We discuss recent progress in the development of cognitive ontologies and summarize three challenges in the coordinated development and application of these resources. Challenge 1 is to adopt a standardized definition for cognitive processes. We describe three possibilities and recommend one that is consistent with the standard view in cognitive and biomedical sciences. Challenge 2 is harmonization. Gaps and conflicts in representation must be resolved so that these resources can be combined for mark-up and interpretation of multi-modal data. Finally, Challenge (...) 3 is to test the utility of these resources for large-scale annotation of data, search and query, and knowledge discovery and integration. As term definitions are tested and revised, harmonization should enable coordinated updates across ontologies. However, the true test of these definitions will be in their community-wide adoption which will test whether they support valid inferences about psychological and neuroscientific data. (shrink)

Mental health research faces a suite of unresolved challenges that have contributed to a stagnation of research efforts and treatment innovation. One such challenge is how to reliably and validly account for the subjective side of patient symptomatology, that is, the patient’s inner experiences or patient phenomenology. Providing a structured, standardised semantics for patient phenomenology would enable future research in novel directions. In this contribution, we aim at initiating a standardized approach to patient phenomenology by sketching a tentative formalisation within (...) the framework of an applied ontology, in the broader context of existing open-source Open Biomedical Ontologies resources such as the Mental Functioning Ontology. We further discuss a number of prevailing challenges and observations bearing on this task. (shrink)

Affective science conducts interdisciplinary research into the emotions and other affective phenomena. Currently, such research is hampered by the lack of common definitions of terms used to describe, categorise and report both individual emotional experiences and the results of scientific investigations of such experiences. High quality ontologies provide formal definitions for types of entities in reality and for the relationships between such entities, definitions which can be used to disambiguate and unify data across different disciplines. Heretofore, there has been little (...) effort directed towards such formal representation for affective phenomena, in part because of widespread debates within the affective science community on matters of definition and categorization. To address this requirement, we are developing an Emotion Ontology (EMO). (shrink)

Affective science conducts interdisciplinary research into the emotions and other affective phenomena. Currently, such research is hampered by the lack of common definitions of te rms used to describe, categorise and report both individual emotional experiences and the results of scientific investigations of such experiences. High quality ontologies provide formal definitions for types of entities in reality and for the relationships between such entities, definitions which can be used to disambiguate and unify data across different disciplines. Heretofore, there has been (...) little effort directed towards such formal representation for affective phenomena, in part because of widespread debates within the affective science community on matters of definition and categorization. We describe our efforts towards developing an Emotion Ontology (EMO) to serve the affective science community. We here focus on conformity to the BFO upper ontology and disambiguation of polysemous terminology. (shrink)

Advances in emotion and affective science have yet to translate routinely into psychiatric research and practice. This is unfortunate since emotion and affect are fundamental components of many psychiatric conditions. Rectifying this lack of interdisciplinary integration could thus be a potential avenue for improving psychiatric diagnosis and treatment. In this contribution, we propose and discuss an ontological framework for explicitly capturing the complex interrelations between affective entities and psychiatric disorders, in order to facilitate mapping and integration between affective science and (...) psychiatric diagnostics. We build on and enhance the categorisation of emotion, affect and mood within the previously developed Emotion Ontology, and that of psychiatric disorders in the Mental Disease Ontology. This effort further draws on developments in formal ontology regarding the distinction between normal and abnormal in order to formalize the interconnections. This operational semantic framework is relevant for applications including clarifying psychiatric diagnostic categories, clinical information systems, and the integration and translation of research results across disciplines. (shrink)

We discuss recent progress in the development of cognitive ontologies and summarize three challenges in the coordinated development and application of these resources. Challenge 1 is to adopt a standardized definition for cognitive processes. We describe three possibilities and recommend one that is consistent with the standard view in cognitive and biomedical sciences. Challenge 2 is harmonization. Gaps and conflicts in representation must be resolved so that these resources can be combined for mark-up and interpretation of multi-modal data. Finally, Challenge (...) 3 is to test the utility of these resources for large-scale annotation of data, search and query, and knowledge discovery and integration. As term definitions are tested and revised, harmonization should enable coordinated updates across ontologies. However, the true test of these definitions will be in their community-wide adoption which will test whether they support valid inferences about psychological and neuroscientific data. (shrink)

Mental and behavioral disorders represent a significant portion of the public health burden in all countries. The human cost of these disorders is immense, yet treatment options for sufferers are currently limited, with many patients failing to respond sufficiently to available interventions and drugs. High quality ontologies facilitate data aggregation and comparison across different disciplines, and may therefore speed up the translation of primary research into novel therapeutics. Realism-based ontologies describe entities in reality and the relationships between them in such (...) a way that – once formulated in a suitable formal language – the ontologies can be used for sophisticated automated reasoning applications. Reference ontologies can be applied across different contexts in which different, and often mutually incompatible, domain-specific vocabularies have traditionally been used. In this contribution we describe the Mental Functioning Ontology (MF) and Mental Disease Ontology (MD), two realism-based ontologies currently under development for the description of humanmental functioning and disease. We describe the structure and upper levels of the ontologies and preliminary application scenarios, and identify some open questions. (shrink)

Ontologies are being developed throughout the biomedical sciences to address standardization, integration, classification and reasoning needs against the background of an increasingly data-driven research paradigm. In particular, ontologies facilitate the translation of basic research into benefits for the patient by making research results more discoverable and by facilitating knowledge transfer across disciplinary boundaries. Addressing and adequately treating mental illness is one of our most pressing public health challenges. Primary research across multiple disciplines such as psychology, psychiatry, biology, neuroscience and pharmacology (...) needs to be integrated in order to promote a more comprehensive understanding of underlying processes and mechanisms, and this need for integration only becomes more pressing with our increase in understanding of differences among individuals and populations at the molecular level concerning susceptibility to specific illnesses. Substance addiction is a particularly relevant public health challenge in the developed world, affecting a substantial percentage of the population, often co-morbid with other illnesses such as mood disorders. Currently, however, there is no straightforward automated method to combine data of relevance to the study of substance addiction across multiple disciplines and populations. In this contribution, we describe a framework of interlinked, interoperable bio-ontologies for the annotation of primary research data relating to substance addiction, and discuss how this framework enables easy integration of results across disciplinary boundaries. We describe entities and relationships relevant for the description of addiction within the Mental Functioning Ontology, Chemical Entities of Biological Interest Ontology, Protein Ontology, Gene Ontology and the Neuroscience Information Framework ontologies. (shrink)

The Emotion Ontology is an ontology covering all aspects of emotional and affective mental functioning. It is being developed following the principles of the OBO Foundry and Ontological Realism. This means that in compiling the ontology, we emphasize the importance of the nature of the entities in reality that the ontology is describing. One of the ways in which realism-based ontologies are being successfully used within biomedical science is in the annotation of scientific research results in publicly available databases. Such (...) annotation enables several objectives, including searching, browsing and cross-database data integration. A key benefit conferred by realismbased ontology is that suitably annotated research results are able to be aggregated and compared in a fashion that is based on the underlying reality that the science is studying. This has the potential of increasing the power of statistical analysis and meta-analysis in data-driven science. This aspect has been fruitfully exploited in the investigation of the functions of genes in molecular biology. Cognitive neuroscience uses functional neuroimaging to investigate the brain correlates of areas of mental functioning such as memory, planning and emotion. The use of functional neuroimaging to study affective phenomena such as the emotions is called ‘affective neuroscience’. BrainMap is the largest curated database of coordinates and metadata for studies in cognitive neuroscience, including affective neuroscience (Laird et al., 2005). BrainMap data is already classified and indexed using a terminology for classification, called the ‘Cognitive Paradigm Ontology’ (CogPO), that has been developed to facilitate searching and browsing. However, CogPO has been developed specifically for the BrainMap database, and the data are thus far not annotated to a realism-based ontology which would allow the discovery of interrelationships between research results across different databases on the basis of what the research is about. In this contribution, we describe ongoing work that aims to annotate affective neuroscience data, starting with the BrainMap database, using the Emotion Ontology. We describe our objectives and technical approach to the annotation, and mention some of the challenges. (shrink)

The answer of Lowe to Ramsey’s argument against the distinction universal vs. indivi- dual: At the beginning of this article Ramsey’s argumentation against universal‐particular distinction is presented. It is based on the assumption that this division requires another one: namely, subject‐predicate distinction. This argumentation was a starting point for Lowe, who does not respect the aforementioned assumption. In his theory, there are not two but four categories, namely: substantial universals, non‐substantial universals, substantial particulars, and non‐substantial particulars. Two of these categories (...) are categories of universals; the other two are categories of particulars. Lowe tries to de ne categories in an ontological way, that is, with essential use of ontological notions. These notions are rigid and non‐rigid existential de‐ pendence, which are themselves de ned in terms of necessity and existence. The contribution of this paper is an analysis of Lowe’s solution. In the rst place, it is con onted with Ramsey remarks. Then other objections are considered. Some of them do not respect the very idea of autonomous ‘ontological way’ in philosophy. Others concern Lowe’s particular version of it. Possible answers to all of these objections are presented, such that Lowe’s theory is defended. However, there is no ultimate conclusion here. In the author’s opinion autonomy and the value of ontology cannot be shown om a purely external position. We should rst assume that this discipline does make sense and then explore its virtues by using its notions. (shrink)

An opinionated encyclopedia entry on Hastings Rashdall, in which several worries about his case for ideal utilitarianism are raised.

Joanna Mary Firth and Jonathan Quong argue that both an instrumental account of liability to defensive harm, according to which an aggressor can only be liable to defensive harms that are necessary to avert the threat he poses, and a purely noninstrumental account which completely jettisons the necessity condition, lead to very counterintuitive implications. To remedy this situation, they offer a “pluralist” account and base it on a distinction between “agency rights” and a “humanitarian right.” I argue, first, that (...) this distinction is spurious; second, that the conclusions they draw from this distinction do not cohere with its premises; third, that even if one granted the distinction, Firth’s and Quong’s implicit premise that you can forfeit your agency rights but not your “humanitarian right” is unwarranted; fourth, that their attempt to mitigate the counterintuitive implications of their own account in the Rape case relies on mistaken ad-hoc assumptions; fifth, that even if they were successful in somewhat mitigating said counterintuitive implications, they would still not be able to entirely avoid them; and sixth, that even in the unlikely case that none of these previous five critical points are correct, Firth and Quong still fail to establish that aggressors can be liable to unnecessary defensive harm since they fail to establish that unnecessary harm can ever be defensive in the first place. (shrink)

The Japanese Transplantation Law is unique among others in that it allows us to choose between "brain death" and "traditional death" as our death. In every country 20 to 40 % of the popularion doubts the idea of brain death. This paper reconsiders the concept, and reports the ongoing rivision process of the current law. Published in Hastings Center Report, 2001.

I address Sinnott-Armstrong's argument that evidence of framing effects in moral psychology shows that moral intuitions are unreliable and therefore not noninferentially justified. I begin by discussing what it is to be epistemically unreliable and clarify how framing effects render moral intuitions unreliable. This analysis calls for a modification of Sinnott-Armstrong's argument if it is to remain valid. In particular, he must claim that framing is sufficiently likely to determine the content of moral intuitions. I then re-examine the evidence which (...) is supposed to support this claim. In doing so, I provide a novel suggestion for how to analyze the reliability of intuitions in empirical studies. Analysis of the evidence suggests that moral intuitions subject to framing effects are in fact much more reliable than perhaps was thought, and that Sinnott-Armstrong has not succeeded in showing that noninferential justification has been defeated. (shrink)

Ideal utilitarianism states that the only fundamental requirement of morality is to promote a plurality of intrinsic goods. This paper critically evaluates Hastings Rashdall’s arguments for ideal utilitarianism, while comparing them with G. E. Moore’s arguments. Section I outlines Rashdall’s ethical outlook. Section II considers two different arguments that he provides for its theory of rightness. Section III discusses his defence of a pluralist theory of value. Section IV argues that Rashdall makes a lasting contribution to the defence of (...) ideal utilitarianism. (shrink)

In recent years, campaigns across the globe have called for the removal of objects symbolic of white supremacy. This paper examines the ethics of altering or removing such objects. Do these strategies sanitize history, destroy heritage and suppress freedom of speech? Or are they important steps towards justice? Does removing monuments and renaming schools reflect a lack of parity and unfairly erase local identities? Or can it sometimes be morally required, as an expression of respect for the memories of people (...) who endured past injustices; a recognition of this history's ongoing legacies; and a repudiation of unjust social hierarchies? (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19 . (shrink)

In recent years, a new generation of activists has reinvigorated debate over the public commemorative landscape. While this debate is in no way limited to statues, it frequently crystallizes around public representations of historical figures who expressed support for the oppression of certain groups or contributed to their past or present oppression. In this paper, I consider what should be done about such representations. A number of philosophers have articulated arguments for modifying or removing public monuments. Joanna Burch-Brown (2017) (...) grounds her argument for removal in what I call the “honorific” function of such representations—the ways in which they express and tend to cultivate admiration for their subjects. In the first two sections of the paper, I develop a novel argument for modifying these representations based on this insight. I argue that leaving such representations unmodified in the public space tends to undermine the dignity of members of oppressed groups as well as their assurance that society and government are committed to their rights and constitutional entitlements. In the paper’s third section, I develop a “balancing test” for determining whether the relevant moral and pragmatic considerations favor making a particular representation inaccessible to the public, or recontextualizing it for public consumption. Unlike some of the existing philosophical treatments of honorific representations that focus on particular monuments, this balancing test is designed for general application to any honorific representation that satisfies the presumptive case for modification. To conclude, I offer some reasons why weak forms of recontextualization that do not involve altering institutional context may often be an insufficient remedy for the problems I describe. (shrink)

The goals and tasks of neuroethics formulated by Farahany and Ramos (2020) link epistemological and methodological issues with ethical and social values. The authors refer simultaneously to the social significance and scientific reliability of the BRAIN Initiative. They openly argue that neuroethics should not only examine neuroscientific research in terms of “a rigorous, reproducible, and representative neuroscience research process” as well as “explore the unique nature of the study of the human brain through accurate and representative models of its function (...) and dysfunction”, but also its responsibilities or social consequences. In our commentary, we would like to concentrate on problem selection, which is shortly noticed by Farahany and Ramos, and by BRAIN Initiative’s Neuroethics Report itself. The document raises an important issue related to problem selection, which is strengthening or perpetuating existing prejudices and biases by choosing a research subject: “scientists are prompted to consider how the questions they choose to study in the laboratory might amplify existing biases.” This leads to several further problems: what constitutes bias?; how biases may be embedded in the selection of research programs?; is it possible to conduct completely unbiased research?; who should be a gatekeeper in the case of research that may amplify biases? We try to notice possible answers to these questions in the context of the research on differences (e.g., cognitive, medical, behavioral) between human populations. (shrink)

Science communication via testimony requires a certain level of trust. But in the context of ideologically-entangled scientific issues, trust is in short supply—particularly when the issues are politically ‘entangled’. In such cases, cultural values are better predictors than scientific literacy for whether agents trust the publicly-directed claims of the scientific community. In this paper, we argue that a common way of thinking about scientific literacy—as knowledge of particular scientific facts or concepts—ought to give way to a second-order understanding of science (...) as a process as a more important notion for the public’s trust of science. (shrink)

The scientific community, we hold, often provides society with knowledge—that the HIV virus causes AIDS, that anthropogenic climate change is underway, that the MMR vaccine is safe. Some deny that we have this knowledge, however, and work to undermine it in others. It has been common to refer to such agents as “denialists”. At first glance, then, denialism appears to be a form of skepticism. But while we know that various denialist strategies for suppressing belief are generally effective, little is (...) known about which strategies are most effective. We see this as an important first step toward their remediation. This paper leverages the approximate comparison to various forms of philosophical skepticism to design an experimental test of the efficacy of four broad strategies of denial at suppressing belief in specific scientific claims. Our results suggest that assertive strategies are more effective at suppressing belief than questioning strategies. (shrink)

May assumes that if moral beliefs are counterfactually dependent on irrelevant factors, then those moral beliefs are based on defective belief-forming processes. This assumption is false. Whether influence by irrelevant factors is debunking depends on the mechanisms through which this influence occurs. This raises the empirical bar for debunkers and helps May avoid an objection to his Debunker’s Dilemma.

Deception of subjects is used frequently in the social sciences. Examples are provided. The ethics of experimental deception are discussed, in particular various maneuvers to solve the problem. The results have implications for the use of deception in the biomedical sciences.

Opioid treatment agreements are written agreements between physicians and patients enumerating the risks associated with opioid medications along with the requirements that patients must meet to receive these medications on an ongoing basis. The choice to use such agreements goes beyond the standard informed consent process, and has a distinctive symbolic significance. Specifically, it suggests that physicians regard it as important to hold their patients accountable for adhering to various protocols regarding the use of their opioid medications. After laying out (...) a taxonomy of accountability relationships between physicians and patients, I argue that opioid treatment agreements are only justifiable for physicians to use in their provision of care if they improve public health outcomes, which has yet to be demonstrated. (shrink)

We consider an ethical dilemma in global health: is it ethically acceptable to provide some patients cheaper treatments that are less effective or more toxic than the treatments other patients receive? We argue that it is ethical to consider local resource constraints when deciding what interventions to provide. The provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.

It is often alleged that Cantor’s views about how the set theoretic universe as a whole should be considered are fundamentally unclear. In this article we argue that Cantor’s views on this subject, at least up until around 1896, are relatively clear, coherent, and interesting. We then go on to argue that Cantor’s views about the set theoretic universe as a whole have implications for theology that have hitherto not been sufficiently recognised. However, the theological implications in question, at least (...) as articulated here, would not have satisfied Cantor himself. (shrink)

The purpose of this paper is to offer some critical remarks on the so-called pragmatist approach to the regulation of robotics. To this end, the article mainly reviews the work of Jack Balkin and Joanna Bryson, who have taken up such ap- proach with interestingly similar outcomes. Moreover, special attention will be paid to the discussion concerning the legal fiction of ‘electronic personality’. This will help shed light on the opposition between essentialist and pragmatist methodologies. After a brief introduction (...) (1.), in 2. I introduce the main points of the methodological debate which opposes pragmatism and essentialism in the regulation of robotics and I examine how legal fictions are framed from a pragmatist, functional perspective. Since this approach entails a neat separation of ontological analysis and legal rea- soning, in 3. I discuss whether considerations on robots’ essence are actually put into brackets when the pragmatist approach is endorsed. Finally, in 4. I address the problem of the social valence of legal fictions in order to suggest a possible limit of the pragmatist approach. My conclusion (5.) is that in the specific case of regulating robotics it may be very difficult to separate ontological considerations from legal reasoning—and vice versa—both on an epistemological and social level. This calls for great caution in the recourse to anthropomorphic legal fictions. (shrink)

This study examines the conflation of terms such as “knowledge” and “understanding” in peer-reviewed literature, and tests the hypothesis that little current research clearly distinguishes between importantly distinct epistemic states. Two sets of data are presented from papers published in the journal Public Understanding of Science. In the first set, the digital text analysis tool, Voyant, is used to analyze all papers published in 2014 for the use of epistemic success terms. In the second set of data, all papers published (...) in Public Understanding of Science from 2010–2015 are systematically analyzed to identify instances in which epistemic states are empirically measured. The results indicate that epistemic success terms are inconsistently defined, and that measurement of understanding, in particular, is rarely achieved in public understanding of science studies. We suggest that more diligent attention to measuring understanding, as opposed to mere knowledge, will increase efficacy of scientific outreach and communication efforts. (shrink)

Perez-Rodriguez and de la Fuente (2017) assume that although human races do not exist in a biological sense (“geneticists and evolutionary biologists generally agree that the division of humans into races/subspecies has no defensible scientific basis,” they exist only as “sociocultural constructions” and because of that maintain an illusory reality, for example, through “racialized” practices in medicine. Agreeing with the main postulates formulated in the article, we believe that the authors treat this problem in a superficial manner and have failed (...) to capture the current state of the field of knowledge in science and the humanities. In our commentary, we want to highlight two main omissions, and to notice three important implications for “a postracial medicine.”. (shrink)

Patients should not always receive hard data about the risks and benefits of a medical intervention. That information should always be available to patients who expressly ask for it, but it should be part of standard disclosure only sometimes, and only for some patients. And even then, we need to think about how to offer it.

Insofar as many older adults fit some definition of disability, disability studies and gerontology would seem to have common interests and goals. However, there has been little discussion between these fields. The aim of this paper is to open up the insights of disability studies as well as philosophy of disability to discussions in gerontology. In doing so, I hope to contribute to thinking about the good life in late life by more critically reflecting upon the meaning of the body, (...) ability, and the variability of each. My central argument is that we should conceptualize age‐associated bodily variations and abilities not in terms of individual capacity, but in terms of what I call “the extended body.” It is in light of the meaning of embodiment and ability in general that we must think differently and more capaciously about the meaning of late life in particular. (shrink)

Reliance on intuitive and emotive responses is widespread across many areas of bioethics, and the current debate on biotechnological human enhancement is particularly interesting in this respect. A strand of “bioconservatives” that has explicitly drawn connections to the modern conservative tradition, dating back to Edmund Burke, appeals explicitly to the alleged wisdom of our intuitions and emotions to ground opposition to some biotechnologies or their uses. So-called bioliberals, those who in principle do not oppose human bioenhancement, tend to rely on (...) rational arguments and to see intuitions and emotions mostly as sources of biases. This approach often translates into shifting the burden of proof onto bioconservatives and challenging them to provide arguments against the proposed enhancement to back what bioliberals perceive as merely intuitive, emotive, and irrational reactions. -/- In this article, I am going to show that the methodological divide between bioliberals and bioconservatives is less significant than at first glance it appears to be and less significant than it is often taken to be. I will do so by defending two theses. The first is that reliance on intuitions and emotions is not a prerogative of bioconservatives: bioliberals have their typical intuitions and emotive responses and are for this reason exposed to potential biases in the same way as bioconservatives are. The second thesis is that reliance on intuitions and emotions is not necessarily antithetic to reason and rationality. This latter thesis has been philosophically defended with particular reference to the debate on biotechnologies, while the former is perhaps more controversial and more difficult to accept—at least for bioliberals. In both cases, I will support the claims by drawing on resources from the field of moral psychology and the sciences of the mind and, particularly, by applying to some positions in the enhancement debate recent findings about the role of intuitions and emotions in human moral assessment. This new empirically informed perspective holds promises for solving the methodological controversy between bioconservatives and bioliberals, thus enabling proper dialogue and debate between the two sides. (shrink)

The article focuses on Burke’s engagement with India and the Impeachment of Warren Hastings. It attempts to trace the way in which Burke, in his rhetoric on India, uses the sentimentalist vocabulary of the Scottish Enlightenment and, more particularly, the concept of sympathy. Burke, it is suggested, passes from a Humean to a Smithian understanding of sympathy, giving however, at every stage of this development, his own turn and character to the concept. Overall, Burke’s writings on India reveal quite (...) advanced for his time political reflexes and oblige us to reconsider the stereotypic image of Burke as an icon of conservatism. (shrink)

When, if ever, can healthcare provider's lay claim to knowing what is best for their patients? In this paper, I offer a taxonomy of clinical disagreements. The taxonomy, I argue, reveals that healthcare providers often can lay claim to knowing what is best for their patients, but that oftentimes, they cannot do so *as* healthcare providers.

In this paper we analyze the non-coercive ways in which researchers can use knowledge about the decision-making tendencies of potential participants in order to motivate them to consent to research enrollment. We identify which modes of influence preserve respect for participants’ autonomy and which disrespect autonomy, and apply the umbrella term of manipulation to the latter. We then apply our analysis to a series of cases adapted from the experiences of clinical researchers in order to develop a framework for thinking (...) through the ethics of manipulating people into research participation. All manipulation disrespects autonomy and is therefore pro tanto wrong. However, only deceptive manipulation invalidates the consent that results from it. Use of the other forms of manipulation can be permissible, but only if the outcome of using manipulation is sufficiently good and if the research cannot be carried out using ethically preferable means to obtain consent. (shrink)

A commentary on “Models of Consent to Return of Incidental Findings in Genomic Research” by Paul S. Appelbaum, Erik Parens, Cameron R. Waldman, Robert Klitzman, Abby Fyer, Josue Martinez, W. Nicholson Price II, and Wendy K. Chung, in the July-August 2014 issue, http://www.thehastingscenter.org/Publications/HCR/Detail.aspx?id=6964.

Drawing on findings from the study of prejudice and prejudice reduction, we identify a number of mechanisms through which religious communities may influence the intergroup attitudes of their members. We hypothesize that religious participation could in principle either reduce or promote prejudice with respect to any given target group. A religious community’s influence on intergroup attitudes will depend upon the specific beliefs, attitudes, and practices found within the community, as well as on interactions between the religious community and the larger (...) social environment in which it is embedded. Basing our proposals on findings from the literature on prejudice formation and prejudice reduction allows us to outline useful directions for future studies of religion and prejudice. (shrink)

The guiding premise from which this special report begins is the conviction and hope that justice is at the normative heart of medicine and that it is the perpetual task of bioethics to bring concerns of justice to bear on medical practice. On such an account, justice is medicine's lifeblood, that by which it contributes to life as opposed to diminishing it. It is in this larger, historical, intersectional, critical, and ethically minded context that we must approach pressing questions facing (...) medicine, including the question of the import and role of genomic knowledge for human life. The second premise is that, at least in principle, the knowledge generated by genomics can be a gift or a weight, or both at the same time. That is to say that, on the one hand, genomic knowledge is a gift, creating novel insights into the genetic drivers of disease and into the geographical paths of our ancestors. And on the other hand, it is a weight, creating new obligations, new forms of social classification, and new forms of surveillance. Because it is in many ways the “common sense” of the day that genomic knowledge is a gift, this special report, which contains nine essays, concentrates on the ways in which such knowledge can be a weight, a weight that has the potential to thwart—and historically has thwarted—medicine from genuinely advancing justice . (shrink)

Torture is unethical and usually counterproductive. It is prohibited by international and national laws. Yet it persists: according to Amnesty International, torture is widespread in more than a third of countries. Physicians and other medical professionals are frequently asked to assist with torture. -/- Medical complicity in torture, like other forms of involvement, is prohibited both by international law and by codes of professional ethics. However, when the victims of torture are also patients in need of treatment, doctors can find (...) themselves torn. To accede to the requests of the torturers may entail assisting or condoning terrible acts. But to refuse care to someone in medical need may seem like abandoning a patient and thereby fail to exhibit the beneficence expected of physicians. -/- In this paper, we argue that this dilemma is real and that sometimes the right thing for a doctor to do, overall, is to be complicit in torture. Though complicity in a wrongful act is itself prima facie wrongful, this judgment may be outweighed by other factors. We propose three criteria for analyzing how those factors apply to particular cases of medical complicity in torture. (shrink)

The volume of clinical research is increasing exponentially—far beyond our ability to process and absorb the results. Given this situation, it may be beneficial to consider reducing the flow at its source. In what follows, I will motivate and critically evaluate the following proposal: researchers should conduct fewer clinical trials. More specifically, I c onsider whether researchers should be permitted to conduct only clinical research of very high quality and, in turn, whether research ethics committees should prohibit all other, lower-quality (...) research, even when it might appear to meet some minimal ethical standard. Following a close analysis of the social-value requirement of ethical clinical research, I argue that this proposal is defensible. The problem identified in this paper has two parts, quantity and quality, and some clarification is needed about the latter because “quality” is a highly contested term in the medical literature. When some scholars advocate for high-quality trials, they mean large-scale, simple, explanatory randomized controlled trials. Others, including myself, have defended a different characterization of high-quality research that tends more toward pragmatic trial design and the use of methods other than RCTs. Pragmatic trials aim to provide evidence that directly supports clinical decision-making in “usual” care settings. Unlike explanatory trials, which aim to abstract away from particular settings and patients, in the hopes of creating ideal conditions for the success of an intervention, pragmatic trials deliberately pursue knowledge of high applicability, through the use of representative subjects, clinically important questions, flexible treatment protocols, patient-oriented outcome measures, and so on. I see applicability as a marker of high-quality research. The context in which research is meant to be applied should be the context in which new interventions are evaluated. (shrink)

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

Population obesity and associated morbidities pose significant public health and economic burdens in the United Kingdom, United States, and globally. As a response, public health initiatives often seek to change individuals’ unhealthy behavior, with the dual aims of improving their health and conserving health care resources. One such initiative—taxes on sugar‐sweetened beverages (SSB)—has sparked considerable ethical debate. Prominent in the debate are arguments seeking to demonstrate the supposed impermissibility of SSB taxes and similar policies on the grounds that they interfere (...) with individuals’ freedom and autonomy. Commentators have often assumed that a policy intended to restrict or change private individuals’ consumption behavior will necessarily curtail freedom and, as a corollary, will undermine individuals’ autonomy with respect to their consumption choices. Yet this assumption involves a conceptual mistake. To address the misunderstanding, it’s necessary to attend to the differences between negative liberty, freedom of options, and autonomy. Ultimately, concerns about negative liberty, freedom, and autonomy do not provide strong grounds for opposing SSB taxes. (shrink)

The search for valuable new products from among the world’s stock of natural biological resources is mostly carried out by people from wealthy countries, and mostly takes place in developing countries that lack the research capacity to profit from it. Surely, the indigenous people should receive some compensation from it. But we must build a robust defense for this intuition, rooted in the Western moral traditions that are widely accepted in wealthy countries, if we are to put it into practice (...) and enforce it. (shrink)

Research studies increasingly use genomic sequencing to draw inferences based on comparisons between the genetic data of a set of purportedly related individuals. As use of this method progresses, it will become much more common to discover that the assumed biological relationships between the individuals are mistaken. Consequently, researchers will have to grapple with decisions about whether to return incidental findings of misattributed parentage on a much larger scale than ever before. In this paper we provide an extended argument for (...) the view that the default position for researchers ought to be the non-disclosure of misattributed parentage. (shrink)

Advances in immunotherapy pave the way for vaccines that target not only infections, but also unhealthy behaviors such as smoking. A nicotine vaccine that eliminates the pleasure associated with smoking could potentially be used to prevent children from adopting this addictive and dangerous behavior. This paper offers an ethical analysis of such vaccines. We argue that it would be permissible for parents to give their child a nicotine vaccine if the following conditions are met: (1) the vaccine is expected to (...) result in a net benefit to each individual vaccinated, (2) the expected harms from the side effects of the vaccine are lower than the non-voluntary harms of smoking, and (3) there are no less manipulative methods available that are as effective at preventing smoking initiation. Finally, we show how the framework developed here could be used to analyze the ethics of other chemical interventions designed to modify children’s behavior. (shrink)

“The Ethics of Infection Challenges in Primates,” by Anne Barnhill, Steven Joffe, and Franklin Miller, is an exceptionally timely contribution to the literature on animal research ethics. Animal research has long been both a source of high hopes and a cause for moral concern. When it comes to infection challenge studies with nonhuman primates, neither the hope—to save thousands of human lives from such diseases as Ebola and Marburg—nor the concern—the conviction that primates deserve especially strong protections—could be much higher. (...) Coming just a few years after the National Institutes of Health adopted the Institute of Medicine's recommendations regarding chimpanzees, Barnhill and colleagues attempt to nudge the clarification and specification—one might say the evolution—of NHP research ethics and regulation. They assert that NHP challenge studies “are not justified by marginal gains in human safety or by efficacy gains that are unlikely to translate directly into saving human lives or preventing morbidity.” How, in turn, is their standard—which, although stringent, does permit causing NHPs to suffer and die for human benefit—to be justified? (shrink)