Moral responsibility and mental illness : a case study

Various authors have argued that progress in the neurocognitive and neuropsychiatric sciences might threaten the commonsense understanding of how the mind generates behavior, and, as a consequence, it might also threaten the commonsense ways of attributing moral responsibility, if not the very notion of moral responsibility. In the case of actions that result in undesirable outcomes (e.g., someone being harmed), the commonsense conception—which is reflected in sophisticated ways in the legal conception—tells us that there are circumstances in which the agent is entirely and fully responsible for the bad outcome (and deserves to be punished accordingly) and circumstances in which the agent is not at all responsible for the bad outcome (and thereby the agent does not deserve to be punished)

Peer - Mediated Distributed Knowledge Management

Distributed Knowledge Management is an approach to knowledge management based on the principle that the multiplicity (and heterogeneity) of perspectives within complex organizations is not be viewed as an obstacle to knowledge exploitation, but rather as an opportunity that can foster innovation and creativity. Despite a wide agreement on this principle, most current KM systems are based on the idea that all perspectival aspects of knowledge should be eliminated in favor of an objective and general representation of knowledge. In this paper we propose a peer-to-peer architecture (called KEx), which embodies the principle above in a quite straightforward way: (i) each peer (called a K-peer) provides all the services needed to create and organize "local" knowledge from an individual's or a group's perspective, and (ii) social structures and protocols of meaning negotiation are introduced to achieve semantic coordination among autonomous peers (e.g., when searching documents from other K-peers). A first version of the system, called KEx, is imple-mented as a knowledge exchange level on top of JXTA

A Peer-to-Peer Architecture for Distributed Knowledge Management.

Most of the knowledge management systems of complex organizations are based on technological architectures that are in contradiction with the social processes of knowledge creation. In particular, centralized architectures are adopted to manage a process that is intrinsically distributed. In this paper, assuming a Distributed approach to Knowledge Management (DKM), is proposed that technological and social architectures must be reciprocally consistent. Moreover, in the domain of Knowledge Management, technological architectures should be designed in order to support the interplay between two qualitatively different processes: the autonomous management of knowledge of individuals and groups - here called Knowledge Nodes (KNs) -, and the coordination required in order to exchange knowledge among them. Finally a peer to peer architecture to support knowledge exchange across distributed and autonomous KNs is presented

Epistocracy for Online Deliberative Bioethics

The suggestion that deliberative democratic approaches would suit the management of bioethical policymaking in democratic pluralistic societies has triggered what has been called the deliberative turn in health policy and bioethics. Most of the empirical work in this area has focused on the allocation of healthcare resources and priority setting at the local or national level. The variety of the more or less articulated theoretical efforts behind such initiatives is remarkable and has been accompanied, to date, by an overall lack of method specificity. We propose a set of methodological requirements for online deliberative procedures for bioethics. We provide a theoretical motivation for these requirements. In particular, we discuss and adapt an epistocratic proposal and argue that, regardless of its merits as a general political theory, a more refined version of its normative claims can generate a useful framework for the design of bioethical forums that combine maximal inclusiveness with informed and reasonable deliberation

Cystic fibrosis carrier screening in Veneto (Italy): an ethical analysis

A recent study by Castellani et al. (JAMA 302(23):2573–2579, 2009) describes the population-level effects of the choices of individuals who underwent molecular carrier screening for cystic fibrosis (CF) in Veneto, in the northeastern part of Italy, between 1993 and 2007. We discuss some of the ethical issues raised by the policies and individual choices that are the subject of this study. In particular, (1) we discuss the ethical issues raised by the acquisition of genetic information through antenatal carrier testing; (2) we consider whether by choosing to procreate naturally these couples can harm the resulting child and/or other members of society, and what the moral implications of such harm would be; (3) we consider whether by choosing to avoid natural procreation carrier couples can harm current or future individuals affected by cystic fibrosis; (4) we discuss whether programs that make carrier testing available can be considered eugenic program

Libertarian Paternalism and Health Care Policy: A Deliberative Proposal

Cass Sunstein and Richard Thaler have been arguing for what they named libertarian paternalism (henceforth LP). Their proposal generated extensive debate as to how and whether LP might lead down a full-blown paternalistic slippery slope. LP has the indubitable merit of having connected the best of the empirical psychological and sociological evidence to public and private policy making. It is unclear, though, to what extent the implementation of policies so constructed could enhance the capability for the exercise of an autonomous citizenship. Sunstein and Thaler submit it that in most of the cases in which one is confronted with a set of choices, some default option must be picked out. In those cases whoever devises the features of the set of options ought to rank them according to the moral principle of non-maleficence and possibly to that of beneficence. In this paper we argue that LP can be better implemented if there is a preliminary deliberative debate among the stakeholders that elicits their preferences, and makes it possible to rationally defend them

Genetic Determinism and the Innate-Acquired Distinction in Medicine

This article illustrates in which sense genetic determinism is still part of the contemporary interactionist consensus in medicine. Three dimensions of this consensus are discussed: kinds of causes, a continuum of traits ranging from monogenetic diseases to car accidents, and different kinds of determination due to different norms of reaction. On this basis, this article explicates in which sense the interactionist consensus presupposes the innate–acquired distinction. After a descriptive Part 1, Part 2 reviews why the innate–acquired distinction is under attack in contemporary philosophy of biology. Three arguments are then presented to provide a limited and pragmatic defense of the distinction: an epistemic, a conceptual, and a historical argument. If interpreted in a certain manner, and if the pragmatic goals of prevention and treatment (ideally specifying what medicine and health care is all about) are taken into account, then the innate–acquired distinction can be a useful epistemic tool. It can help, first, to understand that genetic determination does not mean fatalism, and, second, to maintain a system of checks and balances in the continuing nature–nurture debates