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.' -/- .

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)

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)

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

The soaring promises made by personalized genetic medicine advocates are probably loftier than those in any other medical or scientific realm today. Are they justified?

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.

This article examines two questions about scientists’ search for knowledge. First, which search strategies generate discoveries effectively? Second, is it advantageous to diversify search strategies? We argue pace Weisberg and Muldoon, “Epistemic Landscapes and the Division of Cognitive Labor”, that, on the first question, a search strategy that deliberately seeks novel research approaches need not be optimal. On the second question, we argue they have not shown epistemic reasons exist for the division of cognitive labor, identifying the errors that led (...) to their conclusions. Furthermore, we generalize the epistemic landscape model, showing that one should be skeptical about the benefits of social learning in epistemically complex environments. (shrink)

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

A dilemma exists when a doctor is faced with a child or young person who refuses medically indicated treatment. The Gillick case has been interpreted by many to mean that a child of sufficient age and intelligence could validly consent or refuse consent to treatment. Recent decisions of the Court of Appeal on a child's refusal of medical treatment have clouded the issue and undermined the spirit of the Gillick decision and the Children Act 1989. It is now the case (...) that a child patient whose competence is in doubt will be found rational if he or she accepts the proposal to treat but may be found incompetent if he or she disagrees. Practitioners are alerted to the anomalies now exhibited by the law on the issue of children's consent and refusal. The impact of the decisions from the perspectives of medicine, ethics, and the law are examined. Practitioners should review each case of child care carefully and in cases of doubt seek legal advice. (shrink)

Consensus statement by UK teachers of medical ethics and law.

The spread of liberal individualism to the family is often portrayed as deeply inimical to the welfare of children and young people. In this view, the family is the bastion of the private and the antithesis of the contractual, rights-oriented model that underpins public life. This chapter examines that proposition critically.

Children and young people under 18 years old should no longer be regarded as incompetent to give or withhold consent in decisions involving their health care, Recent research suggests a functional test of cognitive and emotional maturity, rather than a strict age cut-off point. However, it is often difficult to implement these recommendations in practice, not least because the law is, if anything, increasingly 'hard-line' about children's autonomy.

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)

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.

Incompatibilists believe free will is impossible if determinism is true, and they often claim that this view is supported by ordinary intuitions. We challenge the claim that incompatibilism is intuitive to most laypersons and discuss the significance of this challenge to the free will debate. After explaining why incompatibilists should want their view to accord with pretheoretical intuitions, we suggest that determining whether incompatibilism is in fact intuitive calls for empirical testing. We then present the results of our studies, which (...) put significant pressure on the claim that incompatibilism is intuitive. Finally, we consider and respond to several potential objections to our approach. (shrink)

Editorial introduction to series of papers resulting from a European Commission Project on mental capacity.

Collection of essays, literature and first-person accounts on death, dying and bereavement.

Argues for the controversial and initially counterintuitive thesis that theatrical magic (that is, the performance of conjuring tricks) is a form of standup comedy.

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)

Review of book by Cynthia Daniels, At Women's Expense: State Power and the Politics of Fetal Rights.

Problem one: why, if God designed the human mind, did it take so long for humans to develop theistic concepts and beliefs? Problem two: why would God use evolution to design the living world when the discovery of evolution would predictably contribute to so much nonbelief in God? Darwin was aware of such questions but failed to see their evidential significance for theism. This paper explores this significance. Problem one introduces something I call natural nonbelief, which is significant because it (...) parallels and corroborates well-known worries about natural evil. Problems one and two, especially when combined, support naturalism over theism, intensify the problem of divine hiddenness, challenge Alvin Plantinga’s views about the naturalness of theism, and advance the discussion about whether the conflict between science and religion is genuine or superficial. (shrink)

Two general ethical problems in psychiatry are thrown into sharp relief by long term care. This article discusses each in turn, in the context of two anonymised case studies from actual clinical practice. First, previous mental health legislation soothed doubts about patients' refusal of consent by incorporating time limits on involuntary treatment. When these are absent, as in the provisions for long term care which have recently come into force, the justification for compulsory treatment and supervision becomes more obviously problematic. (...) Second, Anglo-American law does not normally allow the preventive detention of someone who may be dangerous but has not actually committed any crime. The justification for detaining a possibly dangerous user of mental health services without his or her consent can only be based on risk assessment, but this raises issues of moral luck. Is the psychiatrist who decides not to take out a supervision order for a possibly dangerous patient with an initial psychotic diagnosis morally at fault if that person harms someone in the community, or himself? Or is the psychiatrist merely unlucky? (shrink)

Anomaly in English law between age of children's permitted consent to treatment and much lower age of criminal responsibility.

Review of Joan Callahan, Reproduction, Ethics and the Law: Feminist Perspectives.

Review of Daniel Callahan, The Troubled Dream of Life.

The feminist movement may seek democratization on a global scale, but women are still hampered by a democratic deficit in terms of economic and political power. On the other hand, global feminist networks and new expanded forms of non-territorial political space do appear to be increasing democratic participation for women.

This paper is a companion piece to my earlier paper “Fallibilism and Concessive Knowledge Attributions”. There are two intuitive charges against fallibilism. One is that it countenances the truth (and presumably acceptability) of utterances of sentences such as “I know that Bush is a Republican, though it might be that he is not a Republican”. The second is that it countenances the truth (and presumably acceptability) of utterances of sentences such as “I know that Bush is a Republican, even though (...) I’m not certain that he is”, or “I know that Bush it a Republican, even though it isn’t certain that he is.” In “Fallibilism and Concessive Knowledge Attributions”, I argue that fallibilism in epistemology does not countenance the truth of utterances of sentences such as “I know that Bush is a Republican, though it might be that he is not a Republican”. In this paper, I argue that there are independent reasons for thinking that utterances of sentences such as “I know that Bush is a Republican, though I’m not certain that he is” and “I know that Bush is a Republican, though it’s not certain that he is” are unassertible. More specifically, I argue that these are simply instances of Moore’s Paradox, such as “Dogs bark, but I don’t know that they do.” The right account of Moore’s Paradox does not involve the falsehood of the semantic content of the relevant utterances, but rather their pragmatic unacceptability. So the anti-fallibilist intuitions turn out to have pragmatic, rather than semantic import, and therefore do not tell against the truth of fallibilism. Fallibilism in epistemology is often thought to be theoretically desirable, but intuitively problematic. My purpose with these two papers is to show that fallibilism is not intuitively problematic. (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)

Alongside a revival of interest in Thomism in philosophy, scholars have realised its relevance when addressing certain contemporary issues in bioethics. This book offers a rigorous interpretation of Aquinas's metaphysics and ethical thought, and highlights its significance to questions in bioethics. Jason T. Eberl applies Aquinas’s views on the seminal topics of human nature and morality to key questions in bioethics at the margins of human life – questions which are currently contested in the academia, politics and the media (...) such as: When does a human person’s life begin? How should we define and clinically determine a person’s death? Is abortion ever morally permissible? How should we resolve the conflict between the potential benefits of embryonic stem cell research and the lives of human embryos? Does cloning involve a misuse of human ingenuity and technology? What forms of treatment are appropriate for irreversibly comatose patients? How should we care for patients who experience unbearable suffering as they approach the end of life? _Thomistic Principles and Bioethics_ presents a significant philosophical viewpoint which will motivate further dialogue amongst religious and secular arenas of inquiry concerning such complex issues of both individual and public concern. (shrink)

I discuss Dante’s understanding that human existence is “ordered by two final goals” and how, for Dante, this understanding defines philosophy’s and revelation’s respective scopes of authority in guiding human conduct. Specifically, I show that, although Dante subordinates our earthly beatitude to spiritual beatitude in a way that seems to suggest the subordination of the authority of philosophy to that of revelation, he in fact limits philosophy’s scope to an arena in which its authority is not only legitimate but also (...) crucial to the cultivation of the higher, spiritual beatitude of human activity. (shrink)

Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly considering (...) whether a version of the reason-giving requirement can be salvaged despite this important difficulty. (shrink)

US citizens perceive their society to be one of the most diverse and religiously tolerant in the world today. Yet seemingly intractable religious intolerance and moral conflict abound throughout contemporary US public life - from abortion law battles, same-sex marriage, post-9/11 Islamophobia, public school curriculum controversies, to moral and religious dimensions of the Black Lives Matter and Occupy Wall Street movements, and Tea Party populism. Healthy Conflict in Contemporary American Society develops an approach to democratic discourse and coalition-building across deep (...) moral and religious divisions. Drawing on conflict transformation in peace studies, recent American pragmatist thought, and models of agonistic democracy, Jason Springs argues that, in circumstances riven with conflict between strong religious identities and deep moral and political commitments, productive engagement may depend on thinking creatively about how to constructively utilize conflict and intolerance. The result is an approach oriented by the recognition of conflict as a constituent and life-giving feature of social and political relationships. (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.

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)

Given the significance of Nicholas of Cusa’s ecclesiastical career, it is no surprise that a good deal of academic attention on Nicholas has focused on his role in the history of the church. Nevertheless, it would also be fair to say that a good deal of the attention that is focused on the life and thought of Nicholas of Cusa is the legacy of prior generations of scholars who saw in his theoretical work an opportunity to define the most salient (...) features of transformations in the habits of thinking leading from the Middle Ages into the epoch of modernity. Thus, although contemporary scholars have not been able to achieve any clear consensus on the question of whether Nicholas belongs to the Middle Ages or to modernity, the field of Cusanus studies has become much more attentive to the possibility that the uniqueness and significance of Nicholas’s vision is a function of his ability to synthesize and redeploy a variety of strands in the Catholic intellectual tradition—strands that are as apt to involve practical matters of canon law and church reform as they are to hinge on a unique and richly developed mystical theology. Given the flourishing of the attention devoted to Nicholas in the late 20th and early 21st centuries, the choices about which texts to include in this article were difficult ones. The rationale for this article’s predominant focus on scholarship of the late 20th and early 21st centuries is that, insofar as the recent studies listed here enter into the debates that have been shaped by their predecessors, the sources mentioned here will point readers to the prior work in the field not acknowledged here. (shrink)

Payment for eggs used in stem cell research puts women at unacceptable risk and encourages exploitative commodification of the female body. Thanks to the development of induced pluripotent stem cells, however, we no longer face a choice between good science and good ethics.

Practical wisdom is the intellectual virtue that enables a person to make reliably good decisions about how, all-things-considered, to live. As such, it is a lofty and important ideal to strive for. It is precisely this loftiness and importance that gives rise to important questions about wisdom: Can real people develop it? If so, how? What is the nature of wisdom as it manifests itself in real people? I argue that we can make headway answering these questions by modeling wisdom (...) on expert skill. Presenting the main argument for this expert skill model of wisdom is the focus of this paper. More specifically, I’ll argue that wisdom is primarily the same kind of epistemic achievement as expert decision-making skill in areas such as firefighting. Acknowledging this helps us see that, and how, real people can develop wisdom. It also helps to resolve philosophical debates about the nature of wisdom. For example, philosophers, including those who think virtue should be modeled on skills, disagree about the extent to which wise people make decisions using intuitions or principled deliberation and reflection. The expert skill model resolves this debate by showing that wisdom includes substantial intuitive and deliberative and reflective abilities. (shrink)

Paradiso 2’s sustained direct address warns readers unprepared for its complexities to “turn back to see your shores again…for perhaps losing me, you would be lost,” but then offers the “other few” who crave “the bread of angels” the promise of a marvel that would rival the deeds of the mythological hero Jason. I will argue that, by appearing to impose this choice on its readers, this direct address in fact activates the craving for the bread of angels (for (...) who, by obeying the interpretive imperative to make such a decision, would not also be one who thereby does choose to pursue the bread that is promised in return for this obedience?). In other words, the very act of interpreting the representation of readers as divided into those who are capable of allegorical interpretation and those who are not constructs and activates the will of a single readership for the Divine Comedy and, consequently, challenges us to provide an articulation of what it means even to read or to misread the Divine Comedy. (shrink)

Fictionalist approaches to ontology have been an accepted part of philosophical methodology for some time now. On a fictionalist view, engaging in discourse that involves apparent reference to a realm of problematic entities is best viewed as engaging in a pretense. Although in reality, the problematic entities do not exist, according to the pretense we engage in when using the discourse, they do exist. In the vocabulary of Burgess and Rosen (1997, p. 6), a nominalist construal of a given discourse (...) is revolutionary just in case it involves a “reconstruction or revision” of the original discourse. Revolutionary approaches are therefore prescriptive. In contrast, a nominalist construal of a given discourse is hermeneutic just in case it is a nominalist construal of a discourse that is put forth as a hypothesis about how the discourse is in fact used; that is, hermeneutic approaches are descriptive. I will adopt Burgess and Rosen’s terminology to describe the two different spirits in which a fictionalist hypothesis in ontology might be advanced. Revolutionary fictionalism would involve admitting that while the problematic discourse does in fact involve literal reference to nonexistent entities, we ought to use the discourse in such a way that the reference is simply within the pretense. The hermeneutic fictionalist, in contrast, reads fictionalism into our actual use of the problematic discourse. According to her, normal use of the problematic discourse involves a pretense. According to the pretense, and only according to the pretense, there exist the objects to which the discourse would commit its users, were no pretense involved. My purpose in this paper is to argue that hermeneutic fictionalism is not a viable strategy in ontology. My argument proceeds in two steps. First, I discuss in detail several problematic consequences of any interesting application of hermeneutic fictionalism. Of course, if there is good evidence that hermeneutic fictionalism is correct in some cases, then some of these drastic consequences would have to be accepted.. (shrink)

In this essay, I discuss in detail two of the earliest such documentaries: Death Mills (1945), directed by Billy Wilder; and Nazi Concentration Camps (1945), directed by George Stevens. Both film-makers were able to get direct footage of the newly-liberated concentration camps from the U.S. Army. Wilder served as a Colonel in the U.S. Army’s Psychological Warfare department in 1945 and was tasked with producing a documentary on the death camps as well as helping to restart Germany’s film industry. I (...) next review the great French Holocaust documentary Night and Fog (1955), directed by Alain Resnais. This was a widely acclaimed film, winning the Prix Jean Vigo in 1956. Resnais employed a camp survivor (Jean Cayrol) to write the dialogue, and it is powerful, indeed, truly lyrical in places. The last film I review in the essay is a generally overlooked British Thames Television documentary, Genocide: 1941-1945 (1974), directed by Michael Darlow (and narrated by Sir Laurence Oliver). It was the first of the major Holocaust documentaries to focus on the point that the Nazi genocide targeted first and foremost the Jewish people, and to explore the development of Nazi racial theory, and the rise of the SS. (shrink)

This paper attempts to explain the conceptual connections between happiness and well-being. It first distinguishes episodic happiness from happiness in the personal attribute sense. It then evaluates two recent proposals about the connection between happiness and well-being: (1) the idea that episodic happiness and well-being both have the same fundamental determinants, so that a person is well-off to a particular degree in virtue of the fact that they are happy to that degree, and (2) the idea that happiness in the (...) personal attribute sense can serve as a ‘‘proxy’’ for well-being, i.e., that a person’s degree of deep or robust happiness approximates their degree of well-being. It is argued that happiness in both these senses is conceptually, metaphysically, and empirically distinct from well- being. A new analysis of welfare, well-being as agential flourishing, can explain welfare’s real connection to happiness in both the episodic and personal attribute senses. It predicts that such happiness is only directly beneficial when it is valued, when it is a form of valuing, or when it underwrites (i.e., serves as the causal basis for) the disposition to realize one’s values. It is therefore a necessary—but not sufficient—condition for especially high levels of well-being. This analysis of welfare integrates many insights from the eudaimonic tradition of welfare and happiness research in psychology, and also addresses common criticisms of these eudaimonic models. (shrink)

A longstanding philosophical tradition holds that the primary objects of hearing are sounds rather than sound sources. In this case, we hear sound sources by—or in virtue of—hearing their sounds. This paper argues that, on the contrary, we have good reason to believe that the primary objects of hearing are sound sources, and that the relationship between a sound and its source is much like the relationship between a color and its bearer. Just as we see objects in seeing their (...) colors, so we hear sound sources in hearing their sounds. (shrink)

Leading versions of hedonism generate implausible results about the welfare value of very intense or unwanted pleasures, while recent versions of desire satisfactionism overvalue the fulfillment of desires associated with compulsions and addictions. Consequently, both these theories fail to satisfy a plausible condition of adequacy for theories of well-being proposed by L.W. Sumner: they do not make one’s well-being depend on one’s own cares or concerns. But Sumner’s own life-satisfaction theory cannot easily be extended to explain welfare over time, and (...) it makes mistaken (autonomous, informed) self-assessment impossible. A new account of well-being based on the stable realization of personal values enjoys the advantages claimed for these subjective theories while avoiding these problems. (shrink)

Winning essay of the American Society for Aesthetics' inaugural Peter Kivy Prize. Extends Kivy's notion of sonic picturing through engagement with recent work in philosophy of perception. Argues that sonic pictures are more widespread and more aesthetically and artistically important than even Kivy envisioned. Topics discussed include: the nature of sonic pictures; the nature of sounds; what we can (and more importantly, cannot) conclude from musical listening; sonic pictures in film; beatboxing as an art of sonic picturing; and cover songs (...) as sonic pictures. To be published in the Journal of Aesthetics and Art Criticism. (shrink)

This article, based on a case study, examines issues of confidentiality and family impact in a diagnosis of Huntington's disease. Genetic-based illness transcends individualistic models of patient autonomy because it also involves other family members, requiring a new approach to patient confidentiality.

The values-based approach to welfare holds that it is good for one to realize goals, activities, and relationships with which one strongly (and stably) identifies. This approach preserves the subjectivity of welfare while affirming that a life well lived must be active, engaged, and subjectively meaningful. As opposed to more objective theories, it is unified, naturalistic, and ontologically parsimonious. However, it faces objections concerning the possibility of self-sacrifice, disinterested and paradoxical values, and values that are out of sync with physical (...) and emotional needs. This paper revises the values-based approach, emphasizing the important—but limited—role consciously held values play in human agency. The additional components of human agency in turn explain why it is important for one’s values to cohere with one’s fixed drives, hard-wired emotional responses, and nonvolitionally guided cognitive pro- cesses. This affords promising responses to the objections above. (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.