None of us will escape the experience of personal loss, illness, aging, or mortality. Yet, psychoanalysis seems to shy away from a discussion of these core human experiences. Existential vulnerability is painful and we all avoid this awareness in different ways. However, when analysts fail to explore the topic of mortality, their own and their patients, they may foreclose an important exploration and short-change patient and therapist. _Entering Night Country_ focuses on the existential condition, and explores how it penetrates professional (...) lives, analytic work, and theoretical formulations. Each chapter explores this topic, shifting the lens from analytic process, to include theoretical assumptions, and professional communities. _Stephanie Brody_ shows how the analytic process is a journey, no less profound than the epic journeys depicted in the classic literature of Homer and repeated in the patient’s own heroic and painful stories. Weaving literary references into the clinical experience of psychoanalysis, Brody reveals the transformative power of the analytic process for the patient and for the analyst. By relating the ancient past to our current struggles, psychoanalyst and patient together are guided to a destination, a life of meaning in the universe of possibilities. Clinical vignettes and personal reflections intersect with motifs from the epic poems and fantasy fiction, where the despair of loss and trauma do not extinguish the wish for change and the search for intimacy. __Entering Night Country__ highlights the common themes that arise for patient and analyst as any person entering an unknown territory. It is intended for psychoanalysts, psychoanalytically oriented psychotherapists, and mental health clinicians. It will also be accessible to those outside the clinical profession, even to individuals who have little understanding of psychoanalysis. (shrink)

2020 Gradiva Award Nominee, Best Edited Book Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership considers how these factors can be understood, nurtured, or thwarted and the subsequent impact on women's identity, authority and satisfaction. Psychoanalysis has long struggled with its ideas about women, about who they are, how to work with them, and how to respect and encourage what women want. This book argues that psychoanalytic theory and practice must evolve to maintain its relevance in (...) a volatile landscape. Each section of the book begins with a chapter that reviews contemporary ideas regarding women, as well as psychoanalytic history, gender bias, and societal norms and deficits. Three composite clinical stories allow our distinguished contributors to discuss the contexts within which individual experience can be affected, and the role that clinical work may have to mobilize and advance passion and vitality. In their discussions, the interplay of clinical psychoanalysis, sociopolitical context, and understanding of gender, combine to offer a unique perspective, built on decades of scholarship, personal experience, and clinical expertise. Psychoanalytic Perspectives on Women and Their Experience of Desire, Ambition and Leadership will serve as a reference for all psychoanalysts and psychoanalytic psychotherapists as well as gender studies scholars interested in the progress of psychoanalytic theory regarding women in the 21st century. Contributors to this book include: Rosemary Balsam, Brenda Bauer, Andrea Celenza, Diane Elise, Adrienne Harris, Dorothy Holmes, Nancy Kulish, Vivian Pendar, Dionne Powell, and Arlene Richards. (shrink)

In recent years, bioethics has increasingly become an international area of inquiry with major contributions being made not only in North America but also in Europe and in the Pacific Rim countries. This general observation is particularly true for research ethics. Little attention has been paid, however, to this internationalization of bioethics in general and research ethics in particular, and there are few studies comparing what has emerged in the different countries.

Restraint as an intervention in the management of acute mental distress has a long history that predates the existence of psychiatry. However, it remains a source of controversy with an ongoing debate as to its role. This article critically explores what to date has seemingly been only implicit in the debate surrounding the role of restraint: how should the concept of validity be interpreted when applied to restraint as an intervention? The practice of restraint in mental health is critically examined (...) using two post-positivist constructions of validity, the pragmatic and the psychopolitical, by means of a critical examination of the literature. The current literature provides only weak support for the pragmatic validity of restraint as an intervention and no support to date for its psychopolitical validity. Judgements regarding the validity of any intervention that is coercive must include reference to the psychopolitical dimensions of both practice and policy. (shrink)

Moral duties are regularly attributed to groups. Does this make conceptual sense or is this merely political rhetoric? And what are the implications for these individuals within groups? Collins outlines a Tripartite Model of group duties that can target political demands at the right entities, in the right way and for the right reasons.

The focus of this paper is the syntax of inverse scope in Hungarian, a language that largely disambiguates quantifier scope at spell-out. Inverse scope is attributed to alternate orderings of potentially large chunks of structure, but with appeal to base-generation, as opposed to nonfeature-driven movement as in Kayne 1998. The proposal is developed within mirror theory and conforms to the assumption that structures are antisymmetrical. The paper also develops a matching notion of scope in terms of featural domination, as opposed (...) to c-command, and applies it to otherwise problematic cases of pied piping. Finally, the interaction of different quantifier types is examined and the patterns are explained invoking morphological considerations on one hand and A-bar reconstruction on the other. (shrink)

The ethics of care has flourished in recent decades yet we remain without a succinct statement of its core theoretical commitment. This book uses the methods of analytic philosophy to argue for a simple care ethical slogan: dependency relationships generate responsibilities. It uses this slogan to unify, specify and justify the wide range of views found within the care ethical literature.

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

Among those who criticize the concept of a common refrain is that we really have no idea what futility means. For example, physicians seem to disagree on whether a treatment being futile means that it has a less than 5% chance of working or a 20% chance of working. If the concept is so unclear, then it seems a thin reed upon which to base a momentous ethical decision—namely, that the physician's judgment should be allowed to override the wishes of (...) the competent patient or the patient's duly appointed surrogate. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

Organizations do moral wrong. States pursue unjust wars, businesses avoid tax, charities misdirect funds. Our social, political, and legal responses require guidance. We need to know what we’re responding to and how we should respond to it. We need a metaphysical and moral theory of wrongful organizations. This book provides a new such theory, paying particular attention to questions that have been underexplored in existing debates. These questions include: where are organizations located as material objects in the natural world? What’s (...) the metaphysical relation between organizations and their members? Can organizations be blameworthy for attitudes and character traits, as well as for actions? What about feelings of guilt, remorse, and shame—can organizations feel these emotions and why does this matter? How and why are members implicated in organizations’ wrongs? How should organizations’ reparative costs be apportioned among members? The book answers these questions. It argues that organizations are material objects with humans as material parts—much like how a pizza is a material object with slices as material parts. This picture helps us make sense of organizations’ blameworthiness, including blame for organization-level actions, attitudes, and character traits. The book argues that organizations can experience moral self-awareness—a crucial component of guilt, remorse, and shame. Members can be implicated in organizations’ actions in numerous ways—and, it is argued, members’ level of implication should determine their share of organizations’ reparative burdens. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

On a Humean account, a person's reasons for action are determined by her desires---in the broadest sense of 'desires', that is, noncognitive pro-attitudes. In four essays, I defend this account against several prominent objections. The first essay addresses the concern that the Humean cannot account for rationalizing reasons . The next three essays concern justifying reasons : reasons for action that are more fully normative than those that merely make action intelligible. Instrumental reasons, prudential reasons, and intrinsic reasons are three (...) different sorts of reasons to which an agent can appeal in justifying her action. ;Each essay focuses on a specific attack against the Humean account. In the second essay I argue that the normatively of instrumental reasons is brute ; and that, contrary to the received view, this is compatible with Humeanism. In the third essay I consider prudential reasons and defend the Humean claim that all and only present concerns provide normative reasons for action. In the final essay I address the fundamental question considerations of deliberative relevance: what makes certain desires and considerations relevant to a specific decision-making context, that is, what puts them among a person's present active reasons. ;In addition to defending a broadly Humean account of practical reasons, I am concerned to expand the components of a plausible form of Humeanism. Specifically, I argue that desires alone are not always sufficient to ground an agent's reasons, and that affective states are sometimes also necessary. I call this view "thick Humeanism". In essays one and four especially, I urge that a central place be given to affective states in determining practical reasons. I also invoke recent studies in cognitive psychology to support my claims about the role of the emotions in practical deliberation. (shrink)

Research on ethical issues within food systems is often human-centric. As a consequence, animal-centric policy debates where regulatory decisions about food are being made tend to be overlooked by food scholars and activists. This absence was notable in the recent debates around Australia’s animal live export industry. Using Foucault’s tools, we explore how ‘food security’ is conceptualised and governed within animal cruelty policy debates about the live export trade. The problem of food security produced in these debates shaped Indonesians as (...) ‘victims’ of food insecurity due to the nation’s inability to produce sufficient quantities of protein. This understanding of the problem reproduced the dominant framing of food security as a problem for developing countries addressed by increasing global food production. The underlying premise uncritically accepted in Australia’s debates on live export trade was that intensive animal agriculture, and Australia’s live export trade specifically, were essential to alleviating global food insecurity. Drawing on our findings, we show how dominant representations of ‘food security’, and related regulatory and technological trajectories, flourish where alliances between animal and food activists, scholarship, and movements are weak. Accordingly, we argue for agri-food scholars to take up opportunities to contribute to the policy discussions about the treatment of animals to effectively expand the kinds of problems, solutions, and strategies of resistance produced in the discourses surrounding food system issues. (shrink)

All treatments, even those labeled as supportive, have burdens as well as benefits. Patients and their surrogates have the right to finally decide whether the offered treatment's cost-benefit calculation is acceptable.

While popular cultural representations portray the “new father” of the past two decades as more involved, more nurturing, and capable of coparenting, many argue that actual fathering conduct has not kept pace. Others, however, question the extent to which the culture of fatherhood does indeed support involved fathering and, if so, what this involvement entails. This study aims to contribute to the exploration of the culture of fatherhood through an analysis of a yearlong Canadian newspaper series dedicated to family issues. (...) Findings suggest that through representations of parental guilt, parental responsibility, work—family balance issues, and hegemonic masculinity, mothers continue to be positioned as primary parents. Support for father involvement, to the extent that it exists, occurs within the framework of fathers as part-time, secondary parents whose relationship with children remains less important than mothers'. (shrink)

An individual's health, genetic, or environmental-exposure data, placed in an online repository, creates a valuable shared resource that can accelerate biomedical research and even open opportunities for crowd-sourcing discoveries by members of the public. But these data become “immortalized” in ways that may create lasting risk as well as benefit. Once shared on the Internet, the data are difficult or impossible to redact, and identities may be revealed by a process called data linkage, in which online data sets are matched (...) to each other. Reidentification, the process of associating an individual's name with data that were considered deidentified, poses risks such as insurance or employment discrimination, social stigma, and breach of the promises often made in informed-consent documents. At the same time, re-ID poses risks to researchers and indeed to the future of science, should re-ID end up undermining the trust and participation of potential research participants. The ethical challenges of online data sharing are heightened as so-called big data becomes an increasingly important research tool and driver of new research structures. Big data is shifting research to include large numbers of researchers and institutions as well as large numbers of participants providing diverse types of data, so the participants’ consent relationship is no longer with a person or even a research institution. In addition, consent is further transformed because big data analysis often begins with descriptive inquiry and generation of a hypothesis, and the research questions cannot be clearly defined at the outset and may be unforeseeable over the long term. In this article, we consider how expanded data sharing poses new challenges, illustrated by genomics and the transition to new models of consent. We draw on the experiences of participants in an open data platform—the Personal Genome Project—to allow study participants to contribute their voices to inform ethical consent practices and protocol reviews for big-data research. (shrink)

The human labor and animal inputs required to manufacture meat products are kept physically and symbolically distanced from the consumer. Recently however, meatpacking plants received significant news media attention when they emerged as hotpots for COVID-19 — threatening workers’ health, requiring plants to slow production, and forcing farmers to euthanize livestock. In light of these disruptions, this research asks: how did news media frame the impact of COVID-19 on the meat industry, and to what extent is a process of _defetishization_ (...) observed? Examining a sample of 230 news articles from coverage of US meatpacking plants and COVID-19 in 2020, I find that news media largely attributes the cause for the spread of COVID-19 in meatpacking plants to the history of exploitative working conditions and business practices of the meat industry. By contrast, the solutions offered to address these problems aim at alleviating the immediate obstacles posed by the pandemic and returning to, rather than challenging, the status quo. These short-run solutions for complex issues demonstrate the constraints in imagining alternatives to a problem rooted in capitalism. Furthermore, my analysis shows that animals are only made visible in the production process when their bodies become a waste product. (shrink)

This chapter argues that the best way for a non-naturalist to explain why the normative supervenes on the natural is to claim that, while there are some sui generis normative properties whose essences cannot be fully specified in non-normative terms and do not specify any non-normative sufficient conditions for their instantiation, there are certain hybrid normative properties whose essences specify both naturalistic sufficient conditions for their own instantiation and sufficient conditions for the instantiation of certain sui generis normative properties. This (...) is the only metaphysical explanation for supervenience on offer, the chapter argues, that can both clearly maintain the pre-theoretical commitments of non-naturalism, and provide a metaphysical explanation not just for supervenience, but for all metaphysical necessities involving natural and normative properties. (shrink)

The Patient Self Determination Act of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient’s preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity. In general, patients are presumed to have DMC. A patient’s DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected. (...) Physicians and other healthcare professionals working in hospital settings where medical illness is frequently comorbid with depression, adjustment disorders, demoralization and suicidal ideation, can expect to encounter ethical tension when medically sick patients who are also depressed or suicidal request do not resuscitate orders. (shrink)

In this paper, I defend the view that the identity of indiscernibles could serve as an adequate basis for a general theory of identity. I then show how a theory of essentialism forces one to modify that general theory. In light of both the original and modified theory, I offer a new resolution of some of the classical and contemporary problems of personal identity.

Tversky and Koehler's support theory attempts to explain why probability judgments are affected by the manner in which formally similar events are described. Support theory suggests that as the explicitness of a description increases, an event will be judged to be more likely. In the present experiment, experienced decision-makers from large, international accounting firms were given case-specific information about an audit client and asked to provide a series of judgments regarding the perceived likelihood of events. Unpacking a hypothesis into four (...) formally equivalent hypotheses more than doubled its perceived likelihood. These results are largely consistent with support theory, extending its generalizability to applied contexts involving business professionals. Further, the paper finds that task-specific factors, a previously untested area, can also affect support theory interpretations. (shrink)

Individuals sometimes pass their duties on to collectives, which is one way in which collectives can come to have duties. The collective discharges its duties by acting through its members, which involves distributing duties back out to individuals. Individuals put duties in and get (transformed) duties out. In this paper we consider whether (and if so, to what extent) this general account can make sense of states' duties. Do some of the duties we typically take states to have come from (...) individuals having passed on certain individual duties? There are complications: states can discharge their duties by contracting fulfilment out to non-members; states seem able to dissolve the duties of non-members; and some of states' duties are not derived in this way. We demonstrate that these complicate, but do not undermine, the general account and its application to states. And the application has an interesting upshot: by asking which individuals robustly participate in this process of duty transfer-and-transformation with a given state, we can begin to get a grip on who counts as a member of that state. (shrink)

A surfeit of research confirms that people activate personal, affective, and conceptual representations when perceiving the states of others. However, researchers continue to debate the role of self–other overlap in empathy due to a failure to dissociate neural overlap, subjective resonance, and personal distress. A perception–action view posits that neural-level overlap is necessary during early processing for all social understanding, but need not be conscious or aversive. This neural overlap can subsequently produce a variety of states depending on the context (...) and degree of common experience and emotionality. We outline a framework for understanding the interrelationship between neural and subjective overlap, and among empathic states, through a dynamic-systems view of how information is processed in the brain and body. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

Business and Society Review, Volume 127, Issue S1, Page 283-298, Spring 2022.

Noninvasive, prenatal whole genome sequencing may be a technological reality in the near future, making available a vast array of genetic information early in pregnancy at no risk to the fetus or mother. Many worry that the timing, safety, and ease of the test will lead to informational overload and reproductive consumerism. The prevailing response among commentators has been to restrict conditions eligible for testing based on medical severity, which imposes disputed value judgments and devalues those living with eligible conditions. (...) To avoid these difficulties, we propose an unrestricted testing policy, under which prospective parents could obtain information on any variant of known significance after a careful informed consent process that uses an interactive decision aid to deliver a mandatory presentation on the purposes, techniques, and limitations of genomic testing, as well as optional resources for reflection and consultation. This process would encourage thoughtful, informed deliberation... (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

Unconsented pelvic exams under anesthesia are assaults cloaked in defense of healthcare education. Preemptive linguistic qualifiers “presumed” or “implied” attempt to justify such violations with flippancy toward their oxymoronic implications: to suggest a priori that consent can be assumed undermines its otherwise standalone social, ethical, and medico-legal reverence. In this paper I conceptualize “medical sexual assault” and argue that presumed consent for intimate exams exemplifies its definition. By bluntly describing pelvic exams as “penetration,” this work aims to reify the intimate (...) reality of the clinical label “pelvic exam” and to call attention to cisheteronormative and androcentric assumptions involved in its practice. Additionally, this scholarship seeks to create a foundation toward broader work in conceptualizing clinical rape culture. Given recent national survey data indicating a surprising frequency of unconsented intimate exams, detailed language as to their problematics is necessary for ongoing legal and ethical efforts. Explicit consent for intimate exams must be the standard of care for conscious and unconscious patients. (shrink)

In the third Critique Kant details an aesthetic operation of judgment that is surprising considering how judgment functioned in the first Critique. In this book, I defend an understanding of Kant’s theory of Geschmacksurteil as detailing an operation of the faculties that does not violate the cognitive structure laid out in the first Critique. My orientation is primarily epistemological, elaborating the determinations that govern the activity of pure aesthetic judging that specify it as a "bestimmte" type of judgment without transforming (...) it into "ein bestimmendes Urteil". I focus on identifying how the logical functions from the table of judgments operate in the pure aesthetic judgment of taste to reveal "the moments to which this power of judgment attends in its reflection". In the course of doing so, a picture emerges of how the world is not just cognizable in a Kantian framework but also charged with human feeling, acquiring the inexhaustible, inchoate meaningfulness that incites "much thinking". The universal communicability of aesthetic pleasure serves as the foundation that grounds robust intersubjective relations, enabling genuine connection to others through a shared a priori feeling. (shrink)

There is currently little empirical information about attitudes towards cognitive enhancement - the use of pharmaceutical drugs to enhance normal brain functioning. It is claimed this behaviour most commonly occurs in students to aid studying. We undertook a qualitative assessment of attitudes towards cognitive enhancement by conducting 19 semi-structured interviews with Australian university students. Most students considered cognitive enhancement to be unacceptable, in part because they believed it to be unethical but there was a lack of consensus on whether it (...) was similar or different to steroid use in sport. There was support for awareness campaigns and monitoring of cognitive enhancement use of pharmaceutical drugs. An understanding of student attitudes towards cognitive enhancement is important in formulating future policy. (shrink)

Which kinds of responsibility can we attribute to which kinds of collective, and why? In contrast, which kinds of collective responsibility can we not attribute—which kinds are ‘gappy’? This study provides a framework for answering these questions. It begins by distinguishing between three kinds of collective and three kinds of responsibility. It then explains how gaps—i.e. cases where we cannot attribute the responsibility we might want to—appear to arise within each type of collective responsibility. It argues some of these gaps (...) do not exist on closer inspection, at least for some collectives and some of the time. (shrink)

In this article, we examine how regulators, prosecutors, and courts might support and encourage the efforts of organizations to not only reintegrate after misconduct but also to improve their conduct in a way that reduces their likelihood of re-offense (rehabilitation). We explore a novel experiment in creative sentencing in Alberta Canada that aimed to try to change the behaviour of an industry by publicly airing the root causes of a failure of one the industry’s leaders. Drawing on this case and (...) prior work, we articulate a model for a responsive and restorative approach to organizational misconduct that balances the punitive role of regulators and courts with new roles in supporting and overseeing rehabilitation. (shrink)