Despite the fact that the requirement to obtain informed consent for medical procedures is deeply enshrined in both U.S. moral and legal doctrine, empirical studies and anecdotal accounts show that women's rights to informed consent and refusal of treatment are routinely undermined and ignored during childbirth. For example, citing the most recent Listening to Mothers survey, Marianne Nieuwenhuijze and Lisa Kane Low state that "a significant number of women said they felt pressure from a caregiver to agree to having an (...) intervention that they did not want during birth". Specifically, Nieuwenhuijze and Low cite that "19% of women who did not have epidural analgesia felt... (shrink)

In A Good Birth, obstetrician and bioethicist Anne Drapkin Lyerly aims to improve women’s experiences of childbirth in the United States by cutting through the vitriolic, shame-inducing, and blame-assigning language of what she terms “the birth wars”—the “polarized debate over where birth should be undertaken and how, who is the presumptive attendant, which professionals need to be supervised, and which way the money should flow”. Too often, women like Lyerly’s friend Erin, whom Lyerly interviewed for the book, are the casualties (...) of the birth wars, as they feel ashamed, distraught, and guilty for not giving birth according to the dictates of a particular ideology. According to Lyerly, Erin planned to... (shrink)

In this article, we discuss decision making during labor and delivery, specifically focusing on decision making around offering women a trial of labor after cesarean section. Many have discussed how humans are notoriously bad at assessing risks and how we often distort the nature of various risks surrounding childbirth. We will build on this discussion by showing that physicians make decisions around TOLAC not only based on distortions of risk, but also based on personal values rather than medical data. As (...) a result of this, we will further suggest that the party who is best epistemically situated to make decisions about TOLAC is the woman herself. (shrink)

In 2018, at least 12 adults and 3 children died in U.S. detention facilities. In 2017, 12 people died in U.S. detention facilities and at least 10 women filed complaints against ICE for mistreatment that led them to miscarry. At the time of this writing, 26 people have died in US Custody during the Trump Administration and 74 people have died in U.S. detention facilities between 2010 and 2018, including Raul Ernesto Morales-Ramos, Augustina Ramirez-Arreola, Moises Tino-Lopez, Jose Azurdia, and Roxana (...) Hernandez. I am not going to argue that these deaths are wrong – I take that as obvious. Instead, I will suggest that nonideal theory shows why bioethicists have special obligations for condemning these deaths and getting involved to make them stop. When we heed nonideal theory’s demand to consider empirical realities, we will see that the role of the bioethicist extends wherever health care does. Moreover, when bioethicists expressly embrace nonideal rather than ideal theories to ground our work, we will see that there are plenty such theories available to us. Shelly Wilcox’s nonideal theory of immigration justice is especially well suited for bioethicists to use in relation to detainee health care and enter the conversation where they are so desperately needed. (shrink)

Using testimonies from immigrants and examples of immigrant policies, this book proposes an interdisciplinary, feminist approach to immigration justice.

The last fifteen years have seen an increasing social science scholarship into the nature and pervasiveness of hooking up amongst college students,1 but research on the philosophical and ethical issues within hookup culture and practice has not kept pace. To the extent that hooking up has been taken up by philosophers, it has been as part of a larger conversation about the ethics of casual sex, broadly construed; a conversation which is dominated by questions of objectification. As such, investigations into (...) the ethics of hookup sex have been limited to questions of whether someone was used in the encounter.2 This essay aims to change this by utilizing Ann Cahill’s recent book, Overcoming Objectification, to argue that the ethical problems with hookup sex in Guyland are not rooted in women’s objectification but rather their derivatization. (shrink)

In September 2020, Project South, along with numerous other organizations, released a report detailing abuses in a Georgia Detention Center – including forced hysterectomies. Whatever other factors are at play, one of them is an intrinsic connection between obstetric violence against pregnant migrants and immigration injustice. It is not incidental that these acts – in US detention centers, along the US‐Mexico border, in Colombian hospitals and clinics – are being perpetrated on immigrant bodies. And it is not accidental or random (...) which immigrant bodies are vulnerable to these violations. Understanding and confronting obstetric violence directed at pregnant migrants, though, requires reconceptualizing the nature of obstetric violence itself. In particular, we must recognize that obstetric violence against pregnant Latin American migrants in the United States and Colombia is a type of immigration injustice, a means to perpetrate immigration injustice, and a product of immigration injustice. As such, bioethicists need to collaborate with immigration scholars to resist it.After providing some background on the nature of obstetric violence and some ways it is perpetuated against pregnant migrants in the United States and Colombia, I will give a brief overview of how I conceptualize immigration justice. From there, I explain how this type of obstetric violence constitutes a type of immigration injustice, a means to perpetrate immigration injustice, and a product of immigration injustice. My hope is that this analysis motivates bioethicists throughout the Americas to engage with immigration scholars and activists to confront the issue more forcefully. (shrink)

At this point, I think it is fair to say that most of us know someone—a family member, a coworker, a friend, a student—who is resisting getting a vaccine against COVID-19. Frankly, this amazes me. I was recently discussing this with a friend—"Rebecca"—when to my utter shock, she confessed to me that she "does not trust the vaccine" and is not planning to get one until there is more certainty of its efficacy and safety. While there are many things that (...) stood out to be in this conversation, what stood out to me was a particular comment she made; she said to me: "The thing is, I'm a skeptic, and you're not."I admit, this comment threw me for a loop. How could I, a feminist bioethicist who has dedicated a good chunk of... (shrink)

With few exceptions, philosophers working on immigration have not taken up the topic of epistemic injustice, primarily, I imagine, because immigration justice is often too narrowly conceived of as encompassing moral and political concerns rather than epistemic ones. But the more I think about the injustices immigrants endure on a daily basis, the more I take this to be a mistake; epistemic injustices must be seen as a central aspect of immigration injustice too. In what follows, I will demonstrate how (...) this is the case. More specifically, after providing an overview of the nature of epistemic injustice, I will highlight some examples of it in the lives of displaced Venezuelan immigrants in Colombia. In doing so, I hope to show why discussions about immigration injustice must include identifying and confronting epistemic wrongs. (shrink)

Alison Bailey has recently explored the nature of what she calls privilege‐evasive epistemic pushback or “the variety of willful ignorance that many members of dominant groups engage in when they are asked to consider both the lived experience and structural injustices that members of marginalized groups experience daily.” In this article, I want to use Bailey's argument to demonstrate how privilege‐evasive epistemic pushback is facilitated and obscured by the disciplinary tools of traditional Western philosophy. Specifically, through exploring philosophical cultures of (...) justification and case studies, this work will reveal how students engage in privilege‐evasive epistemic pushback by deploying the reason/emotion divide and various philosophical norms and practices it underlies to protect their epistemic home turf. Then, I offer three emotion‐enhancing critical philosophical practices aimed at disrupting the ignorance‐promoting moves of privilege‐evasive epistemic pushback and, instead, engage emotion as epistemically significant. (shrink)

In 2010, Taffy Brodesser-Akner published an article entitled, “How Childbirth Caused my PTSD,” on Salon.com. Much to my surprise, her claims that she was seriously traumatized by childbirth encountered strong resistance and disbelief. In trying to understand the source of this resistance, I discovered a type of violence, which I refer to as “metaphysical violence,” that is often overlooked, yet prevalent, in what many people in the United States understand as normal childbirth practices and protocols. In this essay, I will (...) use María Lugones’s Pilgramages/Peregrinajes to offer a detailed account of what constitutes metaphysical violence, how it functions, and why it is so damaging to at least 9% of post-partum women who meet the criteria for PTSD and the 18% of post-partum women who show some sign of the disorder. Then, I will offer suggestions for how we can help women who may be victims of metaphysical violence during birth avoid some of the trauma it so often induces. (shrink)

Feminists have highlighted various ways in which medicalized childbirth is connected to violence. For example, the literature is replete with examples of court-ordered Cesarean sections, intimidation in the delivery room, women diagnosed with post-traumatic stress disorder as a result of their childbirth experiences. The most common approach to the accusations about the connections between medicalized childbirth and violence has been to investigate the degree to which the evidence bears out their accuracy. In this essay, the author takes a different course; (...) instead of trying to confirm or refute reports of violence in childbirth, she posits that understanding the ways in which violence is connected to medicalized childbirth requires us to note the existence of another form of violence that has not been recognized or discussed up to this point – metaphysical violence. The primary focus of this essay is to define that other form of violence as well as to suggest places where the routine practices of medicalized childbirth perpetuate it and possible ways to resist it. (shrink)

Applying Jewish Ethics: Beyond the Rabbinic Tradition is a groundbreaking collection that introduces the reader to applied ethics and examines various social issues from contemporary and largely under-represented, Jewish ethical perspectives.

Este artículo problematiza la forma en la que el feminismo ha interpretado al escepticismo como una amenaza para su proyecto epistemológico, ético y político, y plantea que, a pesar de dicha interpretación, el escepticismo es inherente a la filosofía feminista y un aliado útil para su proyecto. El problema ha estado en cómo el feminismo ha reducido su comprensión del escepticismo a una versión cartesiana extrema y ha pasado por alto otras corrientes de la tradición —como la de David Hume— (...) que podrían ser fructíferas para promover una actitud crítica y emancipatoria. Muestra así como una alianza entre una comprensión moderada del escepticismo y el feminismo puede brindar las herramientas necesarias para cuestionar formas de dominación patriarcal y poner en marcha investigaciones que combatan la opresión de género. (shrink)

In this article, I investigate actions that the United States took against Costa Rica during the 1980s in order to argue that current discussions about global justice and its foundations are flawed in three ways. First, it misidentifies the parties of global justice as individual citizens. Second, it conceptualizes global justice as exclusively a distributive justice concern and, as a result, it misidentifies what constitutes a global injustice as being the adverse fate of individuals who live in a poor nation. (...) Finally, the current debate provides no guidance in what must be considered to identify the specific obligations one nation may have to another nation. Given these three problems, I maintain that we conceptualize global injustice as an issue of social justice rather than one exclusively of distributive justice. This will require identifying nations as the parties to global justice, at least in certain cases, and realizing that our goal is to remedy oppressive global structures of power. Utilizing the social justice I propose will put us on the road toward achieving justice across the Americas. (shrink)

Florencia Luna begins her essay, “Challenges for Assisted Reproduction and Secondary Infertility in Latin America,” by saying: “I want to explore a new way to think about Assisted Reproductive Technologies (ARTs) in the Latin American context.” I think she clearly achieves that objective. I want to suggest that she does more than this, however. In addition to revealing how traditional depictions of infertility in the United States and Europe are anachronistic for Latin America, her analysis offers feminist bioethicists in the (...) United States the opportunity to revisit our own assumptions about infertility and improve our work as a result.Luna states early in her essay that her analysis will center on secondary .. (shrink)

Kant’s formula of universal law (FUL) is standardly understood as a test of the moral permissibility of an agent’s maxim: maxims which pass the test are morally neutral, and so permissible, while those which do not are morally impermissible. In contrast, I argue that the FUL tests whether a maxim is the cause or determining ground of an action at all. According to Kant’s general account of causality, nothing can be a cause of some effect unless there is a law-like (...) relation between the putative cause and effect. Applied to the case of action, no maxim can be the cause of an agent’s action unless there is a law-like relation between maxims of that kind and actions of that kind. The special capacity to act according to maxims as law-like causes is what Kant calls a will; the basic constitutive principle of the will is a non-normative principle I call the categorical declarative. While the actions of a perfectly good will would be described by the categorical declarative alone, human action is determined not only by the causality of the will, but also by competing causes, namely those stemming from inclination. There is thus need for a causal test for putative maxims. The test contained in the FUL is meant to determine whether an action could be grounded solely on the agent’s maxim, or whether it requires a cause external to the will. This account permits one to build eventual distinctions concerning the morality of actions on prior and independent distinctions concerning their causality. (shrink)

Seite dualität: Anarchismus 121. Konsequenzen der individualitätszerstörenden Gleichheitstheorie: Stellung der Frau 123; unhistorische Denkweise 123; ...

This 2005 book is a critical examination of Michel Foucault's relation to ancient Greek thought, in particular his famous analysis of Greek history of sexuality. Wolfgang Detel offers an understanding of Foucault's theories of power and knowledge based on modern analytical theories of science and concepts of power. He offers a complex reading of the texts which Foucault discusses, covering topics such as Aristotle's ethics and theory of sex, Hippocratic dietetics, the earliest treatises on economics, and Plato's theory of love. (...) The result is a philosophically rich and probing critique of Foucault's later writings, and a persuasive account of the relation between ethics, power and knowledge in classical antiquity. His book will have a wide appeal to readers interested in Foucault and in Greek thought and culture. (shrink)

Most people, including philosophers, tend to classify human motives as falling into one of two categories: the egoistic or the altruistic, the self-interested or the moral. According to Susan Wolf, however, much of what motivates us does not comfortably fit into this scheme. Often we act neither for our own sake nor out of duty or an impersonal concern for the world. Rather, we act out of love for objects that we rightly perceive as worthy of love--and it is (...) these actions that give meaning to our lives. Wolf makes a compelling case that, along with happiness and morality, this kind of meaningfulness constitutes a distinctive dimension of a good life. Written in a lively and engaging style, and full of provocative examples, Meaning in Life and Why It Matters is a profound and original reflection on a subject of permanent human concern. (shrink)

The development of genomic technologies has seemed almost magical. Excitement about it, both in medicine and among the public, stems from the belief that genomic techniques will illuminate the causes of health and disease, will lead to effective interventions for both rare and common genetic conditions, and will inform reproductive decision‐making. Novel diagnostic tools, however, are often deployed before targeted therapies are developed, tested, or available and before their psychosocial implications are explored. Newer technologies such as prenatal whole exome screening (...) are seen as offering “decisional autonomy” to expectant parents, although such technologies identify information about genetic sequencing that may not have clear meaning. The “therapeutic gap” between the ability to conduct genetic sequencing and the ability to fully understand what the test results mean, much less what treatments to offer, leaves families with complex and unclear information they cannot act upon with confidence during pregnancy. In this essay, we will consider the psychosocial and ethical implications of such assumptions—and of the uncertain information produced by these technologies—for individuals and families and for societal aspects such as medical service usage and demographic inequities. (shrink)

The executive hypothesis of self-regulation places cognitive information processing at the center of self-regulatory success/failure. While the hypothesis is well supported by cross-sectional studies, no study has tested its primary prediction, that temporary lapses in executive control underlie moments of self-regulatory failure. Here, we conducted a naturalistic experiment investigating whether short-term variation in executive control is associated with momentary self-regulatory outcomes, indicated by negative affect reactivity to everyday stressors. We assessed working memory capacity (WMC) through ultra-brief, ambulatory assessments on smart (...) phones five times per day in a 7-day ecological momentary assessment (EMA) study involving college-aged adults. We found that participants exhibited more negative affect reactivity to stressor exposures during moments when they exhibited lower than usual WMC. Contrary to previous findings, we found no between-person association between WMC and average stress reactivity. We interpret these findings as reflecting the role of executive control in determining one’s effective capacity to self-regulate. (shrink)

In this paper we address the question of when a researcher is justified in describing his or her artificial agent as demonstrating ethical decision-making. The paper is motivated by the amount of research being done that attempts to imbue artificial agents with expertise in ethical decision-making. It seems clear that computing systems make decisions, in that they make choices between different options; and there is scholarship in philosophy that addresses the distinction between ethical decision-making and general decision-making. Essentially, the qualitative (...) difference between ethical decisions and general decisions is that ethical decisions must be part of the process of developing ethical expertise within an agent. We use this distinction in examining publicity surrounding a particular experiment in which a simulated robot attempted to safeguard simulated humans from falling into a hole. We conclude that any suggestions that this simulated robot was making ethical decisions were misleading. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

This paper has both theoretical and practical ambitions. The theoretical ambitions are to explore what would constitute both effective and ethical treatment of Autism Spectrum Disorder.1 However, the practical ambition is perhaps more important: we argue that a dominant form of Applied Behavior Analysis, which is widely taken to be far-and-away the best “treatment”2 for ASD, manifests systematic violations of the fundamental tenets of bioethics. Moreover, the supposed benefits of the treatment not only fail to mitigate these violations, but they (...) often exacerbate them. Warnings of the perils of ABA are not original to us—autism advocates have been ringing this... (shrink)

In this paper, I contest increasingly common "realist" interpretations of Hegel's theory of "the concept" (der Begriff), offering instead a "isomorphic" conception of the relation of concepts and the world. The isomorphism recommended, however, is metaphysically deflationary, for I show how Hegel's conception of conceptual form creates a conceptually internal standard for the adequacy of concepts. No "sideways-on" theory of the concept-world relationship is envisioned. This standard of conceptual adequacy is also "graduated" in that it allows for a lack of (...) fit between concept and world. The possibility for a "maximally isomorphic" fit between concept and world obtains through the teleological realization of concepts, which marks especially the "artificial" world of human culture (law, art, religion, etc.). Some of the most seemingly exaggerated claims Hegel makes about the concept, I contend, can be understood when we consider the significance Hegel ascribes to human making, which is provided for in his conceptual theory. But my framework provides an interpretive key for the way Hegel sees concepts imperfectly realized in the natural world as well. (shrink)

In this paper we examine the case of Tay, the Microsoft AI chatbot that was launched in March, 2016. After less than 24 hours, Microsoft shut down the experiment because the chatbot was generating tweets that were judged to be inappropriate since they included racist, sexist, and anti-Semitic language. We contend that the case of Tay illustrates a problem with the very nature of learning software that interacts directly with the public, and the developer's role and responsibility associated with it. (...) We make the case that when LS interacts directly with people or indirectly via social media, the developer has additional ethical responsibilities beyond those of standard software. There is an additional burden of care. (shrink)

Participant-driven research is a burgeoning domain of research innovation, often facilitated by mobile technologies. Return of results and data are common hallmarks, grounded in transparency and data democracy. PDR has much to teach traditional research about these practices and successful engagement. Recommendations calling for new state laws governing research with mHealth modalities common in PDR and federal creation of review mechanisms, threaten to stifle valuable participant-driven innovation, including in return of results.

There are well-known problems for formalist accounts of game-play with regards to cheating. Such accounts seem to be committed to cheaters being unable to win–or even play–the game, yet it seems that there are instances of cheaters winning games. In this paper, I expand the discussion of such problems by introducing cases of pre-game cheating, and see how a formalist–specifically a Suitsian–account can accommodate such problems. Specifically, I look at two (fictional) examples where the alleged game-players cheat prior to a (...) game-instance in such as a way as to cast doubt on whether the alleged game-players are truly playing the game. To escape the worries brought about by these examples of pre-game cheating, I will appeal to the concept of nested games. This concept will give us the needed tools to explain how the alleged players are cheating and how the alleged players are players. On the whole, this discussion should help illuminate some important issues with regards to cheating and rules on a Suitsian account of game-play, and help give support for formalist accounts more generally. (shrink)

In recent years, theories of social understanding have moved away from arguing that just one epistemic strategy, such as theory-based inference or simulation constitutes our ability of social understanding. Empirical observations speak against any monistic view and have given rise to pluralistic accounts arguing that humans rely on a large variety of epistemic strategies in social understanding. We agree with this promising pluralist approach, but highlight two open questions: what is the residual role of mindreading, i.e. the indirect attribution of (...) mental states to others within this framework, and how do different strategies of social understanding relate to each other? In a first step, we aim to clarify the arguments that might be considered in evaluating the role that epistemic strategies play in a pluralistic framework. On this basis, we argue that mindreading constitutes a core epiststrategy in human social life that opens new central spheres of social understanding. In a second step, we provide an account of the relation between different epistemic strategies which integrates and demarks the important role of mindreading for social understanding. (shrink)

In recent years, theories of social understanding have moved away from arguing that just one epistemic strategy, such as theory-based inference or simulation constitutes our ability of social understanding. Empirical observations speak against any monistic view and have given rise to pluralistic accounts arguing that humans rely on a large variety of epistemic strategies in social understanding. We agree with this promising pluralist approach, but highlight two open questions: what is the residual role of mindreading, i.e. the indirect attribution of (...) mental states to others within this framework, and how do different strategies of social understanding relate to each other? In a first step, we aim to clarify the arguments that might be considered in evaluating the role that epistemic strategies play in a pluralistic framework. On this basis, we argue that mindreading constitutes a core epiststrategy in human social life that opens new central spheres of social understanding. In a second step, we provide an account of the relation between different epistemic strategies which integrates and demarks the important role of mindreading for social understanding. (shrink)

Drawing on a survey of over 4000 students and 1300 faculty members at the University of Maryland Global Campus, we find evidence for a reconceptualization of the use of commercialized websites offering access to “tutors” or “study help” as a type of collaborative cheating. Past studies have examined this behavior as an extension of contract cheating, but we find that students perceive the use of these sites very differently than they perceive contract cheating behaviors. In this paper we will discuss (...) how “tutor” or “study helper” websites combine the phenomena of collaborative cheating with internet-driven shifts in cultural and social perceptions to create a new type of cheating behavior that is viewed differently by students and faculty. (shrink)

Performing two cognitively demanding tasks at the same time is known to decrease performance. The current study investigates the underlying executive functions of a dual-tasking situation involving the simultaneous performance of decision making under explicit risk and a working memory task. It is suggested that making a decision and performing a working memory task at the same time should particularly require monitoring—an executive control process supervising behavior and the state of processing on two tasks. To test the role of a (...) supervisory/monitoring function in such a dual-tasking situation we investigated 122 participants with the Game of Dice Task plus 2-back task (GDT plus 2-back task). This dual task requires participants to make decisions under risk and to perform a 2-back working memory task at the same time. Furthermore, a task measuring a set of several executive functions gathered in the term concept formation (Modified Card Sorting Test, MCST) and the newly developed Balanced Switching Task (BST), measuring monitoring in particular, were used. The results demonstrate that concept formation and monitoring are involved in the simultaneous performance of decision making under risk and a working memory task. In particular, the mediation analysis revealed that BST performance partially mediates the influence of MCST performance on the GDT plus 2-back task. These findings suggest that monitoring is one important subfunction for superior performance in a dual-tasking situation including decision making under risk and a working memory task. (shrink)

Genome-wide association studies raise important ethical and regulatory issues. This is particularly true of the current move toward broad sharing of genomic and phenotypic data. Our survey study examined the opinions of professionals involved in human subjects protection regarding genetic research review. The majority indicated that it is important for their institutional review board to offer guidance about developing and using a data repository or biobank that includes genetic data, and also about sharing this data with other investigators. Only one-third (...) of respondents reported that the National Institutes of Health policy regarding data sharing among researchers in genome-wide association studies is clear. Another third answered that they did not know whether this policy is clear. Findings from this study suggest a need for increased education for IRB professionals regarding the existing data sharing policy, collaboration among IRB professionals and researchers to define best practices, and further empirical research into prospective research participants’ information needs and preferences in the context of wide data sharing. (shrink)

A standard line in the contemporary philosophical literature has it that physical theories are equivalent only when they agree on their empirical content, where this empirical content is often understood as being encoded in the equations of motion of those theories. In this article, we question whether it is indeed the case that the empirical content of a theory is exhausted by its equations of motion, showing that (for example) considerations of boundary conditions play a key role in the empirical (...) equivalence (or otherwise) of theories. Having argued for this, we show that philosophical claims made by Weatherall (2016) that electromagnetism in the Faraday tensor formalism is equivalent to electromagnetism in the vector potential formalism, and by Knox (2011) that general relativity is equivalent to teleparallel gravity, can both be called into question. We then show that properly considering the role of boundary conditions in theory structure can potentially restore these claims of equivalence and close with some remarks on the pragmatics of adjudications on theory identity. (shrink)