ABSTRACT The technological revolution has created enormous opportunities for the provision of affordable, accessible, and flexible mental healthcare. Yet it also creates complexities and ethical challenges. While some of these challenges may be similar to face-to-face care, their nuance in the online milieu is different, as relationships, identities and boundaries in this setting are fluid, and there is an absence of physical presence. In this paper we consider the specific ethical complexities involved in the provision of a social networking intervention (...) for depression and problematic alcohol use involving providers and peers. We present a case in which clinicians encountered a participant who repeatedly expressed suicidal thoughts in this online forum, and reflect on how this situation was managed. In analyzing this case, we use relational ethics—which proposes that interpersonal relationships are the fulcrum for ethical decision-making and action—together with actor-network theory—which highlights the power of technology to transform and mediate social and ethical relationships. Our analysis demonstrates the need to move beyond human-centric approaches, to recognize the role of both human and non-human actors in shaping moral decisions and behavior in the provision of e-mental healthcare. (shrink)

In his recent article entitled ‘Can We Believe the Error Theory?’ Bart Streumer argues that it is impossible (for anyone, anywhere) to believe the error theory. This might sound like a problem for the error theory, but Streumer argues that it is not. He argues that the un-believability of the error theory offers a way for error theorists to respond to several objections commonly made against the view. In this paper, we respond to Streumer’s arguments. In particular, in sections 2-4, (...) we offer several objections to Streumer’s argument for the claim that we cannot believe the error theory. In section 5, we argue that even if Streumer establishes that we cannot believe the error theory, this conclusion is not as helpful for error theorists as he takes it to be. (shrink)

A 16-year-old adolescent who identifies as transgender wishes to consider fertility preservation prior to the use of gender-affirming hormones. The adolescent’s parents are divorced, and one parent supports fertility preservation while the other does not. This case explores the minor’s future reproductive autonomy and parental decision making in a field where there is limited evidence of known harms and benefits to the use of fertility preservation in the transgender population and about future potential regret from lack of consideration of fertility (...) preservation during the prime window of opportunity. This case is created from a composite of cases seen at multiple institutions. (shrink)

In his recent book Error Theory: History, Critique, Defence, Jonas Olson attempts to revive the argument from queerness originally made famous by J.L. Mackie. In this paper, we do three things. First, we eliminate four untenable formulations of the argument. Second, we argue that the most plausible formulation is one that depends crucially upon considerations of parsimony. Finally, we evaluate this formulation of the argument. We conclude that it is unproblematic for proponents of moral non-naturalism—the target of the argument from (...) queerness. (shrink)

We provide a novel defense of the possibility of level-splitting beliefs and use this defense to show that the steadfast response to peer disagreement is not, as it is often claimed to be, unnecessarily dogmatic. To provide this defense, a neglected form of moral disagreement is analysed. Within the context of this particular kind of moral disagreement, a similarly neglected form of level-splitting belief is identified and then defended from critics of the rationality of level-splitting beliefs. The chapter concludes by (...) showing that proponents of the steadfast response to peer disagreement can adopt this form of level-splitting belief in the context of these moral disagreements while exemplifying intellectual humility, rather than dogmatism. (shrink)

Liao and Carbonell argue that medical devices are often not merely biased, but rather materialize oppression through the perpetuation of oppression into the present and future (Liao and Carbonell 2...

Numbers 25 presents a human crisis requiring swift leadership interventions to curb the plague. Leadership failure plays out on a number of levels before decisive and resolute interventions are taken. This passage shows a human-created crisis that somewhat parallels the coronavirus disease 2019 outbreak and offers reflective pragmatic approaches taken to ensure immediate arresting of the pandemic and perhaps future curbing of a similar instigation.CONTRIBUTION: Africa has always been known to respond rather belatedly to crises that cost human lives and (...) also for waiting for solutions to come from elsewhere. How do we change that paradigm going forward and what does it mean for the analysis of biblical texts? African hermeneutical readings that take contextual issues rather seriously are utilised in this study. (shrink)

Even though the concept of sustainability emerged from a reality-life emergency, its discourse seems diverse, built even on different onto-gnoseological and teleological assupmtions. This is mainly due to the different perceptions of life held by individuals, as well as to the hegemonic class interests. Then, derived from this different perceptions of life and interests, has been the behavior of human beings on the Earth; sometimes in accordance to it, but many others in outright aggression to it. And if life’s way (...) shows life itself, it can be changed, even collapsed by the anthropic hegemonic actions that take place in the planet. It is therefore important to reflect on the categorical and conceptual frameworks that underlie discourse, in order to build a way of thinking that includes all formas of life, that enhances the eco-existentiality of the individual and its community for the enrichment of all. (shrink)

As a 2006 Institute of Medicine report highlights, surprisingly little empirical attention has been paid to how prisoners arrive at decisions to participate in modern research. With our study, we aimed to fill this gap by identifying a more comprehensive range of factors as reported by prisoners themselves during semistructured interviews. Our participants described a diverse range of motives, both favoring and opposing their eventual decision to join. Many are well-recognized considerations among nonincarcerated clinical research participants, including a desire for (...) various forms of personal benefit, altruism, and concern about study risks and inconveniences. However, a number of influences seem unique to prisoners. Participants did not report that they were not coerced into enrolling, and they have even been under pressure not to enroll. However, many sought to enroll in order to obtain access to better health care, raising a concern about whether they were unfairly exploited. (shrink)

Privacy by Design, a globally accepted framework for personal data management and privacy protection, advances the view that privacy cannot be assured solely by compliance with regulatory frameworks but must become an organisation’s default mode of operation. We are proposing a similar template for the research ethics review process. The Research Ethics by Design framework involves research ethics committees engaging researchers during the design phase of the proposal so that ethical considerations may be directly embedded in the science as opposed (...) to being viewed as addendums after the fact. This collaborative research design proposal results in the establishment of a culture of ethical research rather than research with ethical oversight. Both researchers and research ethics committees come to view the review process as one in which individual protection and collective benefit co-exist in a doubly-enabling positive-sum manner. (shrink)

With the advent of CRISPR gene-editing technology, designer babies have become a reality. Françoise Baylis insists that scientists alone cannot decide the terms of this new era in human evolution. Members of the public, with diverse interests and perspectives, must have a role in determining our future as a species.

Moorean arguments are a popular and powerful way to engage highly revisionary philosophical views, such as nihilism about motion, time, truth, consciousness, causation, and various kinds of skepticism (e.g., external world, other minds, inductive, global). They take, as a premise, a highly plausible first-order claim (e.g., cars move, I ate breakfast before lunch, it’s true that some fish have gills) and conclude from it the falsity of the highly revisionary philosophical thesis. Moorean arguments can be used against nihilists in ethics (...) (error theorists), too. Recently, error theorists have recognized Moorean arguments as a powerful challenge and have tried to meet it. They’ve argued that moral Moorean premises seem highly credible to us, but aren’t, by offering various debunking explanations. These explanations all appeal to higher-order evidence—evidence of error in our reasoning. I argue that drawing attention to higher-order evidence is a welcome contribution from error theorists, but that the higher-order evidence actually counts further against error theoretic arguments—including their debunking explanations—and further in favor of Moorean arguments and the commonsense views they support. Along the way I answer a few prominent objections to Moorean arguments: that they are objectionably question-begging, rely on categorizing some facts as “Moorean Facts”, and that reports of one’s credence in a proposition bears no interesting relation to that proposition’s credibility. (shrink)

Arguments from disagreement against moral realism begin by calling attention to widespread, fundamental moral disagreement among a certain group of people. Then, some skeptical or anti-realist-friendly conclusion is drawn. Chapter 2 proposes that arguments from disagreement share a structure that makes them vulnerable to a single, powerful objection: they self-undermine. For each formulation of the argument from disagreement, at least one of its premises casts doubt either on itself or on one of the other premises. On reflection, this shouldn’t be (...) surprising. These arguments are intended to support very strong metaphysical or epistemological conclusions about morality. They must therefore employ very strong metaphysical or epistemological premises. But, given the pervasiveness of disagreement in philosophy, especially about metaphysics and epistemology, very strong premises are virtually certain to be the subject of widespread, intractable disagreement—precisely the sort of disagreement that proponents of these arguments think undermine moral claims. Thus, these arguments undermine their own premises. If Chapter 2’s argument is sound, it provides realists with a single, unified strategy for responding to any existing or forthcoming arguments from disagreement. (shrink)

One of the deepest and longest-lasting debates in ethics concerns a version of the Euthyphro question: are choiceworthy things choiceworthy because agents have certain attitudes toward them or are they choiceworthy independent of any agents’ attitudes? Reasons internalists, such as Bernard Williams, Michael Smith, Mark Schroeder, Sharon Street, Kate Manne, Julia Markovits, and David Sobel answer in the first way. They think that all of an agent’s normative reasons for action are grounded in facts about that agent’s pro-attitudes (e.g., her (...) desires, valuing states, normative judgments). According to the most popular brand of internalism, idealizing internalism, an agent’s reasons are grounded, not in her actual pro-attitudes, but rather in what her pro-attitudes would be in suitably idealized conditions. Idealizing internalists presuppose that, for any agent with an irrational set of attitudes, there is one uniquely rational set that that agent would have if she were to undergo the relevant idealizing process. I argue that this assumption is false and that it raises two puzzles for idealizing internalism: one about the existence of practical reasons and another about their normative weight. I argue that idealizing internalists have an adequate solution to the first puzzle but not the second. Indeed, when they try to solve the second puzzle, they confront a dilemma. This second puzzle and the associated dilemma thus constitutes a powerful, but so far unnoticed, difficulty for idealizing internalism. (shrink)

In this thought-provoking work, Tony D. Sampson presents a contagion theory fit for the age of networks. Unlike memes and microbial contagions, _Virality_ does not restrict itself to biological analogies and medical metaphors. It instead points toward a theory of contagious assemblages, events, and affects. For Sampson, contagion is not necessarily a positive or negative force of encounter; it is how society comes together and relates. Sampson argues that a biological knowledge of contagion has been universally distributed (...) by way of the rhetoric of fear used in the antivirus industry and other popular discourses surrounding network culture. This awareness is also detectable in concerns over _too much connectivity_, such as problems of global financial crisis and terrorism. Sampson’s “virality” is as established as that of the biological meme and microbe but is not understood through representational thinking expressed in metaphors and analogies. Rather, Sampson interprets contagion theory through the social relationalities first established in Gabriel Tarde’s microsociology and subsequently recognized in Gilles Deleuze’s ontological worldview. According to Sampson, the reliance on representational thinking to explain the social behavior of networking—including that engaged in by nonhumans such as computers—allows language to overcategorize and limit analysis by imposing identities, oppositions, and resemblances on contagious phenomena. It is the power of these categories that impinges on social and cultural domains. Assemblage theory, on the other hand, is all about relationality and encounter, helping us to understand the viral as a positively sociological event, building from the molecular outward, long before it becomes biological. (shrink)

Selon Spinoza, les idées appartiennent à la nature au même titre que les corps. Et pourtant ce ne sont pas des corps : seule une physique spéciale, nullement métaphorique, peut rendre compte de l'étrange univers qu'elles composent.

Those of us who take skepticism seriously typically have two relevant beliefs: (a) it’s plausible (even if false) that in order to know that I have hands I have to be able to epistemically neutralize, to some significant degree, some skeptical hypotheses, such as the brain-in-a-vat (BIV) one; and (b) it’s also plausible (even if false) that I can’t so neutralize those hypotheses. There is no reason for us to also think (c) that the BIV hypothesis, for instance, is plausible (...) or probably true. In order to take skepticism seriously it’s sufficient to hold (a) and (b); one need not hold (c). Indeed, philosophers who accept (a) and (b) never endorse (c). Show me a philosopher who suspects that he is a brain in a vat and I’ll show you someone who is deranged! That’s one thing that bothers undergraduates in philosophy. They object: why on earth do some philosophers take the BIV hypothesis to pose any threat at all to our beliefs given that those very same philosophers think that there’s no real chance that the BIV hypothesis is true? Sure, the BIV hypothesis is formally inconsistent with my belief that I have hands, so if the former is true then my belief is false. But so what? Why should that bare inconsistency matter so much? Is this strange attitude amongst philosophers the result of some logic fetish infecting the philosophical community? It is sometimes said that the skeptical hypotheses are not only inconsistent with our beliefs but are explanatory of our experiences, which is supposed to make them more of a threat. But students aren’t fooled: although the skeptical hypotheses may attempt to explain why our experience is as it is, it’s the kind of attempt appropriate for science fiction movies that are all special effects and virtually no plot. No one with any sense of reality will take the evil demon hypothesis to be even tenuously explanatory. (shrink)

Problems Section. Problem 3 by Richard Sharvy. Solution to Problems 1 and 2 from previous issue (3:1).

We often say that one reason is stronger, or weightier, than another. These are metaphors. What does normative strength or weight really consist in? Scanlon (2014) offers a novel answer to this question. His answer appeals to counterfactuals of various kinds. I argue that appealing to counterfactuals leads to deep problems for his view.

The purpose of this article is to investigate how cultural meanings associated with the left ventricular assist device inform acceptance and experience of this innovative technology when it is used as a destination therapy. We conducted open-ended, semistructured interviews with family caregivers and patients who had undergone LVAD-DT procedures at six U.S. hospitals. A grounded theory approach was used for the analysis. Thirty-nine patients and 42 caregivers participated. Participants described a sense of obligation to undergo the procedure because of its (...) promise for salvation. However, once the device was implanted, patients described being placed into a liminal state of being neither sick nor healthy, with no culturally scripted role. Consideration of end-of-life decisions was complicated by the uncertainties about how patients with LVADs die. Pre-implantation communications among patient, family, and clinicians should take into account the impact of the technology on meaning, identity, and patient experience. (shrink)

A different picture of learning is suggested by Karl Popper's account of knowledge growing through 'conjectures and refutations'. The facts of human language are best explained by taking language acquisition to be a case of Popperian learning.

In exploring the nature of excess relative to a phenomenology of the limit, Testing the Limit claims that phenomenology itself is an exploration of excess. What does it mean that "the self" is "given"? Should we see it as originary; or rather, in what way is the self engendered from textual practices that transgress—or hover around and therefore within—the threshold of phenomenologial discourse? This is the first book to include Michel Henry in a triangulation with Derrida and Levinas and the (...) first to critique Levinas on the basis of his interpolation of philosophy and religion. Sebbah claims that the textual origins of phenomenology determine, in their temporal rhythms, the nature of the subjectivation on which they focus. He situates these considerations within the broader picture of the state of contemporary French phenomenology (chiefly the legacy of Merleau-Ponty), in order to show that these three thinkers share a certain "family resemblance," the identification of which reveals something about the traces of other phenomenological families. It is by testing the limit within the context of traditional phenomenological concerns about the appearance of subjectivity and ipseity that Derrida, Henry, and Levinas radically reconsider phenomenology and that French phenomenology assumes its present form. (shrink)