If ever I summon before me my highest ideals of men and medicine, I find them sprung from the spirit of Osler. —Wilder Penfield, M.D. Neuroethics is a recently coined term that is shaping our cultu...

If ever I summon before me my highest ideals of men and medicine, I find them sprung from the spirit of Osler. —Wilder Penfield, M.D. Neuroethics is a recently coined term that is shaping our cultu...

: This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in (...) moral problem solving are discussed. (shrink)

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of (...) carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point - even a backbone - for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge. (shrink)

: This response to Lynn Jansen's critique of clinical pragmatism concentrates on two themes: (1) contrasting approaches to moral epistemology and (2) the connection between theory and practice in clinical ethics. Particular attention is paid to the status of principles and the role of consensus, with some closing speculations on how Dewey might view the current state of bioethics.

Book reviewed in this article: How We Die. By Sherwin B. Nuland. New York: Alfred A. Knopf.

What is truth? What value should we see in or attribute to it? The war over the meaning and utility of truth is at the center of contemporary philosophical debate, and its arguments have rocked the foundations of philosophical practice. In this book, the American pragmatist Richard Rorty and the French analytic philosopher Pascal Engel present their radically different perspectives on truth and its correspondence to reality. Rorty doubts that the notion of truth can be of any practical use and (...) points to the preconceptions that lie behind truth in both the intellectual and social spheres. Engel prefers a realist conception, defending the relevance and value of truth as a norm of belief and inquiry in both science and the public domain. Rorty finds more danger in using the notion of truth than in getting rid of it. Engel thinks it is important to hold on to the idea that truth is an accurate representation of reality. In Rorty's view, epistemology is an artificial construct meant to restore a function to philosophy usurped by the success of empirical science. Epistemology and ontology are false problems, and with their demise goes the Cartesian dualism of subject and object and the ancient problematic of appearance and reality. Conventional "philosophical problems," Rorty asserts, are just symptoms of the professionalism that has disfigured the discipline since the time of Kant. Engel, however, is by no means as complacent as Rorty in heralding the "end of truth," and he wages a fierce campaign against the "veriphobes" who deny its value. _What's the Use of Truth?_ is a rare opportunity to experience each side of this impassioned debate clearly and concisely. It is a subject that has profound implications not only for philosophical inquiry but also for the future study of all aspects of our culture. (shrink)