My paper challenges an influential distinction between pain and suffering put forward by physician-ethicist, Eric Cassell. I argue that Cassell’s distinction is philosophically untenable because he contrasts suffering with an outdated theory of pain. In particular, Cassell focuses on one type of pain, the interpretation of nociception induced by noxious stimuli such as heat or sharp objects; yet since the late 1970s, pain scientists have rendered both nociception and noxious stimuli unnecessary for pain. I argue that this discrepancy between Cassell’s (...) distinction and pain science produces three philosophical problems for his distinction: first, he frames his distinction too generally, concentrating on only one type of pain to the neglect of others, such as neuropathy; second, it is possible that Cassell’s understanding of pain may include suffering; and third, Cassell gives examples of pain and suffering manifesting independently of each other, but it is possible that these cases may instead exemplify differences between nociceptive and non-nociceptive types of pain. Due to these problems, I conclude that Cassell’s distinction currently lacks a difference. I call for new efforts to articulate the differences, if any, between pain and suffering. (shrink)

IntroductionA symptom cluster is very common among oncological patients: cancer-related fatigue, emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations. Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance. It seems (...) to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions to improve oncological patients’ quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties.Methods and analysisA power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate. To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study ; immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured.DiscussionIn addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers.Clinical Trial RegistrationClinicalTrials.gov/. Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661. (shrink)

The purpose of the article is to elaborate on the scholarly debate on affect. We consider the site of affect to be the activities of embodied, socioculturally and spatially situated participants: “Affective activity is a form of social practice” (Wetherell, 2015, p. 147). By studying affect as a social phenomenon, we treat affect as a social ontology. Social practices are constituted through participation in social interaction, which makes it possible to study affect empirically. Moreover, we suggest that to consider affect (...) a social ontology connects affect to agency. We regard affect as a participants’ phenomenon where emotions and knowledge are not separated, i.e. as a social epistemology. To capture the complexity of affective activity, the study of situated participation requires video data. We collected data at a centre for persons with acquired brain injury (ABI), which highlights research ethics. The International Classification of Functioning, Disability and Health (ICF) framework defines participation as involvement in life situations. ICF focuses on two broader perspectives: the body and the individual in society. We turn ICF’s abstract societal perspective on participation to meaningful local accomplishments in lived social practices. Our focus is, in line with a critical social ontology in disability studies, on how-ability, the communicative abilities of the residents (Hughes, 2007). To get closer to life situations as they unfold, we analyse participation in its details as embodied actions during activities in the material environment of the centre. To conclude, we demonstrate a resident’s competent participation in an occupational therapy session through a fine-grained analysis of affective activity. Interaction, practices and phenomena are complex theoretical and practical issues. In the analysis of the encounters as complex multimodal and -sensorial situations, we use an extended version of Ethnomethodological Conversation Analysis (EMCA) that incorporates the body and material environment with the interconnectedness of interactional episodes. To do this, we enlarge the scope of analysis from the complexity of local occasions of affective activity to connections between consecutive affective entanglements. In the indicated work we draw on theoretical (lamination) and methodological (nexus analysis) suggestions in order to best pursue the sociocultural nature of situated interactions. (shrink)

Eric Cassell famously defined suffering as a person’s severe distress at a threat to their personal integrity. This article draws attention to some problems with the concept of distress in this theory. In particular, I argue that Cassell’s theory turns on distress but does not define it, which, in light of the complexity of distress, problematizes suffering in three ways: first, suffering becomes too equivocal to apply in at least some cases that Cassell nevertheless identifies as suffering; second, Cassell’s account (...) does not explain what sort of experience suffering is, resulting in theoretical and practical difficulties in distinguishing it from other medical conditions; third, there is good reason to believe that, in medical contexts, ‘distress’ just means ‘suffering’ or some cognate concept not yet distinguished from it, rendering Cassell’s theory circular. I consider a rebuttal to my objections and reply, concluding that Cassell’s theory of suffering needs a definition of distress to settle what the nature of suffering really is. (shrink)

This paper has two aims. The first is to defend a recent critique of the leading medical theory of suffering, which alleges too narrow a focus on violent experiences of suffering. Although sympathetic to this critique, I claim that it lacks a counterexample of the kinds of experiences the leading theory is said to neglect. Drawing on recent clinical cases and the longer intellectual history of suffering, my paper provides this missing counterexample. I then answer some possible objections to my (...) defence, before turning to my second aim: an expansion of my counterexample into a spectrum of suffering that varies according to the selves and purposes that suffering affects. Next, I connect this spectrum to the tolerability of suffering, which I distinguish from its affective intensity. I conclude by outlining some applications of this distinction for the psychometric reliability of assessment instruments that measure suffering in clinical contexts. (shrink)

Eric Cassell famously defined suffering as a person’s severe distress at a threat to their personal integrity. This article draws attention to some problems with the concept of distress in this theory. In particular, I argue that Cassell’s theory turns on distress but does not define it which, in light of the complexity of distress, problematizes suffering in three ways: first, suffering becomes too equivocal to apply in at least some cases that Cassell nevertheless identifies as suffering; second, Cassell’s account (...) does not explain what sort of experience suffering is, resulting in theoretical and practical difficulties in distinguishing it from other medical conditions; third, there is good reason to believe that in medical contexts, ‘distress’ just means ‘suffering’ or some cognate concept not yet distinguished from it, rendering Cassell’s theory circular. I consider a rebuttal to my objections and reply, concluding that Cassell’s theory of suffering needs a definition of distress to settle what the nature of suffering really is. (shrink)

Background In 2001 a report on the provision of clinical ethics support in UK healthcare institutions identified 20 clinical ethics committees. Since then there has been no systematic evaluation or documentation of their work at a national level. Recent national surveys of clinical ethics services in other countries have identified wide variation in practice and scope of activities. Objective To describe the current provision of ethics support in the UK and its development since 2001. Method A postal/electronic questionnaire survey administered (...) to the chairs of all 82 clinical ethics services registered with the UK Clinical Ethics Network in July 2010. Results Response rate was 62% with the majority of responding services situated in acute trusts. All services included a clinical ethics committee with one service also having a clinical ethicist. Lay members were present in 72% of responding committees. Individual case consultation has increased since 2001 with 29% of chairs spending more than 50% of their time on this. Access to and involvement in the process of case consultation is less for patients and families than for clinical staff. There is wide variation in committee processes and levels of institutional support. Over half of the responding committees undertook some form of evaluation. Conclusion Clinical ethics services in the UK are increasing as is their involvement in case consultation. However, the significant variation in committee processes suggests that further qualitative research is needed to understand how these committees function and the role they play in their institution. (shrink)

BackgroundCountries are increasingly devoting significant resources to creating or strengthening research ethics committees, but there has been insufficient attention to assessing whether these committees are actually improving the protection of human research participants.DiscussionResearch ethics committees face numerous obstacles to achieving their goal of improving research participant protection. These include the inherently amorphous nature of ethics review, the tendency of regulatory systems to encourage a focus on form over substance, financial and resource constraints, and conflicts of interest. Auditing and accreditation programs (...) can improve the quality of ethics review by encouraging the development of standardized policies and procedures, promoting a common base of knowledge, and enhancing the status of research ethics committees within their own institutions. However, these mechanisms focus largely on questions of structure and process and are therefore incapable of answering many critical questions about ethics committees' actual impact on research practices.The first step in determining whether research ethics committees are achieving their intended function is to identify what prospective research participants and their communities hope to get out of the ethics review process. Answers to this question can help guide the development of effective outcomes assessment measures. It is also important to determine whether research ethics committees' guidance to investigators is actually being followed. Finally, the information developed through outcomes assessment must be disseminated to key decision-makers and incorporated into practice. This article offers concrete suggestions for achieving these goals.ConclusionOutcomes assessment of research ethics committees should address the following questions: First, does research ethics committee review improve participants' understanding of the risks and potential benefits of studies? Second, does the process affect prospective participants' decisions about whether to participate in research? Third, does it change participants' subjective experiences in studies or their attitudes about research? Fourth, does it reduce the riskiness of research? Fifth, does it result in more research responsive to the local community's self-identified needs? Sixth, is research ethics committees' guidance to researchers actually being followed? (shrink)

Kolbe and de Melo-Martin (2023) raise important concerns about the limited usefulness of measures of moral distress. They propose that moral distress is best measured in terms of “illegitimate inst...

We reflect, using a vignette, on conceptual tensions and the value judgements that lie behind difficult decisions about whether or not the older person with dementia should return home or move into long-term care following hospital admission. The paper seeks, first, to expose some of the difficulties arising from the assessment of residence capacity, particularly around the nature of evaluative judgements and conceptual tensions inherent in the legal approach to capacity. Secondly, we consider the assessment of best interests around place (...) of residence, which demonstrates significant conceptual tensions. In addition, ‘best interests’ raise issues around the perception of risk and the perceptions of the family and crucially involve the notions of autonomy and trust. Finally, we not only gesture at some practical considerations based on insights from values-based medicine, but also make the suggestion that we require tighter functional assessments of residence capacity coupled with broader judgements about best interests. (shrink)

The provision of informed consent is a prerequisite for inclusion of a patient in a clinical research project. In some countries, the legislation on clinical research authorizes a third person to provide informed consent if the patient is unable to do so directly . This is the case during acute stroke, when the symptoms may prevent the patient from providing informed consent and thus require a third party to be approached. Identification of factors associated with the medical team’s decision to (...) resort to surrogate consent may help the care team during the inclusion process and enable the patient’s family circle to be better informed about providing surrogate consent. (shrink)

Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

Germaine de Staël (1766–1817), despite having published a considerable body of work, is seldom regarded as a feminist philosopher. Unlike, for instance, Mary Wollstonecraft of the same period, Staël is not directly arguing for the equality of the sexes. She even, at times, makes surprisingly derogatory remarks about women's nature. I argue that she is nevertheless putting forward a brand of difference feminism, which deserves our attention as a contribution to feminist reflections on gender norms in the early modern (...) era. Staël's contribution takes the form of a plea for the improvement of women's lives that engages with the combined action of nature and society. I clarify the meaning that we should ascribe to Staël's frequent appeals to nature and argue that, for her, society and education should be used to correct (alleged) natural weaknesses instead of reinforcing them. I also give an overview of Staël's political proposals toward the improvement of women's lives, which call for a better form of political regime than the one she lived in, as well as a better access to education and a more egalitarian conception of marriage. (shrink)

Mary Taylor, Charlotte Bront"e's closest and lifelong friend, did indeed fulfill Bront"'s prediction in both her life and her writings. Recently, however, the authenticity of Taylor's feminist classic, Miss Miles, has been put into question. A controversy is now raging among experts and scholars of Victorian fiction over the true authorship of Miss Miles. Did Mary Taylor labor over this novel from her early womanhood until the end of her life, and offer it as her last great (...) act of friendship to women? Or is it the last work of Charlotte Bront"e, taken from her home to prevent its destruction, then published posthumously under Taylor's name? Regardless of its authorship, Miss Miles is a passionate and compelling novel, well deserving of its literary status on its own terms, and fascinating as a part of the Bront"e world. In this, the only edition of Miss Miles available, Taylor breaks with tradition by creating a profoundly feminist and morally intense novel which depicts female friendships as sustaining life and samity through the vicissitudes of Victorian womanhood. Set in the small Yorkshire village of Repton against the backdrop of starvation in the wool districts and the rise of Chartism in the 1830s, this extraordinary work chronicles the lives of four socially disparate women as they learn to find their own voices and support one another. Taylor's own courage and allegiance to her friends is wonderfully reflected in each of these individually ambitious women, while the novel's emphasis on the healing power of women's friendships echoes the relationship between Bront"e and Taylor herself. Originally published in 1890, Miss Miles continues to stand as an eloquent polemic in favor of a women's personal obligation to support herself. It is a classic that will delight all lovers of fine literature. (shrink)

Virginia Woolf, in A Room of One’s Own, asked why there were no women writers before 1800. If she had been thinking about philosophers instead of writers in the traditional women’s areas of plays and fiction, she might have asked why there were no women philosophers at all, for I suspect that most people would find it very hard to name a woman philosopher before the present day. To help her in answering her question, she invented a fictional character, Judith (...) Shakespeare, a sister to William Shakespeare. The conditions of Judith’s life made it impossible for her to write, and so Woolf speculated that the women who would have been writers did not lead the kinds of lives that permitted them to realize their talents. Woolf’s image of Judith Shakespeare is a very powerful one but her speculation is only half right. There undoubtedly were many women in the past who would have been talented writers or philosophers if their lives had been different, but Judith Shakespeare’s image can also blot out our knowledge of women who, contrary to Woolf’s speculation, did exist and did write. Indeed, we know now there were even women who wrote philosophy. These women were in many ways exceptional, for Woolf is quite right that most women did not live either with enough privacy or with enough income to allow them to write. Often, they were members of the aristocracy, whose position enabled them to behave eccentrically, sometimes to be able to demand privacy, and sometimes to be able to invite contacts with leading intellectuals. Quite often, these women were childless, which in an age before birth control made them exceptions to the general rule, and at a time when many women were bearing their last child in their forties, was the only thing that could have given them private time. Nevertheless, research in the last ten or fifteen years has uncovered the work of quite a number of these women: for example, Princess Elizabeth of Bohemia, the Electress Sophie, Queen Christina of Sweden, Queen Sophie Charlotte of Prussia, Anne, Lady Conway, Mary Astell, Damaris, Lady Masham, Catharine Trotter Cockburn, Emilie du Chatelet, Catherine Macaulay, Lady Mary Shepherd, and many more. Woolf’s question then comes up again in a slightly different form. Why is it that the work of these women was for so long unknown? Why do so many people even today remain ignorant of the existence of women philosophers before the present day? I am not going to answer this question directly; in fact, I suspect it has multiple answers. Instead, I am going to present a case study from amongst all the cases of all of these women. I hope by considering the history of this woman, and, in particular, considering the way in which she was read, it will be possible to gain some insights into the ways in which women have failed to be incorporated into philosophical history. The woman I am going to discuss is Lady Mary Shepherd. Mary Shepherd actually falls outside of Woolf’s target date of 1800, since she flourished in the first half of the nineteenth century, but this merely reflects my point about the greater ignorance that prevails about women in philosophy. (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

In this paper I argue that from a feminist perspective well-being is most productively defined in relation to freedom, and it is with regard to questions of freedom that well-being should be pursued. Pursuing well-being from a starting point of oppression and working towards an ideal of freedom, involves two things: a reconception of the self as fundamentally relational and an emphasis on the importance of self-understanding for well-being. The former is something that has been widely acknowledged in the feminist (...) literature, where relational conceptions of the self figure centrally, and the notion of a socially situated self has been identified as one of the key contributions to living well from a feminist perspective. Self-understanding, however, has been largely ignored in feminist accounts of well-being, where the social aspects of well-being are often emphasised to the detriment of individual considerations. I argue that this can cause problems for well-being as the pursuit of freedom, but that such problems can be overcome by supplementing the relational account of the self with an emphasis on self-understanding and highlighting the interrelation between them in the pursuit of well-being qua freedom from oppression. (shrink)

This paper argues that close personal relationships play an important role in our judgments about what is fair. I start with an explanation of leading theories of fairness, highlighting the potential for further work on the grounds of fairness. Next, I offer an account of close personal relationships as having the ability to generate legitimate and reasonable expectations of one or other party to a judgment about fairness, or both. I show how and when close personal relationships can ground fairness.

This article focuses on three themes concerning determinism and indeterminism. The first theme is observational equivalence between deterministic and indeterministic models. Here I discuss several results about observational equivalence and present an argument on how to choose between deterministic and indeterministic models involving indirect evidence. The second theme is whether Newtonian physics is indeterministic. I argue that the answer depends on what one takes Newtonian mechanics to be, and I highlight how contemporary debates on this issue differ from those in (...) the nineteenth century. The third major theme is how the method of arbitrary functions can be used to make sense of deterministic probabilities. I discuss various ways of interpreting the initial probability distributions and argue that they are best understood as physical, biological etc. quantities characterising the particular situation at hand. Also, I emphasise that the method of arbitrary functions deserves more attention than it has received so far. (shrink)

This biography of Hypatia, the female philosopher and mathematician in Christian Egypt, provides background on her work and her life as an elite woman at this time. There are many myths about Hypatia, including her research, inventions and the impact of her murder, all based on a handful of contemporary resources. Through presenting the different theories and myths alongside the available evidence, this book will enable the reader to make their own interpretations about her life. Whilst the evidence does leave (...) many questions unanswered, this book provides the evidence as it stands, separating the myth from reality. There is very little published on Hypatia and she forms quite a niche market in the history of ancient Egypt. However, she is an interesting example of how multicultural Alexandria functioned at such an unstable political time, and provides anecdotal evidence of the atrocities that occurred. This book will appeal to scholars, lay people and political and religious researchers, and will show that the history of Egypt does not end at Cleopatra. (shrink)

With Hegel’s metaphysics attracting renewed attention, it is time to address a long-standing criticism: Scholars from Marx to Popper and Habermas have worried that Hegel’s metaphysics has anti-individualist and authoritarian implications, which are particularly pronounced in his Philosophy of History, since Hegel identifies historical progress with reason imposing itself on individuals. Rather than proposing an alternative non-metaphysical conception of reason, as Pippin or Brandom have done, this article argues that critics are broadly right in their metaphysical reading of Hegel’s central (...) concepts. However, they are mistaken about what Hegel’s approach entails, when one examines the specific types of states discussed by the philosopher in his Philosophy of History. Even on a traditional metaphysical reading, Hegel is not only non-authoritarian; he also makes a powerful argument concerning freedom, whereupon the freest society involves collective oversight and the shaping of social structures so as to ensure that they benefit everybody. (shrink)

This article discusses an interpretation of Kant's conception of transcendental subjectivity, which manages to avoid many of the concerns that have been raised by analytic interpreters over this doctrine. It is an interpretation put forward by selected C19 and early C20 neo-Kantian writers. The article starts out by offering a neo-Kantian interpretation of the object as something that is constituted by the categories and that serves as a standard of truth within a theory of judgment. The second part explicates transcendental (...) subjectivity as the system of categories, which is self-referential and constitutes objects, in order to then evaluate this conception by means of a comparison with Hegel's absolute subject. Rather than delineating the differences between neo-Kantian writers, the article systematically expounds a shared project, which consists in providing the ultimate foundation for judgments by means of an anti-psychologist and non-metaphysical interpretation of transcendental subjectivity. (shrink)

Some commentators have condemned Kant’s moral project from a feminist perspective based on Kant’s apparently dim view of women as being innately morally deficient. Here I will argue that although his remarks concerning women are unsettling at first glance, a more detailed and closer examination shows that Kant’s view of women is actually far more complex and less unsettling than that attributed to him by various feminist critics. My argument, then, undercuts the justification for the severe feminist critique of Kant’s (...) moral project. (shrink)

The neo-Kantian Hermann Cohen is famously anti-empiricist in that he denies that sensations can make a definable contribution to knowledge. However, in the second edition of Kant’s Theory of Experience (1885), Cohen considers a proposition that contrasts with both his other work and that of his followers: a Kantian who studies scientific claims to truth—and the grounds on which they are made—cannot limit himself to studying mathematics and logical principles, but needs to also investigate underlying presuppositions about the empirical element (...) of science. Due to his subjectivist approach, Cohen argues, Kant not only failed to explain how scientific observation and experiments are possible, but also misconceived the role of the ideas, particularly the idea of a system of nature. (shrink)

Charlotte Witt extracts from this text a coherent and provocative view about sensible substance by focusing on Aristotle's account of form or essence.

Trauma-informed care in pediatrics is an organizing principle for health care delivery that is based on the science of toxic stress and the insights of attachment theory. In their groundbreak...

Many interpreters argue that irrational acts of exchange can count as rational and civic-minded for Hegel—even though, admittedly, the persons who are exchanging their property are usually unaware of this fact. While I do not want to deny that property exchange can count as rational in terms of ‘mutual recognition’ as interpreters claim, this proposition raises an important question: What about the irrationality and arbitrariness that individuals as property owners and persons consciously enjoy? Are they mere vestiges of nature in (...) Hegel’s system, or do they constitute a simple yet valid form of freedom that is not only a part of Hegel’s rational system of right, but its necessary starting point? I will argue the latter: The arbitrary, purely egoist self-definition of property owners is the simplest possible type of freedom for Hegel, which he dissects in order to show how the very arbitrary self-definition implicitly relies on an identity between persons, and hence foreshadows the more social forms of freedom Hegel will discuss later in his book. I make this argument by highlighting Hegel’s references to his discussion of atoms and freedom in his Logic of Being. (shrink)

Garrett Cullity contends that fairness is appropriate impartiality (See Cullity (2004) Chapters 8 and 10 and Cullity (2008)). Cullity deploys his account of fairness as a means of limiting the extreme moral demand to make sacrifices in order to aid others that was posed by Peter Singer in his seminal article ‘Famine, Affluence and Morality’. My paper is founded upon the combination of (1) the observation that the idea that fairness consists in appropriate impartiality is very vague and (2) the (...) fact that psychological studies show the self-serving bias is especially likely to infect one’s judgements when the ideas involved are vague. I argue that Cullity’s solution to extreme moral demandingness is threatened by these findings. I then comment on whether some other theories of fairness are vulnerable to the same objection. (shrink)

While Hegel's metaphysics was long reviled, it has garnered more interest in recent years, with even the so-called non-metaphysical Hegelians starting to explicitly discuss Hegel’s metaphysical commitments. This brings up the old question: what are the social-philosophical implications of Hegel’s metaphysics? This chapter provides a unique answer to this question by contrasting the former non-metaphysical reading (as developed by Robert Pippin) with a traditional way of interpreting Hegel’s metaphysics and social philosophy, whose lineage includes not Wittgenstein, Sellars, or Brandom, but (...) rather Schelling, Marx, and Adorno. After discussing the two varieties of metaphysics (Sections 1–3), I will argue that a traditional metaphysical Hegel is more realist when it comes to assessing the power of social structures (Section 4), focused on structural freedom rather than agency (Sections 5 and 6), and more empowering for and lenient towards individuals who can make their interests count and are free to be irrational and egoist (Section 7). (shrink)

Patients have to be respected with dignity as the masters of their own lives. The problem, however, is that autonomy may become so dominant and the fundamental value of caring in professional nursing that the patient’s dignity is affected. The aim of this article is to point out some of the issues with the interplay between autonomy, also called self-management and dignity. Given voice to the patient perspective the background is provided by cases from research conducted through qualitative interviews with (...) patients and expanded by summarizing empirical research concerning the interplay between autonomy and dignity. The search strategy and the research question gave five empirical research papers and three theoretical studies and concept analyses. A concise overview of the relevant research contains information about all the major elements of the studies. The background research and an interpretative summary address new issues to be taken into account in dignity conserving care. (shrink)

Animals do a wide range of work in our society, but they are rarely recognized as workers or accorded any labour rights, and their working conditions are often oppressive and exploitative. Drawing on law, ethics, and labour studies, the essays in this volume explore the potential and dangers of animal labour.

Picking up on Marx’s and Hegel’s analyses of human beings as social and individual, the article shows that what is at stake is not merely the possibility of individuality, but also the correct conception of the universal good. Both Marx and Hegel suppose that individuals must be social or political as individuals, which means, at least in Hegel’s case, that particular interests must form part of the universal good. The good and the rational is not something that requires sacrificing one’s (...) interests for the community or denying one’s particular character so as to become an equal rational agent. Very much to the contrary, the rational or the common good is nothing but the harmonious structuring of particular interests. While Section I introduces Marx’s and Hegel’s conceptions of individual and social beings, Sections II and III discuss their respective views of individuality, and Sections IV and V discuss the notion of a universal good containing individual interests. (shrink)