Consent can only be voluntary, freely given and uncoerced. Can this legal adult standard also apply to children? High-risk surgery is seldom a wanted choice, but compared with the dangers of the un...

This discussion paper considers how seldom recognised theories influence clinical ethics committees. A companion paper examined four major theories in social science: positivism, interpretivism, critical theory and functionalism, which can encourage legalistic ethics theories or practical living bioethics, which aims for theory–practice congruence. This paper develops the legalistic or living bioethics themes by relating the four theories to clinical ethics committee members’ reported aims and practices and approaches towards efficiency, power, intimidation, justice, equality and children’s interests and rights. Different approaches (...) to framing ethical questions are also considered. Being aware of the four theories’ influence can help when seeking to understand and possibly change clinical ethics committee routines. The paper is not a research report but is informed by a recent study in two London paediatric cardiac units. Forty-five practitioners and related experts were interviewed, including eight members of ethics committees, about the work of informing, preparing and supporting families during the extended process of consent to children’s elective heart surgery. The mosaic of multidisciplinary teamwork is reported in a series of papers about each profession, including this one on bioethics and law and clinical ethics committees’ influence on clinical practice. The qualitative social research was funded by the British Heart Foundation, in order that more may be known about the perioperative views and needs of all concerned. Questions included how disputes can be avoided, how high ethical standards and respectful cooperation between staff and families can be encouraged, and how minors’ consent or refusal may be respected, with the support of clinical ethics committees. (shrink)

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

Hartmut Rosa advances an account of the temporal structure of society from the perspective of critical theory. He identifies three categories of change in the tempo of modern social life: technological acceleration, evident in transportation, communication, and production; the acceleration of social change, reflected in cultural knowledge, social institutions, and personal relationships; and acceleration in the pace of life, which happens despite the expectation that technological change should increase an individual's free time. According to Rosa, both the structural (...) and cultural aspects of our institutions and practices are marked by the "shrinking of the present," a decreasing time period during which expectations based on past experience reliably match the future. When this phenomenon combines with technological acceleration and the increasing pace of life, time seems to flow ever faster, making our relationships to each other and the world fluid and problematic. It is as if we are standing on "slipping slopes," a steep social terrain that is itself in motion and in turn demands faster lives and technology. As Rosa deftly shows, this self-reinforcing feedback loop fundamentally determines the character of modern life. (shrink)

How do engineers respond to ethical dilemmas that occur in practice? How do they view their individual and collective responsibilities? How do they make decisions before all the facts are in? Using the space shuttle programme as the framework, this book examines the role of ethical decision making in the practice of engineering. In particular, the book considers the design and development of the main engines of the space shuttle as a paradigm for how individual engineers perceive, articulate, and resolve (...) ethical dilemmas in a large, complex organisation. A series of in-depth case studies show engineers at work on various stages of the project as they balance budgets, deadlines and risks. By documenting the historical development of a single system, the book provides a unique opportunity to explore the complex interactions between political, organisational and technical pressures and engineering and management decisions. (shrink)

There are many ways in which a speaker can confuse their audience. In this paper, I will focus on one such way, namely, a way of talking that seems to manifest a cross-level kind of cognitive dissonance on the part of the speaker. The goal of the paper is to explain why such ways of talking sound so twisted. The explanation is two-pronged, since their twisted nature may come either from the very mental states that the speaker thereby makes manifest, (...) or from how the speaker chooses to express themselves (even if there is nothing wrong with their mental states). So-called ‘Moore-paradoxical’ utterances are but one example of the phenomenon, and the explanation of what is wrong about them is subsumed under a more general explanation here—one that captures also the twisted-ness of utterances whereby questions are raised or intentions expressed. (shrink)

Questo contributo teorico propone una prospettiva innovativa nel dibattito sul concetto di “bullshit”. L’ipotesi principale è che la vaghezza sia un elemento fondamentale delle bullshit, che si focalizza sull’attività. In questo modo si supera il dibattito in letteratura che mette al centro o l’intenzionalità dell’enunciatore o la struttura e il contenuto degli enunciati. Si sostiene inoltre che la vaghezza non debba essere considerata come un limite, ma come un’opportunità per comprendere situazioni comunicative complesse. Questo differente approccio, basato sulla tradizione pragmatista, (...) supera alcuni limiti evidenziati in letteratura, aprendo la strada a una comprensione più approfondita del fenomeno delle bullshit. Offre inoltre una risposta esaustiva ad alcuni quesiti di Frankfurt e riconosce il lato “produttivo” delle bullshit, adattandosi meglio a molteplici circostanze quotidiane. Un approccio pragmatista al fenomeno-bullshit basato sulla vaghezza offre una maggiore comprensione di fenomeni complessi di comunicazione senza cadere nel “paradigma della sincerità” evidenziato da Frankfurt. (shrink)

In this paper I present reasons for us to accept the hypothesis that suspended judgment has correctness conditions, just like beliefs do. Roughly put, the idea is that suspended judgment about p is correct when both p and ¬p might be true in view of certain facts that characterize the subject’s situation. The reasons to accept that hypothesis are broadly theoretical ones: it adds unifying power to our epistemological theories, it delivers good and conservative consequences, and it allows us to (...) assess processes of reasoning involving attitudes of suspended judgment. (shrink)

La inteligencia artificial y la robótica son dos realidades que han venido para quedarse y cuya implicación en nuestra sociedad afecta a distintos ámbitos. El hecho de que nos encontremos ante una tecnología capaz de emular actitudes humanas como son el aprendizaje o la adaptación, convierten a la IA, y en concreto a los robots dotados de la misma, en máquinas imprevisibles. Asimismo, nos encontramos con la agravante de la posible interacción entre máquinas y sujetos de carácter vulnerable como son (...) los consumidores o los pacientes, lo que entraña un riesgo aún mayor. Precisamente por ello es necesario un análisis desde el punto de vista jurídico, así como también ético, de las consecuencias del manejo de los robots inteligentes en nuestra sociedad. (shrink)

This work develops the ethical attitude of courageous vulnerability through the integration of the phenomenon of involuntary memory in Marcel Proust's work and ...

Delusions are often portrayed as paradigmatic instances of incomprehensibility and meaninglessness. Here we investigate the relationship between delusions and meaning from a philosophical perspective, integrating arguments and evidence from cognitive psychology and phenomenological psychopathology. We review some of the empirical and philosophical literature relevant to two claims about delusions and meaning: delusions are meaningful, despite being described as irrational and implausible beliefs; some delusions can also enhance the sense that one’s life is meaningful, supporting agency and creativity in some circumstances. (...) Delusions are not incomprehensible representations of reality. Rather, they can help make sense of one’s unusual experiences and in some circumstances even support one’s endeavours, albeit temporarily and imperfectly. Acknowledging that delusions have meaning and can also give meaning to people’s lives has implications for our understanding of psychotic symptoms and for addressing the stigma associated with psychiatric conditions. (shrink)

It is not yet clear which response behavior requires self-regulatory effort in the moral dilemma task. Previous research has proposed that utilitarian responses require cognitive control, but subsequent studies have found inconsistencies with the empirical predictions of that hypothesis. In this paper we treat participants’ sensitivity to utilitarian gradients as a measure of performance. We confronted participants (N = 82) with a set of five dilemmas evoking a gradient of mean utilitarian responses in a 4-point scale and collected data on (...) heart rate variability and on utilitarian responses. We found positive correlations between tonic and phasic HRV and sensitivity to the utilitarian gradient in the high tonic group, but not in the low tonic group. Moreover, the low tonic group misplaced a scenario with a selfish incentive at the high end of the gradient. Results suggest that performance is represented by sensitivity correlated with HRV and accompanied with a reasonable placement of individual scenarios within the gradient. (shrink)

While the concept of adaptive preferences is an important tool for criticizing injustice, it is often claimed that using the concept involves showing disrespect for persons judged to have adaptive preferences. In this paper, I propose an account of adaptive preferences that does the relevant political work while still showing persons two centrally important kinds of respect. My account is based in what I call an indirect substantive account of autonomy, which places substantive requirements on the options available to a (...) person, rather than on the option that she ultimately prefers. This allows us to pinpoint cases in which a person's circumstances have rendered her insufficiently autonomous, without saying that any conception of the good must be non-autonomous tout court. (shrink)

Research and clinical trial development for rare diseases pose unique bioethical challenges. Much of the literature on rare diseases focuses on patient advocacy and drug development to manage or cu...

Virtue ethics has often been regarded as complementary or laissez-faire ethics in solving business problems. This paper seeks conceptual and methodological improvements by developing a virtue character scale that will enable assessment of the link between organizational level virtue and organizational performance, financial or non-financial. Based upon three theoretical assumptions, multiple studies were conducted; the content analysis of 158 Fortune Global 500 firms ethical values and a survey of 2548 customers and employees. Six dimensions of organizational virtue (Integrity, Empathy, Warmth, (...) Courage, Conscientiousness and Zeal) are identified through confirmatory factor analysis, and validated against satisfaction measure. Strategic implications of virtue characters are discussed. (shrink)

In this paper, I argue for the counter-intuitive conclusion that the same adaptive preference can be both prudentially good and prudentially bad for its holder: that is, it can be prudentially objectionable from one temporal perspective, but prudentially unobjectionable from another. Given the possibility of transformative experiences, there is an important sense in which even worrisome adaptive preferences can be prudentially good for us. That is, if transformative experiences lead us to develop adaptive preferences, then their objects can become prudentially (...) better for our actual selves than the objects of their non-adaptive alternatives would now be. I also argue, however, that the same worrisome adaptive preferences might still be prospectively prudentially objectionable: that is, our pre-transformation selves might be prudentially better off undergoing a non-adaptive alternative transformative experience instead. I argue that both claims hold across the range of the most broadly-defended accounts of well-being in the literature. (shrink)

Unsolicited email campaigns remain as one of the biggest threats affecting millions of users per day. During the past years several techniques to detect unsolicited emails have been developed. This work provides means to validate the hypothesis that the identification of the email messages’ intention can be approached by sentiment analysis and personality recognition techniques. These techniques will provide new features that improve current spam classification techniques. We combine personality recognition and sentiment analysis techniques to analyse email content. We enrich (...) a publicly available dataset adding these features, first separately and after in combination, of each message to the dataset, creating new datasets. We apply several combinations of the best email spam classifiers and filters to each dataset in order to compare results. (shrink)

Desde el ámbito filosófico cada vez más autores muestran interés por abordar la reflexión filosófica de la ingeniería. Del lado de la ingeniería, existe una demanda definida por las sociedades profesionales y los organismos de acreditación de las titulaciones de ingeniería de inclusión de las ciencias sociales y humanidades en la formación de los ingenieros que, sin embargo, presenta deficiencias en su implantación. El objetivo del presente trabajo es justificar la inclusión de la reflexión filosófica en la formación de los (...) titulados en ingeniería y, para mejorar la situación actual, presentar una propuesta de asignaturas que muestre cuál pueda ser su espacio. La propuesta consiste en la inclusión de una asignatura específica que relacione la ingeniería y la sociedad, donde la reflexión filosófica juega un papel significativo, como complemento a la inclusión de la reflexión filosófica sobre problemas concretos en asignaturas específicas de corte tecnológico. (shrink)

I propose that we can explain the contribution of mental time travel to agency through understanding it as a specific instance of our more general capacity for narrative understanding. Narrative understanding involves the experience of a pre-reflective and embodied sense of self, which co-emerges with our emotional involvement with a sequence of events. Narrative understanding of a sequence of events also requires a ‘recombinable system’, that is, the ability to combine parts to make myriad sequences. Mental time travel shares these (...) two characteristics: it involves an embodied sense of self and the ability to create novel scenarios. What is unique about mental time travel is that it is a story explicitly about our selves, and it involves metarepresentation. Agency is enabled by narrative understanding when we are able to put our current situation into a larger narrative context, whereby some possible actions, but not others, make sense. However, new features of agency are enabled when we understand stories that are explicitly about our selves: we gain the ability to plan and act on plans. (shrink)

In this article, I first propose four guidelines that follow from understanding the project of assigning victims duties to resist oppression as an ameliorative project. That is, if we understand the project to be motivated by the urgent aim of ending or mitigating the harm that oppression imposes on the oppressed, I argue that we should focus on developing and assigning duties that satisfy what I call the ability, weighting, fairness, and overdemandingness guidelines. Second, I develop the duty to be (...) a non-normative individual, which satisfies all four guidelines. (shrink)

Although the problem of adaptiveness plays an important motivating role in her work on human capabilities, Martha Nussbaum never gives a clear account of the controversial concept of adaptive preferences on which she relies. In this paper, I aim both to reconstruct the most plausible account of the concept that may be attributed to Nussbaum and to provide a critical appraisal of that account. Although her broader work on the capabilities approach moves progressively towards political liberalism as time passes, I (...) aim to show that her account of adaptive preferences continues to maintain her earlier commitment to perfectionism about the good. I then distinguish between two obligatory kinds of respect for persons, which I call, respectively, primary and secondary recognition respect. This distinction allows us to see that her perfectionist account of adaptive preferences allows her to show persons primary but not secondary recognition respect. Ultimately, I claim that an acceptable account of adaptive prefer.. (shrink)

Este artigo tem por objetivo geral investigar, numa perspectiva foucaultiana, as relações entre governo e subjetividade, através das artes de governar e a constituição do Estado moderno. Nessa tarefa, consideramos os cursos ministrados por Foucault, Segurança, Território, População e O nascimento da biopolítica, para tratar da presença do poder pastoral na constituição da governamentalidade. O objetivo específico é investigar outras possibilidades de organização social, associados a princípios democráticos, como solidariedade e autogestão em oposição aos efeitos gerados pelo neoliberalismo, com a (...) generalização dos valores mercadológicos nas condutas individuais e coletivas. Em nossa hipótese, consideramos a perspectiva anarquista como o contraponto vital na produção de outras formas de vida social e política, para além dos princípios exclusivamente econômicos. Neste ponto, apresentamos conceitos básicos dos valores anarquistas, como a ideia autogestão, apoio mútuo, a ideia de liberdade, encontrados em Bakunin, Kropotkin e Goldman, e a possibilidade de um pensamento sobre resistências e práticas no presente conforme as reflexões de Rago. Passamos também por uma crítica ao modelo de organização social e à própria ideia de democracia, a partir dos apontamentos de Graeber em Um projeto de democracia. Por fim, nosso esforço visa refletir sobre as possibilidades de um mundo outro, a partir de uma perspectiva que se apresenta radicalmente oposta às práticas políticas e sociais que encontramos hoje. Pretendemos, portanto, pensar no tempo presente e na possibilidade de novas formas de existência. (shrink)

O presente estudo se destina a fazer uma breve análise sobre o direito social à educação, sua influência para o alcance da dignidade da pessoa humana e o seu alcance no formato EAD no Brasil. O artigo trata das metodologias de ensino viabilizadas pelo EAD, qual a sua contribuição na formação desses jovens e crianças e se a fruição dos benefícios desse método de ensino são possível por todas as classes sociais de forma isonômica. A pretensão é analisar como o (...) EAD pode trazer a democratização do ensino no país e qual caminho viabilizará isto. (shrink)

Accounts of adaptive preferences are of two kinds: well-being accounts fully theorized for their own sake and political accounts theorized to facilitate the political project of reducing oppression and marginalization. Given their practical role, the latter are often less fully theorized, and are therefore less robust to theoretical criticism. In this paper, I first draw on well-being accounts to identify the well-theorized elements that political accounts should want to adopt in order to strengthen their project and avoid common criticisms. Second, (...) I appeal to the political project to show the shortcomings of the well-being accounts on which I draw. (shrink)

The significance of critical phenomenology for psychiatric praxis has yet to be expounded. In this paper, I argue that the adoption of a critical phenomenological stance can remedy localised instances of hermeneutical injustice, which may arise in the encounter between clinicians and patients with psychosis. In this context, what is communicated is often deemed to lack meaning or to be difficult to understand. While a degree of un-shareability is inherent to subjective life, I argue that issues of unintelligibility can be (...) addressed by shifting from individualistic conceptions of understanding to an interactionist view. This takes into account the contextual, historical and relational background within which meaning is co-constituted. I conclude by providing a corrective for hermeneutical injustice, which entails a specific attentiveness towards the person’s subjectivity, a careful sensitivity to contingent meaning-generating structures, and a degree of hermeneutical flexibility as an attitude of openness towards alternative horizons of possibility. (shrink)