Medical Ethics has many unsung heros and heroines. Here we celebrate one of these and on telling part of her story hope to place modern medical ethics and bioethics in the UK more centrally within its historical and human contex.

We wish to describe and acknowledge the exceptional contributions to medical ethics, both in the UK and internationally, made by Edward Shotter1 who died at home on 3 July 2019. He was founder of the London Medical Group2 3 and instigator of similar student-led medical ethics groups throughout the UK; founder of the Institute of Medical Ethics4 and founder of the Journal of Medical Ethics. Ted Shotter transformed the study of medical ethics in the UK in the interests of patients (...) and professionals alike. In 1963, he established the pioneering ‘Medical Group’ model, an innovative bottom-up method whereby students in the health professions could gain a grounding in ethics that had previously been denied to the profession.5 It was with these Medical Groups that many of the leading figures in contemporary UK medical ethics and law began their careers in the subject including Sir Kenneth Calman, Sir Ian Kennedy, Professor Margaret Brazier OBE, Professor John Harris and Professor Sir Jonathan Montgomery to name but …. (shrink)

Justice, one of the four Beauchamp and Childress prima facie basic principles of biomedical ethics, is explored in two excellent papers in the current issue of the journal. The papers stem from a British Medical Association essay competition on justice and fairness in medical practice and policy. Although the competition was open to all comers, of the 235 entries both the winning paper by Alistair Wardrope1 and the highly commended runner-up by Zoe Fritz and Caitríona Cox2 were written by practising (...) doctors—a welcome indication of the growing importance being accorded to philosophical reflection about medical practice and practices within medicine itself. Both papers are thoroughly thought provoking and represent two very different approaches to the topic. Each deserves a careful read. The competition was a component of a BMA 2019/2020 ‘Presidential project’ on fairness and justice and asked candidates to ‘use ethical reasoning and theory to tackle challenging, practical, contemporary, problems in health care and help provide a solution based on an explained and defended sense of fairness/justice’. In this guest editorial I’d like to explain why, in 2018 on becoming president-elect of the BMA, I chose the theme of justice and fairness in medical ethics for my 2019–2020 Presidential project—and why in a world of massive and ever-increasing and remediable health inequalities biomedical ethics requires greater international and interdisciplinary efforts to try to reach agreement on the need to achieve greater ‘health justice’ and to reach agreement on what that commitment actually means and on what in practice it requires. First, some background. As president I was offered the wonderful opportunity to pursue, with the organisation’s formidable assistance, a ‘project’ consistent with the BMA’s interests and values. As a hybrid of general medical practitioner and philosopher/medical ethicist, and as a firm defender of the Beauchamp …. (shrink)

Intention is one of the masterworks of twentieth-century philosophy in English. First published in 1957, it has acquired the status of a modern philosophical classic. The book attempts to show in detail that the natural and widely accepted picture of what we mean by an intention gives rise to insoluble problems and must be abandoned. This is a welcome reprint of a book that continues to grow in importance.

It is hypothesised and argued that “the four principles of medical ethics” can explain and justify, alone or in combination, all the substantive and universalisable claims of medical ethics and probably of ethics more generally. A request is renewed for falsification of this hypothesis showing reason to reject any one of the principles or to require any additional principle(s) that can’t be explained by one or some combination of the four principles. This approach is argued to be compatible with a (...) wide variety of moral theories that are often themselves mutually incompatible. It affords a way forward in the context of intercultural ethics, that treads the delicate path between moral relativism and moral imperialism. Reasons are given for regarding the principle of respect for autonomy as “first among equals”, not least because it is a necessary component of aspects of the other three. A plea is made for bioethicists to celebrate the approach as a basis for global moral ecumenism rather than mistakenly perceiving and denigrating it as an attempt at global moral imperialism. (shrink)

Developing a boundary-crossing ethics by paying attention to our stories, myths, and moral intuition.

The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption by the WMA General Assembly in October 2022 in Berlin. This article describes and discusses the ICoME, its revision process, the controversial and uncontroversial (...) issues, and the broad consensus achieved among WMA constituent members, representing over 10 million physicians worldwide. The authors analyse the ICoME, including its response to contemporary changes and challenges like ethical plurality and globalisation, in light of ethical theories and approaches, reaching the conclusion that the document is a good example of international ethical professional self-regulation. (shrink)

Study of Nyayabindu of Dharmakirti, 7th cent. and its commentary Nyayabindutika of Dharmottara.

Margaret Whitford's study provides the ideal introduction to Irigaray's thought, offering a sustained interpretation of her whole corpus, including previously untranslated French texts. Whitford suggests that Irigaray's work should be seen as "philosophy in the feminine," actively opposing the complicity of philosophy with other social practices which exclude or marginalize women.

edited by Tuija Takala and Matti Häyry, welcomes contributions on the conceptual and theoretical dimensions of bioethics.

Promoting respect for the four principles remains of great practical importance in ordinary medicineThe following are four “scenarios” with brief outlines of how Raanan Gillon has analysed them using the “four principles” approach. These are the four cases that the commentators were asked to analyse.Professor Gillon has for many years advocated the use of the Beauchamp and Childress four principles approach as a widely and interculturally acceptable method for medical ethics analysis . At present there seems to be (...) a backlash by some bioethicists against this approach, with among others, adherents of feminist ethics, narrative ethics, virtue ethics, and various varieties of regional ethics claiming to offer better approaches to medical ethics.At Raanan Gillon’s request this special issue of the Journal of Medical Ethics is intended to focus on this aspect of his work, with a view not only to discussing the issue of how different approaches to medical ethics are and/or are not compatible with the four principles approach but also to make clear to JME readers what alternative ethics analysis method is preferred and used by the various commentators.THE “STANDARD” JEHOVAH’S WITNESS CASEIn the first scenario, that of the “standard” Jehovah’s Witness case, a competent adult patient loses a massive amount of blood from a blood vessel bleeding in an acute duodenal ulcer. The best chance of …. (shrink)

Through the use of particular pedagogies and the adoption of new modes of thinking, physical literacy promises more realistic models of physical competence and ...

The influence of European and especially German historiography on the formation of the modern academic discipline in Japan is undisputed, as is the importance of the German historian Ludwig Rieß. Undeniably, Rieß contributed to the organization of the academic discipline by teaching future historians and taking an active part in the establishment of the Historical Society, as well as by the example of his own research in the history of Japan. But how significant was his influence on the establishment and (...) maintenance of archives in Japan? Japanese scholars had been collecting and working with primary documents long before Rieß arrived; indeed, the earliest efforts predate even the measures introduced under the Meiji government in the 1870s. This article outlines the beginnings of komonjogaku (the study of primary documents), giving particular attention to the work of its pioneer, Kume Kunitake. The author argues that while European methods based on archival research inspired and served to justify Japanese activities, indigenous traditions were at least equally important. Moreover, parallels with western countries are not merely a result of western imports but reflect the common responses to global processes in the late 19th and early 20th centuries. (shrink)

A comprehensive cross-referenced guide to classical Hinduism from its beginnings to the fifteenth century explains rites, concepts, myths, symbols, literary texts.

History is useful when it is used properly: to understand why we and those we must deal with think and react in certain ways. It can offer examples to inform our decisions and guesses about the consequences of our actions. But we should be wary of looking to history for dogmatic lessons.We should distrust those who abuse history when they call on it to justify unreasonable claims to land, for example, or restitution. MacMillan illustrates how dangerous history can be in (...) the hands of nationalistic or religious or ethnic leaders who use it to foster a sense of grievance and a desire for revenge. (shrink)

This new volume in the acclaimed Oxford Readings in Philosophy sereis offers a selection of the most important philosophical work being done in the new and fast-growing interdisciplinary area of artificial life. Artificial life research seeks to synthesize the characteristics of life by artificial means, particularly employing computer technology. The essays here explore such fascinating themes as the nature of life, the relation between life and mind, and the limits of technology.

In this issue of the journal “Lee Elder”,1 a pseudonymous dissident Jehovah's Witness , previously an Elder of that faith and still a JW, joins the indefatigable Dr Muramoto2–5 in arguing that even by their own religious beliefs based on biblical scriptures JWs are not required to refuse potentially life-saving blood transfusions. Just as the “official” JW hierarchy has accepted that biblical scriptures do not forbid the transfusion or injection of blood fractions so too JW theology logically can and should (...) permit the transfusion of whole blood when this is medically required.Few doctors would argue that they should override the adequately autonomous decisions of Jehovah's Witnesses to refuse blood transfusions even if they are likely to die as a result of such transfusions. However, there is a case to be made for doctors asking such patients to reflect on their potentially fatal refusal of blood and for drawing to these patients' attention the reasoning of members of their own faith that justifies acceptance of potentially life-saving blood transfusions. What is that case? Simply that doctors' primary professional duty to try to benefit the health of their patients entails trying to save their patients' lives when and if doing so will benefit their patients' health. Of course this is not an absolute duty overriding all other duties; in particular if patients who are adequately autonomous to do so refuse such life-prolonging treatment doctors must generally accept such refusal, however sadly. This editorial endorses that view in the case of adequately autonomous legally competent JWs. (In another paper in this issue of the journal Professor Shimon Glick argues that ethics committees should be empowered—as they now are in Israel—to override even competent refusals of life-prolonging treatment where the committee judges that …. (shrink)

Semantics: A Reader contains a broad selection of classic articles on semantics and the semantics/pragmatics interface. Comprehensive in the variety and breadth of theoretical frameworks and topics that it covers, it includes articles representative of the major theoretical frameworks within semantics, including: discourse representation theory, dynamic predicate logic, truth theoretic semantics, event semantics, situation semantics, and cognitive semantics. All the major topics in semantics are covered, including lexical semantics and the semantics of quantified noun phrases, adverbs, adjectives, performatives, and interrogatives. (...) Included are classic papers in the field of semantics as well as papers written especially for the volume. The volume comes with an extensive introduction designed not only to provide an overview of the field, but also to explain the technical concepts the beginner will need to tackle before the more demanding articles. Semantics will have appeal as a textbook for upper level and graduate courses and as a reference for scholars of semantics who want the classic articles in their field in one convenient place. (shrink)

This Australian text provides students with accessible coverage of the central areas of the jurisprudence course. It examines: asking the law question; common law theory; positivism and natural law; legal service; critical legal studies; feminism; post-modernism; and deconstruction.

In this wide-ranging interview Professor Margaret Archer discusses a variety of aspects of her work, academic career and influences, beginning with the role the study of education systems played in...

This paper argues that there is a distinctive vice of hypocrisy, which is Janus-faced. The vice of hypocrisy is the self-excepting avoidance of a particular pain, namely, the pain associated with being an object of blame one believes deserved. One can self-exceptingly avoid this pain attitudinally or behaviorally. With “attitudinal” hypocrisy, a person avoids it at the level of her beliefs: she avoids forming the belief that she is blameworthy for some act, while blaming others for their comparable acts. With (...) “behavioral” hypocrisy, by contrast, a person avoids it at the level of her behavior. She shields herself from the blame she believes her acts merit (e.g. by hiding what she has done), while blaming others for their comparable acts. The paper argues that both forms of hypocrisy are objectionable and explains how they are in tension, such that a given instance of the vice will typically involve only one or the other. Though both attitudinal and behavioral hypocrisy selectively spare the hypocrite the same pain, they require incongruous moral-psychological states: the attitudinal hypocrite avoids blaming herself, while the behavioral hypocrite proceeds on the assumption she is blameworthy. (shrink)

Humanity and the very notion of the human subject are under threat from postmodernist thinking which has declared not only the 'Death of God' but also the 'Death of Man'. This book is a revindication of the concept of humanity, rejecting contemporary social theory that seeks to diminish human properties and powers. Archer argues that being human depends on an interaction with the real world in which practice takes primacy over language in the emergence of human self-consciousness, thought, emotionality and (...) personal identity - all of which are prior to, and more basic than, our acquisition of a social identity. This original and provocative new book from leading social theorist Margaret S. Archer builds on the themes explored in her previous books Culture and Agency (CUP 1988) and Realist Social Theory (CUP 1995). It will be required reading for academics and students of social theory, cultural theory, political theory, philosophy and theology. (shrink)

How is it possible to think new thoughts? What is creativity and can science explain it? And just how did Coleridge dream up the creatures of The Ancient Mariner? When The Creative Mind: Myths and Mechanisms was first published, Margaret A. Boden's bold and provocative exploration of creativity broke new ground. Boden uses examples such as jazz improvisation, chess, story writing, physics, and the music of Mozart, together with computing models from the field of artificial intelligence to uncover the (...) nature of human creativity in the arts. The second edition of The Creative Mind has been updated to include recent developments in artificial intelligence, with a new preface, introduction and conclusion by the author. It is an essential work for anyone interested in the creativity of the human mind. (shrink)

For those open to the possibility that philosophical thought can improve life, David Hume's Essays: Moral, Political, and Literary have something to say. In the first comprehensive study of the Essays, Margaret Watkins engages closely with these neglected texts and shows how they provide important insights into Hume's perspective on the breadth and depth of human life, arguing that the Essays reveal his continued commitment to philosophy as a discipline that can promote both social and individual progress. Addressing topics (...) such as politics, war, slavery, the priesthood, the development of industry, aesthetics, emotional disorders, egoism, friendship, sexuality, gender relations, and the nature of philosophy itself, the volume examines Hume's purposes and aims against the backdrop of the eighteenth century society in which he lived. It will be of interest to scholars of modern thought in philosophy, politics, history, and economics. (shrink)

The central problem of social theory is 'structure and agency'. How do the objective features of society influence human agents? Determinism is not the answer, nor is conditioning as currently conceptualised. It accentuates the way structure and culture shape the social context in which individuals operate, but it neglects our personal capacity to define what we care about most and to establish a modus vivendi expressive of our concerns. Through inner dialogue, 'the internal conversation', individuals reflect upon their social situation (...) in the light of current concerns and projects. On the basis of a series of unique, in-depth interviews, Archer identifies three distinctive forms of internal conversation. These govern agents' responses to social conditioning, their individual patterns of social mobility and whether or not they contribute to social stability or change. Thus the internal conversation is seen as being the missing link between society and the individual, structure and agency. (shrink)

In recent years, the free market position has been gaining strength. In this book, Radin provides a nuanced response to its sweeping generalization.

Late last year the English Court of Appeal confirmed a lower court's ruling that doctors could impose an operation to separate recently born conjoined twins, overriding the refusal of consent of their parents. The doctors believed the operation would probably save one of the babies at the cost of killing the other, while not operating would highly probably be followed by the death of both twins within months of their birth. The parents, said to be devout Roman Catholics, believed that (...) it was absolutely wrong to kill one of their babies, even to save the life of the other.Undoubtedly many people, the writer included, would agree with the English courts that the “least worst” option was to separate the twins and save one at the cost of killing the other. But surely many fewer people would have imposed their own resolution of this acute moral dilemma upon parents who conscientiously chose the other limb of the dilemma, refusing to kill one baby even in order to save the other. Were the English judges right, then, to take away the parents' normal right and duty to make health care decisions on behalf of their children and instead impose their own answer to what they admitted to be a terrible dilemma? Describing the two alternatives in terms of choosing between the lesser of two evils on the one hand, and the obligation not to kill on the other, Lord Justice Ward declared, according to The Times law report,1 that: “Parents who were placed on the horns of such a terrible dilemma simply had to choose the lesser of their inevitable loss [sic]”. But that surely is to beg the moral question in favour of the judges' preferred answer to this moral dilemma. The fact is that there are—as …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Testimony of Sense: Empiricism and the Essay from Hume to Hazlitt by Tim MilnesMargaret WatkinsTim Milnes. The Testimony of Sense: Empiricism and the Essay from Hume to Hazlitt. Oxford: Oxford University Press, 2019. Pp. viii + 278. Hardback. ISBN: 9780198812739. $91.00.In his brief autobiography, “My Own Life,” Hume reports that “almost all [his] life has been spent in literary pursuits and occupations” (E-MOL: xxxi). This is one (...) of at least ten places in this brief work in which he associates himself with “letters” or “literature”—as compared to at most four associations with philosophy. The moral to be inferred is not that Hume considered himself not to be a philosopher. Rather, he conceived of philosophy as a kind of literature. The Treatise was itself a “literary attempt.” Indeed, opposition between the “literary” and “philosophical” aspects of a text would have been foreign to Hume and his contemporaries—a notion for a later age, despite his occasional loose distinction between the relevant genres, as in his list of writings “historical, philosophical, or literary” in “My Own Life” (E-MOL: xxxvi).Yet despite Hume’s own understanding of the continuity between philosophy and literature, broadly conceived, it is still common for contemporary philosophers to ignore literary questions in their examination of Hume’s work, or to presume that one can easily distinguish the “philosophical” parts from the “literary” ones. Tim Milnes’s The Testimony of Sense is therefore a welcome addition to the Hume literature (pun intended). With a particular focus on the essay—a genre of great importance to Hume—Milnes contributes to the small set of engagements with Hume from the disciplinary perspective of English literature. With training in both philosophy and literature, as well as established expertise on Romanticism and its own essays, Milnes is well-qualified for the task. The Testimony of Sense includes sustained engagement with Hume’s contemporaries and successors, but for the purposes of this review, I engage the book primarily as a Hume scholar for Hume scholars.Milnes’s story plays out in three acts. The first establishes the need for public trust created by a skeptical crisis, itself a product of Hume’s criticism of the epistemic program of thinkers in the Cartesian and Lockean traditions. The second explains how the essays of the long eighteenth century constitute a response to that need in various ways. The third reveals in detail how the Romantic essayists, particularly William Hazlitt and Charles Lamb, both respond to and deviate from the “neoclassical” essayists, typified by Hume and Samuel Johnson.The first chapter, “Self and Intersubjectivity,” lays the groundwork by articulating how Hume, Adam Smith, Thomas Reid, and Dugald Stewart identify the need for what we now call intersubjectivity. Milnes describes the common thread as a kind of “natural transcendentalism.” In what sense are these thinkers properly understood as [End Page 175] transcendentalists? The central idea seems to be that all posit things other than reason as “conditions of meaningful thought” (72). For Hume, it is the social, linguistic experience of a community of virtuous judges. The intricate relations between self and other essential to such a community get “internalized within the specular drama of the impartial spectator” (72) in Smith’s writing, which itself takes part in the drama through his “halting, qualified syntax” that mimics “everyday speech” (44). Reid posits a “prescience” of trust, which grounds our reliance on both human testimony and the uniformity of nature, itself undergirded by the design of a benevolent God. Stewart, who posits axiomatic truths that help constitute the “stamina of intellect,” goes furthest, actually calling these truths transcendental (55). This chapter also puts these eighteenth-century thinkers in conversation with twentieth-century theorists, including Habermas, Davidson, and Rorty.Chapter 2, “The Subject of Trust,” deepens the analysis by situating these “natural transcendentalisms” in the broader enlightenment context. In contrast to Descartes, Bacon, and Locke, who were suspicious of our reliance on the opinions of others, the eighteenth-century thinkers understand trust as prior to reason in various ways—though not prior to solidarity. The particulars in each case depend on their responses to skepticism and their accounts of the relation between... (shrink)

An essential work for anyone interested in the creativity of the human mind, "The Creative Mind" has been updated to include recent developments in artificial ...

Recognition of Hannah Arendt's contribution to the history of western philosophy is long overdue. Arendt was a 'political thinker', but this book highlights the importance of her ontological preoccupations for an understanding of her work.