Laura Specker Sullivan (2022) makes a fairly compelling case for the value of the perspectives of Buddhist practitioners in neuroethics. In this study, Tibetan Buddhist monks have been asked, among other things, whether consciousness, in brain-injured patients in a minimally conscious state, entails a duty to preserve life. In our view, some of the participants’ responses could be used to inform the bioethical debate on death determination.

Theoretical ethics includes both metaethics (the meaning of moral terms) and normative ethics (ethical theories and principles). Practical ethics involves making decisions about every day real ethical problems, like decisions about euthanasia, what we should eat, climate change, treatment of animals, and how we should live. It utilizes ethical theories, like utilitarianism and Kantianism, and principles, but more broadly a process of reflective equilibrium and consistency to decide how to act and be.

A core challenge for contemporary bioethics is how to address the tension between respecting an individual’s autonomy and promoting their wellbeing when these ideals seem to come into conflict (Not...

The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...) other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted by (...) two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

Finality, design and purpose have started to be excluded from the language of the natural sciences since the XVIIth century. Darwin succeeded in excluding them from his theory of evolution appealing to a blind and mechanical natural selection. Today, the most usual definitions for the concept of biological function take for granted that functions: 1) are not dependent on a goal; 2) are not dependent on observers, but only on nature; 3) are explicable in causal terms, either with reference to (...) the causal history of the organ (etiological definition), or with reference to its present structure and causal capabilities (dispositional definition). However, we shall see that such presuppositions cannot take into account the normative character of the concept of biological function. We show that a generalization of the concept of scientific objectivity lets us affirm that functions: 1’) are dependent on a goal; 2’) are dependent on both observers and nature; 3’) cannot be reduced to causality, nor break the laws of physics; and yet, 4) are truly objective. (shrink)

The classification of preserved hypothalamic activity in brain death and brainstem death as functional or non-functional has become a subject of debate. While proponents of the neurological criterion claim that these activities lack functional significance (Shemie et al. 2014), Nair-Collins and Joffe (2023) argue for their functional physiological role. However, the interpretation of the term "function" within the medico-legal framework, where death is characterized by the irreversible cessation of all brain functions, remains unclear. -/- My intention here is not to (...) engage in a debate over the validity of different viewpoints regarding the functional significance of preserved activities in the hypothalamus or the heart. Rather, I aim to highlight the critical importance of exploring and defining the concept of function in medicine, which currently lacks clarity. My point is that, whatever our position in the brain death debate, reaching a consensus on this conceptual matter would minimize misunderstandings and establish a robust foundation for further insightful analysis. (shrink)

There is a relationship between touch and language at the heart of which lies the philosophical problem of the secret. As Derrida points out, since Aristotle touch has been qualified as ἄδηλον: secret, nocturnal, barely apparent. After some brief etymological remarks, in this article, I explore the mystery that touch represents for language through Levinas’ concept of the secret, thematizing two levels: first, that of the contemporary critique of ocularcentrism, then the level of the tactile experiences that can hardly be (...) put into words. (shrink)

Drawing on Husserl, Ingarden and Levinas’ works, this article explores Ibsen’s Rosmersholm from a phenomenological perspective, aiming to shed light both on this play and on the phenomenology of hunger and theatre, as well as on the larger meaning of alimentary enjoyment.

As touch remains commonly defined by the closeness it physically implies and it rhetorically evokes, the mere notion of distant touch and of distal haptic perception seems peculiar. But Aristotle’s perspective, which I wish to take as a point of departure, is firm: we perceive the objects of touch, the hot and the cold, the hard and the soft, the curved and the sharp, through other things: δι' ἑτέρων. In this article, I would like to explore this ἕτερος by showing (...) how the otherness of perception always implies an intermediary, a middle point (μέσος), i.e. an other not so other, an other that is able to translate the much more distant otherness of the perceived object. To explore these forgotten layers of alterity that fall into what we commonly conceive of as the impalpable emptiness of distance, I propose to study the idea of distant touch from the perspective of phenomenological aesthetics. In order to do so, I will first examine some aspects of the Husserlian account of perception and will then focus on the phenomenology of distant touch in Alejandra Costamagna’s novel El Sistema del Tacto [The System of Touch] (2018). (shrink)

Two or more attitudinal states are incoherent if and only if, necessarily, under conditions of full transparency, you are disposed to give up one of them. This is roughly the account of incoherence that has recently been put forward by Alex Worsnip (2018). In this paper, I argue that Worsnip’s account of incoherence is incorrect. Not only does it fail to be fully general (i.e., it does not allow us to assess the coherence of all combinations of attitudes), but it (...) also implies that an agent is necessarily incoherent just in virtue of being in one attitudinal state. (shrink)

This dissertation focuses on teleology and functions in biology. More precisely, it focuses on the scientific legitimacy of teleofunctional attributions and explanations in biology. It belongs to a multi-faceted debate that can be traced back to at least the 1970s. One aspect of the debate concerns the naturalization of functions. Most authors try to reduce, translate or explain functions and teleology in terms of efficient causes so that they find their place in the framework of the natural sciences. Our approach (...) here is radically different, as we question the premise that teleological explanations are disguised causal explanations. On the contrary, we defend that they are acceptable in natural sciences and in biology in particular. We challenge the idea that teleological explanations are immature causal explanations, as well as the idea that teleology and functions are some sort of intentional explanations. We therefore reject the accusations of anthropomorphism, vitalism and finalism. On the contrary, we defend that teleology, causality and intentionality correspond to different, autonomous and complementary modes of representation of the outside world. -/- ———[FRANÇAIS]——— -/- Ce travail de thèse porte sur la téléologie et les fonctions en biologie. Plus précisément, il porte sur la légitimité scientifique des attributions et des explications téléofonctionnelles en biologie. Il s’inscrit dans le cadre d’un débat à plusieurs facettes que l’on peut faire remonter au moins jusqu’aux années 1970 et qui est encore très actif aujourd’hui. L’un des aspects du débat porte sur la naturalisation des fonctions, c’est-à-dire sur la manière de les réduire, de les traduire ou de les expliciter en termes de causes efficientes de sorte qu’elles trouvent leur place dans le cadre des sciences de la nature. Notre approche ici est radicalement différente, car nous remettons en question la prémisse selon laquelle les explications téléologiques seraient des explications causales déguisées. Nous défendons au contraire qu’elles sont acceptables en tant que telles aussi bien de façon générale que dans le domaine scientifique et en particulier en biologie. De façon générale, nous remettons en question l’idée selon laquelle la pensée téléologique serait une pensée causale immature, ainsi que sa dépendance présumée vis-à-vis de la psychologie, c’est-à-dire de l’intentionnalité. Nous rejetons donc les accusations d’anthropomorphisme, de vitalisme et de finalisme formulées contre elle. Nous défendons au contraire que la téléologie, la causalité et l’intentionnalité correspondent à des modes différents, autonomes et complémentaires de représentation du monde extérieur. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...) were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

Alireza Bagheri supports a policy on organ procurement where individuals could choose their own definition of death between two or more socially accepted alternatives. First, we claim that such a policy, without any criterion to distinguish accepted from acceptable definitions, easily leads to the slippery slope that Bagheri tries to avoid. Second, we suggest that a public discussion about the circumstances under which the dead donor rule could be violated is more productive of social trust than constantly moving the line (...) between life and death. (shrink)

The requirements of rationality are fundamental in practical and theoretical philosophy. Nonetheless, there exists no correct account of what constitutes rational requirements. This paper attempts to provide a correct constitutive account of ‘rationality requires’. I argue that rational requirements are grounded in ‘necessary explanations of subjective incoherence’, as I shall put it. Rationality requires of you to X if and only if your rational capacities, in conjunction with the fact that you not-X, explain necessarily why you have a non-maximal degree (...) of subjective coherence. (shrink)

Using the KenKen puzzle may improve students’ performance in operating integers. Quasi-experimental research was conducted to determine the effectiveness of this intervention on the performance and attitude of students in a collaborative learning environment. One hundred four purposively selected Grade 7 students in Nueva Ecija served as respondents and the experimentation lasted four days following the K to 12 Learners Manual. An increase in the student’s performance was found after utilizing the KenKen puzzle, where a significant difference between the posttest (...) and pretest was recorded after the four days of utilization of the puzzle. Besides, students’ attitude toward operating integers showed positivity as it is enjoyable, interesting, challenging, and developing creativity and critical thinking. Moreover, a strong relationship was found between the students’ performance and attitude in operating integers. This suggests that the KenKen puzzle helped improve the students’ performance and attitude in operating integers in a collaborative learning environment. (shrink)

I argue that rejection is a speech act that cannot be reduced to assertion. Adapting an argument by Huw Price, I conclude that rejection is best conceived of as the speech act that is used to register that some other speech act is (or would be) violating a rule of the conversation game. This can be naturally understood as registering *norm violations* where speech acts are characterised by their essential norms. However, I argue that rejection itself is not to be (...) characterised by a norm. Instead, registering violations is a necessary condition for understanding the normative framework in the first place. The core observation is that the concept of an 'illegal move' is intelligible, so a speech act can be (say) an assertion, despite violating the essential norm of asserting. Rejection has the function of pointing out that a move is illegal. But registering rule violations is a precondition of playing games with rules (it is part of the concept 'game'), not itself a rule in a game. A similar special role of rejection (that it is not explicable in the terms provided by a framework, but needed to conceptualise these terms) likely occurs in other frameworks as well, e.g. characterising speech acts by commitments or their effect on a common ground. (shrink)

50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. Here I plead (...) for a different approach that has been overlooked in the literature: the philosophy of science approach. Some scholars claim that human death is a matter of fact, a biological phenomenon whose occurrence can be determined empirically, based on science. We should take this claim seriously, whether we agree with it or not. The question is: how do we know that human death is a scientific matter of fact? Taking the philosophy of science approach means, among other things, examining how the determination of human death became an object of scientific inquiry, exploring the nature of the brain death criterion itself, and analysing the meaning of its core concepts such as “irreversibility” and “functions”. (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in (...) the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

[ENGLISH] This article discusses the potential of synthetic biology to address fundamental questions in the philosophy of biology regarding the nature of life and biological functions. Synthetic biology aims to reduce living organisms to their simplest forms by identifying the minimal components of a cell and also to create novel life forms through genetic reprogramming, biobrick assembly, or novel proteins. However, the technical success of these endeavors does not guarantee their conceptual success in defining life. There is a lack of (...) consensus among researchers on how to define and classify the entities produced in the lab, whether they should be considered living or categorized differently. The criteria for minimal cells and minimal life are subject to arbitrary choices and varying interpretations. The concept of function, crucial to synthetic biology, is also difficult to define. The article highlights the need to consider the minimal set of functions that characterize life before determining the smallest genomes that code for those functions. The arbitrary nature of defining both life and function complicates the understanding and classification of these entities. The article suggests that the traditional dichotomy between the living and the non-living may no longer be valid and that the concept of life itself may not require precise scientific definition. As synthetic biology advances, the article emphasizes the importance of redefining or constructing new categories to encompass the expanding possibilities and creations in the field. The ability to create new life forms raises questions about recognition, identification, and ethical implications, requiring a conceptual and philosophical engagement beyond the technical achievements of synthetic biology. -/- [FRENCH] L'article aborde le potentiel de la biologie synthétique pour répondre à des questions fondamentales de la philosophie de la biologie concernant la nature de la vie et des fonctions biologiques. La biologie synthétique vise à réduire les organismes vivants à leurs formes les plus simples en identifiant les composants minimaux d'une cellule et à créer de nouvelles formes de vie grâce à la reprogrammation génétique, à l'assemblage de biobriques ou à des protéines nouvelles. Cependant, le succès technique de ces approches ne garantit pas leur réussite conceptuelle dans la définition de la vie. Il n'y a pas de consensus parmi les chercheurs sur la façon de définir et de classer les entités produites en laboratoire, qu'elles doivent être considérées comme vivantes ou catégorisées différemment. Les critères des cellules minimales et de la vie minimale sont soumis à des choix arbitraires et à des interprétations variables. La notion de fonction, essentielle en biologie synthétique, est également difficile à définir. L'article met en évidence la nécessité de prendre en compte l'ensemble minimal de fonctions qui caractérisent la vie avant de déterminer les plus petits génomes qui codent ces fonctions. La nature arbitraire de la définition de la vie et de la fonction complique la compréhension et la classification de ces entités. L'article suggère que la dichotomie traditionnelle entre le vivant et le non-vivant pourrait ne plus être valable et que le concept même de vie ne nécessite pas une définition scientifique précise. À mesure que la biologie synthétique progresse, l'article souligne l'importance de redéfinir ou de construire de nouvelles catégories pour englober les possibilités et créations croissantes dans le domaine. La capacité à créer de nouvelles formes de vie soulève des questions de reconnaissance, d'identification et d'implications éthiques, nécessitant une réflexion conceptuelle et philosophique au-delà des avancées techniques de la biologie synthétique. (shrink)

Can we employ the property of rationality in establishing what rationality requires? According to a central and formal thesis of John Broome’s work on rational requirements, the answer is ‘no’ – at least if we expect a precise answer. In particular, Broome argues that (i) the property of full rationality (i.e. whether or not you are fully rational) is independent of whether we formulate conditional requirements of rationality as having a wide or a narrow logical scope. That is, (ii) by (...) replacing a wide-scope requirement with a corresponding narrow-scope requirement (or vice versa), we do not alter the situations in which a person is fully rational. As a consequence, (iii) the property of full rationality is unable to guide us in determining whether a rational requirement has a wide or a narrow logical scope. We cannot resolve the wide/narrow scope debate by appealing to a theory of fully rational attitudes. This paper argues that (i), (ii) and (iii) are incorrect. Replacing a wide- with a corresponding narrow-scope requirement (or vice versa) can alter the set of circumstances in which a person is fully rational. The property of full rationality is therefore not independent of whether we formulate conditional requirements of rationality as having a wide or a narrow logical scope. As a consequence, the property of full rationality can guide us in determining what rationality requires – even in cases where we expect a precise answer. (shrink)

Is the boundary between the normal and the pathological real or fiction? Are health and disease just a matter of fact or are they value-laden? Here we present some examples of how alleged diseases can be invented and propagated by the industry (disease mongering) or by the methodology of medical science itself. We show that the boundary between health and disease is blurred and depends on individual and social representations, culture relative ways of categorising things and people, and by the (...) society’s degree of medicalisation. However, we do not mean that it is not real, rather that it is more complex than expected, as the subjectivity of social constructions and individual experiences makes them no less real. Finally, we conclude that health and disease belong to both objective and subjective kinds of reality, so the fictional can be real. (shrink)

Recent advances in the Super Linguistics of pictures have laid the Super Semantic foundation for modelling the phenomena of narrative sequencing and co-reference in pictorial and mixed linguistic-pictorial discourses. We take up the question of how one arrives at the pragmatic interpretations of such discourses. In particular, we offer an analysis of: (i) the discourse composition problem: how to represent the joint meaning of a multi-picture discourse, (ii) observed differences in narrative sequencing in prima facie equivalent linguistic vs pictorial discourses, (...) and (iii) the phenomenon of co-referencing across pictures. We extend Segmented Discourse Representation Theory to spell out a formal Super Pragmatics that applies to linguistic, pictorial and mixed discourses, while respecting the particular ‘genius’ of either medium and computing their distinctive pragmatic interpretations. (shrink)

This paper aims to provide a theoretical framework for explaining the subjective character of pain experience in terms of what we will call ‘embodied predictive processing’. The predictive processing (PP) theory is a family of views that take perception, action, emotion and cognition to all work together in the service of prediction error minimisation. In this paper we propose an embodied perspective on the PP theory we call the ‘embodied predictive processing (EPP) theory. The EPP theory proposes to explain pain (...) in terms of processes distributed across the whole body. The prediction error minimising system that generates pain experience comprises the immune system, the endocrine system, and the autonomic system in continuous causal interaction with pathways spread across the whole neural axis. We will argue that these systems function in a coordinated and coherent manner as a single complex adaptive system to maintain homeostasis. This system, which we refer to as the neural-endocrine-immune (NEI) system, maintains homeostasis through the process of prediction error minimisation. We go on to propose a view of the NEI ensemble as a multiscale nesting of Markov blankets that integrates the smallest scale of the cell to the largest scale of the embodied person in pain. We set out to show how the EPP theory can make sense of how pain experience could be neurobiologically constituted. We take it to be a constraint on the adequacy of a scientific explanation of subjectivity of pain experience that it makes it intelligible how pain can simultaneously be a local sensing of the body, and, at the same time, a more global, all-encompassing attitude towards the environment. Our aim in what follows is to show how the EPP theory can meet this constraint. (shrink)

The work of Emmanuel Levinas has been both abundantly recognized and criticized in moral philosophy. This Janus-faced attitude is also present in ecological theories, which find fertile ground in Levinas’ thought without being able to explain its apparent anthropocentrism. Opposing hermeneutical paths tend to focus either on otherness as an absolute alterity, implying a potentially unlimited responsibility for all alterities, or on otherness as a re-foundation of humanism, leading to the conclusion that responsibility is unlimited only among humans. Here I (...) seek to disentangle Levinas from these two extreme interpretations, first by reviewing ecological readings of his philosophy, in both the Francophone and Anglophone spheres, and second by analyzing specific Levinasian terms that might be particularly helpful for a non-anthropocentric or deep ecology. The main results of this investigation are a distinction between the ethics of responsibility and the ethics of vulnerability, an explanation of Levinasian compulsory or methodological humanism, and a schematic model of sensibility as enjoyment/vulnerability capable of supporting deep ecology without the traditional notions of free will, rights, or values. (shrink)

The authors respond to a wide range of objections defending our argument that some forms of behaviour modification utilising advances in the cognitive sciences are desirable and need not necessarily undermine autonomy or freedom.

The COVID-19 pandemic has intensified the extent to which economies in the developed and developing world rely on gig workers to perform essential tasks such as health care, personal transport, food and package delivery, and ad hoc tasking services. As a result, workers who provide such services are no longer perceived as mere low-skilled laborers, but as essential workers who fulfill a crucial role in society. The newly elevated moral and economic status of these workers increases consumer demand for corporate (...) social responsibility regarding this stakeholder group – specifically for practices that increase worker freedom and rewards. We provide algorithmic tools for online labor platforms to meet this demand, thereby bolstering their social purpose and ethical branding while better protecting themselves from future reputational crises. To do so, we advance a managerial strategy rooted in moral self-awareness theory in order to leverage customers’ virtuous self-perception and increase gig-worker freedom. (shrink)

Numerous high-profile ethics scandals, rising inequality, and the detrimental effects of climate change dramatically underscore the need for business schools to instill a commitment to social purpose in their students. At the same time, the rising financial burden of education, increasing competition in the education space, and overreliance on graduates’ financial success as the accepted metric of quality have reinforced an instrumentalist climate. These conflicting aims between social and financial purpose have created an existential crisis for business education. To resolve (...) this impasse, we draw on the concept of moral self-awareness to offer a system-theoretical strategy for crowding-in a culture of ethics within business schools. We argue that to do so, business schools will need to (1) reframe the purpose of business, (2) reframe the meaning of professional success, and (3) reframe the ethos of business education itself. (shrink)

We argue that attempts to extrapolate moral motives for non-egoistic behavior in organizational behavior often interpret results empathically or deontically, while leaving other moral motivational frames, such as the utilitarian and virtue ethical, under-examined. We encourage the creation of experimental measures to distinguish various philosophical frames.

Behavioral intervention techniques leveraging reactive responses have gained popularity as tools for promoting ethical behavior. Choice architects, for example, design and present default opt-out options to nudge individuals into accepting preselected choices deemed beneficial to both the decision-maker and society. Such interventions can also employ mild financial incentives or affective triggers including joy, fear, empathy, social pressure, and reputational rewards. We argue, however, that ethical competence is achieved via reflection, and that heavy reliance on reactive behavioral interventions can undermine the (...) development of ethical competence over the long term. Specifically, drawbacks may occur through motivational displacement, dependency, moral crowding out, loss of personal autonomy, and reactance. We introduce complementary cognitive boosting techniques designed to stimulate reflective cognition, as a more promising long-term strategy for instilling ethical behavior. One such approach is the Moral Self-Awareness (MSA) motivational construct, which incrementally leads agents to increasing levels of ethical reflection. We explain why ethical boosting approaches present more edifying and durable alternatives to reactive behavioral interventions and offer suggestions for social and organizational policy. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...) can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...) Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. -/- Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. -/- Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data. (shrink)

The European project European and Latin American Systems of Ethics Regulation of Biomedical Research Project (EULABOR) has carried out the first comparative analysis of ethics regulation systems for biomedical research in seven countries in Europe and Latin America, evaluating their roles in the protection of human subjects. We developed a conceptual and methodological framework defining ‘ethics regulation system for biomedical research’ as a set of actors, institutions, codes and laws involved in overseeing the ethics of biomedical research on humans. This (...) framework allowed us to develop comprehensive national reports by conducting semi-structured interviews to key informants. These reports were summarised and analysed in a comparative analysis. The study showed that the regulatory framework for clinical research in these countries differ in scope. It showed that despite the different political contexts, actors involved and motivations for creating the regulation, in most of the studied countries it was the government who took the lead in setting up the system. The study also showed that Europe and Latin America are similar regarding national bodies and research ethics committees, but the Brazilian system has strong and noteworthy specificities. (shrink)

We offer an argument for the extended mind based on considerations from brain development. We argue that our brains develop to function in partnership with cognitive resources located in our external environments. Through our cultural upbringing we are trained to use artefacts in problem solving that become factored into the cognitive routines our brains support. Our brains literally grow to work in close partnership with resources we regularly and reliably interact with. We take this argument to be in line with (...) complementarity or “second-wave” defences of the extended mind that stress the functional differences between biological elements and external, environmental resources in putative cases of extended cognition. Complementarity defences argue that many of the kinds of cognition humans excel at can only be accomplished by brains working together with a body that directly manipulates and acts on the world [Rowlands (1999); Menary (2007); Sutton (2010)]. We argue that complementarity and functionalist defences of the extended mind aren’t opposed, but that complementarity considerations can provide much needed and hitherto under exploited leverage in defending EMT. Moreover, the developmental work we will describe adds extra weight to the complementarity case for EMT. (shrink)

Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was successfully accepted in part because the assimilation of brain death state to death was presented by medicine --and acritically assumed by most of societies-- as a (...) scientific and objective fact. Nevertheless, many people do not think that the patients suffering brain death are actually dead. We show here that those people are not necessarily wrong. It can be argued that, in fact, the justification of the neurological criterion is not scientific but moral. We outline the thesis that the problem surrounding the vital status of brain dead patients is due to a confusion between factual and normative questions. Furthermore, we claim that the donation of organs and the withdrawal of life-support could be ethically acceptable even if the patients suffering brain death are considered as alive. As an alternative to the dead donor rule, we propose a justification for organ donation of brain-dead patients based on the (moral) concepts of harm and consent : what truly justifies the procurement of organs on those patients is not that they are dead, but that they wish to donate their organs and that, since they have irreversibly lost their brain, they cannot be harmed. (shrink)

The counter majoritarian difficulty is one of the main objections against the judicial review. In this paper, this objection is analyzed from the standpoint of the norm formulation/norm distinction. By stressing the distinc- tion between norm formulations and norms, I claim that when judicial review prevents the application of a norm to an individual case the counter majoritarian difficulty objection does not hold.

This paper presents a novel account of focal stress and pitch contour in English dialogue. We argue that one should analyse and treat focus and pitch contour jointly, since (i) some pragmatic interpretations vary with contour (e.g., whether an utterance accepts or rejects; or whether it implicates a positive or negative answer); and (ii) there are utterances with identical prosodic focus that in the same context are infelicitous with one contour, but felicitous with another. We offer an account of two (...) distinct pitch contours that predicts the correct felicity judgements and implicatures, outclassing other models in empirical coverage or formality. Prosodic focus triggers a presupposition, where what is presupposed and how the presupposition is resolved depends on prosodic contour. If resolving the presupposition entails the proffered content, then the proffered content is uninteresting and hence the utterance is in-felicitous. Otherwise, resolving the presupposition may lead to an implicature. We regiment this account in SDRT. (shrink)

The ontological nature of works of music has been a particularly lively area of philosophical debate during the past few years. This paper serves to introduce the reader to some of the most fertile and interesting issues. Starting by distinguishing three questions – the categorial question, the individuation question, and the persistence question – the article goes on to focus on the first: the question of which ontological category musical works fall under. The paper ends by introducing, and briefly considering, (...) meta-ontological questions in the ontology of music. (shrink)

Is the brain the biological substrate of consciousness? Most naturalistic philosophers of mind have supposed that the answer must obviously be «yes » to this question. However, a growing number of philosophers working in 4e (embodied, embedded, extended, enactive) cognitive science have begun to challenge this assumption, arguing instead that consciousness supervenes on the whole embodied animal in dynamic interaction with the environment. We call views that share this claim dynamic sensorimotor theories of consciousness (DSM). Clark (2009) a founder and (...) leading proponent of the hypothesis of the extended mind, demurs, arguing that as matter of fact the biology of consciousness doesn’t allow for a brain, body and world boundary crossing architecture. We begin by looking at one of the arguments for DSM, the variable neural correlates argument. We then outline two criticisms that Clark has made of this argument and endorse his criticisms. However we finish up by using the case of sensory substitution to argue that something of this argument for DSM nevertheless survives. We suggest that Clark ought to concede sensory substitution as a case in which the conscious mind extends. (shrink)

There is growing concern that a global economic system fueled predominately by financial incentives may not maximize human flourishing and social welfare externalities. If so, this presents a challenge of how to get economic actors to adopt a more virtuous motivational mindset. Relying on historical, psychological, and philosophical research, we show how such a mindset can be instilled. First, we demonstrate that historically, financial self-interest has never in fact been the only guiding motive behind free markets, but that markets themselves (...) are representations of our individual and collective moral identities. Building on this understanding, we review the research on how economic incentives crowd out virtue-oriented concerns. We then introduce the concept of moral self-awareness (MSA), an evolving mindset informed by reflection on moral identity, namely what one’s actions say about oneself given the impacts on others or society that one’s action may effect. MSA comprises three fundamental aspects of virtue-oriented reasoning: pride, shame, and guilt. Finally, we offer a four-stage model anchored in systems theory, yielding ever more refined motivating strategies for maximizing human flourishing and social welfare externalities. (shrink)

Van Inwagen proposes that besides simples only living organisms exist as composite objects. This paper suggests expanding van Inwagen’s ontology by also accepting composite objects in the case that physical bonding occurs (plus some extra conditions). Such objects are not living organ-isms but rather physical bodies. They include (approximately) the complete realm of inanimate ordinary objects, like rocks and tables, as well as inanimate scientific objects, like atoms and mol-ecules, the latter filling the ontological gap between simples and organisms in (...) van Inwagen’s origi-nal picture. We thus propose a compositional pluralism claiming that composition arises if and on-ly if bonding or life occurs. (shrink)

Response to commentaries on Savulescu and Dickenson article on preferences and advance directives.

Extant research suggests that individuals employ traditional moral heuristics to support their observed altruistic behavior; yet findings have largely been limited to inductive extrapolation and rely on relatively few traditional frames in so doing, namely, deontology in organizational behavior and virtue theory in law and economics. Given that these and competing moral frames such as utilitarianism can manifest as identical behavior, we develop a moral framing instrument—the Philosophical Moral-Framing Measure (PMFM)—to expand and distinguish traditional frames associated and disassociated with observed (...) altruistic behavior. The validation of our instrument based on 1015 subjects in 3 separate real stakes scenarios indicates that heuristic forms of deontology, virtue-theory, and utilitarianism are strongly related to such behavior, and that egoism is an inhibitor. It also suggests that deontic and virtue-theoretical frames may be commonly perceived as intertwined and opens the door for new research on self-abnegation, namely, a perceived moral obligation toward suffering and self-denial. These findings hold the potential to inform ongoing conversations regarding organizational citizenship and moral crowding out, namely, how financial incentives can undermine altruistic behavior. (shrink)

Our rapidly increasing reliance on frictionless AI interactions may increase cognitive and emotional distance, thereby letting our adaptive resilience slacken and our ethical virtues atrophy from disuse. Many trends already well underway involve the offloading of cognitive, emotional, and ethical labor to AI software in myriad social, civil, personal, and professional contexts. Gradually, we may lose the inclination and capacity to engage in critically reflective thought, making us more cognitively and emotionally vulnerable and thus more anxious and prone to manipulation (...) from false news, deceptive advertising, and political rhetoric. In this article, I consider the overarching features of this problem and provide a framework to help AI designers tackle it through system enhancements in smartphones and other products and services in the burgeoning internet of things (IoT) marketplace. The framework is informed by two ideas: psychologist Daniel Kahneman’s cognitive dual process theory and moral self-awareness theory, a four-level model of moral identity that I developed with Benjamin M. Cole. (shrink)

Delusions have traditionally been considered the hallmark of mental illness, and their conception, diagnosis and treatment raise many of the fundamental conceptual and practical questions of psychopathology. One of these fundamental questions is whether delusions are understandable. In this paper, we propose to consider the question of understandability of delusions from a philosophy of language perspective. For this purpose, we frame the question of how delusions can be understood as a question about the meaning of delusional utterances. Accordingly, we ask: (...) “what meaning(s) can delusional utterances possibly have?”. We argue that in the current literature, there is a standard approach to the meaning of delusional utterances, namely the descriptive account which assumes that a delusional utterance “p” means that p is the case. Drawing on Speech Act Theory, we argue that solely relying on the descriptive account disregards essential ways of how linguistic meaning is constituted. Further, we show that Speech Act Theory can prove a helpful addition to the theoretical and clinical “toolbox” used for attempting to understand delusional utterances. This, we believe, may address some of the theoretical and clinical shortcomings of using only the currently predominant descriptive account. (shrink)

Anti-realism is plagued by Fitch’s paradox: the remarkable result that if one accepts that all truths are knowable, minimal assumptions about the nature of knowledge entail that every truth is known. Dorothy Edgington suggests to address this problem by understanding p is knowable to be a counterfactual claim, but her proposal must contend with a forceful objection by Timothy Williamson. I revisit Edgington’s basic idea and find that Williamson’s objection is obviated by a refined understanding of counterfactual knowability that is (...) grounded in possible courses of inquiry. I arrive at a precise definition of knowability that is not just a technical avoidance of paradox, but is metaphysically sound and does justice to the anti-realist idea. (shrink)