In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand (...) on health care resources. If age were to become a limiting factor, as Dr. Callahan suggests it should, the limits that will be set are limits that will affect women more drastically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women. (shrink)

Many of the demands being voiced for a "humanizing" of health care center on the public's concern that they have some say In determining what happens to the individual in health care institutions. The essays in this volume address fundamental questions of conflicts of rights and autonomy as they affect four selected, controversial areas in health care ethics: the Limits of Professional Autonomy, Refusing! Withdrawing from Treatment, Electing "Heroic" Measures, and Advancing Reproductive Technology. Each of the topics is addressed in (...) such a way that it includes an examination of the locus of responsibility for ethical decision making. The topics are not intended to exhaustively review those areas of health care provision where conflicts of rights might be said to be an issue. Rather they constitute an examination of the difficulties so often encountered in these specific contexts that we hope will illuminate similar conflicts in other problem areas by raising the level of the reader's moral awareness. Many books in bioethics appeal only to a limited audience in spite of the fact that their subject matter is of deep personal concern to everyone. In part, this is true because they are frequently written from the perspective of a single discipline or a single profession. As a result, one is often left with the impression that such a book views the philosophical, historical, and! or theological problems as essentially indifferent to clinical, legal, and! or policy-making problems. (shrink)

In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand (...) on health care resources. If age were to become a limiting factor, as Dr. Callahan sug-gests it should, the limits that will be set are limits that will affect women more dras” tically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women. (shrink)

A series of letters between a professor of philosophy and an eleven-year-old girl.

Review of Alastair V. Campbell: Medicine, Health and Justice: The Problem of Priorities.

In Setting Limits, Daniel Callahan advances the provocative thesis that age be a limiting factor in decisions to allocate certain kinds of health services to the elderly. However, when one looks at available data, one discovers that there are many more elderly women than there are elderly men, and these older women are poorer, more apt to live alone, and less likely to have informal social and personal supports than their male counterparts. Older women, therefore, will make the heaviest demand (...) on health care resources. If age were to become a limiting factor, as Dr. Callahan suggests it should, the limits that will be set are limits that will affect women more drastically than they affect men. This review essay examines the implications of Callahan's thesis for elderly women. (shrink)

Epistemologies have power. They have the power not only to transform worlds, but to create them. And the worlds that they create can be better or worse. For many people, the worlds they create are predictably and reliably deadly. Epistemologies can turn sacred land into ‘resources’ to be bought, sold, exploited, and exhausted. They can turn people into ‘labor’ in much the same way. They can not only disappear acts of violence but render them unnamable and unrecognizable within their conceptual (...) architectures. Settler systems of epistemic and conceptual resources and the relations among them are constructed to preclude certain forms of knowledge. This is not an accident; it is a central goal of colonial violence. Colonization and land dispossession would not be possible without the violent disruption of Indigenous knowledge systems and ongoing organized attempts to disrupt their survival. Violently disrupting the relationships of people to land is as much an epistemic project as it is a material one, and these two projects are inherently linked. The task of theorizing epistemic oppression is not only about epistemic oppression. Epistemic oppression is a story that gives language to a phenomenon in order to get past it, to carry on with the maintaining and reviving the forms of Indigenous and diasporic knowledge that colonialism has worked tirelessly to corrupt and silence. (shrink)

The increasing use of cluster randomised trials in low-resource settings raises unique ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomised Trials is the first international ethical guidance document specific to cluster trials, but it is unknown if it adequately addresses issues in low-resource settings. In this paper, we seek to identify any gaps in the Ottawa Statement relevant to cluster trials conducted in low-resource settings. Our method is to analyse a prototypical cluster trial conducted (...) in a low-resource setting with the Ottawa Statement; to identify ethical issues in the design or conduct of the trial not captured adequately and to make recommendations for issues needing attention in forthcoming revisions to the Ottawa Statement. Our analysis identified six ethical aspects of cluster randomised trials in low-resource settings that require further guidance. The forthcoming revision of the Ottawa Statement should provide additional guidance on these issues: streamlining research ethics committee review for collaborating investigators who are affiliated with other institutions; the classification of lay health workers who deliver study interventions as health providers or research participants; the dilemma experienced by investigators when national standards seem to prohibit waivers of consent; the timing of gatekeeper engagement, particularly when researchers face funding constraints; providing ancillary care in health services or implementation trials when a routine care control arm is known to fall below national standards and defining vulnerable participants needing protection in low-resource settings. (shrink)

I Norge har vi hatt kontroverser omkring regulering avhumanmedisinsk bioteknologi siden 1980-tallet. Denneartikkelen analyserer et lite utsnitt av disse reguleringsdebattene,nærmere bestemt kontroversen omkring forskningpå befruktede egg. Med utgangspunkt i skriftlig materialeknyttet til tre reguleringsrunder undersøker vi her hvordan ulike aktører arbeidet forå ramme inn denne kontroversen, bl.a. ved hjelp av ulikevitenskapelige og politiske representasjoner av det befruktedeegget.Vi finner at det i perioden 1987–2007 ble arbeidet medulike innramminger som utgangspunkt for retoriske ogpolitiske strategier: På den ene siden ser vi forsøk på (...) å innrammekontroversen i et risikorammeverk som først ogfremst fokuserte på de potensielle negative sidene vedhumanmedisinsk bioteknologi, og som spesielt vektlarespekten for det ufødte liv. På den andre siden ser vi atman arbeidet med en forventningsinnramming som lahovedvekten på håpet om nye behandlingsregimer foralvorlig syke mennesker.Forbudet mot forskning på befruktede egg som ble vedtatti 1987, ble opprettholdt i 1994 og 2003. Med lovendringeni 2008 fikk vi imidlertid et markant brudd i dennorske lovgivningspraksisen, da forskning på befruktedeegg ble tillatt på visse premisser. Vi argumenterer for at den viktigste årsaken til denne lovendringen var Mehmet-saken, en sak som medførtesåkalte «oversvømmelser» i begge innrammingsforsøkenesom er omtalt ovenfor. Mehmet-saken eksponerte samtidig et generelt demokratiskdilemma. Saken illustrerte hvor sårbare lovregler og etiske prinsippkan være for det som for allmennheten fremstår som helt urimelig, og dennesaken etterspør slik sett mer hybride måter å tenke forholdet mellom det universelleog det partikulære, mellom prinsipiell etikk og lekmannsskjønn, mellomfakta og verdier som utgangspunkt for politikkutforming.Nøkkelord: humanmedisinsk bioteknologi, forskning på befruktede egg,kontrovers, representasjoner, Mehmet-sakenEnglish abstract: Effective representations? Concerns and expectationsregarding research on fertilized eggsSince the 1980s, there have been several debates and controversies concerningthe regulation of medical biotechnology. In this article, we analyze three suchinstances in Norway, mainly the debates concerning research on fertilizedeggs. Analyzing the debates surrounding the regulations of 1994, 2003/2004and 2008, we investigate how different stakeholders strived to mobilize whatwe call different framings of the controversy, utilizing the different scientificand political representations of the fertilized egg.Framing involves creating baselines for rhetorical and political stratagems.Two framings appear more pronounced than others in the Norwegian debate.On one hand, we find attempts of framing the controversy in a risk centricframework, which mostly emphasizes the potential negative effects of medicalbiotechnology as it focuses on the universal reverence for the unborn life. Onthe other hand, we see attempts to mobilize a positive frame of expectationthat emphasizes on the hope of finding new and effective treatment options forthe severely ill.The ban against research on fertilized eggs that was passed in Norway in1987 was repeated in 1994 and 2003. However, with the changes introducedto the law in 2008, there was a noticeable shift in Norwegian legislation, asresearch on fertilized eggs became permissible if specific conditions were met.We argue that the turning point in this regulative change was the Mehmentcase, a particular case that entailed the so-called «overflowing» in both the negative and the positive frame. The Mehmet case exposed a moregeneral democratic and political dilemma. In our opinion, it illustrates howvulnerable can regulation that is based on general ethical principles be in theface of what appears to the laity as unreasonable. Thus, we argue that thisactualizes the need for more hybridized ways to view the relationship betweenthe universal and the particular, between principle-based ethics and theunderstandings of lay people, between facts, and values and actual cases inpolicy shaping and practice. (shrink)

[1] Elul. Yamim Noraʼim. Sukot -- [2] Pesaḥ. Shevuʻot. Galut u-geʼulot. Ḥanukah. Purim.

ha-R. ha-ḳ. R. Mosheh mi-Drogiṭshin -- ha-R. ha-ḳ. R. Avraham me-Ulinov -- ha-R. ha-ḳ. R. Shelomoh Leyb mi-Lenṭshna -- ha-R. ha-ḳ. R. Meʼir mi-Primishla -- ha-R. ha-ḳ. R. Avraham mi-Miḳalyov -- ha-R. ha-ḳ. R. Daṿid mi-Zovliṭov -- ha-R. ha-ḳ. R. Shmelḳe mi-Sasov -- ha-R. ha-ḳ. R. Yeshaʻy. Shor -- ha-R. ha-ḳ. R. Yeḥiʼel Mikhal.

The Mirror Game (MG) is a common exercise in dance/movement therapy and drama therapy. It is used to promote participants’ ability to enter and remain in a state of togetherness. In spite of the wide use of the MG by practitioners, it is only recently that scientists begun to use the MG in research, examining its correlates, validity and reliability. This study joins this effort by reporting on the identification of scale items to describe the nonverbal behaviour expressed during the (...) MG and its correlation to measures of attachment. Thus, we explored the application of the MG as a tool for assessing the embodiment of attachment in adulthood. Forty-eight participants (22 females, mean age = 33.2) played the MG with the same gender-matched expert players. All MG were videotaped. In addition, participants were evaluated on two central measurements of attachment in adulthood: The Adult Attachment Interview (AAI) and the Experience in Close Relationship questionnaire (ECR). To analyse the data, we developed the “mirror game scale” that coded the nonverbal behavior during the movement interaction, using 19 parameters. The sub-scales were reduced using factor analysis into two dimensions referred to as “together” and “free”. The free factor was significantly correlated to both measurements of attachment: Participants classified as having secure attachment on the AAI, received higher scores on the MG free factor than participants classified as insecure (t (46) = 7.858, p =.000). Participants who were high on the avoidance dimension on the ECR, were low on the MG free factor (r (48) =-.-285, p =.007). This is the first study to examine the MG as it is used by practitioners and its correlation to highly standardized measures. This exploratory study may be considered as part of the first steps of exploring the MG as a standardized assessment tool. The advantages of the MG as a simple, non-verbal movement interaction demonstrate some of the strengths of dance/movement and drama therapy practice. (shrink)

Epistemic exploitation occurs when privileged persons compel marginalized persons to educate them about the nature of their oppression. I argue that epistemic exploitation is marked by unrecognized, uncompensated, emotionally taxing, coerced epistemic labor. The coercive and exploitative aspects of the phenomenon are exemplified by the unpaid nature of the educational labor and its associated opportunity costs, the double bind that marginalized persons must navigate when faced with the demand to educate, and the need for additional labor created by the default (...) skepticism of the privileged. I explore the connections between epistemic exploitation and the two varieties of epistemic injustice that Fricker (2007) identifies, testimonial and hermeneutical injustice. I situate epistemic exploitation within Dotson’s (2012; 2014) framework of epistemic oppression, and I address the role that epistemic exploitation plays in maintaining active ignorance and upholding dominant epistemic frameworks. (shrink)

Structural gaslighting arises when conceptual work functions to obscure the non-accidental connections between structures of oppression and the patterns of harm they produce and license. This paper examines the role that structural gaslighting plays in white feminist methodology and epistemology using Fricker’s (2007) discussion of hermeneutical injustice as an illustration. Fricker’s work produces structural gaslighting through several methods: i) the outright denial of the role that structural oppression plays in producing interpretive harm, ii) the use of single-axis conceptual resources to (...) understand intersectional oppression, and iii) the failure to recognize the legacy of women of color’s epistemic resistance work surrounding the issue of sexual harassment in the workplace. I argue that Fricker’s whitewashed discussion of epistemic resistance to sexual harassment in the United States is a form of structural gaslighting that fails to treat women of color as knowers and exemplifies the strategic forgetting that is a central methodological tactic of white feminism. (shrink)

In 2023, online search engine provider Microsoft integrated a language model that provides direct answers to search queries into its search engine Bing. Shortly afterwards, Google also introduced a similar feature to its search engine with the launch of Google Gemini. This introduction of direct answers to search queries signals an important and significant change in online search. This article explores the implications of this new search paradigm. Drawing on Donna Haraway’s theory of _Situated Knowledges_ and Rainer Mühlhoff’s concept of (...) _Sealed Surfaces_, I introduce the term _Sealed Knowledges_ to draw attention to the increasingly difficult access to the plurality of potential answers to search queries through the output of a singular, authoritative, and plausible text paragraph. I argue that the integration of language models for the provision of direct answers into search engines is based on a de-situated and disembodied understanding of knowledge and affects the subjectivities of its users. At the same time, the _sealing of knowledges_ can lead to an increasing spread of misinformation and may make marginalized knowledge increasingly difficult to find. The paper concludes with an outlook on how to resist the increasing _sealing of knowledges_ in online search. (shrink)

[1] Pinḳas ha-ḳabalot -- [2] Talmidaṿ (2 v.) -- [3] ʻInyene Elul ṿe-Yamim Noraʼim -- [4] ʻInyene Ḥanukah u-Furim.

This paper argues that scientific realism commits us to a metaphysical determination relation between the mathematical entities that are indispensible to scientific explanation and the modal structure of the empirical phenomena those entities explain. The argument presupposes that scientific realism commits us to the indispensability argument. The viewpresented here is that the indispensability of mathematics commits us not only to the existence of mathematical structures and entities but to a metaphysical determination relation between those entities and the modal structure of (...) the physical world. The no-miracles argument is the primary motivation for scientific realism. It is a presupposition of this argument that unobservable entities are explanatory only when they determine the empirical phenomena they explain. I argue that mathematical entities should also be seen as explanatory only when they determine the empirical facts they explain, namely, the modal structure of the physical world. Thus, scientific realism commits us to a metaphysical determination relation between mathematics and physical modality that has not been previously recognized. The requirement to account for the metaphysical dependence of modal physical structure on mathematics limits the class of acceptable solutions to the applicability problem that are available to the scientific realist. (shrink)

Maternal insightfulness or the capacity to see things from the child’s point of view, is considered to be a crucial construct for therapeutic change. In the present study, we aimed to implement the knowledge gleaned from the studies on attachment theory and maternal insightfulness into clinical practice to create an intervention program for mothers of children-at-risk due to inadequate parental care. We used drama therapy to “practice” maternal insightfulness in more “experiential” ways, because the use of creative expressive means may (...) be accessible and effective for the target population of the study and help improve maternal care. We used a manualized 10-week drama therapy-group intervention, focusing on the core concepts of maternal insightfulness: insightfulness, separateness, complexity, and acceptance. We used various dramatic means to explore and experience these components of maternal insightfulness. Forty mothers of children-at-risk took part in eight groups of parental insightfulness drama therapy. To evaluate the efficacy of the intervention, we used the Insightfulness Assessment interview, which produces 10 scales and a final classification of PI and non-PI. The Child Behavior Check List was used to evaluate a change in children’s behavior problems. The assessment took place at three time points: before the intervention, right after the end of the intervention, and 6 months following the intervention. Results at T2 showed a significant improvement compared to T1 in some of the maternal insightfulness scales, but not in the maternal insightfulness categorical classification. At T3, there was a significant change in the classification of the mothers, from non-insightful to positively insightful. At T3, there was also a significant decline in the children’s externalized and general behavioral problems. The results of this study contribute to an evidence-based practice of using drama therapy in the treatment of mothers and children at risk. (shrink)

There is good reason to believe that scientific realism requires a commitment to the objective modal structure of the physical world. Causality, equilibrium, laws of nature, and probability all feature prominently in scientific theory and explanation, and each one is a modal notion. If we are committed to the content of our best scientific theories, we must accept the modal nature of the physical world. But what does the scientific realist’s commitment to physical modality require? We consider whether scientific realism (...) is compatible with Humeanism about the laws of nature, and we conclude that it is not. We specifically identify three major problems for the best-systems account of lawhood: its central concept of strength cannot be formulated non-circularly, it cannot offer a satisfactory account of the laws of the special sciences, and it can offer no explanation of the success of inductive inference. In addition, Humeanism fails to be naturalistically motivated. For these reasons, we conclude that the scientific realist must embrace natural necessity. (shrink)

Calls for civility have been on the rise recently, as have presumptions that civility is both an academic virtue and a prerequisite for rational engagement and discussion among those who disagree. One imperative of epistemic decolonization is to unmask the ways that familiar conceptual resources are produced within and function to uphold a settler colonial epistemological framework. I argue that rhetorical deployments of ‘civility’ uphold settler colonialism by obscuring the systematic production of state violence against marginalized populations and Indigenous peoples, (...) relying on the colonial conceptual framework of ‘civilized’ vs ‘savage’, and excusing death-promoting rhetoric under the guise of liberal disagreement. (shrink)

Recent developments in AI programming allow for new applications: individualized chatbots which mimic the speaking and writing behaviour of one specific living or dead person. ‘Deathbots’, chatbots of the dead, have already been implemented and are currently under development by the first start-up companies. Thus, it is an urgent issue to consider the ethical implications of deathbots. While previous ethical theories of deathbots have always been based on considerations of the dignity of the deceased, I propose to shift the focus (...) on the dignity and autonomy of the bereaved users of deathbots. Drawing on theories of internet-scaffolded affectivity and on theories of grief, I argue that deathbots may have a negative impact on the grief process of bereaved users and therefore have the potential to limit the emotional and psychological wellbeing of their users. Deathbot users are likely to become dependent on their bots which may make them susceptible to surreptitious advertising by deathbot providing companies and may limit their autonomy. At the same time, deathbots may prove to be helpful for people who suffer from prolonged, severe grief processes. I caution against the unrestricted usage of deathbots and suggest that they should be classified as medical devices. This classification would not the least mean that their non-harm, as well as their helpfulness for people suffering from prolonged grief needs to be proven and that their potential for autonomy infringements is reduced. (shrink)

This Element introduces major issues in the epistemology of experimental physics through discussion of canonical physics experiments and some that have not yet received much philosophical attention. The primary challenge is to make sense of how physicists justify crucial decisions made in the course of empirical research. Judging a result as epistemically significant or as calling for further technical scrutiny of the equipment is one important context of such decisions. Judging whether the instrument has been calibrated, and which data should (...) be included in the analysis are others. To what extent is it possible to offer philosophical analysis, systematization, and prescriptions regarding such decisions? To what extent can there be explicit epistemic justification for them? The primary aim of this Element is to show how a nuanced understanding of science in practice informs an epistemology of experimental physics that avoids strong social constructivism. (shrink)

Traditionally, empiricism has relied on the specialness of human observation, yet science is rife with sophisticated instrumentation and techniques. The present article advances a conception of empirical evidence applicable to actual scientific practice. I argue that this conception elucidates how the results of scientific research can be repurposed across diverse epistemic contexts: it helps to make sense of how evidence accumulates across theory change, how different evidence can be amalgamated and used jointly, and how the same evidence can be used (...) to constrain competing theories in the service of breaking local underdetermination. (shrink)

O livro em questão, O Pecado: do descrédito ao aprofundamento, é uma bela obra para pesquisa, estudo e ensino. O autor, além de denunciar o pecado, mostra caminhos de conversão e aponta valores que possam remir do pecado qualquer ser humano, independente de raça, crença, posição social ou religiosa.

Based on brain imaging findings, we present a model according to which addiction emerges as an imbalance in the information processing and integration among various brain circuits and functions. The dysfunctions reflect (a) decreased sensitivity of reward circuits, (b) enhanced sensitivity of memory circuits to conditioned expectations to drugs and drug cues, stress reactivity, and (c) negative mood, and a weakened control circuit. Although initial experimentation with a drug of abuse is largely a voluntary behavior, continued drug use can eventually (...) impair neuronal circuits in the brain that are involved in free will, turning drug use into an automatic compulsive behavior. The ability of addictive drugs to co‐opt neurotransmitter signals between neurons (including dopamine, glutamate, and GABA) modifies the function of different neuronal circuits, which begin to falter at different stages of an addiction trajectory. Upon exposure to the drug, drug cues or stress this results in unrestrained hyperactivation of the motivation/drive circuit that results in the compulsive drug intake that characterizes addiction. (shrink)

While the pursuitworthiness of philosophical ideas has changed over time, philosophical practice and methodology have not kept pace. The worthiness of a philosophical pursuit includes not only the ideas and objectives one pursues but also the methods with which one pursues them. In this paper, we articulate how empirical approaches benefit philosophy of science, particularly advocating for the use of qualitative methods for understanding the social and normative aspects of scientific inquiry. After situating qualitative methods within empirical philosophy of science, (...) we discuss how to adapt these traditionally sociological methods to empirically inform philosophical questions. Our aim is to normalize and legitimize qualitative methods for philosophical purposes and discuss how they can elucidate descriptive and normative components of scientific practice in a more generalizable non-idealized manner. We contend that qualitative methods are particularly well suited to philosophical interest in the social norms of science, their achievability, and their mutability. Furthermore, unlike more historical case studies in philosophy, qualitative methods enable more confidence in generalizability, albeit limited, from a concrete sample to a larger class. We conclude by addressing anxieties about the distinctness of empirical philosophy of science from social epistemology and from sociology of science. (shrink)

Privileged-perspective realism (PPR) is a version of metaphysical realism that takes certain irreducibly perspectival facts to be partly constitutive of reality. PPR asserts that there is a single metaphysically privileged standpoint from which these perspectival facts obtain. This chapter discusses several views that fall under the category of privileged-perspective realism. These include presentism, which is PPR about tensed facts, and non-multiverse interpretations of quantum mechanics, which the chapter argues, constitute PPR about world-indexed facts. Using the framework of the bird perspective (...) and the frog perspective, it argues that PPR views methodologically treat the frog perspective as metaphysically primary. This chapter considers case studies of metaphysical interpretations of special relativity and quantum mechanics in order to demonstrate that such motivations for PPR are non-naturalistic. Further, it considers psychological factors that motivate the appeal of PPR views and offers naturalistic explanations of why we should not expect them to produce an adequate metaphysics of science. (shrink)

In a recent editorial published in Nature, the journal's editors comment on a new automated software that has been used to check findings in psychology publications. The editors express concern with the way in which the anonymous fact-checkers have proceeded, but at the same time, they underscore the crucial role of peer criticism for scientific progress and insist: "self-correction is at the heart of science." Brief as it is, the editorial showcases that peer criticism and the application of norms of (...) good research practice are very thorny issues indeed.It is essential for the functioning of science that empirical findings, arguments, as well as methodological approaches are scrutinized... (shrink)

Causal structuralism is the view that, for each natural, non-mathematical, non-Cambridge property, there is a causal profile that exhausts its individual essence. On this view, having a property’s causal profile is both necessary and sufficient for being that property. It is generally contrasted with the Humean or quidditistic view of properties, which states that having a property’s causal profile is neither necessary nor sufficient for being that property, and with the double-aspect view, which states that causal profile is necessary but (...) not sufficient. Shoemaker’s (1998) and Hawthorne’s (2001) arguments in favor of causal structuralism primarily focus on problematic consequences of the other two views. I argue, however, that causation does not provide an appropriate framework within which to characterize all physical properties for two main reasons. First, there are physical properties that do not have causal profiles and properties whose causal profiles do not exhaust their essences. Second, there is no unified notion of causation across the sciences. After distinguishing between the causal and the nomological, I suggest that what is needed is a structuralist view of properties that is not merely causal but that incorporates a physical property’s higher-order mathematical and nomological properties into its identity conditions. Such a view retains the naturalistic motivations for causal structuralism while avoiding the problems it faces. (shrink)