In this paper we set out to explore the enactments of risk by clinicians involved in the development of stem cell therapy for liver disease. In the process, we contribute to a performative re-thinking of how ‘risk’ can be analytically treated in relation to health. The bulk of the paper, drawing on interview data, is concerned with how clinicians’ accounts about the risks entailed in their research-oriented work performatively ‘make’ clinicians themselves, but also various other ‘constituencies’ – notably, publics and (...) regulatory actors, and also such diverse ‘entities’ as scientific rigour and ethics. We trace the ways in which they enact the complexities of taking risks in the context of public demands, regulatory constraints, and resource limitation and explore how clinicians tend to represent themselves as caught between the ‘rock of courage’ and the ‘hard place of caution’. (shrink)

The study of bioethics has always been conducted by multiple disciplines. However the interaction between these disciplines has sometimes been marked by division, discord and disagreement, especially so between philosophically and sociologically minded contributors. This has been particularly true in recent years, and post the ‘empirical turn’ in bioethics. In our introduction we trace these disagreements and then take a wider look at the nature of disciplines and of interdisciplinary relations. These considerations are then brought back to the disciplines that (...) contribute work to bioethics as an explanation of why relationships within the field are difficult, and how we can start to address these divides. (shrink)

In the introduction to this volume we have argued that being an interdisciplinary scholar involves managing a complex interplay of disciplinary identities, as well as the ontologies and ways of knowing and understanding that are associated with the subject matter. We argued that trying to force a bioethical interdiscipline without a special regard to the individual epistemological, ontological and social aspects of the disciplines is unlikely to bear fruit in the long-term. Although bioethics has always been a multidisciplinary activity, the (...) relations between the various disciplines involved have traditionally been fraught, particularly so at the intersection between sociological and philosophical bioethics. We therefore proposed approaching bioethical interdisciplinarity in a manner that is careful and measured. This does not involve abandoning disciplines or disciplinarity, rather we are advocating for an increased level of cross-fertilisation between established disciplines or the way in which research is done, in the broadest sense. (shrink)

This paper offers a realist critique of socialresearch on health inequalities. A conspectus of thefield of health inequalities research identifies twomain research approaches: the positivist quantitativesurvey and the interpretivist qualitative `casestudy'. We argue that both approaches suffer fromserious philosophical limitations. We suggest that aturn to realism offers a productive `third way' bothfor the development of health inequality research inparticular and for the social scientific understandingof the complexities of the social world in general.

In this article we focus upon the embodiment of vulnerability as an area in which medicine, society and the humanities can be profitably conjoined. We illustrate our argument with two interrelated case studies of narratives of the embodiment of ageing and longevity. First, we draw upon Leoš Janáček’s opera The Makropulos Case (1926) as a locus for debates about human longevity. Second, we discuss 70-year-old Janáček’s decade of unrequited love for a woman 37 years younger than himself, through an examination (...) of their intimate letters. We suggest that both the opera and elements of Janáček’s biography illuminate the passionate emotions that are often hidden behind ‘the mask of ageing’. Finally, we propose that a focus on the embodiment of vulnerability is a productive catalyst for research on narratives of ageing. (shrink)

This book is an interdisciplinary contribution to bioethics, bringing together philosophers, sociologists and Science and Technology Studies researchers as a way of bridging the disciplinary divides that have opened up in the study of bioethics. Each discipline approaches the topic through its own lens providing either normative statements or empirical studies, and the distance between the disciplines is heightened not only by differences in approach, but also disagreements over the values, interpretations and problematics within bioethical research. In order to converse (...) across these divides, this volume includes contributions from several disciplines. The volume examines the sociological issues faced by interdisciplinary research in bioethics, the role of expertise, moral generalisations, distributed agency, and the importance of examining what is not being talked about. Other contributions try to take an interdisciplinary look at a range of specific situations, fetal alcohol syndrome in the media, citizen science, electronic cigarettes and bioethical issues in human geography. (shrink)

This paper aims to make an empirically informed analytical contribution to the development of a more socially embedded bioethics. Drawing upon 10 interviews with cutting edge stem cell researchers (5 scientists and 5 clinicians) it explores and illustrates the ways in which the role positions of translational researchers are shaped by the ‘normative structures’ of science and medicine respectively and in combination. The empirical data is used to illuminate three overlapping themes of ethical relevance: what matters in stem cell research, (...) experimental treatment, and responsible claim making (as contrasted with ‘hype’. Finally, we suggest that this kind of ‘descriptive’ ethical analysis has potential relevance for understanding other substantive areas of stem cell ethics in practice, and we briefly consider the questions our analysis raises about role positions and ethical agency, and the implications for bioethics as a field of scholarship. (shrink)

Argues that the tradition of critical theory has had significant problems dealing with the concept of nature and that their solutions require taking seriously the idea of nature as socially constructed.

I call for “postnaturalism” in environmental philosophy—for an environmental philosophy that no longer employs the concept nature. First, the term is too ambiguous and philosophically dangerous and, second, McKibben and others who argue that nature has already ended are probably right—except that perhaps nature has always already ended. Poststructuralism, environmental history, and recent science studies all point in the same direction: the world we inhabit is always already one transformed by human practices. Environmental questions are social and political ones, to (...) be answered by us and not by nature. Many will worry that this conclusion leads to environmentally pernicious consequences, and to problems of relativism and idealism, but I argue that it does not. Practices are real, not ideal, and not all practices are equal: those that acknowledge human responsibility for transforming the world are preferable to those that don’t. Environmental harm results when we do not recognize our own responsibility for the world our practices create. (shrink)

We present an investigation of the ways in which speakers' subjective perspectives are likely to affect the meaning of gradable adjectives like tall or heavy. We present the results of a study showing that people tend to use themselves as a yardstick when ascribing these adjectives to human figures of varied measurements: subjects' height and weight requirements for applying tall and heavy are found to be positively correlated with their personal measurements. We draw more general lessons regarding the definition of (...) subjectivity and the ways in which a standard of comparison and a significant deviation from that standard are specified. (shrink)

In response to the case study of Mr. Rivers, we will speak to three critical elements for an ethics consultant to address when a consult is requested due to moral distress. First, discern if the re...

Should people get vaccinated for the sake of others? What could ground—and limit—the normative claim that people ought to do so? In this paper, we propose a reasons-based consequentialist account of vaccination for the benefit of others. We outline eight harm-based and probabilistic factors that, we argue, give people moral reasons to get vaccinated. Instead of understanding other-directed vaccination in terms of binary moral duties (i.e., where people either have or do not have a moral duty to get vaccinated), we (...) develop a scalar approach according to which people can have stronger or weaker moral reasons to get vaccinated in view of the moral good of vaccination. One advantage of our approach is that it can capture why a person might have strong moral reasons to get vaccinated with Vaccine A, but only weak moral reasons to get vaccinated with Vaccine B. We discuss theoretical strengths of our approach and provide a case study of vaccination against COVID-19 to demonstrate its practical significance. (shrink)

In 2017, Carson and Flood outlined a general duty to be vaccinated, arguing from Catholic social teaching on justice, love, solidarity and the common good. This necessarily relied on assumptions about the typical nature of vaccination, assumptions which do not always hold true in concrete situations. I identify twelve criteria that, where they hold, strengthen the particular duty to be vaccinated, and, if not met, weaken or reverse it. These pertain to the biological agent which vaccination aims to protect against, (...) the vaccine and its supply, the costs and benefits of vaccination to the individual and society, and the alternative courses of action. The two-way relationship between the moral duty to be vaccinated and vaccine mandates is discussed. Individuals and policy-makers need to know these criteria – and be provided the necessary information to evaluate vaccination against them – in order to make a truly rational judgement. (shrink)

Based on an unfinished manuscript by the late philosopher Dallas Willard, this book makes the case that the 20th century saw a massive shift in Western beliefs and attitudes concerning the possibility of moral knowledge, such that knowledge of the moral life and of its conduct is no longer routinely available from the social institutions long thought to be responsible for it. In this sense, moral knowledge--as a publicly available resource for living--has disappeared. Via a detailed survey of main developments (...) in ethical theory from the late 19th through the late 20th centuries, Willard explains philosophy's role in this shift. In pointing out the shortcomings of these developments, he shows that the shift was not the result of rational argument or discovery, but largely of arational social forces--in other words, there was no good reason for moral knowledge to have disappeared. The Disappearance of Moral Knowledge is a unique contribution to the literature on the history of ethics and social morality. Its review of historical work on moral knowledge covers a wide range of thinkers including T.H Green, G.E Moore, Charles L. Stevenson, John Rawls, and Alasdair MacIntyre. But, most importantly, it concludes with a novel proposal for how we might reclaim moral knowledge that is inspired by the phenomenological approach of Knud Logstrup and Emmanuel Levinas. Edited and eventually completed by three of Willard's former graduate students, this book marks the culmination of Willard's project to find a secure basis in knowledge for the moral life. (shrink)

Moralization is a social-psychological process through which morally neutral issues take on moral significance. Often linked to health and disease, moralization may sometimes lead to good outcomes; yet moralization is often detrimental to individuals and to society as a whole. It is therefore important to be able to identify when moralization is inappropriate. In this paper, we offer a systematic normative approach to the evaluation of moralization. We introduce and develop the concept of ‘mismoralization’, which is when moralization is metaethically (...) unjustified. In order to identify mismoralization, we argue that one must engage in metaethical analysis of moralization processes while paying close attention to the relevant facts. We briefly discuss one historical example and two contemporary cases related to COVID-19 that we contend to have been mismoralized in public health. We propose a remedy of de-moralization that begins by identifying mismoralization and that proceeds by neutralizing inapt moral content. De-moralization calls for epistemic and moral humility. It should lead us to pull away from our tendency to moralize—as individuals and as social groups—whenever and wherever moralization is unjustified. (shrink)

Does artificial intelligence (AI) exhibit consciousness or self? While this question is hotly debated, here we take a slightly different stance by focusing on those features that make possible both, namely a basic or fundamental subjectivity. Learning from humans and their brain, we first ask what we mean by subjectivity. Subjectivity is manifest in the perspectiveness and mineness of our experience which, ontologically, can be traced to a point of view. Adopting a non-reductive neurophilosophical strategy, we assume that the point (...) of view exhibits two layers, a most basic neuroecological and higher order mental layer. The neuroecological layer of the point of view is mediated by the timescales of world and brain, as further evidenced by empirical data on our sense of self. Are there corresponding timescales shared with the world in AI and is there a point of view with perspectiveness and mineness? Discussing current neuroscientific evidence, we deny that current AI exhibits a point of view, let alone perspectiveness and mineness. We therefore conclude that, as per current state, AI does not exhibit a basic or fundamental subjectivity and henceforth no consciousness or self is possible in models such as ChatGPT and similar technologies. (shrink)

Winner of 2002 Edward Goodwin Ballard Prize In a penetrating and lucid discussion of the enigmatic relationship between the work of Edmund Husserl and Martin Heidegger, Steven Galt Crowell proposes that the distinguishing feature of twentieth-century philosophy is not so much its emphasis on language as its concern with meaning. Arguing that transcendental phenomenology is indispensable to the philosophical explanation of the space of meaning, Crowell shows how a proper understanding of both Husserl and Heidegger reveals the distinctive contributions (...) of each to that ongoing phenomenological project. (shrink)

The leading models of disability struggle to fully encompass all aspects of “disability.” This difficulty arises, the author argues, because the models fundamentally misunderstand the nature of disability. Current theoretical approaches to disability can be understood as “nounal,” in that they understand disability as a thing that is caused or embodied. In contrast, this paper presents an adverbial perspective on disability, which shows that disability is experienced as a personally irremediable impediment to daily-living tasks or goals-like-ours. The picture theory of (...) disability technically constitutes a species of relational approach because its analysis references the interplay between an individual and their environment; it differs from other relational accounts, however, by interpreting disability as a certain kind of negative experience—rather than a function of that relationship. This purely descriptive theory makes no normative claims about disability and operates as both a mechanism for the evaluation of the experience of disability and a heuristic device for the proper interpretation of disability. When disability is reframed in this way, the theory offers a particularist perspective which shows if, when, where, and how disability is experienced. (shrink)

Sorry that he is no longer here to read it, I consider in this paper Scott Cameron’s discussion of my views questioning the value of the concept of “nature” for environmental philosophy. Scott had suggested, based on arguments from hermeneutics, that although we never have access to a nature independent of our interpretations of it, still the existence of such a nature is necessarily presupposed by all such interpretations. I claim in response that if we replace the (idealist) notion of (...) interpretation by the (materialist) one of practice, that presupposition is no longer necessary: the independence required is built into the notion of practice itself, and need not be seen as a characteristic of the world “outside” of us. (shrink)

Sorry that he is no longer here to read it, I consider in this paper Scott Cameron’s discussion of my views questioning the value of the concept of “nature” for environmental philosophy. Scott had suggested, based on arguments from hermeneutics, that although we never have access to a nature independent of our interpretations of it, still the existence of such a nature is necessarily presupposed by all such interpretations. I claim in response that if we replace the (idealist) notion of (...) interpretation by the (materialist) one of practice, that presupposition is no longer necessary: the independence required is built into the notion of practice itself, and need not be seen as a characteristic of the world “outside” of us. (shrink)

The earliest phase of philosophy in Europe saw the beginnings of cosmology and rational theology, metaphysics, epistemology, and ethical and political theory. It also saw the development of a wide range of radical and challenging ideas, from Thales' claim that magnets have souls and Parmenides' account of one unchanging existence to the development of an atomist theory of the physical world. This general account of the Presocratics introduces the major Greek philosophical thinkers from the sixth to the middle of the (...) fifth century B.C. It explores how we might reconstruct their views and understand the motivation and context for their work, and it highlights the ongoing philosophical interest of their often surprising claims. Separate chapters are devoted to each of the major Presocratic thinkers, including Xenophanes, Heraclitus, Parmenides, Anaxagoras, Empedocles, Leucippus, and Democritus. With a chronology and guide to further reading, this book is an ideal introduction for the student and general reader. _Copub: Acumen Publishing Limited_. (shrink)

Motive and Rightness is the first book-length attempt to answer the question, Does the motive of an action ever make a difference in whether that action is morally right or wrong? Steven Sverdlik argues that the answer is yes. His book examines the major theories now being discussed by moral philosophers to see if they can provide a plausible account of the relevance of motives to rightness and wrongness. Sverdlik argues that consequentialism gives a better account of these matters (...) than Kantianism or certain important forms of virtue ethics. In carrying out the investigation Sverdlik presents an analysis of the nature of motives, and he considers their relations to normative judgments and intentions. A chapter is devoted to analyzing the extent to which motives are 'available' to rational agents, and the importance of feelings and unconscious motives. Historical figures such as Kant, Bentham, Mill and Ross are discussed, as well as contemporary writers like Korsgaard, Herman, Hurka, Slote and Hursthouse. Motive and Rightness is unusual in its interweaving of ethical theory, both historical and contemporary, with moral psychology, action theory, and psychology. (shrink)

The locale corresponding to the real interval [ − 1, 1] is an interval object, in the sense of Escardó and Simpson, in the category of locales. The map, mapping a stream s of signs ±1 to, is a proper localic surjection; it is also expressed as a coequalizer. The proofs are valid in any elementary topos with natural numbers object.

Pollution results from humankind’s failure to be good stewards of creation. Guided by Catholic environmental bioethics, Catholic health care organizations have reduced their contribution to this pollution, but they also encounter its human cost. Catholic hospitals treat countless patients sickened by pollution, which most strongly impacts the poor and disenfranchised—those whom the Church expresses a preferential responsibility to care for, in part via the charity care that Catholic health care provides. The poor encounter another cost of pollution: the financial cost (...) of seeking health care, particularly in the US. The authors argue that Catholic health care institutions should take the moral harm of pollution seriously by reducing the financial burden on those sickened by pollution. As an example, they highlight the situation of those sickened by lead exposure in the US and outline how Catholic health care institutions could consider lessening the financial burden of treating this sickness. (shrink)

Van der Pijl et al outline data suggesting an alarmingly high incidence of violation of the bodily integrity of patients in labour, including episiotomies performed without patients’ consent, or over their explicit objection.1 Similar data have been reported from the USA and Canada.2 The authors appropriately conclude that explicit consent is required at the time of all invasive obstetrical procedures, including episiotomy. Commonsense adjustments to the duration and detail of consent under conditions of clinical urgency are appropriate and should be (...) familiar to any clinician involved in perinatal care, as well as non-obstetric proceduralists caring for acutely ill patients. However, complete omission of consent for any of these procedures is both disrespectful to patients’ autonomy and strongly associated with morbidity from birth-related psychosocial trauma.3–5 The true incidence of obstetrical procedures performed without patients’ consent is difficult to determine for multiple reasons, including sample selection, recall bias and patients’ reluctance to reengage with traumatic experiences; however, …. (shrink)

The Sarbanes–Oxley Act of 2002 requires audit committees of public companies’ boards of directors to install an anonymous reporting channel to assist in deterring and detecting accounting fraud and control weaknesses. While it is generally accepted that the availability of such a reporting channel may reduce the reporting cost of the observer of a questionable act, there is concern that the addition of such a channel may decrease the overall effectiveness compared to a system employing only non-anonymous reporting options. The (...) rationale underlying this concern involves the would-be reporter’s likelihood of reporting, the seriousness with which the organization treats an anonymous report, and the organization’s ability to thoroughly follow-up the report. Thus, we explore the extent to which the availability of an anonymous reporting channel influences intended use of non-anonymous reporting channels. Further, in response to Sarbanes–Oxley and the environment of financial scandals that led to its passage, many firms are strengthening their internal audit departments, and providing them with greater independence from upper management’s direct control. Accordingly, our examination tests whether the intended use of the internal audit department as an internal reporting channel is greater when the internal audit department is of “high” versus “low” quality. Finally, the study investigates intended reporting behavior across three different cases (e.g., settings). Results show that the existence of an anonymous channel does reduce the likelihood of reporting to non-anonymous channels, that generally the internal audit department quality does not affect reporting to non-anonymous channels, and that case-setting affects the type of channel to be used. Implications from the study are discussed. (shrink)

We report the results of a study that examines the association between gender and individuals’ intentions to report fraudulent financial reporting using non-anonymous and anonymous reporting channels. In our experimental study, we examine whether reporting intentions in response to discovering a fraudulent financial reporting act are associated with the participants’ gender, the perpetrator’s gender, and/or the interaction between the participants’ and perpetrator’s gender. We find that female participants’ reporting intentions for an anonymous channel are higher than for male participants; the (...) fraud perpetrator’s gender and the interaction with participants’ gender were not significantly associated with anonymous channel reporting intentions. Neither of the two factors nor the interaction between the two factors was associated with reporting intentions to a non- anonymous reporting channel. Results from an additional analysis indicate that male and female participants differ in the extent to which they judge the reduction in personal costs of an anonymous reporting channel compared to a non-anonymous reporting channel and that the reduction in personal costs mediates the relationship between participant gender and anonymous reporting intentions. (shrink)

The fields of positive psychology, cognitive behavioral therapy, mindfulness, and goal-setting have all demonstrated that individuals can modify their beliefs, attitudes, intentions, and behaviors to improve their subjective happiness. But which ethical beliefs affect happiness positively? In comparison to ethical belief systems such as deontology, consequentialism, and altruism, rational egoism appears to be alone in suggesting that an individual’s long-term self-interest and subjective happiness is possible, desirable, and moral. Albeit an important theoretical foundation of the rational egoism philosophy, the relationship (...) between rational egoism and subjective happiness has yet to be investigated empirically. Using (Overall and Gedeon, Business and Professional Ethics. 38:43–78, 2018) 24-item rational egoism scale, we test this relationship on a random sample of 534 full-time American workers using partial least squares structural equation modelling (PLS-SEM). Consistent with rational egoism theory, the main contribution to knowledge of this research is finding a statistically significant relationship between rational egoism and subjective happiness. Implications for practice and areas for future study are suggested. (shrink)

Despite the significant contribution of cognitive-behavioral therapy to effective treatment options for specific syndromes, treatment progress has been stagnating, with response rates plateauing over the past several years. This stagnation has led clinical researchers to call for an approach that instead focuses on processes of change and the individual in their particular context. Process-based therapy is a general approach representing a model of models, grounded in evolution science, with an emphasis on idiographic methods, network models of case conceptualization, and enhancing (...) wellbeing. In this paper, we describe the theory underlying PBT and present a case study for how to apply PBT tools and principles to deliver process-informed and person-centered evidence-based treatment. In addition, we discuss lessons learned from our case and provide suggestions for future considerations when implementing PBT in clinical settings. (shrink)

When new drugs are approved by the Food and Drug Administration, the default assumption is that they will be available by prescription only, safe for use exclusively under clinical supervision. The paternalism underlying this default must be interrogated in order to ensure appropriate respect for patient autonomy. Upon closer inspection, prescription requirements are justified when nonprescription status would risk harm to third parties and when a large segment of the population would struggle to exercise their autonomy in using a drug (...) safely and effectively on their own. Although these justifications can support prescription status for many drugs, we propose that reversing the FDA's current default to instead begin with a presumption in favor of over‐the‐counter status is the best way to avoid interference with valid claims of patient autonomy. Under this approach, a range of drug products could be considered for an OTC switch, including oral contraceptives, statins, and HIV‐prevention drugs. (shrink)

Recent, well-publicized accounting scandals have shown that the penalties outsiders impose on those found culpable of earnings management can be severe. However, less is known about how colleagues within internal labor markets respond when they believe fellow managers have managed earnings. Designers of responsibility accounting systems need to understand the reputational costs managers impose on one another within internal labor markets. In an experimental study, 159 evening MBA students were asked to assume the role of a manager in a company (...) and respond to a scenario in which another manager (the target manager) has the opportunity to engage in earnings management. Participants provided causal attributions, assessed the morality of the target manager, and indicated whether they would change their judgments about the target manager's reputation. The study manipulated three between-subjects factors: (1) whether the target manager chose to engage in earnings management, (2) whether the company's budgetary control system was rigid or flexible, and (3) whether the target manager's work history was average or above average. We found that causal attributions are affected more by the budgetary systems when the target did not manage earnings than when the manager did. We also found that morality judgments were significantly associated with the target manager's behavior, but not with the budgetary system. In addition, participants' judgments about the target manager's reputation were more strongly associated with morality judgments than with causal attributions. We discuss implications of the role of reputation in management control systems design. (shrink)

Thirty years after the publication of Dominique Janicaud’s criticism of what he termed the “theological turn” of phenomenology in France, what is the state of the debate? This paper addresses that question, by examining the phenomenology of revelation in Marion, Lacoste, and others, in turn replying to various arguments that have been advanced against the theological turn and on behalf of methodological atheism. Not only is revelation a viable topic of phenomenological analysis, the attempts to formulate a methodologically atheist phenomenology (...) fail. (shrink)

This chapter explores the ethics of Robert Daly's actions in the episode “USS Callister”. We consider issues of privacy that relate to him stealing his co‐workers DNA in order to scan them into the game, as well as the ethics of how he treats the digital avatars of his co‐workers within the game. Examining Daly's actions from a few different approaches, we argue that Daly's actions towards his co‐workers avatars are very likely immoral, though ultimately we cannot know without knowing (...) Daly's thoughts. Finally, we end the chapter with some considerations relating to video games in general and the ways in which we must act when we play video games. (shrink)

This article evaluates the moral implications of two leading theories on biodiversity preservation/conservation (Paul Taylor's biocentric egalitarianism and J. Baird Callicott's holistic communitarianism). Taylor argues for the moral equality of all members of the Earth's community of life, calling for an ethic of respect for nature to conserve biodiversity. Callicott argues for the moral consideration of ecosystems to maintain their integrity, stability, and beauty. The article makes two major claims. First, we need a plausible account of moral egalitarianism to disrupt (...) ethical anthropocentrism. Second, the ethics of respect for nature requires a critical bottom-up character-based ethical theory to be morally forceful. These missing elements are central to the ubuntu philosophy about personhood and are significant for enriching egalitarian-communitarian solutions to biodiversity loss. (shrink)