Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of (...) ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients’ access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices. (shrink)

Recently, Australia became the second jurisdiction worldwide to legalize the use of mitochondrial donation technology. The Mitochondrial Donation Law Reform (Maeve’s Law) Bill 2021 allows individuals with a family history of mitochondrial disease to access assisted reproductive techniques that prevent the inheritance of mitochondrial disease. Using inductive content analysis, we assessed submissions sent to the Senate Committee as part of a programme of scientific inquiry and public consultation that informed drafting of the Bill. These submissions discussed a range of bioethical (...) and legal considerations of central importance to the political debate. Significantly, submissions from those with a first-hand experience of mitochondrial disease, including clinicians and those with a family history of mitochondrial disease, were in strong support of this legislation. Those in support of the Bill commended the two-staged approach and rigorous licencing requirements as part of the Bill’s implementation strategy. Submissions which outlined arguments against the legislation either opposed the use of these techniques in general or opposed aspects of the implementation strategy in Australia. These findings offer a window into the ethical arguments and perspectives that matter most to those Australians who took part in the Senate inquiry into mitochondrial donation. The insights garnered from these submissions may be used to help refine policy and guidelines as the field progresses. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

In today’s evolving understanding of gender, questions arise about the future of the feminist movement. Using Simone de Beauvoir’s The Second Sex, Hugh Ryan's “Who's Afraid of Social Contagion,” and Ben Kesslen’s “How the Idea of a 'Transgender Contagion' Went Viral—and Caused Untold Harm,” this paper explores the concept of the Other to analyze social contagion and gender-based oppression. It argues that while feminism must adapt, its future lies in embracing the experiences of all classified as the Other. Through de (...) Beauvoir's work, historical definitions of gender, and social constructivism, this paper proposes a new idea for the future of feminism. (shrink)

In this book, Newell makes the case for unified theories by setting forth a candidate.

This masterful work on Kant's Religion within the Boundaries of Mere Reason explores Kant's treatment of the Idea of God, his views concerning evil, and the moral grounds for faith in God. Kant and Religion works to deepen our understanding of religion's place and meaning within the history of human culture, touching on Kant's philosophical stance regarding theoretical, moral, political, and religious matters. Wood's breadth of knowledge of Kant's corpus, philosophical sharpness, and depth of reflection sheds light not only on (...) Kant, but also on the fate of religion and its relation to philosophy in the modern world. (shrink)

This article explores chemical skin bleaching practices in urban Ghana to demonstrate the ways that particular racialized understandings of meaning are deployed in a contemporary postcolonial African society. I argue that the processes of racialization indexed by skin bleaching in Ghana must be contextualized within global racial formations; specifically, they can only be understood by examining the interlinked local and global ideologies and practices of race. In elaborating this argument, the essay also engages with contemporary African diaspora theorization that tends (...) to foreground diasporic identity and experience at the expense of contemporary continental processes. By bringing a postcolonial African society into a dialogue about race, processes of racialization, and the interlinked transnational construction of black identities, this essay offers one way out of the ambivalent relationship that I believe diaspora theorization has with Africa. (shrink)

This article argues that Judith Butler’s neglect of biopolitics in her reading of Michel Foucault’s work on sexuality leads her to propose a genealogy of gender ontology rather than conduct a genealogy of gender itself. Sex was not an effect of a cultural system for Foucault, but an apparatus of biopower that emerged in the eighteenth century for the administration of life. Butler, however, is interested in uncovering how something we call or identify as gender manifests itself in different times (...) and contexts, rather than asking what relations of power made necessary the emergence of gender as a discourse. After examining the theoretical configurations underpinning Butler’s engagement with Foucault’s Herculine Barbin, I suggest a more biopolitically informed reading of how the material body becomes captured by the discourses of sexuality and sex. Finally, the article sets out preliminary questions with which a more strictly Foucauldian genealogy of gender might be conducted. (shrink)

Aesthetics and the Environment presents fresh and fascinating insights into our interpretation of the environment. Traditional aesthetics is often associated with the appreciation of art, but Allen Carlson shows how much of our aesthetic experience does not encompass art but nature--in our response to sunsets, mountains or horizons or more mundane surroundings, like gardens or the view from our window. Carlson argues that knowledge of what it is we are appreciating is essential to having an appropriate aesthetic experience and (...) that a scientific understanding of nature can enhance our appreciation of it, rather than denigrate it. (shrink)

This book explores Kant's views on the concept of God and on the attempt to demonstrate God's existence as a means of understanding Kant's work as a whole and of achieving a proper appreciation of the contents of Kant's moral faith.

Within barely a year, two school shootings shook Finland. The school shootings shocked Finnish society, forcing media, academics and experts, police and politicians alike to search for reasons behind the violent incidents. Focusing their analysis on the two main Finnish newspapers, Helsingin Sanomat and Hufvudstadsbladet, authoritative sources of information for Finland’s two language communities, the authors maintain that the Finnish case contributes to research on school shootings by evidencing the intimate linkages between the state, gender and violence. The authors argue (...) that violence is to be understood through different discourses about the Finnish state. In particular, they discern three discourses about the state that produce gendered discourses of violence: the welfare state, the realist state and the neoliberal state. The authors conclude that these discourses produce different notions of rational and irrational violence thereby providing different legitimizations for male-embodied/masculine violence. (shrink)

Epistemic akrasia arises when one holds a belief even though one judges it to be irrational or unjustified. While there is some debate about whether epistemic akrasia is possible, this paper will assume for the sake of argument that it is in order to consider whether it can be rational. The paper will show that it can. More precisely, cases can arise in which both the belief one judges to be irrational and one’s judgment of it are epistemically rational in (...) the sense that both are supported by sufficient evidence. (shrink)

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

In Beyond Humanity a leading philosopher offers a powerful and controversial exploration of urgent ethical issues concerning human enhancement.

Steven Pinker has said that one of the most important questions humans can ask of themselves is whether moral progress has occurred or is likely to occur. Buchanan and Powell here address that question, in order to provide the first naturalistic, empirically-informed and analytically sophisticated theory of moral progress--explaining the capacities in the human brain that allow for it, the role of the environment, and how contingent and fragile moral progress can be.

This book, written by four internationally renowned bioethicists and first published in 2000, was the first systematic treatment of the fundamental ethical issues underlying the application of genetic technologies to human beings. Probing the implications of the remarkable advances in genetics, the authors ask how should these affect our understanding of distributive justice, equality of opportunity, the rights and obligations as parents, the meaning of disability, and the role of the concept of human nature in ethical theory and practice. The (...) book offers a historical context to contemporary debate over the use of these technologies by examining the eugenics movement of the late nineteenth and early twentieth centuries. The questions raised in this book will be of interest to any reflective reader concerned about science and society and the rapid development of biotechnology, as well as to professionals in such areas as philosophy, bioethics, medical ethics, health management, law, and political science. (shrink)

Environmental aesthetics is an emerging field of study that focuses on nature's aesthetic value as well as on its ethical and environmental implications. Drawing on the research of a number of disciplines, this exciting new area speaks to scholars working in a range of fields, including not only philosophy, but also environmental and cultural studies, public policy and planning, social and political theory, landscape design and management, and art and architecture. _Nature, Aesthetics, and Environmentalism: From Beauty to Duty_ addresses the (...) complex relationships between aesthetic appreciation and environmental issues and emphasizes the valuable contribution that environmental aesthetics can make to environmentalism. Allen Carlson, a pioneer in environmental aesthetics, and Sheila Lintott, who has published widely in aesthetics, combine important historical essays on the appreciation of nature with the best contemporary research in the field. They begin with classic pieces by Ralph Waldo Emerson, Henry Thoreau, John Muir, John Burroughs, and Aldo Leopold, as well as an essay by Eugene Hargrove that lays out the scientific, artistic, and aesthetic foundations of current environmental beliefs and attitudes. The second section of the book addresses prevailing views on the conceptualization of nature and the various debates on how to properly and respectfully appreciate nature. The third section introduces positive aesthetics, the belief that everything in nature is essentially beautiful, even the devastation caused by earthquakes or floods. The essays in the final section explicitly bring together aesthetics, ethics, and environmentalism to explore the ways in which each might affect the others. (shrink)

On the occasion of a first conference on Cognitive Science, it seems appropriate to review the basis of common understanding between the various disciplines. In my estimate, the most fundamental contribution so far of artificial intelligence and computer science to the joint enterprise of cognitive science has been the notion of a physical symbol system, i.e., the concept of a broad class of systems capable of having and manipulating symbols, yet realizable in the physical universe. The notion of symbol so (...) defined is internal to this concept, so it becomes a hypothesis that this notion of symbols includes the symbols that we humans use every day of our lives. In this paper we attempt systematically, but plainly, to lay out the nature of physical symbol systems. Such a review is in ways familiar, but not thereby useless. Restatement of fundamentals is an important exercise. (shrink)

Exclusive moral concern for human beings is often thought to be the ideological source of many contemporary environmental problems. So the development of a non-anthropocentric theory of intrinsic moral value, according to which at least some parts of the non-human world are morally considerable for their own sake, is often thought to be a defining characteristic of a satisfying environmental ethic. This chapter unpacks three distinct forms of anthropocentrism, outlines three versions of ethical nonanthropocentrism, and sketches some of the debate (...) between anthropocentrists and nonanthropocentrists before concluding that a virtue-theoretic approach to human natural goodness exemplifies one form of anthropocentrism that may continue to play a vital role in developing an environmental ethic suitable to the Anthropocene. (shrink)

Today humanity faces radical global climate change, mass species extinctions, and unprecedented transformations to both terrestrial and aquatic ecosystems across the globe. Environmental ethics is an academic subfield of philosophy concerned with normative and evaluative propositions about the world of nature and, perhaps more generally, the moral fabric of relations between human beings and the world we occupy. This Handbook contains 45 newly commissioned essays written by leading experts and emerging voices and represent some of the best and most contemporary (...) thinking in environmental ethics. The chapters range over a broad variety of issues, concepts, and perspectives that are both central to and characteristic of the field, thus providing an authoritative but accessible account of the history, analysis, and prospect of ideas that are essential to contemporary environmental ethics. (shrink)

The roots of environmental aesthetics reach back to the ideas of eighteenth-century thinkers who found nature an ideal source of aesthetic experience. Today, having blossomed into a significant subfield of aesthetics, environmental aesthetics studies and encourages the appreciation of not just natural environments but also human-made and human-modified landscapes. _Nature and Landscape_ is an important introduction to this rapidly growing area of aesthetic understanding and appreciation. Allen Carlson begins by tracing the development of the field's historical background, and then (...) surveys contemporary positions on the aesthetics of nature, such as scientific cognitivism, which holds that certain kinds of scientific knowledge are necessary for a full appreciation of natural environments. Carlson next turns to environments that have been created or changed by humans and the dilemmas that are posed by the appreciation of such landscapes. He examines how to aesthetically appreciate a variety of urban and rural landscapes and concludes with a discussion of whether there is, in general, a correct way to aesthetically experience the environment. (shrink)

This book is the first in-depth attempt to provide a moral assessment of the heart of the modern human rights enterprise: the system of international legal human rights.

The development and nature of environmental aesthetics -- Aesthetic appreciation and the natural environment -- The requirements for an adequate aesthetics of nature -- Aesthetic appreciation and the human environment -- Appreciation of the human environment under different conceptions -- Aesthetic appreciation and the agricultural landscape -- What is the correct way to aesthetically appreciate landscapes?

First published in 1877, this book analyses the laws that govern human relations with society and with the natural world.

Truth is a value in that sense that a belief is good (or successful, or correct) just in case it is true. But it does not follow that truth is a good-making property, nor does it follow that the nature of truth explains its value. Instead, this paper argues that the nature of belief explains its value.

In Better than Human, noted bioethicist Allen Buchanan grapples with the ethical dilemmas of the medical revolution and biomedical enhancements. One problem, he argues, is that the debate over these enhancements has divided into polar extremes--into denunciations of meddling in the natural order, or else a heady optimism that we can cure all that ails humanity. In fact, Buchanan notes, the human genome has always been unstable, and intervention is no offense against nature.

Which nonhuman animals experience conscious pain?1 This question is central to the debate about animal welfare, as well as being of basic interest to scientists and philosophers of mind. Nociception—the capacity to sense noxious stimuli—is one of the most primitive sensory capacities. Neurons functionally specialized for nociception have been described in invertebrates such as the leech Hirudo medicinalis and the marine snail Aplysia californica (Walters 1996). Is all nociception accompanied by conscious pain, even in relatively primitive animals such as Aplysia, (...) or is it the case, as some philosophers continue to maintain, that conscious experiences are the exclu- sive province of human beings? What philosophical and scientific resources are presently available for assessing claims lying between these extremes? (shrink)

In this original work of cultural criticism, Allen S. Weiss explores the meaning of radio to the modern imagination.

This book is the most comprehensive treatment available of one of the most urgent - and yet in some respects most neglected - problems in bioethics: decision-making for incompetents. Part I develops a general theory for making treatment and care decisions for patients who are not competent to decide for themselves. It provides an in-depth analysis of competence, articulates and defends a coherent set of principles to specify suitable surrogate decisionmakers and to guide their choices, examines the value of advance (...) directives, and investigates the role that considerations of cost ought to play in decisions concerning incompetents. Part II applies this theoretical framework to the distinctive problems of three important classes of individuals, many of whom are incompetent: minors, the elderly and psychiatric patients. The authors' approach combines a probing analysis of fundamental issues in ethical theory with a sensitive awareness of the concrete realities of health care institutions and the highly personal and individual character of difficult practical problems. Its broad scope will appeal to health professionals, moral philosophers and lawyers alike. (shrink)

Ethical analyses of biomedical human enhancement often consider the issue of authenticity — to what degree can the accomplishments of those utilizing biomedical enhancements be considered authentic or worthy of praise? As research into Brain-Computer Interface technology progresses, it may soon be feasible to create a BCI device that enhances or augments natural human intelligence through some invasive or noninvasive biomedical means. In this article we will review currently existing BCI technologies and to what extent these can be said to (...) enhance or augment the capabilities of the respective users, describe one hypothetical type of BCI device that could augment or enhance a specific aspect of human knowledge — namely, mathematical ability, and relate these concepts to the active externalism view of the extended mind as espoused by Clark and Chalmers in order to argue that knowledge of mathematics derived from the usage of a BCI and the application thereof constitutes authentic knowledge and achievement. (shrink)

Possession Trance and Dramatic Perversity Dionysus arrives as a stranger, enigmatic, disquieting, contagious, spreading an epidemic of mania leading to ...

Environmental aesthetics is a relatively new sub-field ofphilosophical aesthetics. It arose within analytic aesthetics in thelast third of the twentieth century. Prior to its emergence,aesthetics within the analytic tradition was largely concerned withphilosophy of art. Environmental aesthetics originated as a reactionto this emphasis, pursuing instead the investigation of the aestheticappreciation of natural environments. Since its early stages, thescope of environmental aesthetics has broadened to include not simplynatural environments but also human and human-influenced ones. At thesame time, the discipline has also (...) come to include the examination ofthat which falls within such environments, giving rise to what iscalled the aesthetics of everyday life. This area involves theaesthetics of not only more common objects and environments, but alsoa range of everyday activities. Thus, early in the twenty-firstcentury, environmental aesthetics embraced the study of the aestheticsignificance of almost everything other than art. Together with thisbroader scope of environmental aesthetics, the twenty-first centuryhas also given rise to renewed and more intense investigations of therelationship between environmental aesthetics and environmentalism aswell as to several new interests and directions. (shrink)

This Volume contains seven works of Kant, newly translated and edited, with Introductions. What does it mean to orient oneself in thinking? 1786 (Allen Wood) On the miscarriage of all philosophical trials in theodicy. 1791 (George di Giovanni Religion within the boundaries of mere reason. 1793 (George di Giovanni) The end of all things. 1794 (Allen Wood) The conflict of the faculties. 1798 (Mary J. Gregor & Robert Anchor) Preface to Reinhold Bernhard Jackmann's examination of the Kantian Philosophy (...) of Religion. 1800 (Allen W. Wood) Lectures on the philosophical doctrines of religion (1817) (Allen W. Wood -/- . (shrink)