My strategy is to examine a recent trend in philosophical discussions of responsibility, a trend that tries, but I think ultimately fails, to give an acceptable analysis of the conditions of responsibility. It fails due to what at first appear to be deep and irresolvable metaphysical problems. It is here that I suggest that the condition of sanity comes to the rescue. What at first appears to be an impossible requirement for responsibility---the requirement that the responsible agent have created her- (...) or himself---turns out to be the vastly more mundane and non controversial requirement that the responsible agent must, in a fairly standard sense, be sane. (shrink)

The Rejected Body argues that feminist theorizing has been skewed toward non-disabled experience, and that the knowledge of people with disabilities must be integrated into feminist ethics, discussions of bodily life, and criticism of the cognitive and social authority of medicine. Among the topics it addresses are who should be identified as disabled; whether disability is biomedical, social or both; what causes disability and what could 'cure' it; and whether scientific efforts to eliminate disabling physical conditions are morally justified. Wendell (...) provides a remarkable look at how cultural attitudes towards the body contribute to the stigma of disability and to widespread unwillingness to accept and provide for the body's inevitable weakness. (shrink)

In this paper, I treat the question of the meta-axiological standing of Nietzsche's own values, in the service of which he criticizes morality. Does Nietzsche, I ask, regard his perfectionistic valorization of human excellence and cultural flourishing over other ideals to have genuine evaluative standing, in the sense of being correct, or at least adequate to a matter-of-fact? My goal in this paper is modest, but important: it is not to attribute to Nietzsche some sophisticated meta-axiological view, because I am (...) doubtful that he has one. It is, however, to show that Nietzsche's texts do not necessitate the sceptical meta-axiological positions that have been attributed to him in the recent secondary literature. And it is thereby to suggest that we need not give up on the idea that Nietzsche takes the values he champions to have genuine evaluative standing – not because he has some sophisticated realist theory to this effect, but in a more philosophically unreflective way. (shrink)

: Chronic illness is a major cause of disability, especially in women. Therefore, any adequate feminist understanding of disability must encompass chronic illnesses. I argue that there are important differences between healthy disabled and unhealthy disabled people that are likely to affect such issues as treatment of impairment in disability and feminist politics, accommodation of disability in activism and employment, identification of persons as disabled, disability pride, and prevention and "cure" of disabilities.

Bioethics has paid surprisingly little attention to the special problems faced by women and to feminist analyses of current health care issues other than ...

The legal environment -- Regulation of nursing practice -- Nurses in legal actions -- Standards of care -- Defenses to negligence or malpractice -- Prevention of malpractice -- Nurses as witnesses -- Professional liability insurance -- Accepting or refusing an assignment/patient abandonment -- Delegation to unlicensed assistive personnel -- Patients' rights and responsibilities -- Confidential communication -- Competency and guardianship -- Informed consent -- Refusal of treatment -- Pain control -- Patient teaching and health counseling -- Medication administration -- Clients (...) with AIDS and HIV testing -- Abusive situations -- Reproductive services -- Restraints -- Emergency psychiatric admissions -- Organ and tissue donation and transplantation -- Discharge against medical advice -- The medical record and documentation standards -- Electronic health information and communications -- Interdependent nursing functions: verbal orders and telenursing -- Event reporting and compliance -- Quality and safety in nursing practice -- Forensic issues -- Employer and employee rights -- Contracts -- Corporate liability -- Employment contracts and unionization -- Employment status liability -- Staffing issues and floating -- Americans with Disabilities Act -- Employees with AIDS/HIV infection and exposure to bloodborne pathogens -- Impaired nurses -- Sexual harassment in the workplace -- Violence in the workplace -- Intentional torts -- Environmental health and safety -- Ethical decision making -- Professional boundaries and patient relationships -- Moral courage and patient advocacy -- Social media and online professionalism -- Reporting illegal, unethical, or unsafe conduct -- Maternal versus fetal rights -- Futility of care -- Advance directives and end-of-life decisions -- Assisted suicide. (shrink)

Background Dynamic consent has been proposed as a process through which participants and patients can gain more control over how their data and samples, donated for biomedical research, are used, resulting in greater trust in researchers. It is also a way to respond to evolving data protection frameworks and new legislation. Others argue that the broad consent currently used in biobank research is ethically robust. Little empirical research with cohort study participants has been published. This research investigated the participants’ opinions (...) of adding a dynamic consent interface to their existing study. Methods Adult participants in the Extended Cohort for E-health, Environment and DNA longitudinal cohort study who are members of the EXCEED Public and Participant Engagement Group were recruited. Four focus groups were conducted and analysed for thematic content. Discussion topics were derived from a review of the current literature on dynamic consent. Results Participants were in favour of many aspects of a dynamic consent interface, such as being able to update their information, add additional data to their records and choose withdrawal options. They were supportive provided it was simple to use and not intrusive. Participants expressed a markedly high level of trust in the study and its investigators and were unanimously happy with their current participation. No strong support was found for adding a dynamic consent interface to EXCEED. Conclusions Trust in the study researchers was the strongest theme found. Openness and good data security were needed to retain their trust. While happy to discuss dynamic consent, participants were satisfied with the current study arrangements. There were indications that changing the study might unnecessarily disturb their trust. This raised the question of whether there are contexts where dynamic consent is more appropriate than others. This study was limited by the small number of participants who were committed to the study and biased towards it. More research is needed to fully understand the potential impact of adding a dynamic consent interface to an existing cohort study. (shrink)

In 1872 Nietzsche shocked the European philological community with the publication of the Birth of Tragedy. In this fervid first book Nietzsche looked to ancient Greek culture in the hope of finding the path to a revitalization of modern German culture. Cultural health was at this point unquestionably his paramount concern. Yet postwar Nietzsche scholarship has typically held that after his Untimely Meditations which followed soon after, Nietzsche’s philosophy took a sharply individualist turn—an interpretation largely due to Walter Kaufmann’s noble (...) and influential effort to counter the Nazi appropriation of Nietzsche by stressing Nietzsche’s anti-political individualism and downplaying his seemingly more noxious Kulturphilosophie. But even after Nietzsche gave up on the idea of German culture as something blessed with inner truth and greatness and Nietzsche gave up on the idea of German culture as something blessed with inner truth and greatness and pregnant with the potential for renewed splendor–heaping scorn instead on the Germans and their newly-founded Reich–he still, I argue, continued to take culture, as a collective social achievement, to be something of prime importance. Indeed, it is for this reason that he took the flourishing of great individuals–especially artists and intellectuals–to be vital. Their singularity and their excellence redeems the decadent cultural landscape from the bovine blight of the “last man” and the self-satis!ed, uncreative, and barren mediocrity he represents. My dissertation uses Nietzsche’s perfectionistic ideal of a flourishing culture as a point of departure for investigating many of the central themes in his work: his criticism of the ideals enshrined in conventional morality; his attack on Christianity; his celebration of individual human excellence and cultural accomplishment; his lamentations about cultural decline; his troubling remarks about the need for slavery (“in some sense or other”) if a society is to flourish; and his grand ambitions for a “revaluation of all values.”. (shrink)

Nietzsche famously discusses a psychological condition he calls ressentiment, a condition involving toxic, vengeful anger. I offer a free-standing theory in philosophical psychology of the familiar...

Can a person ever occurrently believe p and yet have the simultaneous, occurrent belief q that this very belief that p is false? Surely not, most would say: that description of a person’s epistemic economy seems to misunderstand the very concept of belief. In this paper I question this orthodox assumption. There are, I suggest, cases where we have a first-order mental state m that involves taking the world to be a certain way, yet although we ourselves acknowledge that we (...) are in m, we reflectively disavow m’s propositional content. If such an epistemic stance is possible, does this irrationally persistent first-order state m really deserve the title of belief, or should it instead be classified under some other, less doxastic appellation? I argue in this paper that the belief terminology is warranted, and thus, that we can be correctly described as having the second-order belief that a specific first-order belief that we nonetheless continue to hold is false. In such cases, our first-order state is what I refer to as a naughty belief. Like naughty toddlers, naughty beliefs are recalcitrant in the face of epistemic authority. (shrink)

Health is a central concept in Nietzsche’s work. Yet in the most philosophically sophisticated secondary literature on Nietzsche, there has been fairly little sustained treatment of just what Nietzschean health consists in. In this paper, I aim to provide an account of some of the central marks of this health: resilience, discipline, vitality, a certain positive condition of the will to power, a certain tendency toward integration, and so on. This exposition and discussion will be the main task of the (...) paper. Then in the concluding section of the paper, I consider a line taken in some related secondary literature, which would suggest that health might ultimately be understood in formal or dynamic terms, relating to one’s will to power and/or the unity of one’s drives. I will present the beginnings of an argument against such an account of health. In focusing on the formal and dynamic side exclusively, it cannot get the full story. In particular, it seems to me to miss the substantive dimension that is essential if we are to understand health properly. As I shall suggest, the core concept of Nietzschean health is not fully explicable except by reference to normative terms. (shrink)

In the Infamous Opening Sections from Part IX of Beyond Good and Evil, Nietzsche celebrates a strident kind of elitism and countenances, in however attenuated a form, the institution of slavery. “Every enhancement of the type ‘man,’” he writes, “has so far been the work of an aristocratic society—and it will be so again and again—a society that believes in the long ladder of an order of rank and difference in worth [Werthverschiedenheit] between man and man, and that needs slavery (...) [Sklaverei] in some sense or other” (257). In the section that follows, Nietzsche describes a “good and healthy aristocracy” as “accept[ing] with a good conscience the sacrifice of untold human beings who, for its sake [um ihretwillen] .. (shrink)

Nihilism is one of Nietzsche’s foremost philosophical concerns. But characterizing it proves elusive. His nihilists include those in despair in the wake of the “death of God.” Yet they also include believing Christians. We have, among these nihilists, those fervently committed to frameworks of cosmic meaning. But we also have those who lack any such commitment, epitomized in the “last man.” We have those who want to escape this life. And we have those who wouldn’t dream of such a prospect. (...) Extant accounts have shed helpful light on the particularities of these various manifestations of nihilism. Yet they have not explained what ties these together. In this paper, I propose a unifying thread. Nihilists, on my reading of Nietzsche, are those who have come unmoored from the most important values. That is not to say that there is nothing more to nihilism than being wrong. But it is to say that we don’t understand Nietzschean nihilism fully if we just focus on the descriptive psychology of valuers. The unifying thread of Nietzschean nihilism, on my reading, in fact turns out to be structurally similar to the familiar idea of it we get in a number of other 19th century thinkers and authors—and ironically with those moralists who brand Nietzsche himself a nihilist. Where he differs from them is not in his account of what nihilism fundamentally is, but in the values he sees nihilists as having come unmoored from. (shrink)

Re-consent in research, the asking for a new consent if there is a change in protocol or to confirm the expectations of participants in case of change, is an under-explored issue. There is little clarity as to what changes should trigger re-consent and what impact a re-consent exercise has on participants and the research project. This article examines applicable policy statements and literature for the prevailing arguments for and against re-consent in relation to longitudinal cohort studies, tissue banks and biobanks. (...) Examples of re-consent exercises are presented, triggers and non-triggers for re-consent discussed and the conflicting attitudes of commentators, participants and researchers highlighted. We acknowledge current practice and argue for a greater emphasis on ‘responsive autonomy,’ that goes beyond a one-time consent and encourages greater communication between the parties involved. A balance is needed between respecting participants' wishes on how they want their data and samples used and enabling effective research to proceed. (shrink)

It is a truism that Nietzsche is a critic of morality. But what does Nietzsche have against this institution of morality? I consider the prominent interpretation of Brian Leiter’s that Nietzsche takes morality to task for its bad effects in hampering the flourishing of great individuals and cultures. There are good reasons, I argue, to resist this reading as the best, and certainly as the exclusive, account of the grounds for Nietzsche’s criticism of morality. I go on to propose an (...) alternative construal that sees Nietzsche as objecting to the expressive character of moral values themselves . My project, in the first instance, is the exegetical one of understanding what is going on in Nietzsche’s texts when he criticizes morality. Nonetheless, there are important philosophical lessons to be learned here from Nietzsche’s work, if not necessarily about the actual failings of morality itself, the.. (shrink)

Is there a distinctively artistic value that works of art have over and above their aesthetic value? No, Dominic McIver Lopes claims in a recent paper. He canvases various non-aesthetic options for underwriting artistic value. Yet he dispenses too quickly with a promising account of artistic value that would look to the artwork's status as an achievement as the basis of its value: On this achievement-based view, the value of the work of art as art (that is, its distinctively artistic (...) value) consists in the artistically-relevant achievement that it itself constitutes. While I will not seek to vindicate the achievement view itself, I do want to show that Lopes's arguments against it are unsound. Moreover, I argue that Lopes's claim that artistic value might be nothing over and above aesthetic value is untenable, unless it is supplemented by the more basic claim that the aesthetic value in question is something achieved by an artist. Lopes's argument thus only works if he makes recourse to the achievement conception of artistic value that he is keen to reject. (shrink)

Where research was once strictly confined to one laboratory or office, investigators now widely share and compare their plans, analyses, and results. With the advent of genomic knowledge, researchers are seeking to understand the genetics and genomics of complex human disease. They are combining their efforts into international consortia in order to take on problems that face individuals around the world, such as cancer and malaria — problems that are too large to solve by one country alone. These consortia bring (...) together diverse research groups from different parts of the world to focus on a common goal. Their projects may all focus on one disease or condition, but examine it from different perspectives and share the newly gained information with each other and the wider scientific community. (shrink)

Proponents of actual intentionalism hold that an author’s actual intentions should constrain the proper interpretation of his or her works. If, for example, we have good reason to think Proust intends his character Marcel to set out to write a different novel from In Search of Lost Time itself, then that is how we should interpret the text. After decades of being denigrated as the ‘intentional fallacy’, actual intentionalism has enjoyed a renaissance in philosophical aesthetics in recent years, thanks in (...) large part to the image of the conversation that has been enlisted in its favour: when we neglect the author’s intended construal of the text and opt instead for some clever alternative interpretation of our own, we are depriving ourselves of the chance to engage in a conversation (in some metaphorical sense) with this author—and thus are losing the chance (again, in some metaphorical sense) to commune with another human being. In this paper I will raise doubts about whether this appeal to conversation actually helps the actual intentionalist’s case. When we reflect on the essentially interactive nature of any conversation worthy of that name, we see that this conversation metaphor will not deliver the restrictive lesson of actual intentionalism. In fact, it militates against it. (shrink)

Book synopsis: The first full and sustained discussion of Parfit's views on objectivity in ethics Leading philosophers respond to Parfit's criticisms and advance our understanding of the arguments An essential companion volume to Parfit's On What Matters, Volume Three In the first two volumes of On What Matters Derek Parfit argues that there are objective moral truths, and other normative truths about what we have reasons to believe, and to want, and to do. He thus challenges a view of the (...) role of reason in action that can be traced back to David Hume, and is widely assumed to be correct, not only by philosophers but also by economists. In defending his view, Parfit argues that if there are no objective normative truths, nihilism follows, and nothing matters. He criticizes, often forcefully, many leading contemporary philosophers working on the nature of ethics, including Simon Blackburn, Stephen Darwall, Allen Gibbard, Frank Jackson, Peter Railton, Mark Schroeder, Michael Smith, and Sharon Street. Does Anything Really Matter? gives these philosophers an opportunity to respond to Parfit's criticisms, and includes essays on Parfit's views by Richard Chappell, Andrew Huddleston, Katarzyna de Lazari-Radek and Peter Singer, Bruce Russell, and Larry Temkin. A third volume of On What Matters, in which Parfit engages with his critics and breaks new ground in finding significant agreement between his own views and theirs, is appearing as a separate companion volume. (shrink)

The past decade and a half has seen a considerable flowering of interest in Nietzsche’s metaethics. In this time, Nietzsche has been presented with nearly as wide a range of views in metaethics as there are exegetical options on the table—views ranging from nihilism to subjective realism to expressivism to fictionalism to objective realism to, most recently, constructivism and constitutivism. Interpreters must square Nietzsche’s apparently skeptical remarks about the objectivity of value with his seeming commitment to a certain privileged set (...) of values, in light of which he purports to “revalue” the values of the moral tradition. Is this apparent commitment nothing more than rhetorical bluster? Or does he think... (shrink)

In this book, Susan Mendus seeks to address these important questions to assess whether this apparent tension between morality and politics is real and, if so, ...

Does Spinoza present philosophy as the preserve of an elite, while condemning the uneducated to a false though palliative form of ‘true religion’? Some commentators have thought so, but this contribution aims to show that they are mistaken. The form of religious life that Spinoza recommends creates the political and epistemological conditions for a gradual transition to philosophical understanding, so that true religion and philosophy are in practice inseparable.

[ Susan Hurley] I argue that the aim to neutralize the influence of luck on distribution cannot provide a basis for egalitarianism: it can neither specify nor justify an egalitarian distribution. Luck and responsibility can play a role in determining what justice requires to be redistributed, but from this we cannot derive how to distribute: we cannot derive a pattern of distribution from the 'currency' of distributive justice. I argue that the contrary view faces a dilemma, according to whether (...) it understands luck in interpersonal or counterfactual terms. /// [Richard J. Arneson] Does it make sense to hold that, if it is bad that some people are worse off than others, it is worse if those who are worse off come to be so through sheer bad luck that it is beyond their power to control? In her contribution to this symposium, Susan Hurley cautions against a closely related fallacy: from the fact that people have come to an unequal condition through unchosen bad luck, it does not follow that, if we aim to undo the influence of unchosen luck, we ought to institute equality of condition. Forswearing the fallacy that Hurley analyses is compatible with answering the question affirmatively, and more generally with holding that principles of distributive justice should be sensitive to the distinction between chosen and unchosen bad luck. This essay explores how this might be done. (shrink)

Most answers to the mind-body problem are claims about the nature of mental properties and substances. But advocates of non-reductive physicalism have generally neglected the topic of the nature of substance, quickly nodding to the view that all substances are physical, while focusing their intellectual energy on understanding how mental properties relate to physical ones. Let us call the view that all substances are physical or are exhaustively composed of physical substances substance physicalism (SP). Herein, I argue that non-reductive physicalism (...) (NRP) cannot uphold substance physicalism and is thereby false. For NRP faces a mind problem: its commitment to property irreducibility prevents that which bears the mental properties—the mind, or on some views, the self or person—from being a physical thing. (shrink)