Drawing on philosophy, law and political science, and on a wealth of practical experience delivering emergency medical services in conflict-ridden settings, Lepora and Goodin untangle the complexities surrounding compromise and complicity.

Medical complicity in torture is prohibited by international law and codes of professional ethics. But in the many countries in which torture is common, doctors frequently are expected to assist unethical acts that they are unable to prevent. Sometimes these doctors face a dilemma: they are asked to provide diagnoses or treatments that respond to genuine health needs but that also make further torture more likely or more effective. The duty to avoid complicity in torture then comes into conflict with (...) the doctor’s duty to care for patients. Sometimes the right thing for a doctor to do requires complicity in torture. Whether this is the case depends on: the expected consequences of the doctor’s actions; the wishes of the patient; and the extent of the doctor’s complicity with wrongdoing. Medical associations can support physicians who face this dilemma while maintaining a commitment to clear principles denouncing torture. (shrink)

Compromise arises in contexts where irreconcilable claims must nonetheless somehow be resolved. Ordinary people in everyday life, politicians and artists, doctors engaging in research, humanitarian workers providing aid in the midst of war – all of them will have faced situations where compromise appeared to be the only reasonable option, and yet will have felt that there was nevertheless something deeply wrong with it. The aim of this paper is to help make sense of that sentiment. The focus of this (...) paper will be on some aspects of the morality of compromise. Its lynchpin will be to construe compromise as a joint action, in particular, a joint wrongdoing – taking part in, and sharing responsibility for, the doing of things that are wrong from the point of view of those who are the parties to the compromise. The question of ‘what is wrong with compromise?’ is thus recast as a question of ‘what is my part in the wrongs being done as part of the compromise?’ It is tempting to suppose that a compromise serves to dilute personal responsibility, parsing it out among parties to the compromise. Viewing a compromise as a joint action, in contrast, will help us to see how a compromise actually increases responsibility among parties to it. They are now jointly collaborating in some action that each of them sees as wrong, at least in part (albeit in differing parts). Discussions of compromise traditionally prioritize the inter-personal aspect – compromise, in the transitive form of ‘compromising with’ someone. But I argue that the intransitive form – ‘compromise of’ – deserves pride of place. The reason for prioritizing the intransitive ‘compromise of’ is simple: that is what is involved in the intra-personal calculation that must, of necessity, go on inside one's own head in the process of deciding whether or not to agree to a 'compromise with' someone else. In this paper I shall concentrate specifically on compromises of principles, or (more precisely) on ‘matters of principled concern to the compromising parties’. Not only is that the most troubling and morally problematic sort of compromise, it is also logically the most central case. I demonstrate that that is so by shifting the focus from inter-personal compromise to the more fundamental intra-personal process underlying it – the compromise we are involved in when adjudicating among our own conflicting values, to decide whether or not to agree to a compromise of the inter-personal sort. This is the subject of the first section of the paper below. Compromise involves resolving conflicts of principles through mutual concessions that are accepted and undertaken by all parties. Doing so may be on-balance desirable, not only from some larger perspective (of social peace, or whatever) but also from each party's own perspective. Nevertheless, from each party's perspective, compromise necessarily involves interacting with, and sometimes contributing to, wrongdoing. Morally, something is lost, even if more is gained on balance. (shrink)

Torture is unethical and usually counterproductive. It is prohibited by international and national laws. Yet it persists: according to Amnesty International, torture is widespread in more than a third of countries. Physicians and other medical professionals are frequently asked to assist with torture. -/- Medical complicity in torture, like other forms of involvement, is prohibited both by international law and by codes of professional ethics. However, when the victims of torture are also patients in need of treatment, doctors can find (...) themselves torn. To accede to the requests of the torturers may entail assisting or condoning terrible acts. But to refuse care to someone in medical need may seem like abandoning a patient and thereby fail to exhibit the beneficence expected of physicians. -/- In this paper, we argue that this dilemma is real and that sometimes the right thing for a doctor to do, overall, is to be complicit in torture. Though complicity in a wrongful act is itself prima facie wrongful, this judgment may be outweighed by other factors. We propose three criteria for analyzing how those factors apply to particular cases of medical complicity in torture. (shrink)

Complicity consists in one person contributing to someone else's wrongdoing. But there is a diverse cluster ways of being involved in another’s wrongdoing. For a ‘diagnosis by exclusion’, we first fix the meaning of complicity in contrast to that with which it is often wrongly conflated. Literally cooperating in wrongdoing with others, for instance, is more than complicity. Each and every cooperator is actually a co-principal in the wrong jointly committed; and each bears the full responsibility, shared with all co-principals, (...) for the outcomes of that wrongdoing. Other sorts of involvement with wrongs committed by others amount to less than complicity because the involvement there is causally inert and hence does not actually contribute to the other’s wrongdoing at all. Pardoning wrongs wholly in the past may be like that. So too may be some cases of wilfully overlooking wrongs that others commit under one's very nose. Complicity is a very precise way of being involved in wrongdoing. Complicity consists in a secondary contribution of a causal (or potentially causal) sort to a wrong committed by someone else. That ‘contribution factor’ can be graded on many axes, in terms of how proximate, reversible or frequent the contribution was. Other things being equal, one is more complicit the …. (shrink)

Complicity with wrongdoing comes in many forms and many degrees. We distinguish subcategories cooperation, collaboration and collusion from connivance and condoning, identifying their defining features and assessing their characteristic moral valences. We illustrate the use of these distinctions by reference to events in refugee camps in and around Rwanda after the 1994 genocide, and the extent to which international organizations and nongovernment organizations were wrongfully complicit with the misuse of refugees as human shields by the perpetrators of the genocide who (...) were allowed to run those camps. (shrink)

Gesundheit and colleagues offer dramatic examples of the medical treatment of terrorists but then pose the suggestion that those who engage in terrorism forfeit their right to medical care, and, consequently, that physicians have no obligation to treat them. Their argument presupposes that a physician’s obligation to provide medical care depends on the patients’ right to health care. Therefore, someone who commits heinous and abhorrent acts thereby waives the right to health care and the physicians’ duty to provide health care (...) might consequently be absolved. This view may appeal to physicians who have experienced the complexity and discomfort of treating someone whose morality or even humanity they question, such as a rapist, a serial killer, or a perpetrator of genocide. However we have grounds to believe that the duty of physicians to treat is not based on the moral worth of patients, but rather on the duties that physicians have, and this notion renders any concern about the unacceptability of any person’s behavior irrelevant in determining whether to provide treatment. We will first argue that not all duties are directly derived from rights, and then illustrate how deontological views, along with common views on the role morality of physicians, provide a basis for offering indiscriminate medical care. Second, we will discuss the physician’s role in the context of war, and offer one compelling moral reason on the basis of which warfare norms do indeed obligate physicians to extend their duty to care toward enemies, terrorists included, independently of whatever right they maintain. (shrink)

Peter French’s and Steven Ratner’s thoughtful comments are helpful in advancing the analysis we offered in our book On Complicity and Compromise. Inevitably, there are areas of disagreement and bones to pick. However, our primary concern in this reply will be to press, with their assistance, the more positive agenda.

The cautions of our commentators are all well taken, and we are grateful for them. When we say that physicians should respect the wishes of their patients for medical treatment, even if that would make them complicit in torture being inflicted on their patients, Henry Shue reminds us that that assumes that the patients undergoing torture retain minimally adequate decision-making capacity. Insofar as the torture aims at, and succeeds in, producing ‘regression to an infantile state’, patients who are victims of (...) such torture would likely fail standard tests of that. True though that observation may be, it leaves us with no solution to our initial problem. Were we to assume that the victim does not have decision-making capacity, and reject his request for treatment on that basis, we would victimise him further by abandoning him to his fate leaving him with no alternatives and no support whatsoever. Furthermore, in regimes of psychologically sophisticated torture of the sort Shue discusses, there may be an even stronger reason for a physician to comply with a victim-patient's request for her to treat him. For a physician to refuse a would-be patient's request for treatment, on grounds he lacks adequate decision-making capacity, might further reinforce the infantilising message of the torturers. If so, that would amount to complicity in his torture, insofar as it furthers the wrong done by perpetrators. In the absence of victim's consent, doctors typically use criteria like family's advice, patient's best interest or heuristics identifying what most patients would prefer in similar situations. None of these options is available to doctors caring for torture survivors during the course of their torture, however. The first is obviously not. The second is not because the physician cannot be altogether sure what is in her victim-patient's best interests, given that treating him will …. (shrink)

Bioethics: 50 Puzzles, Problems, and Thought Experiments collects 50 cases—both real and imaginary—that have been, or should be, of special interest and importance to philosophical bioethics. Cases are collected together under topical headings in a natural order for an introductory course in bioethics. Each case is described in a few pages, which includes bioethical context, a concise narrative of the case itself, and a discussion of its importance, both for broader philosophical issues and for practical problems in clinical ethics and (...) health policy. Each entry also contains a brief, annotated, list of suggested readings. In addition to the classic cases in bioethics, the book contains discussion of cases that involve several emerging bioethical issues: especially, issues around disability, social justice, and the practice of medicine in a diverse and globalized world. (shrink)

Chiara Lepora and Robert Goodin invite us to join their insightful ‘conversation’ on complicity and compromise. Their book makes a dense, utterly precise and rewarding reading, as one proceeds stepwise through the logic of their philosophical arguments. For those unfamiliar with the relatively new discipline of ‘humanitarian ethics’, it might be disconcerting at first to see humanitarian actions brought to illustrate theories on complicity, with the Rwandan refugees crisis of 1994 and the tortured patient taken as two exemplary (...) cases. Actually, this connects with an increasing body of research and reflexions, showing that humanitarian workers face frequent ethical challenges, some of them amounting to a distressful sense of complicity. Lepora and Goodin carefully elaborate on definitions, arguing that complicity stricto sensu implies both causality with morally wrong actions and knowledge thereof. Nothing else. Perhaps controversially but in any case convincingly, in their strict definition of complicity they leave out of account a ‘shared …. (shrink)

This paper is an attempt to think through paranoia’s epistemic and affective features, which pervade both the worldview presented in Senecan tragedy and the inner life of many of its protagonists. Drawing upon recent literary-critical work, I argue that paranoia is temporally and epistemically ambivalent: subjects simultaneously attempt to “get ahead” of a looming cataclysm—looking to the future in an attempt to avert disaster—while inevitably “falling behind,” failing to predict or preempt the future in time to protect themselves. Much of (...) Senecan tragedy plays out paranoia’s future-oriented vigilance on the formal level. Foreshadowing, allusions, and meta-literary flourishes serve to render both readers and characters hyperaware of the earth-shattering horrors to come; however, in doing so, they also reveal that this forward-oriented bracing only serves to dredge up negative affect in advance. By contrast, I argue that Seneca’s Phoenissae thematizes in the character of Oedipus not only paranoia’s future-looking vigilance but also its inherent lagging, the failure to know and act in advance. These elements of slowness, stuckness, and delay open a space for stillness, relief, and intimacy, even within a narrative which hurtles toward cataclysm. (shrink)

The current situation around COVID-19 portrays a threat to us in several ways: It imposes uncertainty, a lack of control and reminds us of our own mortality. People around the world have reacted to these threats in seemingly unrelated ways: From stockpiling yeast and toilet paper to favoring nationalist ideas or endorsing conspiratorial beliefs. According to the General Process Model of Threat and Defense the confrontation with a threat - a discrepant experience - makes humans react with both proximal and (...) distal threat responses. While the proximal response manifests in behavioral inhibition that leads to heightened anxious arousal and vigilance, distal responses seek to lower behavioral inhibition and the associated state of anxiety and vigilance through engaging in distal defenses. In the present research, we propose that the reactions to COVID-19 may represent distal defense strategies to the pandemic (in the form of environmental or group related worldview defenses) and therefore can be explained and forecasted by the model. Thus we hypothesized increased perceived COVID-19 threat perception to lead to a proximal threat response in the form of heightened behavioral inhibition. This, in return, should enhance the use of distal defenses (i.e.: several ingroup biases, system justification and conspiratorial beliefs) overlapping with the reactions observed as a response to COVID-19. This hypothesized mediated effect of increased perceived COVID-19 threat on distal defenses was tested in two pre-registered studies: In Study 1 (N = 358) results showed perceived COVID-19 threat to be related to behavioral inhibition and in turn to be associated with increased distal defenses (i.e., higher entitativity, control restoration motivation, passive party support). In Study 2 (N = 348) we manipulated COVID-19 threat salience and found results suggesting the distal defenses of system justification and conspiratorial beliefs to be mediated by the proximal threat response. The results of the present research hint towards a common mechanism through which the seemingly unrelated reactions to COVID-19 can be explained. The results might help to predict future behavior during the COVID-19 pandemic and design measures to counteract detrimental effects of the pandemic. (shrink)

This study offers a new interpretation of the poem of the founder of Western philosophy: Parmenides. It shows that there is more in his poem than the description of Being by means of negative adjectives such as ingenerated and immobile. His words ask his audience to question their habits, to modify their goals, to engage in new enterprises and to look with a critical eye at their previous attempts to get knowledge. It operates as a travel guide that leads the (...) audience on a journey that will educate them and help them to gradually become philosophically mature, to become true themselves, which can also be described as the encouragement to become Being. (shrink)

The present paper focuses on a specific aspect of Michel Foucault’s interest in literature, addressing his study on the French poet and novelist Raymond Roussel. Published only few days before The Birth of the Clinic: An Archaeology of Medical Perception (1963), Death and the Labyrinth (1963) provides a philosophical reading of some Roussel’s writings, in a constant confrontation with the posthumous essay How I Wrote Certain of My Books (1935) in which Roussel explains his peculiar process of composition. Here, I (...) propose considering that Death and the Labyrinth offers not only a critical account on the relationship between philosophy and literature, but it also displays the significance of philosophy towards the study of literature. From this perspective, I will mainly focus on three themes – the death of the language; the repetition of the language; the duality of the language –, showing also that the first source of the Foucauldian further interest on the relationship between “words” and “things” has been Roussel’s oeuvre. (shrink)

Argues for viewing Empedocles' work as a unified whole of religion and physics by showing how rebirth is a positive doctrine which underlies his cosmic system. Essential for all scholars of early Greek philosophy, but will also appeal to those of epic poetry, Plato and Pythagoras studies, and ancient religion.

Saggio storico-pedagogico costruito su scritti editi e inediti di Elena Marano, pedagogista, filantropa, scrittrice vissuta tra la il XIX e il XX secolo ad Adrano (Ct). Ancorato alla pedagogia tradizionale, il suo pensiero trae alimento da ideologi del Risorgimento (Mazzini e Gioberti), si confronta con studiosi e intellettuali coevi, si apre a forme di rigenerazione didattico-educative i cui temi precorrono la contemporaneità: riposizionamento morale per contrastare emergenza educativa, istruzione diffusa per abbattere disagio sociale e analfabetismo, formazione delle bambine per favorire (...) cittadinanza femminile e inserimento delle donne nella società, relazionalità produttiva e funzione pedagogica del lavoro per conseguire «quella legalità che è attributo dello Stato». Diversi gli aspetti dell'educazione – morale, intellettuale, civile...– che, avviando corresponsabilità educativa tra docente e studente, scuola e famiglia, costituiscono strumento di interazione tra le discipline e l'unità di pensiero, necessaria diade per la deduzione del vero. (shrink)

What are the most detailed descriptions under which subjects intend to perform bodily actions? According to Pacherie (2006), these descriptions may be found by looking into motor representations—action representations in the brain that determine the movements to be performed. Specifically, for any motor representation guiding an action, its subject has an M‐intention representing that action in as much detail. I show that some M‐intentions breach the constraints that intentions should meet. I then identify a set of intentions—motor intentions—that represent actions (...) in as much detail as some motor representations while meeting the constraints that intentions should meet. (shrink)

Throughout the present paper, I propose an analysis of René Magritte’s artwork Les mots et les images (La Révolution surréaliste, 1929) in connection with a reflection on the associated theories he formulated in the handout for his London lecture (1937). Read in reference to selected writings (and in erratic observation with other artworks of his oeuvre), the eighteen propositions of Les mots et les images, along with their development in the 1937 document, might help at investigating the aesthetic principles that (...) guide and characterise Magritte’s reflection around language. In this same regard, in the last part of my article I will focus on Michel Foucault’s Ceci n’est pas une pipe (1973) and, particularly, on the distinction between resemblance (ressemblance) and similitude (similitude). These last remarks, I argue, offer the opportunity not only to think about the way in which images and words are related to each other in Magritte’s works, but also to inves- tigate the vital issue of language, which has occupied a crucial place within French thought. (shrink)

We develop an account of how mutually inconsistent models of the same target system can provide coherent information about the system. Our account makes use of ideas from the debate surrounding rob...

Boredom, in cinema as well as in our everyday experience, is usually associated with a generalised loss of meaning or interest. Accordingly, boredom is often perceived as that which ought to be avo...

After initially emerging in China, the coronavirus outbreak has advanced rapidly. The World Health Organization has recently declared it a pandemic, with Europe becoming its new epicentre. Italy has so far been the most severely hit European country and demand for critical care in the northern region currently exceeds its supply. This raises significant ethical concerns, among which is the allocation of scarce resources. Professionals are considering the prioritisation of patients most likely to survive over those with remote chances, and (...) this news has triggered an intense debate about the right of every individual to access healthcare. The proposed analysis suggests that the national emergency framework in which prioritisation criteria are currently enforced should not lead us to perceive scarce resources allocation as something new. From an ethical perspective, the novelty of the current emergency is not grounded in the devastating effects of scarce resources allocation, which is rife in recent and present clinical practice. Rather, it has to do with the extraordinarily high number of people who find themselves personally affected by the implications of scarce resources allocation and who suddenly realise that the principle of ‘equals should be treated equally’ may no longer be applicable. Along with the need to allocate appropriate additional financial resources to support the healthcare system, and thus to mitigate the scarcity of resources, the analysis insists on the relevance of a medical ethics perspective that does not place the burden of care and choice solely on physicians. (shrink)

In the philosophy of science and epistemology literature, robustness analysis has become an umbrella term that refers to a variety of strategies. One of the main purposes of this paper is to argue that different strategies rely on different criteria for justifications. More specifically, I will claim that: i) robustness analysis differs from de-idealization even though the two concepts have often been conflated in the literature; ii) the comparison of different model frameworks requires different justifications than the comparison of models (...) that differ only for the assumption under test; iii) the replacement of specific assumptions with different ones can encounter specific difficulties in scientific practice. These claims will be supported by a case study in population ecology and a case study in geographical economics. (shrink)

There is a vast class of things that science has so far almost entirely neglected. They are central to the understanding of physical reality both at an everyday level and at the level of the most fundamental phenomena in physics, yet have traditionally been assumed to be impossible to incorporate into fundamental scientific explanations. They are facts not about what is--the actual--but about what could be: counterfactuals. According to physicist Chiara Marletto, laws about things being possible or impossible may (...) generate an alternative way of providing explanations. This fascinating, far-reaching approach holds promise for revolutionizing the way fundamental physics is formulated, but also for providing essential tools to face existing technological challenges, from delivering the next generation of information-processing devices, beyond the universal quantum computer, to designing AIs. Each chapter in the book delineates how an existing vexed open problem in science can be solved by this radically different approach; and it is augmented by short fictional stories that explicate the main point of the chapter. As Marletto demonstrates, contemplating what is possible can give us a more complete and hopeful picture of the physical world. (shrink)

Mathematics reinterpreted as political practice and not just as theory constitutes an extraordinary exercise in democracy: like democracy, it is based on a system of rules, creates groups, and works on relationships. Like democracy, mathematics widens but doesn't nullify things. By studying mathematics one can understand many things about truth. For instance, the fact that truths are shared and therefore the principles of authority do not exist; the fact that all truths are absolute but transient because they depend on the (...) set of definitions and on the surrounding conditions. Solving a mathematical problem is an exercise in democracy because those who do not accept error and do not strive to understand the world are not able to change or govern it. In her polemical pamphlet Chiara Valerio pieces together a parallel between mathematics and democracy, two fields that do not succumb to the dictatorship of urgency--Translated from back cover. (shrink)

Il volume comprede una serie di saggi sui passi più significativi del commento di Alessandro di Afrodisia al IV libro dei Topici di Aristotele. In particolare, i saggi sono dedicati ai seguenti tre argomenti, su cui Alessandro espone tesi estremamente interessanti. Il primo tratta la dialettica, cioè l'argomento dei Topici; segue poi il genere, che costituisce l'argomento del IL libro in particolare; infine l'anima, le discussioni intorno alla quale costituiscono per il commentatore un esempio privilegiato per illustare i "luoghi" dialettici (...) via via discussi."--Page 2 of cover. (shrink)

Epicurus’ original version of atomism takes atoms to be physically indivisible but not completely unanalysable: each atom contains a finite number of minima. This paper explores the nature of the minima by focusing on a specific question: in which sense are the minima minimal? I do so by investigating the notions of parthood and divisibility into parts that are at play in paragraphs 56–59 of the Letter to Herodotus, where the theory of minima is introduced. By focusing on the analogy (...) (noticed by Francesco Verde) between Epicurean minima and Aristotelian limits, I argue that the minima should be understood as the minimal realiser of the atom’s physical functions. This allows me to keep together two very plausible but apparently incompatible claims: (i) the minima are supposed to block the paradoxes of theoretical divisibility, but (ii) their existence and their indivisibility can only be justified in physical (rather than geometrical) terms. (shrink)

Disagreement among philosophers over the proper justification for political institutions is far from a new phenomenon. Thus, it should not come as a surprise that there is substantial room for dissent on this matter within democratic theory. As is well known, instrumentalism and proceduralism represent the two primary viewpoints that democrats can adopt to vindicate democratic legitimacy. While the former notoriously derives the value of democracy from its outcomes, the latter claims that a democratic decision-making process is inherently valuable. This (...) article has two aims. First, it introduces three variables with which we can thoroughly categorise the aforementioned approaches. Second, it argues that the more promising version of proceduralism is extrinsic, rather than intrinsic, and that extrinsically procedural accounts can appeal to other values in the justification of democracy without translating into instrumentalism. This article is organised as follows. I present what I consider to be the ‘implicit view’ in the justification of democracy. Then, I analyse each of the three variables in a different section. Finally, I raise an objection against procedural views grounded in relational equality, which cannot account for the idea that democracy is a necessary condition for political legitimacy. (shrink)

The exponential accumulation, processing and accrual of big data in healthcare are only possible through an equally rapidly evolving field of big data analytics. The latter offers the capacity to rationalize, understand and use big data to serve many different purposes, from improved services modelling to prediction of treatment outcomes, to greater patient and disease stratification. In the area of infectious diseases, the application of big data analytics has introduced a number of changes in the information accumulation models. These are (...) discussed by comparing the traditional and new models of data accumulation. Big data analytics is fast becoming a crucial component for the modelling of transmission—aiding infection control measures and policies—emergency response analyses required during local or international outbreaks. However, the application of big data analytics in infectious diseases is coupled with a number of ethical impacts. Four key areas are discussed in this paper: automation and algorithmic reliance impacting freedom of choice, big data analytics complexity impacting informed consent, reliance on profiling impacting individual and group identities and justice/fair access and increased surveillance and population intervention capabilities impacting behavioural norms and practices. Furthermore, the extension of big data analytics to include information derived from personal devices, such as mobile phones and wearables as part of infectious disease frameworks in the near future and their potential ethical impacts are discussed. Considered together, the need for a constructive and transparent inclusion of ethical questioning in this rapidly evolving field becomes an increasing necessity in order to provide a moral foundation for the societal acceptance and responsible development of the technological advancement. (shrink)

RNA modifications have recently emerged as an important regulatory layer of gene expression. The most prevalent and reversible modification on messenger RNA (mRNA), N6‐methyladenosine, regulates most steps of RNA metabolism and its dysregulation has been associated with numerous diseases. Other modifications such as 5‐methylcytosine and N1‐methyladenosine have also been detected on mRNA but their abundance is lower and still debated. Adenosine to inosine RNA editing is widespread on coding and non‐coding RNA and can alter mRNA decoding as well as protect (...) against autoimmune diseases. 2′‐O‐methylation of the ribose and pseudouridine are widespread on ribosomal and transfer RNA and contribute to proper RNA folding and stability. While the understanding of the individual role of RNA modifications has now reached an unprecedented stage, still little is known about their interplay in the control of gene expression. In this review we discuss the examples where such interplay has been observed and speculate that with the progress of mapping technologies more of those will rapidly accumulate. (shrink)