Polemicists and disciplinary puritans commonly make a sharp distinction between the normative, “prescriptive,” philosophical work of bioethicists and the empirical, “descriptive” work of anthropologists and sociologists studying medicine, healthcare, and illness. Though few contemporary medical anthropologists and sociologists of health and illness subscribe to positivism, the legacy of positivist thought persists in some areas of the social sciences. It is still quite common for social scientists to insist that their work does not contain explicit normative analysis, offers no practical recommendations (...) for social reform or policy making, and simply interprets social worlds. (shrink)

Contemporary liberal democracies contain multiple cultural, religious, and philosophical traditions. Within these societies, different interpretive communities provide divergent models for understanding health, illness, and moral obligations. Bioethicists commonly draw upon models of moral reasoning that presume the existence of shared moral intuitions. Principlist bioethics, case-based models of moral deliberation, intuitionist frameworks, and cost-benefit analyses all emphasise the uniformity of moral reasoning. However, religious and cultural differences challenge assumptions about common modes of moral deliberation. Too often, bioethicists minimize or ignore the (...) existence of multiple traditions of moral inquiry. Careful consideration of the presence of multiple horizons for moral deliberation generates challenging questions about the capacity of bioethicists to effectively resolve complex cases and social policy disputes. (shrink)

For many individuals, religious traditions provide important resources for moral deliberation. While contemporary philosophical approaches in bioethics draw upon secular presumptions, religion continues to play an important role in both personal moral reasoning and public debate. In this analysis, I consider the connections between religious traditions and understandings of morality, medicine, illness, suffering, and the body. The discussion is not intended to provide a theological analysis within the intellectual constraints of a particular religious tradition. Rather, I offer an interpretive analysis (...) of how religious norms often play a role in shaping understandings of morality. While many late 19th and early 20th century social scientists predicted the demise of religion, religious traditions continue to play important roles in the lives of many individuals. Whether bioethicists are sympathetic or skeptical toward the normative claims of particular religious traditions, it is important that bioethicists have an understanding of how religious models of morality, illness, and healing influence deliberations within the health care arena. (shrink)

Scientists, bioethicists, and policy makers are currently engaged in a contentious debate about the scientific prospects and morality of efforts to increase human longevity. Some demographers and geneticists suggest that there is little reason to think that it will be possible to significantly extend the human lifespan. Other biodemographers and geneticists argue that there might well be increases in both life expectancy and lifespan. Bioethicists and policy makers are currently addressing many of the ethical, social, and economic issues raised by (...) life extension research. However, the emphasis on philosophical argument supporting or condemning efforts to increase human longevity means that much less attention is currently being given to the factors that might play a role in generating interest in efforts to increase human longevity. This analysis considers three factors that might play a role in heightening public interest in efforts to develop biomedical technologies capable of retarding or reversing aging processes. While discussions of life extension research can seem quite futuristic and impractical, there are some powerful existential factors that might well generate considerable public support for life extension strategies if effective biomedical interventions emerge. Rather than providing philosophical justifications supporting or condemning efforts to increase human longevity, this essay seeks to promote a better understanding of the factors generating contemporary interest in prolonging life and postponing death. (shrink)

Bioethicists recognize the conflicts of interest that can arise for clinicians and scientists. However, few scholars exploring the moral dimensions of medicine and the sciences publicly address potential conflicts of interest concerning their own research. Increasingly, however, bioethicists will be confronted with difficult choices in which opportunities to obtain funding will sometimes conflict with the pursuit of critical, rigorous scholarship conducted without regard for corporate interests.

Countries throughout Asia promote themselves as leading destinations for international travelers seeking inexpensive healthcare. India, Indonesia, Malaysia, Singapore, the Philippines, and Thailand are all trying to attract greater numbers of what their promotional campaigns call “medical tourists.” Government tourism initiatives, hospital associations, medical tourism companies, and individual hospitals advertise hip and knee replacements, spinal surgery, cosmetic surgery, and other medical procedures. In contrast to most nations marketing treatments to international patients, the Philippines differentiates itself by selling “all inclusive” kidney transplant (...) packages. Patients from other countries travel to the Philippines and receive kidneys purchased from poor individuals. (shrink)

Last year I published a short article urging bioethicists to carefully examine the question of what ought to constitute the canonical issues topics and questions driving research and teaching in bioethics. Why some subjects dominate the field whereas other topics are regarded as matters for scholars in other disciplines is a question that has intrigued me for nearly a decade. How are the boundaries of bioethics established? What factors influence research agendas and the creation of bioethics curricula? How do funding (...) agencies, editors, and leading scholars shape the field of bioethics? These questions are increasingly receiving scrutiny from Charles Bosk, Raymond De Vries, and other researchers as they explore the sociology of bioethics and the “construction” of the “ethical enterprise.". (shrink)

: Many bioethicists assume that morality is in a state of wide reflective equilibrium. According to this model of moral deliberation, public policymaking can build upon a core common morality that is pretheoretical and provides a basis for practical reasoning. Proponents of the common morality approach to moral deliberation make three assumptions that deserve to be viewed with skepticism. First, they commonly assume that there is a universal, transhistorical common morality that can serve as a normative baseline for judging various (...) actions and practices. Second, advocates of the common morality approach assume that the common morality is in a state of relatively stable, ordered, wide reflective equilibrium. Third, casuists, principlists, and other proponents of common morality approaches assume that the common morality can serve as a basis for the specification of particular policies and practical recommendations. These three claims fail to recognize the plural moral traditions that are found in multicultural, multiethnic, multifaith societies such as the United States and Canada. A more realistic recognition of multiple moral traditions in pluralist societies would be considerably more skeptical about the contributions that common morality approaches in bioethics can make to resolving contentious moral issues. (shrink)

Anthropologists and sociologists offer numerous critiques of bioethics. Social scientists criticize bioethicists for their arm-chair philosophizing and socially ungrounded pontificating, offering philosophical abstractions in response to particular instances of suffering, making all-encompassing universalistic claims that fail to acknowledge cultural differences, fostering individualism and neglecting the importance of families and communities, and insinuating themselves within the “belly” of biomedicine. Although numerous aspects of bioethics warrant critique and reform, all too frequently social scientists offer ungrounded, exaggerated criticisms of bioethics. Anthropological and sociological (...) critiques of bioethics are hampered by the tendency to equate bioethics with clinical ethics and moral theory in bioethics with principlist bioethics. Also, social scientists neglect the role of bioethicists in addressing organizational ethics and other “macro-social” concerns. If anthropologists and sociologists want to provide informed critiques of bioethics they need to draw upon research methods from their own fields and develop richer, more informed analyses of what bioethicists say and do in particular social settings. (shrink)

Cultural models of health, illness, and moral reasoning are receiving increasing attention in bioethics scholarship. Drawing upon research tools from medical and cultural anthropology, numerous researchers explore cultural variations in attitudes toward truth telling, informed consent, pain relief, and planning for end-of-life care. However, culture should not simply be equated with ethnicity. Rather, the concept of culture can serve as an heuristic device at various levels of analysis. In addition to considering how participation in particular ethnic groups and religious traditions (...) can shape moral reasoning, bioethicists need to consider processes of socialization into professional cultures, organizational cultures, national civic culture, and transnational culture. From the local world of the community clinic or oncology unit to the transnational workings of human rights agencies, attentiveness to the concept of culture can illuminate how patients, family members, and health care providers interpret illness, healing, and moral obligations. (shrink)

Open any standard bioethics textbook, and therein can be found a host of subjects ranging from the abortion rights controversy to the morality of xenographic tissue transplantation. Just as there is a wide scope to the subject matter of bioethics, its practitioners come from a multitude of disciplines, including law, medicine, nursing, theology, philosophy, sociology, and anthropology. And yet, despite a rich variety of investigators and methods, bioethicists overlook numerous subjects that deserve to be addressed. In particular, they neglect issues (...) of public health, preventive medicine, and social medicine. Although topics such as physician-assisted suicide, prenatal genetic testing, and the ethics of new reproductive technologies constitute the contemporary canon of bioethics and deserve sustained analysis, these subjects are not so significant that they should eclipse other issues. For example, gun control policies, the regulation of food additives. immunization programs, prenatal care, leave programs enabling employees to care for dying relatives, the provision of nutrition and medical care to the homeless, and the use of emergency rooms by the most impoverished citizens are all topics neglected by bioethicists. (shrink)

Open any standard bioethics textbook, and therein can be found a host of subjects ranging from the abortion rights controversy to the morality of xenographic tissue transplantation. Just as there is a wide scope to the subject matter of bioethics, its practitioners come from a multitude of disciplines, including law, medicine, nursing, theology, philosophy, sociology, and anthropology. And yet, despite a rich variety of investigators and methods, bioethicists overlook numerous subjects that deserve to be addressed. In particular, they neglect issues (...) of public health, preventive medicine, and social medicine. Although topics such as physician-assisted suicide, prenatal genetic testing, and the ethics of new reproductive technologies constitute the contemporary canon of bioethics and deserve sustained analysis, these subjects are not so significant that they should eclipse other issues. For example, gun control policies, the regulation of food additives. immunization programs, prenatal care, leave programs enabling employees to care for dying relatives, the provision of nutrition and medical care to the homeless, and the use of emergency rooms by the most impoverished citizens are all topics neglected by bioethicists. (shrink)

When journalists and health researchers address the subject of patients in the United States undergoing unproven stem cell–based interventions, they have historically crafted narratives about "stem cell tourism" to facilities located in such countries as China, India, Mexico, Panama, and Thailand. These latter nations often are depicted as jurisdictions where clinics providing access to SCBIs operate without meaningful oversight, relevant regulations are nonexistent or have significant loopholes, and regulatory bodies are underfunded, understaffed, corrupt, or otherwise unable to provide effective oversight (...) (Caul-field et al. 2009;... (shrink)

Contemporary scholarship examining clinical outcomes in medical travel for cosmetic surgery identifies cases in which patients traveled abroad for medical procedures and subsequently returned home with infections and other surgical complications. Though there are peer‐reviewed articles identifying patient deaths in cases where patients traveled abroad for commercial kidney transplantation or stem cell injections, no scholarly publications document deaths of patients who traveled abroad for cosmetic surgery or bariatric surgery. Drawing upon news media reports extending from 1993 to 2011, this article (...) identifies and describes twenty‐six reported cases of deaths of individuals who traveled abroad for cosmetic surgery or bariatric surgery. Over half of the reported deaths occurred in two countries. Analysis of these news reports cannot be used to make causal claims about why the patients died. In addition, cases identified in news media accounts do not provide a basis for establishing the relative risk of traveling abroad for care instead of seeking elective cosmetic surgery at domestic health care facilities. Acknowledging these limitations, the case reports suggest the possibility that contemporary peer‐reviewed scholarship is underreporting patient mortality in medical travel. The paper makes a strong case for promoting normative analyses and empirical studies of medical travel. In particular, the paper argues that empirically informed ethical analysis of ‘medical tourism’ will benefit from rigorous studies tracking global flows of medical travelers and the clinical outcomes they experience. The paper contains practical recommendations intended to promote debate concerning how to promote patient safety and quality of care in medical travel. (shrink)

Current approaches in bioethics largely overlook the multicultural social environment within which most contemporary ethical issues unfold. For example, principlists argue that the common morality of society supports four basic ethical principles. These principles, and the common morality more generally, are supposed to be a matter of shared common sense. Defenders of case-based approaches to moral reasoning similarly assume that moral reasoning proceeds on the basis of common moral intuitions. Both of these approaches fail to recognize the existence of multiple (...) cultural and religious traditions in contemporary multicultural societies. In multicultural settings, patients and their families bring many different cultural models of morality, health, illness, healing, and kinship to clinical encounters. Religious convictions and cultural norms play significant roles in the framing of moral issues. At present, mainstream bioethics fails to attend to the particular moral worlds of patients and their family members. A more anthropologically informed understanding of the ethical issues that emerge within health care facilities will need to better recognize the role of culture and religion in shaping modes of moral deliberation. (shrink)

Peer review is an important component of scholarly research. Long a black box whose practical mechanisms were unknown to researchers and readers, peer review is increasingly facing demands for accountability and improvement. Numerous studies address empirical aspects of the peer review process. Much less consideration is typically given to normative dimensions of peer review. This paper considers what authors, editors, reviewers, and readers ought to expect from the peer review process. Integrity in the review process is vital if various parties (...) are to have trust, or faith, in the credibility of peer review mechanisms. Trust in the quality of peer review can increase or diminish in response to numerous factors. Five core elements of peer review are identified. Constitutive elements of scholarly peer review include: fairness in critical analysis of manuscripts; the selection of appropriate reviewers with relevant expertise; identifiable, publicly accountable reviewers; timely reviews, and helpful critical commentary. The F.A.I.T.H. model provides a basis for linking conceptual analysis of the core norms of peer review with empirical research into the adequacy and effectiveness of various processes of peer review. The model is intended to describe core elements of high-quality peer review and suggest what factors can foster or hinder trust in the integrity of peer review. (shrink)

The authors co-organized (Snyder and Crooks) and gave a keynote presentation at (Turner) a conference on ethical issues in medical tourism. Medical tourism involves travel across international borders with the intention of receiving medical care. This care is typically paid for out-of-pocket and is motivated by an interest in cost savings and/or avoiding wait times for care in the patient’s home country. This practice raises numerous ethical concerns, including potentially exacerbating health inequities in destination and source countries and disrupting (...) continuity of care for patients. In this report, we synthesize conference presentations and present three lessons from the conference: 1) Medical tourism research has the potential for cross- or inter-disciplinarity but must bridge the gap between researchers trained in ethical theory and scholars unfamiliar with normative frameworks; 2) Medical tourism research must engage with empirical research from a variety of disciplines; and 3) Ethical analyses of medical tourism must incorporate both individual and population-level perspectives. While these lessons are presented in the context of research on medical tourism, we argue that they are applicable in other areas of research where global practices, such as human subject research and health worker migration, are occurring in the face of limited regulatory oversight. (shrink)

Peer review is an important component of scholarly research. Long a “black box” whose practical mechanisms were unknown to researchers and readers, peer review is increasingly facing demands for accountability and improvement. Numerous studies address empirical aspects of the peer review process. Much less consideration is typically given to normative dimensions of peer review. This paper considers what authors, editors, reviewers, and readers ought to expect from the peer review process. Integrity in the review process is vital if various parties (...) are to have trust, or faith, in the credibility of peer review mechanisms. Trust in the quality of peer review can increase or diminish in response to numerous factors. Five core elements of peer review are identified. Constitutive elements of scholarly peer review include: fairness in critical analysis of manuscripts; the selection of appropriate reviewers with relevant expertise; identifiable, publicly accountable reviewers; timely reviews, and helpful critical commentary. The F.A.I.T.H. model provides a basis for linking conceptual analysis of the core norms of peer review with empirical research into the adequacy and effectiveness of various processes of peer review. The model is intended to describe core elements of high-quality peer review and suggest what factors can foster or hinder trust in the integrity of peer review. (shrink)

Abstract:Qi has been both understood separately as substance and as field. This essay argues that qi in the Zhuangzi is both substance and field together. This qi field-substance is bidimensional where its vertical axis is that of substance and its horizontal axis that of field. This essay argues that the vertical dimension does not imply a substance dualism but a holism where qi differs in degrees of refinement; it argues that the horizontal dimension is composed of interrelated yinyang forces that (...) constitute an "empty" field. It also argues that at the center of this qi field-substance is the heart-mind and the body and, by drawing on rich resonances between the Zhuangzi and phenomenology, that human beings bring the fields of qi that they are situated in into certain coherences. (shrink)

The papers in this collection on Aristotle’s Eudemian Ethics by Charles, Rowe, McCabe, Whiting, and Buddensiek, offer new readings of Aristotle on the voluntary, friendship, and good fortune in the EE, by treating the EE on its own terms.

Central to the teachings of Christianity is a puzzle: on the one hand, sin seems something that humans do not do freely and so cannot be not responsible for, since it is unavoidable; on the other hand, sin seems something that we must be responsible for and so do freely, since we are enjoined to repent of it, and since it makes us liable to divine condemnation and forgiveness. After laying out the puzzle in more depth, this Element considers three (...) possible responses—libertarian, soft determinist, and free-will skeptic—and weighs the costs and benefits of each. (shrink)

Practice Then and Now "Practice theory" has a long history in philosophy, under various names, but current practice theory is a response to failures of projects of modernity or enlightenment which attempt to reduce science or politics to formulae. Heidegger, Oakeshott, and MacIntyre are each examples of philosophers who turned to practice conceptions. Foucault and Bourdieu made similar turns. Practice accounts come in different forms: some emphasize skill-like individual accomplishments, others emphasize the social character or presupposition-like character of the tacit (...) conditions of activities. The Social Theory of Practices problematized the idea of sameness, the idea that participants in an activity had the same tacit possessions, which undermined the idea that practices were collective objects in which individuals participated. Later critics, such as Schatzki and Rouse, emphasized the normative coherence and character of practice, which has a collective aspect. Pickering and others suggested a notion of practices that was de-mentalized and focused on the objects that were part of the practical activity, which provided for the continuity and sociality of practice without collectivizing its mental content. The discovery of mirror neurons suggested a non-collective mode of transmission of practices. The implications of these developments can be seen in connection with ethics, where the conflict between the ethical and the practical can be understood in terms of the intrinsic conflict between the need to behave successfully and our learned ethical intuitions. (shrink)

This paper contributes to the growing literature in social epistemology of diagnosing the epistemically problematic features of fake news. I identify two novel problems: the problem of relevant alternatives; and the problem of the degradation of the epistemic environment. The former arises among individual epistemic transactions. By making salient, and thereby relevant, alternatives to knowledge claims, fake news stories threaten knowledge. The problem of the degradation of the epistemic environment arises at the level of entire epistemic communities. I introduce the (...) notion of an epistemic environment, roughly the totality of resources and circumstances relevant to assessing the epistemically interesting statuses, such as knowledge. Fake news degrades our epistemic environment by undermining confidence in epistemic institutions and altering epistemic habits, thereby making the environment less conducive to achieving positive epistemic statuses. This is problematic even if the decrease in confidence and the altering of habits are rational. I end by considering solutions to these problems, stressing the importance of reproaching each other for proliferating fake news. I argue that we should reproach even faultless purveyors of fake news. This is because fake news typically arises in abnormal epistemic contexts, where there is widespread ignorance of, and noncompliance with, correct epistemic norms. (shrink)

Theological Determinism Theological determinism is the view that God determines every event that occurs in the history of the world. While there is much debate about which prominent historical figures were theological determinists, St. Augustine, Thomas Aquinas, John Calvin, and Gottfried Leibniz all seemed to espouse the view at least at certain points in their … Continue reading Theological Determinism →.

A closely argued book about what the negative tradition in Western theology involves.

Trust is often an assumed outcome of participation in Alternative Food Networks (AFNs) as they directly connect producers with consumers. It is based on this potential for trust “between producers and consumers” that AFNs have emerged as a significant field of food studies analysis as it also suggests a capacity for AFNs to foster associated embedded qualities, like ‘morality’, ‘social justice’, ‘ecology’ and ‘equity’. These positive benefits of AFNs, however, cannot be taken for granted as trust is not necessarily an (...) outcome of AFN participation. Using Chinese case studies of AFNs, which are characterised by a distinct form of trust pressure—consumers who are particularly cynical about small scale farmers, food safety and the organic credentials of producers—this paper highlights how the dynamics of trust are in constant flux between producers and consumers. I suggest that it is the careful construction of the aesthetic and multi-sensory qualities of food, which is often celebrated via social media, that human centred relations in Chinese AFNs are mediated. This leads to two key conclusions: first, that the key variable for establishing trust is satisfying the consumer's desire for safe (i.e. "fresh") food; and second, the materiality of the food and the perception of foods materiality (especially through social media), must both be actively constructed by the farmer to fit the consumer's ideal of freshness. (shrink)

Explores Martin Heidegger's rich and profound engagement with ancient philosophy and literature and demonstrates both his essential place within the discourse of classical studies and the fundamental significance of classical thought for his own work.

Chris Turner argues that Stephen Harper's attack on basic science, science communication, environmental regulations, and the environmental NGO community is the most vicious assault ever waged by a Canadian government on the fundamental principles of the Enlightenment. From the closure of Arctic research stations as oil drilling begins in the High Arctic to slashed research budgets in agriculture, dramatic changes to the nation's fisheries policy, and the muzzling of government scientists, Harper's government has effectively dismantled Canada's long-standing scientific tradition. (...) Drawing on interviews with scientists whose work has been halted by budget cuts and their colleagues in an NGO community increasingly treated as an enemy of the state, The War on Science paints a vivid and damning portrait of a government that has abandoned environmental stewardship and severed a national commitment to the objective truth of basic science as old as Canada itself. (shrink)

Logical pluralism is the view that there is more than one logic. Logical normativism is the view that logic is normative. These positions have often been assumed to go hand-in-hand, but we show that one can be a logical pluralist without being a logical normativist. We begin by arguing directly against logical normativism. Then we reformulate one popular version of pluralism—due to Beall and Restall—to avoid a normativist commitment. We give three non-normativist pluralist views, the most promising of which depends (...) not on logic’s normativity but on epistemic goals. (shrink)