Ethical reflection on the justice/injustice of past public health policy can inform current and future policy creation and assessment. For eight years in the 1980s, Haitians were prohibited from donating blood in the USA due to their national origin, a supposed risk factor for AIDS. This case study underlines the racial stereotypes and cultural ignorance at play in risk assignment—which simultaneously marked Haitians as risky ‘others’ and excluded them as significant participants in policy-making. This article also discerns Haitian understandings of (...) justice related to this donor policy and explores how dimensions of this past policy relate to current blood donor policy. (shrink)

In a plenary presentation on structural racism at the 2019 American Society of Bioethics and Humanities Annual Meeting, invited speaker Mary T. Bassett asserted that there is no solidarity without...

U.S. Food and Drug Administration policy prohibits blood donation from men who have had sex with men even one time since 1977. Growing moral criticism claims that this policy is discriminatory, a claim rejected by the FDA. An overview of U.S. blood donation, recent donor deferral policy, and the conventional ethical debate introduce the need for a different approach to analyzing discrimination claims. I draw on an institutional understanding of injustice to discern and describe five features of the MSM policy (...) and its FDA context that contribute to its discriminatory effect. I note significant similarities in the 1980s policy of deferring Haitians, suggesting an historical pattern of discrimination in FDA deferral policy. Finally, I point to changes needed to move toward a nondiscriminatory deferral policy. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S50-S56, March‐April 2022.

This response to Kariyawasam and Rai affirms their critique of the pathologization of trans youth but forecasts a foreseeable negative outcome of their proposed elimination of diagnosis as a prerequisite to gender-affirming care (GAC) — the risk of removing GAC entirely from the medical sphere and compromising the wellbeing of those transgender individuals for whom GAC is deeply affirming. We suggest an ethical framework of GAC that expands past a focus on autonomy to incorporate a principle of respect for persons (...) that affirms the dignity and diversity of trans youth — recognizing the need to facilitate both medical assistance and social change. (shrink)

The factions debating health care reform in the United States have gravitated toward one of two positions: that just health care is an individual responsibility or that it must be regarded as a national concern. Both arguments overlook a third possibility: that justice in health care is multilayered and requires the participation of multiple and diverse communities. _Communities of Health Care Justice_ makes a powerful ethical argument for treating communities as critical moral actors that play key roles in defining and (...) upholding just health policy. Drawing together the key community dimensions of health care, and demonstrating their neglect in most prominent theories of health care justice, Charlene Galarneau postulates the ethical norms of community justice. In the process, she proposes that while the subnational communities of health care justice are defined by shared place, including those bound by culture, religion, gender, and race that together they define justice. As she constructs her innovative theorization of health care justice, Galarneau also reveals its firm grounding in the work of real-world health policy and community advocates. _Communities of Health Care Justice_ not only strives to imagine a new framework of just health care, but also to show how elements of this framework exist in current health policy, and to outline the systemic, conceptual, and structural changes required to put these justice norms into fuller practice. (shrink)

“Probably Peirce’s best-known works are the first two articles in a series of six that originally were collectively entitled Illustrations of the Logic of Science and published in Popular Science Monthly from November 1877 through August 1878. The first is entitled ‘The Fixation of Belief’ and the second is entitled ‘How to Make Our Ideas Clear.’ In the first of these papers Peirce defended, in a manner consistent with not accepting naive realism, the superiority of the scientific method over other (...) methods of overcoming doubt and ‘fixing belief.’” — Robert Burch, “Charles Sanders Peirce,” entry in the Stanford Encyclopedia of Philosophy (2021 revision) -/- “Pragmatist epistemologies often explore how we can carry out inquiries in a self-controlled and fruitful way. (Where much analytic epistemology centres around the concept of knowledge, considered as an idealised end-point of human thought, pragmatist epistemology centres around the concept of inquiry, considered as the process of knowledge-seeking and how we can improve it.) So pragmatists often provide rich accounts of the capacities or virtues that we must possess in order to inquire well, and the rules or guiding principles that we should adopt. A canonical account is Peirce’s classic early paper ‘The Fixation of Belief‘. Here Peirce states that inquiry is a struggle to replace doubt with “settled belief“, and that the only method of inquiry that can make sense of the fact that at least some of us are disturbed by inconsistent beliefs, and will subsequently reflect upon which methods of fixing belief are correct is the Method of Science, which draws on the Pragmatic Maxim described above. This contrasts with three other methods of fixing belief: i) refusing to consider evidence contrary to one’s favored beliefs (the Method of Tenacity), ii) accepting an institution’s dictates (the Method of Authority), iii) developing the most rationally coherent or elegant-seeming belief-set (the A Priori Method).“ — Catherine Legg, “Pragmatism,” entry in the Stanford Encyclopedia of Philosophy (2021 revision). (shrink)

We often speak of health care as a social good. What kind of good it is-and what of us in making it available to the members of society-depends on how society underst value of health care may be understood in many different ways within society.

According to most accounts of trust, you can only trust other people (or groups of people). To trust is to think that another has goodwill, or something to that effect. I sketch a different form of trust: the unquestioning attitude. What it is to trust, in this sense, is to settle one’s mind about something, to stop questioning it. To trust is to rely on a resource while suspending deliberation over its reliability. Trust lowers the barrier of monitoring, challenging, checking, (...) and questioning. Trust sets up open pipelines between yourself and parts of the external world. Trust permits external resources to have a similar relationship to one as one’s internal cognitive faculties. This creates efficiency, but at the price of exquisite vulnerability. We must trust in this way because we are cognitively limited beings in a cognitively overwhelming world. Crucially, we can hold the unquestioning attitude towards objects and technologies. When I trust my climbing rope, I stop worrying about its reliability. When I trust my online calendaring system, I simply go to the events indicated, without question. But, one might worry, how could one ever hold such a normatively loaded attitude as trust towards mere objects? How could it ever make sense to feel betrayed by an object? Trust is our engine for expanding and outsourcing our agency — for binding external processes into our practical selves. Thus, we can be betrayed by our smartphones in the same way that we can be betrayed by our memory. When we trust, we try to make something a part of our agency, and we are betrayed when our part lets us down. To unquestioningly trust something is to let it in—to attempt to bring it inside one’s practical functioning. This suggests a new form of gullibility: agential gullibility, which occurs when agents too hastily and carelessly integrate external resources into their own agency. (shrink)

Value capture occurs when an agent’s values are rich and subtle; they enter a social environment that presents simplified — typically quantified — versions of those values; and those simplified articulations come to dominate their practical reasoning. Examples include becoming motivated by FitBit’s step counts, Twitter Likes and Re-tweets, citation rates, ranked lists of best schools, and Grade Point Averages. We are vulnerable to value capture because of the competitive advantage that such crisp and clear expressions of value have in (...) our private reasoning and our public justification. There is, however, a price. In value capture, we take a central component of our autonomy — our ongoing deliberation over the exact articulation of our values — and we outsource it. And the metrics to which we outsource usually engineered for the interests of some external force, like a large-scale institution’s interest in cross-contextual comprehensibility and quick aggregability. That outsourcing cuts off one of the key benefits to personal deliberation. In value capture, we no longer adjust our values and their articulations in light of own rich experience of the world. Our values should often be carefully tailored to our particular selves or our small-scale communities, but in value capture, we buy our values off the rack. In some cases – like decreasing CO2 emissions – the costs of non-tailored values are outweighed by the benefit of precise collective coordination. In other cases, like in our aesthetic lives, they are not. This suggests that we should want different values suited to different scales. We should want value federalism. Some values are perhaps best pursued at the largest-scale level, others at smaller scales. The problem occurs when we exhibit an excess preference for the largest-scale values – when we consistently let the universal metrics swamp our quieter interests. (shrink)

The U.S. 2010 Patient Protection and Affordable Care Act exempts members of health care sharing ministries from the individual mandate to have minimum essential insurance coverage. Little is generally known about these religious organizations and even less critical attention has been brought to bear on them and their ACA exemption. Both deserve close scrutiny due to the exemption’s less than clear legislative justification, their potential influence on the ACA’s policy and ethical success, and their salience to current religious liberty debates (...) surrounding the expansion of religious exemptions from ACA responsibilities for both individuals and corporations. Analyzing documents of the United States’ three largest health care sharing ministries and related material, I examine these organizations and their ACA exemption with particular consideration of their ethical dimensions. Here a thick description of the nature and workings of health care sharing ministries precedes a similar account of the ACA exemption. From these empirical analyses, five ethical and policy concerns emerge: the charity versus insurance status of these ministries; the conflation of two ACA religious exemptions; the tension between the values of religious liberty and of justice; the potential undermining of ACA policy goals; and the questionable compliance of health care sharing ministries with ACA exemption requirements. An accurate and informed understanding of HCSMs is required for policymakers and others to justify the ACA exemption of health care sharing ministry members. A sufficient justification would address at least the five ethical and policy concerns raised here. (shrink)

U.S. Food and Drug Administration policy prohibits blood donation from men who have had sex with men even one time since 1977. Growing moral criticism claims that this policy is discriminatory, a claim rejected by the FDA. An overview of U.S. blood donation, recent donor deferral policy, and the conventional ethical debate introduce the need for a different approach to analyzing discrimination claims. I draw on an institutional understanding of injustice to discern and describe five features of the MSM policy (...) and its FDA context that contribute to its discriminatory effect. I note significant similarities in the 1980s policy of deferring Haitians, suggesting an historical pattern of discrimination in FDA deferral policy. Finally, I point to changes needed to move toward a nondiscriminatory deferral policy. (shrink)

Given the enduring inequities in US health and health care, it is no surprise that particular communities are bearing the disproportionate brunt of the Covid‐19 pandemic and our responses to it. Many ethical aspects of the pandemic involve diverse communities bound by race, ethnicity, disability, income, residence, age, and more. How does bioethics engage these communities in theory and in practice? Only faintly, despite Covid‐19's relentless reminder that communities matter morally. This article sketches initial directions for developing a community‐inclusive bioethics, (...) one that understands communities as critical moral participants in the work of bioethics as well as in health and health care. (shrink)

The report from the Presidential Commission for the Study of Bioethical Issues is clear that the public health services research conducted in Guatemala mid‐century was wrong, but its focus on individual responsibilities is inadequate for the structural and institutional factors at the root of that research. Ethically Impossible”: STD Research in Guatemala from 1946 to 1948, released in September 2011 by the Presidential Commission for the Study of Bioethical Issues, 1 responds to President Obama's request for a “thorough fact‐finding investigation” (...) into research carried out by the U.S. Public Health Service in Guatemala from 1946 to 1948. “Ethically Impossible” offers a detailed narrative of what happened in Guatemala and a self‐described “unvarnished ethical analysis.” I argue, however, that being “ever vigilant” to prevent exploitation, as well as learning as a society from this past and honoring the memory of Guatemalan victims, requires a more complex ethical analysis than the commission offers in this report. Specifically, we need to identify the structural injustices that innervated the social relations and the institutions fundamental to the moral landscape of this 1940s research, and we need to expand our understandings of moral responsibility accordingly. The report posits three “longstanding and widely accepted moral principles” as the framework for evaluating this research: (1) to treat persons fairly and with respect, (2) not to harm (or risk harming) persons unless the risk is reasonable and the benefit proportional, and (3) not to treat persons as means to others’ ends. As critically important as the three principles are to research ethics writ large, they alone are unfitting tools for addressing the kind of structural and institutional moral factors that are so important in these PHS studies. (shrink)

Health justice seeks, both conceptually and in practice, to strengthen community engagement and empowerment as an integral means of addressing health disparities. In this essay, we explore the nature of communities and their roles in health care/public health. We propose that an ethical principle of respect for communities is a requisite part of health justice. It is this respect for communities that ethically grounds health justice’s calls for greater community engagement and empowerment. Conceptions of health justice, we claim, will gain (...) ethical power and coherence as this principle is more clearly recognized and further developed. (shrink)

Recent conversation has blurred two very different social epistemic phenomena: echo chambers and epistemic bubbles. Members of epistemic bubbles merely lack exposure to relevant information and arguments. Members of echo chambers, on the other hand, have been brought to systematically distrust all outside sources. In epistemic bubbles, other voices are not heard; in echo chambers, other voices are actively undermined. It is crucial to keep these phenomena distinct. First, echo chambers can explain the post-truth phenomena in a way that epistemic (...) bubbles cannot. Second, each type of structure requires a distinct intervention. Mere exposure to evidence can shatter an epistemic bubble, but may actually reinforce an echo chamber. Finally, echo chambers are much harder to escape. Once in their grip, an agent may act with epistemic virtue, but social context will pervert those actions. Escape from an echo chamber may require a radical rebooting of one's belief system. (shrink)

Short overview of the From Small Beginnings Project and its relevance for resisting eugenics in contemporary society.

This classic and controversial book examines the roots of the idea of virtue, diagnoses the reasons for its absence in modern life, and proposes a path for its recovery.

"This edition, which replaces the original Loeb edition..., offers text, translation, and annotation that are fully current with modern scholarship"--Front flap of dust jacket, volume 1.

forthcoming in R. Cameron, B. Hale and A. Hoffmann (ed.s), The Logic, Epistemology and Metaphysics of Modality, Oxford University Press. Presents a concept-grounding account of modal knowledge.

Why do moral people so often fail to act morally? Standard scientific answers point to poor moral judgment (based on deficient character development, reason, or intuition) or to situational pressure. I consider a third possibility: a relative lack of truly moral motivation and emotion. What has been taken for moral motivation is often instead a subtle form of egoism. Recent research provides considerable evidence for moral hypocrisy—motivation to appear moral while, if possible, avoid the cost of actually being moral—but very (...) little evidence for moral integrity—motivation to actually be moral. The lack of truly moral motivation may, in turn, be linked to a lack of truly moral emotion, at least in response to violation of certain moral standards. (shrink)

Анотація. У статті проаналізовані досягнення Соціального Вчительства Католицької Церкви, репрезентовані працями Лева ХІІІ, Пія ХІ, Пія ХІІ, Івана Павла ІІ, що розкривають змістовні характеристики поняття «принцип субсидіарності», його роль і значення в системі християнських цінностей. Принцип субсидіарності робить можливими такі взаємовідносини в соціальному житті, коли спільнота вищого порядку не втручається у внутрішнє життя спільноти нижчого порядку, перебираючи на себе належні тій функції; заради спільного добра, спільного блага вона надає їй у разі потреби підтримку й допомогу, узгоджуючи у такий спосіб її (...) взаємодію з іншими соціальними структурами. Принцип субсидіарності скеровує соціальну практику на утвердження спільного блага в людському співтоваристві. Поширення і застосування принципу субсидіарності протистоїть небезпеці «одержавлення» суспільства та найзагрозливіших проявів колективізму, обмежує абсолютизацію влади, бюрократизацію державних і соціокультурних структур, стає одним із гарантів дотримання прав і свобод громадян своєї країни. (shrink)

I argue that acknowledging Hume as a doxastic naturalist about belief in a deity allows an elegant, holistic reading of his Dialogues. It supports a reading in which Hume's spokesperson is Philo throughout, and enlightens many of the interpretive difficulties of the work. In arguing this, I perform a comprehensive survey of evidence for and against Philo as Hume's voice, bringing new evidence to bear against the interpretation of Hume as Cleanthes and against the amalgamation view while correcting several standard (...) mistakes. I ultimately isolate the interpretation of Philo's Reversal at the end of the Dialogues as of paramount importance, and show how my naturalistic interpretation makes this, and other notoriously difficult passages, unproblematic. (shrink)

Philosophers of biology typically pose questions about individuation by asking “what is an individual?” For example, we ask, “what is an individual species”, “what is an individual organism”, and “what is an individual gene?” In the first part of this chapter, I present my account of the gene concept and how it is used in investigative practices in order to motivate a more pragmatic approach. Instead of asking “what is a gene?”, I ask: “how do biologists individuate genes?”, “for what (...) purposes?”, and “do their practices of individuating genes serve these purposes?" In the second part of this chapter, I propose that we use this approach when analyzing concepts of organisms and biological individuals. Following philosophical pragmatism, I argue that we should abstain from attempts to situate individuation of Darwinian individuals or of holobionts in a philosophy of nature. Instead, we should analyze practices of individuating organisms in terms of three-place relations between the world, ideas, and human purposes and actions. I conclude with three lessons: an ontological, an epistemological, and a meta-philosophical lesson, which I suggest, apply to philosophy of science generally and to philosophy and metaphysics at large. (shrink)

In this critique, Martha Nussbaum argues that our dominant theories of development have given us policies that ignore our most basic human needs for dignity and self-respect.

(2013). Review of Anne-Maree Farrell, The Politics of Blood: Ethics, Innovation and the Regulation of Risk. The American Journal of Bioethics: Vol. 13, No. 4, pp. 54-56. doi: 10.1080/15265161.2013.768869.

This edition of Martin Ostwald's revised version of J. B. Skemp's 1952 translation of _Statesman_ includes a new selected bibliography, as well as Ostwald's interpretive introduction, which traces the evolution in Plato's political philosophy from _Republic_ to _Statesman to Laws_--from philosopher-king to royal statesman.

The question I wish to explore is this: Does idealism conflict with common sense? Unfortunately, the answer I give may seem like a rather banal one: It depends. What do we mean by ‘idealism’ and ‘common sense?’ I distinguish three main varieties of idealism: absolute idealism, Berkeleyan idealism, and dualistic idealism. After clarifying what is meant by common sense, I consider whether our three idealisms run afoul of it. The first does, but the latter two don’t. I conclude that while (...) Moore’s famous common sense critique is sound against external world skepticism, against Berkeleyan idealism and dualist idealism it is unavailing. (shrink)

The abstract structure of inquiry - the process of acquiring and changing beliefs about the world - is the focus of this book which takes the position that the "pragmatic" rather than the "linguistic" approach better solves the philosophical problems about the nature of mental representation, and better accounts for the phenomena of thought and speech. It discusses propositions and propositional attitudes (the cluster of activities that constitute inquiry) in general and takes up the way beliefs change in response to (...) potential new information, suggesting that conditional propositions should be understood as projections of epistemic policies onto the world.Robert C. Stalnaker is a professor in the Sage School of Philosophy at Cornell University. A Bradford Book. (shrink)

Alasdair MacIntyre explores some central philosophical, political and moral claims of modernity and argues that a proper understanding of human goods requires a rejection of these claims. In a wide-ranging discussion, he considers how normative and evaluative judgments are to be understood, how desire and practical reasoning are to be characterized, what it is to have adequate self-knowledge, and what part narrative plays in our understanding of human lives. He asks, further, what it would be to understand the modern condition (...) from a neo-Aristotelian or Thomistic perspective, and argues that Thomistic Aristotelianism, informed by Marx's insights, provides us with resources for constructing a contemporary politics and ethics which both enable and require us to act against modernity from within modernity. This rich and important book builds on and advances MacIntyre's thinking in ethics and moral philosophy, and will be of great interest to readers in both fields. (shrink)

Монографія "Функціональність релігії: український контекст".

A revolutionary new theory and call to action on animal rights, ethics, and law from the renowned philosopher Martha C. Nussbaum.