Neil Manson

Informed consent is a central topic in contemporary biomedical ethics. Yet attempts to set defensible and feasible standards for consenting have led to persistent difficulties. In Rethinking Informed Consent in Bioethics Neil Manson and Onora O'Neill set debates about informed consent in medicine and research in a fresh light. They show why informed consent cannot be fully specific or fully explicit, and why more specific consent is not always ethically better. They argue that consent needs distinctive communicative transactions, by which other obligations, prohibitions, and rights can be waived or set aside in controlled and specific ways. Their book offers a coherent, wide-ranging and practical account of the role of consent in biomedicine which will be valuable to readers working in a range of areas in bioethics, medicine and law.

Is genetic information of special ethical significance? Does it require special regulation? There is considerable contemporary debate about this question (the genetic exceptionalism debate). Genetic information is an ambiguous term and, as an aid to avoiding conflation in the genetic exceptionalism debate, a detailed account is given of just how and why genetic information is ambiguous. Whilst ambiguity is a ubiquitous problem of communication, it is suggested that genetic information is ambiguous in a particular way, one that gives rise to the problem of significance creep (i.e., where claims about the significance of certain kinds of genetic information in one context influence our thinking about the significance of other kinds of genetic information in other contexts). A contextual and contrastive methodology is proposed: evaluating the significance of genetic information requires us to be sensitive to the polysemy of genetic information across contexts and then examine the contrast in significance (if any) of genetic, as opposed to nongenetic, information within contexts. This, in turn, suggests that a proper solution to the regulatory question requires us to pay more attention to how and why information, and its acquisition, possession and use, come to be of ethical significance

How do reason explanations explain? One view is that they require the deployment of a tacit psychological theory; another is that even if no tacit theory is involved, we must still conceive of reasons as mental states. By focusing on the subjective nature of agency, and by casting explanations as responses to 'why' questions that assuage agents' puzzlement, reason explanations can be profitably understood as part of our traffic in first-order content amongst perspectival subjects. An outline is offered of such an account of reason explanation, one that fully acknowledges the distinctive first-order first-person normative perspective of agency.

The fact that we can engage in first-person discourse about our own mental states seems, intuitively, to be bound up with consciousness. David Rosenthal draws upon this intuition in arguing for his higher-order thought theory of consciousness. Rosenthal's argument relies upon the assumption that the truth-conditions for "p" and "I think that p" differ. It is argued here that the truth-conditional schema debars "I think" from playing one of its roles and thus is not a good test for what is asserted when "I think" is employed in making an assertoric utterance. The critique of Rosenthal's argument allows us to make explicit the intuitions which shape higher-order representation theories of consciousness in general. Consciousness and first-person mental discourse seem to be connected primarily because consciousness is an epistemic term, used to denote first-person knowledge of minds. Higher-order thought theories of consciousness draw upon this epistemic notion of consciousness, and because self-knowledge seems to involve higher-order representation, the higher-order theorist can deploy what is in effect an "error theory" about conscious experience disguised as a kind of conceptual analysis of our ordinary concept of a conscious mental state. The conclusion reached is that there is unlikely to be a simple or direct path from considerations about mental discourse to conclusions about the nature of consciousness.

Some self-ascriptions of belief, desire and other attitudes exhibit first-person authority. The aim here is to offer a novel account of this kind of first-person authority. The account is a development of Robert Gordon's ascent routine theory but is framed in terms of our ability to bring it about that others know of our attitudes via speech acts which do not deploy attitudinal vocabulary but which nonetheless ‘show’ our attitudes to others. Unlike Gordon's ascent routine theory, the theory readily applies to attitudes other than belief, avoids a need to appeal to processes of making up one's mind, and does not rest upon a distinction between ‘outward looking’ and ‘inward looking’ processes

Informed consent is a central concept of contemporary medical ethics. Clinicians and medical researchers are under an obligation to inform patients and research subjects about the nature, purposes, risks, and side effects of proposed courses of action. A vast body of literature has been produced, over the past 30 years or so, about the nature, justification, scope, and limits of informed consent. Here we will focus on what informed consent is, how it came to have a central place in medical ethics, and then briefly introduce some of the main problems and issues with informed consent.

In recent years there has been wide-ranging discussion of epistemic virtues. Given the value and importance of acquiring knowledge this discussion has tended to focus upon those traits that are relevant to the acquisition of knowledge. This acquisitionist focus ignores or downplays the importance of epistemic restraint: refraining from seeking knowledge. In contrast, in many periods of history, curiosity was viewed as a vice. By drawing upon critiques of curiositas in Middle Platonism and Early Christian philosophy, we gain useful insights into the value and importance of epistemic restraint. The historical discussion paves the way for a clarification of epistemic restraint, one that distinguishes the morally relevant features of epistemic process, content, purpose, and context. Epistemic restraint is identified as an important virtue where our epistemic pursuits pose risks and burdens, where such pursuits have opportunity costs, where they are pursued for vicious purposes. But it is in the social realm where epistemic restraint has most purchase, epistemic restraint is important both because privacy is important and because being trusted are important. Finally, some suggestions are offered as to why epistemic restraint has not received the contemporary attention that it deserves

There is empirical evidence that many patients want information about treatment options even though they do not want to take a full part in decision-making about treatment. Such evidence may have considerable ethical implications but is methodologically problematic. It is argued here that, in fact, it is not at all surprising that patients' informational interests should be separable from their interests in decision-making. A number of different reasons for wanting information are offered, some to do with the content of information; some with the process, others with the fact or occasion of informing. This philosophical clarification leads to some suggestions for further empirical study.

The idea of individual responsibility for action is central to our conception of what it is to be a person. Behavioural genetic research may seem to call into question the idea of individual responsibility with possible implications for the criminal justice system. These implications will depend on the understandings of the various agencies and professional groups involved in responding to violent and anti-social behaviour, and, the result of negotiations between them over resulting practice. The paper considers two kinds of approaches to the question of responsibility and ‘criminal genes’ arising from a sociological and philosophical perspective respectively. One is to consider the social context and possible practical implications of research into ‘criminal genes’ which will later be examined through interviews and discussions with a range of experts including lawyers and social workers. A second and different kind of approach is to ask whether the findings of behavioural genetics ought to have implications for attributions of responsibility. Issues of genetic influence are central to both approaches