The image of the hospital is presented to the public as a place of healing. Though the oft‐criticized total institutions of the past have been notably dismantled, the totalizing practices therein are now operationalized in the health care system. Through the lens of Erving Goffman, this article offers ways in which health care institutions operationalize totalizing practices, contributing to the mortification of patients and nurses alike in service to the bureaucratic machine. This article examines the ways in which totalizing practices (...) may disrupt the agency of both patients and nurses alike. (shrink)

This paper begins with the lived accounts of emergency and critical care medical interventions in which an unhoused person is brought to the emergency department in cardiac arrest. The case is a dramatised representation of the extent to which biopolitical forces via reduction to bare life through biopolitical and necropolitical operations are prominent influences in nursing and medical care. This paper draws on the scholarship of Michel Foucault, Giorgio Agamben, and Achille Mbembe to offer a theoretical analysis of the power (...) dynamics that influence the health care and death care of patients who are caught in the auspices of a neoliberal capitalist healthcare apparatus. This paper offers analysis of the overt displays of biopower over those individuals cast aside as generally unworthy of access to healthcare in a postcolonial capitalist system, in addition to the ways in which humans are reduced to ‘bare life’ in their dying days. We analyse this case study through Agamben's description of thanatopolitics, a ‘regime of death’, and the technologies that accompany the dying process, particularly in that of the homo sacer. Additionally, this paper illustrates the ways in which necropolitics and biopower are integral to understanding how the most advanced and expensive medical interventions make visible the political values of the healthcare system and how nurses and healthcare functions in these deathworlds. The purpose of this paper is to develop a greater understanding of biopolitical and necropolitical operations in acute and critical care environments, and to offer guidance to nurses in these spaces as they work to uphold ethical duties in a system that increasingly dehumanises. (shrink)

This paper opens with first‐hand accounts of critical care medical interventions in which detainees, in the custody of U.S. Immigration and Customs Enforcement (ICE), are brought to the emergency department for treatment. This case dramatizes the extent to which the provision of ethical and acceptable nursing care is jeopardized by federal law enforcement paradigms. Drawing on the scholarship of Michel Foucault and Giorgio Agamben, this paper offers a theoretical account of the power dynamics that inform the health care of patients (...) who find themselves caught in the custodial scaffolding of a vast immigration and detention apparatus. It offers an analysis of the display of sovereign and biopolitical power over the lives (and deaths) of detainees (Foucault), as well as the ways these individuals are reduced to “bare life” under the political pretext of an emergency or “state of exception” (Agamben). Our purpose here is both theoretical and practical: to better understand the often hidden agency or impersonal “will” exercised by the immigrant detention system, but also to equip clinicians in these and cognate facilities (e.g., prisons) with the critical tools by which they might better navigate incommensurable paradigms (i.e., care vs. custody) in order to deliver the best care while upholding their ethical duties as a care provider. This is all the more pressing because hospitals are not sanctuaries and given the incursion of federal law enforcement agents, nurses may find themselves conscripted as de facto agents of the state. (shrink)

Healthcare under the auspices of late‐stage capitalism is a total institution that mortifies nurses and patients alike, demanding conformity, obedience, perfection. This capture, which resembles Deleuze's enclosure, entangles nurses in carceral systems and gives way to a postenclosure society, an institution without walls. These societies of control constitute another sort of total institution, more covert and insidious for their invisibility (Deleuze, 1992). While Delezue (1992) named physical technologies like electronic identification badges as key to understanding these societies of control, the (...) political economy of late‐stage capitalism functions as a total institution with no cohesive, centralized, connected material apparatus required. In this manuscript, we outline the ways in which the healthcare industrial complex demands nurse conformity and how that, in turn, operationalizes nurses in service to the institution. This foundation leads to the assertion that nursing must foster a radical imagination for itself, unbound by reality as it presently exists, in order that we might conjure more just, equitable futures for caregivers and care receivers alike. To tease out what a radical imagination might look like, we dwell in paradox: getting folks the care they need in capitalist healthcare systems; engaging nursing's deep history to inspire alternative understandings for the future of the discipline; and how nursing might divest from extractive institutional structures. This paper is a jumping‐off place to interrogate the ways institutions telescope and where nursing fits into the arrangement. (shrink)

Professionalized nursing and anarchism could not be more at odds. And yet, if nursing wishes to have a future in the precarious times in which we live and die, the discipline must take on the lessons that anarchism has on offer. Part love note to a problematic profession we love and hate, part fever dream of what could be, we set out to think about what nursing and care might look like after it all falls down, because it is all (...) falling down. Drawing on alternate histories, alternate visions of nursing history, we imagine what nursing values would look like, embracing anarchist principles. We consider examples of community survival, mutual aid, and militant joy as strategies to achieve what nursing could be if nurses put an end to their cop shit, shrugging off their shroud of white cisheteropatriarchal femininity that manifests as professionalism and civility. We conclude with a call to action and a plan for skill-building because this can all be different. (shrink)

Context: The need to reinvigorate medical confidentiality protections is recognised as an important objective in building patient trust necessary for successful health outcomes. Little is known about patient understanding and expectations from medical confidentiality.Objective: To identify and describe patient views of medical confidentiality and to assess provisionally the range of these views.Design: Qualitative study using indepth, open ended face-to-face interviews.Setting: Southeastern Pennsylvania and southern New Jersey, USA.Participants: A total of 85 women interviewed at two clinical sites and three community/research centres.Main (...) outcome measures: Subjects’ understanding of medical confidentiality, beliefs about the handling of confidential information and concerns influencing disclosure of information to doctors.Results: The subjects defined medical confidentiality as the expectation that something done or said would be kept “private” but differed on what information was confidential and the basis and methods for protecting information. Some considered all medical information as confidential and thought confidentiality protections functioned to limit its circulation to medical uses and reimbursement needs. Others defined only sensitive or potentially stigmatising information as confidential. Many of these also defined medical confidentiality as a strict limit prohibiting information release, although some noted that specific permission or urgent need could override this limit.Conclusions: Patients share a basic understanding of confidentiality as protection of information, but some might have expectations that are likely not met by current practice nor anticipated by doctors. Doctors should recognise that patients might have their own medical confidentiality models. They should address divergences from current practice and provide support to those who face emotional or practical obstacles to self-revelation. (shrink)

We consider the complex interactions between rape culture and epistemology. A central case study is the consideration of a deferential attitude about the epistemology of sexual assault testimony. According to the deferential attitude, individuals and institutions should decline to act on allegations of sexual assault unless and until they are proven in a formal setting, i.e., a criminal court. We attack this deference from several angles, including the pervasiveness of rape culture in the criminal justice system, the epistemology of testimony (...) and norms connecting knowledge and action, the harms of tacit idealizations away from important contextual factors, and a contextualist semantics for 'knows' ascriptions. (shrink)

We propose that the prevalent moral aversion to AWS is supported by a pair of compelling objections. First, we argue that even a sophisticated robot is not the kind of thing that is capable of replicating human moral judgment. This conclusion follows if human moral judgment is not codifiable, i.e., it cannot be captured by a list of rules. Moral judgment requires either the ability to engage in wide reflective equilibrium, the ability to perceive certain facts as moral considerations, moral (...) imagination, or the ability to have moral experiences with a particular phenomenological character. Robots cannot in principle possess these abilities, so robots cannot in principle replicate human moral judgment. If robots cannot in principle replicate human moral judgment then it is morally problematic to deploy AWS with that aim in mind. Second, we then argue that even if it is possible for a sufficiently sophisticated robot to make ‘moral decisions’ that are extensionally indistinguishable from (or better than) human moral decisions, these ‘decisions’ could not be made for the right reasons. This means that the ‘moral decisions’ made by AWS are bound to be morally deficient in at least one respect even if they are extensionally indistinguishable from human ones. Our objections to AWS support the prevalent aversion to the employment of AWS in war. They also enjoy several significant advantages over the most common objections to AWS in the literature. (shrink)

Book Information The Blackwell Guide to Continental Philosophy. The Blackwell Guide to Continental Philosophy Robert C. Solomon and David Sherman, eds., Oxford: Blackwell, 2003, viii + 345, $69.30 (cloth) Edited by Robert C. Solomon; and David Sherman. Oxford: Blackwell. Pp. viii + 345. $69.30 (cloth:).

The partial aim of this paper is to suggest that Merleau-Ponty’s ontology is prefigured in Schelling’s conception of God as presented in Ages of the World. This will specifically be demonstrated by explicating the parallels between Merleau-Ponty’s paradoxical notion of the flesh and Schelling’s equally complex idea of Ungrund. Understanding the significance of Schelling’s influence on Merleau-Ponty becomes pivotal upon the recognition that the contemporary French political philosopher Claude Lefort’s idea of the political instituting politics is directly linked to Merleau-Ponty’s (...) ontology of the invisible and visible. The implication here involves the suggestion that Lefort’s conception of the political parallels Schelling’s conception of God as mediated by Merleau-Ponty. It is then suggested that the political form of modernity should be understood less as the emergence of a novel form and conceived of more as an originary dimension where the theological and the political become indistinguishable. (shrink)

This essay attempts to provide a historical account of Michael Oakeshott’s famous distinction between civil and enterprise association. As such, it demonstrates that Oakeshott’s political skepticism and his concomitant view of civil association can in part be explained by his reliance on Augustinian theology. In a similar vein, Oakeshott’s linkage of enterprise association with the rationalism of Bacon must be considered in terms of Oakeshott’s understanding of Pelagianism and Gnosticism. Unsurprisingly, it will be demonstrated that despite Oakeshott’s disagreements with the (...) political philosopher Eric Voegelin, he was very impressed by Voegelin’s work on the Gnostic origins of modernity. Consequently, a major claim of this essay is that Oakeshott’s speculative understanding of modern political thought constitutes a theological genealogy of political modernity in all but name. (shrink)

One of the principal challenges to human survival will be for human beings, embedded in a plurality of cultural contexts, to engage with and learn from one another respectfully in the continuing task of creating a more liveable world. I argue here that theoretical psychology can contribute to setting some of the terms for this effort through the kind of conception it advances of the person as agent. I discuss broadly two philosophical perspectives toward human agency which have become prominent (...) in psychology in the last few decades, the humanistic and the hermeneutic. I argue that these two different frameworks make complementary contributions to the project of understanding ourselves and furthering the development of our humanity. 2012 APA, all rights reserved). (shrink)

As robots slip into more domains of human life - from the operating room to the bedroom - they take on our morally important tasks and decisions, as well as create new risks from psychological to physical. This book answers the urgent call to study their ethical, legal, and policy impacts.

Friends of Wright-entitlement cannot appeal to direct epistemic consequentialism (believe or accept what maximizes expected epistemic value) in order to account for the epistemic rationality of accepting Wright-entitled propositions. The tenability of direct consequentialism is undermined by the “Truth Fairy”: a powerful being who offers you great epistemic reward (in terms of true beliefs) if you accept a proposition p for which you have evidence neither for nor against. However, this chapter argues that a form of indirect epistemic consequentialism seems (...) promising as a way to deal with the Truth Fairy problem. The relevant form of indirect consequentialism accommodates evidentialism but allows for exceptions in the case of anti-sceptical hypotheses. Since these are the kind of propositions to which Wright-entitlement is supposed to apply—i.e. cornerstone propositions—indirect consequentialism is entitlement-friendly. (shrink)

SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

To many, the idea of autonomous weapons systems (AWS) killing human beings is grotesque. Yet critics have had difficulty explaining why it should make a significant moral difference if a human combatant is killed by an AWS as opposed to being killed by a human combatant. The purpose of this paper is to explore the roots of various deontological concerns with AWS and to consider whether these concerns are distinct from any concerns that also apply to long-distance, human-guided weaponry. We (...) suggest that at least one major driver of the intuitive moral aversion to lethal AWS is that their use disrespects their human targets by violating the martial contract between human combatants. On our understanding of this doctrine, service personnel cede a right not to be directly targeted with lethal violence to other human agents alone. Artificial agents, of which AWS are one example, cannot understand the value of human life. A human combatant cannot transfer his privileges of targeting enemy combatants to a robot. Therefore, the human duty-holder who deploys AWS breaches the martial contract between human combatants and disrespects the targeted combatants. We consider whether this novel deontological objection to AWS forms the foundation of several other popular yet imperfect deontological objections to AWS. (shrink)

I argue that evaluating the knowledge norm of practical reasoning is less straightforward than is often assumed in the literature. In particular, cases in which knowledge is intuitively present, but action is intuitively epistemically unwarranted, provide no traction against the knowledge norm. The knowledge norm indicates what it is appropriately to hold a particular content as a reason for action; it does not provide a theory of what reasons are sufficient for what actions. Absent a general theory about what sorts (...) of reasons, if genuinely held, would be sufficient to justify actions—a question about which the knowledge norm is silent—many of the kinds of cases prevalent in the literature do not bear on the knowledge norm. (shrink)

ABSTRACTThe jus ad bellum criterion of right intention is a central guiding principle of just war theory. It asserts that a country’s resort to war is just only if that country resorts to war for the right reasons. However, there is significant confusion, and little consensus, about how to specify the CRI. We seek to clear up this confusion by evaluating several distinct ways of understanding the criterion. On one understanding, a state’s resort to war is just only if it (...) plans to adhere to the principles of just war while achieving its just cause. We argue that the first understanding makes the CRI superfluous, because it can be subsumed under the probability of success criterion. On a second understanding, a resort to war is just only if a state’s motives, which explain its resort to war, are of the right kind. We argue that this second understanding of the CRI makes it a significant further obstacle to justifying war. However, this second understanding faces a possible infinite regress problem, wh... (shrink)

To many, the idea of autonomous weapons systems (AWS) killing human beings is grotesque. Yet critics have had difficulty explaining why it should make a significant moral difference if a human combatant is killed by an AWS as opposed to being killed by a human combatant. The purpose of this paper is to explore the roots of various deontological concerns with AWS and to consider whether these concerns are distinct from any concerns that also apply to long- distance, human-guided weaponry. (...) We suggest that at least one major driver of the intuitive moral aversion to lethal AWS is that their use disrespects their human targets by violating the martial contract between human combatants. On our understanding of this doctrine, service personnel cede a right not to be directly targeted with lethal violence to other human agents alone. Artificial agents, of which AWS are one example, cannot understand the value of human life. A human combatant cannot transfer his privileges of targeting enemy combatants to a robot. Therefore, the human duty-holder who deploys AWS breaches the martial contract between human combatants and disrespects the targeted combatants. We consider whether this novel deontological objection to AWS forms the foundation of several other popular yet imperfect deontological objections to AWS. (shrink)

As robots slip into more domains of human life-from the operating room to the bedroom-they take on our morally important tasks and decisions, as well as create new risks from psychological to physical. This book answers the urgent call to study their ethical, legal, and policy impacts.

Carrie Jenkins presents a new account of arithmetical knowledge, which manages to respect three key intuitions: a priorism, mind-independence realism, and empiricism. Jenkins argues that arithmetic can be known through the examination of empirically grounded concepts, non-accidentally accurate representations of the mind-independent world.

In July 2020, more than 1000 companies that advertise on social media platforms withdrew their business, citing failures of the platforms (especially Facebook) to address the proliferation of harmful content. The #StopHateForProfit movement invites reflection on an understudied topic: the ethics of boycotting by corporations. Under what conditions is corporate boycotting permissible, required, supererogatory, or forbidden? Although value-driven consumerism has generated significant recent discussion in applied ethics, that discussion has focused almost exclusively on the consumption choices of individuals. As this (...) article underscores, value-driven consumerism by business corporations complicates these issues and invites further examination. We propose principles for the ethics of boycotting by corporations, indicate how these principles relate to different CSR paradigms, and show how these insights can help assess recent instances of corporate boycotting. (shrink)

Across languages, lexical items specific to infant‐directed speech (i.e., ‘baby‐talk words’) are characterized by a preponderance of onomatopoeia (or highly iconic words), diminutives, and reduplication. These lexical characteristics may help infants discover the referential nature of words, identify word referents, and segment fluent speech into words. If so, the amount of lexical input containing these properties should predict infants’ rate of vocabulary growth. To test this prediction, we tracked the vocabulary size in 47 English‐learning infants from 9 to 21 months (...) and examined whether the patterns of growth can be related to measures of iconicity, diminutives, and reduplication in the lexical input at 9 months. Our analyses showed that both diminutives and reduplication in the input were associated with vocabulary growth, although measures of iconicity were not. These results are consistent with the hypothesis that phonological properties typical of lexical input in infant‐directed speech play a role in early vocabulary growth. (shrink)

Elizabeth Barnes and Robert Williams have developed a theory of metaphysical indeterminacy, via which they defend the theoretical legitimacy of vague objects. In this paper, we argue that while the Barnes–Williams theory supplies a viable account of genuine metaphysical vagueness, it cannot underwrite an account of genuinely vague objects. First we clarify the distinction between these two key theses. Then we argue that the Barnes–Williams theory of metaphysical vagueness not only fails to deliver genuinely vague objects, it in fact provides (...) grounds for rejecting them. (shrink)

Feminist analyses of gender concepts must avoid the inclusion problem, the fault of marginalizing or excluding some prima facie women. Sally Haslanger’s ‘ameliorative’ analysis of gender concepts seeks to do so by defining woman by reference to subordination. I argue that Haslanger’s analysis problematically marginalizes trans women, thereby failing to avoid the inclusion problem. I propose an improved ameliorative analysis that ensures the inclusion of trans women. This analysis yields ‘twin’ target concepts of woman, one concerning gender as class and (...) the other concerning gender as identity, both of which I hold to be equally necessary for feminist aims. (shrink)

We investigate the question of whether (and if so why) creating or distributing deepfake pornography of someone without their consent is inherently objectionable. We argue that nonconsensually distributing deepfake pornography of a living person on the internet is inherently pro tanto wrong in virtue of the fact that nonconsensually distributing intentionally non-veridical representations about someone violates their right that their social identity not be tampered with, a right which is grounded in their interest in being able to exercise autonomy over (...) their social relations with others. We go on to suggest that nonconsensual deepfakes are especially worrisome in connection with this right because they have a high degree of phenomenal immediacy, a property which corresponds inversely to the ease with which a representation can be doubted. We then suggest that nonconsensually creating and privately consuming deepfake pornography is worrisome but may not be inherently pro tanto wrong. Finally, we discuss the special issue of whether nonconsensually distributing deepfake pornography of a deceased person is inherently objectionable. We argue that the answer depends on how long it has been since the person died. (shrink)

This paper develops an inventory and conceptual map of espoused organizational values. We suggest that espoused values are fundamentally different to other value forms as they are collective value statements that need to coexist as a basis for organizational activity and performance. The inventory is built from an analysis of 3112 value items espoused by 554 organizations in the UK and USA in both profit and not-for-profit sectors. We distil these value items into 85 espoused value labels, and these are (...) assessed in terms of their similarity and difference through judgements made by 53 experienced individuals. The resulting conceptual map facilitates the evaluation of values which are espoused at the organizational level, as opposed to aggregations of personal values, an important distinction that is often ignored in the literature. This analysis identifies a number of distinct areas of emphasis occupied by espoused values. In particular, the richness of value labels that relates to broader ethical issues may be aimed at external stakeholder management, but also may have an increasing influence on organizational behaviour as they are embedded into organizational practices. By advancing our understanding of espoused values, through an analysis of those being used in practice, we provide a means by which future research into organizational values and ethical issues can progress. (shrink)