Feminist bioethicists of a variety of persuasions discuss the 2013 case of Marlise Munoz, a pregnant woman whose medical care was in dispute after she became brain dead.

Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...) ethical vignettes. The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles. This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings. (shrink)

Much has been written about medicine and the market in recent years. This book is the first to include an assessment of market influence in both developed and developing countries, and among the very few that have tried to evaluate the actual health and economic impact of market theory and practices in a wide range of national settings. Tracing the path that market practices have taken from Adam Smith in the eighteenth century into twenty-first-century health care, Daniel Callahan and (...) Angela A. Wasunna add a fresh dimension: they compare the different approaches taken in the market debate by health care economists, conservative market advocates, and liberal supporters of single-payer or government-regulated systems. In addition to laying out the market-versus-government struggle around the world -- from Canada and the United States to Western Europe, Latin America, and many African and Asian countries -- they assess the leading market practices, such as competition, physician incentives, and co-payments, for their economic and health efficacy to determine whether they work as advertised. This timely and necessary book engages new dimensions of a development that has urgent consequences for the delivery of health care worldwide. (shrink)

The social sciences playa variety of multifaceted roles in the policymaking process. So varied are these roles, indeed, that it is futile to talk in the singular about the use of social science in policymaking, as if there were one constant relationship between two fixed and stable entities. Instead, to address this issue sensibly one must talk in the plural about uses of dif ferent modes of social scientific inquiry for different kinds of policies under various circumstances. In some cases, (...) the influence of social scientific research is direct and tangible, and the connection between the find ings and the policy is easy to see. In other cases, perhaps most, its influence is indirect-one small piece in a larger mosaic of politics, bargaining, and compromise. Occasionally the findings of social scientific studies are explicitly drawn upon by policymakers in the formation, implementation, or evaluation of particular policies. More often, the categories and theoretical models of social science provide a general background orientation within which policymakers concep tualize problems and frame policy options. At times, the in fluence of social scientific work is cognitive and informational in nature; in other instances, policymakers use social science primarily for symbolic and political purposes in order to le gitimate preestablished goals and strategies. Nonetheless, amid this diversity and variety, troubling general questions persistently arise. (shrink)

When (if ever) may a professional deceive a client for the client's own good? Under what conditions (if any) is whistle-blowing morally required? These are just some of the questions that scholars as diverse as Michael D. Bayles, Thomas Nagel, Sissela Bok, Jessica Mitford, and Peter A. French confront in this stimulating anthology. Organized around philosophical issues such as the moral foundations of professional ethics, models of the professional-client relationship, deception, informed consent, privacy and confidentiality, professional dissent, and professional virtue, (...) the volume illuminates the complex ethical issues that arise in journalism, law, health care, counselling, education, engineering, business, politics, and social science research. A variety of pedagogical aids--including clear introductions to and study questions for each set of readings, concrete cases designed to focus discussion, and an appendix on preparing cases and position papers--makes the text invaluable for both students and teachers of professional ethics. (shrink)

The essays in this interdisciplinary collection share the conviction that modern western paradigms of knowledge and reality are gender-biased.

This paper argues that, by construing emotion as epistemologically subversive, the Western tradition has tended to obscure the vital role of emotion in the construction of knowledge. The paper begins with an account of emotion that stresses its active, voluntary, and socially constructed aspects, and indicates how emotion is involved in evaluation and observation. It then moves on to show how the myth of dispassionate investigation has functioned historically to undermine the epistemic authority of women as well as other social (...) groups associated culturally with emotion. Finally, the paper sketches some ways in which the emotions of underclass groups, especially women, may contribute to the development of a critical social theory. (shrink)

Recently, the theory theory has led to much interesting research. However, this is the first book to look at the theory in extensive detail and to systematically contrast it with other theories.

Much has been written about medicine and the market in recent years. This book is the first to include an assessment of market influence in both developed and developing countries, and among the very few that have tried to evaluate the actual health and economic impact of market theory and practices in a wide range of national settings. Tracing the path that market practices have taken from Adam Smith in the eighteenth century into twenty-first-century health care, Daniel Callahan and (...) Angela A. Wasunna add a fresh dimension: they compare the different approaches taken in the market debate by health care economists, conservative market advocates, and liberal supporters of single-payer or government-regulated systems. In addition to laying out the market-versus-government struggle around the world -- from Canada and the United States to Western Europe, Latin America, and many African and Asian countries -- they assess the leading market practices, such as competition, physician incentives, and co-payments, for their economic and health efficacy to determine whether they work as advertised. This timely and necessary book engages new dimensions of a development that has urgent consequences for the delivery of health care worldwide. (shrink)

The decline in the interest in ethical theory is first outlined, as a background to the author’s discussion of principlism. The author’s own stance, that of a communitarian philosopher, is then described, before the subject of principlism itself is addressed. Two problems stand in the way of the author’s embracing principlism: its individualistic bias and its capacity to block substantive ethical inquiry. The more serious problem the author finds to be its blocking function. Discussing the four scenarios the author finds (...) that the utility of principlism is shown in the two scenarios about Jehovah’s Witnesses but that when it comes to selling kidneys for transplantation and germline enhancement, principlism is of little help. (shrink)

David Albert explains why we can typically influence the future but not the past by appealing to an initial low-entropy state of the universe. And he argues that in the rare cases where we can influence the past, we cannot use this influence to knowingly gain future rewards: so it does not constitute control. I introduce an important new case in which Albert's account implies we can not only influence the past but control it: a case where our actions in (...) the present are reliably correlated with several events in the present and past. To deal with such cases, we need to appeal to epistemic conditions on deliberation: being agents requires our decisions being epistemically undetermined at the time we make them. In a world with the past-hypothesis, this implies that deliberation will typically come prior to decision. Once deliberation in this direction is established, correlations towards the past cannot then be exploited for control. To explain why we cannot effectively control the past, we need to appeal to deliberation, whether as part of a defence of Albert's account, or used independently to explain the asymmetry of control. (shrink)

Philosophy and Phenomenological Research, EarlyView.

This is a bold and controversial feminist, philosophical critique of postmodernism. While providing a brief and accessible introduction to postmodernist feminist thought, Enlightened Women is also a unique defence of realism and enlightenment philosophy. The first half of the book covers an analysis of some of the most influential postmodernist theorists, such as Luce Irigaray and Judith Butler. In the second half Alison Assiter advocates a return to modernism in feminism. She argues, against the current orthodoxy, that there can (...) be a distinction between "sex" and "gender". For students trying to pick their way through the maze of literature in the area of postmodernist feminism, Enlightened Women is a concise guide to contemporary thought - as well as a radical contribution to the debate. (shrink)

Kierkegaard is no doubt a philosopher whose focus is inwardness and irreducible individuality. On the surface, he therefore seems to have little to teach us about the sphere of the political: not only was this dimension never explicitly addressed in the writings of the Danish philosopher, but also the positions he took with regard to such a domain where always marked by a strong critical attitude. Moreover, he appeared to be a conservative with regard to any movement towards democratization and (...) equality, opposing liberal democracy as well as socialism, while not refraining from taking up explicitly misogynous positions. With this in mind, one could easily dismiss Kierkegaardian philosophy as exclusively relevant to the private domain of individual existence and irremediably unable to speak to wider concerns such as those encountered in the public dimension. However, in spite of his emphasis on singularity, or perhaps precisely because of it, over the years Kierkegaard's philosophy has given rise to interpretations that recognise its relevance for the political. For instance, the crucial importance of such ideas as self-choice, earnestness and subjective passion are easily imported from the individual sphere into the realm of the political, coming to have a bearing on notions such as responsibility and commitment. In addition, Kierkegaard's accent on the irreducibility of the individual to the universal resonates interestingly in those forms of thinking that, from the margins, call into question the domination of an exclusionary model of reason. Furthermore, his ethical writings on love are directly relevant to the political sphere. This book seeks to draw out, from a range of perspectives, some of the ways in which Kierkegaard's ideas are not only relevant, but highly significant for political thought. (shrink)

The Beloved Self is about the holy grail of moral philosophy, an argument against egoism that proves that we all have reasons to be moral. Part One introduces three different versions of egoism. Part Two looks at attempts to prove that egoism is false, and shows that even the more modest arguments that do not try to answer the egoist in her own terms seem to fail. But in part Three, Hills defends morality and develops a new problem for egoism, (...) an epistemological problem. She shows that it is not epistemically rational to believe the most plausible versions of egoism. The first part of the book will be most relevant to those interested in moral theory, as it contains detailed discussions of recent interpretations of virtue ethics and especially of Kant's moral theory. The second and third part of the book turn to epistemology, particularly moral epistemology, and include an account of the relationship between knowledge and action, a new theory of moral understanding, and a discussion of the epistemically rational response to various kinds of disagreement. Hills also defends a new account of virtue and of morally worthy action. (shrink)

American bioethics began in the late 1960s, stimulated by a plethora of new medical technologies and biological knowledge and by a scandal-induced interest in human subject research. Although it was understood that there would be ethical debate , no one thought the disputes would be ideological in character, as if part of one's voting pattern as liberal or conservative, Democrat or Republican. There were arguments, often sharp, but no culture wars.

Obesity is one of several targets of public health efforts related to availability of and access to healthy foods. The tension between individual food decisions and social contexts of food production, preparation, and consumption makes targeting individuals deeply problematic and yet tempting. Such individualization of responsibility for obesity and nutrition is unethical and impractical. This article warns public health campaigns against giving into the temptation to individualize responsibility, and presents an argument for why they should proceed with all due caution, (...) advising providers and public health organizations to keep in mind structural factors rather than aiming at individuals. (shrink)

The possibility of human cloning first surfaced in the 1960s, stimulated by the report that a salamander had been cloned. James D. Watson and Joshua Lederberg, distinguished Nobel laureates, speculated that the cloning of human beings might one day be within reach; it was only a matter of time. Bioethics was still at that point in its infancybioethicsand cloning immediately caught the eye of a number of those beginning to write in the field. They included Paul Ramsey, Hans Jonas, and (...) Leon Kass. Cloning became one of the symbolic issues of what was, at that time, called a biology that would be dominated by molecular genetics. Over a period of five years or so in the early 1970s a number of articles and book chapters on the ethical issues appeared, discussing cloning in its own right and cloning as a token of the radical genetic possibilities. (shrink)

This paper problematises the ways women’s leadership has been understood in relation to male leadership rather than on its own terms. Focusing specifically on ethical leadership, we challenge and politicise the symbolic status of women in leadership by considering the practice of New Zealand Prime Minister Jacinda Ardern. In so doing, we demonstrate how leadership ethics based on feminised ideals such as care and empathy are problematic in their typecasting of women as being simply the other to men. We apply (...) different strategies of mimesis for developing feminist leadership ethics that does not derive from the masculine. This offers a radical vision for leadership that liberates the feminine and women’s subjectivities from the masculine order. It also offers a practical project for changing women’s working lives through relationality, intercorporeality, collective agency and ethical openness with the desire for fundamental political transformation in the ways in which women can lead. (shrink)

Abstract: If anger is the emotion of injustice, and if most injustices have prominent epistemic dimensions, then where is the anger in epistemic injustice? Despite the question my task is not to account for the lack of attention to anger in epistemic injustice discussions. Instead, I argue that a particular texture of transformative anger – a knowing resistant anger – offers marginalized knowers a powerful resource for countering epistemic injustice. I begin by making visible the anger that saturates the silences (...) that epistemic injustices repeatedly manufacture and explain the obvious: silencing practices produce angry experiences. I focus on tone policing and tone vigilance to illustrate the relationship between silencing and angry knowledge management. Next, I use María Lugones’s pluralist account of anger to bring out the epistemic dimensions of knowing resistant anger in a way that also calls attention to their histories and felt textures. The final section draws on feminist scholarship about the transformative power of angry knowledge to suggest how it might serve as a resource for resisting epistemic injustice. (shrink)

In Feminist, Queer, Crip Alison Kafer imagines a different future for disability and disabled bodies. Challenging the ways in which ideas about the future and time have been deployed in the service of compulsory able-bodiedness and able-mindedness, Kafer rejects the idea of disability as a pre-determined limit. She juxtaposes theories, movements, and identities such as environmental justice, reproductive justice, cyborg theory, transgender politics, and disability that are typically discussed in isolation and envisions new possibilities for crip futures and feminist/queer/crip (...) alliances. This bold book goes against the grain of normalization and promotes a political framework for a more just world. (shrink)

I argue that miscarriage, referred to by poet Susan Stewart as “the event that was nothing,” is a liminal event along four distinct and inter-related dimensions: parenthood, procreation, death, and induced abortion. It is because of this liminality that miscarriage has been both poorly addressed in our society, and enrolled in larger debates over women's reproduction and responsibility for reproduction, both conceptually and legally. If miscarriage’s liminality were better understood, if miscarriage itself were better theorized, perhaps it would not so (...) easily be enrolled in these other debates to the detriment of women who miscarry, and their families. However, its very liminality and the fact that it is enrolled in these debates sheds light on the complicated network of concepts within which miscarriage lies. (OPEN ACCESS AT URL). (shrink)

This book examines the ways that Heidegger, Lacoue-Labarthe, and Nancy adopt and reconfigure the Kantian understanding of "aesthetic presentation." In Kant, "aesthetic presentation" is understood in a technical sense as a specific mode of experience within a typology of different spheres of experience. This study argues that Heidegger, Lacoue-Labarthe, and Nancy generalize the elements of this specific mode of experience so that the aesthetic attitude and the vocabulary used by Kant to describe it are brought to bear on things in (...) general. The book goes beyond documenting the well-known influence of Kant's Critique of Judgment , however, to open up a new way of approaching some of the central issues in post-Kantian thought—including why it is that art, the art work, and the aesthetic are still available as a vehicle of critique even, or especially, after Auschwitz. It shows that a genealogy of contemporary theory needs to look at the question of presentation, which has arguably been a question that has worried philosophy from its very beginning. (shrink)

This Element introduces the philosophy of Frances Power Cobbe (1822-1904), a very well-known moral theorist, advocate of animal welfare and women's rights, and critic of Darwinism and atheism in the Victorian era. After locating Cobbe's achievements within nineteenth-century British culture, this Element examines her duty-based moral theory of the 1850s and then her 1860s accounts of duties to animals, women's rights, and the mind and unconscious thought. From the 1870s, in critical response to Darwin's evolutionary ethics, Cobbe put greater moral (...) weight on the emotions, especially sympathy. She now criticised atheism for undermining morality, emphasised women's duties to develop virtues of character, and recommended treating animals with sympathy and compassion. The Element links Cobbe's philosophical arguments to her campaigns for women's rights and against vivisection, brings in critical responses from her contemporaries, explains how she became omitted from the history of philosophy, and shows the lasting importance of her work. (shrink)

Standpoint theory is an explicitly political as well as social epistemology. It’s distinctive features are commitment to understand the social locations that shape the epistemic capacities and resources of individuals in structural terms, and a recognition that those who are marginalized within hierarchically structured systems of social differentiation are often epistemically advantaged. In some crucial domains they know more and know better as a contingent function of their situated experience and knowledge. This “inversion thesis” counters the alignment of social with (...) epistemic privilege. (shrink)

The early Epicurean revival in Florence and Italy -- Medicean Florence : Ficino and Bartolomeo Scala -- Republican Florence : the university lectures of Marcello Adriani -- Niccol Machiavelli and the influence of Lucretius -- Lucretian networks in the late fifteenth and early sixteenth centuries -- Appendix : notes on Machiavelli's transcription of MS Vat. Rossi 884.

Steven Pinker, a cognitive psychologist and linguist at Harvard and a savant of big ideas, is one of the latest to take on the idea of progress. He does it under the aegis of “enlightenment,” which comes down to a kind of holy trinity of reason, science, and humanism. His new book, Enlightenment Now: The Case for Reason, Science, Humanism, and Progress, is ambitious and cantankerous and heady with hope. On the whole, Pinker makes a good case for the benefits (...) of progress, but with an overdose of feel‐good prose. His greatest failure comes in exaggerating the threats to science and in avoiding some problems altogether. He ignores its complexity, its shadows, its creation of new problems raised by its solutions to old ones. Pinker has a particular animus against bioethics, and he misses what has been, I would argue, at the heart of bioethics from its beginning fifty or so years ago. Bioethics was prompted by a new class of medical dilemmas that require a difficult balancing of harms and benefits. Most of them are still with us, and most of them are the result of the progress of postwar medical research and fast‐changing clinical practices. (shrink)

I argue that understanding why p involves a kind of intellectual know how and differsfrom both knowledge that p and knowledge why p (as they are standardly understood).I argue that understanding, in this sense, is valuable.