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Welcome to the first Bioethics Digest, brought to you in association with the editors of the Bioethics Forum. This digest aims to bring you commentary on today’s most topical bioethics issues. The opinions expressed are those of the authors and not The Hastings Center.
One of the long-term contributions of Earth Day, which occurred on April 22, is that it offers a regular, semi-official reminder that a sense of the sacred is a vital part of environmentalism. But in the era of biotechnology, the notion of sacredness can pull in other directions.
A recent public form on synthetic biology hosted by Friends of the Earth and some other civil society groups effectively brought out how the notion of sacredness is woven into objections to genetically modifying microorganisms to produce fuel, cosmetics, medicines, and other chemicals. The event was titled “Sacred versus Synthetic: Competing Visions for Life on Earth,” and what was especially remarkable and helpful about it was that the presentations continually brought concerns about the possible practical harms of GM microorganisms back down to concerns about the very idea of GM microorganisms. To the speakers, the genetic modification of an organism is by definition a harm to nature, and it is perhaps the most fundamental harm to nature.
The goal of protecting life and preserving nature is a good moral starting point, writes Gregory E. Kaebnick, a research scholar at The Hastings Center and editor of the Hastings Center Report and author of Humans in Nature: The World as We find It and the World as We Create It. But a concern to preserve the natural world still requires careful thinking about which ways of altering nature constitute fundamental harms to nature.
“When I first began reading and writing about the genetic modification of organisms, I, too, felt that there was something particularly unattractive about it, that a sense of life’s value should guide us away from all forms of it,” Kaebnick writes. “I now believe that the real friends of earth should look at the big picture–at ecosystems and biodiversity, at the land, at the earth–and that the modification of DNA, per se, is not really the issue. The real issues have to do with the overall human-caused damage to the planet. We should focus on the problems of global climate change, pollution, ecosystem destruction, and human-driven extirpation of species.”
The idea that we can get better grades at school and advance our careers by taking drugs that improve concentration and other brain functions is at once controversial and tempting. Is this cheating, or is it in the same realm as drinking coffee to increase alertness? Bioethicists, medical professionals, and the general public are divided on this question.
What’s not contested is that teenagers and adults in the United States are using prescription medications such as Ritalin for nonmedical purposes in an attempt to enhance normal cognitive functioning. People are getting the drugs from doctors, or from patients (such as classmates) with prescriptions for neurological conditions who are willing to sell or share their pills.
Against this Wild West backdrop, the Presidential Commission for the Study of Bioethical Issues (PCSBI) has taken a significant step by issuing recommendations on the ethical use of medications and other means of “neural modification,” which includes drugs and interventions such as deep brain stimulation that might either treat neurological disorders or augment normal brain function. The recommendations are part of its final report, Grey Matters: Topics at the Intersection of Neuroscience, Ethics and Society.
Those who firmly believe that college students without ADHD who take Ritalin before finals are cheaters or that people in hard-driving careers who use drugs to sustain a seemingly inhuman output of work are frauds (or victims of coercion in a hypercompetitive job market) are likely to be disappointed by the commission’s report, writes Susan Gilbert, editor of Bioethics Forum, the blog of the Hastings Center Report. It is guardedly optimistic about the prospects for neural modification for enhancement purposes, stating that “contemplating novel methods of improving such functions as learning and memory in school or performance in competitive professions is truly exciting.” The commission does not assume that cognitive enhancers will necessarily promote injustice (by benefiting mainly those who are able to afford them) or help level the playing field (by enabling people with below average but still normal memory and other brain functions to perform better). But it concludes that it’s worth finding out.
A 78-year‐old man in Iowa, Henry Rayhons, was charged with third‐degree felony sexual abuse for having sex with his wife, who had severe Alzheimer’s, in her nursing home last year. Though Rayhons was acquitted last month, the case raises questions about the capacity to consent in cases of severe dementia, an issue that is not limited to sexual relations, writes Bonnie Steinbock, a Hastings Center Fellow, who is professor emeritus of philosophy at the University at Albany, State University of New York and a professor of bioethics at Union Graduate College’s Center for Bioethics and Clinical Leadership. It also comes up also in cases where patients with dementia initially resist food and water, but can be coaxed to eat. Does opening one’s mouth and ultimately swallowing indicate consent?
The importance of consent in sexual relations is well recognized, but this case is clearly not a case of spousal rape. No one suggests that Mrs. Rayhons resisted sexual contact with her husband, nor were there any signs of abuse. Indeed, by all accounts, theirs was a loving and affectionate relationship, and Mrs. Rayhons was always pleased to see her husband, even in the final stages of her dementia.
In other contexts, the absence of affirmative consent to sexual relations may be the right criterion for rape or other sexual abuse. On many college campuses, the movement is away from “no means no” (absence of consent) to a standard of affirmative consent. That is, both partners must give affirmative consent, whether verbal or otherwise, for sex to be consensual.
However, using affirmative consent as the standard for patients with severe dementia would deprive them of sexual relationships, because few retain the capacity to articulate a desire for sex. That would be a shame, because of the importance for human beings—including those who have dementia — of physical intimacy.
Brought to you in association with the editors of:
Bioethics Forum, the blog of the Hastings Center Report, publishes thoughtful commentary from a range of perspectives on timely issues in bioethics. Starting this month, Philosopher’s Eye will bring you a digest of the most relevant commentary from Bioethics Forum and Hastings Center scholars. With over 100 contributing bloggers working in a variety of positions, the blog supports a breadth of topics relevant to researchers, medical practitioners, health care professionals, ethicists, and philosophers. The opinions expressed are those of the authors and not The Hastings Center.
The Hastings Center Report has a long-standing history of exploring the ethical, legal, and social issues in medicine, health care, public health, and the life sciences. Wiley is proud of our continued partnership with the Hastings Center and their publications. For more information on this publication, take a look at their free sample issue for 2015.
Nurses, doctors, and physicians, our every-day heroes of the the medical profession, grapple with the delicate balance of philosophy and ethics as a practitioner. To them, the philosophical debates of medical ethics is actualized throughout their jobs on an actionable level. In celebration of its 20th anniversary, The Journal of Evaluation in Clinical Practice has compiled a special issue on the philosophy of ethics. The issue offers a variety of articles on the topic of philosophy and ethics in healthcare, with focuses from evidence-based medicine to person-centred care.
Wiley has an array of journals dedicated to bioethics and medical ethics that explore the crucial scholarly work surrounding the philosophy of ethics within health care. Also free until May 22nd, an additional collection of resources on the topic includes three of the top 10 journals by impact factor for medical ethics, Developing World Bioethics, Bioethics, and The Hastings Center Report. Special Collection in Medical Ethics is freely available until May 22, 2015. Read Here.
The Southern Journal of Philosophy has just published an annual Spindel Supplement on animalism and a new theory of personal identity. The problem of personal identity is one of the most bewitching puzzles in all of philosophy. Consider how much each of us changes during our lifetimes. In so many ways—biologically, psychologically, socially, physically—you are today very different from the person you were last year or twenty years ago or on the day of your birth. And yet just one person has persisted through these changes. The first facet of the problem of personal identity focuses our attention on this question: what exactly are the conditions under which beings like you and me persist through time and change?
Until quite recently, most philosophers subscribed to the answers to these questions advocated by the seventeenth-century British philosopher, John Locke. Locke held that our fundamental nature is given by our status as self-conscious, rational agents (“persons”) and that the conditions under which we persist through time and change are thus to be accounted for in terms of psychological continuity. Central to this view is a sharp distinction between the person and her animal body.
But today’s Lockeans face a powerful new challenge to the distinction underlying their core commitments. According to the view known as animalism, there is no distinction to be drawn between human persons and their animal bodies. You do not “have” a body in the sense that you are one thing and the animal located where you are is something else. Rather, on this view, human persons just are their animal bodies: the primate located where you are is you.
Though Aristotelian in spirit, animalism is a relative latecomer to the debate over personal identity, having been articulated and defended only within the past twenty-five years or so. During these first two and a half decades of work, advocates of the view sought mainly to specify and defend its central claims and to understand its relation to the Lockean opposition. While highly important work along these lines continues to be done, a second, overlapping wave of work on animalism seems now to be emerging. This new wave is beginning to broaden animalism’s import beyond metaphysics and philosophy of mind into a diverse array of fields and topics, including ethics, philosophy of language, conjoined twinning, epistemology, evolutionary theory, philosophy of religion, death, and so on.
The guiding aim of the thirty-second annual Spindel Conference on “The Lives of Human Animals” (University of Memphis, September 26–28, 2013) was to spotlight and facilitate this second wave of work by providing a forum in which metaphysicians and philosophers of mind working on animalism were brought together with philosophers who are presently engaged in pertinent debates in other areas of philosophy. The Spendel conference and supplementary issue were organized by Stephen Blatti, former SJP editor and associate professor of philosophy at the University of Memphis.
Wu’s article has just been published in the September 2014 issue of Mind & Language and is free to access until the end of the year.
According to the influential dual systems model of visual processing (Milner & Goodale 1995/2006, Goodale & Milner 2004), information present in the dorsal processing stream does not contribute to the specific contents of conscious visual experience. “Visual phenomenology,” A.D. Milner and Melvyn Goodale write, “can arise only from processing in the ventral stream, processing that we have linked with recognition and perception…. Visual-processing modules in the dorsal stream, despite the complex computations demanded by their role in the control of action, are not normally available to awareness” (Milner & Goodale 1995/2006, 202). In his article, Wayne argues that certain types of information arising in the dorsal stream, contrary to Milner and Goodale, do play a role in realizing the contents of visual experience. In particular, he argues that information carried in dorsal stream areas such as VIP and LIP support awareness of visual spatial constancy across saccadic eye-movements. Wayne also adduces evidence that dorsal stream areas play a role in conscious visual motion and depth perception.