Obesity is one of several targets of public health efforts related to availability of and access to healthy foods. The tension between individual food decisions and social contexts of food production, preparation, and consumption makes targeting individuals deeply problematic and yet tempting. Such individualization of responsibility for obesity and nutrition is unethical and impractical. This article warns public health campaigns against giving into the temptation to individualize responsibility, and presents an argument for why they should proceed with all due caution, (...) advising providers and public health organizations to keep in mind structural factors rather than aiming at individuals. (shrink)

The concept of vulnerability is widely used in bioethics, particularly in research ethics and public health ethics. The traditional approach construes vulnerability as inherent in individuals or the groups to which they belong and views vulnerability as requiring special protections. Florencia Luna and other bioethicists continue to challenge traditional ways of conceptualizing and applying the term. Luna began proposing a layered approach to this concept and recently extended this proposal to offer two new concepts to analyze the concept of vulnerability, (...) namely understanding external conditions that trigger vulnerability and layers of vulnerability with cascading effects. Luna's conception of vulnerability is useful, which we demonstrate by applying her layered view and the new analyses in multiple contexts. We begin by outlining Luna's view and we use vignettes from healthcare involving transgender patients, the care of patients in psychiatric contexts, and research involving prisoners to illustrate how each part of Luna's concept elucidates important moral issues. (shrink)

Obesity is one of several targets of public health efforts related to availability of and access to healthy foods. The tension between individual food decisions and social contexts of food production, preparation, and consumption makes targeting individuals deeply problematic and yet tempting. Such individualization of responsibility for obesity and nutrition is unethical and impractical. This article warns public health campaigns against giving into the temptation to individualize responsibility, and presents an argument for why they should proceed with all due caution, (...) advising providers and public health organizations to keep in mind structural factors rather than aiming at individuals. (shrink)

I argue that miscarriage, referred to by poet Susan Stewart as “the event that was nothing,” is a liminal event along four distinct and inter-related dimensions: parenthood, procreation, death, and induced abortion. It is because of this liminality that miscarriage has been both poorly addressed in our society, and enrolled in larger debates over women's reproduction and responsibility for reproduction, both conceptually and legally. If miscarriage’s liminality were better understood, if miscarriage itself were better theorized, perhaps it would not so (...) easily be enrolled in these other debates to the detriment of women who miscarry, and their families. However, its very liminality and the fact that it is enrolled in these debates sheds light on the complicated network of concepts within which miscarriage lies. (OPEN ACCESS AT URL). (shrink)

In this book chapter in the Routledge Handbook of Food Ethics, I examine the moral responsibility that agents have for hunger resulting from climate change. I introduce the problem of global changes in food production and distribution due to climate change, explore how philosophical conceptions of vulnerability can help us to make sense of what happens to people who are or will be hungry because of climate change, and establish some obligations regarding vulnerability to hunger.

In a morally diverse society, moral agents inevitably run up against intractable disagreements. Civility functions as a valuable constraint on the sort of behaviors which moral agents might deploy in defense of their deeply held moral convictions and generally requires tolerance of other views and political liberalism, as does pluralism. However, most visions of civility are exceptionless: they require civil behavior regardless of how strong the disagreement is between two members of the same society. This seems an excellent idea when (...) those required to do the tolerating might otherwise smash us. However, the demands of civility are universal and fall upon everyone, including ourselves. They may seem to require us to tolerate the intolerable, leading us not into pluralism but rather into functional relativism, and also require the powerless to moderate their demands for redress. They also place moral agents in a very difficult position with respect to realizing our deeply held moral values. Isaiah Berlin’s pluralism, by contrast, allows us to violate tolerance when we come up against values which, put into practice, are incompatible with a form of life we can tolerate. Despite the many fronts on which civility and pluralism align, they are also pitted against each other. Only a qualified (not exceptionless) civility based in respect for persons can cohere with pluralism and thus resolve the double bind in which the moral agent seemed to be placed by exceptionless civility. I develop a rule for Accepted Exceptions that helps to explain how moral agents can be civil, value pluralism, demand redress, and maintain their own deeply held moral commitments. (shrink)

The process of medicalization has been analyzed in the medical humanities with disapprobation, with much emphasis placed on its ability to reinforce existing social power structures to ill effect. While true, this is an incomplete picture of medicalization. I argue that medicalization can both reinforce and disrupt existing social hierarchies within the clinic and outside of it, to ill or good effect. We must attend to how this takes place locally and globally lest we misunderstand how medicalization mediates power and (...) justice. I provide concrete examples of how this occurs by considering dysesthesia ethiopsis, autism, chronic fatigue syndrome, depression, and HIV/AIDS. (shrink)

The fundamental standard of health care is health. Theories of health affect how we conceive of good health, ill health, Good patients, and Good providers. They also profoundly affect how we go about attempting to solve health problems once we’ve identified them. In this chapter, I argue that the way health care providers, bioethicists, and public health experts approach health relies on ideal theory despite the heavy knowledge that this world will never be ideal. We need a conception of health (...) that accounts for this. I outline the weakness of ideal theory in general and with respect to theories of health, and argue in favor of a nonideal approach to health that is rooted in intersubjectivity, empiricism, inclusivity, contextual specificity, and reflexivity which are not entrusted to any one set of knowers. Throughout, I use the example of how we approach fatness, and medicalize obesity, to illustrate where we’ve gone wrong and to chart a path toward how we can go right. (shrink)

Food behaviors, both private and public, are deeply affected by gender norms concerning both masculinity and femininity. In some ways, food-centered activities constitute gender relations and identities across cultures. This entry provides a non-exhaustive overview of how gender norms bear on food behaviors broadly construed, focusing on three categories: food production, food preparation, and food consumption.

Traditional considerations of justice for those who require caregiving have centered on what is due to the dependent person. However, considerations of justice also bear strongly on what is due to the caregiver. I focus on unpaid dependency work, too long treated as a private matter rather than a public concern. More is owed to those who render care: the division of labor is unjust, the nature of dependency work creates vulnerabilities for caregivers, and unpaid caregivers are disadvantaged in the (...) world of paid work. Obligations to mitigate these facts are ultimately based on the truth that all members of society at some point in their lives benefit from caregiving and that noncaregivers benefit unfairly from the heavy distribution of dependency work to a small number of certain kinds of individuals. It is necessary to ask which agents of justice are responsible for remedying this state of affairs, and how. I propose a distributed scheme of obligation in which members of society and the state, as arbiter of social responsibility, share responsibility for the remedy. It is incumbent upon us as a society to refrain from making vulnerable the most essential among us, to reap benefits without sowing unjust burdens. (shrink)

In this paper, I argue the cooking is a fraught issue for women, and especially women who self-identify as feminist, because it is so deeply gendered.

Feminist bioethicists of a variety of persuasions discuss the 2013 case of Marlise Munoz, a pregnant woman whose medical care was in dispute after she became brain dead.

In this paper, I analyze multiple aspects of how gender norms pervaded the 2016 election, from the way Clinton and Trump announced their presidency to the way masculinity and femininity were policed throughout the election. Examples include Hillary Clinton, Donald Trump, Barack Obama, and Gary Johnson. I also consider how some women who support Trump reacted to allegations about sexual harassment. The difference between running for President as a man and running for President as a woman makes all the difference (...) in the world. (OPEN ACCESS). (shrink)

In this bioethical poem, the narrator reflects on the experience of their father's degenerative illness, and decisions that must be made about whether to continue life support technologies such as ventilation and nutrition/hydration. What is it that is owed to family and patient at the end of life? What must no one who loves anyone ever do to the one they love?

Goold and Stern (2006) offer a much needed dose of insight into the weakness of medical education from the perspective of resident and nonresident physicians. One of their findings pertains not to...

In this paper, I sound a warning note about the medicalization of risk conditions such as high cholesterol, especially in a health care climate of resource scarcity.

McLeod focuses her book on what she calls "typical refusals in reproductive healthcare." She defines this at several points, describing these as primarily refusals that "target services that are standard and that the objectors believe will result in the death of a human being that has the moral or religious status of a person ". Abortion is one procedure that is commonly targeted by "typical refusals." McLeod notes that clinicians engaging in such refusals may refuse not only the procedure itself (...) but also to make a referral for a procedure because they find this kind of indirect complicity to still be a violation of conscience. This... (shrink)

Even without Alzheimer's or dementia, most of us are prone to “ordinary forgetting”. The Good Place and careful philosophical reflection can help us think through memory loss, relationships, and making a place for each other as we live through the human condition. Throughout The Good Place, Chidi and Eleanor help each other develop and sustain their moral selves as well as their relationship. Stories are fundamental to our sense of self, right and wrong, and the kind of people we are. (...) To understand memory as a construction, we must understand the three stages of individual memory: encoding, storage, and retrieval. How we scaffold each other's identities and how we hold space for each other in the real world are ethical issues that have everything to do with memory and the stories we tell ourselves and each other. The Good Place can help us grapple with this. (shrink)

A summary and brief discussion of the pedagogical usefulness of Hilary Putnam’s classic thought experiment from Reason, Truth, and History.

A summary and brief discussion of the pedagogical usefulness of Hilary Putnam’s classic thought experiment from Reason, Truth, and History.

In this investigation, I focus on individual memory behaviors for which we commonly blame and praise each other. Alas, we too often do so unreflectively. Blame and praise should not be undertaken lightly or without a good grasp on both what we are holding people responsible for, and the conditions under which they can be held responsible. I lay out the constructivist view of memory with consideration for both remembering and forgetting, and special attention to how we remember events as (...) well as whether we remember them. I generate seven defeasible generalized moral rules that should govern individual memory behaviors including remembering our own past wrongs, holding grudges, and creating positive as well as negative memories. By such means may we all remember and forget rightly and not for ill. (shrink)