Interview on the commodified body with Donna Dickenson by Alana Cattapan.

Interview by Klasien Horstman on gender and genetics. 'Unlike many gender theorists, I do not view the body as socially constructed; nor do I share postmodern and deconstructionist disquiet at the notion of a unified subject. Frankly, I think these constructions get in the way of political action and are bad for women’s rights.' -/- .

This article, arising from a comparative European Commission project, analyses different national perspectives on bioethics issues.

It is well known that there is a shortage of human ova for in vitro fertilization (IVF) purposes, but little attention has been paid to the way in which the demand for ova in stem-cell technologies is likely to exacerbate that shortfall and create a trade in human eggs. Because the 'Dolly' technology relies on enucleated ova in large quantities, allowing for considerable wastage, there is a serious threat that commercial and research demands for human eggs will grow exponentially from (...) the combination of these two pressures. In the absence of legal regulation in the United Kingdom, and in the context of a globalized trade in human organs, we face a 'Wild West' situation in genetic and biotechnological research that involves human ova. (shrink)

A central question in the philosophy of science is: What is a law of nature? Different answers to this question define an important schism: Humeans, in the wake of David Hume, hold that the laws of nature are nothing over and above what actually happens and reject irreducible facts about natural modality (Lewis, 1983, 1994; cf. Miller, 2015). According to Non-Humeans, by contrast, the laws are metaphysically fundamental (Maudlin, 2007) or grounded in primitive modal structures, such as dispositional essences of (...) powerful properties (Bird, 2007), necessitation relations (Armstrong, 1983), or primitive subjunctive facts (Lange, 2009). This volume focuses on recent developments in the discussion of Humeanism, specifically on pragmatic versions of the view that put the needs of limited agents like us front and center. (shrink)

Wilfrid Sellars's "Empiricism and the Philosophy of Mind" begins with an argument against sense-datum epistemology. There is some question about the validity of this attack, stemming in part from the assumption that Sellars is concerned with epistemic foundationalism. This paper recontextualizes Sellars's argument in two ways: by showing how the argument of EPM relates to Sellars's 1940s work, which does not concern foundationalism at all; and by considering the view of H.H. Price, Sellars's teacher at Oxford and the only classical (...) datum theorist to receive substantive comment in EPM. Timm Triplett has claimed that Sellars's discussion simply begs the question against Price, but this depends on the mistaken assumption that Sellars's concern is with foundationalism. On the contrary, Sellars's argument concerns the assumption that the innate capacity for sensory experience counts as "thinking in presence" in the way needed for empiricist accounts of content acquisition. Price's distinction between noticing universals and being aware of them encapsulates the tensions empiricists face here. (shrink)

What explains the outcomes of chance processes? We claim that their setups do. Chances, we think, mediate these explanations of outcome by setup but do not feature in them. Facts about chances do feature in explanations of a different kind: higher-order explanations, which explain how and why setups explain their outcomes. In this paper, we elucidate this 'mediator view' of chancy explanation and defend it from a series of objections. We then show how it changes the playing field in four (...) metaphysical disputes concerning chance. First, it makes it more plausible that even low chances can have explanatory power. Second, it undercuts a circularity objection against reductionist theories of chance. Third, it redirects the debate about a prominent argument against epistemic theories of chance. Finally, it sheds light on potential chancy explanations of the Universe's origin. (shrink)

New developments in biotechnology radically alter our relationship with our bodies. Body tissues can now be used for commercial purposes, while external objects, such as pacemakers, can become part of the body. Property in the Body: Feminist Perspectives transcends the everyday responses to such developments, suggesting that what we most fear is the feminisation of the body. We fear our bodies are becoming objects of property, turning us into things rather than persons. This book evaluates how well-grounded this fear is, (...) and suggests innovative models of regulating what has been called 'the new Gold Rush' in human tissue. This is an up-to-date and wide-ranging synthesis of market developments in body tissue, bringing together bioethics, feminist theory and lessons from countries that have resisted commercialisation of the body, in a theoretically sophisticated and practically significant approach. (shrink)

Even in the increasingly individualized American medical system, advocates of 'personalized medicine' claim that healthcare isn't individualized enough. With the additional glamour of new biotechnologies such as genetic testing and pharmacogenetics behind it, 'Me Medicine'-- personalized or stratified medicine-- appears to its advocates as the inevitable and desirable way of the future. Drawing on an extensive evidence base, this book examines whether these claims are justified. It goes on to examine an alternative tradition rooted in communitarian ideals, that of the (...) common good as a goal in medicine. (shrink)

Abstract Gender and Ethics Committees: Where’s the Different Voice? -/- Prominent international and national ethics commissions such as the UNESCO Bioethics Commission rarely achieve anything remotely resembling gender equality, although local research and clinical ethics committees are somewhat more egalitarian. Under-representation of women is particularly troubling when the subject matter of modern bioethics so disproportionately concerns women’s bodies, and when such committees claim to derive ‘universal’ standards. Are women missing from many ethics committees because of relatively straightforward, if discriminatory, demographic (...) factors? Or are the methods of analysis and styles of ethics to which these bodies are committed somehow ‘anti-female’? It has been argued, for example, that there is a ‘different voice’ in ethical reasoning, not confined to women but more representative of female experience. Similarly, some feminist writers, such as Evelyn Fox Keller and Donna Haraway, have asked difficult epistemological questions about the dominant ‘masculine paradigm’ in science. Perhaps the dominant paradigm in ethics committee deliberation is similarly gendered? This article provides a preliminary survey of women’s representation on ethics committees in Eastern and Western Europe, a critical analysis of the supposed ‘masculinism’ of the principlist approach, and a case example in which a ‘different voice’ did indeed make a difference. (shrink)

In this paper I discuss critically Richard Swinburne’s concept of God, which I find to be incoherent, and his understanding of Christianity, which I find to be based on a precritical use of the New Testament.

The controversy over the old ideal of “value-free science” has cooled significantly over the past decade. Many philosophers of science now agree that even ethical and political values may play a substantial role in all aspects of scientific inquiry. Consequently, in the last few years, work in science and values has become more specific: Which values may influence science, and in which ways? Or, how do we distinguish illegitimate from illegitimate kinds of influence? In this paper, I argue that this (...) problem requires philosophers of science to take a new direction. I present two case studies in the influence of values on scientific inquiry: feminist values in archaeology and commercial values in pharmaceutical research. I offer a preliminary assessment of these cases, that the influence of values was legitimate in the feminist case, but not in the pharmaceutical case. I then turn to three major approaches to distinguish legitimate from illegitimate influences of values, including the distinction between epistemic and non-epistemic values and Heather Douglas’ distinction between direct and indirect roles for values. I argue that none of these three approaches gives an adequate analysis of the two cases. In the concluding section, I briefly sketch my own approach, which draws more heavily on ethics than the others, and is more promising as a solution to the current problem. This is the new direction in which I think science and values should move. (shrink)

How can we allocate scarce health care resources justly? In particular, are markets the most efficient way to deliver health services? Much blood, sweat and ink has been shed over this issue, but rarely has either faction challenged the unspoken assumption behind the claim made by advocates of markets: that efficiency advances the interests of both individuals and society. Whether markets actually do increase efficiency is arguably a matter for economists, but the deeper ethical question is whether efficiency is the (...) correct criterion, in terms of social justice and individual needs. (shrink)

This chapter considers ethical issues involved in genetic testing and screening for susceptibility to various forms of cancer.

The rise of personalised medicine can be seen as an extension of individualism and as a threat to the common good.

Correction of major error in review of Bioethics: All That Matters.

This book examines the moral luck paradox, relating it to Kantian, consequentialist and virtue-based approaches to ethics. It also applies the paradox to areas in medical ethics, including allocation of scarce medical resources, informed consent to treatment, withholding life-sustaining treatment, psychiatry, reproductive ethics, genetic testing and medical research. If risk and luck are taken seriously, it might seem to follow that we cannot develop any definite moral standards, that we are doomed to moral relativism. However, Dickenson offers strong counter-arguments to (...) this view that enable us to think in terms of universal standards. (shrink)

This book contributes to the feminist reconstruction of political theory. Although many feminist authors have pointed out the ways in which women have been property, they have been less successful in suggesting how women might become the subjects rather than the objects of property-holding. This book synthesises political theory from liberal, Marxist, Kantian and Hegelian traditions, applying these ideas to history and social policy.

Most opponents of somatic cell nuclear transfer and embryonic stem cell technologies base their arguments on the twin assertions that the embryo is either a human being or a potential human being, and that it is wrong to destroy a human being or potential human being in order to produce stem cell lines. Proponents’ justifications of stem cell research are more varied, but not enough to escape the charge of obsession with the status of the embryo. What unites the two (...) warring sides in ‘the stem cell wars’ is that women are equally invisible to both: ‘the lady vanishes.’ Yet the most legitimate property in the body is that which women possess in their reproductive tissue and the products of their reproductive labour. By drawing on the accepted characterisation in the common law of property as a bundle of rights, and on a Hegelian model of contract as mutual recognition, we can lessen the impact of the tendency to regard women and their ova as merely receptacles and women’s reproductive labour as unimportant. (shrink)

Reductionist accounts of objective chance rely on a notion of fit, which ties the chances at a world to the frequencies at that world. Here, I criticize extant measures of the fit of a chance system and draw on recent literature in epistemic utility theory to propose a new model: chances fit a world insofar as they are accurate at that world. I show how this model of fit does a better job of explaining the normative features of chance, its (...) role in the laws of nature, and its status as an expert function than do previous accounts. (shrink)

To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effect. A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on "Death and Dying" was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on "Decisions near the End of Life". Practitioners accept the relevance of concepts widely disparaged (...) by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/withdrawing treatment. Within the UK nurses' group a "rationalist" axis of respondents who describe themselves as having "no religion" are closer to the bioethics consensus on withholding and withdrawing treatment. Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

Standard accounts of counterfactuals with metaphysically impossible antecedents take them to by trivially true. But recent work shows that nontrivial countermetaphysicals are frequently appealed to in scientific modeling and are indispensable for a number of metaphysical projects. I focus on three recent discussions of counterpossible counterfactuals, which apply counterpossibles in both scientific and metaphysical modeling. I show that a sufficiently developed modal counterpart theory can provide a semantics for a wide range of counterpossibles without any inconsistent possibilities or other forms (...) of impossible worlds. But such a view faces problems: in order for the metaphysical views I discuss to bear weight, there must be a significant difference between the metaphysical possibilities and impossibilities. I will show how the counterpart-theoretic view delineates the possible from impossible, while still making room for the impossible. (shrink)

Speculative enhancement technologies are premised on the notion that I have a duty to be the best Me I can possibly be. This article takes a sceptical look at that claim.

For a long time critics of modern and postmodern art have relied on the "Isn't that disgusting" strategy. By that I mean the strategy of pointing out that given works of art are ugly, trivial, or in bad taste, that "a five-year-old could have made them," and so on. And they have mostly left it at that. The points have often been true, but they have also been tiresome and unconvincing—and the art world has been entirely unmoved. -/- Of course, (...) the major works of the twentieth-century art world are ugly. Of course, many are offensive. Of course, a five-year old could in many cases have made an indistinguishable product. Those points are not arguable—and they are entirely beside the main question. The important question is: Why has the art world of the twentieth-century adopted the ugly and the offensive? Why has it poured its creative energies and cleverness into the trivial and the self-proclaimedly meaningless? (shrink)

Morally speaking, what should one do when one is morally uncertain? Call this the Moral Uncertainty Question. In this paper, I argue that a non-ideal moral theory provides the best answer to the Moral Uncertainty Question. I begin by arguing for a strong ought-implies-can principle---morally ought implies agentially can---and use that principle to clarify the structure of a compelling non-ideal moral theory. I then describe the ways in which one's moral uncertainty affects one's moral prescriptions: moral uncertainty constrains the set (...) of moral prescriptions one is subject to, and at the same time generates new non-ideal moral reasons for action. I end by surveying the problems that plague alternative answers to the Moral Uncertainty Question, and show that my preferred answer avoids most of those problems. (shrink)

Several philosophers have recently argued that decision-theoretic frameworks for rational choice under risk fail to provide prescriptions for choice in cases of moral uncertainty. They conclude that there are no rational norms that are “sensitive” to a decision-maker's moral uncertainty. But in this paper, I argue that one sometimes has a rational obligation to take one's moral uncertainty into account in the course of moral deliberation. I first provide positive motivation for the view that one's moral beliefs can affect what (...) it's rational for one to choose. I then address the problem of value comparison, according to which one cannot determine the expected moral value of one's actions. I argue that we should not infer from the problem of value comparison that there are no rational norms governing choice under moral uncertainty. (shrink)

In this paper, I argue that the fetishism objection to moral hedging fails. The objection rests on a reasons-responsiveness account of moral worth, according to which an action has moral worth only if the agent is responsive to moral reasons. However, by adopting a plausible theory of non-ideal moral reasons, one can endorse a reasons-responsiveness account of moral worth while maintaining that moral hedging is sometimes an appropriate response to moral uncertainty. Thus, the theory of moral worth upon which the (...) fetishism objection relies does not, in fact, support that objection. (shrink)

In the specific case of geography, the real world consists on the one hand of physical geographic features (bona fide objects) and on the other hand of various fiat objects, for example legal and administrative objects, including parcels of real estate, areas of given soil types, census tracts, and so on. It contains in addition the beliefs and actions of human beings directed towards these objects (for example, the actions of those who work in land registries or in census bureaux), (...) and the relations between these beliefs and actions and their targets. The document is a Report of the Specialist Meeting held under the auspices of the Varenius Project. (shrink)

'An alarming and illuminating book. The story of how we have allowed private corporations to patent genes, to stockpile human tissue, and in short to make profits out of what many people feel ought to be common goods is a shocking one. No one with any interest at all in medicine and society and how they interact should miss this book, and it should be required reading for every medical student,'--Philip Pullman.

My dissertation combines philosophy of science and political philosophy. Drawing directly on the work of Alasdair MacIntyre and inspired by John Dewey, I develop two rival conceptions of scientific practice. I show that these rivals are closely linked to the two basic sides in the science and values debate -- the debate over the extent to which ethical and political values may legitimately influence scientific inquiry. Finally, I start to develop an account of justice that is sensitive to these legitimate (...) and illegitimate influences. (shrink)

The notions of family and community disintegration, supposedly brought on by focus on children's rights, are only a form of moral panic.

There are cases in which, intuitively, an agent’s action is both morally right in one sense, and morally wrong in another sense. Such cases (along with other intuitions about blameless wrongdoing and action-guidance) support distinguishing between the objective moral ‘ought’ and the subjective moral ‘ought.’ This chapter argues against drawing this distinction, on the grounds that the prescriptions delivered by an adequate objective moral theory must be sensitive to the mental states of agents. Specifically, an adequate theory of the objective (...) moral ‘ought’ must respect a strong ought-implies-can principle—morally ought implies agentially can—in order to prescribe actions to real-life agents. An agent’s mental states determine what is agentially possible for that agent; thus, what an agent objectively morally ought to do is in part determined by the agent’s mental states. This chapter describes the structure of a compelling non-ideal moral theory that is both objective and mental state-sensitive. This non-ideal theory illuminates the shortcomings of extant objectivist and subjectivist moral theories, and illustrates how we can dispense with the subjective moral ‘ought.’. (shrink)

Both Wilfrid Sellars and John McDowell reject Kant’s conclusion that the world is fundamentally unknowable, and on similar grounds: each invokes conceptual change, what I call the diachronic instability of a conceptual scheme. The similarities end there, though. It is important to Sellars that the world is only knowable at “the end of inquiry” – he rejects a commonsense realism like McDowell’s for its inability to fully appreciate diachronic instability. To evaluate this disagreement, I consider Timothy Williamson’s argument that the (...) knowability thesis, as it rules out “elusive objects”, is problematically idealistic. I argue that McDowell’s insistence on diachronic instability suffices to address Williamson’s worry, and as such that his reply ought to be available to Sellars too. That Sellars would instead invoke the end of inquiry suggests it is he who underestimates the ineliminability of conceptual change. (shrink)

What does it mean to respect autonomy and encourage meaningful consent to treatment in the case of patients who have dementia or are otherwise incompetent? This question has been thrown into sharp relief by the Law Lords' decision in R.v Bournewood Community and Mental Health NHS Trust, ex parte L.

In this article I evaluate a resurrected French resistance movement--to biotechnological commodification. The official French view that ‘the body is the person’ has been dismissed as a ‘taboo’ by the French political scientist Dominique Memmi . Yet France has indeed resisted the models of globalised commodification adopted in US bioechnology, as, for example, when the government blocked a research collaboration between the American firm Millennium Pharmaceuticals and a leading genomics laboratory, le Centre d’Etude du Polymorphisme Humain, on the grounds the (...) ‘French DNA’ should not be given away. -/- This example, however, itself suggests why the ‘new French Resistance’ is not altogether liberating. The absolutist conception of all bodies as belonging to the French state—indeed, as constituting the body politic —is so potentially invasive that a counter-ideology of inviolability of the body is maintained assiduously. This inviolability is defended particularly strongly against commercialisation, but only at the moment when tissue is taken from the individual subject, who is not to be paid or compensated-- although commercial enterprises who subsequently use the tissue are not similarly constrained. -/- . (shrink)

Reproductive ageing has effects on individual and public health, now and in generations to come. This volume of presentations from a conference at the Royal College of Obstetricians and Gynaecologists brings together a diverse but timely set of contributions.. in ny chapter I specifically examine the responsibilities of the College to women outside normal reproductive age.

Until very recently the question of who owns embryonic or fetal tissue was of limited importance to clinicians, but advances in stem cell research have made such tissue commercially valuable. This chapter examines the legal and ethical basis of claims to property in embryonic or fetal tissue, taking a critical stance.

Guidelines on embryo storage prioritise 'respect for the embryo' above the wishes of the women whose labour and tissue have gone into creating the embryo in the first place, effectively making women and the female body disappear. In this article I draw a parallel between this phenomenon relating to embryo storage and other instances of a similar phenomenon that I have called 'the lady vanishes', particularly in stem cell and 'mitochondrial transfer' research. I suggest that a modified property regime could (...) protect women's interests in embryo storage, making a parallel with the Yearworth case, in which it was recognised that men had limited but actionable interests in their stored sperm.. (shrink)

With the highest profile seller of $99 genetic tests under fire, will public trust in personalised medicine suffer?

There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and payment (...) for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes. (shrink)

Critical examination of the concept of property in the body, with particular relevance to Stephen Munzer's work on umbilical cord blood.

The present article proposes to study Condillac’s analysis of Spinoza’s Ethics, against the background of the more general criticism that the French abbot makes of the seventeenth-century logique de système. From the Essai sur l’origine des connaissances humaines to the Traité des systèmes to the later texts, Condillac’s theory and critique of systems are crossed by two components: on the one hand, the search for the sensory origin of ideas, that Condillac radicalizes in his Traité des sensations into a theory (...) of knowledge as a ‘transformed sensation’. On the other hand, an operative logic of signs, which from the Essai to the works subsequent to the Traité des sensations translates sensibility into a knowledge, or a ‘well-made language’, whose logic is calculation. My objective is to clarify how the new ‘systematic spirit’, repeatedly invoked by the abbot, departs from the ‘bad metaphysics’ that he claims to liquidate. The comparison with the Spinozist system will be illuminating: in his treatise on the metaphysical systems of the seventeenth century Condillac proposes a critical analysis of the ‘geometrical spirit’; in his latest work, La langue des calculs, he proposes a new logic to which he assigns the task of bringing together the abstract and the concrete, beyond the ruins of classical metaphysics. The ‘systematic spirit’ and ‘spirit of system’ will be revealed, in spite of Condillac’s efforts, as being much closer to what it appears at first sight. (shrink)

How can intellectuals who oppose the illegitimate war in Iraq come to similar terms with the U.S. neoconservatives, and their unrepentant British collaborators, who have stranded us in it? In the Tempest, Shakespeare’s most political play, comedy though it is meant to be, intellectuals are warned not to consider themselves guiltless. But how can those who marched against the war, or who tried to speak truth to power in other ways, be guilty of its misuses? Surely this is too harsh (...) a view of the role of the public intellectual. What choice did Prospero really have? He was exiled, hapless, stranded. What choice do intellectuals who are against the war have? We, too, are powerless. Aren’t we? (shrink)

In this article we explore the underpinnings of what we view as a recent "backlash" in English law, a judicial reaction against considering children's and young people's expressions of their own feelings about treatment as their "true" wishes. We use this case law as a springboard to conceptual discussion, rooted in (a) empirical psychological work on child development and (b) three key philosophical ideas: rationality, autonomy and identity. Using these three concepts, we explore different understandings of our central theme, true (...) wishes. These different conceptual interpretations, we argue, help to elucidate important clinical questions in the area of children's informed consent to treatment. For example, how much should a child's own wishes count in making medical decisions? Does it make a difference if the child or young person is undergoing psychiatric treatment?—if in some sense her wishes are abnormal, not "true" expressions of what she really wants? If the child's wishes do not count, why not? If they do matter but count for less, how much less? We conclude by advocating functional tests of a young person's true wishes, applicable on a case-by-case basis, rather than a black-and-white distinction between "incompetent" children and "competent" adults. (shrink)

How heavily should ethical considerations weigh in allowing or disallowing genetic patents? The concept of 'ordre public' can be useful in offsetting a simple utilitarian view.

The results of a recent survey of Nigerian women might give pause to opponents of female genital mutilation (FGM). One could well argue that if these Nigerian women themselves favour FGM, then it is ironically paternalistic to oppose it. Should Western feminists actually support FGM if it is what women in the South want? I argue in this commentary that such an argument rests on shaky statistical, psychological, medical, political and philosophical grounds. We should go on opposing female genital mutilation (...) with all our power. (shrink)

For a long time discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. However, a narrow focus on medical resources prevents us from seeing that there are many cases-- perhaps the majority-- in which less dramatic but equally important issues of rationing occur. The allocation of nurses' time is one such issue.

For a long time, discussion about scarce health care resource allocation was limited to allocation of medical resources, with the paradigmatic case being kidney transplants. This narrow focus on medical resource prevents us from seeing that there are many cases-- perhaps even the majority--in which time is the real scarce resource, particularly nurse time. What ethical principles should apply to nurse time as a scarce health care resource?

This paper considers the obligation higher income countries have to lower and middle income countries during a global pandemic. Further considers which reforms are needed to the global supply-chain of medical resources. The short-comings in distribution and medical infrastructure have exacerbated the health crisis in developing countries. Global justice demands radical redistribution of medical resources in order to prevent mass casualties. This is argued first by highlighting that the COVID-19 pandemic should be acknowledged as an issue of global justice, secondly, (...) higher income countries ought to account for distribution inequity as a matter of rectifying past injustices, and thirdly argue for reform in distribution while considering the vaccine rollout as a prime example. We aim to show how the differences from country to country in response capabilities are a result of the economic foundation colonialism established and a direct result of cyclical poverty, which wealthy countries perpetuate to this day. (shrink)