How research studies should use social media to recruit research participants is a timely question. Importantly, the question is how, not if, studies should use...

While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate (...) the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion. (shrink)

The neurodiversity view makes both a conceptual and a political claim. Conceptually, the neurodiversity view holds that certain neurocognitive differences currently classified as disorders—autism, most notably—are best understood as forms of diversity. Politically, it holds that, rather than being medicalized and ‘treated’, neurodiversity ought to be respected in the way other human differences—such as differences in race and sexual orientation—are respected. In this article, I challenge the arguments given in support of neurodiversity’s conceptual claim, while defending its political aims of (...) respect, inclusion, and accommodation. Although neurodiversity provides a compelling challenge to the status quo, I conclude that its most prominent arguments fall short of establishing that autism is not a disorder. As I go on to argue, however, the fact that autism is a disorder does not entail that medicalization is the only course. My view is ultimately that social change and medical intervention need not be considered mutually exclusive. (shrink)

One way of thinking about the tension this case presents is as a simple conflict between law and ethics: Does the team follow the patient’s legally authorized surrogate, or the surrogate who is bet...

Work done within the realm of what is sometimes called ‘descriptive ethics’ brings two questions readily to mind: How can empirical findings, in general, inform normative debates? and How can these empirical findings, in particular, inform the normative debate at hand? Brick et al 1 confront these questions in their novel investigation of public views about lives worth living and the permissibility of withdrawing life-sustaining treatment from critically ill infants. Mindful of the is-ought gap, the authors suggest modestly that their (...) data ‘may be useful when constructing guidelines for clinical practice’. In this commentary, I consider some potential limitations on the generalisability of these data in the context of policy and clinical practice, limitations which may in turn serve as directions for future empirical research. The authors’ study presented participants six case scenarios, five of which involved the possibility of withdrawing life-sustaining treatment from critically ill infants. The results revealed that “[a]lmost all respondents agreed that at some level of quality of life, life may be of no benefit or worse than death for an infant” and that “participants significantly favoured withdrawal of treatment for the most severe cases.” One salient detail in these scenarios …. (shrink)

Volume 20, Issue 2, February 2020, Page 66-68.

Hastings Center Report, Volume 52, Issue 1, Page 42-50, January/February 2022.

Abstract“Suffering” is a central concept within bioethics and often a crucial consideration in medical decision making. As used in practice, however, the concept risks being uninformative, ambiguous, or even misleading. In this paper, we consider a series of cases in which “suffering” is invoked and analyze them in light of prominent theories of suffering. We then outline ethical hazards that arise as a result of imprecise usage of the concept and offer practical recommendations for avoiding them. Appeals to suffering are (...) often getting at something ethically important. But this is where the work of ethics begins, not where it ends. (shrink)

Volume 20, Issue 4, May 2020, Page 48-50.

Volume 20, Issue 7, July 2020, Page 190-192.

Volume 19, Issue 11, November 2019, Page 82-84.

If the COVID-19 crisis has brought any benefits, one is the increased attention paid to persons with disabilities in the contexts of clinical medicine and public health. There has been a great deal of insightful discussion since the outbreak about controversial disability issues the pandemic has brought to light. For a population often overlooked in both academic circles and the public square, mere visibility is a victory. There are at least two important respects in which the discussion remains underdeveloped, however.First, (...) much of the work being done has focused on disability considerations in policies governing triage and the rationing of critical care resources under crisis conditions. This is undoubtedly an... (shrink)

How should clinical ethicists be trained? Scholars have stated that clinical ethics fellowships create well-trained, competent ethicists. While this appears intuitive, few features of fellowship programs have been publicly discussed, let alone debated. In this paper, we examine how fellowships can foster effective mentoring relationships. These relationships provide the foundation for the fellow’s transition from novice to competent professional. In this essay, we begin by discussing our pedagogical commitments. Next, we describe the structures our program has created to assist our (...) fellows in becoming competent ethicists. We then outline the kinds of knowledge, skills, and professional attributes mentors should possess. Following this, we focus on the knowledge, skills, and professional attributes that fellows develop as they co-create effective mentoring relationships. We will not prescribe a single approach to fellowship training; instead, our perspective will, we hope, become a catalyst for further conversation on training and mentoring clinical ethics fellows. (shrink)

Patients who experience difficulty making medical decisions are often referred to as “ambivalent.” However, the current lack of attention to the nuances between a cluster of phenomena that resemble...

While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...) patient’s capacity. While inconsistency may count as _prima_ _facie_ evidence of incapacity—enough evidence to justify a closer look—when making such determinations, it is important for clinicians to slow down, inquire about the reasons underlying the inconsistency and clearly show which of the elements of capacity the patient fails to satisfy. (shrink)

Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention—a bridge to recovery or transplant—not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of (...) withdrawal, including distributive justice, quality of life, patients’ rights, professional integrity, and the Equivalence Thesis. We find that existing justifications for unilateral withdrawal of ECMO support in capacitated patients are problematic, which leads us to conclude that either: (1) additional ethical arguments are necessary to defend this approach or (2) the claim that it is not appropriate to use ECMO as a destination therapy should be questioned. (shrink)

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)

While it is not explicitly included in capacity assessment tools, “consistency” has come to feature as a central concern when assessing patients’ capacity. In order to determine whether inconsistency indicates incapacity, clinicians must determine the source of the inconsistency with respect to the process or content of a patient’s decision-making. In this paper, we outline common types of inconsistency and analyze them against widely accepted elements of capacity. We explore the question of whether inconsistency necessarily entails a deficiency in a (...) patient’s capacity. While inconsistency may count as prima facie evidence of incapacity—enough evidence to justify a closer look—when making such determinations, it is important for clinicians to slow down, inquire about the reasons underlying the inconsistency and clearly show which of the elements of capacity the patient fails to satisfy. (shrink)

Ms. P. is in the ICU with respiratory failure and sepsis. She has been on a ventilator for almost a week, and now has impending kidney failure. Her children, who have been taking turns at the bedsi...

In “Bioethics and the Moral Authority of Experience,” Ryan Nelson et al. (2022) argue that personal experience can simultaneously be an asset and a liability in the practice of bioethics and medici...

Very diverse societies pose real problems for Rawlsian models of public reason. This is for two reasons: first, public reason is unable accommodate diverse perspectives in determining a regulative ideal. Second, regulative ideals are unable to respond to social change. While models based on public reason focus on the justification of principles, this book suggests that we need to orient our normative theories more toward discovery and experimentation. The book develops a unique approach to social contract theory that focuses on (...) diverse perspectives. It offers a new moral stance that author Ryan Muldoon calls, "The View From Everywhere," which allows for substantive, fundamental moral disagreement. This stance is used to develop a bargaining model in which agents can cooperate despite seeing different perspectives. Rather than arguing for an ideal contract or particular principles of justice, Muldoon outlines a procedure for iterated revisions to the rules of a social contract. It expands Mill's conception of experiments in living to help form a foundational principle for social contract theory. By embracing this kind of experimentation, we move away from a conception of justice as an end state, and toward a conception of justice as a trajectory. (shrink)

The thirty-three essays in <I>Relativism: A Contemporary Anthology</I> grapple with one of the most intriguing, enduring, and far-reaching philosophical problems of our age. Relativism comes in many varieties. It is often defined as the belief that truth, goodness, or beauty is relative to some context or reference frame, and that no absolute standards can adjudicate between competing reference frames. Michael Krausz's anthology captures the significance and range of relativistic doctrines, rehearsing their virtues and vices and reflecting on a spectrum of (...) attitudes. Invoking diverse philosophical orientations, these doctrines concern conceptions of relativism in relation to facts and conceptual schemes, realism and objectivity, universalism and foundationalism, solidarity and rationality, pluralism and moral relativism, and feminism and poststructuralism. Featuring nine original essays, the volume also includes many classic articles, making it a standard resource for students, scholars, and researchers. <B>Table of Contents:</B> Foreword by Alan Ryan Preface Introduction Michael Krausz <B>Part I. Orienting Relativism</B> 1. Mapping Relativisms Michael Krausz 2. A Brief History of Relativism Maria Baghramian <B>Part II. Relativism, Truth, and Knowledge</B> 3. Subjective, Objective, and Conceptual Relativisms Maurice Mandelbaum 4. “Just the Facts, Ma’am!” Nelson Goodman 5. Relativism in Philosophy of Science Nancy Cartwright 6. The Truth About Relativism Joseph Margolis 7. Making Sense of Relative Truth John MacFarlane 8. On the Very Idea of a Conceptual Scheme Donald Davidson 9. Truth and Convention: On Davidson’s Refutation of Conceptual Relativism Hilary Putnam 10. Conceptual Schemes Simon Blackburn 11. Relativizing the Facts Paul A. Boghossian 12. Targets of Anti-Relativist Arguments Harvey Siegel 13. Realism and Relativism Akeel Bilgrami <B>Part III. Moral Relativism, Objectivity, and Reasons</B> 14. Moral Relativism Defended Gilbert Harman 15. The Truth in Relativism Bernard Williams 16. Pluralism and Ambivalence David B. Wong 17. The Relativity of Fact and the Objectivity of Value Catherine Z. Elgin 18. Senses of Moral Relativity David Wiggins 19. Ethical Relativism and the Problem of Incoherence David Lyons 20. Understanding Alien Morals Gopal Sreenivasan 21. Value: Realism and Objectivity Thomas Nagel 22. Intuitionism, Realism, Relativism, and Rhubarb Crispin Wright 23. Moral Relativism and Moral Realism Russ Schafer-Landau <B>Part IV. Relativism, Culture, and Understanding</B> 24. Anti Anti-Relativism Clifford Geertz 25. Solidarity or Objectivity? Richard Rorty 26. Relativism, Power, and Philosophy Alasdair MacIntyre 27. Internal Criticism and Indian Rationalist Traditions Martha C. Nussbaum and Amartya Sen 28. Phenomenological Rationality and the Overcoming of Relativism Jitendra N. Mohanty 29. Understanding and Ethnocentricity Charles Taylor 30. Relativism and Cross-Cultural Understanding Kwame Anthony Appiah 31. Relativism, Persons, and Practices Amélie Oksenberg Rorty 32. One What? Relativism and Poststructuralism David Couzens Hoy 33. Must a Feminist Be a Relativist After All? Lorraine Code List of Contributors Index. (shrink)

This book explores the constraints which justice imposes on immigration policy. Like liberal nationalists, Ryan Pevnick argues that citizens have special claims to the institutions of their states. However, the source of these special claims is located in the citizenry's ownership of state institutions rather than in a shared national identity. Citizens contribute to the construction and maintenance of institutions, and as a result they have special claims to these institutions and a limited right to exclude outsiders. Pevnick shows (...) that the resulting view justifies a set of policies - including support for certain types of guest worker programs - which is distinct from those supported by either liberal nationalists or advocates of open borders. His book provides a framework for considering a number of connected topics including issues related to self-determination, the scope of distributive justice and the significance of shared national identity. (shrink)

In this pathbreaking book, which includes a powerful new translation of Hesiod's Works and Days by esteemed translator David Grene, Stephanie Nelson argues that a society's vision of farming contains deep indications about its view of the human place within nature, and our relationship to the divine. She contends that both Hesiod in the Works and Days and Vergil in the Georgics saw farming in this way, and so wrote their poems not only about farming itself, but also about (...) its deeper ethical and religious implications. Hesiod, Nelson argues, saw farming as revealing that man must live by the sweat of his brow, and that good, for human beings, must always be accompanied by hardship. Within this vision justice, competition, cooperation, and the need for labor take their place alongside the uncertainties of the seasons and even of particular lucky and unlucky days to form a meaningful whole within which human life is an integral part. Vergil, Nelson argues, deliberately modeled his poem upon the Works and Days, and did so in order to reveal that his is a very different vision. Hesiod saw the hardship in farming; Vergil sees its violence as well. Farming is for him both our life within nature, and also our battle against her. Against the background of Hesiods poem, which found a single meaning for human life, Vergil thus creates a split vision and suggests that human beings may be radically alienated from both nature and the divine. Nelson argues that both the Georgics and the Works and Days have been misread because scholars have not seen the importance of the connection between the two poems, and because they have not seen that farming is the true concern of both, farming in its deepest and most profoundly unsettling sense. (shrink)

La resistencia comunitaria noviolenta es una estrategia para transformar conflictos. Este estudio contiene el análisis de la Asamblea Municipal Constituyente (AMC) como proceso de resistencia en Mogotes, Santander, Colombia. En el desarrollo del artículo se retoma la experiencia de investigación llevada adelante en el municipio para indagar acerca de la contribución de las redes sociales en el desarrollo y mantenimiento de las políticas de identidad en el proceso de resistencia Para esto se emplearon métodos etnográficos tales como entrevistas a profundidad (...) a miembros de la asamblea, y el contenido de programas radiales de la emisora del municipio. Como conclusión se plantea que el fortalecimiento de las políticas de identidad se ve influenciado por las redes sociales que intervienen en el proceso. (shrink)

Uncovers the truth behind the ideas, struggles, and eventually success of Black and Puerto Rican Nationalists regarding key feminist issues of the 1960s, 1970s, and 1980s While most people believe that the movement to secure voluntary reproductive control for women centered solely on abortion rights, for many women abortion was not the only, or even primary, focus. Jennifer Nelson tells the story of the feminist struggle for legal abortion and reproductive rights in the 1960s, 1970s, and early 1980s through (...) the particular contributions of women of color. She explores the relationship between second-wave feminists, who were concerned with a woman's right to choose, Black and Puerto Rican Nationalists, who were concerned that Black and Puerto Rican women have as many children as possible “for the revolution,” and women of color themselves, who negotiated between them. Contrary to popular belief, Nelson shows that women of color were able to successfully remake the mainstream women's liberation and abortion rights movements by appropriating select aspects of Black Nationalist politics—including addressing sterilization abuse, access to affordable childcare and healthcare, and ways to raise children out of poverty—for feminist discourse. (shrink)

Feminism, Science, and the Philosophy of Science brings together original essays by both feminist and mainstream philosophers of science that examine issues at the intersections of feminism, science, and the philosophy of science. Contributors explore parallels and tensions between feminist approaches to science and other approaches in the philosophy of science and more general science studies. In so doing, they explore notions at the heart of the philosophy of science, including the nature of objectivity, truth, evidence, cognitive agency, scientific method, (...) and the relationship between science and values. (shrink)

Body integrity identity disorder (BIID), previously called apotemnophilia, is an extremely rare condition where sufferers desire the amputation of a healthy limb because of distress associated with its presence. This paper reviews the medical and philosophical literature on BIID. It proposes an evidenced based and ethically informed approach to its management. Amputation of a healthy limb is an ethically defensible treatment option in BIID and should be offered in some circumstances, but only after clarification of the diagnosis and consideration of (...) other treatment options. (shrink)

This paper advances the claim that skilful reflection is a master virtue in that skilful reflection shapes and corrects the other epistemic and intellectual virtues. We make the case that skilful reflection does this with both competence-based epistemic virtues and character-based intellectual virtues. In making the case that skilful reflection is a master virtue, we identify the roots of ideas central to our thesis in Confucian philosophy. In particular, we discuss the Confucian conception of reflection, as well as different levels (...) of epistemic virtue. Next we set out the Dual Process Hypothesis of Reflection, which provides an explanation of the workings of reflection in relation to Type 1 and Type 2 cognitive processes. In particular, we flag how repetition of Type 2 processes may eventually shape Type 1 processes and produce what we call downstream reflection. We distinguish competence-based epistemic virtues from character-based intellectual virtues. We also explain how our metacognition account of reflection, drawing on a Confucian conception of reflection and the Dual Process Hypothesis of Reflection, explains skilful reflection as a master virtue. Finally we outline an application of our metacognition account of reflection to a current debate in epistemology. (shrink)

This paper presents the theoretical bases and central proposes of anarchism, a social philosophy undergoing a resurgence in contemporary societies as the cornerstone of a possible radical utopia by demonstrating its renewed relevance to today’s socio-political circumstances while undermin..

Currently, the central questions in the philosophical debate surrounding the ethics of automated warfare are (1) Is the development and use of autonomous lethal robotic systems for military purposes consistent with (existing) international laws of war and received just war theory?; and (2) does the creation and use of such machines improve the moral caliber of modern warfare? However, both of these approaches have significant problems, and thus we need to start exploring alternative approaches. In this paper, I ask whether (...) autonomous robots ought to be programmed to be pacifists. The answer arrived at is “Yes”, if we decide to create autonomous robots, they ought to be pacifists. This is to say that robots ought not to be programmed to willingly and intentionally kill human beings, or, by extension, participate in or promote warfare, as something that predictably involves the killing of humans. Insofar as we are the ones that will be determining the content of the robot’s value system, then we ought to program robots to be pacifists, rather than ‘warists’. This is (in part) because we ought to be pacifists, and creating and programming machines to be “autonomous lethal robotic systems” directly violates this normative demand on us. There are no mitigating reasons to program lethal autonomous machines to contribute to or participate in warfare. Even if the use of autonomous lethal robotic systems could be consistent with received just war theory and the international laws of war, and even if their involvement could make warfare less inhumane in certain ways, these reasons do not compensate for the ubiquitous harms characteristic of modern warfare. In this paper, I provide four main reasons why autonomous robots ought to be pacifists, most of which do not depend on the truth of pacifism. The strong claim being argued for here is that automated warfare ought not to be pursued. The weaker claim being argued for here is that automated warfare ought not to be pursued, unless it is the most pacifist option available at the time, and other alternatives have been reasonably explored, and we are simultaneously promoting a (long term) pacifist agenda in (many) other ways. Thus, the more ambitious goal of this paper is to convince readers that automated warfare is something that we ought not to promote or pursue, while the more modest—and I suspect, more palatable—goal is to spark sustained critical discussion about the assumptions underlying the drive towards automated warfare, and to generate legitimate consideration of its pacifist alternatives,in theory, policy, and practice. (shrink)

Eric Nelson presents the first critical edition of the translations of Homer's Iliad and Odyssey composed by the great seventeenth-century philosopher and political theorist Thomas Hobbes. Nelson shows that these translations are not only of great literary interest but offer special insights into Hobbes's own thought.

The Egli-Milner power-ordering is used to define verisimilitude orderings on theories from preference orderings on models. The effects of the definitions on constraints such as stopperedness and soundness are explored. Orderings on theories are seen to contain more information than orderings on models. Belief revision is defined in terms of both types of orderings, and conditions are given which make the two notions coincide.

NATURES AND FUTURES FOR POLITICAL THEORY John S. Nelson What are the problematics, histories, forms, aims, conditions, methods, and topics proper to political theory? Plainly, these change from one context to another; and yet they may ...

This interview with Bernard Stiegler’s long-time translator and collaborator, Daniel Ross, examines the connections between different periods of Stiegler’s work, thought, writing and activism. Moving from the three volumes of Technics and Time to the final large-scale collaborative project of The Internation, the discussion concentrates on Stiegler’s conceptualization of ‘protentionality’, hope and care for a world confronted by climate crises, entropy and computational economic reconfigurations of work, economy and imaginations for futural possibilities. The interview foreshadows the special issue on The (...) Internation project planned by Bishop and Stiegler for TCS that will appear in the near future. (shrink)