Because medicine can preserve and restore health and function, it is widely acknowledged as a basic good that a just society owes its members. Yet there is controversy over the scope of what should be provided, to whom, how, when and why. This comprehensive and authoritative book - by well-known philosophers, doctors, lawyers, political scientists, and economists - lays a theoretical foundation for understanding the debate, assesses how health care is distributed in different countries and to various social groups, and (...) analyzes practical issues in constructing a socially just health care system. (shrink)

La metáfora del teatro no sólo aparece en el título del _Teatro crítico universal_ (1726–1739) de Benito Jerónimo Feijoo, sino también fue aducida por Pierre Bayle en su _Projet et fragmens d’un dictionaire critique _(1692). Es cierto que, a principios de la Edad Moderna, la metáfora del teatro podía emplearse y se empleaba en multitud de contextos y con fines muy diversos. Sin embargo, la combinación de teatro y error, tal y como se da tanto en Bayle como en Feijoo, (...) merece un examen más detenido. Se muestra cómo el _Theatrum vitae humanae_ (1565) de Theodor Zwinger, que es el texto en el que Bayle afirma basar su _Dictionnaire_, introduce una noción de teatro que no se centra en el escenario sino en el auditorio. Esto es significativo tanto para las estrategias de escritura de Bayle como para las de Feijoo, ya que apunta a la gestión de vastos cuerpos de conocimiento y, en última instancia, a la citacionalidad de ambos proyectos. Al mismo tiempo, sitúa al lector frente a la sabiduría tradicional y prepara así un espacio para el modo emergente de la crítica – por algunos caracterizado como escepticismo – que informa los proyectos de ambos autores. (shrink)

Drug Safety Communications are used by the Food and Drug Administration to inform health care providers, patients, caregivers, and the general public about safety issues related to FDA-approved drugs. To assess patient knowledge of the messaging contained in DSCs related to the sleep aids zolpidem and eszopiclone, we conducted a large, cross-sectional patient survey of 1,982 commercially insured patients selected by stratified random sampling from the Optum Research Database who had filled at least two prescriptions for either zolpidem or eszopiclone (...) between July 1, 2012 and June 30, 2013. Among the 594 respondents, two-thirds reported hearing generally about drug safety information prior to starting a new drug, with the remaining one-third “rarely” or “never” hearing such information. Providers and pharmacists were primary sources of drug safety information. Two-thirds of zolpidem users and half of eszopiclone users reported having heard about the related DSC messages, ability to accurately identify the major factual messages was limited. Respondents reacted to new drug safety information about their sleep aids by reporting that they would want to learn about alternative ways to help them sleep and seek out more information about the safety of their specific sleeping pill. Opportunities may exist for the FDA to work with providers and pharmacies to help ensure the DSC information is more widely received and is more fully understood by those taking the affected medications. (shrink)

A fundamental tenet of hermeneutic phenomenology is that people seek to create meaning of their experience from the response sited within human consciousness. The focus of this study is on the world of the lived experience as it is interpreted by participants through memory and language as accessed by interviews in order to produce an understanding of the participants’ experience. Three participants were interviewed whose adult children had died as a result of an AIDS-related illness. The interviews were recorded and (...) transcribed, and interwoven analyses sought to illustrate the participants’ lived experience of the phenomenon. An attempt was made to understand how the various phenomena relating to parental bereavement were reflected by participants in the interviews. Common themes included reactions to the knowledge of the illness, the experience of being with their dying child, coping with the pain of the loss, and spiritual and existential concerns. There are references to how others judge their grieving behaviour. Issues of retribution and punishment are prominent and these appear to place a particular burden of sorrow on the grieving parent. The study provided insight into the lived experience of bereavement and the forging of new meaning structures that can accommodate the loss. (shrink)

This paper contributes to the discussion on methodological decolonisation in business ethics research by illustrating how local epistemologies can shape methodology. Historically, business ethics research has been dominated by Western methodologies, which have been argued to be restrictive and limit contextually relevant theorising in non-Western contexts. Over the past decade, scholarship has called for more diversity in research methods and epistemologies. This paper regards arguments founded along neatly divided universalist versus contextualised methodologies as a false dilemma. Instead, we explore how (...) _ubuntu_, a sub-Saharan African epistemology, can contribute as a complementary epistemology and methodology to interpretivism when conducting business ethics research in sub-Saharan Africa. The paper discusses four aspects—research agenda, access, power relations, and context-sensitive methods—that highlight practical ways in which _ubuntu_ epistemology, with its communitarian and relational underpinnings, can enhance business ethics research. We illustrate that methodological decolonisation can be achieved by fusing relevant elements of local epistemologies and methodologies and conventional methodologies to generate context-relevant research approaches. (shrink)

Meaning lies at the very heart of the development of language. Therefore, it is not surprising that the linguists have long been fascinated by the study of meaning, from the early days of the discipline to the present. Over time, the approach to meaning has evolved, shifting from structuralist analyses of linguistic signs to a focus on the combinatory potential of grammatical structures. Currently, the dominant cognitive-semantics approach examines meaning in relation to concepts and the human brain's abilities. One of (...) the most intriguing questions throughout the history of semantics has been the one that deals with the relationship between an individual and the linguistic community within the framework of the wider sign-meaning relation. This essential, but insufficiently explored relationship was the central topic of the 33rd International Conference of the Croatian Applied Linguistics Society. (shrink)

Negative emotions are familiar enough, but they have rarely been a topic of study in their own right. This volume brings together fourteen chapters on negative emotions, written in a highly accessible style for non-specialists and specialists alike. It starts with chapters on general issues raised by negative emotions, such as the nature of valence, the theoretical implications of nasty emotions, the role of negative emotions in fiction, as well as the puzzles raised by ambivalent and mixed emotions. The second (...) part of the volume consists of studies of specific emotional phenomena, ranging from the emotion of being moved and the sense of uncanniness to jealousy, hatred, shame, contempt, anxiety, and grief. (shrink)

The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)

This paper describes differences in two perspectives on the idea of virtue as a theoretical foundation for positive organizational ethics (POE). The virtue ethics perspective is grounded in the philosophical tradition, has classical roots, and focuses attention on virtue as a property of character. The positive social science perspective is a recent movement (e.g., positive psychology and positive organizational scholarship) that has implications for POE. The positive social science movement operationalizes virtue through an empirical lens that emphasizes virtuous behaviors. From (...) a virtue ethics perspective, a behaviorally based account of virtue is a weak theory of virtue. Observations are suggested for integrating the two perspectives. First, virtue should always be understood as an excellence and is often an optimal point between extreme dysfunctions on continuum of potential states. Second, an empirical exploration of virtue needs to account for character and context. Finally, the properties of organization-level virtue need to be further specified and explored. Implications and directions for future research are discussed. (shrink)

How do I know whether there are any minds beside my own? This problem of other minds in philosophy raises questions which are at the heart of all philosophical investigations--how it is that we know, what is in the mind, and whether we can be certain about any of our beliefs. In this book, Anita Avramides begins with a historical overview of the problem from the Ancient Skeptics to Descartes, Malebranche, Locke, Berkeley, Reid, and Wittgenstein. The second part of (...) the book investigates the views of influential contemporary philosophers such as Strawson, Davidson, Nagel and Searle. (shrink)

Anita Chari revives the concept of reification from Marx and the Frankfurt School to spotlight the resistance to neoliberal capitalism now forming at the level of political economy and at the more sensate, experiential level of subjective transformation. Reading art by Oliver Ressler, Zanny Begg, Claire Fontaine, Jason Lazarus, and Mika Rottenberg, as well as the politics of Occupy Wall Street, Chari identifies practices through which artists and activists have challenged neoliberalism's social and political logics, exposing its inherent tensions (...) and contradictions. (shrink)

Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This revised report was prompted (...) by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report. (shrink)

The paper evaluates Christopher Hookway's claim that individual epistemic vice can enhance the value of collective epistemic virtue. I suggest that this claim can be defended on the grounds of a dynamic account of collective intentional properties that is supplemented by an account of a spontaneous ordering mechanism such as the "intangible hand". Both these accounts try to explain how individual traits integrate into collective traits by way of aggregation. In this respect, they are different from normative and summative accounts (...) of plural subjects. I argue that it is the repeatable and self-amplifying nature of character traits that calls for a dynamic account of collective virtues. With regard to epistemic virtues and their role in the acquisition of knowledge I hold that their dynamic and self-amplifying character warrants their reliability, since it is this character that bottoms out in repeated acts of epistemally correct behavior that constitute a 'responsible practice'. The successful appliance of the latter amplifies the attitude it origins from. If epistemic virtues construed along these lines are attributed to collectives, a dynamic aggregate account supplemented by an account of an "intan-gible hand" device might explain how an aggregate of virtuous efforts of individuals can not only absorb a certain amount of vice but be even enhanced by the 'spice' of some non-intentional epistemically vicious side effects of epistemically virtuous en- deavor. (shrink)

One of the most intriguing of philosophical puzzles concerns other minds. How do you know there are any? Yes, you're surrounded by living organisms that look and behave much as you do. They even say they have minds. But do they? Perhaps other humans are mindless zombies: like you on the outside, but lacking any inner conscious life, including emotions, thoughts, experiences and even pain. What grounds do you possess for supposing that other humans aren't zombies? Perhaps less than you (...) think. Anita Avramides tackles this fascinating question. (shrink)

The Gricean account of language is at the center of much current work in the philosophy of language and the philosophy of mind. Anita Avramides maintains that Grice's paradigm can be used to defend very different conceptions of mind and of meaning. In this clearly argued book she describes Grice's analysis of meaning and proposes two interpretations of it, one reductive and one nonreductive. Much current work in cognitive science assumes that the content of words and thoughts can be (...) explained in naturalistic terms. A leading idea (advanced mainly by Stephen Schiffer and Brian Loar) is that the naturalistic account of content will proceed in two stages: a reduction of the semantic features of word; to the contents of propositional attitudes and then a reduction of the latter to physical or functional notions. The appeal of Grice's work on meaning to this two stage reductionist strategy is that Gricean definitions seem to provide the only way of reducing the semantic to the psychological, a reduction that is required for a naturalistic account of intentionality. While Avramides defends the method of analysis as one suited to the concept of meaning, she rejects a reductive interpretation of the analysis. She argues that any attempt to reduce the semantic to the psychological leads to a mistaken conception of mind. She exposes the assumptions behind the reductive interpretation and offers fresh and original arguments for the antireductionist position. Against the reductive Gricean she defends the idea that there is a deep epistemological symmetry between semantic and propositional attitude notions, a result of which is that semantically characterized linguistic behavior is central to our concept of belief. Anita Avramides is Lecturer in Philosophy at The Queens College, The University of Oxfor. A Bradford Book. (shrink)

'Anita L. Allen breaks new ground...A stunning indictment of women's status in contemporary society, her book provides vital original scholarly research and insight.' |s-NEW DIRECTIONS FOR WOMEN.

Today, more corporations disclose information about their environmental performance in response to stakeholder demands of environmental responsibility and accountability. What information do corporations disclose on their websites? This paper investigates the environmental management policies and practices of the 200 largest corporations in the world. Based on a content analysis of the environmental reports of Fortune’s Global 200 companies, this research analyzes the content of corporate environmental disclosures with respect to the following seven areas: environmental planning considerations, top management support to (...) the institutionalization of environmental concerns, environmental structures and organizing specifics, environmental leadership activities, environmental control, external validations or certifications of environmental programs, and forms of corporate environmental disclosures. (shrink)

Recent developments in neuroscience have enabled technological advances to modulate cognitive functions of the brain. Despite ethical concerns about cognitive enhancement, both individuals and society as a whole can benefit greatly from these technologies, depending on how we regulate their use. To date, regulatory analyses of neuromodulation technologies have focused on a technology itself – for instance, the U.S. Food and Drug Administration regulation of a brain stimulation device – rather than the use of a technology, such as the use (...) of a brain stimulation device at work or school. Given that some forms of cognitive enhancement have already started to penetrate the general public’s everyday life, we should begin our discussion on potential regulatory issues regarding their use in various real-world situations. The goal of the article is to fill the gap by providing an analytic framework to examine these regulatory issues. More specifically, it aims to illustrate the issues around respecting autonomy and preventing coercive use of cognitive enhancement. The proposed framework categories the real-world settings where a neuromodulation technology can be used for cognitive enhancement based on two criteria – who is subjected to cognitive enhancement and who imposes cognitive enhancement. Based on this framework, the article analyzes regulatory issues arising out of every combination of subject/imposing party by taking one example case. Focusing on the regulations in the U.S., this analysis shows the current lack of adequate safeguards against the coercive use and calls for more attention from government agencies and researchers to develop sound policies regarding current and potentially more widespread use of cognitive enhancement. (shrink)

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society (...) for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here. (shrink)

Uncertainty is inherent in new and unexpected viral outbreaks such as the current COVID-19 pandemic. It imposes challenges for health officials in soliciting cooperative behavioural changes based on incomplete information. In this paper, we use evolving mask recommendations in the United States as an example to analyse the ethical importance and practical demonstration of trustworthiness in pandemic messaging and decision-making. We argue that responsible public health interventions in the time of uncertainties requires explicit intersecting ethical considerations both in action and (...) in communication to promote trustworthiness. First, as public health decisions have to be made in the face of incomplete and evolving data, health officials need to exhibit competence while committing to epistemic humility. They can explain the methods used in making and updating mask recommendations as well as explicitly acknowledge the need to incorporate sociocultural and other contextual considerations in translating scientific data into mask recommendations. Second, officials and agencies must uphold and communicate decisional transparency as part of their effort to demonstrate accountability and promote the public’s understanding of the evolving pandemic. Third, especially since both the pandemic and mask recommendations may have disparate impact on different populations, officials should start with the fair implementation of the least restrictive measures that can help reduce harm. (shrink)

I analyse the political, economic, and cultural circumstances that have given rise to persistent political disputes about race (known colloquially as “the culture war”) among a subset of Americans. I argue that they point to a deep tension between widely held normative aspirations and pervasive and readily observable material facts about our society. The characterological pathologies this gives rise to are discussed, and a normatively preferable path forward for an individual attempting to reconcile themselves to the current social order is (...) suggested. (shrink)

Liberalism welcomes diversity in substantive ideas of the good but not in the process whereby these ideas are formed. Ideas of the good acquire weight on the presumption that each is a person's own, formed independently. But people differ in their capacities to conceptualize. Some, appropriately characterized as cerebral, are proficient in and profoundly involved with conceptualizing. Others, labeled cognitively disabled, range from individuals with mild limitations to those so unable to express themselves that we cannot be sure whether their (...) behavior is mediated by concepts at all. Constricted cognitive capacities have been thought to prevent participation in the prescribed process for forming personalized ideas of the good. So liberal theory, when formulating principles and practices of justice, often disregards cognitively disabled peoples' perspectives. We put aside metaphysically driven notions about personhood and show how interpersonal processes of “prosthetic” thinking (different from surrogacy) can satisfy liberalism's standards, positioning cognitively disabled individuals as fully participating subjects of justice. (shrink)

How should we respond to individuals with disabilities? What does it mean to be disabled? Over fifty million Americans, from neonates to the fragile elderly, are disabled. Some people say they have the right to full social participation, while others repudiate such claims as delusive or dangerous. In this compelling book, three experts in ethics, medicine, and the law address pressing disability questions in bioethics and public policy. Anita Silvers, David Wasserman, and Mary B. Mahowald test important theories of (...) justice by bringing them to bear on subjects of concern in a wide variety of disciplines dealing with disability. They do so in the light of recent advances in feminist, minority, and cultural studies, and of the groundbreaking Americans with Disabilities Act. (shrink)

A feminist ethics that bases morality on dependence or vulnerability challenges the moral priority of uniform over disparate treatment. Persons with disabilities resist equality's homogenization of moral personhood. But displacing equality in favor of caring or trust reprises the repression of those already marginalized. The ethics of difference proves an ineffective remedy for the negative consequences attendant on how historically marginalized groups are different. An historicized conception of equality resolves the dilemma.

The aim of the present paper is to evaluate the notion of collective guilt feeling both in the light of research in affectivity and in collective intentionality. The paper is divided into an introduction and three main sections. Section 1) highlights relevant features of guilt‐family emotions such as the relation between feeling guilt and objective guilt, the relation between feeling guilt and its content, and the relation between feeling guilt and the ‘self’. Moreover, the distinction between feeling guilt and feeling (...) regret is given due attention. Section 2) examines Margaret Gilbert's arguments in favor of a collectivist view of collective guilt feeling , according to which groups do genuinely feel guilt. Against the collectivist position I argue for an individualist ‘membership account’ of collective guilt feeling in terms of individual members' we‐feeling of guilt. The membership account of collective guilt feeling is vindicated on grounds of a naturalist and non‐judgmentalist understanding of emotions, as well as on the logic of personal pronouns. It combines individualism regarding the subject of the feeling with collectivism regarding the irreducibility of we‐feelings and provides, as I further argue, the required moral force attributed to collective guilt feeling. The concern of section 3) is the question of the appropriate emotional response to collective wrongdoing. I argue against the view that group members are categorically ‘committed to feel guilt as a body’ for wrongdoings committed by the group. Given that individual members often do not participate in their groups' wrongdoings, it seems unjust to impose a requirement for feeling guilt upon them. I suggest that in a general account of the appropriate assessment of collective wrongdoing, feeling regret is the better candidate than feeling guilt for the role of the minimally required emotional response.For us collectively to feel guilt over our action A is for us to be jointly committed to feeling guilt as a body over our action A. [. . .] The parties [. . .] constitute, as far as possible, a single subject of guilt feelings .[A] collective cannot respond affectively [. . .], only its constitutive members can. The lack of an affective counter‐response is troubling, because the efficacy of responses of accountability partially depends upon affect. The response of shame, guilt, and regret help to register the significance of the harm. (shrink)

In recent decades, the intertwining ideas of self-determination and well-being have received tremendous support in bioethics. Discussions regarding self-determination, or autonomy, often focus on two dimensions—the capacity of the patient and the freedom from external coercion. The practice of obtaining informed consent, for example, has become a standard procedure in therapeutic and research medicine. On the surface, it appears that patients now have more opportunities to exercise their self-determination than ever. Nonetheless, discussions of patient autonomy in the bioethics literature, which (...) focus on individual patients making particular decisions, neglect the social structure within which health-care decisions are made. Looking through the lens of disability and informed by the feminist conception of relational autonomy, this essay argues that the issue of autonomy is much more complex than the individualist model suggests. The social system and the ableist ideology impose various forms of pressure or oppressive power that can affect people’s ability to choose according to their value system. Even if such powers are not directly coercive, they influence potential parents’ decisions indirectly—they structure their alternatives in such a way that certain options are never considered as viable and other decisions must be made. This paper argues that, instead of only focusing on the individual act of decision-making, we need to pay attention to the social structure that frames people’s decision. (shrink)

BackgroundAdherence to widely accepted practice standards is a frequently used measure of healthcare quality. In the U.S., the most widely recognized authoritative source of practice standards for ethics consultation (EC) is the second edition of the American Society for Bioethics and Humanities’ Core Competencies for Healthcare Ethics Consultation report.MethodsTo determine the extent to which EC practices in U.S. hospitals adhere to these practice standards, we developed and analyzed 12 evaluative measures from a national survey.ResultsOnly three of the 12 standards achieved (...) over 75% adherence with reported EC practices: allowing anyone involved in a case to request an EC (100%), not requiring an attending physician’s permission to conduct an EC (97.6%), and having at least one person on the ethics consultation service (ECS) with advanced level EC proficiency (79.3%).ConclusionsImplications are discussed for achieving consensus on EC standards as they continue to evolve. (shrink)

In this paper, we reflect on the disciplinary contours of contemporary sociology, and social science more generally, in the age of ‘big and broad’ social data. Our aim is to suggest how sociology and social sciences may respond to the challenges and opportunities presented by this ‘data deluge’ in ways that are innovative yet sensitive to the social and ethical life of data and methods. We begin by reviewing relevant contemporary methodological debates and consider how they relate to the emergence (...) of big and broad social data as a product, reflexive artefact and organizational feature of emerging global digital society. We then explore the challenges and opportunities afforded to social science through the widespread adoption of a new generation of distributed, digital technologies and the gathering momentum of the open data movement, grounding our observations in the work of the Collaborative Online Social Media ObServatory project. In conclusion, we argue that these challenges and opportunities motivate a renewed interest in the programme for a ‘public sociology’, characterized by the co-production of social scientific knowledge involving a broad range of actors and publics. (shrink)

Disagreement about the properattitude toward disability proliferates. Yetlittle attention has been paid to an importantmeta-question, namely, whether ``disability'' isan essentially contested concept. If so, recentdebates between bioethicists and the disabilitymovement leadership cannot be resolved. Inthis essay I identify some of the presumptionsthat make their encounters so contentious. Much more must happen, I argue, for anydiscussions about disability policy andpolitics to be productive. Progress depends onconstructing a neutral conception ofdisability, one that neither devaluesdisability nor implies that persons withdisabilities are inadequate. So, (...) first, I clearaway the conceptual underbrush that makes usthink our idea of disability must bevalue-laden. Second, I sketch someconstituents of, and constraints upon, aneutral notion of disability. (shrink)

It is possible to tease out two questions in connection with the epistemological problem of other minds: (i) How do I know what others think and feel? and (ii) How do I know that others think and feel? Fred Dretske offers a perceptual account of our knowledge of other minds that yields an answer to (i) but not (ii). Quassim Cassam uses Dretske’s perceptual account to show how we can answer both (i) and (ii). In this paper I show how (...) we can use Dretske’s work to understand some work by Stanley Cavell. I suggest that, where Dretske claims that we cannot answer (ii), Cavell holds that (ii) is a question that reflects a misunderstanding of our relations to others. In the place of asking how I can know that others think and feel, Cavell holds that I must acknowledge the other. And at the heart of this acknowledgment is an acceptance of others as separate from me. I must acknowledge the other as an other to me. (shrink)