Ethics,Brain Injuries,and Sports: Prohibition,Reform, and Prudence

Abstract

In this paper, we explore the issue of the elimination of sports, or elements of sports, that present a high risk of brain injury. In particular, we critically examine two elements of Angelo Corlett’s and Pam Sailors’ arguments for the prohibition of football and Nicholas Dixon’s claim for the reformation of boxing to eliminate blows to the head based on (a) the empirical assumption of an essential or causal connection between brain injuries incurred in football and the development of a degenerative brain disease known as chronic traumatic encephalopathy (CTE); and (b) John Stuart Mill’s rejection of consensual domination (ie voluntary enslavement). We present four arguments to contest the validity of Corlett, Dixon’s and Sailor’s positions. Specifically, we argue that (i) certain autonomy-based arguments undermine paternalist arguments for reform; (ii) the nature of the goods people pursue in their lives might justify their foregoing (degrees of) future autonomy; (iii) Mill’s argument against consensual domination draws on ambiguous and arbitrary distinctions; (iv) the lack of consensus and empirical evidence regarding CTE arising from brain injuries in sport underdetermines calls for reform. We conclude that these proposals for reforming or eliminating sports with high risks of brain injuries are not well founded.     

On the psycho-social conditions of psychotherapy in post-Soviet Georgia

The article describes the social, economic and political conditions that influence the practice of psychotherapy in post-Soviet Georgia. The author looks at the specific Soviet and post-Soviet mentalities and defines certain characteristics of these mentalities, the master-slave relationship between the people and the State, the materialistic world view, the nostalgia for the past and idealization of Soviet times, the identity crisis produced by the socio-economic traumas. The paper then provides clinical illustrations of these phenomena and shows how they can interfere with the process of psychotherapy.     

Genetic Ignorance and Reasonable Paternalism

The question concerning an individual's rightto remain in ignorance regarding her owngenetic makeup is central to debates aboutgenetic information. Whatever is decided onthis matter has a weighty bearing on all of therelated third-party issues, such as whetherfamily members or employers should be toldabout an individual's genetic makeup. Thosearguing that no right to genetic ignoranceexists tend to argue from a viewpoint I havecalled in this paper reasonablepaternalism. It is an appealing position whichrests on widely shared intuitions on reasonablechoices, but which, in the end, smugglespaternalism back to medical practice.     

Do We Need Toleration as a Moral Virtue?

In this essay, I reconstruct tolerance as a moral virtue, by critically analysing its definition, circumstances, justification and limits. I argues that, despite its paradoxical appearance, tolerance qualifies as a virtue, by means of a restriction of its proper object to differences that are chosen. Since this excludes the most important and divisive differences of contemporary pluralism from the scope of the virtue of tolerance, the moral model of toleration cannot constitute the micro-foundation of the corresponding political practice. However, if the political ideal of toleration must be founded on independent political reasons of justice, the moral model can bridge the gap between private morality and public reason, providing citizens with moral motives to supplement the political obligation to neutrality. This revised version was published online in August 2006 with corrections to the Cover Date.     

Technological paternalism: On how medicine has reformed ethics and how technology can refine moral theory

The objective of this article is to investigate ethical aspects of technology through the moral term “paternalism”. The field of investigation is medicine. The reason for this is twofold. Firstly, “paternalism” has gained moral relevance through modern medicine, where physicians have been accused of behaving paternalistic and threatening patients’ autonomy. Secondly, medicine is a brilliant area to scrutinise the evaluative aspects of technology. It is argued that paternalism is a morally relevant term for the ethics of technology, but that its traditional conception is not adequate to address the challenges of modern technology. A modification towards a “technological paternalism” is necessary. That is, “technological paternalism” is a fruitful term in the ethics of technology. Moreover, it is suited to point out the deficiencies of the traditional concept of paternalism and to reform and vitalise the conception of paternalism in ethics in order to handle the challenges of technology.     

Ethical Criteria for Health-Promoting Nudges: A Case-by-Case Analysis

Health-promoting nudges have been put into practice by different agents, in different contexts and with different aims. This article formulates a set of criteria that enables a thorough ethical evaluation of such nudges. As such, it bridges the gap between the abstract, theoretical debates among academics and the actual behavioral interventions being implemented in practice. The criteria are derived from arguments against nudges, which allegedly disrespect nudgees, as these would impose values on nudgees and/or violate their rationality and autonomy. Instead of interpreting these objections as knock-down arguments, I take them as expressing legitimate worries that can often be addressed. I analyze six prototypical nudge cases, such as Google’s rearrangement of fridges and the use of defaults in organ donation registration. I show how the ethical criteria listed are satisfied by most—but not all—nudges in most—but not all—circumstances.     

Ethically Problematic Value Change as an Outcome of Psychotherapeutic Interventions

Values nonpaternalism—the ethical imperative to avoid imposing values onto clients—is implicit in most widely used ethical frameworks employed by psychotherapists. Although changes in client values may represent desired psychotherapeutic outcomes, some such changes may be ethically problematic. Interventions are characterized by values paternalism when they are intended to promote client welfare but are accompanied by impositions against client values. Providers and consumers of psychotherapy may routinely lack awareness of this consideration. Psychotherapists may have a duty to be informed about ethically problematic value change accompanying psychotherapy and to inform clients about this phenomenon.     

Chimpanzees help others with what they want; children help them with what they need

Humans, including young children, are strongly motivated to help others, even paying a cost to do so. Humans’ nearest primate relatives, great apes, are likewise motivated to help others, raising the question of whether the motivations of humans and apes are the same. Here we compared the underlying motivation to help in human children and chimpanzees. Both species understood the situation and helped a conspecific in a straightforward situation. However, when helpers knew that what the other was requesting would not actually help her, only children gave her what she needed instead of giving her what she requested. These results suggest that both chimpanzees and human children help others but the underlying motivation for why they help differs. In comparison to chimpanzees, young children help in a paternalistic manner. The evolutionary hypothesis is that uniquely human socio‐ecologies based on interdependent cooperation gave rise to uniquely human prosocial motivations to help others paternalistically.     

临床麻醉中知情同意的思考

临床麻醉工作中,尊重患者自主权是知情同意的基础,知情同意反映了患者自主权与医学干涉主义之间的相互妥协。在信任基础上的知情同意,是患者自主权的最佳体现,也是对医学干涉主义的尊重,从而为患者的利益提供服务。