There is an as yet unacknowledged and incomparable contribution to the philosophical debates about know-how to be found in the writings of Ludwig Wittgenstein. It is sourced in his investigations into knowledge and certainty in On Certainty, though it is not limited to these late passages. Understanding the ramifications of this putative contribution (even if one does not agree with it) highlights the extent to which (i) there is now a new range of issues pertaining to know-how which no future (...) philosophical consideration of the topic can ignore, except on pain of failing to engage comprehensively with the subject; (ii) the topic of know-how has been inappropriately marginalised by naturalized epistemology, and may well be as central to epistemology as the propositional knowledge which currently dominates epistemology’s attention; and (iii) any engagement with these potential Wittgensteinian contributions will need to be conducted in tandem with a reflection on the meta-philosophy of epistemology, since their potential impact extends to epistemology’s main methodology, i.e., naturalized reflective equilibrium. These three conclusions, together with a diagnosis of where and why all the current intellectualist accounts of know-how are either internally inconsistent, or irreconcilably flawed on their own terms, provide the motivation and the opportunity for a New Epistemology of Know-How. These conclusions established, I offer one possible Wittgensteinian-orientated version of the New Epistemology of Know-How, providing the first example of a non-naturalized philosophical approach to the topic since Gilbert Ryle. (shrink)

The current COVID-19 pandemic and the previous SARS/MERS outbreaks of 2003 and 2012 have resulted in a series of major global public health crises. We argue that in the interest of developing effective and safe vaccines and drugs and to better understand coronaviruses and associated disease mechenisms it is necessary to integrate the large and exponentially growing body of heterogeneous coronavirus data. Ontologies play an important role in standard-based knowledge and data representation, integration, sharing, and analysis. Accordingly, we initiated the (...) development of the community-based Coronavirus Infectious Disease Ontology in early 2020. -/- As an Open Biomedical Ontology (OBO) library ontology, CIDO is open source and interoperable with other existing OBO ontologies. CIDO is aligned with the Basic Formal Ontology and Viral Infectious Disease Ontology. CIDO has imported terms from over 30 OBO ontologies. For example, CIDO imports all SARS-CoV-2 protein terms from the Protein Ontology, COVID-19-related phenotype terms from the Human Phenotype Ontology, and over 100 COVID-19 terms for vaccines (both authorized and in clinical trial) from the Vaccine Ontology. CIDO systematically represents variants of SARS-CoV-2 viruses and over 300 amino acid substitutions therein, along with over 300 diagnostic kits and methods. CIDO also describes hundreds of host-coronavirus protein-protein interactions (PPIs) and the drugs that target proteins in these PPIs. CIDO has been used to model COVID-19 related phenomena in areas such as epidemiology. The scope of CIDO was evaluated by visual analysis supported by a summarization network method. CIDO has been used in various applications such as term standardization, inference, natural language processing (NLP) and clinical data integration. We have applied the amino acid variant knowledge present in CIDO to analyze differences between SARS-CoV-2 Delta and Omicron variants. CIDO's integrative host-coronavirus PPIs and drug-target knowledge has also been used to support drug repurposing for COVID-19 treatment. -/- CIDO represents entities and relations in the domain of coronavirus diseases with a special focus on COVID-19. It supports shared knowledge representation, data and metadata standardization and integration, and has been used in a range of applications. (shrink)

Promotion of prescription drugs may appear to be severely limited in some jurisdictions due to restrictions on direct-to-consumer advertising. However, in most jurisdictions, strategies exist to raise consumer awareness about prescription drugs, notably through the deployment of direct-to-consumer information campaigns that encourage patients to seek help for particular medical conditions. In Canada, DTCI is presented by industry and regulated by Health Canada as being purely informational activities, but their design and integration in broader promotional campaigns raise very similar ethical concerns (...) as those associated with DTCA. Specifically, DTCI can be an effective means of familiarizing the public with the scope and benefits of a particular prescription drug and so, like DTCA, can promote increased patient-consumer demand and thus a problematic rise in the prescribing and use of medications that may be neither the most appropriate nor the most cost-effective. Yet, with DTCI the industry is playing within the existing rules and regulations set by health regulators. To respond appropriately to this regulatory incoherence, we argue that DTCI should be regulated as a type of direct-to-consumer indirect advertising. Even if the case and specific regulations presented here are Canadian, the implications extend to every country that has a partial or total prohibition on DTCA. (shrink)

While the Value-Free Ideal of science has suffered compelling criticism, some advocates like Gregor Betz continue to argue that science policy advisors should avoid value judgments by hedging their hypotheses. This approach depends on a mistaken understanding of the relations between facts and values in regulatory science. My case study involves the morning-after pill Plan B and the “Drug Fact” that it “may” prevent implantation. I analyze the operative values, which I call zygote-centrism, responsible for this hedged drug label. Then, (...) I explain my twofold account of value-ladenness, involving the constitutive role of value judgments in science and the social function of facts as political tools. Because this drug fact is ineliminably value-laden in both senses, I conclude that hedged hypotheses are not necessarily value-free. (shrink)

Programs of drug testing welfare recipients are increasingly common in US states and have been considered elsewhere. Though often intensely debated, such programs are complicated to evaluate because their aims are ambiguous – aims like saving money may be in tension with aims like referring people to treatment. We assess such programs using a proportionality approach, which requires that for ethical acceptability a practice must be: reasonably likely to meet its aims, sufficiently important in purpose as to outweigh harms incurred, (...) and lower in costs than feasible alternatives. In the light of empirical findings, we argue that the programs fail the three requirements. Pursuing recreational drug users is not important in the light of costs incurred, while dependent users who may require referral are usually identifiable without testing and typically need a broader approach than one focussing on drugs. Drug testing of welfare recipients is therefore not ethically acceptable policy. (shrink)

Studies have shown that both serotonin and glutamate receptor systems play a crucial role in the mechanisms underlying drug-induced synesthesia. The specific nature of these mechanisms, however, continues to remain elusive. Here we propose two distinct hypotheses for how synesthesia triggered by hallucinogens in the serotonin-agonist family may occur. One hypothesis is that the drug-induced destabilization of thalamic projections via GABAergic neuronal circuits from sensory areas leads to a disruption of low-level, spontaneous integration of multisensory stimuli. This sort of integration (...) regularly occurs when spatial and temporal attributes match. Destabilization of feedback loops, however, can result in incongruent experiences or binding of random thalamus activation with sensory input in a particular sensory modality. The second hypothesis builds on embodied cognition, cases in which visual images of external stimuli activate task-related neural regions. On this proposal, binding processes that do not normally generate awareness become accessible to consciousness as a result of decreased attentional discrimination among incoming stimuli. (shrink)

Disintegration is the most important step for drug bioavailability because after, the disintegration process, the ingredients of solid dosage forms dissolve and become bioavailable. Generally, the tablets and capsules should be taken with a glass of water otherwise the manufacturer gives instructions to use the proper beverage. Several drugs are taken with different forms of beverages to ensure easy swallowing of the tablet, masking the bad taste of the drug and overcoming the drug aftertaste, these beverages can influence the disintegration (...) of the solid dosage form. The most common cold beverages consumed by the Libyan population are juice, milk, and Coca-Cola. These beverages are consumed without awareness of the possible effect of these beverages on drugs, especially over-the-counter drugs such as analgesic, antipyretic, and anti-inflammatory drugs that are taken without a prescription. This study aimed to evaluate the influence of three beverages, namely: orange juice, milk, and Coca-Cola on the disintegration time of four over-the-counter-drugs: Panadol, Congestal, Brufen, and Reality Extra using disintegration test of drugs in 0.1 N HCL and in hybrid medium prepared by combination of 150 ml 0.1 N HCL and 550 ml of beverage to simulate in vivo condition. The findings show that the orange juice significantly increases the disintegration time of all the investigated drugs. Coca-Cola significantly increases the disintegration time of Reality Extra, and slightly increases the disintegration time of Brufen, Congestal, and Panadol and the full-fat milk significantly increases the disintegration time of Reality Extra and Panadol while slightly increasing the disintegration time for Brufen and Congestal. It is concluded that commonly used beverages affect the disintegration time of the examined over-the-counter drugs. Patients should be advised to take these medications without beverages which may delay the disintegration and the onset of action of the drug. (shrink)

Objective: Primary care, which is often the first level of contact for patients with various communicable diseases (CDs) and noncommunicable diseases (NCDs), might exhibit patterns of injectable drug utilization different from hospitals. We aimed to examine injection prescribing to adults with CD or NCD in primary care. -/- Methods: In this retrospective study, single-diagnosis injectable drug-containing prescription data from Family Medicine Information System comprising 32 provinces of Turkey were analysed. The prescriptions were grouped by diagnosis as “CD” (n=3848) and “NCD” (...) (n=9338). Injectable drug utilization patterns in these groups were analysed by demographics, diagnoses, and drug subgroups. -/- Results: Out of 13186 prescriptions, 70.8% were issued for NCDs. NCD prescriptions were mostly generated for women and elderly (p<0.05 for both). About 63.3% (n=2948) of injectable drugs in CD prescriptions were antibiotics and 12.6% were analgesics. Cefazolin (15.2%) was the most commonly prescribed antibiotic for acute pharyngitis and acute sinusitis, and benzathine benzylpenicillin (12.8%) was the top-choice for acute tonsillitis and rheumatic fever. In NCD prescriptions, 34.0% (n=4214) of injectable agents were analgesics and 16.9% were muscle relaxants. The most frequently encountered drug in NCD prescriptions was thiocolchicoside (16.3%), which was the top-choice in all seven common musculoskeletal diagnoses. -/- Conclusion: Muscle relaxants and analgesics were the most commonly prescribed injectable drugs for NCDs, musculoskeletal diseases in particular. Antibiotics were frequently encountered in CD prescriptions, mostly as broad-spectrum for lower respiratory tract infections (RTIs) and narrow-spectrum for upper RTIs. These findings may elucidate the issues to especially focus on regarding excessive use of injections. (shrink)

Disintegration is the most important step for drug bioavailability because after, the disintegration process, the ingredients of solid dosage forms dissolve and become bioavailable. Generally, the tablets and capsules should be taken with a glass of water otherwise the manufacturer gives instructions to use the proper beverage. Several drugs are taken with different forms of beverages to ensure easy swallowing of the tablet, masking the bad taste of the drug and overcoming the drug aftertaste, these beverages can influence the disintegration (...) of the solid dosage form. The most common cold beverages consumed by the Libyan population are juice, milk, and Coca-Cola. These beverages are consumed without awareness of the possible effect of these beverages on drugs, especially over-the-counter drugs such as analgesic, antipyretic, and anti-inflammatory drugs that are taken without a prescription. This study aimed to evaluate the influence of three beverages, namely: orange juice, milk, and Coca-Cola on the disintegration time of four over-the-counter-drugs: Panadol, Congestal, Brufen, and Reality Extra using disintegration test of drugs in 0.1 N HCL and in hybrid medium prepared by combination of 150 ml 0.1 N HCL and 550 ml of beverage to simulate in vivo condition. The findings show that the orange juice significantly increases the disintegration time of all the investigated drugs. Coca-Cola significantly increases the disintegration time of Reality Extra, and slightly increases the disintegration time of Brufen, Congestal, and Panadol and the full-fat milk significantly increases the disintegration time of Reality Extra and Panadol while slightly increasing the disintegration time for Brufen and Congestal. It is concluded that commonly used beverages affect the disintegration time of the examined over-the-counter drugs. Patients should be advised to take these medications without beverages which may delay the disintegration and the onset of action of the drug. (shrink)

We discuss the crucial, but easily missed, link between paternalism and incarceration. Legal paternalists believe law should be used to help individuals stay healthy or moral or become healthier or morally better. Criminal laws are paternalistic if they make it illegal to perform some action that would be bad for the actor to do, regardless of effects on others. Yet, one result of such laws is the punishment, including incarceration, of the very same actors—also clearly bad for them even if (...) meant to be rehabilitative. Therein lies an oddity: paternalist criminal law—and thepresumably rehabilitativepunishments that serve as responses to infringements of such laws—is meant to help the actor but in fact has the opposite effect on net. Incarceration is particularly problematic on this front as it harms the alleged criminal in ways that go beyond the harm they would have caused themselves. Incarceration also may undermine the actor’s ability to improve his decision-making abilities or his moral character. The effects of the punishment also drift to others—family and friends, as well as business associates, of the punished. Paternalists, inasmuch as they are motivated by beneficence or concern about moral character, must account for all of these costs as threats to well-being and the conditions for acting morally. Given the link between paternalism and incarceration, we propose that if we are to take seriously the problem of over-incarceration in the U.S., we must reconsider the use of paternalism in criminal law; we sketch several alternatives. We believe paternalists should support our resistance to incarceration and seriously consider these alternatives. (shrink)

Torben Kjærsgaard’s argues that the term “cognitive enhancement substances” is an inappropriate term considering that stimulants do not enhance cognition, but rather only enhance motivation. Therefore, he concludes that stimulants are best described as “performance maintenance” and not “performance enhancement.” I challenge his conclusion on the grounds that both life’s ordinary, daily activities and life’s extraordinary activities are types of performances necessary for living the kinds of lives that we want to live, which can be enhanced, not just maintained, with (...) the effects of cognitive enhancing substances. “Cognitive enhancing substances” may be a misleading term, but referring to the effects of cognitive enhancing substances as “performance maintenance,” rather than “performance enhancing,” misguidedly minimizes the role that motivation plays into our self-determined lives. (shrink)

Recently, dramatic price increases by several pharmaceutical companies have provoked public outrage. These scandals raise questions both about how pharmaceutical firms should be regulated and about how pharmaceutical executives ethically ought to make pricing decisions when drug prices are largely unregulated. Though there is an extensive literature on the regulatory question, the ethical question has been largely unexplored. This article defends a Kantian approach to the ethics of pharmaceutical pricing in an unregulated market. To the extent possible, pharmaceutical companies must (...) price drugs so that those who genuinely need them can get them without financial ruin. This requirement is an ethical side constraint, like the moral prohibitions on deception and theft, that takes precedence over a business’s interest in maximizing profit. That said, the requirement’s application is sensitive to the need to recoup the costs of research and to produce a return that financially justifies the original investment. It may not be either feasible or desirable for government to attempt to enforce the ethical requirements concerning just pharmaceutical pricing. Either price regulation or subsidy could fulfill government’s obligation to protect patients from being objectionably vulnerable to pricing decisions by private companies. (shrink)

In the United States, prohibitionist policies are used as the primary approach to combat the negative effect of substance use on society. An extensive academic literature spanning the disciplines of economics, political science, and multiculturalism documents the great social costs of the United States’ “War on Drugs” both nationally and internationally. These costs come with at best marginal effect on substance abuse and other crimes linked to the drug trade. In many cases, there is a reason to believe that these (...) policies exacerbate the problems they aim to address. This article explores psychologists’ ethical commitments to social change concerning such drug policy, given the field of psychology’s expanding commitment to social justice. We examine arguments regarding the boundaries between psychologists’ personal and professional ethics with regard to political participation. Using drug prohibition as an exemplar, we suggest that many psychologists’ political actions and professional ethics may be misaligned. Ultimately, we conclude that the endorsement of prohibitionist drug policies is in direct conflict with the guiding ethical principles put forth by the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. (shrink)

Pharmaceutical paternalism is the normative stance upheld by pharmaceutical regulatory agencies like the US Food and Drug Administration. These agencies prevent patients from accessing treatments declared safe and ineffective for the patient’s good without their consent. Libertarian critics of the FDA have shown a number of significant flaws in regulatory paternalism. Against these objections, I will argue that, in order to make an informed decision about treatments, a libertarian patient should request full disclosure of the uncertainty about an experimental treatment. (...) But pharmaceutical markets, on their own, are not a reliable source of information about such uncertainty. And companies have the power to capture any independent expert who may assess it. Therefore, the libertarian is better off deferring on an independent regulatory body the assessment of the pharmaceutical risks, constraining access to treatments until tested. (shrink)

A medical intervention is a medical procedure or application intended to relieve or prevent illness or injury. Examples of medical interventions include vaccination and drug administration. After a medical intervention, adverse events (AEs) may occur which lie outside the intended consequences of the intervention. The representation and analysis of AEs are critical to the improvement of public health. Description: The Ontology of Adverse Events (OAE), previously named Adverse Event Ontology (AEO), is a community-driven ontology developed to standardize and integrate data (...) relating to AEs arising subsequent to medical interventions, as well as to support computer-assisted reasoning. OAE has over 3,000 terms with unique identifiers, including terms imported from existing ontologies and more than 1,800 OAE-specific terms. In OAE, the term ‘adverse event’ denotes a pathological bodily process in a patient that occurs after a medical intervention. Causal adverse events are defined by OAE as those events that are causal consequences of a medical intervention. OAE represents various adverse events based on patient anatomic regions and clinical outcomes, including symptoms, signs, and abnormal processes. OAE has been used in the analysis of several different sorts of vaccine and drug adverse event data. (shrink)

We argue that the fragility of contemporary marriages—and the corresponding high rates of divorce—can be explained (in large part) by a three-part mismatch: between our relationship values, our evolved psychobiological natures, and our modern social, physical, and technological environment. “Love drugs” could help address this mismatch by boosting our psychobiologies while keeping our values and our environment intact. While individual couples should be free to use pharmacological interventions to sustain and improve their romantic connection, we suggest that they may have (...) an obligation to do so as well, in certain cases. Specifically, we argue that couples with offspring may have a special responsibility to enhance their relationships for the sake of their children. We outline an evolutionarily informed research program for identifying promising biomedical enhancements of love and commitment. (shrink)

Multiple drug resistant strains of HIV and continuing difficulties with vaccine development highlight the importance of psychologi- cal interventions which aim to in uence the psychosocial and emo- tional factors empirically demonstrated to be significant predictors of immunity, illness progression and AIDS mortality in seropositive persons. Such data have profound implications for psychological interventions designed to modify psychosocial factors predictive of enhanced risk of exposure to HIV as well as the neuroendocrine and immune mechanisms mediating the impact of such factors (...) on disease progression. Many of these factors can be construed as unconscious mental ones, and psychoanalytic self-psychology may be a useful framework for conceptualizing psychic and immune de- fence as well as bodily and self-integration in HIV infection. Al- though further prospective studies and cross-cultural validation of research are necessary, existing data suggest that psychoanalytic insights may be useful both in therapeutic interventions and evaluative research which would require an underlying epistemology of the complementarity of mind and matter. (shrink)

This chapter conceptually analyzes the post-traumatic stress injuries called moral injury, moral fatigue or exhaustion, and broken spirit. It then identifies two puzzles. First, soldiers sometimes sustain moral injury even from doing right actions. Second, they experience moral exhaustion from making decisions even where the morally right choice is so obvious that it shouldn’t be stressful to make it; and even where rightness of decision is so murky that no decision could be morally faulted. The injuries result of mistaken moral (...) self-evaluation. Methods of preventing and treating these injuries are defended, including training in self-forgiveness, moral off-loading of actions and decisions to persons and devices less likely to feel inappropriate guilt, and the use of drugs to prevent such guilt. The foregoing has been about moral injury erroneously resulting from the non-violation of a correct moral code. But the chapter then introduces the concept of moral pseudo-injury—felt moral injury that has in reality resulted from violation of a false moral code, so that no one has really been morally injured. This can be used as a method in warfighting. And since the injuries it produces are illusory, this would be morally superior to physical violence. For it causes less injury to its victims, and should cause less guilt in those who must inflict it. Historical precedents are considered. Finally, our enemies often use moral pseudo-injury against us, in the form of terrorist violence against civilians. Terrorism causes comparatively few harms, yet we mistakenly see it as more morally horrific than conventional combat that causes much worse loss of life among armed forces members. Here we need the nuancing and clarifying power of philosophy to restore a sense of proportion, thence to prevent or therapize the moral pseudo-injury we may experience from these sorts of attacks. (This is a pre-penultimate version of the published version, available from OUP at the external link, which contains minor variances. The paper was earlier known as "PTSD Weaponized: A Theory of Moral Injury"; that now superseded version is archived under "past conferences" on the Center for Ethics and the Rule of Law website.). (shrink)

Why is cannabis not our drug of choice? On the face of it, cannabis seems so much better than legal drugs: it does not cause aggression, it gives the user no hangover, makes everything seem funny, and appears to be a lot healthier. Of course, at the dark end of the spectrum, cannabis is thought by some to act as a gateway drug, gets the user involved with criminals, causes social isolation and depression, and can lead to psychosis or even (...) schizophrenia. Regardless of the supposed pros and cons of cannabis use, it certainly is the drug of choice for many. For instance, 22.7% of English and Welsh 16 to 29 year olds had used cannabis in the previous 12 months in 2001/2002.1 The popularity of cannabis raises concerns that the use of less popular drugs perhaps does not, namely, how does the use of cannabis affect the quality of life and what sort of socio-economical impact does it have? Given the widespread use of cannabis, the implications that it may have should be taken under careful consideration. In what follows, I will examine both the adverse effects as well as potential benefits that cannabis use is likely to have in the light of recent research. The inquiry will be divided into two sections: the implications of cannabis use from the point of view of the individual on one hand, and from the point of view of society on the other. (shrink)

Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...) lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future. I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …. (shrink)

Crime-preventing neurointerventions (CPNs) are increasingly being used or advocated for crime prevention. There is increasing use of testosterone-lowering agents to prevent recidivism in sexual offenders, and strong political and scientific interest in developing pharmaceutical treatments for psychopathy and anti-social behaviour. Recent developments suggest that we may ultimately have at our disposal a range of drugs capable of suppressing violent aggression, and it is not difficult to imagine possible applications of such drugs in crime prevention. But should neurointerventions be used in (...) crime prevention, and may the state ever permissibly impose CPNs as part of the criminal justice process? It is widely thought that preventing recidivism is one of the aims of criminal justice, yet existing means of pursuing this aim are often poorly effective, restrictive of basic freedoms, and harmful. Incarceration, for example, tends to be disruptive of personal relationships and careers, detrimental to physical and mental health, highly restrictive of freedom of movement and association, and rarely more than modestly effective at preventing recidivism. Neurointerventions hold the promise of preventing recidivism in ways that are more effective and more humane, but the use of CPNs in criminal justice raises several ethical concerns. CPNs could be highly intrusive and may threaten fundamental human values, such as bodily integrity and freedom of thought, and humanity has a track record of misguided, harmful, and unwarrantedly coercive use of neurotechnological ‘solutions’ to criminality. This collection brings together original contributions from emerging scholars and internationally renowned moral and political philosophers to address these issues. (shrink)

A number of concerns have been raised about the possible future use of pharmaceuticals designed to enhance cognitive, affective, and motivational processes, particularly where the aim is to produce morally better decisions or behavior. In this article, we draw attention to what is arguably a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are already having unintended effects on these processes, and thus on moral decision making and morally significant behavior. We review current evidence on the moral effects (...) of three widely used drugs or drug types: propranolol, selective serotonin reuptake inhibitors, and drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision making and behavior caused by these agents may have important and difficult-to-evaluate consequences, at least at the population level. We argue that the moral effects of these and other widely used pharmaceuticals warrant further empirical research and ethical analysis. (shrink)

Can addiction be credibly invoked as an excuse for moral harms secondary to particular decisions to use drugs? This question raises two distinct sets of issues. First, there is the question of whether addiction is the sort of consideration that could, given suitable assumptions about the details of the case, excuse or mitigate moral blameworthiness. Most discussions of addiction and moral responsibility have focused on this question, and many have argued that addiction excuses. Here I articulate what I take to (...) be the best argument for this view, based on the substantial difficulty that people with severe addiction experience in controlling drug-related behavior. This, I argue, may in some cases be sufficient to ground a mitigating excuse, given the way in which addiction undermines agents’ responsiveness to relevant moral reasons to do otherwise. Much less attention has been devoted to a second set of issues that critically affect the possibility of applying this mitigating excuse in particular cases, derived from the ambivalent nature of agential control in addiction. In order to find a fitting response to moral harm, the person with the right standing to blame must make a judgment about the extent to which the agent possessed certain morally relevant capacities at the time of the act. In practice, this will often prove tremendously difficult to assess. The ethical challenge for the person with the right standing to blame is fundamentally one of making a judgment about matters that seem underdetermined by the available evidence. (shrink)

In recent years, the scientific study of meditation and psychedelic drugs has seen remarkable developments. The increased focus on meditation in cognitive neuroscience has led to a cross-cultural classification of standard meditation styles validated by functional and structural neuroanatomical data. Meanwhile, the renaissance of psychedelic research has shed light on the neurophysiology of altered states of consciousness induced by classical psychedelics, such as psilocybin and LSD, whose effects are mainly mediated by agonism of serotonin receptors. Few attempts have been made (...) at bridging these two domains of inquiry, despite intriguing evidence of overlap between the phenomenology and neurophysiology of meditation practice and psychedelic states. In particular, many contemplative traditions explicitly aim at dissolving the sense of self by eliciting altered states of consciousness through meditation, while classical psychedelics are known to produce significant disruptions of self-consciousness, a phenomenon known as drug-induced ego dissolution. In this article, we discuss available evidence regarding convergences and differences between phenomenological and neurophysiological data on meditation practice and psychedelic drug-induced states, with a particular emphasis on alterations of self-experience. While both meditation and psychedelics may disrupt self-consciousness and underlying neural processes, we emphasize that neither meditation nor psychedelic states can be conceived as simple, uniform categories. Moreover, we suggest that there are important phenomenological differences even between conscious states described as experiences of self-loss. As a result, we propose that self-consciousness may be best construed as a multidimensional construct, and that “self-loss,” far from being an unequivocal phenomenon, can take several forms. Indeed, various aspects of self-consciousness, including narrative aspects linked to autobiographical memory, self-related thoughts and mental time travel, and embodied aspects rooted in multisensory processes, may be differently affected by psychedelics and meditation practices. Finally, we consider long-term outcomes of experiences of self-loss induced by meditation and psychedelics on individual traits and prosocial behavior. We call for caution regarding the problematic conflation of temporary states of self-loss with “selflessness” as a behavioral or social trait, although there is preliminary evidence that correlations between short-term experiences of self-loss and long-term trait alterations may exist. (shrink)

Response to commentary. We are grateful to Crockett and Craigie for their interesting remarks on our paper. We accept Crockett’s claim that there is a need for caution in drawing inferences about patient groups from work on healthy volunteers in the laboratory. However, we believe that the evidence we cited established a strong presumption that many of the patients who are routinely taking a medication, including many people properly prescribed the medication for a medical condition, have morally significant aspects of (...) their cognition and behavior modified in a way that is unintended and may sometimes be unwelcome. Crockett notes that in some cases the effects of long-term drug use may differ, sometimes markedly, from the effects of short-term use. However, if acute use of a drug affects a neural system involved in mediating moral cognition or behavior, this nevertheless provides some evidence that chronic use of the drug may affect that same system and thus have morally significant effects. It is also plausible, in some cases, that an acute moral effect would give rise to a chronic moral effect via cognitive mechanisms. ... (shrink)

A common misunderstanding of the selected effects theory of function is that natural selection operating over an evolutionary time scale is the only functionbestowing process in the natural world. This construal of the selected effects theory conflicts with the existence and ubiquity of neurobiological functions that are evolutionary novel, such as structures underlying reading ability. This conflict has suggested to some that, while the selected effects theory may be relevant to some areas of evolutionary biology, its relevance to neuroscience is (...) marginal. This line of reasoning, however, neglects the fact that synapses, entire neurons, and potentially groups of neurons can undergo a type of selection analogous to natural selection operating over an evolutionary time scale. In the following, I argue that neural selection should be construed, by the selected effect theorist, as a distinct type of function-bestowing process in addition to natural selection. After explicating a generalized selected effects theory of function and distinguishing it from similar attempts to extend the selected effects theory, I do four things. First, I show how it allows one to identify neural selection as a distinct function-bestowing process, in contrast to other forms of neural structure formation such as neural construction. Second, I defend the view from one major criticism, and in so doing I clarify the content of the view. Third, I examine drug addiction to show the potential relevance of neural selection to neuroscientific and psychological research. Finally, I endorse a modest pluralism of function concepts within biology. (shrink)

In an essay on performance-enhancing drugs, author Chuck Klosterman (2007) argues that the category of enhancers extends from hallucinogens used to inspire music to steroids used to strengthen athletes—and he criticizes those who would excuse one means of enhancement while railing against the other as a form of cheating: After the summer of 1964, the Beatles started taking serious drugs, and those drugs altered their musical performance. Though it may not have been their overt intent, the Beatles took performance-enhancing drugs. (...) And . . . absolutely no one holds it against them. No one views “Rubber Soul” and “Revolver” as “less authentic” albums, despite the fact that they would not (and probably could .. (shrink)

There has been much debate regarding the 'double-effect' of sedatives and analgesics administered at the end-of-life, and the possibility that health professionals using these drugs are performing 'slow euthanasia.' On the one hand analgesics and sedatives can do much to relieve suffering in the terminally ill. On the other hand, they can hasten death. According to a standard view, the administration of analgesics and sedatives amounts to euthanasia when the drugs are given with an intention to hasten death. In this (...) paper we report a small qualitative study based on interviews with 8 Australian general physicians regarding their understanding of intention in the context of questions about voluntary euthanasia, assisted suicide and particularly the use of analgesic and sedative infusions (including the possibility of voluntary or non-voluntary 'slow euthanasia'). We found a striking ambiguity and uncertainty regarding intentions amongst doctors interviewed. Some were explicit in describing a 'grey' area between palliation and euthanasia, or a continuum between the two. Not one of the respondents was consistent in distinguishing between a foreseen death and an intended death. A major theme was that 'slow euthanasia' may be more psychologically acceptable to doctors than active voluntary euthanasia by bolus injection, partly because the former would usually only result in a small loss of 'time' for patients already very close to death, but also because of the desirable ambiguities surrounding causation and intention when an infusion of analgesics and sedatives is used. The empirical and philosophical implications of these findings are discussed. (shrink)

The relation between body and mind is one of the oldest riddles that has puzzled mankind. That material and mental events may interact is accepted even by the law: our mental capacity to concentrate on the task can be seriously reduced by drugs. Physical and chemical processes may act upon the mind; and when we are writing a difficult letter, our mind acts upon our body and, through a chain of physical events, upon the mind of the recipient of the (...) letter. This is what the authors of this book call the 'interaction of mental and physical events'. We know very little about this interaction; and according to recent philosophical fashions this is explained by the alleged fact that we have brains but no thoughts. The authors of this book stress that they cannot solve the body mind problem; but they hope that they have been able to shed new light on it. Eccles especially with his theory that the brain is a detector and amplifier; a theory that has given rise to important new developments, including new and exciting experiments; and Popper with his highly controversial theory of 'World 3'. They show that certain fashionable solutions which have been offered fail to understand the seriousness of the problems of the emergence of life, or consciousness and of the creativity of our minds. In Part I, Popper discusses the philosophical issue between dualist or even pluralist interaction on the one side, and materialism and parallelism on the other. There is also a historical review of these issues. In Part II, Eccles examines the mind from the neurological standpoint: the structure of the brain and its functional performance under normal as well as abnormal circumstances. The result is a radical and intriguing hypothesis on the interaction between mental events and detailed neurological occurrences in the cerebral cortex. Part III, based on twelve recorded conversations, reflects the exciting exchange between the authors as they attempt to come to terms with their opinions. (shrink)

Animal-derived constituents are frequently used in anaesthesia and surgery, and patients are seldom informed of this. This is problematic for a growing minority of patients who may have religious or secular concerns about their use in their care. It is not currently common practice to inform patients about the use of animal-derived constituents, yet what little empirical data does exist indicates that many patients want the opportunity to give their informed consent. First, we review the nature and scale of the (...) problem by looking at the groups who may have concerns about the use of animal-derived constituents in their care. We then summarise some of the products used in anaesthesia and surgery that can contain such constituents, such as anaesthetic drugs, surgical implants and dressings. Finally, we explore the problem of animal-derived constituents and consent using Beauchamp and Childress’ four principles approach, examining issues of autonomy, beneficence, nonmaleficence and justice. Disclosing the use of animal-derived constituents in anaesthesia and surgery is warranted under Beauchamp and Childress’ four principles approach to the problem. Although there exist systemic and practical challenges to implementing this in practice, the ethical case for doing so is strong. The Montgomery ruling presents additional legal reason for disclosure because it entails that patients must be made aware of risks associated with their treatment that they attach significance to. (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)

(Winner of The Res Publica Essay Prize) This article defends a moderate version of state perfectionism by using Gerald Gaus’s argument for liberal neutrality as a starting point of discussion. Many liberal neutralists reject perfectionism on the grounds of respect for persons, but Gaus has explained more clearly than most neutralists how respect for persons justifies neutrality. Against neutralists, I first argue that the state may promote the good life by appealing to what can be called “the qualified judgments about (...) the good life,” which have not been considered by liberal perfectionists including Joseph Chan and Steven Wall. Then I clear up several possible misunderstandings of these judgments, and argue that: (a) moderate perfectionism does not rely on controversial rankings of values and is committed to promoting different valuable ways of life by pluralistic promotion; and (b) moderate perfectionism requires only an indirect form of coercion in using tax money to support certain moderate perfectionist measures, which is justifiable on the grounds of citizens’ welfare. Thus, I maintain that moderate perfectionism does not disrespect citizens, and is not necessarily unfair to any particular group of people. It is, in fact, plausible and morally important. The defence of moderate perfectionism has practical implications for the state’s policies regarding art development, drug abuse, public education, and so on. (shrink)

The underreporting of suspected adverse drug reactions hinders pharmacovigilance. Solutions to underreporting are oftentimes directed at clinicians and health care professionals. However, given the recent rise of public inclusion in medical science, solutions may soon begin more actively involving patients. I aim to offer an evaluative framework for future possible proposals that would engage patients with the aim of mitigating underreporting. The framework may also have value in evaluating current reporting practices. The offered framework is composed of three criteria that (...) are bioethical, social-epistemic, and pragmatic: (i) patients should not be exposed to undue harms, e.g., nocebo effects; (ii) data should be collected, analyzed, and communicated prioritizing pharmacovigilance’s aims, i.e., free from industry bias; and (iii) proposals should account for existing and foreseeable pragmatic constraints like clinician ‘buy in’ and existing reporting infrastructure. Proposals to engage patients in pharmacovigilance that fulfil or address these criteria are preferable to those that do not. (shrink)

This dispatch tells the story of Julian, a librarian who left his stationary library job for a much more dynamic pursuit: to bring libraries to people instead of the other way around. Julian’s “mobile library” vision was to get new books – and new ideas – to people living in the most remote areas of Colombia. Books on his back, Julian criss-crosses the veredas (rural villages) and the corregimientos (indigenous areas) by motorbike or on foot. He visits small villages of (...) just one or two thousand people, scattered across the mountains. Villages, where there are no libraries, and where there may be no books. Villages, where schools have only textbooks, nothing more, and where it takes long walks for children to go to school. Julian tours his mobile library through the mountains of Cauca, a region in southwest Colombia. The Nasa indigenous people live in this region, as do guerrillas, paramilitaries and drug traffickers. Julian spreads media through his books and storytelling. He gives people a much more personal recounting of life and the country’s social condition. Words and ideas which may shine light on the actual enemy for all readers: the structural and historical inequalities, and the propaganda fuelling the violence against the wrong target. Once we understand the extent of Julian’s offer, it is no longer about the mobile library’s books and storytelling workshops, it is about offering paper mirrors to exhausted warriors on all sides. (shrink)

I show that Pickard’s argument against the irresistibility of addiction fails because her proposed dilemma, according to which either drug-seeking does not count as action or addiction is resistible, is flawed; and that is the case whether or not one endorses Pickard’s controversial definition of action. Briefly, we can easily imagine cases in which drug-seeking meets Pickard’s conditions for agency without thereby implying that the addiction was not irresistible, as when the drug addict may take more than one route to (...) go meet her dealer. (shrink)

The police are one of the important law enforcement agency in Bangladesh. Police are the best agency to protect human rights. Indeed, the police have a special responsibility to protect people. In addition, to their duty, they also serve in people's social and moral call, especially during COVID-19 situations they imprint many examples of humanity. People experience many good deeds of police during a national disaster as well. However, allegation against the police for violations of human rights is not uncommon. (...) Cases of torture, death in police custody, involvement in the drug trade and robberies, entrapment with drug, helping in land grabbing, etc. are being published in newspapers. Nevertheless, to protect human rights or to take care of human rights is the prime function of the police. This research efforts to find out the answer to why police violate human rights. This research may help police professionals or administrators in taking policy initiatives to erase the negative image of the police. (shrink)

In times of crises, public health leaders may claim that trials of public health interventions are unethical. One reason for this claim can be that equipoise—i.e. a situation of uncertainty and/or disagreement among experts about the evidence regarding an intervention—has been disturbed by a change of collective expert views. Some might claim that equipoise is disturbed if the majority of experts believe that emergency public health interventions are likely to be more beneficial than harmful. However, such beliefs are not always (...) justified: where high quality research has not been conducted, there is often considerable residual uncertainty about whether interventions offer net benefits. In this essay we argue that high-quality research, namely by means of well-designed randomized trials, is ethically obligatory before, during, and after implementing policies in public health emergencies (PHEs). We contend that this standard applies to both pharmaceutical and non-pharmaceutical interventions, and we elaborate an account of equipoise that captures key features of debates in the recent pandemic. We build our case by analyzing research strategies employed during the COVID-19 pandemic regarding drugs, vaccines, and non-pharmaceutical interventions; and by providing responses to possible objections. Finally, we propose a public health policy reform: whenever a policy implemented during a PHE is not grounded in high-quality evidence that expected benefits outweigh harms, there should be a planned approach to generate high-quality evidence, with review of emerging data at preset time points. These preset timepoints guarantee that policymakers pause to review emerging evidence and consider ceasing ineffective or even harmful policies, thereby improving transparency and accountability, as well as permitting the redirection of resources to more effective or beneficial interventions. (shrink)

As the federal government distributed remdesivir to some of the states COVID-19 hit hardest, policymakers scrambled to develop criteria to allocate the drug to their hospitals. Our state, Michigan, was among those states to receive an initial quantity of the drug from the U.S. government. The disparities in burden of disease in Michigan are striking. Detroit has a death rate more than three times the state average. Our recommendation to the state was that it should prioritize the communities that bear (...) a disproportionate burden of suffering in the allocation of the new potential treatment. This recommendation is justified not only for new drugs with uncertain effects, but also for drugs of certain benefit or vaccines. For states with significant health disparities, such as Michigan, this allocation priority may help to repair them. In fact, any other allocation strategy may make them worse. (shrink)

In what sense is a person addicted to drugs or alcohol incompetent, and so a legitimate object of coercive treatment? The standard tests for competence do not pick out the capacity that is lost in addiction: the capacity to properly regulate consumption. This paper is an attempt to sketch a justificatory framework for understanding the conditions under which addicted persons may be treated against their will. These conditions rarely obtain, for they apply only when addiction is extremely severe and great (...) harm threatens. It will be argued also that to widen the measures currently in place in some jurisdictions, though philosophically well-motivated, would require very strong evidence of a set of conditions disposing a person to an addictive future. It is doubtful that any such currently available evidence is strong enough to justify coercive treatment. Nevertheless, coercive treatment of addiction is already a reality, with the potential for more, and so some discussion will be presented regarding the extraordinary safeguards necessary to prevent misapplication of such treatment policies. (shrink)

Though this volume is a bit dated, there are few recent popular books dealing specifically with the psychology of murder and it’s a quick overview available for a few dollars, so still well worth the effort. It makes no attempt to be comprehensive and is somewhat superficial in places, with the reader expected to fill in the blanks from his many other books and the vast literature on violence. For an update see e.g., Buss, The Handbook of Evolutionary Psychology 2nd (...) ed. V1 (2016) p 265, 266, 270–282, 388–389, 545–546, 547, 566 and Buss, Evolutionary Psychology 5th ed. (2015) p 26, 96–97,223, 293-4, 300, 309–312, 410 and Shackelford and Hansen, The Evolution of Violence (2014) He has been among the top evolutionary psychologists for several decades and covers a wide range of behavior in his works, but here he concentrates almost entirely on the psychological mechanisms that cause individual people to murder and their possible evolutionary function in the EEA (Environment of Evolutionary Adaptation—i.e., the plains of Africa during the last million years or so). -/- Buss starts by noting that as with other behaviors, ‘alternative’ explanations such as psychopathology, jealousy, social environment, group pressures, drugs and alcohol etc. do not really explain, since the question still remains as to why these produce homicidal impulses, i.e., they are the proximate causes and not the ultimate evolutionary (genetic) ones. As always, it inevitably boils down to inclusive fitness (kin selection), and so to the struggle for access to mates and resources, which is the ultimate explanation for all behavior in all organisms. Sociological data (and common sense) make it clear that younger poorer males are the most likely to kill. He presents his own and others homicide data from industrialized nations, and tribal cultures, conspecific killing in animals, archeology, FBI data and his own research into normal people's homicidal fantasies. Much archeological evidence continues to accumulate of murders, including that of whole groups, or of groups minus young females, in prehistoric times. -/- After surveying Buss’s comments, I present a very brief summary of intentional psychology (the logical structure of rationality), which is covered extensively in my many other articles and books. -/- Those with a lot of time who want a detailed history of homicidal violence from an evolutionary perspective may consult Steven Pinker’s ‘The Better Angels of Our Nature Why Violence Has Declined’(2012), and my review of it easily available on the net and in two of my recent ebooks. Briefly, Pinker notes that murder has decreased steadily and dramatically by a factor of about 30 since our days as foragers. So, even though guns now make it extremely easy for anyone to kill, homicide is much less common. Pinker thinks this is due to various social mechanisms that bring out our ‘better angels’, but I think it’s due mainly to the temporary abundance of resources from the merciless rape of our planet, coupled with increased police presence, with communication and surveillance and legal systems that make it far more likely to be punished. This becomes clear every time there is even a brief and local absence of the police. -/- Those wishing a comprehensive up to date framework for human behavior from the modern two systems of thought viewpoint may consult my e-book ‘The Logical Structure of Philosophy, Psychology, Mind and Language in Wittgenstein and Searle 367p (2016). Those interested in more of my writings on psychology may see Suicidal Utopian Delusions in the 21st Century--Philosophy, Human Nature and the Collapse of Civilization 392p (2017). For all my writings in their most recent versions, please consult my e-book Philosophy, Human Nature and the Collapse of Civilization - Articles and Reviews 2006-2017 3rd Ed. 686p (2017). -/- All of my papers and books have now been published in revised versions both in ebooks and in printed books. -/- Talking Monkeys: Philosophy, Psychology, Science, Religion and Politics on a Doomed Planet - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B071HVC7YP. -/- The Logical Structure of Philosophy, Psychology, Mind and Language in Ludwig Wittgenstein and John Searle--Articles and Reviews 2006-2016 (2017) https://www.amazon.com/dp/B071P1RP1B. -/- Suicidal Utopian Delusions in the 21st century: Philosophy, Human Nature and the Collapse of Civilization - Articles and Reviews 2006-2017 (2017) https://www.amazon.com/dp/B0711R5LGX -/- . (shrink)

Synthetic biology is a field of research that concentrates on the design, construction, and modification of new biomolecular parts and metabolic pathways using engineering techniques and computational models. By employing knowledge of operational pathways from engineering and mathematics such as circuits, oscillators, and digital logic gates, it uses these to understand, model, rewire, and reprogram biological networks and modules. Standard biological parts with known functions are catalogued in a number of registries (e.g. Massachusetts Institute of Technology Registry of Standard Biological (...) Parts). Biological parts can then be selected from the catalogue and assembled in a variety of combinations to construct a system or pathway in a microbe. Through the innovative re-engineering of biological circuits and the optimization of certain metabolic pathways, biological modules can be designed to reprogram organisms to produce products or behaviors. Synthetic biology is what is known as a “platform technology”. That is, it generates highly transferrable theoretical models, engineering principles, and know-how that can be applied to create potential products in a wide variety of industries. Proponents suggest that applications of synthetic biology may be able to provide scientific and engineered solutions to a multitude of worldwide problems from health to energy. Synthetic biology research has already been successful in constructing microbial products which promise to offer cheaper pharmaceuticals such as the antimalarial synthetic drug artemisinin, engineered microbes capable of cleaning up oil spills, and the engineering of biosensors that can detect the presence of high concentrations of arsenic in drinking water. One of the potential benefits of synthetic biology research is in its application to biofuel production. It is this application which is the focus of this entry. The term “biofuel” has referred generally to all liquid fuels that are sourced from plant or plant byproducts and are used for energy necessary for transportation vehicles (Thompson 2012). Biofuels that are produced using synthetic biological techniques re-engineer microbes into biofuel factories are a subset of these. (shrink)

Biomedical science has been remarkably successful in explaining illness by categorizing diseases and then by identifying localizable lesions such as a virus and neoplasm in the body that cause those diseases. Not surprisingly, researchers have aspired to apply this powerful paradigm to addiction. So, for example, in a review of the neuroscience of addiction literature, Hyman and Malenka (2001, p. 695) acknowledge a general consensus among addiction researchers that “[a]ddiction can appropriately be considered as a chronic medical illness.” Like other (...) diseases, “Once addiction has taken hold, it tends to follow a chronic course.” (Koob and La Moal 2006, p. ?). Working from this perspective, much effort has gone into characterizing the symptomology of addiction and the brain changes that underlie them. Evidence for involvement of dopamine transmission changes in the ventral tegmental area (VTA) and nucleus accumbens (NAc) have received the greatest attention. Kauer and Malenka (2007, p. 844) put it well: “drugs of abuse can co-opt synaptic plasticity mechanisms in brain circuits involved in reinforcement and reward processing”. Our goal in this chapter to provide an explicit description of the assumptions of medical models, the different forms they may take, and the challenges they face in providing explanations with solid evidence of addiction. <br>. (shrink)

COVID-19 often manifests with different outcomes in different patients, highlighting the complexity of the host-pathogen interactions involved in manifestations of the disease at the molecular and cellular levels. In this paper, we propose a set of postulates and a framework for systematically understanding complex molecular host-pathogen interaction networks. Specifically, we first propose four host-pathogen interaction (HPI) postulates as the basis for understanding molecular and cellular host-pathogen interactions and their relations to disease outcomes. These four postulates cover the evolutionary dispositions involved (...) in HPIs, the dynamic nature of HPI outcomes, roles that HPI components may occupy leading to such outcomes, and HPI checkpoints that are critical for specific disease outcomes. Based on these postulates, an HPI Postulate and Ontology (HPIPO) framework is proposed to apply interoperable ontologies to systematically model and represent various granular details and knowledge within the scope of the HPI postulates, in a way that will support AI-ready data standardization, sharing, integration, and analysis. As a demonstration, the HPI postulates and the HPIPO framework were applied to study COVID-19 with the Coronavirus Infectious Disease Ontology (CIDO), leading to a novel approach to rational design of drug/vaccine cocktails aimed at interrupting processes occurring at critical host-coronavirus interaction checkpoints. Furthermore, the host-coronavirus protein-protein interactions (PPIs) relevant to COVID-19 were predicted and evaluated based on prior knowledge of curated PPIs and domain-domain interactions, and how such studies can be further explored with the HPI postulates and the HPIPO framework is discussed. (shrink)

In this new post-genomic age of medicine and biomedical technology, there will be novel approaches to understanding disease, and to finding drugs and cures for diseases. Hundreds of new “disease genes” thought to be the causative agents of various genetic maladies will be identified and added to the list of hundreds of such genes already identified. Based on this knowledge, many new genetic tests will be developed and used in genetic screening programs. Genetic screening is the foundation upon which reproductive (...) technologies such as pre-natal diagnosis (PND) and preimplantation genetic diagnosis (PGD) are based. Genetic information arising from the human genome may also be used in attempts to redesign the human genetic inheritance by engineering the human germline (germline engineering). In each of these technologies—PND, PGD, and germline engineering—there are serious ethical and social concerns. Moreover, all three are eugenic in nature because they strive to control which genes are passed down to future generations. The goals of this article are threefold: 1) to introduce the science behind the three technologies; 2) to give a brief overview of eugenics in the past century and show how these genetic technologies are eugenic; and 3) to present a vision of social justice that rejects the genetic determinism upon which eugenics is based and embraces a holistic, ecological view of nature and humanity. (shrink)

A typical device in film is to have a character narrating what is going on, but this narration is not always a reliable guide to the events. According to Maier, distortions may be caused by the narrator’s intent, naivety, use of drugs, and/or cognitive disorder/illness. What is common to these various causes, he argues, is the presence of a point of view, which appears in a movie as shots. While this perspective-based account of unreliability covers most cases, I unpack its (...) methodological consequences and gesture at a possibility that Maier’s analysis overlooks. A narration, I suggest, can be unreliable simply because it is ill-timed with the events shown on screen. In such a case, the distortion is not due to any character’s point of view; rather, it comes from the film medium’s ability to divorce what is seen and what is heard. As a consequence of this mismatch, it is possible to have a reliable narrator but an unreliable narration. Since voice and context of utterance usually match in ordinary speech, I conclude that philosophy of language may be ill-suited to properly understand this particular phenomenon. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 12.3 (2005) 257-259 [Access article in PDF] Atrocity, Banality, Self-Deception Adam Morton Keywords evil, self-deception, banality, atrocity, motivation When talking about evil we must make a fundamental choice about how we are to use the term. We may use it as half of the contrast "good versus evil," in which case it covers everything that is not good. That includes moral incompetence, lack of imagination, (...) willingness to follow orders, overreactions, and a host of other reasons why people who do not have personalities that we would call evil do things that are wrong, often very wrong. Call this the weak reading of evil: evil as wrongdoing. Or we may use it with the meaning suggested by "evil person," "really evil act," "the evil lurking in all of us," and other such idioms. If we do this, we focus on a particular class of actions, and the motives and people that produce them, that arouse a particular moral revulsion in us. Call this the strong reading of evil: evil as atrocity (for more on this contrast see Morton [2004] and Card [2002]).Kubarych, following Peck, thinks of evil in the strong way. Most of the time at any rate: Some of the philosophers, such as Kant, that he draws on are thinking of evil in the weak way, and some of his quotations are from the German, where good/bad/evil distinctions are not drawn in the same way as in English. He explores a general explanation of evil that seems to be targeted at the psychology of extremely abhorrent actions. But, I argue, his account is in danger of collapse in either of two directions. Depending on how we interpret Kubarych's account, it could turn out that it describes all wrongdoing as evil, or, making some different choices, it could turn out that there are no really evil people.The strong reading of evil is definitely the most interesting and potentially fruitful. After all, we have no shortage of satisfying explanations of why people lie to get out of unwelcome appointments, steal to support their children or their drug habits, or defraud investors to become rich. But we do feel deeply puzzled by those who commit torture, serial murder, or genocide. We ask of these people not so much "Why did he do it?" as "How could he do it?" We feel the need of a philosophical or psychological theory that can give us even a slight handle of these people and their deeds. There are two risks associated with the project of explaining atrocity, though. The first is the risk of accepting unsatisfactory accounts, just because they purport to explain what we desperately want to understand. The second is the risk of supposing that there is a single explanation when the causes of the phenomenon are in fact too varied. On other topics these two risks have often combined to make people believe what seem to us now to be evident falsehoods. Humans have often for example wanted to know the causes of disease, and as a result have accepted blanket explanations, in terms of [End Page 257] evil spirits or lack of faith, that seem ludicrous to us now that we have a better grasp of the variety of factors that can cause our bodies to misfunction. So before asking naively "Why and how can people do these awful things?" we should ask "Is there a deeper causal unity here, beyond the fact that we react to these acts with horror?"My suspicion is that there is not much unity, that it is asking too much to want a common profile to the psychology of serial killers, or of proponents of genocide, let alone a profile that applies across these and other categories. What we can do, I believe, is describe our concept of evil in such a way that we can leave some parameters to be filled in by a large variety of objective psychological factors. Even this runs the risk that the really relevant factors cannot be forced into the role that the philosophical account requires. In... (shrink)

The objective of the paper is to analyze whether that the pharmaceutical companies producing HIV drugs have moral obligation(s) towards the HIV victims in developing countries who don‟t have access to get drug to reduce their risks. The primary assessment is that the pharmaceutical companies have minimum moral obligation(s) to the HIV patients especially in developing countries. It is because they are human beings and hence they are the subject of moral considerations. The paper argues that from the sense of (...) benevolence, there may be an obligation that will tend pharmaceutical companies to make an opportunity of the concerned HIV patients of developing countries to get drugs. The discussion will be made from the utilitarian point of view. Though it is assumed that, utilitarianism is too demanding, I will show that the too demanding ness of utilitarianism can be minimized and it will not be contradictory with the main theme of utilitarian morality. In this respect the counter examples and arguments will also be analyzed to make the claim stronger. The paper also argues that though the primary aim of the pharmaceutical companies is to make money, the actions that might be taken by the pharmaceutical companies for the welfare of HIV victims will not hamper them in making money for which they are deployed. (shrink)

Recent discussions of cognitive enhancement often note that drugs and technologies that improve cognitive performance may do so at the risk of “cheapening” our resulting cognitive achievements Arguing about bioethics, Routledge, London, 2012; Harris in Bioethics 25:102–111, 2011). While there are several possible responses to this worry, we will highlight what we take to be one of the most promising—one which draws on a recent strand of thinking in social and virtue epistemology to construct an integrationist defence of cognitive enhancement.. (...) According to such a line, there is—despite initial appearances to the contrary—no genuine tension between using enhancements to attain our goals and achieving these goals in a valuable way provided the relevant enhancement is appropriately integrated into the agent’s cognitive architecture. In this paper, however, we show that the kind of integration recommended by such views will likely come at a high cost. More specifically, we highlight a dilemma for users of pharmacological cognitive enhancement: they can meet the conditions for cognitive integration at the significant risk of dangerous dependency, or remain free of such dependency while foregoing integration and the valuable achievements that such integration enables. After motivating and clarifying the import of this dilemma, we offer recommendations for how future cognitive enhancement research may offer potential routes for navigating past it. (shrink)

The most plausible line of anti-doping argumentation starts with the fact that performance enhancing substances are harmful and put at considerable risk the health and the life of those who indulge in the overwhelming promises these substances hold. From a liberal point of view, however, this is not a strong reason neither to morally reject doping altogether, nor to put a blanket ban on it; on the contrary, allowing adult, competent and informed athletes to have access to performance enhancement drugs (...) is often showcased as a liberty-related right of noninterference. In this article I will first discuss doping from the liberal point of view, especially in the light of the harm principle as it was introduced by Mill and elaborated by his successors, most notably by Joel Feinberg. Then I will examine whether – and to what degree – one’s decision to receive performance enhancement drugs would mean to use humanity in one’s own person only as a means, which would be self-defeating in the light of Kantian ethics. From this I will move one step backwards to what I consider as the core question concerning the ethics of doping, the one that is logically prior to any other in my view, and concerns the consistency of the thesis that doping may be compatible with sport. I will argue that there is an inherent logical antinomy between doing sport and using performance enhancement drugs, one that presents any argumentation in favor of doping as essentially self-contradictory. (shrink)

The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)