Since the last ice age, when ice enveloped most of the northern continents, the earth has warmed by about five degrees. Within a century, it is likely to warm by another four or five. This revolution in our climate will have immense and mostly harmful effects on the lives of people not yet born. We are inflicting this harm on our descendants by dumping greenhouse gases into the atmosphere. We can mitigate the harm a little by taking measures to control (...) our emissions of these gases, and to adapt to the changes by, for instance, building sea walls around coastlines threatened by rising sea levels. But these measures will be very expensive, and the costs will be born by us, the present generation, whereas the benefits will come to future generations. How much should we sacrifice for the sake of the future? Economists and philosophers have independently worked on the question of our responsibility to future generations. This book brings their work together and applies it to global warming. It suggests a programme for future research on the economic and ethical issues. The book is intended for economists, and for philosophers and other social scientists who have a little knowledge of economic methods. (shrink)

Every year, hundreds of patients in England die whilst waiting for a kidney transplant, and this is evidence that the current system of altruistic-based donation is not sufficient to address the shortage of kidneys available for transplant. To address this problem, we propose a monopsony system whereby kidney donors can opt-in to receive financial compensation, whilst still preserving the right of individuals to donate without receiving any compensation. A monopsony system describes a market structure where there is only one ‘buyer’—in (...) this case the National Health Service. By doing so, several hundred lives could be saved each year in England, wait times for a kidney transplant could be significantly reduced, and it would lessen the burden on dialysis services. Furthermore, compensation would help alleviate the common disincentives to living kidney donation, such as its potential associated health and psychological costs, and it would also help to increase awareness of living kidney donation. The proposed system would also result in significant cost savings that could then be redirected towards preventing kidney disease and reducing health disparities. While concerns about exploitation, coercion, and the ‘crowding out’ of altruistic donors exist, we believe that careful implementation can mitigate these issues. Therefore, we recommend piloting financial compensation for living kidney donors at a transplant centre in England. (shrink)

The rapid development of artificial womb technologies means that we must consider if and when it is permissible to kill the human subject of ectogestation—recently termed a ‘gestateling’ by Elizabeth Chloe Romanis—prior to ‘birth’. We describe the act of deliberately killing the gestateling as gestaticide, and argue that there are good reasons to maintain that gestaticide is morally equivalent to infanticide, which we consider to be morally impermissible. First, we argue that gestaticide is harder to justify than abortion, primarily because (...) the gestateling is completely independent of its biological parents. Second, we argue that gestaticide is morally equivalent to infanticide. To demonstrate this, we explain that gestatelings are born in a straightforward sense, which entails that killing them is infanticide. However, to strengthen our overall claim, we also show that if gestatelings are not considered to have been born, killing them is still equivalent to killing neonates with congenital anomalies and disabilities, which again is infanticide. We conclude by considering how our discussion of gestaticide has implications for the permissibility of withdrawing life-sustaining treatment from gestatelings. (shrink)

It is commonly argued that a serious right to life is grounded only in actual, relatively advanced psychological capacities a being has acquired. The moral permissibility of abortion is frequently argued for on these grounds. Increasingly it is being argued that such accounts also entail the permissibility of infanticide, with several proponents of these theories accepting this consequence. We show, however, that these accounts imply the permissibility of even more unpalatable acts than infanticide performed on infants: organ harvesting, live experimentation, (...) sexual interference, and discriminatory killing. The stronger intuitions against the permissibility of these ‘pre-personal acts’ allow us to re-establish a comprehensive and persuasive reductio against psychological accounts of persons. (shrink)

Medicines and medical devices containing animal-derived ingredients are frequently used on patients without their informed consent, despite a significant proportion of patients wanting to know if an animal-derived product is going to be used in their care. Here, I outline three arguments for why this practice is wrong. First, I argue that using animal-derived medical products on patients without their informed consent undermines respect for their autonomy. Second, it risks causing nontrivial psychological harm. Third, it is morally inconsistent to respect (...) patients’ dietary preferences and then use animal-derived medicines or medical devices on them without their informed consent. I then address several anticipated objections and conclude that the continued failure to address this issue is an ethical blind spot that warrants applying the principles of respect for autonomy and informed consent consistently. There are no data in this work. (shrink)

In this commentary, I will consider the implications of the argument made by Christopher Stratman (2020) in ‘Ectogestation and the Problem of Abortion’. Clearly, the possibility of ectogestation will have some effect on the ethical debate on abortion. However, I have become increasingly sceptical that the possibility of ectogestation will transform the problem of abortion. Here, I outline some of my reasons to justify this scepticism. First, that virtually everything we already know about unintended pregnancies, abortion and adoption does not (...) prima facie support the assumption that a large shift to ectogestation would occur. Moreover, if ectogestation does not lead to significant restrictions to abortion then there is unlikely to be any radical transformation of the practice of abortion. Second, abortion is already associated with stigma and so the presence of ectogestation would need to create additional stigma to modify behaviour. Finally, I argue that ectogestation shifts the debate away from the fetus to the human subject of the artificial womb—the gestateling. Therefore, creating a new category of killing—gestaticide—and this would only reorient the debate rather than end it. (shrink)

Formal clinical trials of pig-to-human organ transplant—known as xenotransplantation—may begin this decade, with the first trials likely to consist of either adult renal transplants or pediatric cardiac transplant patients. Xenotransplantation as a systematic scientific study only reaches back to the latter half of the 20th century, with episodic xenotransplantation events occurring prior to that. As the science of xenotransplantation has progressed in the 20th and 21st centuries, the public's knowledge of the potential therapy has also increased. With this, there have (...) been shifting ethical stances toward xenotransplantation in key areas, such as religious and public viewpoints towards xenotransplantation, animal rights, and public health concerns. This review provides a historical–ethical account of xenotransplantation and details if or how viewpoints have shifted over time. (shrink)

Matt Zwolinski argues that libertarians “should see the Basic Income Guarantee (BIG)—a guarantee that all members will receive income regardless of why they need it—as an essential part of an ideally just libertarian system.” He regards the satisfaction of a Lockean proviso—a stipulation that individuals may not be rendered relevantly worse off by the uses and appropriations of private property—as a necessary condition for a private property system’s being just. BIG is to be justified precisely because it prevents proviso violations. (...) We deem Zwolinski’s argument a “Direct Proviso-Based Argument” for BIG. We argue that because this sort of argument for the BIG is in tension with other principles libertarians within the Lockean tradition hold dear, specifically prohibitions on seizing legitimately held property and forcing individuals to labor, the Direct Proviso-Based Argument fails. (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)

There is a global shortage of organs for transplantation and despite many governments making significant changes to their organ donation systems, there are not enough kidneys available to meet the demand. This has led scientists and clinicians to explore alternative means of meeting this organ shortfall. One of the alternatives to human organ transplantation is xenotransplantation, which is the transplantation of organs, tissues, or cells between different species. The resurgence of interest in xenotransplantation and recent scientific breakthroughs suggest that genetically-engineered (...) pigs may soon present a realistic alternative as sources of kidneys for clinical transplantation. It is therefore important for nurses and allied health professionals to understand what is involved in xenotransplantation and its future implications for their clinical practices. First, we explore the insufficiency of different organ donation systems to meet the kidney shortage. Second, we provide a background and a summary of the progress made so far in xenotransplantation research. Third, we discuss some of the scientific, technological, ethical, and economic issues associated with xenotransplantation. Finally, we summarise the literature on the attitudes of healthcare professionals toward xenotransplantation. (shrink)

The debate regarding the role of conscientious objection in healthcare has been protracted, with increasing demands for curbs on conscientious objection. There is a growing body of evidence that indicates that in some cases, high rates of conscientious objection can affect access to legal medical services such as abortion—a major concern of critics of conscientious objection. Moreover, few solutions have been put forward that aim to satisfy both this concern and that of defenders of conscientious objection—being expected to participate in (...) the provision of services that compromise their moral integrity. Here we attempt to bring some resolution to the debate by proposing a pragmatic, long-term solution offering what we believe to be an acceptable compromise—a quota system for medical trainees in specialties where a conscientious objection can be exercised, and is known to cause conflict. We envisage two main objectives of the quota system we propose. First, as a means to introduce conscientious objection into countries where this is not presently permitted. Second, to minimise or eliminate the effects of high rates of conscientious objection in countries such as Italy, where access to legal abortion provision can be negatively affected. (shrink)

The development of artificial womb technology is proceeding rapidly and will present important ethical and theological challenges for Christians. While there has been extensive secular discourse on artificial wombs in recent years, there has been little Christian engagement with this topic. There are broadly two primary uses of artificial womb technology—ectogestation as a form of enhanced neonatal care, where some of the gestation period takes place in an artificial womb, and ectogenesis, where the entire gestation period is within an artificial (...) womb. Ectogestation for the latter weeks or months of pregnancy could be possible within a decade or so, while ectogenesis for humans is far more speculative. Ectogestation is likely to significantly decrease maternal and neonatal morbidity and mortality, and so there is a strong case for supporting its development. Ectogenesis, however, may bring a number of challenges, including the commodification of children, and the pathologizing of pregnancy and childbirth. Its long-term effects on those who are created through this process are also unknown. In the event that it becomes ubiquitous, we may also find the central theological significance of pregnancy and birth diminished. The dilemma for Christians is that the development of ectogestation seems likely to normalise the use of artificial gestation, and, in time, pave the way for ectogenesis. (shrink)

This chapter surveys some of the issues that arise in policy making when the wellbeing of future generations must be taken into account. It analyses the discounting of future wellbeing, and considers whether it is permissible. It argues that the effects of policy on the number of future people should not be ignored, and it considers what is an appropriate basis for setting a value on these effects. It considers the implications of the non-identity effect for intergenerational justice and for (...) the Pareto principle. (shrink)

Two options are incommensurate in value if neither is better than the other, and if a small improvement or worsening of one does not necessarily make it determinately better or worse than the other. If a person faces a sequence of choices between incommensurate options, she may end up with a worse options than she could have had, even though none of her choices are irrational. Yet it seems that rationality should save her from this bad outcome. This is the (...) practical problem posed by incommensurability of values, and it may be solved by a new account of practical reasoning. (shrink)

This article will explore and summarise the four main ethical theories that have relevance for healthcare assistants. These are utilitarianism, deontology, virtue ethics, and principlism. Understanding different ethical theories can have a number of significant benefits, which have the potential to shape and inform the care of patients, challenge bad practice and lead staff to become better informed about areas of moral disagreement.

Most properties have comparatives, which are relations. For instance, the property of width has the comparative relation denoted by `_ is wider than _'. Let us say a property is reducible to its comparative if any statement that refers to the property has the same meaning as another statement that refers to the comparative instead. Width is not reducible to its comparative. To be sure, many statements that refer to width are reducible: for instance, `The Mississippi is wide' means the (...) same as `The Mississippi is wider than most rivers'. But some statements that refer to width are not reducible: for instance, `Electrons have zero width' is not. A property is not reducible to its comparative if it has absolute degrees, and specifically an absolute zero. A property's comparative relation places things in an order from those that have the property least to those that have it most. If there is an absolute zero point somewhere in this ordering, the property is not reducible to its comparative. For width, there is an absolute zero at one end of the ordering, so width is not reducible. The property of goodness is reducible to its comparative, betterness. In particular, there is no absolute zero of goodness. Things are ordered by betterness – some things are better than others – but nothing is absolutely good or absolutely bad. This is an exaggeration. In certain applications, goodness does have absolute degrees of a sort, and an absolute zero. For instance, it makes sense to say an event is good, and another event bad. These are absolute degrees of a sort, but they are themselves reducible to betterness. To say an event is good simply means the event is better than what would otherwise have happened. The goodness of lives has a different sort of absolute zero. Lives are ordered by betterness; some lives are better than others. We can make sense of the question `Where in this ordering is the division between lives that are good and those that are bad?' The division between good and bad lives is again reducible to betterness. To say a person's life is good means it is better that the person should continue living, rather than that she should die. Or it may mean it is better that her life should be lived rather than that it should never have been lived at all. As it is often put: a good life is a life worth living. Derek Parfit appears to attach a different sense to the idea of a good life. He appears to mean a life that contains a preponderance of good things (such as pleasure) over bad things (such as pain). If a life contains no good things and no bad things, it has zero goodness in this sense. In this sense, absolute goodness and the absolute zero of goodness are not reducible to betterness. However, this is a naturalistic sense of goodness, and it is subject to the open-question objection. If a life contains no good things and no bad things, it is an open question whether it has zero goodness. It might, for instance, be a bad thing that this life should be lived. In discussing the evil of death, some philosophers seem to have been searching for an absolute goodness that is not reducible to betterness. Thomas Nagel speaks of an asymmetry between what is good about life and what is bad about death. But if a person's life is good, that only means it would be better that she should continue living than that she should die. And if a person's death would be bad, that only means it would be worse that she should die than that she should continue living. So there can be no asymmetry. (shrink)

(for Adam Morton's half) I argue that if we take the values of persons to be ordered in a way that allows incomparability, then the problems Broome raises have easy solutions. In particular we can maintain that creating people is morally neutral while killing them has a negative value.

This article examines the relationship between teaching and trust and argues that a good trust relationship is essential to effective teaching. Unfortunately, the increasingly commercial nature of the modern university undermines this and contributes to the mistaken idea that teaching is a contractual one, thereby undermining a core feature of good teaching.

Betrayal is both a “people” problem and a philosopher’s problem. Philosophers should be able to clarify the concept of betrayal, compare and contrast it with other moral concepts, and critically assess betrayal situations. At the practical level people should be able to make honest sense of betrayal and also to temper its consequences: to handle it, not be assaulted by it. What we need is a conceptually clear account of betrayal that differentiates between genuine and merely perceived betrayal, and which (...) also provides systematic guidance for the assessment of alleged betrayal in real life. In what follows I offer an account of betrayal that attempts to meet the two requirements of conceptual clarity and contextual adequacy. There is a great temptation to use the events in Washington of the past few years as the case study for such an analysis, but I believe that, for a variety of reasons, including the difficulty of viewing events from “within,” this would only complicate matters rather than clarify them. Rather, I believe that betrayal in literature is fruitful ground for analysis. I have chosen Jane Austen’s Sense and Sensibility for examples of trust and betrayal, because Austen displays the needed complexity and subtlety of human relationships and because she recognizes that violations of trust come in a variety of shades and colors. This particular novel, moreover, not only supplies multiple instances of trusting relationships gone awry, but also a common, detailed, and intelligible landscape within which these relationships exist. Again, however, in order to illuminate betrayal and appropriately assess a purported betrayal, rich examples are not enough. We need a clear concept of betrayal. I will develop this concept by beginning with the related concept of trust. By starting with an explicit definition of trust and using this definition to analyze the various examples Austen provides, betrayal will emerge as but one of two types of violation of trust. This in turn will allow us to distinguish actual from merely “felt” betrayals. I will finally argue that understanding and being sensitive to the other form of violation of trust, which I call abandonment, may be even more significant to our moral life. (shrink)

Polytheism is a strange view to hold in modernity. Connected as it is in the popular imagination with archaic, animistic, magical, prescientific systems of thought, we don’t hesitate much before casting it into the dustbin of history. Even if we are not monotheists, we are likely to think of monotheism as the obviously more plausible position. The traditional arguments for the existence of God, which have been enormously influential in Western philosophy of religion, do not necessarily rule out polytheism but (...) they are clearly formulated with monotheism in mind. While there could be multiple first causes, intelligent designers, or beings than which nothing greater can be conceived, the simplest and most natural... (shrink)

Perioperative staff are frequently exposed to surgical smoke or plume created by using heat-generating devices like diathermy and lasers. This is a concern due to mounting evidence that this exposure can be harmful with no safe level of exposure yet identified. First, I briefly summarise the problem posed by surgical smoke exposure and highlight that many healthcare organisations are not sufficiently satisfying their legal and ethical responsibilities to protect their staff from potential harm. Second, I explore the ethical case for (...) compulsory smoke evacuation systems using the principlist framework and its four ethical principles – autonomy, beneficence, nonmaleficence, and justice. I then consider some objections and argue that surgical smoke evacuation systems – when indicated – should be made compulsory. (shrink)

Friendship between professors and students have the potential for hurting those involved and can be hurtful to the larger society in which they occur. This paper examines what sort of boundary lines can be drawn for appropriate faculty-student relationships by considering three arguments against faculty-student friendships. After rejecting these arguments on the grounds that they rely upon a flawed conceptualization of friendship, the paper, drawing on William Rawlins’s theory of friendship, argues that faculty-student relationships are neither desirable nor undesirable per (...) se. However, if such relationships do arise, it is possible that they can be conducted in an ethically responsible and professionally appropriate way. (shrink)

Those who turn to phenomenological psychopathology as an answer to problems in psychiatric healthcare may find a philosophical tradition rooted in the early-mid 20th century that has done little to adapt to modern ideas in psychiatric healthcare and psychiatric research. The Renewing Phenomenological Psychopathology project, funded by the Wellcome Trust and led by Professor Matthew Broome and Professor Giovanni Stanghellini, calls for reflection, revitalization and reconstruction of this discipline, diversifying global scholarship and working with lived experience scholars, so that it (...) can pave new paths in psychiatric understanding. The contributions of the current special issue aim to breathe new life into a vital method in psychopathology and to chart its future trajectory. (shrink)

In 2002, Bernard Williams delivered a lecture that revisited the arguments of his article 'Ought and moral obligation', published in his Moral Luck. The lecture attributed to the earlier article the thesis that there are no ‘personal’ or (as I put it) ‘owned’ oughts. It also rejected this thesis. This paper explains the idea of an owned ought, and supports Williams’s lecture in asserting that there are owned oughts. It also examines the question of how accurately Williams’s later lecture interprets (...) his earlier article. (shrink)

Juvenile offenders are sometimes transferred to a criminal court where they may stand trial as adults. The rationale for this current trend cannot be justified based on evidence from developmental psychology, the evidence of consistent positive effects for particular intervention strategies, and ethical arguments for justification of punishment. The rationale in actuality reflects the selective manipulation of the alternative conceptions of young people as dependent and vulnerable or as autonomous and responsible to continue to justify policies that entail cultural and (...) racial discrimination. Discretionary decisions at various stages of the justice process amplify racial disparities as minority youths proceed through the system and result in more severe dispositions that for comparable White youths. (shrink)

A substantial proportion of human embryos spontaneously abort soon after conception, and ethicists have argued this is problematic for the pro-life view that a human embryo has the same moral status as an adult from conception. Firstly, if human embryos are our moral equals, this entails spontaneous abortion is one of humanity’s most important problems, and it is claimed this is absurd, and a reductio of the moral status claim. Secondly, it is claimed that pro-life advocates do not act as (...) if spontaneous abortion is important, implying they are failing to fulfill their moral obligations. We report that the primary cause of spontaneous abortion is chromosomal defects, which are currently unpreventable, and show that as the other major cause of prenatal death is induced abortion, pro-life advocates can legitimately continue efforts to oppose it. We also defend the relevance of the killing and letting die distinction, which provides further justification for pro-life priorities. (shrink)

Anna Smajdor and Joona Räsänen argue that we have good reason to classify pregnancy as a disease. They discuss five accounts of disease and argue that each account either implies that pregnancy is a disease or, if it does not, it faces problems. This strategy allows Smajdor and Räsänen to avoid articulating their own account of disease. Consequently, they cannot establish that pregnancy is a disease, only that plausible accounts of disease suggest this. Some readers will dismiss Smajdor and Räsänen’s (...) claims as counterintuitive. By analogy, if a mathematical proof concludes ‘2+2=5’, readers will know—without investigation—that an error occurred. Rather than dismiss Smajdor and Räsänen’s work, however, the easiest way to undermine their argument is to describe at least one plausible account of disease that (i) excludes pregnancy and (ii) avoids the problems they raise for it. This is our strategy. We focus on dysfunction accounts of disease. After outlining Smajdor and Räsänen’s main arguments against dysfunction accounts, we explain why pregnancy is not a disease on these accounts. Next, we defend dysfunction accounts against the three problems that Smajdor and Räsänen raise. If successful, then contra Smajdor and Räsänen, at least one plausible account of disease does not imply that pregnancy is a disease. We suspect that defenders of other accounts can respond similarly. Yet, we note that insofar as dysfunction accounts align with the commonsense intuition that pregnancy is not a disease, this, all else being equal, seems like a point in their favour. (shrink)

Conscientious objection in healthcare has come under heavy criticism on two grounds recently, particularly regarding abortion provision. First, critics claim conscientious objection involves a refusal to provide a legal and beneficial procedure requested by a patient, denying them access to healthcare. Second, they argue the exercise of conscientious objection is based on unverifiable personal beliefs. These characteristics, it is claimed, disqualify conscientious objection in healthcare. Here, we defend conscientious objection in the context of abortion provision. We show that abortion has (...) a dubitable claim to be medically beneficial, is rarely clinically indicated, and that conscientious objections should be accepted in these circumstances. We also show that reliance on personal beliefs is difficult to avoid if any form of objection is to be permitted, even if it is based on criteria such as the principles and values of the profession or the scope of professional practice. (shrink)

There is a transpersonal reality behind the doors of perception. This reality manifests itself in the observable world in such diverse areas as psychology, physics, and biology. This paper explores the evidence in these diverse disciplines, discussing the need for a paradigm change which recognizes the importance of considering non-material influences which the transpersonal realm exerts on the physical world, and concludes with examples of individuals who have experienced this super-ordinate realm, noting the similarities in their descriptions of those experiences.

Like all reasoning, practical reasoning is a process that takes a person from some of her existing mental states to a new mental state. Theoretical reasoning concludes in a belief; practical reasoning in an intention. This paper concentrates on instrumental reasoning, a species of practical reasoning in general. It argues that instrumental reasoning is correct if the content of the reasoning is a valid derivation, just as theoretical reasoning is correct if its content is a valid derivation. It also argues (...) that neither theoretical nor practical reasoning gives a reason for its conclusion. If a piece of reasoning is correct, it concludes in a state - a belief or an intention - that is rationally required by the states it is derived from, but rationally requiring a conclusion is not the same as giving a reason for it. (shrink)

This editorial introduces the Journal of Consciousness Studies special issue on "Animal Consciousness". The 15 contributors and co-editors answer the question "How should we study animal consciousness scientifically?" in 500 words or fewer.

Reports of the intent to kill oneself are not always met with the credibility they deserve, with potentially fatal results. We recognise this as testimonial injustice, whereby a person’s testimony is not taken seriously due to a pervasive identity prejudice attached to the speaker (Fricker 2007). To meet the government’s ‘zero suicide ambition’ for mental health patients, we need to adopt epistemically just methods of evaluating suicide claims.

There is evidence to suggest that God occasionally communicates directly with humanity and that His voice is “heard”. (1 Samuel Chapter 3) This paper addresses the nature of this communication and whether this act by God is scientifically discernable and mechanistic. In communicating with human beings how does God transcend the Divine/human boundary?

Economists can value things for cost-benefit analysis using either a structured or an unstructured approach. The first imposes some theoretical structure on the valuation; the second does not. This paper explains the difference between the approaches and examines the relative merits of each. Cost-benefit analysis may be aimed at finding what would be the best action, or alternatively at finding which action should be done in a democracy. The paper explains the difference, and argues that the appropriate aim is the (...) first. Given that, it comes down in favour of the structured approach to valuation. As an example, it discusses different approaches to valuing life in economics. (shrink)

This paper investigates Robert Brandom’s programme of logical expressivism and in the process attempts to clarify his use of the term practice, by means of a detailed comparison with the works of sociologist and anthropologist Pierre Bourdieu. It turns out that the two scholars have a number of concerns in common, including the means by which core practices can be amalgamated into more sophisticated ones, and the possibility of explicating practices without distorting them or generating incoherent codifications. We find some (...) congruences between the two approaches but also a number of divergences. In particular, Bourdieu deprecates the well-known distinctions between langue and parole (Saussure), and competence and performance (Chomsky), while (we argue) Brandom ends up instituting his own “competence” model. We conclude by questioning how far this is compatible with his avowed aim of developing an “analytic pragmatism”. (shrink)

Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then examine (...) their comments regarding the analogy between abortion and HRT, and the language of informed consent. We also scrutinize the data upon which Ashley relies to defend the claim that informed consent without assessment always yields positive outcomes, finding this conclusion to be overstated. Finally, even if Ashley’s arguments were vindicated, the claim that the gatekeeping of HRT is motivated by hostility towards transgender people remains unsupported. (shrink)

It is envisioned that one day xenotransplantation will bring about a future where transplantable organs can be safely and efficiently grown in transgenic pigs to help meet the global organ shortage. While recent advances have brought this future closer, worries remain about whether it will be beneficial overall. The unique challenges and risks posed to humans that arise from transplanting across the species barrier, in addition to the costs borne by non-human animals, has led some to question the value of (...) xenotransplantation altogether. In response, we defend the value of xenotransplantation research, because it can satisfy stringent welfare conditions on the permissibility of animal research and use. Along the way, we respond to the alleged concerns, and conclude that they do not currently warrant a cessation or a curtailing of xenotransplantation research. (shrink)

Most mental health research largely ignores or minimises gender and age differences in depression. In ‘Don't mind the gap: Why do we not care about the gender gap in mental health?’, Patalay and Demkowicz identify a dearth of research on the causal factors of depression in young women. They attribute this to an over-reliance on biological accounts of gender differences in depression. Patalay and Demkowicz conclude that a person-centred approach that meaningfully engages with the reports of young women with depression (...) is more likely to expose the social drivers of depression that impact this group. This commentary focuses on Patalay and Demkowicz's call to examine the patient's lived experience. We argue that there is an urgent need to reflect upon the methodologies involved in examining lived experience and how they can be best utilised. Ultimately, we advocate for an approach known as ‘phenomenological psychopathology’, through a phenomenological investigation of depression in young women, we can go some way towards closing the gender gap. (shrink)

In ’Abortion and deprivation: a reply to Marquis’, Anna Christensen contends that Don Marquis’ influential ’future like ours’ argument for the immorality of abortion faces a significant challenge from the Epicurean claim that human beings cannot be harmed by their death. If deprivation requires a subject, then abortion cannot deprive a fetus of a future of value, as no individual exists to be deprived once death has occurred. However, the Epicurean account also implies that the wrongness of murder is also (...) not grounded in the badness of death, which is strongly counterintuitive. There is an alternative: we can save our intuitions by adopting a more moderate Epicurean account such as that proposed by David Hershenov, who grounds the wrongness of killing in the prevention of the benefit of further good life rather than in the badness of death. Hershenov’s account, however, is equally applicable to Marquis’ argument: abortion similarly prevents a fetus from enjoying the benefit of a future like ours. Consequently, we conclude that Christensen’s criticism of Marquis’ argument fails to undermine his reasoning. (shrink)

Understood in their historical context, current debates about psychiatric classification, prompted by the publication of the DSM-5, open up new opportunities for improved translational research in psychiatry. In this paper, we draw lessons for translational research from three time slices of 20th century psychiatry. From the first time slice, 1913 and the publication of Jaspers’ General Psychopathology, the lesson is that translational research in psychiatry requires a pluralistic approach encompassing equally the sciences of mind (including the social sciences) and of (...) brain. From the second time slice, 1953 and a conference in New York from which our present symptom-based classifications are derived, the lesson is that, while reliability remains the basis of psychiatry as an observational science, validity too is essential to effective translation. From the third time slice, 1997 and a conference on psychiatric classification in Dallas that brought together patients and carers with researchers and clinicians, the lesson is that we need to build further on collaborative models of research combining expertise-by-training with expertise-by-experience. This is important if we are to meet the specific challenges to translation presented by the complexity of the concept of mental disorder, particularly as reflected in the diversity of desired treatment outcomes. Taken together, these three lessons – a pluralistic approach, reliability and validity, and closer collaboration – provide an emerging framework for more effective translation of research into practice in 21st century psychiatry. (shrink)

Pro-life advocates commonly argue that fetuses have the moral status of persons, and an accompanying right to life, a view most pro-choice advocates deny. A difficulty for this pro-life position has been Judith Jarvis Thomson’s violinist analogy, in which she argues that even if the fetus is a person, abortion is often permissible because a pregnant woman is not obliged to continue to offer her body as life support. Here, we outline the moral theories underlying public health ethics, and examine (...) the COVID-19 pandemic as an example of public health considerations overriding individual rights. We argue that if fetuses are regarded as persons, then abortion is of such prevalence in society that it also constitutes a significant public health crisis. We show that on public health considerations, we are justified in overriding individual rights to bodily autonomy by prohibiting abortion. We conclude that in a society that values public health, abortion can only be tolerated if fetuses are not regarded as persons. (shrink)

Introduction to The Oxford Handbook of Phenomenological Psychopathology.