Effective Altruism is a popular social movement that encourages individuals to donate to organizations that effectively address humanity’s most severe poverty. However, because Effective Altruists are committed to doing the most good in the most effective ways, they often argue that it is wrong to help those nearest to you. In this paper, I target a major subset of Effective Altruists who consider it a moral obligation to do the most good possible. Call these Obligation-Oriented Effective Altruists (OOEAs), and their (...) movement Obligation-Oriented Effective Altruism (OOEA). I argue that insofar as this variety of OOEA seems to commit us to refrain from helping the people right in front of us, there is something intuitively wrong about it. In response, I introduce an alternative model that embraces partiality: Mutual Aid. Mutual Aid is a network of community members, usually from the same geographical region, who share a commitment to offer, receive, and exchange material goods, wealth, and social support. I recommend Mutual Aid as a liberatory model, which—through empathy, solidarity, and care—mobilizes community building and provides a catalyst for community advocacy. As such, we should resist the claims of OOEAs that partially distributing our funds to people or causes we care about is morally wrong or even less than ideal. We do not have a moral obligation to use our funds “effectively;” rather, we have a broader obligation to address human suffering, and Mutual Aid is one moral alternative for discharging this duty. (shrink)

In this paper we argue that moral deference is prima facie obligatory in cases in which the testifier is a member of a marginalized social group that the receiver is not and testifies about their marginalized experience. We distinguish between two types of deference: epistemic deference, which refers to believing p in virtue of trusting the testifier, and actional deference, which involves acting appropriately in response to the testimony given. The prima facie duty we propose applies to both epistemic and (...) actional deference, though defeaters may quash either or both obligations. Even if one fails to epistemically defer to the marginalized testifier, we argue that they may still be ethically obligated to act in accordance with their testimony. (shrink)

Despite increasing evidence that the traditional lecture is inefficient for student learning, such methods remain the central paradigm for teaching logic. In this paper, I identify the deficits of the lecture model and outline the many benefits of flipping the logic classroom—namely that students can absorb information at their own pace, freeing classroom time for active learn- ing activities, and allowing the students to come prepared to actively engage in deeper levels of learning. I provide advice for curricular change from (...) the traditional model, and guidance for flipped classroom implementation. I also offer suggestions for the best use of newly available class time, and advice for keeping students accountable for learning the information prior to class. Last, I consider common challenges with the flipped classroom model. I acknowledge possible obstacles to flipping the undergraduate logic course and address these challenges with potential solutions. (shrink)

While it is largely agreed upon that solidarity is a kind of unity among persons, this agreement is short-lived – for if solidarity involves unity, what kind of unity is this? That is, does solidarity coalesce around shared identity or simply fellow-feeling? Shared action or fate? Or is solidarity merely a matter of commitment to a particular cause to achieve certain ends? Below, I look to examples of Mutual Aid to reject a piece-meal model of solidarity (where solidarity is this (...) but not that) in favor of a more pluralistic account. The notion of solidarity need not be constrained, all or nothing, by a specific strain of interpretation. Instead, we should recognize that solidarity is a matter of variety and degree. (shrink)

J.L. Austin argues that ordinary language should be used to identify when it is appropriate or inappropriate to make, accept, or reject knowledge claims. I criticize Austin’s account: In our ordinary life, we often accept justifications rooted in racism, sexism, ableism, and classism as reasons to dismiss knowledge claims or challenges, despite the fact such reasons are not good reasons. Austin’s Ordinary Language Epistemology (OLE) classifies the discounting of knowledge claims in classic cases of epistemic injustice as legitimate ordinary maneuvers. (...) I provide recommendations for revision of OLE and offer a means of distinguishing between dismissals in cases of epistemic injustice and their legitimate counterparts. (shrink)

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool. ECQAT enables raters to assess the (...) quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation, established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT,.. (shrink)

Marie was 15 when her abdominal pain began. After two years of negative work-ups, countless visits to gastroenterologists, and over 70 days of high school missed, she found herself readmitted to the hospital. “Refractory abdominal pain” was her ostensible diagnosis; “troubled teen” who was “going to be difficult” was embedded in the emergency department’s sign-out. When the medical team arrived to meet Marie, she was huddled in the corner of her hospital bed, silent and withdrawn. Her intern noted the numerous (...) scars cutting across her forearms as she felt for her radial pulses. Marie squirmed in pain when the intern palpated her abdomen.The ED’s work-up had been negative for abdominal pathology. When the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Figures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism ed. by Christopher N. Gamble and Joshua S. HananSavannah Greer DowningFigures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism. Edited by Christopher N. Gamble and Joshua S. Hanan. Routledge, 2021. xvi + 122 pp. $168 (hardcover), $47.16 (electronic book). ISBN: 9780367903794.Rhetorical scholars have turned to various new materialist frameworks (...) to shift the discipline's historically anthropocentric focus and fully engage matter's rhetoricity. While all such frameworks attempt to challenge "the anthropocentric assumption that nonhuman matter is intrinsically passive or non-agential and thus external to or separable from (human) meaning," Figures of Entanglement enters this burgeoning conversation by centering the unique contributions of Karen Barad (xi, x). Readers may recognize this collection from a 2016 special issue of Review of Communication. Yet, with a new foreword by editors Christopher N. Gamble and Joshua S. Hanan and an afterword by Laurie Gries, this collection makes Barad's distinct approach to matter's rhetoricity even more apparent, underscoring its fruitful potential for new materialist rhetorics invested in ethical, political transformation.In the book's foreword Gamble and Hanan differentiate Barad's per-formative new materialism from "vital" as well as what they refer to as "negative" new materialisms to show the generative potential of Barad's framework and the notion of entanglement (x). Other new materialisms tend to be "inclusionary"—add matter and stir—and fail to complicate "the human" itself and its differences (xiv, xi). First, vital and negative new materialisms maintain a distinction between being and knowing, allowing humans to emerge with a unique capacity to "objectively observe and know the existence of something essential, determinate, and unchanging about [End Page 395] reality that precedes and remains unaffected by both its own activities and our observations of it" (xi). On the contrary, Barad's performative approach suggests that "no aspect of reality—including human thought, meaning, and observation—is in any sense external to matter or ever remains entirely unchanged by matter's ongoing performances" (x). Here, humans are not "outside" of observation, but all observation "human or otherwise" co-constitutes what is observed (xi). Second, failing to interrogate "the human" in an attempt to observe matter's vitality is an ethical flaw that makes other approaches less capable of grappling with difference: they have been charged with "erasing associations between race, gender, and matter" and (re)producing a homogenizing, "Western-colonialist notion of humanness" (xiv). In contrast, Barad's is a "thoroughly relational," performative new materialism (1).Barad's concept of "entanglement" draws attention to the indeterminacy of matter and meaning, but it is accompanied by an ethical imperative to examine how difference, human or otherwise, is produced and the implications of power imbalances that arise through these enactments. For Barad, the notion of entanglement does not dissolve difference; difference is what matters. Indeed, they give us a way of thinking about how performative intra-actions produce difference through material-discursive practices, or apparatuses—differences that may be expected but are not inevitable. Rhetorical scholars are therefore invited to interrogate the production of boundaries that cause harm and reconfigure them, rather than assume the discreteness of boundaries from the start. Gamble and Hanan thus make a convincing case for how Barad's work may contribute to important scholarship in decolonial and critical rhetorics for which vital and negative new materialisms are less equipped.Gamble and Hanan utilize the introduction to show how Barad's per-formative new materialism both "supports and affirms" rhetorical materialism, or rhetoric's materiality, and enriches it (5). Ushered in by Michael Calvin McGee, "standard" rhetorical materialism worked to challenge the centuries-old debate about rhetoric's secondary, supplementary status vis-à-vis philosophy by recognizing rhetoric as part of a "shifting and dynamic material history" (6). Building upon this view, Ronald Walter Greene utilizes Foucault's notion of the apparatus to demonstrate how even the "material history" McGee called our attention to is itself "produced by apparatuses"—history is not "outside" of meaning (6). Instead, rhetoric's materiality is a "publicity effect" produced through technologies of rhetoric and intersecting power... (shrink)

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...) in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

Decreasing unintended teenage pregnancy, especially repeat teenage pregnancy, is an important public health goal. Unfortunately, legal barriers in the USA impede this goal as all minors are unable to consent for birth control in 24 states, and only 10 of those states allow consent after the minor has given birth according to state statutory law. Placement of long-acting reversible contraception is one of the most effective methods of preventing rapid repeat pregnancies. However, restrictions are placed on adolescents who may not (...) have the option of parental consent if the parents are unwilling, or not present, to give consent. A predicament arises when healthcare professionals are willing to place the contraceptive for the patient, but cannot due to the restrictions and guidelines outlined by each state. Even though these adolescents are legally viewed as minors, adolescent mothers should be able to consent to the placement of LARC. Notably, adolescents have the legal ability to give consent for the healthcare of their child starting in the prenatal period. I argue that this ability should be extended to include adolescent consent for their own healthcare. Additionally, the procedure to place LARC is relatively low risk and highly effective, which is an opportune situation to allow minors to consent. Allowing adolescents to consent to LARC after delivery is a simple and effective way to decrease rapid repeat pregnancy rates in the USA. All data relevant to the study are included in the article. (shrink)

Much ink has been spilled on the pros and cons of U.S. president Barack Obama's decision not to strike the regime of Syrian president Bashar al-Assad after that regime launched a deadly chemical weapons attack in 2013. Often missing from those debates, however, are the perspectives of Syrians themselves. While not all Syrians oppose Assad, and not all opponents endorsed intervention, many Syrian oppositionists resolutely called for Obama to uphold his “red line” militarily. As part of the roundtable “The Ethics (...) of Limited Strikes,” this essay analyzes diverse expressions of such opinion and finds that they highlight three dimensions of the ethical case for limited strikes against Assad. First, they remind us that the ethical context of the red line question was many Syrians’ sense of abandonment by the international community. Second, they emphasize the ethical stakes of the limited strikes; namely an opportunity to hold the Syrian regime accountable, weaken it from within, and thus change the equation of the war. Third, they make sense of the ethical consequences of the nonintervention outcome, and especially its effect in deepening civilians’ despair, accelerating extremism, and convincing Assad and his allies that they could kill with impunity. These views controvert both legalistic arguments precluding military intervention and assumptions that U.S. intervention is always imperialist and warmongering. In this case, consideration of the case for military intervention from the viewpoint of those on whose behalf the intervention would have taken place challenges us to think deeply about circumstances in which limited strikes might be not only ethically justified but also imperative. (shrink)

Empirical research pertaining to cardiopulmonary resuscitation (CPR), clinician behaviors related to do-not-resuscitate (DNR) orders and substituted judgment suggests potential contributions to medical ethics. Research quantifying the likelihood of surviving CPR points to the need for further philosophical analysis of the limitations of the patient autonomy in decision making, the nature and definition of medical futility, and the relationship between futility and professional standards. Research on DNR orders has identified barriers to the goal of patient involvement in these life and death (...) discussions. The initial data on surrogate decision making also points to the need for a reexamination of the moral basis for substituted judgment, the moral authority of proxy decision making and the second-order status of the best interests standard. These examples of empirical research suggest that an interplay between empirical research, ethical analysis and policy development may represent a new form of interdisciplinary scholarship to improve clinical medicine. (shrink)

Filmmaking is one of the most complexly layered forms of artistic production. It is a deeply interactive process, socially, culturally, and technologically. Yet the bulk of popular and academic discussion of filmmaking continues to attribute creative authorship of films to directors. Texts refer to “a Scorsese film,” not a film by “Scorsese et al.” We argue that this kind of attribution of sole creative responsibility to film directors is a misapprehension of filmmaking processes, based in part on dubious individualist assumptions (...) about creative minds. Such a misapprehension is effacing the public value that a more inclusive and accurate understanding of filmmaking offers. By “public value” we mean the potential to enhance social and cultural well-being, particularly in working lives and collaborative undertakings in the screen industries. Better understanding of the systemic and social nature of creativity in filmmaking can potentially help in democratising aesthetics, which we consider a clear public good. (shrink)

From 1956, when the complex ultrastructure of meiotic chromosomes was discovered, 1 until 1985, when the isolation of meiotic chromosome cores was reported, knowledge of the molecular structure of the meiotic chromosome was at best a dream. The dissection of meiotic chromosome structures has become a realistic challenge through the arrival of isolated symptonemal complexes (SCs), monoclonal and polyclonal antibodies against SCs, the possibility for screening expression libraries for genes that encode SC proteins, the isolation of SC‐associated DNA, and the (...) development of techniques for the in situ recognition of DNA sequences in the context of the meiotic chromosome structure. (shrink)

Context: Although ethics consultation is commonplace in United States hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the “best informant” within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services were found in 81% of all general hospitals in the U.S., and in 100% (...) of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians, nurses, social workers, or chaplains. Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

How does emigration affect access to and struggles for power in sending states? For competing groups in the homeland, emigration presents a contradiction: demographic losses but possible economic gains. Wins and losses from this trade-off evolve with shifts in who migrates, to where, and when. I illustrate these relationships in the case of Lebanon since 1860, focusing on the balance of power among sectarian communities. The country’s first migratory wave concentrated material benefits and population deficits in the Christian community. It (...) also encouraged subsequent emigration that, over time, involved more Muslim Lebanese, as well. Such broadening diffused the profits of labor abroad. Due to changes in destinations and historical circumstances, however, many of these migrants remained more connected to their homeland. This aided social mobility for their communities without sapping resident strength. Outmigration thereby helped redistribute human and material resources among sects, and hence created the demographic and material foundations of the competition for power. (shrink)

Philosophical discussions of film are divided in their treatment of the subject rhythm in film editing. Analytic philosophers tend to avoid discussion of it, while continental philosophers give it expansive consideration. This chapter aims to bridge these two traditions by analytically articulating what rhythm is, how it is shaped, and what it is for, while still respecting that it is, in both a film editor’s and an audience’s experience, a felt phenomenon. In order to do this, consideration is given both (...) to the firsthand perspective of experienced editors and the articulations of philosophers. This synthesis of practice and theory reveals how an understanding of the editor’s embodied cognitions, affective responses, and expert actions in shaping rhythm can shed light on rhythm’s effect on audiences. The chapter finds that rhythm in film editing is time, energy, and movement shaped by timing, pacing, and trajectory phrasing for the purpose of creating cycles of tension and release. (shrink)

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly (...) distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions. (shrink)

Why do some national movements use violent protest and others nonviolent protest? Wendy Pearlman shows that much of the answer lies inside movements themselves. Nonviolent protest requires coordination and restraint, which only a cohesive movement can provide. When, by contrast, a movement is fragmented, factional competition generates new incentives for violence and authority structures are too weak to constrain escalation. Pearlman reveals these patterns across one hundred years in the Palestinian national movement, with comparisons to South Africa and (...) Northern Ireland. To those who ask why there is no Palestinian Gandhi, Pearlman demonstrates that nonviolence is not simply a matter of leadership. Nor is violence attributable only to religion, emotions or stark instrumentality. Instead, a movement's organizational structure mediates the strategies that it employs. By taking readers on a journey from civil disobedience to suicide bombings, this book offers fresh insight into the dynamics of conflict and mobilization. (shrink)

Cutting Rhythms is about rhythm in film editing. It breaks down the issue of rhythm in an accessible way that allows filmmakers to apply the principles to their own work and film scholars access to creative practice principles. This book offers possibilities rather than prescriptions. It presents questions editors or filmmakers can ask themselves about their work, or that scholars can pose in the analysis or evaluations of work.

This paper proposes an ethical framework for rationing publicly financed health care. We begin by classifying alternative rationing criteria according to their ethical basis. We then examine the ethical arguments for four rationing criteria. These alternatives include rationing high technology services, non-basic services, services to patients who receive the least medical benefit, and services that are not equally available to all. We submit that a just health care system will not limit basic health care to persons unable to pay for (...) it. Furthermore, justice in health care requires limiting publicly-financed non-basic health care, striving for equality in access to basic health care, and relying on medical benefit to ration non-basic health care. (shrink)

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

The “fearful ape hypothesis” is interesting but is currently underspecified. We need more research on whether it is specific to fear, specific to humans (or even cooperative breeders in general), what is included in “fear,” and whether these patterns would indeed evolve despite arms races to extract help from audiences. Specifying these will result in a more testable hypothesis.

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients and managers ; semi-structured interviews with managers, clinicians, and ethics committee chairpersons. Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on (...) patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

The Ethics Consultation Quality Assessment Tool (ECQAT) establishes standards by which the quality of ethics consultation records (ECRs) can be assessed. These standards relate to the ethics question, consultation-specific information, ethical analysis, and recommendations and/or conclusions, and result in a score associated with one of four levels of ethics consultation quality. For the ECQAT to be useful in assessing and improving the quality of healthcare ethics consultations, individuals who rate the quality of ECRs need to be able to reliably use (...) the tool.We developed a short course to train ethics consultants in using the ECQAT, and evaluated whether the participants (1) achieved an acceptable level of calibration in matching expert-established quality scores for a set of ethics consultations, and (2) were satisfied with the course. We recruited 28 ethics consultants to participate in a virtual, six-session course. At each session participants and faculty reviewed, rated, and discussed one to two ECRs. The participants’ calibration in matching expert-established quality scores improved with repeated exposure at all levels of ethics consultation quality. Participants were generally more accurate when assessing consultation quality at the dichotomous level of “acceptable” (scores of three or four) versus “unacceptable” (scores of one or two) than they were with a more specific score. Participants had higher rates of accuracy with the extreme ratings of “strong” (level four) or “poor” (level one). Although participants were highly satisfied with the course, only a minority of participants achieved the prespecified acceptable level of calibration (that is, 80 percent or greater accuracy between their score and expert-established scores). These results suggest that ECQAT training may require more sessions or need modification in the protocol to achieve higher reliability in scoring. Such trainings are an important next step in ensuring that the ECQAT is a tool that can be used to promote improvement in ethics consultation quality. (shrink)

BackgroundThe ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines are widely endorsed but compliance is limited. We sought to determine whether journal-requested completion of an ARRIVE checklist improves full compliance with the guidelines.MethodsIn a randomised controlled trial, manuscripts reporting in vivo animal research submitted to PLOS ONE (March–June 2015) were randomly allocated to either requested completion of an ARRIVE checklist or current standard practice. Authors, academic editors, and peer reviewers were blinded to group allocation. Trained reviewers performed outcome adjudication (...) in duplicate by assessing manuscripts against an operationalised version of the ARRIVE guidelines that consists 108 items. Our primary outcome was the between-group differences in the proportion of manuscripts meeting all ARRIVE guideline checklist subitems.ResultsWe randomised 1689 manuscripts (control: n = 844, intervention: n = 845), of which 1269 were sent for peer review and 762 (control: n = 340; intervention: n = 332) accepted for publication. No manuscript in either group achieved full compliance with the ARRIVE checklist. Details of animal husbandry (ARRIVE subitem 9b) was the only subitem to show improvements in reporting, with the proportion of compliant manuscripts rising from 52.1 to 74.1% (X2 = 34.0, df = 1, p = 2.1 × 10−7) in the control and intervention groups, respectively.ConclusionsThese results suggest that altering the editorial process to include requests for a completed ARRIVE checklist is not enough to improve compliance with the ARRIVE guidelines. Other approaches, such as more stringent editorial policies or a targeted approach on key quality items, may promote improvements in reporting. (shrink)

The use of deception in medical care is highly suspect in this country. Yet there is one condition for which deception is often used as a diagnostic tool. Nonepileptic seizures, a psychiatric condition in which emotional or psychological conflicts manifest themselves unconsciously through bodily symptoms, are currently diagnosed by a procedure called “provocative saline infusion.” The test is fundamentally deceptive, requiring the physician to intentionally and directly lie to the patient, causing the patient to believe that the administered solution caused (...) his seizures. Without such deception, the test might be useless. (shrink)