Philosophy Archives - Page 8 of 13 - Protection of Conscience Project Library

First and second things, and the operations of conscience in science

Bruce G Charlton

Abstract
Why is modern science less efficient than it used to be, why has revolutionary science declined, and why has science become so dishonest? One plausible explanation behind these observations comes from an essay First and second things published by CS Lewis. First Things are the goals that are given priority as the primary and ultimate aim in life. Second Things are subordinate goals or aims – which are justified in terms of the extent to which they assist in pursuing First Things. The classic First Thing in human society is some kind of religious or philosophical world view. Lewis regarded it as a ‘universal law’ that the pursuit of a Second Thing as if it was a First Thing led inevitably to the loss of that Second Thing: ‘You can’t get second things by putting them first; you can get second things only by putting first things first’. I would argue that the pursuit of science as a primary value will lead to the loss of science, because science is properly a Second Thing. Because when science is conceptualized as a First Thing the bottom-line or operational definition of ‘correct behaviour’ is approval and high status within the scientific community. However, this does nothing whatsoever to prevent science drifting-away from its proper function; and once science has drifted then the prevailing peer consensus will tend to maintain this state of corruption. I am saying that science is a Second Thing, and ought to be subordinate to the First Thing of transcendental truth. Truth impinges on scientific practice in the form of individual conscience (noting that, of course, the strength and validity of conscience varies between scientists). When the senior scientists, whose role is to uphold standards, fail to posses or respond-to informed conscience, science will inevitably go rotten from the head downwards. What, then, motivates a scientist to act upon conscience? I believe it requires a fundamental conviction of the reality and importance of truth as an essential part of the basic purpose and meaning of life. Without some such bedrock moral underpinning, there is little possibility that individual scientific conscience would ever have a chance of holding-out against an insidious drift toward corruption enforced by peer consensus.

Charlton BG. First and second things, and the operations of conscience in science. Med Hypotheses. 2010 Jan;74(1):1-3.

A nursing manifesto: an emancipatory call for knowledge development, conscience, and praxis

Paula N Kagan, Marlaine C Smith, W Richard Cowling, eggy L Chinn

Abstract
The purpose of this paper is to present the theoretical and philosophical assumptions of the Nursing Manifesto, written by three activist scholars whose objective was to promote emancipatory nursing research, practice , and education within the dialogue and praxis of social justice. Inspired by discussions with a number of nurse philosophers at the 2008 Knowledge Conference in Boston, two of the original Manifesto authors and two colleagues discussed the need to explicate emancipatory knowing as it emerged from the Manifesto. Our analysis yielded an epistemological framework based on liberation principles to advance praxis in the discipline of nursing. This paper adds to what is already known on this topic, as there is not an explicit contribution to the literature of this specific Manifesto, its significance, and utility for the discipline. While each of us have written on emancipatory knowing and social justice in a variety of works, it is in this article that we identify, as a unit of knowledge production and as a direction towards praxis, a set of critical values that arose from the emancipatory conscienceness and intention seen in the framework of the Nursing Manifesto.

Kagan PN, Smith MC, Cowling WR, Chinn PL. A nursing manifesto: an emancipatory call for knowledge development, conscience, and praxis. Nurs Philos. 2010 Jan;11(1)67-84.

First and second things, and the operations of conscience in science

Bruce G. Charlton

Author Summary
Why is modern science less efficient than it used to be, why has revolutionary science declined, and why has science become so dishonest? One plausible explanation behind these observations comes from an essay First and second things published by CS Lewis. First Things are the goals that are given priority as the primary and ultimate aim in life. Second Things are subordinate goals or aims – which are justified in terms of the extent to which they assist in pursuing First Things. The classic First Thing in human society is some kind of religious or philosophical world view. Lewis regarded it as a ‘universal law’ that the pursuit of a Second Thing as if it was a First Thing led inevitably to the loss of that Second Thing: ‘You can’t get second things by putting them first; you can get second things only by putting first things first’. I would argue that the pursuit of science as a primary value will lead to the loss of science, because science is properly a Second Thing. Because when science is conceptualized as a First Thing the bottom-line or operational definition of ‘correct behaviour’ is approval and high status within the scientific community. However, this does nothing whatsoever to prevent science drifting-away from its proper function; and once science has drifted then the prevailing peer consensus will tend to maintain this state of corruption. I am saying that science is a Second Thing, and ought to be subordinate to the First Thing of transcendental truth. Truth impinges on scientific practice in the form of individual conscience (noting that, of course, the strength and validity of conscience varies between scientists). When the senior scientists, whose role is to uphold standards, fail to posses or respond-to informed conscience, science will inevitably go rotten from the head downwards. What, then, motivates a scientist to act upon conscience? I believe it requires a fundamental conviction of the reality and importance of truth as an essential part of the basic purpose and meaning of life. Without some such bedrock moral underpinning, there is little possibility that individual scientific conscience would ever have a chance of holding-out against an insidious drift toward corruption enforced by peer consensus.

Charlton BG. First and second things, and the operations of conscience in science. Med Hypotheses. 2010 Jan;74(1):1-3. Epub 2009 Sep 5.

Cooperation with Securities Fraud

Ronald J Colombo

Abstract
Although “proximity” is itself an indefinite concept, we are not without tools in deciphering it. For we have at our disposal a well-developed, longtested method of analyzing proximity with an eye toward the just imposition of culpability: moral philosophy’s “principles of cooperation.” By turning to these principles, we have at our fingertips a ready-made set of factors to consider in assessing whether one’s conduct should be deemed proximate versus remote to another’s fraud. The principles of cooperation also provide a framework around which we can organize securities fraud jurisprudence in general. For the insights gleaned from the principles regarding moral culpability in many respects parallel the conclusions reached by courts and commentators construing liability under the securities laws. Perhaps, in addition to the assistance it provides us in resolving the difficult issue of proximity, this framework could serve as a useful aid in resolving other, and future, securities fraud questions..

Colombo RJ. Cooperation with Securities Fraud. Alabama University Law Review. 2009 Dec;61(1)-66.

An ethically justified practical approach to offering, recommending, performing, and referring for induced abortion and feticide

Frank A Chervenak, Laurence B McCullough

American Journal of Obstetrics & Gynecology

Abstract
We provide comprehensive, practical guidance for physicians on when to offer, recommend, perform, and refer patients for induced abortion and feticide. We precisely define terminology and articulate an ethical framework based on respecting the autonomy of the pregnant woman, the fetus as a patient, and the individual conscience of the physician. We elucidate autonomy-based and beneficence-based obligations and distinguish professional conscience from individual conscience. The obstetrician’s role should be based primarily on professional conscience, which is shaped by autonomy-based and beneficence-based obligations of the obstetrician to the pregnant and fetal patients, with important but limited constraints originating in individual conscience.

Chervenak FA, McCullough LB. An ethically justified practical approach to offering, recommending, performing, and referring for induced abortion and feticide. Am J Obstet Gynecol. 2009 Dec;201(6):560.e1-560.e6.

Human Self-Determination, Biomedical Progress, and God

Udo Schuklenk

Extract
Why am I an atheist? Why do I think it is important to speak out against the harmful consequences of religious interpretations of the world and of our place in it? In this essay, I argue not only that we have no good reason to believe that a good, all-powerful, all-knowing God exists, but also that organizations and institutions campaigning in the name of God are frequently working toward preventing desirable societal progress in a number of crucial areas affecting our daily lives.

Schuklenk U. Human Self-Determination, Biomedical Progress, and God. In: Blackford R, Schuklenk U editors. 50 Voices of Disbelief: Why We Are Atheists. Wiley-Blackwell, 2009 Oct 19; 323-331.

What is conscience and why is respect for it so important?

Daniel P Sulmasy

Abstract
The literature on conscience in medicine has paid little attention to what is meant by the word ‘conscience.’ This article distinguishes between retrospective and prospective conscience, distinguishes synderesis from conscience, and argues against intuitionist views of conscience. Conscience is defined as having two interrelated parts: (1) a commitment to morality itself; to acting and choosing morally according to the best of one’s ability, and (2) the activity of judging that an act one has done or about which one is deliberating would violate that commitment. Tolerance is defined as mutual respect for conscience. A set of boundary conditions for justifiable respect for conscientious objection in medicine is proposed.

Sulmasy DP. What is conscience and why is respect for it so important? Theor Med Bioeth. 2008;29(3):135-149.

Religion, conscience and clinical decisions

John D Lantos, Farr A Curlin

Extract
However, as long as medicine is practiced in a pluralistic democracy where some people find moral guidance in religions and others do not, situations will arise in which two paediatricians, both acting deliberately and conscientiously, will choose different responses to a given clinical decision. The policy challenge becomes one of specifying the situations for which conscience claims ought to be tolerated. . . For situations in which disagreement is consistent with good medical practice, practitioners must be free to follow the dictates of conscience. The risks of disallowing conscientious practice to the profession are greater than that of allowing grounded and well-articulated zones of moral pluralism.

Lantos JD, Curlin FA. Religion, conscience and clinical decisions. Acta Paediatrica. 2008;97(3):265-266.

Physicians and Execution

Gregory D Curfman, Stephen Morrissey, Jeffrey M Drazen

New England Journal of Medicine, NEJM — New England Journal of Medicine

Extract
Physicians and other health care providers should not be involved in capital punishment, even in an advisory capacity. A profession dedicated to healing the sick has no place in the process of execution.

Curfman GD, Morrissey S, Drazen JM. Physicians and Execution. N Engl J Med. 2008 Jan 24;358(4):403-404.

The Proper Place of Values in the Delivery of Medicine (Conscience in Medicine)

Julian Savulescu

Extract
Physicians who fail to act in their patient’s interests breach the fundamental duty of care of a physician. It is negligent to deny a person who would benefit a blood transfusion, a vaccination, an abortion, intensive care or sedation at the end of their life. Physicians should not play God. If they morally disagree with some medical treatment, they can give their reasons to their patients and they can take that debate to the level of law and professional bodies. But in a liberal society they should not inflict their judgments on their patients. Physicians can disagree, but they should not dictate.

Savulescu J. The Proper Place of Values in the Delivery of Medicine (Conscience in Medicine). Am J Bioeth. 2007 Dec 19;21-22.