the conceptual clarification of other components of PIAAAS and contribute to the development of the empirical measures that Gilbert and colleagues [1] propose.

In this article, we sketch how theoretical neuroethics can clarify the concept of autonomy. We hope that this can both serve as a model for the conceptual clarification of other components of PIAAAS and contribute to the development of the empirical measures that Gilbert and colleagues [1] propose.

When a new, brain-based definition of death was proposed fifty years ago, no one realized that the issue would remain unresolved for so long. Recently, six new controversies have added to the debate: whether there is a right to refuse apnea testing, which set of criteria should be chosen to measure the death of the brain, how the problem of erroneous testing should be handled, whether any of the current criteria sets accurately measures the death of the brain, whether standard (...) criteria include measurements of all brain functions, and how minorities who reject whole-brain-based definitions should be accommodated. These controversies leave little hope of consensus on how to define death for social and public policy purposes. Rather, there is persistent disagreement among proponents of three major groups of definitions of death: whole-brain, cardiocirculatory or somatic, and higher-brain. Given the persistence and reasonableness of each of these groups of definitions, public policy should permit individuals and their valid surrogates to choose among them. (shrink)

For decades, physicians, philosophers, theologians, lawyers, and the public considered brain death a settled issue. However, a series of recent cases in which individuals were declared brain dead yet physiologically maintained for prolonged periods of time has challenged the status quo. This signals a need for deeper reflection and reexamination of the underlying philosophical, scientific, and clinical issues at stake in defining death. In this paper, I consider four levels of philosophical inquiry regarding death: the ontological basis, actual states of (...) affairs, epistemological standards, and clinical criteria for brain death. I outline several candidates for the states of affairs that may constitute death, arguing that we should strive for a single, unified ontological definition of death as a loss of integrated functioning as a unified organism, while acknowledging that two states of affairs may satisfy this concept. I argue that the clinical criteria for determining whole-brain death should be bolstered to meet the epistemic demand of sufficient certainty in defining death by adding indicators of cerebro-somatic dis-integration to the traditional triad of loss of consciousness, loss of brainstem function, and absence of confounding explanations. (shrink)

In the near future developments in non-invasive prenatal testing may soon provide couples with the opportunity to test for and diagnose a much broader range of heritable and congenital conditions than has previously been possible. Inevitably, this has prompted much ethical debate on the possible implications of NIPT for providing couples with opportunities for reproductive choice by way of routine prenatal screening. In view of the possibility to test for a significantly broader range of genetic conditions with NIPT, the European (...) Society of Human Genetics and American Society of Human Genetics recommend that, pending further debate, prenatal screening for reproductive choice should only be offered where concerning serious congenital conditions and childhood disorders. In support of this recommendation, the ESHG and ASHG discuss a number of ethical issues on which they prompt further debate: the informational privacy of the future child, the trivialization of abortion, the risk of information overload, and issues of distributive justice. This paper responds to this call with further reflection on each ethical issue and how it relates to the moral justification of providing couples with opportunities for meaningful reproductive choice. The paper concludes that whilst there may be good reasons for qualifying the scope of any unsolicited prenatal screening offer to serious congenital conditions and childhood disorders, if prenatal screening is justified for providing couples with opportunities for meaningful reproductive choice, then health services may have obligations to empower couples with the same opportunity where concerning other conditions. (shrink)

Recently, there has been a lot of enthusiasm for mindfulness practice and its use in healthcare, businesses and schools. An increasing number of studies give us ground for cautious optimism about the potential of mindfulness-based interventions (MBIs) to improve people's lives across a number of dimensions. This paper identifies and addresses some of the main ethical and political questions for larger-scale MBIs. First, how far are MBIs compatible with liberal neutrality given the great diversity of lifestyles and conceptions of the (...) good characteristic of modern societies? It will be argued that the potential benefits of contemporary secular mindfulness practice are indeed of a sufficiently primary or all-purpose nature to qualify as suitable goals of liberal public policy. Second, what challenges are brought up if mindfulness is used in contexts and applications—such as military settings—whose goals seem incompatible with the ethical and soteriological views of traditional mindfulness practice? It will be argued that, given concerns regarding liberal neutrality and reasonable disagreement about ethics, MBIs should avoid strong ethical commitments. Therefore, it should, in principle, be applicable in contexts of controversial moral value. Finally, drawing on recent discussions within the mindfulness community, it is argued that we should not overstate the case for mindfulness and not crowd out discussion of organisational and social determinants of stress, lowered well-being, and mental illness and the collective measures necessary to address them. (shrink)

Is implementing the beneficent nudge program morally permissible in worlds like ours? I argue that there is reason for serious doubt. I acknowledge that beneficent nudging is highly various, that nudges are in some circumstances morally permissible and even called for, and that nudges may exhibit respect for genuine autonomy. Nonetheless, given the risk of epistemic injustice that nudges typically pose, neither the moral permissibility of beneficent nudging in the abstract, nor its case-by-case vindication, appears sufficient to justify implementing a (...) nudge program in worlds like ours. Drawing on Miranda Fricker’s account of epistemic injustice, I argue that the cogent defense of any nudge program, relative to worlds like ours, stands in need of serious attention to its potential for fostering or sustaining epistemic injustice. A more specific point hinges on recognizing a form of epistemic injustice not enough attended to in the literature to date, which I call reflective incapacitational injustice. This includes relative disadvantages in the attaining of the capacity to engage in critical reason, such as the capacity to go in for potentially critical reasoned deliberation and discursive exchange concerning ends. Since Cass Sunstein’s First Law of behaviorally informed regulation would be taken, in worlds like ours, to justify indeterminately many nudges leading to such epistemic injustice we have general grounds for doubting the moral permissibility of this nudge program. We should hence oppose the implementation of any such program until it is shown not to violate the demands of epistemic justice. (shrink)

Patients who experience difficulty making medical decisions are often referred to as “ambivalent.” However, the current lack of attention to the nuances between a cluster of phenomena that resemble...

Many people believe in the intention principle, according to which an agent’s intention in performing an act can sometimes make an act that would otherwise have been permissible impermissible, other things being equal. Judith Jarvis Thomson, Frances Kamm and Thomas Scanlon have offered cases that seem to show that it can be permissible for an agent to act even when the agent has bad intentions. If valid, these cases would seem to cast doubt on the intention principle. In this paper, (...) I point out that these cases have confounding factors that have received little attention in the literature. I argue that these confounding factors undermine the putative force of these cases against the intention principle. Indeed, when cases without these confounding factors are considered, it becomes clear, so I argue, that intentions can be relevant for the permissibility of an act. (shrink)

Is the mammalian embryo/fetus a part of the organism that gestates it? According to the containment view, the fetus is not a part of, but merely contained within or surrounded by, the gestating organism. According to the parthood view, the fetus is a part of the gestating organism. This paper proceeds in two stages. First, I argue that the containment view is the received view; that it is generally assumed without good reason; and that it needs substantial support if it (...) is to be taken seriously. Second, I argue that the parthood view derives considerable support from a range of biological and physiological considerations. I tentatively conclude in favour of the parthood view, and end by identifying some of the interesting questions it raises. (shrink)

Mammalian placental pregnancy is a neglected problem case for theories of organismality. This example is closer to home than those typically discussed within philosophy of biology. I apply evolutio...

Forthcoming, Journal of Philosophy [pdf manuscript].

Introduction : death, metaphysics, and morality / John Martin Fischer Death knocks / Woody Allen Rationality and the fear of death / Jeffrie G. Murphy Death / Thomas Nagel The Makropulos case : reflections on the tedium of immortality / Bernard Williams The evil of death / Harry S. Silverstein How to be dead and not care : a defense of Epicurus / Stephen E. Rosenbaum The dead / Palle Yourgrau The misfortunes of the dead / George Pitcher Harm to (...) others / Joel Feinberg Reasons and persons / Derek Parfit Why is death bad? / Anthony L. Brueckner and John Martin Fischer Death and the value of life / Jeff McMahan Annihilation / Steven Luper-Foy Epicurus and annihilation / Stephen E. Rosenbaum Some puzzles about the evil of death / Fred Feldman Well-being and time / J. David Velleman. (shrink)

Recent animal research suggests that it may soon be possible to support the human fetus in an artificial uterine environment for part of a pregnancy. A technique of extending gestation in this way (“ectogestation”) could be offered to parents of extremely premature infants (EPIs) to improve outcomes for their child. The use of artificial uteruses for ectogestation could generate ethical questions because of the technology’s potential impact on the point of “viability”—loosely defined as the stage of pregnancy beyond which the (...) fetus may survive external to the womb. Several medical decisions during the perinatal period are based on the gestation at which infants are considered viable, for example decisions about newborn resuscitation and abortion, and ectogestation has the potential to impact on these. Despite these possible implications, there is little existing evidence or analysis of how this technology would affect medical practice. In this paper, we combine empirical data with ethical analysis. We report a survey of 91 practicing Australian obstetricians and neonatologists; we aimed to assess their conceptual understanding of “viability,” and what ethical consequences they envisage arising from improved survival of EPIs. We also assess what the ethical implications of extending gestation should be for newborn and obstetric care. We analyze the concept of viability and argue that while ectogestation might have implications for the permissibility of neonatal life‐prolonging treatment at extremely early gestation, it should not necessarily have implications for abortion policy. We compare our ethical findings with the results of the survey. (shrink)

Claims about needs are a ubiquitous feature of everyday practical discourse. It is therefore unsurprising that needs have long been a topic of interest in moral philosophy, applied ethics, and political philosophy. Philosophers have devoted much time and energy to developing theories of the nature of human needs and the like. -/- Philosophers working on needs are typically committed to the idea that there are different kinds of needs and that within the different kinds of needs is a privileged class (...) of needs that is especially normatively significant. -/- Some philosophers go further and make rather grand claims about needs. They claim that needs are central or fundamental to moral thinking and that we must have a needs-centred moral theory or a general reorientation of moral philosophy around needs. -/- In this paper I aim to do two things. First, to show how applying recent work on modal terms can help us to understand thought and talk about needs. This is the positive part. I then use these ideas to cast doubt on the more ambitious claims about needs. Put briefly, a proper understanding of claims about needs undermines the idea that the concept of needs is fundamental in moral thought or in moral philosophy. Ambitious needs theory fails. (shrink)

There is a strong moral presumption against the use of coercion, and those who are coerced seem to be less responsible for the actions they were coerced to perform. Both these considerations seem to reflect the effect of coercion on the victim’s choice. This paper examines three ways of understanding this effect. First, I argue against understanding victims as unable to engage in genuine action. Next, I consider the suggestion that victims are unable to consent to participate in the coercer’s (...) plan. Although this suggestion is promising, I argue that the inability to consent reflects a more basic problem. Victims are unable to exercise what I call ‘normative authority’: they are unable to make discretionary changes in the permissions and obligations that they and others have. This final account yields a compelling understanding of why coercion is impermissible when it is and reveals a unique way in which impermissible coercion affects the responsibility of victims. (shrink)