While the clinical promise of much stem cell research remains largely theoretical, patients are nonetheless pursuing unproven stem cell therapies in jurisdictions around the world—a phenomenon referred to as “stem cell tourism.” These treatments are generally advertised on a direct-to-consumer basis via the Internet. Research shows portrayals of stem cell medicine on such websites are overly optimistic and the claims made are unsubstantiated by published evidence. However, anecdotal evidence suggests that parents are pursing these “treatments” for their children, despite potential (...) physical and financial risk. Physicians are in a unique position as they can be expected to be involved in, or privy to, such decisions. In this paper, we consider what duties physicians may have toward minor patients whose parents/guardians wish to engage in stem cell tourism on their behalf. We use the Canadian perspective to address the broadly relevant issues raised by this trend. (shrink)

The pursuit of unproven stem cell-based interventions is an emerging issue that raises various concerns. Physicians play different roles in this market, many of which engage their legal, ethical and professional obligations. In Canada, physicians are members of a self-regulated profession and their professional regulatory bodies are responsible for regulating the practice of medicine and protecting the public interest. They also provide policy guidance to their members and discipline members for unprofessional conduct.

The concept of medical necessity plays a central role in many healthcare systems, including Canada's, by helping determine which healthcare services will receive funding. Despite its significance in health policy frameworks, medical necessity has proven to be notoriously difficult to define and operationalise. A shift toward a more personalised and genetically‐informed approach to the provision of healthcare seems likely to heighten associated policy challenges. One of the stated goals of personalised medicine is to save healthcare systems money by facilitating the (...) use of less and more effective treatments. However, any cost saving potential may ultimately be thwarted by physicians' legal and ethical obligations, given that physicians will inevitably be required to implement and define the bounds of genetically‐informed medical necessity for their patients. (shrink)

Stem cell tourism is a growing industry in which patients pursue unproven stem cell therapies for a wide variety of illnesses and conditions. It is a challenging market to regulate due to a number of factors including its international, online, direct-to-consumer approach. Calls to provide education and information to patients, their families, physicians, and the general public about the risks associated with stem cell tourism are mounting. Initial studies examining the perceptions of patients who have pursued stem cell tourism indicate (...) many are highly critical of the research and regulatory systems in their home countries and believe them to be stagnant and unresponsive to patient needs. We suggest that educational material should include an explanation of the translational research process, in addition to other aspects of stem cell tourism, as one means to help promote greater understanding and, ideally, curb patient demand for unproven stem cell interventions. The material provided must stress that strong scientific research is required in order for therapies to be safe and have a greater chance at being effective. Through an analysis of educational material on stem cell tourism and translational stem cell research from patient groups and scientific societies, we describe essential elements that should be conveyed in educational material provided to patients. Although we support the broad dissemination of educational material on stem cell translational research, we also acknowledge that education may simply not be enough to engender patient and public trust in domestic research and regulatory systems. However, promoting patient autonomy by providing good quality information to patients so they can make better informed decisions is valuable in itself, irrespective of whether it serves as an effective deterrent of stem cell tourism. (shrink)

Stem cell tourism is a form of medical tourism in which patients travel to receive unproven or untested stem cell-based interventions for many different diseases and conditions. A few studies indicate that patients and the public have several reasons for seeking these treatments for themselves or for their loved ones. Among these are the feeling of not having any other clinical options left, distrust of or frustration with their home country’s health care system, and a perception that their home country (...) has a burdensome or sluggish regulatory system for the approval of novel stem cell therapies. These last two viewpoints may contribute to a certain sense of distrust of regulatory agencies governing the conduct of clinical research, and perhaps the perception of a health care system that seems unresponsive to the needs of patients suffering from severe conditions. (shrink)

BackgroundIn 2009, Dr. Paolo Zamboni proposed chronic cerebrospinal venous insufficiency (CCSVI) as a possible cause of multiple sclerosis (MS). Although his theory and the associated treatment (“liberation therapy”) received little more than passing interest in the international scientific and medical communities, his ideas became the source of tremendous public and political tension in Canada. The story moved rapidly from mainstream media to social networking sites. CCSVI and liberation therapy swiftly garnered support among patients and triggered remarkable and relentless advocacy efforts. (...) Policy makers have responded in a variety of ways to the public’s call for action.DiscussionWe present three different perspectives on this evolving story, that of a health journalist who played a key role in the media coverage of this issue, that of a health law and policy scholar who has closely observed the unfolding public policy developments across the country, and that of a medical ethicist who sits on an expert panel convened by the MS Society of Canada and the Canadian Institutes of Health Research to assess the evidence as it emerges.SummaryThis story raises important questions about resource allocation and priority setting in scientific research and science policy. The growing power of social media represents a new level of citizen engagement and advocacy, and emphasizes the importance of open debate about the basis on which such policy choices are made. It also highlights the different ways evidence may be understood, valued and utilized by various stakeholders and further emphasizes calls to improve science communication so as to support balanced and informed decision-making. (shrink)

Numerous social, economic and academic pressures can have a negative impact on representations of biomedical research. We review several of the forces playing an increasingly pernicious role in how health and science information is interpreted, shared and used, drawing discussions towards the role of narrative. In turn, we explore how aspects of narrative are used in different social contexts and communication environments, and present creative responses that may help counter the negative trends. As traditional methods of communication have in many (...) ways failed the public, changes in approach are required, including the creative use of narratives. (shrink)

While post- and decolonial theorists have thoroughly debunked the idea of historical progress as a Eurocentric, imperialist, and neocolonialist fallacy, many of the most prominent contemporary thinkers associated with the Frankfurt School--Jürgen Habermas, Axel Honneth, and Rainer Forst--have persistently defended ideas of progress, development, and modernity and have even made such ideas central to their normative claims. Can the Frankfurt School's goal of radical social change survive this critique? And what would a decolonized critical theory look like? Amy Allen fractures (...) critical theory from within by dispensing with its progressive reading of history while retaining its notion of progress as a political imperative, so eloquently defended by Adorno. Critical theory, according to Allen, is the best resouce we have for achieving emancipatory social goals. In reimagining a decolonized critical theory after the end of progress, she rescues it from oblivion and gives it a future. (shrink)

Empathy has for a long time, at least since the eighteenth century, been seen as centrally important in relation to our capacity to gain a grasp of the content of other people's minds, and predict and explain what they will think, feel, and do; and in relation to our capacity to respond to others ethically. In addition, empathy is seen as having a central role in aesthetics, in the understanding of our engagement with works of art and with fictional characters. (...) A fuller understanding of empathy is now offered by the interaction of research in science and the humanities. This volume draws together nineteen original chapters by leading researchers across several disciplines, together with an extensive Introduction by the editors. The individual chapters reveal how important it is, in a wide range of fields of enquiry, to bring to bear an understanding of the role of empathy in its various guises. It offers the ideal starting-point for the exploration of this intriguing aspect of human life. (shrink)

Imagination is celebrated as our vehicle for escape from the mundane here and now. It transports us to distant lands of magic and make-believe, and provides us with diversions during boring meetings or long bus rides. Yet the focus on imagination as a means of escape from the real world minimizes the fact that imagination seems also to furnish us with knowledge about it. Imagination seems an essential component in our endeavor to learn about the world in which we live--whether (...) we're planning for the future, aiming to understand other people, or figuring out whether two puzzle pieces fit together. But how can the same mental power that allows us to escape the world as it currently is also inform us about the world as it currently is? Ten original essays grapple with this neglected question; in doing so, they present a diverse array of positions ranging from cautious optimism to deep-seated pessimism. Blending perspectives from philosophy of mind, cognitive science, epistemology, aesthetics, and ethics, Knowledge Through Imagination sheds new light on the epistemic role of imagination. (shrink)

Opponents of abortion sometimes hold that it is impermissible because fetuses are persons from the moment of conception. But miscarriage, which ends up to 89 % of pregnancies, is much deadlier than abortion. That means that if opponents of abortion are right, then miscarriage is the biggest public-health crisis of our time. Yet they pay hardly any attention to miscarriage, especially very early miscarriage. Attempts to resolve this inconsistency by adverting to the distinction between killing and letting die or to (...) the difficulty of preventing miscarriage fail, leaving a dilemma. Opponents of abortion should either advocate a substantial shift in our political and medical priorities or else give up the view that fetuses are persons from the moment of conception. (shrink)

In recent analytic metaphysics, the view that ‘ordinary inanimate objects such as sticks and stones, tables and chairs, simply do not exist’ has been defended by some noteworthy writers. Thomasson opposes such revisionary ontology in favour of an ontology that is conservative with respect to common sense. The book is written in a straightforward, methodical and down-to-earth style. It is also relatively non-specialized, enabling the author and her readers to approach problems that are often dealt with in isolation in a (...) more unified way.Thomasson's arguments are mainly counter-attacks on six ‘eliminativist’ arguments against ordinary objects. A causal redundancy argument espoused by Trenton Merricks holds that to suppose that there are ordinary objects is to suppose that these objects have distinctive causal powers. However, the casual efficacy of a baseball, for example, is exhausted by that of some suitably arranged …. (shrink)

Creations of the Mind: Essays on Artifacts and their Representation, ed. Stephen Laurence and Eric Margolis, Oxford: Oxford University Press, 2007.

The effective altruism movement (EA) is one of the most influential philosophically savvy movements to emerge in recent years. Effective Altruism has historically been dedicated to finding out what charitable giving is the most overall-effective, that is, the most effective at promoting or maximizing the impartial good. But some members of EA want the movement to be more inclusive, allowing its members to give in the way that most effectively promotes their values, even when doing so isn’t overall-effective. When we (...) examine what it means to give according to one’s values, I argue, we will see that this is both inconsistent with what EA is like now and inconsistent with its central philosophical commitment to an objective standard that can be used to critically analyze one’s giving. While EA is not merely synonymous with act utilitarianism, it cannot be much more inclusive than it is right now. (shrink)

Does critical theory still need psychoanalysis? In Critique on the Couch, Amy Allen offers a cogent and convincing defense of its ongoing relevance. Countering the overly rationalist and progressivist interpretations of psychoanalysis put forward by contemporary critical theorists such as Jürgen Habermas and Axel Honneth, Allen argues that the work of Melanie Klein offers an underutilized resource. She draws on Freud, Klein, and Lacan to develop a more realistic strand of psychoanalytic thinking that centers on notions of loss, negativity, ambivalence, (...) and mourning. Far from leading to despair, such an understanding of human subjectivity functions as a foundation of creativity, productive self-transformation, and progressive social change. At a time when critical theorists are increasingly returning to psychoanalytic thought to diagnose the dysfunctions of our politics, this book opens up new ways of understanding the political implications of psychoanalysis while preserving the progressive, emancipatory aims of critique. (shrink)

Introduction : the politics of our selves -- Foucault, subjectivity, and the enlightenment : a critical reappraisal -- The impurity of practical reason : power and autonomy in Foucault -- Dependency, subordination, and recognition : Butler on subjection -- Empowering the lifeworld? autonomy and power in Habermas -- Contextualizing critical theory -- Engendering critical theory.

A longstanding problem with the study of empathy is the lack of a clear and agreed upon definition. A trend in the recent literature is to respond to this problem by advancing a broad and all-encompassing view of empathy that applies to myriad processes ranging from mimicry and imitation to high-level perspective taking. I argue that this response takes us in the wrong direction and that what we need in order to better understand empathy is a narrower conceptualization, not a (...) broader one. I propose that empathy be conceptualized as a complex, imaginative process through which an observer simulates another person's situated psychological states while maintaining clear self–other differentiation. I defend my view through an examination of three processes: emotional contagion, a process of self-oriented perspective taking that I call “pseudo-empathy,” and empathy proper. Drawing on recent findings in social neuroscience, I highlight the differences among these processes and discuss conceptual, empirical, and normative reasons for keeping them theoretically and conceptually distinct. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

To what extent are countability distinctions subject to systematic semantic variation? Could there be a language with no countability distinctions—in particular, one where all nouns are count? I argue that the answer is no: even in a language where all NPs have the core morphosyntactic properties of English count NPs, such as combining with numerals directly and showing singular/plural contrasts, countability distinctions still emerge on close inspection. I divide these distinctions into those related to sums and those related to parts. (...) In the Sahaptian language Nez Perce, evidence can be found for both types of distinction, in spite of the absence of anything like a traditional mass–count division in noun morphosyntax. I propose an extension of the Nez Perce analysis to Yudja, analyzed by Lima as lacking any countability distinctions. More generally, I suggest that at least one countability distinction may be universal and that languages without any countability distinctions may be unlearnable. (shrink)

This essay focuses on how the global war on terror was constructed and how it has set down deep institutional roots both in government and popular culture. The war on terror represents an "extraordinarily powerful narrative," which must be rewritten in order to change policy dynamics.

This challenging study places fiction squarely at the centre of the discussion of metaphysics. Philosophers have traditionally treated fiction as involving a set of narrow problems in logic or the philosophy of language. By contrast Amie Thomasson argues that fiction has far-reaching implications for central problems of metaphysics. The book develops an 'artifactual' theory of fiction, whereby fictional characters are abstract artifacts as ordinary as laws or symphonies or works of literature. By understanding fictional characters we come to understand how (...) other cultural and social objects are established on the basis of the independent physical world and the mental states of human beings. (shrink)

The most widely debated conception of democracy in recent years is deliberative democracy--the idea that citizens or their representatives owe each other mutually acceptable reasons for the laws they enact. Two prominent voices in the ongoing discussion are Amy Gutmann and Dennis Thompson. In Why Deliberative Democracy?, they move the debate forward beyond their influential book, Democracy and Disagreement.What exactly is deliberative democracy? Why is it more defensible than its rivals? By offering clear answers to these timely questions, Gutmann and (...) Thompson illuminate the theory and practice of justifying public policies in contemporary democracies. They not only develop their theory of deliberative democracy in new directions but also apply it to new practical problems. They discuss bioethics, health care, truth commissions, educational policy, and decisions to declare war. In "What Deliberative Democracy Means," which opens this collection of essays, they provide the most accessible exposition of deliberative democracy to date. They show how deliberative democracy should play an important role even in the debates about military intervention abroad.Why Deliberative Democracy? contributes to our understanding of how democratic citizens and their representatives can make justifiable decisions for their society in the face of the fundamental disagreements that are inevitable in diverse societies. Gutmann and Thompson provide a balanced and fair-minded approach that will benefit anyone intent on giving reason and reciprocity a more prominent place in politics than power and special interests. (shrink)

This grounded study investigated the negotiation of authorship by faculty members, graduate student mentors, and their undergraduate protégés in undergraduate research experiences at a private research university in the northeastern United States. Semi-structured interviews using complementary scripts were conducted separately with 42 participants over a 3 year period to probe their knowledge and understanding of responsible authorship and publication practices and learn how faculty and students entered into authorship decision-making intended to lead to the publication of peer-reviewed technical papers. Herein (...) the theoretical model for the negotiation of authorship developed through the analysis of these interviews is reported. The model identifies critical causal and intervening conditions responsible for the coping strategies faculty and students employ, which, in our study, appear to often produce unfortunate consequences for all involved. The undergraduate student researchers and their graduate student mentors interviewed in this study exhibited a limited understanding of authorship and the requirements for authorship in their research groups. The power differential between faculty and students, the students’ limited epistemic development, the busy-ness of the faculty, and the faculty’s failure to prioritize authorship have been identified as key factors inhibiting both undergraduate and graduate students from developing a deeper understanding of responsible authorship and publication practices. Implications for graduate education and undergraduate research are discussed, and strategies for helping all students to develop a deeper understanding of authorship are identified. (shrink)

How are we to understand the phenomenology of imagining? Attempts to answer this question often invoke descriptors concerning the “vivacity” or “vividness” of our imaginative states. Not only are particular imaginings often phenomenologically compared and contrasted with other imaginings on grounds of how vivid they are, but such imaginings are also often compared and contrasted with perceptions and memories on similar grounds. Yet however natural it may be to use “vividness” and cognate terms in discussions of imagination, it does not (...) take much reflection to see that these terms are ill understood. In this paper, I review both some relevant empirical literature as well as the philosophical literature attempt to get a handle on what it could mean, in an imaginative context, to talk of vividness. As I suggest, this notion ultimately proves to be so problematic as to be philosophically untenable. (shrink)

Liz Jackson is Professor of Education and Head of Department of International Education at the Education University of Hong Kong. Liz served as the President of the Philosophy of Education Society...

When we can’t live up to the ultimate standards of morality, how can moral theory give us guidance? We can distinguish between ideal and non-ideal theory to see that there are different versions of the voluntarist constraint, ‘ought implies can.’ Ideal moral theory identifies the best standard, so its demands are constrained by one version. Non-ideal theory tells us what to do given our psychological and motivational shortcomings and so is constrained by others. Moral theory can now both provide an (...) ultimate standard and give us guidance; this view also gives us new insights into demandingness and blame. (shrink)

Power is clearly a crucial concept for feminist theory. Insofar as feminists are interested in analyzing power, it is because they have an interest in understanding, critiquing, and ultimately challenging the multiple array of unjust power relations affecting women in contemporary Western societies, including sexism, racism, heterosexism, and class oppression. In "The Power of Feminist Theory," Amy Allen diagnoses the inadequacies of previous feminist conceptions of power, and draws on the work of a diverse group of theorists of power, including (...) Michel Foucault, Judith Butler, and Hannah Arendt, in order to construct a new feminist conception of power. The conception of power developed in this book enables readers to theorize domination, resistance, and solidarity, and, perhaps more importantly, to do so in a way that illuminates the interrelatedness of these three modalities of power. (shrink)

Philosophy Compass, Volume 1. Oxford: Blackwell, 2006.

What is the best way to make sustained societal progress over time? Non-ideal theory done on its own faces the problem of second best, but ideal theory seems unable to cope with disagreement about how to make progress. If ideal theory gives up its claims to completeness, then we can use the method of incompletely theorized agreements to make progress over time.

A vision of a living code of ethics is proposed to counter the emphasis on negative phenomena in the study of organizational ethics. The living code results from the harmonious interaction of authentic leadership, five key organizational processes (attraction–selection–attrition, socialization, reward systems, decision-making and organizational learning), and an ethical organizational culture (characterized by heightened levels of ethical awareness and a positive climate regarding ethics). The living code is the cognitive, affective, and behavioral manifestation of an ethical organizational identity. We draw (...) on business ethics literature, positive organizational scholarship, and management literature to outline the elements of positive ethical organizations as those exemplary organizations consistently practicing the highest levels of organizational ethics. In a positive ethical organization, the right thing to do is the only thing to do. (shrink)

The novel COVID-19 pandemic has placed medical triage decision-making in the spotlight. As life-saving ventilators become scarce, clinicians are being forced to allocate scarce resources in even the wealthiest countries. The pervasiveness of air travel and high rate of transmission has caused this pandemic to spread swiftly throughout the world. Ethical triage decisions are commonly based on the utilitarian approach of maximising total benefits and life expectancy. We present triage guidelines from Italy, USA and the UK as well as the (...) Jewish ethical prospective on medical triage. The Jewish tradition also recognises the utilitarian approach but there is disagreement between the rabbis whether human discretion has any role in the allocation of scarce resources and triage decision-making. (shrink)

Many working women will experience sexual harassment at some point in their careers. While some report this harassment, many leave their jobs to escape the harassing environment. This mixed-methods study examines whether sexual harassment and subsequent career disruption affect women’s careers. Using in-depth interviews and longitudinal survey data from the Youth Development Study, we examine the effect of sexual harassment for women in the early career. We find that sexual harassment increases financial stress, largely by precipitating job change, and can (...) significantly alter women’s career attainment. (shrink)

In this essay I will explore an understanding of the potential moral agency of robots; arguing that the key characteristics of physical embodiment; adaptive learning; empathy in action; and a teleology toward the good are the primary necessary components for a machine to become a moral agent. In this context; other possible options will be rejected as necessary for moral agency; including simplistic notions of intelligence; computational power; and rule-following; complete freedom; a sense of God; and an immaterial soul. I (...) argue that it is likely that such moral machines may be able to be built; and that this does not diminish humanity or human personhood. (shrink)

Caring for Liberalism brings together chapters that explore how liberal political theory, in its many guises, might be modified or transformed to take the fact of dependency on board. In addressing the place of care in liberalism, this collection advances the idea that care ethics can help respond to legitimate criticisms from feminists who argue that liberalism ignores issues of race, class, and ethnicity. The chapters do not simply add care to existing liberal political frameworks; rather, they explore how integrating (...) dependency might leave core components of the traditional liberal philosophical apparatus intact, while transforming other aspects of it. Additionally, the contributors address the design of social and political institutions through which care is given and received, with special attention paid to non-Western care practices. This book will appeal to scholars working on liberalism in philosophy, political science, law, and public policy, and it is a must-read for feminist political philosophers. (shrink)

A qualitative analysis of societal silences, demonstrating how the unsaid directs social action and shapes individual and collective lives.

This essay develops a concept of curiotization, through which people are reduced to a curio for the fascination of others. I argue that trans people as they have appeared in media, philosophy, and narratives of history are curiotized as forever fascinating, new, titillating, and controversial. In contrast to the narrative of momentous trans progress in the mid-2010s, I point out that frameworks such as the "Transgender Tipping Point" worked to position its "trans moment" as unprecedented and always on the threshold (...) of arrival. To work through a specific example, I point to decades of renewed fascination over trans women being capable of breastfeeding and the long history of trans fascination in popular music. I conclude by emphasizing the obscured world-historical presence of transsexuality as it coincides with the history of pharmaceuticals, hormone technologies, and birth control. In contrast to a "goldfish memory optics" through which trans people become eternally new, fascinating, and debatable, I stress the importance of restoring the complexity of "trans" and its histories back into an understanding of the present. (shrink)