Providing heroin to heroin addicts taking part in medical trials to assess the effectiveness of the drug as a treatment alternative, breaches ethical research standards, some ethicists maintain. Heroin addicts, they say, are unable to consent voluntarily to take part in these trials. Other ethicists disagree. In our view, both sides of the debate have an inadequate understanding of voluntariness. In this article we therefore offer a fuller conception, one which allows for a more flexible, case-to-case approach in which (...) some heroin addicts are considered capable of consenting voluntarily, others not. An advantage of this approach, it is argued, is that it provides a safety net to minimize the risk of inflicting harm on trial participants. (shrink)

Many epidemics consist in individuals spreading infection to others. From the population perspective, they also have population characteristics important in modeling, explaining, and intervening in epidemics. I analyze epidemiology’s contemporary population perspective through the example of epidemics by examining two central principles attributed to Geoffrey Rose: a distinction between the causes of cases and the causes of incidence, and between “high-risk” and “population” strategies of prevention. Both principles require revision or clarification to capture the sense in which they describe distinct (...) perspectives on the same phenomenon, each perspective capturing a different level of contrastive analysis. (shrink)

What meaning does epidemiological evidence have for the individual? In evidence-based medicine, epidemiological evidence measures the patient’s risk of the outcome or the change in risk due to an intervention. The patient’s risk is commonly understood as an individual probability. The problem of understanding epidemiological evidence and risk thus becomes the challenge of interpreting individual patient probabilities. I argue that the patient’s risk is interpreted ontically, as a propensity. After exploring formidable problems with this interpretation in the medical context, I (...) propose an epistemic reinterpretation of individual patient probabilities as credences. On this view, epidemiological evidence informs medical uncertainty. (shrink)

With the ascent of modern epidemiology in the Twentieth Century came a new standard model of prediction in public health and clinical medicine. In this article, we describe the structure of the model. The standard model uses epidemiological measures-most commonly, risk measures-to predict outcomes (prognosis) and effect sizes (treatment) in a patient population that can then be transformed into probabilities for individual patients. In the first step, a risk measure in a study population is generalized or extrapolated to a target (...) population. In the second step, the risk measure is particularized or transformed to yield probabilistic information relevant to a patient from the target population. Hence, we call the approach the Risk Generalization-Particularization (Risk GP) Model. There are serious problems at both stages, especially with the extent to which the required assumptions will hold and the extent to which we have evidence for the assumptions. Given that there are other models of prediction that use different assumptions, we should not inflexibly commit ourselves to one standard model. Instead, model pluralism should be standard in medical prediction. (shrink)

It is sometimes thought that randomized study group allocation is uniquely proficient at producing comparison groups that are evenly balanced for all confounding causes. Philosophers have argued that in real randomized controlled trials this balance assumption typically fails. But is the balance assumption an important ideal? I run a thought experiment, the CONFOUND study, to answer this question. I then suggest a new account of causal inference in ideal and real comparative group studies that helps clarify the roles of confounding (...) variables and randomization. 1Confounders and Causes2The Balance Assumption3The CONFOUND Study 3.1CONFOUND 13.2CONFOUND 24Disjunction C and the Ideal Study 4.1The ultimate ‘other cause’: C4.2The ideal comparative group study4.3Required conditions for causal inference5Confounders as Causes, Confounders as Correlates6Summary. (shrink)

Over the past several decades, we devoted much energy to generating, reviewing and summarizing evidence. We have given far less attention to the issue of how to thoughtfully apply the evidence once we have it. That’s fine if all we care about is that our clinical decisions are evidence-based, but not so good if we also want them to be well-reasoned. Let us not forget that evidence based medicine (EBM) grew out of an interest in making medicine ‘rational’, with the (...) idea that rational clinical evaluations should be evidence-based. I agree with the uncontroversial statement that the best decision is supported, at least in part, by the best available evidence. Rationality, however, is constituted by reasoning, not evidence. Complete arguments are necessary for rational evaluations, arguments that begin with general evidence and end in a conclusion about a particular patient. In order to traverse these inferential gaps, medicine must address the issue of how to establish, as an intermediate premise, what the evidence has to say about the efficacy of an intervention for particular patients in a particular practice setting. (shrink)

Introduction: Clinical practice guidelines (CPGs) are an important source of justification for clinical decisions in modern evidence-based practice. Yet, we have given little attention to how they argue their evidence. In particular, how do CPGs argue for treatment with long-term medications that are increasingly prescribed to older patients? Approach and rationale: I selected six disease-specific guidelines recommending treatment with five of the medication classes most commonly prescribed for seniors in Ontario, Canada. I considered the stated aims of these CPGs and (...) the techniques employed towards those aims. Finally, I reconstructed and logically analysed the arguments supporting recommendations for pharmacotherapy. Analysis: The primary function of CPGs is rhetorical, or persuasive, and their means of persuasion include both a display of their credibility and their argumentation. Arguments supporting pharmacotherapy recommendations for the target population follow a common inductive pattern: statistical generalization from randomized controlled trial (RCT) and meta-analysis evidence. Two of the CPGs also argue their treatment recommendations for older patients in this style, while three fail to justify pharmacotherapy specifically for the older population. Discussion: The arguments analysed lack the auxiliary assumptions that would warrant making a generalization about the clinical effectiveness of medications for the older population. Guidelines reason using simple induction, while ignoring important inferential gaps. Future guidelines should aspire to be well-reasoned rather than simply evidence-based; argue from a plurality of evidence; be wary of hasty inductions; appropriately limit the scope of their recommendations; and avoid making law-like, prescriptive generalizations. (shrink)

An important philosophical issue in the study of addiction is what difference the fact that a person is addicted makes to attributions of autonomy (and responsibility) to their drug-oriented behavior. In spite of accumulating evidence suggesting the role of emotional dysregulation in understanding addiction, it has received surprisingly little attention in the debate about this issue. I claim that, as a result, an important aspect of the autonomy impairment of many addicted individuals has been largely overlooked. A widely shared assumption (...) in the philosophical literature is that for addiction to impair a person’s autonomy it has to make them (in some sense) take drugs against their will. So-called “willing addicts” are therefore usually seen as exempted from the autonomy impairment believed to characterize “unwilling addicts”, the latter being those who ‘truly want’ to stop using drugs but find their attempts repeatedly derailed by failures of self-control. In this article, I argue that the association between addiction and emotional dysregulation shows why this assumption is false. Emotional dysregulation is not only consistent with the possibility that many addicts take drugs ‘willingly’, it supports the hypothesis that they use drugs because they truly want to. The article proposes an explanation for why emotional dysregulation should nevertheless be seen as an aspect of their loss of control and an important reason why they have impaired autonomy. I end by exploring some implications of this account for addict’s decision-making capacity when they are prescribed the drugs to which they are addicted. -/- . (shrink)

It is an orthodoxy of modern political thought that violence is morally incompatible with politics, with the important exception of the permissible violence carried out by the state. The “commonsense argument” for permissible political violence denies this by extending the principles of defensive ethics to the context of state-subject interaction. This article has two aims: First, I critically investigate the commonsense argument and its limits. I argue that the scope of permissions it licenses is significantly more limited than its proponents (...) allow. Second, I develop an alternative (and supplementary) framework for thinking about permissible political violence. I argue that under certain circumstances, subjects may violently protest their treatment, where protest is understood as an expression of rejection of those circumstances. On my view, protest, including violent protest, is permissible when it is the fitting response to those circumstances. This alternative framework accounts for an important class of cases of intuitively permissible political violence, including cases in which such violence does not serve strategic political ends or is even counterproductive towards those ends. (shrink)

The new field of meta-research investigates industry bias, publication bias, contradictions between studies, and other trends in medical research. I argue that its findings should be used as meta-evidence for evaluating therapies. ‘Meta-evidence’ is evidence about the support that direct ‘first-order evidence’ provides the hypothesis. I consider three objections to my proposal: the irrelevance objection, the screening-off objection, and the underdetermination objection. I argue that meta-research evidence works by rationally revising our confidence in first-order evidence and, consequently, in the hypothesis—typically, (...) downward. (shrink)

Over the past 25 years, several new “medicines” have come screeching onto health care’s various platforms, including narrative medicine, personalized medicine, precision medicine and person-centred medicine. Philosopher Miriam Solomon calls the first three of these movements different “ways of knowing” or “methods,” and argues that they are each a response to shortcomings of methods that came before them. They should also be understood as reactions to the current dominant model of medicine. In this article, I will describe our dominant model, (...) which I call “the new medical model.” I will argue that several towering problems in modern medicine can be traced to its philosophical foundations, which calls for philosophical analysis. (shrink)

In this article, I will reconstruct the monocausal model and argue that modern 'multifactorial diseases' are not monocausal by definition. 'Multifactorial diseases' are instead defined according to a constitutive disease model. On closer analysis, infectious diseases are also defined using the constitutive model rather than the monocausal model. As a result, our classification models alone cannot explain why infectious diseases have a universal etiology while chronic and noncommunicable diseases lack one. The explanation is instead provided by the nineteenth-century germ theorists.

Non‐governmental aid programs are an important source of health care for many people in the developing world. Despite the central role non‐governmental organizations play in the delivery of these vital services, for the most part they either lack formal systems of accountability to their recipients altogether, or have only very weak requirements in this regard. This is because most NGOs are both self‐mandating and self‐regulating. What is needed in terms of accountability is some means by which all the relevant stakeholders (...) can have their interests represented and considered. An ideally accountable decision‐making process for NGOs should identify acceptable justifications and rule out unacceptable ones. Thus, the point of this paper is to evaluate three prominent types of justification given for decisions taken at the Dutch headquarters of Médecins sans Frontières. They are: population health justifications, mandate‐based justifications and advocacy‐based justifications. The central question at issue is whether these justifications are sufficiently robust to answer the concerns and objections that various stakeholders may have. I am particularly concerned with the legitimacy these justifications have in the eyes of project beneficiaries. I argue that special responsibilities to certain communities can arise out of long‐term engagement with them, but that this type of priority needs to be constrained such that it does not exclude other potential beneficiaries to an undesirable extent. Finally, I suggest several new institutional mechanisms that would enhance the overall equity of decisions and so would ultimately contribute to the legitimacy of the organization as a whole. (shrink)

This article is a response to William Lynch’s, ‘Social Epistemology Transformed: Steve Fuller’s Account of Knowledge as a Divine Spark for Human Domination,’ an extended and thoughtful reflection on my Knowledge: The Philosophical Quest in History. I grant that Lynch has captured well, albeit critically, the spirit and content of the book – and the thirty-year intellectual journey that led to it. In this piece, I respond at two levels. First, I justify my posture towards my predecessors and contemporaries, (...) which Lynch shrewdly sees as my opposition to deference. However, most of the response concerns an elaboration of my theodicy-focussed sense of social epistemology, which is long-standing but only started to become prominent about ten years ago, in light of my involvement in the evolution controversies. Here I aim to draw together a set of my abiding interests – scientific, theological and philosophical – in trying to provide a normative foundation for the future of humanity. (shrink)

Thomas Pogge and Andrew Kuper suggest that we should promote an ‘institutional’ solution to global poverty. They advocate the institutional solution because they think that non-governmental organizations (NGOs) can never be the primary agents of justice in the long run. They provide several standard criticisms of NGO aid in support of this claim. However, there is a more serious problem for institutional solutions: how to generate enough goodwill among rich nation-states that they would be willing to commit themselves to supranational (...) institutional reforms. In the current international political climate, the implementation of such institutional reforms introduces several intractable problems, including difficulties of global coordination and enforcement. I defend the solution of NGO aid from the criticisms presented by Pogge and Kuper, and propose how it might be reformed. My main suggestion is that all practising NGOs should be required to be ‘accountable for reasonableness’ in the sense that Norman Daniels and James Sabin have outlined. (shrink)

Edmund Husserl is the founder of phenomenology and the Logical Investigations is his most famous work. It had a decisive impact on twentieth century philosophy and is one of few works to have influenced both continental and analytic philosophy. This is the first time both volumes have been available in paperback. They include a new introduction by Dermot Moran, placing the Investigations in historical context and bringing out their contemporary philosophical importance. These editions include a new preface by Sir (...) Michael Dummett. (shrink)

Many people in the developing world access essential health services either partially or primarily through programs run by international non-governmental organizations (INGOs). Given that such programs are typically designed and run by Westerners, and funded by Western countries and their citizens, it is not surprising that such programs are regarded by many as vehicles for Western cultural imperialism. In this chapter, I consider this phenomenon as it emerges in the context of development and humanitarian aid programs, particularly those delivering medical (...) treatment, nutrition and access to clean water. I argue that in order to avoid contributing to cultural imperialism, INGOs have a duty to ensure that they do not offer services in a way that requires their beneficiaries to choose between accessing essential health services and violating or otherwise undermining traditional norms and practices which have significance for their beneficiaries. Following Onora O'Neill, I argue that offers requiring such a choice are effectively “unrefuseable” and so coercive. INGOs therefore, must avoid making such offers, and can accomplish this by means of an iterated process of reciprocal negotiation under conditions of equality, in which both the INGOs’ and the beneficiaries’ deep values and concerns play a role. In essence, I claim that employing such a process is a requirement of procedural justice, given the non-ideal conditions in which INGOs must operate. (shrink)

Theorists and activists favor empowering government agencies to regulate technology; but an examination of such regulation by the US government exposes the inadequacy of any such regimen. Vested interests routinely interfere, e.g., keeping administration of polio vaccine in the hands of physicians, political infighting with regard to cancer research funding, advantages gained from noncompliance with military technology-constraining treaties. Public/private salary differences limit availability of the best talents for government positions, nor are truly appropriate regulatory policies easily arrived at in the (...) absence of meaningful funding. Solutions such as a Science Court are unreliable given the influences that would undermine neutrality as well as competence. (shrink)

A description of how microelectronics and robotics are tending to increase unemployment, followed by comparisons between the social policies of Western European countries and the United States with reard to this problem. A conclusion points out the need for a social philosophy of technology that acknowledges workers' rights.

Joan McGregor argues that “colleges and universities should adopt as part of their core mission the development of skills of civil discourse” rather than engaging in the practice of restricting controversial speakers from making presentations on campuses. I agree with McGregor concerning the need for increased civil discourse. However, this does not mean universities should welcome speakers to publicly present any material they wish without restriction or oversight. In this paper, I make three main arguments: (i) Colleges and universities have (...) a duty to protect members of the campus community from the harm and exclusion resulting from hateful or harmful speech, in the same way that they must protect them from sexual assaults and concussions. (ii) In the vast majority of cases, this duty can be fulfilled by holding speakers to standards of discourse that prevail in academic debate, and insisting on a number of procedural requirements. (iii) We should be wary of conservative arguments framed in terms of free speech, because they can be deployed to undermine important functions of the university in a democratic society, namely, to teach students how to be discerning citizens, and to protect thinkers willing to be critical of the government and the ruling classes. (shrink)

Following John Rawls, nonideal theory is typically divided into: (1) “partial-compliance theory” and (2) “transitional theory." The former is concerned with those circumstances in which individuals and political regimes do not fully comply with the requirements of justice, such as when people break the law or some individuals do not do their fair share within a distributive scheme. The latter is concerned with circumstances in which background institutions may be unjust or may not exist at all. This paper focuses on (...) issues arising in transitional theory. In particular, I am concerned with what Rawls’ has called “burdened societies," that is, those societies that find themselves in unfavorable conditions, such that their historical, social or economic circumstances make it difficult to establish just institutions. The paper investigates exactly how such burdened societies should proceed towards a more just condition in an acceptable fashion. Rawls himself tells us very little, except to suggest that societies in this condition should look for policies and courses of action that are morally permissible, politically possible and likely to be effective. In this paper I first try to anticipate what a Rawlsian might say about the best way for burdened societies to handle transitional problems and so move towards the ideal of justice. Next, I construct a model of transitional justice for burdened societies. Ultimately, I argue for a model of transitional justice that makes use of a nonideal version of Rawls’ notion of the worst-off representative person. (shrink)

Forensics is proposed as a means to understand, trace, and recompile data and computational activities. It has a securitocratic dimension and one that is being developed as a means of opening processes, events and systems into a more public state. This article proposes an analysis of forces at play in the circulation of a ‘screener’ of Quentin Tarantino’s The Hateful Eight and associated files, to suggest that forensic approaches used to control flows of data may be repurposed for dis­semination. The (...) article maps a brief history of digital forensics and sets out some of its political entailments, indicating further lines of enquiry regarding the inter-relation of technosocial powers constituted in the interactions between forensics and coun­ter-measures. The article proposes that the posthumanities are partially constituted by a renewed relationship between questions of culture, subjectivity, knowledge and the technical. Some propositions for the technical as grounds for cultural politics are made. (shrink)

There have been several calls from LIS researchers for practical or applied research not to ignore the epistemological assumptions underlying the systems and artifacts they design lest they showcase only the dominant theory at a given time. Others have also deplored the "epistemological promiscuity" or "eclecticism" of the field, its incessant borrowing of theories and models from elsewhere and the fact that the field has largely neglected the contributions that philosophy and epistemology could have made in its research. This problem (...) raises that of the boundaries of LIS and is all the more troublesome because boundaries between epistemological theories are fuzzy. Indeed, some epistemological theories share the same basic assumptions or are historically derived from one another. Gathering a wide array of acknowledged theorists in philosophy of science and epistemology, this panel aims to examine how research work in the LIS field can clearly articulate the epistemological assumptions underlying that research and under what constraints this can be achieved. The topic is of prime importance to Information studies as a whole and to ASIST as the scientific flag bearer of information scientists worldwide. (shrink)

Recently theorists have demonstrated a growing interest in the ethical aspects of resource allocation in international non-governmental humanitarian, development and human rights organizations (INGOs). This article provides an analysis of Thomas Pogge's proposal for how international human rights organizations ought to choose which projects to fund. Pogge's allocation principle states that an INGO should govern its decision making about candidate projects by such rules and procedures as are expected to maximize its long-run cost-effectiveness, defined as the expected aggregate moral value (...) of the projects it undertakes divided by the expected aggregate cost of these projects? I critique Pogge's argument on two fronts: (1) I demonstrate that his view is problematic on his own terms, even if we accept the cost-effectiveness framework he employs. (2) I take issue with his overall approach because it generates results which can undermine the integrity of INGOs. Further, his approach mis-characterizes the nature of INGOs, and this mistake is at the root of his problematic view of INGO priority-setting. Ultimately, I argue for a conception of INGOs in which they are understood as ?organizations of principle?, in the sense that they are independent moral agents and so should be permitted a fairly wide sphere of autonomy within reasonable moral constraints. (shrink)

Citizens of liberal, affluent societies are regularly encouraged to support reforms meant to improve conditions for badly-off people in the developing world. Our economic and political support is solicited for causes such as: banning child labor, implementing universal primary education, closing down sweatshops and brothels, etc. But what if the relevant populations or individuals in the developing world do not support these particular reforms or aid programs? What if they would strongly prefer other reforms and programs, or would rank the (...) various benefits that might be offered differently than seems reasonable to the Western, liberal supporters of these campaigns and organizations? What is the proper liberal response here? I argue that the proper liberal response is to support those programs and reforms that the global poor most value. The bulk of the paper is devoted to arguing against the popular liberal argument which states that we can safely disregard the preferences of the oppressed when they seem very unreasonable because these individuals suffer from “adaptive preferences.” This typically is taken to mean that their preferences are “not their own” in an important sense. I put forward various different proposals for why adaptive preferences can be safely dismissed, but ultimately argue that they are not persuasive. And if it is no longer legitimate to appeal to adaptive preferences as a basis for disregarding what oppressed people want, then I argue that to do so is straightforward paternalism, and so is unjustifiable in all but the most extreme cases. Finally, I argue for the following concrete recommendations: Given that resources are not infinite, we should (1) Support programs that give oppressed people increased access to information, such as access to technology, (2) support those reforms and aid programs that the oppressed themselves regard as most important, with special emphasis on those opportunities for education that they deem valuable, and (3) refrain from supporting coercive policies intended to thwart adaptive preferences. (shrink)

Instead of the question, ‘do we have an obligation to obey the law?,’ we should first ask the more modest question, ‘do we have reasons to obey the law?’ This paper offers a new account of the notion of the content-independence of legal reasons in terms of the grounding relation. That account is then used to mount a defense of the claim that we do indeed have content-independent moral reasons to obey the law (because it is the law), and that (...) these reasons, very plausibly, often amount to an obligation to so act. (shrink)

A drone industry has emerged in the US, initially funded almost exclusively for military applications. There are now also other uses both governmental and commercial. Many military drones are still being made, however, especially for surveillance and targeted killings. Regarding the latter, this essay calls into question their legality and morality. It recognizes that the issues are complex and controversial, but less so as to the killing of non-combatant civilians. The government using drones for targeted killings maintains secrecy and appeals (...) to non-traditional justifications. Most scholars who assess these killer drone practices support citizen immunity, either by favoring a modified just war theory that prioritizes civilians’ right to life or by challenging official deviations from applicable laws. They accordingly declare such killing immoral if not a war crime. The manufacturers of these killer drones are not themselves the killers, but they are abetters, i.e., sine qua non facilitators. So, I argue that any company concerned about its corporate social responsibility should cease manufacturing them. (shrink)

Impairment of self-control is often said to be a defining feature of addiction. Yet many addicts display what appears to be a considerable amount of control over their drug-oriented actions. Not only are their actions clearly intentional and frequently carried out in a conscious and deliberate manner, there is evidence that many addicts are responsive to a wide range of ordinary incentives and counter-incentives. Moreover, addicts have a wide variety of reasons for using drugs, reasons which often seem to go (...) a long way towards explaining their drug-oriented behavior. Many use drugs, for example, to cope with stressful or traumatic experiences. In this article I argue that some standard philosophical explanations of addicts’ impairment of self-control are inadequate, and propose an alternative. (shrink)

In his target article and recent interesting book about addiction and the brain, Marc Lewis claims that the prevalent medical view of addiction as a brain disease or a disorder, is mistaken. In this commentary we critically examine his arguments for this claim. We find these arguments to rest on some problematical and largely undefended assumptions about notions of disease, disorder and the demarcation between them and good health. Even if addiction does seem to differ from some typical brain diseases, (...) we believe contrary to Lewis, that there are still good reasons to maintain its classification as a mental or behavioral disorder. (shrink)

What is self-control and how does the concept of self-control relate to the notion of will-power? A widespread philosophical opinion has been that the notion of will-power does not add anything beyond what can be said using other motivational notions, such as strength of desire and intention. One exception is Richard Holton who, inspired by recent research in social psychology, has argued that will-power is a separate faculty needed for persisting in one's resolutions, what he calls 'strength of will'. However, (...) he distinguishes strength of will from self-control. In this paper I argue that will-power is essential also to a certain form of self-control. I support this claim by arguments showing that the traditional philosophical accounts of self-control run into difficulties because they pay insufficient attention to will-power as an independent source of motivation. (shrink)

Business ethicists should examine not only business practices but whether a particular type of business is even prima facie ethical. To illustrate how this might be done I here examine the contemporary U.S. defense industry. In the past the U.S. military has engaged in missions that arguably satisfied the just war self-defense rationale, thereby implying that its suppliers of equipment and services were ethical as well. Some recent U.S. military missions, however, arguably fail the self-defense rationale. At issue, then, is (...) whether a business supporting these latter missions may not be circumstantially unethical. No it is not, say defense industry advocates, for two principal reasons. For one, this business benefits society at large in numerous ways. And, for another, the organizer of these military missions is a superpower which by its very nature is not subject to the ethical constraints of the self-defense rationale. I dispute both reasons, argue against the second, and conclude that the U.S. military-industrial complex (MIC) is circumstantially unethical. (shrink)

[ES] En este breve trabajo, se presenta una edición bilingüe de Is Justified True Belief Knowledge?, de Edmund L. Gettier, donde se presentan contraejemplos a la definición de «conocimiento» como «creencia verdadera justificada». [ES] In this brief text, a bilingual edition of Is Justified True Belief Knowledge?, by Edmund L. Gettier, some counterexamples are presented to the definition of «knowledge» as «justified true belief».

Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behaviour under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures (...) and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behaviour. In this paper we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior. -/- . (shrink)

Does addiction to heroin undermine the voluntariness of heroin addicts' consent to take part in research which involves giving them free and legal heroin? This question has been raised in connection with research into the effectiveness of heroin prescription as a way of treating dependent heroin users. Participants in such research are required to give their informed consent to take part. Louis C. Charland has argued that we should not presume that heroin addicts are competent to do this since heroin (...) addiction by nature involves a loss of ability to resist the desire for heroin. In this article, I argue that Charland is right that we should not presume that heroin addicts are competent to consent, but not for the reason he thinks. In fact, as Charland's critics correctly point out, there is plenty of evidence showing that heroin addicts can resist their desire for heroin. These critics are wrong, however, to conclude from this that we should presume that heroin addicts are competent to give their voluntary consent. There are, I shall argue, other conditions associated with heroin addiction that might constrain heroin addicts' choice in ways likely to undermine the voluntariness of their consent. In order to see this, we need to move beyond the focus on the addicts' desires for heroin and instead consider the wider social and psychological circumstances of heroin addiction, as well as the effects these circumstances may have on the addicts' beliefs about the nature of their options. (shrink)

How should addictive behavior be explained? In terms of neurobiological illness and compulsion, or as a choice made freely, even rationally, in the face of harmful social or psychological circumstances? Some of the disagreement between proponents of the prevailing medical models and choice models in the science of addiction centres on the notion of “loss of control” as a normative characterization of addiction. In this article I examine two of the standard interpretations of loss of control in addiction, one according (...) to which addicts have lost free will, the other according to which their will is weak. I argue that both interpretations are mistaken and propose therefore an alternative based on a dual-process approach. This alternative neither rules out a capacity in addicts to rationally choose to engage in drug-oriented behavior, nor the possibility that addictive behavior can be compulsive and depend upon harmful changes in their brains caused by the regular use of drugs. (shrink)

Can humans exist without machines? Yes, in principle; but not in the numbers or in the manner to which they have become accustomed. However, the quality of machine-intensive existence is directly proportional to the degree of humans' control over their technology. Such control they can exercise, if at all, only by controlling the corporations from which technologies emanate. This can't be achieved by individuals acting in isolation but requires collective cooperation, e.g., in the form of worker control, which may eventually (...) lead to altered modes of human existence. In the meantime, our identity will not necessarily be found in what we make. (shrink)

Business ethics should include illicit businesses as targets of investigation. For, though such businesses violate human rights they have been largely ignored by business ethicists. It is time to surmount this indifference in view of recent international efforts to define illicit businesses for regulatory purposes. Standing in the way, however, is a meta-ethical question as to whether any business can be declared unqualifiedly immoral. In support of an affirmative answer I address a number of counter-indications by comparing approaches to organized (...) crime and to corporate crime, comparing the ethical critique of businesses studied in business ethics and those socially banned, and comparing the business ethics assumption as to businesses’ ethicality to societal ethical neutrality regarding war-related businesses. My conclusion: to help advance respect for human rights, business ethicists should apply their expertise to the task of defining illicit businesses. (shrink)

What sort of connection is there between business ethics and philosophy? The answer given here: a weak one, but it may be getting stronger. Comparatively few business ethics articles are structurally dependent on mainstream academic philosophy or on such sub-specialities thereof as normative ethics, moral theory, and social and political philosophy. Examining articles recently published in the Journal of Business Ethics that declare some dependence, the author finds that such declarations often constitute only a pro forma gesture which could be (...) omitted without detriment to the paper's content and conclusions. He also finds, however, that some authors do draw on solid philosophical work in ways that are establishing ever more meaningful interconnections between business ethics and academic philosophy. These cross-disciplinary studies, he concludes, are ground-breaking and invite creative imitation. (shrink)

There have been different interpretations of satisficing rationality. A common view is that it is sometimes rationally permitted to choose an option one judges is good enough even when one does not know that it is the best option. But there is available a more radical view of satisficing. On this view, it is rationally permitted to choose an option one judges is good enough even when a better option is known to be available. In this paper I distinguish between (...) two possible interpretations of ‘genuine’ satisficing, a de re and a de dicto interpretation. I then argue that while de re genuine satisficing is always irrational, de dicto genuine satisficing might be rationally permissible. In fact, de dicto genuine satisficing does not appear to be covered by existing accounts of satisficing behaviour. (shrink)

Corporate social responsibility has become a focal point for research aimed at extending business ethics to extra-corporate issues; and as a result many companies now seek to at least appear dedicated to one or another version of CSR. This has not affected the arms industry, however. For, this industry has not been discussed in CSR literature, perhaps because few CSR scholars have questioned this industry's privileged status as an instrument of national sovereignty. But major changes in the organization of political (...) communities call traditional views of sovereignty into question. With these considerations in mind I assess the U.S. arms industry on the basis of CSR requirements regarding the environment, social equity, profitability, and use of political power. I find that this industry fails to meet any of these four CSR requirements. Countering a claim that these failings should not be held against arms manufacturers because their products are crucial to national defense, I contend that many of these companies function not as dutiful agents of a nation-state but as politically powerful entities in their own right. So, I conclude, they should be held responsible for the foreseeable consequences that flow from use of their products. This responsibility should include civil liability and, in cases involving war crimes and violations of human rights, responsibility under international human rights standards. (shrink)

Deliberation incompatibilism is the view that an agent being rational and deliberating about which of (mutually excluding) actions to perform, is incompatible with her believing that there exist prior conditions that render impossible the performance of either one of these actions. However, the main argument for this view, associated most prominently with Peter van Inwagen, appears to have been widely rejected by contemporary authors on free will. In this paper I argue first that a closer examination of van Inwagen's argument (...) shows that the standard objections are based on a misunderstanding of the notion of ‘deliberation’ presupposed in this argument. Second, I attempt to strengthen the case for deliberation incompatibilism by offering a different argument in its support. (shrink)

It is common to think of addiction as involving behavior which in some sense is ?out of control.? But does this mean addictive actions occur because of compulsion or because of ordinary weakness of will? Many philosophers argue that addictive actions occur because of weakness of will, since there is plenty of evidence suggesting that they are not caused by irresistible desires. In fact, addicts seem, in general, to perform these actions freely in the sense of having the ability to (...) refrain from doing so. In this paper I argue, first, that it is not the addiction-as-compulsion view that is mistaken, but rather the view that irresistible desires are a defining feature of compulsion. Second, drawing on some results in addiction neuroscience, I construct and defend a new analysis of compulsivity that distinguishes addictive from weak-willed actions in a way that is consistent with the view that addictive actions are performed freely. (shrink)