(2013). Review of Anne-Maree Farrell, The Politics of Blood: Ethics, Innovation and the Regulation of Risk. The American Journal of Bioethics: Vol. 13, No. 4, pp. 54-56. doi: 10.1080/15265161.2013.768869.

In a plenary presentation on structural racism at the 2019 American Society of Bioethics and Humanities Annual Meeting, invited speaker Mary T. Bassett asserted that there is no solidarity without...

U.S. Food and Drug Administration policy prohibits blood donation from men who have had sex with men even one time since 1977. Growing moral criticism claims that this policy is discriminatory, a claim rejected by the FDA. An overview of U.S. blood donation, recent donor deferral policy, and the conventional ethical debate introduce the need for a different approach to analyzing discrimination claims. I draw on an institutional understanding of injustice to discern and describe five features of the MSM policy (...) and its FDA context that contribute to its discriminatory effect. I note significant similarities in the 1980s policy of deferring Haitians, suggesting an historical pattern of discrimination in FDA deferral policy. Finally, I point to changes needed to move toward a nondiscriminatory deferral policy. (shrink)

The factions debating health care reform in the United States have gravitated toward one of two positions: that just health care is an individual responsibility or that it must be regarded as a national concern. Both arguments overlook a third possibility: that justice in health care is multilayered and requires the participation of multiple and diverse communities. _Communities of Health Care Justice_ makes a powerful ethical argument for treating communities as critical moral actors that play key roles in defining and (...) upholding just health policy. Drawing together the key community dimensions of health care, and demonstrating their neglect in most prominent theories of health care justice, Charlene Galarneau postulates the ethical norms of community justice. In the process, she proposes that while the subnational communities of health care justice are defined by shared place, including those bound by culture, religion, gender, and race that together they define justice. As she constructs her innovative theorization of health care justice, Galarneau also reveals its firm grounding in the work of real-world health policy and community advocates. _Communities of Health Care Justice_ not only strives to imagine a new framework of just health care, but also to show how elements of this framework exist in current health policy, and to outline the systemic, conceptual, and structural changes required to put these justice norms into fuller practice. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S50-S56, March‐April 2022.

The U.S. 2010 Patient Protection and Affordable Care Act exempts members of health care sharing ministries from the individual mandate to have minimum essential insurance coverage. Little is generally known about these religious organizations and even less critical attention has been brought to bear on them and their ACA exemption. Both deserve close scrutiny due to the exemption’s less than clear legislative justification, their potential influence on the ACA’s policy and ethical success, and their salience to current religious liberty debates (...) surrounding the expansion of religious exemptions from ACA responsibilities for both individuals and corporations. Analyzing documents of the United States’ three largest health care sharing ministries and related material, I examine these organizations and their ACA exemption with particular consideration of their ethical dimensions. Here a thick description of the nature and workings of health care sharing ministries precedes a similar account of the ACA exemption. From these empirical analyses, five ethical and policy concerns emerge: the charity versus insurance status of these ministries; the conflation of two ACA religious exemptions; the tension between the values of religious liberty and of justice; the potential undermining of ACA policy goals; and the questionable compliance of health care sharing ministries with ACA exemption requirements. An accurate and informed understanding of HCSMs is required for policymakers and others to justify the ACA exemption of health care sharing ministry members. A sufficient justification would address at least the five ethical and policy concerns raised here. (shrink)

We often speak of health care as a social good. What kind of good it is-and what of us in making it available to the members of society-depends on how society underst value of health care may be understood in many different ways within society.

U.S. Food and Drug Administration policy prohibits blood donation from men who have had sex with men even one time since 1977. Growing moral criticism claims that this policy is discriminatory, a claim rejected by the FDA. An overview of U.S. blood donation, recent donor deferral policy, and the conventional ethical debate introduce the need for a different approach to analyzing discrimination claims. I draw on an institutional understanding of injustice to discern and describe five features of the MSM policy (...) and its FDA context that contribute to its discriminatory effect. I note significant similarities in the 1980s policy of deferring Haitians, suggesting an historical pattern of discrimination in FDA deferral policy. Finally, I point to changes needed to move toward a nondiscriminatory deferral policy. (shrink)

Health justice seeks, both conceptually and in practice, to strengthen community engagement and empowerment as an integral means of addressing health disparities. In this essay, we explore the nature of communities and their roles in health care/public health. We propose that an ethical principle of respect for communities is a requisite part of health justice. It is this respect for communities that ethically grounds health justice’s calls for greater community engagement and empowerment. Conceptions of health justice, we claim, will gain (...) ethical power and coherence as this principle is more clearly recognized and further developed. (shrink)

The report from the Presidential Commission for the Study of Bioethical Issues is clear that the public health services research conducted in Guatemala mid‐century was wrong, but its focus on individual responsibilities is inadequate for the structural and institutional factors at the root of that research. Ethically Impossible”: STD Research in Guatemala from 1946 to 1948, released in September 2011 by the Presidential Commission for the Study of Bioethical Issues, 1 responds to President Obama's request for a “thorough fact‐finding investigation” (...) into research carried out by the U.S. Public Health Service in Guatemala from 1946 to 1948. “Ethically Impossible” offers a detailed narrative of what happened in Guatemala and a self‐described “unvarnished ethical analysis.” I argue, however, that being “ever vigilant” to prevent exploitation, as well as learning as a society from this past and honoring the memory of Guatemalan victims, requires a more complex ethical analysis than the commission offers in this report. Specifically, we need to identify the structural injustices that innervated the social relations and the institutions fundamental to the moral landscape of this 1940s research, and we need to expand our understandings of moral responsibility accordingly. The report posits three “longstanding and widely accepted moral principles” as the framework for evaluating this research: (1) to treat persons fairly and with respect, (2) not to harm (or risk harming) persons unless the risk is reasonable and the benefit proportional, and (3) not to treat persons as means to others’ ends. As critically important as the three principles are to research ethics writ large, they alone are unfitting tools for addressing the kind of structural and institutional moral factors that are so important in these PHS studies. (shrink)

Given the enduring inequities in US health and health care, it is no surprise that particular communities are bearing the disproportionate brunt of the Covid‐19 pandemic and our responses to it. Many ethical aspects of the pandemic involve diverse communities bound by race, ethnicity, disability, income, residence, age, and more. How does bioethics engage these communities in theory and in practice? Only faintly, despite Covid‐19's relentless reminder that communities matter morally. This article sketches initial directions for developing a community‐inclusive bioethics, (...) one that understands communities as critical moral participants in the work of bioethics as well as in health and health care. (shrink)

This response to Kariyawasam and Rai affirms their critique of the pathologization of trans youth but forecasts a foreseeable negative outcome of their proposed elimination of diagnosis as a prerequisite to gender-affirming care (GAC) — the risk of removing GAC entirely from the medical sphere and compromising the wellbeing of those transgender individuals for whom GAC is deeply affirming. We suggest an ethical framework of GAC that expands past a focus on autonomy to incorporate a principle of respect for persons (...) that affirms the dignity and diversity of trans youth — recognizing the need to facilitate both medical assistance and social change. (shrink)

Short overview of the From Small Beginnings Project and its relevance for resisting eugenics in contemporary society.

AI has numerous applications and in various fields, including the military domain. The increase in the degree of autonomy in some decision-making systems leads to discussions on the possible future use of lethal autonomous weapons systems (LAWS). A central issue in these discussions is the assignment of moral responsibility for some AI-based outcomes. Several authors claim that the high autonomous capability of such systems leads to a so-called “responsibility gap.” In recent years, there has been a surge in philosophical literature (...) around the concept of responsibility gaps and different solutions have been devised to close or bridge these gaps. In order to move forward in the research around LAWS and the problem of responsibility, it is important to increase our understanding of the different perspectives and discussions in this debate. This paper attempts to do so by disentangling the various arguments and providing a critical overview. After giving a brief outline of the state of the technology of LAWS, I will review the debates over responsibility gaps using three differentiators: those who believe in the existence of responsibility gaps versus those who do not, those who hold that responsibility gaps constitute a new moral problem versus those who argue they do not, and those who claim that solutions can be successful as opposed to those who believe that it is an unsolvable problem. (shrink)

The history of note?taking has only begun to be written. On the one hand, the basic functions of selecting, summarizing, storing and sorting information garnered from reading, listening, observing and thinking can be identified in most literate contexts in some form or other. On the other hand, Renaissance humanists emphasized with unprecedented success the virtues of stockpiling notes on large scales and for the long term, thanks to the availability of paper and a new abundance of books, but also to (...) their ability to transmit their own keen motivation to avoid any future loss of learning. We continue to share many early modern ideals for insuring the collection and retrievability of information and have built on early modern practices that facilitate the accumulation and the organization of information, including collaborative work and the use of rearrangeable slips. (shrink)

Dispositional compatibilists argue that a proper understanding of our abilities vindicates both compatibilism and the principle of Alternate Possibilities (the claim that the ability to do otherwise is required for freedom and moral responsibility). In this paper, I argue that this is mistaken. Both analyses of dispositions and abilities should distinguish between local and global dispositions or abilities. Once this distinction is in place, we see that neither thesis is established by an analysis of abilities.

Two significant, apparently unrelated, trends have emerged in American society and medicine. First, American medicine is reexamining its approach to dying. The Institute of Medicine, the American Medical Association and private funding organizations have recognized that too many dying people suffer from pain and other distress that clinicians can prevent or relieve. Second, this past decade has marked a sharp increase in the number of physicians prosecuted for criminal negligence based on arguably negligent patient care. The case often cited as (...) a watershed is People u. Einaugfer, which involved a New York nursing home patient whose physician was convicted in 1993 of two criminal misdemeanors after he ordered an elderly dialysis patient to be tube fed through a peritoneal dialysis Catheter.How is the growing awareness of dying patients’ pain and the increasing willingness of prosecutors to charge physicians with crimes connected? Pain at the end of life is frequently treated with narcotics, prescription drugs that are closely regulated by state and federal law. That complex web of laws—and a growing fear of legal sanctions—has deterred physicians from prescribing controlled substances. As those legal sanctions move from disciplinary actions to criminal charges, physicians’ fears may expand. (shrink)

The causal theory of properties is standardly combined with a realist's ontology of universals or tropes. In this paper, I consider an uncharted alternative – a nominalist causal theory of properties. I discuss advantages and disadvantages of the resulting theory of properties, and explore the Rylean understanding of causal powers that emerges.

I consider a grand, yet neglected proposal put forward by Shoemaker—a functionalist theory of all properties. I argue that two possible ways of developing this proposal meet with substantial objections. However, if we are prepared to endorse an ontology of tropes, one of these functionalist analyses can be developed into an original and informative theory of properties.

Considerations upon the nature of properties and laws have led some philosophers to claim that the correct epistemic attitude with regards to the intrinsic properties of particulars is scepticism. I examine one particularly clear version of this line of argument, and contend that a serious form of scepticism is not established. However, I argue that the theories of properties and laws underlying the argument have unwanted metaphysical implications. These provide a stronger reason to jettison the analyses. I end by sketching (...) an alternative view that avoids these difficulties. -/- . (shrink)

The Routledge Companion to Feminist Philosophy is an outstanding guide and reference source to the key topics, subjects, thinkers, and debates in feminist philosophy. Fifty-six entries, written by an international team of contributors specifically for the _Companion_, are organized into five sections: Engaging the Past Mind, Body, and World Knowledge, Language, and Science Intersections Ethics, Politics, and Aesthetics. The volume provides a mutually enriching representation of the several philosophical traditions that contribute to feminist philosophy, including the analytic and continental traditions. (...) It also foregrounds issues of global concern and scope; shows how feminist theory meshes with rich theoretical approaches that start from transgender identities, race and ethnicity, sexuality, disabilities, and other axes of identity and oppression; and highlights the interdisciplinarity of feminist philosophy and the ways that it both critiques and contributes to the whole range of subfields within philosophy. (shrink)

It is argued that dignity can be considered both subjectively, taking into account individual differences and idiosyncrasies, and objectively, as the foundation of human rights. Dignity can and should also be explored as both an other-regarding and a self-regarding value: respect for the dignity of others and respect for one’s own personal and professional dignity. These two values appear to be inextricably linked. Aristotle’s doctrine of the mean enables nurses to reflect on the appropriate degree of respect for the dignity (...) of others and of respect for themselves. To develop an understanding of the rationale for and the significance and implications of dignity in health care practice, a view of human nature is proposed that implies vulnerability and fallibility, and that urges that an ethic of aspiration is embraced. Anonymized vignettes are included to illustrate points about the everyday nature of dignity. (shrink)

The feminist philosopher and social scientist shows how "gendering" has affected the social and natural sciences as she reconciles the long-standing dichotomy between the quantitative and qualitative methods and demonstrates the tandem use of both experimental and intuitive approaches.

Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

This research explored the ethical decision-making process of civilians in response to real-world military dilemmas. Results revealed the complexity of these dilemmas, with about equal proportions of civilians choosing each of two response options. The moral intensity dimension of social consensus significantly predicted moral judgment in both dilemmas, whereas that of magnitude of consequences did so in only one dilemma, partially supporting our hypothesis. Both dimensions were significant predictors of moral intent in both dilemmas as was moral judgment, also supporting (...) our hypotheses. We conclude with suggestions for future research questions in this compelling area. (shrink)

Theories of perception have traditionally dismissed the sense of smell as a notoriously variable and highly subjective sense, mainly because it does not easily fit into accounts of perception based on visual experience. So far, philosophical questions about the objects of olfactory perception have started by considering the nature of olfactory experience. However, there is no philosophically neutral or agreed conception of olfactory experience: it all depends on what one thinks odors are. We examine the existing philosophical methodology for addressing (...) our sense of smell: on the one hand appeals to phenomenology that focus on the experiential dimensions of odor perception and on the other approaches that look at odor sources and their material dimensions. We show that neither strategy provides enough information to account for the human sense of smell and argue that the inclusion of the missing dimension of biology, with its concern for the function (or functions) of olfaction, provides the means to develop a satisfactory and empirically informed philosophy of smell. (shrink)

This Margaret Mann Phillips lecture of 2018 examines Erasmus’s relationships with his amanuenses, building on the work of Franz Bierlaire and others. It especially considers when and why members of Erasmus’s familia appeared in print in his works. Mention of servants functioned in a variety of ways to allay the author’s responsibility for features of the text that might be criticized. Manuscript evidence also shows Erasmus working with his amanuenses in the preparation of publications and indexes in particular.

The co-instantiation thesis is pivotal to a significant solution to the problem of causal exclusion. But this thesis has been subject to some powerful objections. In this paper, I argue that these difficulties arise because the thesis lacks the necessary metaphysical framework in which its claims should be interpreted and understood. Once this framework is in place, we see that the co-instantiation thesis can answer its critics. The result is a rehabilitated co-instantiation solution to the troubling problem of causal exclusion. (...) But questions remain concerning the viability of certain of its applications. (shrink)

Through a phenomenological study of horse-human relations, this article explores the ways in which, as embodied beings, we live relationally, rather than as separate human identities. Conceptually this challenges oppositional logic and humanist assumptions, but where poststructuralist treatments of these issues tend to remain abstract, this article is concerned with an embodied demonstration of the ways in which we experience a relational or in-between logic in our everyday lives.

While there is an extensive subfield in sociology studying the sources, content, and consequences of collective memory, the study of future projections has been much more fragmentary. In part, this has to do with the challenge of measurement; how do you measure something that has not happened yet? In this article, I argue that future projections can be studied via their externalizations in attitudes, narratives, performance, and material forms. They are particularly evident in what I call “sites of hyperprojectivity,” that (...) is, sites of heightened, future-oriented public debate about possible futures. As a pilot project, I examine contending narratives about possible futures in the online documents of the United Nations Conference on Sustainable Development and the accompanying “People’s Summit,” held in Rio de Janeiro in June 2012. I propose a framework for studying how public interventions into debates about “sustainable futures” and the “green economy” differ on various dimensions of projectivity, including their temporal reach, attention to contingency and causality, and network mapping of future actors. I present a preliminary analysis at the level of narrative and grammar, by analyzing the use of predictive, imperative, and subjunctive verb forms in both programmatic and oppositional texts. I close with a discussion of how different genres of future projection might be put to analytical use in studying processes of interest to social scientists, such as coalition formation, institution building, political mobilization, and policy change. (shrink)

"Ann Plato was the first black to publish a collection of essays, in 1841."--Newsweek.

Ann Radcliffe foi uma autora de extrema importância para a literatura britânica da virada do século XVIII para o XIX. Como se sabe, foi a autora mais bem paga da década de 1790. Os Mistérios de Udolpho, seu romance mais conhecido, foi dos mais influentes no que diz respeito à ficção gótica. Isso fica evidente, por exemplo, quando observamos que Jane Austen o coloca em destaque em boa parte da trama de seu Abadia de Northanger, de maneira que se pode (...) dizer que Udolpho representa, ao longo dessa obra, o exemplo mais bem acabado da ficção gótica da época. Walter Scott, por sua vez, como nos lembra Ellen Moers. (shrink)

Background:The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves.Objectives:This study describes operating theatre nurses’ experiences of ethical value conflicts in perioperative practice.Research design:Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation.Ethical consideration:The study followed ethical principles (...) in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee.Findings:The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient’s care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient’s best. This occurred when operating theatre nurses’ competence was not taken seriously and was ignored in patient care.Conclusion:Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations. (shrink)

Michel de Montaigne, the inventor of the essay, has always been acknowledged as a great literary figure but has never been thought of as a philosophical original. This book treats Montaigne as a serious thinker in his own right, taking as its point of departure Montaigne's description of himself as 'an unpremeditated and accidental philosopher'. Whereas previous commentators have treated Montaigne's Essays as embodying a scepticism harking back to classical sources, Ann Hartle offers an account that reveals Montaigne's thought to (...) be dialectical, transforming sceptical doubt into wonder at the most familiar aspects of life. This major reassessment of a much admired but also much underestimated thinker will interest a wide range of historians of philosophy as well as scholars in comparative literature, French studies and the history of ideas. (shrink)

Northern researchers and service providers espousing modernist theories of development in order to understand and aid countries and peoples of the South ignore their own non-universal starting points of knowledge and their own vested interests. Universal ethics are rejected in favor of situated ethics, while a modified empowerment development model for aiding women in the South based on poststructuralism requires building a bridge identity politics to promote participatory democracy and challenge Northern power knowledges.

Some have argued that our intuitive reactions to a number of cases of moral responsibility can only be preserved at the expense of a unified account of moral responsibility for acts and omissions. I argue against this conclusion, proposing that a plausible condition on responsibility, the Causal Condition can, when properly elaborated, justify the relevant intuitive data.

Male-dominated and sex segregated elite professional and amateur sport1 in North America constitutes a "sport nexus" (Burstyn, 1999; Heywood & Dworkin, 2003) that combines economic and cultural influence to reinforce and perpetuate gender injustice. The sport nexus is an androcentric sex-segregated commercially powerful set of institutions that is highly visible and at the same time almost completely taken for granted to the extent that its anti-democratic impetus goes virtually unnoticed. The sport nexus’s hegemonic role in defining sporting norms (Coakley & (...) Donnelly, 2004) means that its role in shaping lower level amateur and recreational sporting institutions and cultures is highly significant. Fraser (2007) defines gender justice, and hence democracy, in terms of "participatory parity," that is, material and cultural equality for women. The sport nexus itself is characterized by highly gendered occupational segregation (Coventry, 2004). It further contributes to gender injustice, homophobia and transphobia by promoting the ideology of the two sex system (Fausto-Sterling, 2000) and gendering citizenship as fundamentally male (Burstyn, 1999). Feminist strategies for sport reformation attempt to reduce or eradicate the role of the sport nexus in legitimating and perpetuating gender injustice. In this article I consider the potential of these strategies and conclude with a set of recommendations for transforming organized sport at both elite and recreational levels. (shrink)

I distinguish between two opposing intuitions about the nature of the singular causal relation. The first stresses the nomological character of causation, while the second emphasises is seemingly local character. My question is this: is it possible to formulate an account of causation which incorporates both intuitions? Anscombe gives us reason to think that these intuitions could not be jointly met in an account of causation. Foster and Tooley's acount seems to provide a counter‐instance to her claim, but this proves (...) to be a false start. I put forward an alternative suggestion which, by utilising tropes, manages to reconcile both the local and nomological character of causation. (shrink)

Background:Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them.Purpose:To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic.Design:Qualitative descriptive component within a larger mixed-methods study.Participants and research context:Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis was used (...) to analyze the data.Ethical considerations:The study was approved by the ethics committee at the researchers’ university in eastern Canada.Results:A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety.Discussion:Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed.Conclusion:Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being. (shrink)