生前预嘱制度的伦理困境与化解路径

随着医疗技术在医疗领域的迅速发展,个人对医疗措施具备了更宽泛的选择权。然而,我国对生前预嘱制度的引入存在较大的伦理争议,主要表现为基于目标冲突、责任冲突和角色冲突导致的伦理困境。通过解析救死扶伤的时代理解、父权主义的时代抛弃、自然死亡的时代定位与生前预嘱的时代需求,提出我国应对救死扶伤进行重新定义、确立个人中心主义、正确对待自然死亡、推进生前预嘱制度入法的应对策略,以从根本上破解生前预嘱制度的伦理困境,促进生前预嘱制度在我国的落地实施。

     

Readiness potentials driven by non-motoric processes

An increase in brain activity known as the “readiness potential” (RP) can be seen over central scalp locations in the seconds leading up to a volitionally timed movement. This activity precedes awareness of the ensuing movement by as much as two seconds and has been hypothesized to reflect preconscious planning and/or preparation of the movement. Using a novel experimental design, we teased apart the relative contribution of motor-related and non-motor-related processes to the RP. The results of our experiment reveal that robust RPs occured in the absence of movement and that motor-related processes did not significantly modulate the RP. This suggests that the RP measured here is unlikely to reflect preconscious motor planning or preparation of an ensuing movement, and instead may reflect decision-related or anticipatory processes that are non-motoric in nature.     

Schopenhauer on the aimlessness of the will

Schopenhauer asserts that ‘the will, which is objectified in human life as it is in every appearance, is a striving without aim and without end’. The article rejects some recent readings of this claim, and offers the following positive interpretation: however many specific aims of my specific desires I manage to attain, none is a final aim, in the sense that none terminates my ‘willing as a whole’, none turns me into a non-willing being. To understand Schopenhauer’s claim we must recognize his central contrast between happiness and will-lessness. Happiness is the satisfaction of individual desire, but no act of will that succeeds in satisfying individual desire is the attainment of a final aim, in that none brings about a conscious state in which the subject experiences no more unfulfilled desires. Such a state is the ultimate goal of existence, in Schopenhauer’s view, but happiness does not provide a route along which it can be attained.     

Incompatibilism proved

The consequence argument attempts to show that incompatibilism is true by showing that if there is determinism, then we never had, have or will have any choice about anything. Much of the debate on the consequence argument has focused on the “beta” transfer principle, and its improvements. We shall show that on an appropriate definition of “never have had, have or will have any choice”, a version of the beta principle is a theorem given one plausible axiom for counterfactuals (weakening). Instead of being about transfer principles, the debate should be over whether the distant past and laws are up to us.     

Objections and replies within the fifth meditation

Malebranche held that God acts only by general volitions and so is not constantly interfering in the world. The content of God's volitions appears to include the general laws of nature and the particular initial configuration of the created world, so that occasional or natural causes have an important explanatory role. It is clear that at the least Malebranche meant by a ‘general volition’ the willing of events which followed general laws. Steven Nadler argued that this is all we should understand by a ‘general volition’, and so we should think that general volitions are simply particular volitions which follow a general law.

I argue that this view is not the correct interpretation of Malebranche's general volitions, for it does not do justice to the theological doctrine of the Treatise, masks the genuine difference between Arnauld and Malebranche, and conflicts with what Malebranche says about practical volitions. I then argue that despite Malebranche's view of general volitions, there is still an important difference between his view and Leibniz's.     

Nietzsche on the health of the soul

Abstract

Health (particularly of the soul [Seele]) is a central concept in Nietzsche’s work. Yet in the most philosophically sophisticated secondary literature on Nietzsche, there has been fairly little sustained treatment of just what Nietzschean health consists in. In this paper, I aim to provide an account of some of the central marks of this health: resilience, discipline, vitality, a certain positive condition of the will to power, a certain tendency toward integration, and so on. This exposition and discussion will be the main task of the paper. Then in the concluding section of the paper, I consider a line taken in some related secondary literature, which would suggest that health might ultimately be understood in formal or dynamic terms, relating to one’s will to power and/or the unity of one’s drives. I will present the beginnings of an argument against such an account of health. In focusing on the formal and dynamic side exclusively, it cannot get the full story. In particular, it seems to me to miss the substantive dimension that is essential if we are to understand health properly. As I shall suggest, the core concept of Nietzschean health is not fully explicable except by reference to normative terms.     

PASTORAL COUNSEL FOR THE ANXIOUS NATURALIST: DANIEL DENNETT'S FREEDOM EVOLVES

Abstract: Daniel Dennett's Freedom Evolves is a rhetorically powerful but philosophically unconvincing attempt to show that a deterministic and ontologically reductionist, but epistemologically pluralist, outlook may peacefully coexist with a robust acceptance of human freedom and moral responsibility. The key to understanding the harmony rests in recognizing that freedom is not a metaphysical or physical condition but is instead a product of deeply embedded social practices. I argue that Dennett's project rests on an unargued and implausible deflationary stance toward basic metaphysics.     

COMPATIBILISM EVOLVES?: ON SOME VARIETIES OF DENNETT WORTH WANTING

Abstract: I examine the extent to which Dennett's account in Freedom Evolves might be construed as revisionist about free will or should instead be understood as a more traditional kind of compatibilism. I also consider Dennett's views about philosophical work on free agency and its relationship to scientific inquiry, and I argue that extant philosophical work is more relevant to scientific inquiry than Dennett's remarks may suggest.     

从肾功能衰竭的治疗革新审视医学科技的内在张力

肾功能衰竭的治疗方法作为人类战胜疾病的一种工具,随着人类对疾病本质认识的不断深化而随之不断更新。每一种治疗手段都有其特定的时空性,在治疗肾功能衰竭过程中,医务工作者应当在尊重患者意愿的基础上,优化组合治疗方法以期发挥最佳的治疗效果。     

The Free will Revolution (Continued)

I seek to reply to the thoughtful and penetrating comments by William Rowe, Alfred Mele, Carl Ginet, and Ishtiyaque Haji. In the process, I hope that my overall approach to free will and moral responsibility is thrown into clearer relief. I make some suggestions as to future directions of research in these areas. I thank Michael McKenna for his thoughtful comments, his generous introduction, and all his hard work in putting this together. Also, I wish to thank J. Angelo Corlett for his very pleasantly surprising decision to do this volume, and for his outstanding work in editing this wonderful journal from its inception.