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)

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

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)

This paper begins by drawing attention to inadequacies in common characterizations of the vice of complacency. An alternative account is presented that avoids these flaws. The distinctive nature of complacency is then clarified by contrasting it with related vices, including apathy, resignation, akrasia, excessive pride, and hypocrisy.

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)

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)

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

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.

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.

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)

The term ‘propaganda’ is normally taken in the pejorative sense of deceitful messaging. Propaganda is considered dubious if it is produced by a government agency, especially by a ministry of war or propaganda. In this article, I apply the theory of propaganda I sketched in a prior piece in these pages, under which propaganda is simply messaging intended to persuade others to do something or to support something. Under this theory, propaganda is reasonable if but only if it is evidence-based, (...) truthful, broadly logical, not coercive, targeted at mentally competent adults, and transparent—meaning that the audience should be aware that the message is intended to persuade them to do or support something. I then examine three WWII-era government propaganda films, one—A Defeated People (1946)—produced by the British military, and two—The Negro Soldier (1944) and Teamwork (1947)—produced by the American military. I explain first why I chose these particular films. I then analyze these films in some detail and show that while they were not perfectly rational, they all effectively conveyed the persuasive message that the respective militaries wanted to convey. And they did this by meeting all of the criteria for propaganda to be rational. (shrink)

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

Review of Graeme Laurie, Genetic Privacy.

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 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)

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)

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)

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)

This book is a case of “too little, too late”: too little in that it represents voices not from the developing world as a whole but from a particular Catholic viewpoint in the Philippines, too late in that others have already gone “beyond a Western bioethics”—which, in any case, is not the unified and rigid set of principles that the authors make it out to be. The publication is a long delayed spinoff of a series of bioethics seminars held in (...) Manila and Houston under the leadership of H Tristram Engelhardt Jr, who has contributed an introduction to the volume on Western bioethics reconsidered. (As Engelhardt writes: “Like good wine, this work has come slowly into its own” (page xii). Engelhardt’s bias is evident in the phrase he uses early on in this introduction, “the customary American/western European indoctrination in …. (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)

Epistemologists often assume that an agent’s epistemic goal is simply to acquire as much knowledge as possible for herself. Drawing on an analogy with ethics and other practices, I argue that being situated in an epistemic community introduces a range of epistemic virtues (and goals) which fall outside of those typically recognized by both individualistic and social epistemologists. Candidate virtues include such traits as honesty, integrity (including an unwillingness to misuse one’s status as an expert), patience, and creativity. We can (...) understand such traits to be epistemic virtues insofar as they tend to produce knowledge – not for the agent alone, but for her community. Recognition of such ‘otherregarding epistemic virtues’ both broadens the area of inquiry of epistemology, and introduces new standards for the evaluation of epistemic agents. (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)

Simon Keller and Sarah Stroud have both argued that the demands of being a good friend can conflict with the demands of standard epistemic norms. Intuitively, good friends will tend to seek favorable interpretations of their friends’ behaviors, interpretations that they would not apply to strangers; as such they seem prone to form unjustified beliefs. I argue that there is no such clash of norms. In particular, I argue that friendship does not require us to form beliefs about our friends (...) in the biased fashion suggested by Stroud and Keller. I further argue that while some slight bias in belief-formation might be permitted by friendship, any such bias would fall within the bounds of epistemic propriety. (shrink)

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

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)

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)

It is argued that Nozick's experience machine thought experiment does not pose a particular difficulty for mental state theories of well-being. While the example shows that we value many things beyond our mental states, this simply reflects the fact that we value more than our own well-being. Nor is a mental state theorist forced to make the dubious claim that we maintain these other values simply as a means to desirable mental states. Valuing more than our mental states is compatible (...) with maintaining that the impact of such values upon our well-being lies in their impact upon our mental lives. (shrink)

A consensus exists among contemporary philosophers of biology about the history of their field. According to the received view, mainstream philosophy of science in the 1930s, 40s, and 50s focused on physics and general epistemology, neglecting analyses of the 'special sciences', including biology. The subdiscipline of philosophy of biology emerged (and could only have emerged) after the decline of logical positivism in the 1960s and 70s. In this article, I present bibliometric data from four major philosophy of science journals (Erkenntnis, (...) Philosophy of Science, Synthese, and the British Journal for the Philosophy of Science), covering 1930-59, which challenge this view. (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)

Review of Graeme Laurie, Genetic Privacy: A Challenge to Medico-Legal Norms.

Confirmational holism is at odds with Jeffrey conditioning --- the orthodox Bayesian policy for accommodating uncertain learning experiences. Two of the great insights of holist epistemology are that (i) the effects of experience ought to be mediated by one's background beliefs, and (ii) the support provided by one's learning experience can and often is undercut by subsequent learning. Jeffrey conditioning fails to vindicate either of these insights. My aim is to describe and defend a new updating policy that does better. (...) In addition to showing that this new policy is more holism-friendly than Jeffrey conditioning, I will also show that it has an accuracy-centered justification. (shrink)

Many philosophers, in discussing supererogation, maintain that supererogatory actions must be done for the benefit of others. In this paper I argue that there can be instances of self-regarding supererogatory actions. That is, there are cases in which the primary (or sole) intended beneficiary of a supererogatory action is the agent herself, and she need not be acting out of a concern for morality or moral rules. In such cases the agent still acts suitably 'beyond the call of duty', and (...) in a morally praiseworthy fashion. (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)

Recent work in the psychology of happiness has led some to conclude that we are unreliable assessors of our lives and that skepticism about whether we are happy is a genuine possibility worth taking very seriously. I argue that such claims, if true, have worrisome implications for procreation. In particular, they show that skepticism about whether many if not most people are well positioned to create persons is a genuine possibility worth taking very seriously. This skeptical worry should not be (...) confused with a related but much stronger version of the argument, which says that all human lives are very bad and not worth starting. I criticize the latter stance, but take seriously the former stance and hope it can be answered in future work. (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)

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)

This paper contributes to the recent explosion of literature on the epistemological role of emotions and other affective states by defending two claims. First, affective states might do more than position us to receive evidence or function as evidence. Affective states might be thought to appraise evidence, in the sense that affective states influence what doxastic state is rational for someone given a body of evidence. The second claim is that affective evidentialism, the view that affective states function rationally in (...) this way, is not just possible but plausible and fruitful. We offer two arguments in favor of affective evidentialism. (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)

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)

Objectives—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 effectDesign, subjects and setting–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”.Results–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.Conclusions—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)