In past decades, significant work in behavioural economics has decisively revealed the limitations of the human agency model known as Homo Economicus, whereby humans are purely driven by material self-interest. These behavioural findings are, however, far from integrated in mainstream economic theory, which builds heavily on the neoclassical tradition. Unbeknown to modern economics, Bernard Mandeville and Adam Smith already proposed a richer model of human agency in which choices also depend on the desire for social approbation. The social approbation mechanism (...) complements material self-interest and provides a more diverse toolset, which is able to explain social preferences. Mainstream economic agency confines the study of human action to an artificially-limited spectrum because it reduces society to atomistic individuals who maximise one all-purpose measure of value: utility, which is often instrumented by consumption. Collective action is therefore only sustainable where material incentives are in place, as the economic agent rides for free unless financially penalised. To explain pro-social behaviour from the standpoint of self-interest, Mandeville and Smith proposed that agents also maximise social approbation, which conveys incentives to act pro-socially because the desire for others' approval encourages compliance with social norms. The upshot for collective action is that, assuming social norms represent common interests, approval from others provides an extrinsic motive for pro-social behaviour. I formalise the mechanism by proposing a simple utility function in which agents maximise social approbation as well as material self-interest. (shrink)

Two problems seem to plague Adam Smith’s account of sympathy and approbation in The Theory of Moral Sentiments (TMS). First, Smith’s account of sympathy at the beginning of TMS appears to be inconsistent with the account of sympathy at the end of TMS. In particular, it seems that Smith did not appreciate the distinction between ‘self-oriented sympathy’ and ‘other-oriented sympathy’, that is, between imagining being oneself in the actor’s situation and imagining being the actor in the actor’s situation. Second, Smith’s (...) account of approbation, according to which a sentiment of approval arises when there is recognition of concordance between the spectator’s sympathetic passion and the actor’s original passion, seems to face the following problem: since the spectator attains both his own sympathetic passion and the actor’s original passion by sympathizing with the actor, the sympathetic passion of the spectator and the original passion of the actor will necessarily be identical. Therefore, Smith’s account of approbation requires that the spectator utilize both self-oriented and other-oriented sympathy (‘the double-sympathy model of approbation’). I offer a novel developmental account of sympathy in TMS that renders Smith’s account of sympathy consistent and allows for the utilization of the double-sympathy model of approbation. (shrink)

Adam Smith rejected Mandeville's invisible-hand doctrine of 'private vices, publick benefits'. In The Theory of Moral Sentiments his model of the 'impartial spectator' is driven not by sympathy for other people, but by their approbation. The innate capacity for sympathy makes approbation credible. Approbation needs to be authenticated, and in Smith's model authentication relies on innate virtue, which is not realistic. An alternative model of 'regard' makes use of signalling and is more pragmatic. Modern versions of the invisible hand in (...) rational choice theory and neo- liberalism are shown to be radical departures from the ethical legacy of Enlightenment and utilitarian economics, and are not consistent with Adam Smith's own position. (shrink)

(1)In this necessarily condensed account there have been presented the personality systems of James, Freud, and McDougall, the first and the last of these exhibiting certain common factors, with certain extensions peculiar to each system. With the Freudian system these factors vaguely appear, but their form is badlydefined and their delineation incomplete. The criticism of the three systems may be summarised as follows:—that of James is lacking in content, i.e. of the sentiments, while that of McDougall is more in line (...) with a simple self concept than that of a complete personality system and hence is lacking in organisation. That of Freud, while possessing some features in common with that of McDougall appears naive and undeveloped. By combining the systems of the first-mentioned pair, a final system may be obtained, whichmore completely explains personality than any one of them. (2)According to this final system the main features of personality consist of:— (a)A basic system of instincts which tends to operate independently as personality phases; among these first fear, and later, submission and self assertion act as regulative factors. The former of this pair is inhibitive in its general effect on conduct, the latter accentuating it. (b)From a combination of instinctive tendencies focussed upon mental objects the sentiments develop. Like sentiments are grouped into a more or less defined entity styled a social self,this self being a product primarily of a particular environment. More than one social self tends to exist side by side in the same personality, each self retaining a specific set of moral sanctions of its own. Social selves may be independent and contradictory in their “mores” if there exist no overlap of common factors in apperception systems, sentiments and will attitudes. (c)At adolescence a rational process begins. Abstract sentiments and ideal personalities develope, and in place of social authority there is substituted the approbation or disfavour of anideal community existent in the mind of the subject; this forms the background of the promptings of conscience. An ethical code finally emerges whichis more or less universal in its applications. This development may be designated a rational, spiritual, or ethical self, and it acts as a unifying influence upon the social selves by legislating for opposed sanctions, and thus affording a final court of appeal in the case of conflict. Hence it becomes the crowning development of a unified personality. A clarification of the terms “self” and “personality” is thus afforded, whereby the term “self” is regarded as a phase of the latter. (shrink)

Having explained the moral approbation attending merit or virtue, there remains nothing but briefly to consider our interested obligation to it, and to inquire whether every man, who has any regard to his own happiness and welfare, will not best find his account in the practice of every moral duty. [W]hat theory of morals can ever serve any useful purpose, unless it can show, by a particular detail, that all the duties which it recommends, are also the true interest of (...) each individual? (shrink)

Integrity not only is a central concept within virtue ethics and a subject of considerable debate among philosophers regarding its nature and relation to other virtues, but also is important for our understanding of what it means to possess a constituted and coherent self. Much of the literature on integrity is focused on relationships among moral principles and virtues, while less attention is paid to any relationship that integrity might have to practical agency or personal identity. In maintaining this focus, (...) philosophers fail to appreciate the special relation integrity has to the constitution of a coherent self. Central to integrity are considerations about self-identity and agency because it is through ongoing and deliberate activities that reflect the type of person with which she wishes to identify that a person constitutes self-identity and agency in a coherent manner. Once the relationship between integrity and a coherent self is properly understood, it becomes clear that the moral content of integrity is relatively thin and that the approbation usually associated with a person of integrity stems not from judgments about convictions or principles, but from the relationship between actions and commitments. (shrink)

High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

The Norman Rockwell image of the American physician who fixed the broken arm of a child, treated the father for hypertension, and brought an unborn child into this world is now almost nonexistent. Since the time of the Rockwell portrait, a highly technical medical industry has evolved. Now two-thirds of physicians are board certified in subspecialties, and patients visit an average of 3–4 different physicians per year. Today's physicians see themselves less as “benevolent and wise counselors overseeing the patient's welfare (...) and more as objective scientists applying the latest technical methods to bring about the desired end.” The intimate patient-physician relationship that was once the norm in our society is rapidly disappearing. (shrink)

This book provides a philosophical examination of the extent to which legalizing same-sex marriage can contribute to ending the discrimination and social stigma faced by LGBT men and women in the Western world.

Hate speech is one of the most important conceptual categories in anti‐oppression politics today; a great deal of energy and political will is devoted to identifying, characterizing, contesting, and penalizing hate speech. However, despite the increasing inclusion of gender identity as a socially salient trait, antipatriarchal politics has largely been absent within this body of scholarship. Figuring out how to properly situate patriarchy‐enforcing speech within the category of hate speech is therefore an important politico‐philosophical project. My aim in this article (...) is twofold: first, I argue that sexist speech, though oppressive, is not hate speech. Second, I argue that misogynistic speech is hate speech, even when it is intradivisional. This is important because recognizing that the concepthate speechapplies to certain forms of patriarchy‐enforcing speech is another step in clarifying what is wrong with the practice, and how bad it is in relation to other abuses. Consequently, this article provides a more nuanced account of the kinds of expressions that can and should count as instances of hate speech. (shrink)

This book aims to understand why women are the targets of online hate speech and how we can stop this from occurring.

In this article I analyse two complaints of white vilification, which are increasingly occurring in Australia. I argue that, though the complainants (and white people generally) are not harmed by such racialized speech, the complainants in fact harm Australians of colour through these utterances. These complaints can both cause and constitute at least two forms of epistemic injustice (willful hermeneutical ignorance and comparative credibility excess). Further, I argue that the complaints are grounded in a dual misrecognition: the complainants misrecognize themselves (...) in their own privileged racial specificity, and they misrecognize others in their own marginal racial specificity. Such misrecognition preserves the cultural imperialism of Australia’s dominant social imaginary—a means of oppression that perpetuates epistemic insensitivity.Bringing this dual misrecognition to light best captures the indignity that is suffered by the victims of the aforementioned epistemic injustices. I argue that it is only when we truly recognize difference in its own terms, shifting the dominant social imaginary, that “mainstream Australians”can do their part in bringing about a just society. (shrink)

ABSTRACT In this commentary I evaluate what McGowan’s project would conclude with respect to the treatment of professional Australian Football League player Adam Goodes, who was incessantly ‘booed’ by crowds for the final two years of his career. Analysing Goodes’ case in light of McGowan’s argument leads me to two observations. First, McGowan’s norm-enactment approach is incredibly useful because it explains how words like ‘boo’ (with unstable meaning) can constitute actionable discrimination. Second, however, I wonder if a narrow focus on (...) whether such speech is legally actionable might encourage an overestimation of the power of laws to shepherd new g-norms into social practices. (shrink)

Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are imperative (...) in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

The prominent call to legalise same-sex marriage in Australia raises questions concerning whether its achievement will result in amplified societal acceptance of lesbian, gay, bisexual, and transgender (LGBT) people, and on what grounds this acceptance will take place. Same-sex marriage may not challenge heteronormative and patriarchal features typically associated with marriage, and may serve to reinforce a hierarchy that promotes traditional marriage as the ideal relationship structure. This may result in only assimilationist acceptance of LGBT people. However, the consequence of (...) inclusion to marriage ought to reflect social acceptance of LGBTs as people worthy of equal treatment in dignity and in rights, regardless of perceived differences or similarities to a supposed majority standard. This article argues that justice would be best served by introducing and promoting a variety of State-sanctioned unions whilst simultaneously introducing same-sex marriage. This ‘pluralisation strategy’ would increase awareness and legitimacy of other relationship-recognition options, promoting respectful acceptance of LGBT and heterosexual people alike. (shrink)

The medical ethicist is a fairly recent addition to the clinical setting. The following four potential roles of the clinical ethicist are identified and discussed: consultant in difficult cases, educator of health care providers, counselor for health care providers and finally patient advocate to protect the interests of patients. While the various roles may sometimes overlap, the roles of educator and counselor are viewed as being more congruent with the education and training of medical ethicists than are the roles of (...) consultant and patient advocate. (shrink)

This article identifies five genres of anti-queer hate speech found in The Australian’s Facebook comments sections, exposing and analyzing the ways in which such comments are used to derogate cisgender and heterosexual women. One may be tempted to think of cis-het women as third-party victims of queerphobia; however, this article argues that these genres of anti-queer speech are, in fact, misogynistic. Specifically, it argues that these are instances of cis-hetero-misogynistic hate speech. Cis-hetero-misogyny functions as the “law enforcement branch” of a (...) cis-hetero-patriarchal gender order. Given the existence of such an order, it is clear that cis-het women’s liberation is inextricable from queer liberation. This article argues that to facilitate allyship and challenge this gender order—the order that elicits such hate speech acts—we need an epistemological revolution in the way we recognize and re-cognize human difference. (shrink)

This study investigates the three major educational philosophies behind the medical humanities programs in the United States. It summarizes the characteristics of the Cultural Transmission Approach, the Affective Developmental Approach, and the Cognitive Developmental Approach. A questionnaire was sent to 415 teachers of medical humanities asking for their perceptions of the amount of time and effort devoted by their programs to these three philosophical approaches. The 234 responses constituted a 54.6% return. The approximately 80:20 gender ratio of males to females (...) and other demographic data on age and educational background were consistent with other studies of the field of medical humanities.Reflections on the results in Table II indicate that some changes need to take place in the teaching of the medical humanities if the perceived ideal is to be achieved. In order for the current teachers of the medical humanities to think that the appropriate philosophies behind the teaching of the medical humanities are being implemented as they should be, much less time and effort need to be devoted to the Cultural Transmission Approach. With no other published reports on the educational philosophies behind the medical humanities programs, this study created a new knowledge base about this relatively young and rapidly emerging field. (shrink)

The past two decades have been a time of heightened interest in the moral aspects of the practice of medicine. This interest has been reflected in medical education by the establishment of medical humanities programs in both preclinical and clinical education in many medical schools. It has also been reflected in the literature with a dramatic increase in journal articles on medical ethics as well as the development of medical ethics in textbooks. A number of journals have developed that are (...) specifically devoted to medical ethics, including The Journal of Medical Ethics, The Journal of Medicine and Philosophy, The Journal of Medical Humanities, Theoretical Medicine, Cambridge Quarterly of Healthcare Ethics, just to name a few. The literature includes both theoretical foundations and conceptual analyses of particular issues as well as practical advice and general suggestions for how to implement programs in medical humanities. (shrink)

The most important distinction in value theory is the subjective-objective distinction which determines the epistemological status of value judgments about medical intervention. Ethical decisions in medical intervention presuppose one of three structures of justification — namely, an inductive approach, a deductive approach which can be either consequentialist or non-consequentialist, and a uniquely ethical approach. Inductivism and deductivism have been discussed extensively in the literature and are only briefly described here. The uniquely ethical approach which presupposes value objectivism is analyzed in (...) detail. This method involves a purely ethical inference which moves from facts to values directly with an emphasis on reason which involves a non-logical justification (as opposed to illogical). It involves the use of natural practical arguments which have an imperative conclusion but no imperative premise and exhibit a value-requiredness between two states of affairs. (shrink)

A study of physicians and medical students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in medicine and their epistemological presuppositions in relationship to the subjective-objective controversy in value theory. The study revealed that most physicians and medical students tend to be objectivists in value theory, i.e., believe that value judgements are knowledge claims capable of being true or false and are expressions of moral requirements and normative imperatives emanating from an external value (...) structure or moral order in the world, but that most physicians and medical students are inconsistent in the philosophical foundations of their medical ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. The study also revealed that most physicians and medical students think more emphasis should be placed upon medical ethics in medical education. (shrink)

A study of nurses and nursing students was conducted to determine the various philosophical positions they hold with respect to ethical decision-making in nursing and their relationship to the subjective-objective controversy in value theory. The study revealed that most nurses and nursing students tend to be subjectivists in value theory, i.e., believe that value judgments are purely personal, private expressions of one's own opinion or inner-feelings and not believe that value judgments are knowledge claims capable of being true or false (...) and therefore not expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most nurses and nursing students are inconsistent in the philosophical foundations of their ethical decision-making, i.e., in decision-making regarding values they tend to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

A study of clinical medical ethicists was conducted to determine the various philosophical positions they hold with respect to ethical decision making in medicine and their various positions' relationship to the subjective-objective controversy in value theory. The study consisted of analyzing and interpreting data gathered from questionnaires from 52 clinical medical ethicists at 28 major health care centers in the United States. The study revealed that most clinical medical ethicists tend to be objectivists in value theory, i.e., believe that value (...) judgments are knowledge claims capable of being true or false and therefore expressions of moral requirements and normative imperatives emanating from an external value structure or moral order in the world. In addition, the study revealed that most clinical medical ethicists are consistent in the philosophical foundations of their ethical decision making, i.e., in decision making regarding values they tend not to hold beliefs which are incompatible with other beliefs they hold about values. (shrink)

This reissued work, originally published in 1985, is a uniquely broad and original survey of theories and beliefs about the growth, behaviour, performance and reform of the governments of modern Western democracies. After analysing the external pressures which have shaped modern governments, the author examines four different schools of political thought which seek to explain the behaviour and performance of governments, and which offer different remedies for the pluralism, corporatism and bureaucracy. To examine and test these general theories, the author (...) looks closely at how governments actually work. The book is illustrated with examples drawn from various Western societies. The final chapters present the author’s own conclusion about the future role of government, the limits of market philosophy, the future of politics, and the principles and problems of institutional reform. (shrink)

The enormous growth in medical humanities programs during the past decade has resulted in an extensive literature concerning the content of the discipline and the issues that have been addressed. Comparatively little attention, however, has been devoted to the structure of the discipline of medical humanities concerning the process or the theoretical aspects of the pedagogy of teaching the discipline. This report explicitly addresses the pedagogical aspects of the discipline by comparing and contrasting two different basic approaches to the discipline (...) referred to as the classical humanities approach and the humanistic psychology approach which roughly approximate the cognitive and affective approaches respectively. These two approaches are compared and contrasted in terms of their goals, objectives, methods of implementation, philosophical assumptions and evaluational techniques. (shrink)

After noting why the issue of the use of animals in medical education and research needs to be addressed, this article briefly reviews the historical positions on the role of animals in society and describes in more detail the current positions in the wide spectrum of positions regarding the role of animals in society. The spectrum ranges from the extremes of the animal exploitation position to the animal liberation position with several more moderate positions in between these two extremes. Then (...) the philosophical issue of the moral agency of animals is discussed in terms of an explication of the concept of rights and the concept of personhood. Further research is suggested concerning institutional policies regarding medical students who refuse to do physiology dog labs or other assignments which involve the suffering and/or death of animals. (shrink)

In recent years, the theoretical work of Gilligan in women's psychological development has led to the development of the concept of moral orientation or moral voice in contrast to the concept of moral reasoning or moral judgment developed by Kohlberg. These concepts have been of particular interest in gender studies, especially as applied to adolescence. These concepts of moral orientation and moral reasoning are being increasingly employed in healthcare ethics studies in a wide variety of settings. The recent work has (...) included studies of physicians, nurses, dentists, veterinarians, social workers, teachers of medical ethics, and hospital ethics committees. However, the study of moral development in healthcare providers has been hampered because collecting the necessary data from healthcare workers has been labor intensive and extremely time consuming. More efficient methods are needed. (shrink)

In the wake of a pilot study that indicated that the experience of medical education appears to Inhibit moral development In medical students, increased attention needs to be given to the structure of medical education and the Influence it has on medical students. Interest in ethics and moral reasoning has become widespread in many aspects of professional and public life. Society has exhibited great interest in the ethical issues confronting physicians today. Considerable effort has been undertaken to train medical students, (...) interns, and residents In how to reason through medical-ethical dilemmas. Media attention has focused on Issues such as abortion, euthanasia, care of severely handicapped infants, organ transplantation, and so forth, producing heated debates in both the professional and lay literature over the morality of the various positions. The curriculum of medical education has paralleled and reflected this general Interest in medical ethics. Most medical schools now offer, and frequently require, course work in ethics. However, further research Is needed to better characterize and understand the relationship of medical education to moral development. (shrink)

Socialism grew up in opposition to capitalism, just as liberalism developed in reaction to feudalism. Both liberalism and socialism combined potent critiques of the existing socio‐economic order with blueprints for a desirable future society. However, liberalism provides a rather more coherent body of thought than does socialism, and its theories are linked with the emergence of a dominant system combining capitalism and liberal democracy. By contrast, no widespread socio‐economic order has as yet emerged which can be confidently or closely associated (...) with the ideas of socialism. In both cases the relationship between theories and actual systems is a contestable one, but it has been particularly problematic in the history of socialism. (shrink)

Following a brief consideration of two contrasting purposes for teaching the medical humanities, a description is given of a film discussion elective course. In contrast to the usual teaching of medical ethics which is primarily a cognitive activity emphasizing the development of a code of principles such as justice, autonomy, and beneficence, the film discussion elective was primarily an affective activity emphasizing the development of an ethical ideal of caring, relatedness, and sensitivity to others. The pass/fail elective, offered for one (...) credit each quarter for two quarters, met once a week for one hour for twenty-four weeks. Each week a film was shown followed by a group discussion. A wide variety of social issues were covered. The objective of the course was to increase the ethical sensitivity of the medical students through promotion of introspection and reflection on social issues. A brief discussion is given of the importance and appropriateness of using film to promote the affective focus of medicine on the relief of suffering. Examples are given of how the course achieved its objective. A detailed description of the resource materials is provided. (shrink)

In contrast to theoretical discussions about potential professional liability of clinical ethicists, this report gives the results of empirical data gathered in a national survey of clinical medical ethicists. The report assesses the types of activities of clinical ethicists, the extent and types of their professional liability coverage, and the influence that concerns about legal liability has on how they function as clinical ethicists. In addition demographic data on age, sex, educational background, etc. are reported. The results show that while (...) nearly one third (28.9%) of the ethicists regularly make recommendations about patient care, only 10.8% of them regularly make entries in the medical record; only approximately half (53.0%) of them are covered by professional liability (malpractice) insurance; and the vast majority (84.3%) of them say that concerns about legal liability do not influence the way they function as clinical ethicists. (shrink)