In conversation with Hortense Gallois’ recent essay on the importance of bioethicists participating in public discourse, I suggest that speaking up is as fraught as it is important. Focusing on the anti-trans movement’s misuse of expertise, I highlight the fine line between correcting misinformation and inadvertently causing harm through ill-timed speech. Drawing on the work of Eva Feder Kittay, I suggest that knowing when to speak up and when to stay silent starts with understanding the communities we speak about and (...) the consequences that our words can have on them. (shrink)

Although informed consent models for prescribing hormone replacement therapy are becoming increasingly prevalent, many physicians continue to require an assessment and referral letter from a mental health professional prior to prescription. Drawing on personal and communal experience, the author argues that assessment and referral requirements are dehumanising and unethical, foregrounding the ways in which these requirements evidence a mistrust of trans people, suppress the diversity of their experiences and sustain an unjustified double standard in contrast to other forms of clinical (...) care. Physicians should abandon this unethical requirement in favour of an informed consent approach to transgender care. (shrink)

By attending to how people speak about their gender, we can find diverse answers to the question of what it is like to have a gender identity. To some, it is little more than having a body whereas others may report it as more attitudinal or dispositional—seemingly contradictory views. In this paper, I seek to reconcile these disparate answers by developing a theory of how individual gender identity comes about. In the simplest possible terms, I propose that gender identity is (...) how we make sense of our gender subjectivity, the totality of our gendered experiences of ourselves. Gender identity is constituted by gender subjectivity, but this constitutive relationship is underdetermined. While gender subjectivity may narrow the range of inhabitable gender identities, it is always compatible with more than one. To arrive at a gender identity, we arrange gender subjectivity like building materials. My theory helps us understand how different people offer seemingly incompatible accounts of their gender identity without questioning their authenticity or validity. They simply arrange similar building materials differently. (shrink)

Drawing on the principle of subsidiarity, this article develops a framework for allocating medical decision-making authority in the absence of capacity to consent and argues that decisional authority in paediatric transgender healthcare should generally lie in the patient. Regardless of patients’ capacity, there is usually nobody better positioned to make medical decisions that go to the heart of a patient’s identity than the patients themselves. Under the principle of subsidiarity, decisional authority should only be held by a higher level decision-maker, (...) such as parents or judges, if lower level decision-makers are incapable of satisfactorily addressing the issue even with support and the higher level decision-maker is better positioned to satisfactorily address the issue than all lower level decision-makers. Because gender uniquely pertains to personal identity and self-realisation, parents and judges are rarely better positioned to make complex medical decisions. Instead of taking away trans youth’s authority over their healthcare decisions, we should focus on supporting their ability to take the best possible decision for themselves. (shrink)

A recent paper by Teresa Baron and Geoffrey Dierckxsens argues that puberty blockers and hormone therapy should be disallowed before adulthood on prudential and consent-related grounds. This response contends that their argument fails because it is predicated on unsupported premises and misinterpretations of the available evidence. There is no evidence that a large proportion of pubertal and postpubertal youths later discontinue medical transition. Meaningful assent is a viable and commonly accepted alternative to meaningful consent in paediatric bioethics. And finally, the (...) primary purpose of transition-related interventions is to actualise youths’ gendered self-image, not treat an underlying mental illness. (shrink)

Volume 19, Issue 6, June 2019, Page W3-W4.

In a previous article, I argued that assessment requirements for transgender hormone replacement therapy are unethical and dehumanising. A recent response published by the Journal of Medical Ethics criticises this proposal. In this reply, I advance that their response misunderstood core parts of my argument and fails to provide independent support for assessment requirements. Though transition-related care may have similarities with cosmetic surgeries, this does not suffice to establish a need for assessments, and nor do the high rates of depression (...) and anxiety justify assessments, especially given the protective role HRT plays towards mental well-being. (shrink)

This article analyses the legacy of Marsha P. Johnson as a heroine through the notion of labour, emphasising how heroine narratives are both a product of labour as well as a form of labour. After offering a short account of Marsha P. Johnson’s role in the Stonewall riots and STAR, we explore the development of trans communities’ ability to create, sustain and disseminate heroine narratives, emphasising Tourmaline’s pivotal archival role in establishing Johnson’s legacy. Then, we elucidate the role of heroine (...) narratives in creating and sustaining a collective identity. We argue that community attachment to Marsha P. Johnson reclaims the place of trans communities in LGBTQ+ history but is often done in a manner that obscures the whiteness of mainstream trans advocacy. We suggest that the recent increase in interest towards the life-sustaining labour of STAR House reflects the evolution of trans collective identity in the post-visibility era. (shrink)

How to account for participants’ psychological and emotional exhaustion with research has been under‐explored in the research ethics literature. Research fatigue, as it is known, has significant impacts on patients’ well‐being and their ongoing and future participation in studies. From the perspective of researchers and researched communities, research fatigue also creates selection bias and opportunity costs, negatively impacting the collective scientific enterprise. Institutional Review Boards should systematically consider research fatigue during the research approval process and strive to mitigate it.

Transgender conversion practices involve attempts to alter, discourage, or suppress a person’s gender identity and/or desired gender presentation, including by delaying or preventing gender transition. Proponents of the practices have argued that they should be allowed until proven to be harmful. Drawing on the notion of expressive equality, I argue that conversion practices are prima facie unethical because they do not fulfill a legitimate clinical purpose and conflict with the self-understanding of trans communities.

Volume 19, Issue 6, June 2019, Page W3-W4.

The decades following the Second Vatican Council witnessed Catholic theology's break from classicism. Deductive, classical theology was replaced by an empirical, historically minded theology. The result was moral confusion and intellectual controversy whose effects are still felt by the Church. Benedict Ashely agreed that some revision in moral theology was necessary after Vatican II to formulate and integrate the mysteries of the Catholic faith. The question was how such teachings could be reformulated while preserving their substantive content. Ashley presents (...) a method of theological reflection that challenges the subjectivity, relationality, and language of historical mindedness with a tradition focusing on Scripture, the Magisterium, sound natural science, and a considered relationship between subjectivity and objectivity. This volume also contains commentary by four distinguished scholars: Matthew McWhorter provides an intellectual biography of Ashley, examining the development of this thought before and after Vatican II. Rev. Cajetan Cuddy, OP, reviews Ashley's philosophical theology in its principles, especially as grounded in natural law philosophy. Matthew Minerd assesses Ashley's approach to the authority of the Catholic Magisterium, the papacy, and the formation of conscience. Rev. Nicanor Pier Giorgio Austriaco, OP, evaluates Ashley's application of his moral theology to beginning- and end-of-life decision-making. (shrink)

The age of modern biomedical science has raised many difficult ethical questions. Accordingly, leaders in bioethics have articulated methods to direct the on-going discourse while providing the systems necessary for making morally efficient decisions. In this thought-provoking study, Ashley John Moyse suggests a theory of ethics that interrupts and transforms the contemporary and abstract modes of moral discourse. Moyse moves the moral discussion of bioethics beyond abstract ends, obligations, and common moral categories. At the same time, he challenges readers (...) to take seriously the concrete moral tasks of existence. Moyse engages with Karl Barth's philosophical and theological thinking in order to investigate the moral discussions surrounding biomedical ethics. The book engagingly illuminates a path toward moral discernment that recognizes the significance of human flourishing. According to Moyse, Barth's moral theology not only grounds humans as ontologically relational but also fuels responsibility to, with, and for one's neighbors. (shrink)

What does the development of a truly robust contemporary theory of domination require? Ashley J. Bohrer argues that it is only by considering all of the dimensions of race, gender, sexuality, and class within the structures of capitalism and imperialism that we can understand power relations as we find them nowadays. Bohrer explains how many of the purported incompatibilities between Marxism and intersectionality arise more from miscommunication rather than a fundamental conceptual antagonism. As the first monograph entirely devoted to (...) this issue, »Marxism and Intersectionality« serves as a tool to activists and academics working against multiple systems of domination, exploitation, and oppression. (shrink)

Programmatic secularism aims to secure public reason from rival rationalities, notably those from religious experience and education. The gathering of knowledge in clinical ethics into a concrete array of consensus claims and consensus-derived principles are thought by Janet Malek to secure such public reason—an essential tool for clinical ethics consultants to execute their professional role. The author compares this gathering of knowledge to an understanding of what technology is. Accordingly, the following interrogates Malek’s programmatic secularism, which is a moral technique (...) that not only homogenizes moral dialogue but also dehumanizes persons as it tyrannizes the creative freedom for moral conversation and genuine encounter. Thus, the reader is encouraged to dissent of such a vision for delimiting the role of clinical ethics consultants according to the rule and measure of technology, the ontology of our age. (shrink)

Matthew Ratcliffe's Grief Worlds: A Study of Emotional Experience aims to provide a theory of grief that identifies features common to most if not all experienc.

This Companion addresses fundamental questions about the nature of music from a psychological perspective. Music cognition is presented as the field that investigates the psychological, physiological, and physical processes that allow music to take place, seeking to explain how and why music has such powerful and mysterious effects on us. This volume provides a comprehensive overview of research in music cognition, balancing accessibility with depth and sophistication. A diverse range of global scholars-music theorists, musicologists, pedagogues, neuroscientists, and psychologists-address the implications (...) of music in everyday life while broadening the range of topics in music cognition research, deliberately seeking connections with the kinds of music and musical experiences that are meaningful to the population at large but are often overlooked in the study of music cognition. Consisting of over forty essays, the volume is organized by five primary themes. The first section, "Music from the Air to the Brain," provides a neuroscientific and theoretical basis for the book. The next three sections are based on musical actions: "Hearing and Listening to Music," "Making and Using Music," and "Developing Musicality." The closing section, "Musical Meanings," returns to fundamental questions related to music's meaning and significance, seen from historical and contemporary perspectives. (shrink)

This book disseminates practical solutions to the automation of open and distance learning. It discusses computational methods, algorithms, implemented prototype systems, and applications of open and distance learning. It also provides state-of-the-art research on the impact and general principles of ethical computer use in academics, while also emphasizing the cyber philosophical aspect of human-computer interaction.

This chapter contains sections titled: Goldilocks Epistemology: Not Too Soft, Not Too Firm, but Just Right Sex Talk: You Should Know Better Epistemology Helps You Be More You (… in bed) How To Get Better Sex From Epistemologists The View from Here.

An ongoing debate in affective science concerns whether certain discrete, “basic” emotions have evolutionarily based signals that are easily, universally, and innatel...

Feminism is going to ruin your life--in the best way possible--because society screams numerous messages every moment about how women must look, act, and speak in order to earn their right to be seen and heard. The only thing any human needs to do in order to earn their right to exist, however, is to exist. Break free of the insidious narratives that hold you back from being your most authentic self.

Understanding everyday behavior relies heavily upon understanding our ability to improvise, how we are able to continuously anticipate and adapt in order to coordinate with our environment and others. Here we consider the ability of musicians to improvise, where they must spontaneously coordinate their actions with co-performers in order to produce novel musical expressions. Investigations of this behavior have traditionally focused on describing the organization of cognitive structures. The focus, here, however, is on the ability of the time-evolving patterns of (...) inter-musician movement coordination as revealed by the mathematical tools of complex dynamical systems to provide a new understanding of what potentiates the novelty of spontaneous musical action. We demonstrate this approach through the application of cross wavelet spectral analysis, which isolates the strength and patterning of the behavioral coordination that occurs between improvising musicians across a range of nested time-scales. Revealing the sophistication of the previously unexplored dynamics of movement coordination between improvising musicians is an important step towards understanding how creative musical expressions emerge from the spontaneous coordination of multiple musical bodies. (shrink)

Musical improvisation is a natural case of human pattern formation, and Walton and colleagues investigate the way that different contextual constraints affect patterns of improvisation and their aesthetic quality. The authors find that coordination patterns are more diversified between two musicians when the musical space in which to improvise is relatively more constrained. They also find that listeners experience more diversified, complementary patterns between musicians as more enjoyable and harmonious.

La mayoría de la gente o no conoce a Adrienne von Speyr o piensa en ella como en una extraña figura mística que trabajó con el teólogo Hans Urs von Balthasar. Sin embargo, pocos la conocen como médica de Basilea entre los años 30 y 50 del siglo XX. Ejerció su profesión con una pasión inspirada por su fe, integrando constantemente ciencia y espiritualidad. El objetivo de este artículo es presentar esta faceta poco estudiada de la vida de Adrienne von (...) Speyr, y el modo en que su actividad médica modeló su lectura de las Escrituras, en particular del capítulo 11 del evangelio de Juan. También y sobre todo destaca la originalidad de su contribución a la ética médica de su época. (shrink)

According to the powerful qualities view, properties are both powerful and qualitative. Indeed, on this view the powerfulness of a property is identical to its qualitativity. Proponents claim that this view provides an attractive alternative to both the view that properties are pure powers and the view that they are pure qualities. It remains unclear, however, whether the claimed identity between powerfulness and qualitativity can be made coherent in a way that allows the powerful qualities view to constitute this sort (...) of alternative. I argue here that this can be done, given a particular conception of both the qualitativity and powerfulness of properties. On this conception, a property is qualitative just in the sense that its essence is fixed independently of any distinct properties, and it is powerful just if its essence grounds its dispositional role. (shrink)

The use of nonhuman animals as models in research and drug testing is a key route through which contemporary scientific knowledge is certified. Given ethical concerns, regulation of animal research promotes the use of less “sentient” animals. This paper draws on a documentary analysis of legal documents and qualitative interviews with Named Veterinary Surgeons and others at a commercial laboratory in the UK. Its key claim is that the concept of animal sentience is entangled with a particular imaginary of how (...) the general public or wider society views animals. We call this imaginary societal sentience. Against a backdrop of increasing ethnographic work on care encounters in the laboratory, this concept helps to stress the wider context within which such encounters take place. We conclude that societal sentience has potential purchase beyond the animal research field, in helping to highlight the affective dimension of public imaginaries and their ethical consequences. Researching and critiquing societal sentience, we argue, may ultimately have more impact on the fate of humans and nonhumans in the laboratory than focusing wholly on ethics as situated practice. (shrink)

It is often taken for granted that our desires can contribute to what it is rational for us to do. This paper examines an account of desire—the ‘guise of the good’— that promises an explanation of this datum. I argue that extant guise-of-the-good accounts fail to provide an adequate explanation of how a class of desires—basic desires—contributes to practical rationality. I develop an alternative guise-of-the-good account on which basic desires attune us to our reasons for action in virtue of their (...) biological function. This account emphasises the role of desire as part of our competence to recognise and respond to normative reasons. (shrink)

There is a deep distrust of experts in America today. Influenced by populist politics, many question or downright ignore the recommendations of scientists, scholars, and others with specialized training. It appears that expertise, a critical component of democratic life, no longer appeals to wide swaths of the body politic. On Expertise is a robust defense of the expert class. Ashley Rose Mehlenbacher examines modern and ancient theories of expertise through the lens of rhetoric and interviews some forty professionals, revealing (...) how they understand their own expertise and how they came to be known as “experts.” She shows that expertise requires not only knowledge and skill but also, crucially, an acknowledgment by others—both specialists and laypeople—that one is a credible authority. At its heart, expertise is a rhetorical construct, and to be persuasive, experts must have the ability to apply their knowledge and skills rightly—in the right way, at the right time, to achieve the right end. Ultimately, Mehlenbacher argues that experts apply their technical knowledge effectively and win others’ trust through acting prudently and cultivating goodwill. Timely, practical, and sophisticated, On Expertise provides vital scaffolding for our understanding of expertise and its real-world application. This book is essential for beginning the work of rehabilitating the expert class amid a politics of extreme populism and anti-intellectualism. (shrink)

Ashley J. Bohrer argues that it is only by considering race, gender, sexuality, and ability within the structures of capitalism and imperialism that we can understand power relations. Bohrer explains how the purported incompatibilities between Marxism and intersectionality arise more from miscommunication than a fundamental conceptual antagonism.

Moral distress, is, at its core, an organizational problem. It is experienced on a personal level, but its causes originate within the system itself. In this commentary, we argue that moral distress is not inherently good, that effective interventions must address the external sources of moral distress, and that while there is a place for resilience in the healthcare professions, it cannot be an effective antidote to moral distress.

In this article, we consider infants’ acquisition of foundational aspects of language and emotion through the lens of statistical learning. By taking a comparative developmental approach, we highlight ways in which the learning problems presented by input from these two rich communicative domains are both similar and different. Our goal is to encourage other scholars to consider multiple domains of human experience when developing theories in developmental cognitive science.

Many philosophers have suggested that claims of need play a special normative role in ethical thought and talk. But what do such claims mean? What does this special role amount to? Progress on these questions can be made by attending to a puzzle concerning some linguistic differences between two types of 'need' sentence: one where 'need' occurs as a verb, and where it occurs as a noun. I argue that the resources developed to solve the puzzle advance our understanding of (...) the metaphysics of need, the meaning of 'need' sentences, and the function of claims of need in ethical discourse. (shrink)

Modern longitudinal studies collect feature data at many timepoints, often of the same order of sample size. Such studies are typically affected by dropout and positivity violations. We tackle these problems by generalizing effects of recent incremental interventions to accommodate multiple outcomes and subject dropout. We give an identifying expression for incremental intervention effects when dropout is conditionally ignorable and derive the nonparametric efficiency bound for estimating such effects. Then we present efficient nonparametric estimators, showing that they converge at fast (...) parametric rates and yield uniform inferential guarantees, even when nuisance functions are estimated flexibly at slower rates. We also study the variance ratio of incremental intervention effects relative to more conventional deterministic effects in a novel infinite time horizon setting, where the number of timepoints can grow with sample size and show that incremental intervention effects yield near-exponential gains in statistical precision in this setup. Finally, we conclude with simulations and apply our methods in a study of the effect of low-dose aspirin on pregnancy outcomes. (shrink)

Examines the nature of life from physical life and nutrition, to behavior and sentient life, to conscious life and mind, to values and spirituality.