Background For a variety of sociological reasons, different types of centredness have become important in health and social care. In trying to characterize one type of centredness, we were led to consider, at a conceptual level, the importance of the notion of centredness in general and the reasons for there being different types of centeredness. Method We searched the literature for papers on client-, family-, patient-, person- and relationship- centred care. We identified reviews or papers that defined or discussed the (...) notions at a conceptual level. The reviews and papers were analyzed as text transcripts. Results We identified 10 themes that were common to all the types of centredness. At a conceptual level we could not identify thematic differences between the types of centredness. These findings were subjected to a philosophical critique using ideas derived from Wittgenstein. Conclusion Different types of centredness are required in different contexts. The differences are justified by their practical utility. The unifying themes of centredness, however, reflect a movement in favour of increasing the social, psychological, cultural and ethical sensitivity of our human encounters. (shrink)

Weighing Lives in War examines the core principles of the modern law of war: necessity, proportionality, and distinction, and provides new and innovative insights into the process of weighing lives implicit in all theories of jus in bello.

It is well-documented that the alteration of portrait photographs can have a negative impact on a viewer’s self-esteem. One might think that providing written disclaimers warning of alteration might help to mitigate this effect, yet empirical studies have shown that viewers continue to feel like what they are seeing is real, and thus attainable, despite knowing it is not. I propose that this cognitive dissonance occurs because disclaimers fail to show viewers how to look at the contents of a photographic (...) image differently. Consequently, viewers have the same perceptual experience, where the picture appears to faithfully resemble a direct visual experience of the subject, which conflicts with their changing sense of warrant. However, I argue that the degree of perceived similarity, and so contact, may be subject to change depending on what a viewer is attentive to during their viewing of an image, including subtle but unrealistic signs of alteration. (shrink)

Autonomy is a vital concept in much of modern theory, defining the Subject as capable of self-governance. Democratic theory relies on the concept of autonomy to provide justification for participatory government and the normative goal of democratic governance, which is to protect the ability of the individual to self-govern. Offering the first examination of the concept of autonomy from a postfoundationalist perspective, _The Autonomous Animal _analyzes how the ideal of self-governance has shaped everyday life. Claire E. Rasmussen begins by (...) considering the academic terrain of autonomy, then focusing on specific examples of political behavior that allow her to interrogate these theories. She demonstrates how the adolescent—a not-yet-autonomous subject—highlights how the ideal of self-governance generates practices intended to cultivate autonomy by forming the individual’s relationship to his or her body. She points up how the war on drugs rests on the perception that drug addicts are the antithesis of autonomy and thus must be regulated for their own good. Showing that the animal rights movement may challenge the distinction between human and animal, Rasmussen also examines the place of the endurance athlete in fitness culture, where self-management of the body is the exemplar of autonomous subjectivity. (shrink)

This short paper is based on a presentation delivered by four young people from Sunderland Children Services—Amy, Claire, Jordan and Glen (supported by Grace Roddam, Young People's Training and Development Mentor, and Dave Laverick, Workforce Development Consultant)—at the ‘Learning Professional Wisdom: Courage and Compassion’ Ethics and Social Welfare conference, which took place on 15 May 2009 at St Mary's College, Durham University, UK. The conference was organized by the newly formed Ethics and Social Welfare network, with support from the (...) Social Work and Policy Subject Centre (SWAP), Durham University and Ethics & Social Welfare journal. The conference focused on the contested nature of ‘moral character’ in professional education, whether this can be learnt and developed and how it links with judgements about ‘suitability for practice’. The four young people, drawing on their specific experiences of the looked after system, provided a valuable contribution which will assist understanding of what is meant by the term ‘ethical practitioner’ and the values and attributes they believe practitioners should have in order to fulfil their ethical obligations. (shrink)

Within a context of rapid growth and diversification in higher degree research programs, there is increasing pressure for the results of doctoral research to be made public. Doctoral students are now being encouraged to publish not only after completion of the doctorate, but also during, and even as part of their research program. For many this is a new and challenging feature of their experience of doctoral education. _Publishing Pedagogies for the Doctorate and Beyond_ is a timely and informative collection (...) of practical and theorised examples of innovative pedagogies that encourage doctoral student publishing. The authors give detailed accounts of their own pedagogical practices so that others may build on their experiences, including: a program of doctoral degree by publication; mentoring strategies to support student publishing; innovations within existing programs, including embedded publication pedagogies; co-editing a special issue of a scholarly journal with students; ‘publication brokering’, and writing groups and writing retreats. With contributions from global leading experts, this vital new book: explores broader issues pertaining to journal publication and the impacts on scholarly research and writing practices for students, supervisors and the academic publishing community takes up particular pedagogical problems and strategies, including curriculum and supervisory responses arising from the ‘push to publish’ documents explicit experiences and practical strategies that foster writing-for-publication during doctoral candidature. _Publishing Pedagogies for the Doctorate and Beyond_ explores the challenges and rewards of supporting doctoral publishing and provides new ways to increase research publication outputs in a pedagogically sound way. It will be a valued resource for supervisors and their doctoral students, as well as for program coordinators and managers, academic developers, learning advisors, and others involved in doctoral education. (shrink)

Most people encounter art images as digital reproductions on a computer screen instead of as originals in a museum or gallery. With the development of digital technologies, high-resolution artworks can be accessed anywhere and anytime by a large number of viewers. Since these digital images depict the same content and are attributed to the same artist as the original, it is often implicitly assumed that their aesthetic evaluation will be similar. When it comes to the digital reproductions of art, however, (...) it is also obvious that reproductions do differ from the originals in various aspects. Besides image quality, resolution, and format, the most obvious change is in the representation of color. The effects of subjectively varying surface-level image features on art evaluation have not been clearly assessed. To address this gap, we compare the evaluation of digital reproductions of 16 expressionist and impressionist paintings manipulated to have a high color saturation vs. a saturation similar to the original. We also investigate the impact of viewing time and expertise, two other aspects that may impact the perception of art in online contexts. Moreover, we link these dimensions to a recent model of aesthetic experience [the Vienna Integrated Model of Top-Down and Bottom-Up Processes in Art Perception ]. Results suggest that color saturation does not exert a major influence on liking. Cognitive and emotional aspects, however, are affected – to different extents for experts and laypersons. For laypersons, the increase in color saturation led to more positive assessments of an artwork, whereas it resulted in increased confusion for art experts. This insight is particularly important when it comes to reproducing artworks digitally. Depending on the intended use, increasing or decreasing the color saturation of the digitally reproduced image might be most appropriate. We conclude with a discussion of these findings and address the question of why empirical aesthetics requires more precise dimensions to better understand the subtle processes that take place in the perception of today’s digitally reproduced art environment. (shrink)

There is a sustained phenomenological tradition of describing the character of photographic pictorial experience to consist in part of a feeling of contact with the subject of the photograph. Philosophers disagree, however, about the exact cause of the ‘contact phenomenon’ and whether there is a difference in the phenomenal character between the pictorial experiences of photographs and handmade pictures so that, if a viewer mistakes the type that a token image belongs to, their sense of contact can alter. I argue (...) that the contact phenomenon is contingent upon, and triggered by, the viewer’s perceptual experience of the image, which may be subject to change depending upon how a viewer attends to an image. I develop a hybrid account to resolve how the perceptual and cognitive aspects of a viewer’s experience interact and produce the complex phenomenology, including conflicting mental states, that a viewer can undergo during the described experiences. (shrink)

Research using the intermodal preferential looking paradigm (IPLP) has consistently shown that English‐learning children aged 2 can associate transitive argument structure with causal events. However, studies using the same methodology investigating 2‐year‐old children’s knowledge of the conjoined agent intransitive and semantic role assignment have reported inconsistent findings. The aim of the present study was to establish at what age English‐learning children have verb‐general knowledge of both transitive and intransitive argument structure using a new method: the forced‐choice pointing paradigm. The results (...) suggest that young 2‐year‐olds can associate transitive structures with causal (or externally caused) events and can use transitive structure to assign agent and patient roles correctly. However, the children were unable to associate the conjoined agent intransitive with noncausal events until aged 3;4. The results confirm the pattern from previous IPLP studies and indicate that children may develop the ability to comprehend different aspects of argument structure at different ages. The implications for theories of language acquisition and the nature of the language acquisition mechanism are discussed. (shrink)

This article considers children’s status in society and how this may be elevated with a view to imagining a possible future. Children’s status is such that the structures and systems under which they live diminish their agency. In so doing, their opportunity to contribute to the shaping of what appears to be an uncertain future is limited. The article proposes that looking towards children as saviours of our tomorrows is misguided and that a healthier view is to recognise the networked (...) nature of children, which recognises children’s humanity and sees them as connected to the world in which and of which they are a part. By accepting the networked nature of children, adults may come to think and behave differently towards children, beginning to see themselves and children as ‘one among many’. This perspective allows for compassion, a notion that supports our living together. This article proposes that Philosophy with Children may offer an approach to engaging in community and dialogue that allows us to think our way to a future that is epistemically inclusive. Ultimately, engaging with children as potential knowers demands that we are more overtly political in the ways in which we engage with Philosophy with Children. (shrink)

Information on the factors influencing parents’ decision-making process following a lethal, life-limiting or severely debilitating prenatal diagnosis remains deficient. A comprehensive systematic review and meta-synthesis was conducted to explore the influencing factors for parents considering termination or continuation of pregnancy following identification of lethal, life-limiting or severely debilitating fetal abnormalities. Electronic searches of 13 databases were conducted. These searches were supplemented by hand-searching Google Scholar and bibliographies and citation tracing. Thomas and Harden’s thematic synthesis method was used to synthesise data (...) from identified studies. Twenty-four papers were identified and reviewed, but two papers were removed following quality assessment. Three main themes were identified through systematic synthesis. Theme 1, entitled ‘all life is precious’, described parents’ perception of the importance of the fetus’ life, a fatalistic view of their situation alongside moral implications as well as the implications decisions would have on their own life, in consideration of previous life experiences. Theme 2 contained two sub-themes which considered the parent’s own imagined future and the influence of other people’s experiences. Finally, Theme 3 presented three sub-themes which may influence their parental decision-making: These described parental consideration of the quality of life for their unborn child, the possibility of waiting to try for another pregnancy, and their own responsibilities and commitments. The first review to fully explore parental decision-making process following lethal, life-limiting, or severely debilitating prenatal diagnosis provided novel findings and insight into which factors influenced parents’ decision-making process. This comprehensive and systematic review provides greater understanding of the factors influential on decision-making, such as hope, morality and potential implications on their own and other’s quality of life, will enable professionals to facilitate supported decision-making, including greater knowledge of the variables likely to influence parental choices. (shrink)

BackgroundIn 2019, the Constitutional Court of South Korea ruled that the anti-abortion provisions in the Criminal Act, which criminalize abortion, do not conform to the Constitution. This decision will lead to a total reversal of doctors’ legal duty from the obligation to refuse abortion services to their requirement to provide them, given the Medical Service Act that states that a doctor may not refuse a request for treatment or assistance in childbirth. I argue, confined to abortion services in Korea that (...) will take place in the near future, that doctors should be granted the legal right to exercise conscientious objection to abortion.Main textConsidering that doctors in Korea have been ethically and legally obligated to refrain from abortions for many years, imposing a universal legal duty to provide abortions that does not allow exception may endanger the moral integrity of individual doctors who chose a career when abortion was illegal. The universal imposition of such a duty may result in repudiation of doctors as moral agents and damage trust in doctors that forms the basis of medical professionalism. Even if conscientious objection to abortion is granted as a legal right, most patients would experience no impediment to receiving abortion services because the healthcare environment of Korea provides options in which patients can choose their doctors based on prior information, there are many doctors who would be willing to provide an abortion, and Korea is a relatively small country. Finally, the responsibility to effectively balance and guarantee the respective rights of the two agents involved in abortion, the doctor and the patient, should be imposed on the government rather than individual doctors. This assertion is based on the government’s past behaviours, the nature of its relationship with doctors, and the capacity it has to satisfy both doctors’ right to conscientious objection and patients’ right to legal medical services.ConclusionWith regard to abortion services that will be sought in the near future, doctors should be granted the legal right to exercise conscientious objection based on the importance of doctor’s moral integrity, lack of impediment to patients, and government responsibility. (shrink)

Recently, we showed that conscious and unconscious rewards affect the active maintenance of goal-relevant information differently. Here, we elaborate on the mechanisms enabling the boosting or disrupting effects of consciously processed high rewards, and discuss a few methodological and theoretical implications that may be worth considering in future research on the role of reward processing in working memory performance.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Epistemological Warfare and Hope in Critical Dystopia by Emrah AtasoyClaire P. CurtisEmrah Atasoy. Epistemological Warfare and Hope in Critical Dystopia. Ankara: Nobel Bilimsel Eserler, 2021. vii+ 167 pp. ISBN: 978-625-7589-04-8This book is an application of the idea of critical dystopia to three understudied novels and the beginning of an argument about utopian desire itself. Emrah Atasoy, a prolific author who reviewed Turkish speculative fiction in a well-received 2021 (...) Utopian Studies article, is modeling a search for hope in dystopian texts. In this book, derived from his dissertation, he examines three British novels written in three different eras of the twentieth century: Katherine Burdekin's Swastika Night (1937), Anthony Burgess's The Wanting Seed (1962), and P. D. James's The Children of Men (1992). In each novel, Atasoy argues, the protagonists move from an ignorance that served the interest of the dystopian forces to a resistant knowledge that should be read as offering hope, both as resistance and as knowledge.The book is organized in a straightforward way, with an introduction, conclusion, and then three analytical chapters, one for each of the novels. The introduction is expansive, offering both brief surveys of the nature of utopia and dystopia and a recounting of a number of themes taken up by dystopian texts: education, politics, gender roles, family life, and more. Layered onto this is a discussion of theorizing around knowledge and power and the transition from ignorance to understanding. The chapters focused on the individual novels are all similarly expansive. Atasoy offers biographical information about the authors along with considerations of the primary social and political events to which the authors might be responding. The analyses of the novels focus primarily on the motivations of the protagonists, but interspersed in the plot summaries are narrative cul-de-sacs explaining particular textual details (for example, the discussion of Theo's choice of the Greek statue of Diadoumenos as allocation to leave a note for the Warden [James, 37]). These [End Page 519] little detours are often interesting but can be distracting from the primary analytic focus.The analyses themselves also cover a lot of territory. The middle section of the chapter on The Children of Men (118–34) includes discussions of power, eugenics, religion, sexuality, punishment, assisted suicide, and immigration. Each of these is used to elucidate modes of social and political control wielded by the Warden, but the sheer number of issues included in the fast-moving analysis left me wanting more. Atasoy's analysis of Quietus nicely captures the ways in which James has created a world where the elderly are both encouraged and manipulated to end their lives for the good of the whole. This discussion fits especially well with the larger focus of his analysis on modes of social engineering. Fewer themes and more close readings like this one would have deepened the reading experience. But for anyone beginning a project on one of these novels, this book is a good place to start.This book begins and ends with the interesting contention that times of catastrophe diminish the literary production of utopia, and potentially the capacity for hope itself. While the point of this book is not to defend this claim empirically, it is one worth considering for any scholar of utopia, or any person interested in the potential of future change for the better. The book may underplay the fact of twentieth-century literary utopias (there is a brief discussion of the feminist utopias written in the 1970s and 1980s), but it is surely correct that there is an imbalance in the production of utopia in favor of dystopia. Utopias are more challenging to construct and potentially (especially in this day and time) less formulaic than dystopia, which is an increasingly popular (and marketable) genre.Kim Stanley Robinson noted in a recent interview that "[utopias] shape people's conception of what's possible that could be good in the future."1 Atasoy's book offers the possibility that a close reading of dystopian texts might well help us uncover other ways of finding out what future good is possible. By extolling the value of finding the... (shrink)

The purpose of this paper is to show through the concrete example of epileptic seizure anticipation how neuro-dynamic analysis and “pheno-dynamic” analysis may guide and determine each other. We will show that this dynamic approach to epileptic seizure makes it possible to consolidate the foundations of a cognitive non pharmacological therapy of epilepsy. We will also show through this example how the neuro-phenomenological co-determination could shed new light on the difficult problem of the “gap” which separates subjective experience from neurophysiological (...) activity. (shrink)

International humanitarian law and international human rights law both prohibit the use of child soldiers in armed conflict. The protection afforded to children is problematic because the age a child may become a soldier and what constitutes child “soldiering” fluctuates between States and cultures. Differing levels of children soldiers’ protection leave them vulnerable to particular abuses. This paper examines some different attitudes and approaches towards the use of child soldiers and concludes that international human rights law and international humanitarian law (...) does not adequately protect children. (shrink)

We can imagine a world in which ectogenesis provides a safe gestating space that eliminates maternal morbidity and mortality while maximising healthy outcomes for babies. In this world, women, no longer physically—and visibly—pregnant, are no longer economically, socially or physically disadvantaged due to the potential for pregnancy and birth. Because everyone can access the same technology, women are able to work without fear of pregnancy-related discrimination or restrictions, and health disparities among individuals in gestation and birth based on socioeconomic status (...) are eliminated. This imagining allows us to explore the ethical and social underpinnings of such a world, and consider how to achieve it in our current paradigm. Having explored the freedom and equality that is possible in an ideal hypothetical where all have equal access to such technologies, we can now imagine that same world without ectogenesis: women, no longer economically, socially or physically disadvantaged due to pregnancy and birth, despite still becoming pregnant. Such is the potential political perspective and provocation that can be spurred on by discussion of ectogenesis. As Cavaliere argues, the technological reality of ectogenesis may not achieve the freedom and equality that …. (shrink)

Student satisfaction measures serve to provide a measure of ‘quality’ in the current audit culture of universities. This paper argues that the form of satisfaction valued within contemporary Higher Education amounts to a form of settling, where the primary aim is to settle the students’ expectations, and meet their needs. Drawing initially on the etymology of ‘satisfaction’, the paper then turns to the work of Martin Heidegger and his notion of the ‘uncanny’, to discuss how we are ontologically unsettled. The (...) uncanny will be discussed in relation to the Greek play Antigone, and illustrated with examples from the novel Stoner. In provoking angst or anxiety by leaving students ‘unsettled’ in terms of their thinking, this may open students up to a consideration of more ontological concerns – within their Higher Education but also in their lives more generally. (shrink)

The debate on the value of Boyer's minimally counter-intuitive theory continues to generate considerable theoretical and empirical attention. Although the theory offers an explanation as to why certain cultural texts and narratives are particularly well conveyed and transmitted, amidst society and over time, conflicting evidence remains for any mnemonic advantage of minimally counter-intuitive concepts. In an effort to reconcile these conflicting results, Barrett has made a comprehensive attempt in presenting a formal system for quantifying counter – intuitiveness including a distinction (...) between counter-intuitive and counter-schematic concepts. The present article uses this system to generate sentences containing different levels of counter-intuitiveness, and tests whether minimally counter-intuitive items show a mnemonic advantage over concepts which are more counter-intuitive or counter-schematic. Results indicate that MCI concepts hold a mnemonic advantage over counter-schematic and maximally counter-intuitive concepts but only for one-week delayed recall. Interference effects may have masked immediate recall effects. Yes-no recognition after one week delay showed almost 100% accuracy suggesting that availability of retrieval cues is the factor which determines the mnemonic advantage of MCI concepts. (shrink)

Oppression is commonly deemed a problem of freedom. How though should we conceptualise the freedom-restricting nature of oppression? This paper aims to show that the unfreedom in oppression may be understood in terms of individual negative liberty. The controversial concept of collective unfreedom is not needed. Non-cooperation among the oppressed generates constraints on individual freedom. This non-cooperation is ultimately attributable to the exercise of social power by oppressors. It is in this sense that the resultant states of individual unfreedom are (...) due relations of oppression. (shrink)

Coercive medico-legal interventions are often employed to prevent people deemed to be unable to make competent decisions about their health, such as minors, people with mental illness, disability or problematic alcohol or other drug use, from harming themselves or others. These interventions can entail major curtailments of individuals' liberty and bodily integrity, and may cause significant harm and distress. The use of coercive medico-legal interventions can also serve competing social interests that raise profound ethical, legal and clinical questions. Examining the (...) ethical, social and legal issues involved in coerced care, this book brings together the views and insights of leading researchers from a range of disciplines, including criminology, law, ethics, psychology and public health, as well as legal and medical practitioners, social-service 'consumers' and government officials. Topics addressed in this volume include: compulsory treatment and involuntary detention orders in civil mental health and disability law; mandatory alcohol and drug treatment programs and drug courts; community treatment orders; the use of welfare cards with Indigenous populations; mandated treatment of seriously ill minors; as well as adult guardianship and substituted decision-making regimes. These contributions attempt to shed light on why we use coercive interventions, whether we should, whether they are effective in achieving the benefits that are offered to justify their use, and the impact that they have on some of society's most vulnerable citizens in the names of 'justice' and 'treatment'. This book is essential reading for clinicians, researchers and legal practitioners involved in the study and application of coerced care, as well as students and scholars in the fields of law, medicine, ethics and criminology. The collection asks important questions about the increasing use of coercive care that demand to be answered, and offers critical insights, guidance and recommendations for those working in the field. (shrink)

Photo ID 72893750 © Rawpixelimages|Dreamstime.com ABSTRACT Solidarity is a concept increasingly employed in bioethics whose application merits further clarity and explanation. Given how vital cooperation and community-level care are to mitigating communicable disease transmission, we use lessons from the COVID-19 pandemic to reveal how solidarity is a useful descriptive and analytical tool for public health scholars, practitioners, and policymakers. Drawing upon an influential framework of solidarity that highlights how solidarity arises from the ground up, we reveal how structural forces can (...) impact the cultivation of solidarity from the top down, particularly through ensuring robust access to important social determinants of health. Public health institutions can support solidarity movements among individuals and communities by adopting a lens of social justice when considering public health priorities and, in turn, promote health equity. INTRODUCTION Over the past two decades, scholars have invoked the concept of solidarity when assessing a wide range of topics in bioethics, from CRISPR-Cas9 technology to organ donation to structural racism.[1] However, the growing literature on solidarity has not fully examined the roles and responsibilities of institutions and governments in fostering solidarity, especially regarding public health measures that implicate entire populations. We argue that it remains unclear how public health institutions should engage with solidarity and how their engagement will affect public health and its ethics. We first take Prainsack and Buyx’ three-tiered framework as an analytical starting point.[2] We then explore how public health institutions can foster solidarity by carefully considering factors that may bolster it on an interpersonal, community, and national scale. We conclude that public health institutions should adopt a lens of social justice to promote solidarity at the interpersonal and community levels, thereby promoting equity in future public health efforts. BACKGROUND Calls for solidarity in bioethics raise longstanding normative questions about the nature and limits of our duties to one another and how to weigh autonomy over considerations of justice.[3] Though the term is diversely applied, Prainsack and Buyx propose a potentially unifying definition in the 2011 Nuffield Council report, “Solidarity: Reflections On An Emerging Concept in Bioethics.” The report defines solidarity as an activity involving “shared practices reflecting a collective commitment to carry financial, social, emotional, and or other ‘costs’ to assist others.” Their conceptualization also includes important features that distinguish solidarity from other values like empathy or altruism: solidarity emphasizes action rather than mere internal feeling and recognition of connection as motivation.[4] Bioethicists have since applied this conceptualization when analyzing issues in public and global health, given that population-level efforts need cooperation from individuals and communities. Prainsack and Buyx further note that solidarity is relevant in bioethics discourses about justice and equity, in support of providing aid to low- and middle-income countries, and as a value exemplified by European welfare states.[5] Other bioethicists have argued that promoting solidarity can contribute to community engagement, partnership with Tribal communities, and global health equity.[6] Most recently, scholars have applied solidarity as a lens to assess the COVID-19 pandemic, highlighting the pitfalls of national mitigation efforts and global disparities in disease outcomes.[7] I. Solidarity at Three Levels It seems impossible to foster solidarity in public health if we cannot identify it in general contexts. Prainsack and Buyx articulate three levels of solidarity: interpersonal solidarity, group solidarity, and legal or contractual codifications of solidarity.[8] They argue that each level inherently informs the one ‘above’ it in a unilateral direction. In other words, solidarity is fundamentally a bottom-up phenomenon. Solidarity among individuals influences group norms, which then have the potential to shape policy and institutional practice.[9] Within the Prainsack and Buyx framework, it would seem nonsensical to posit how solidarity might be expressed vertically or from the “top down.” It appears intuitively odd to imagine how a government entity might ‘be’ in solidarity with a person or group if solidarity requires some cognition about their condition per Prainsack and Buyx’ definition. Some have argued that solidarity does not seem like something that one can impose, as instances of it arise from agents recognizing and acting upon some bond rather than in response to a command. Indeed, people may be rightfully hesitant to engage in solidarity if the official messaging is overly paternalistic or coercive.[10] However, some authors have countered that governments can express solidarity through enacting structural and policy changes, though it is ambiguous how these actions are distinct from a justice-driven approach.[11] If a bottom-up approach is thus the most practical means of achieving policy that reflects solidarity, then it does not add much to public health. Institutions would be ineffective without the population’s initiation of the corresponding social norms. However, we find this conclusion overly pessimistic. Fostering a culture of solidarity to improve public health has potential merit. Prainsack and Buyx’ framework overlooks how public health actors can influence solidarity between individuals and across communities. To clarify, we agree with the view that solidarity is a bottom-up phenomenon. Solidarity may not be able to originate in a top-down fashion, but we suggest that public health institutions can take a more active role in providing the public with accurate information, promoting social justice, and intervening in the social determinants of health. II. The COVID-19 Pandemic as a Case Study Lessons learned from the ongoing COVID-19 pandemic support our argument. The pandemic deepened socioeconomic disparities in the US and hindered access to vital resources such as food, housing, and healthcare.[12] Prainsack recently noted: “[n]ext to the immediate health effects of the virus, poverty and grave inequalities have been the root causes of human suffering during the pandemic.”[13] Prior to the pandemic, many rural and low-income populations lacked reliable access to the internet and devices like laptops or smartphones. This continued lack of access restricts the flow of information and prevents people from accessing telemedicine services.[14] Preexisting social, political, and health inequities worsened health outcomes among many marginalized racial and ethnic groups. It is well-documented that communities of color, including Black, American Indian or Alaska Native, and Latinx populations, had greater COVID-related mortality and morbidity due to the effects of structural racism.[15] Although federal US agencies such as the Centers for Disease Control and Prevention enacted laws that provided safety nets (e.g., the Federal Eviction Moratorium), the majority of such programs have ended, leaving many with little assistance and the threat of further hardship.[16] These disparities are relevant because Prainsack, Buyx, and others note that solidarity arises from agents recognizing and acting on some perceived attainable collective goal(s). Income inequality and disparate access to food, education, and health care may lead people to consider public health goals unattainable. This could limit the desire to work toward those goals collectively.[17] The existing literature on collective action theory supports this intuition. It emphasizes that structural conditions, such as an absence of perceived hope for social change among a group, can lead to low ‘group efficacy’ and little willingness to cooperate, both within and across socioeconomic strata.[18] The pandemic spurred countless messages from public health agencies. The messaging did not recognize or attend to the different material realities and circumstances of the US population. How can people feel comfortable getting vaccinated if they deeply distrust the government, including public health institutions? How can people remain motivated to wear masks and distance themselves if they cannot afford basic necessities and work jobs without adequate pay and leave policies? We ask these questions to illustrate how socioeconomic disparities can marginalize people if they feel ignored, apathetic, or resentful of those better off or those in power whom they perceive to “not be doing enough.” This marginalization precludes the formation of solidarity. There are instances when a population has disparate access to resources and social capital, but solidarity may still emerge from a shared goal or vision for the future. For example, a heterogeneous population living in the same town may come together to protest an environmental injustice that impacts their water supply with the common goal of securing access to safe drinking water. However, many populations in the US failed to recognize shared goals of this kind during the COVID-19 pandemic. A significant minority of the US population was reluctant to acknowledge the severity of COVID-19 infection and thus refused to participate in efforts to mitigate its spread. Even between groups who shared the goal of slowing COVID-19 transmission, the methods were widely debated. Approximately 20 percent of the adult population eligible for vaccination remains unvaccinated.[19] Governmental bodies responsible for disseminating information, coordinating the allocation of resources, and establishing guidelines have a large role in mediating these disagreements and intervening in socioeconomic conditions that impact people's ability and willingness to engage in solidarity. III. Solidarity, Social Justice, and the Role of Public Health Institutions Adopting a lens of social justice provides further insights into how public health actors impact solidarity. Powers and Faden argue that the “foundational moral justification for the social institution of public health is social justice.”[20] Their theory of social justice has two aims. First, it ensures that everyone has a sufficient amount of the six core elements of well-being and that public health institutions are responsible for “adopting policies and creating environments” where all can flourish.[21] Second, public health institutions should distribute resources meant to promote well-being and focus on the “needs of those who are the most disadvantaged.”[22] Public health institutions should enact policies that address injustice. In doing so, public health institutions can seed the opportunity to build solidarity from the bottom up. Equipping individuals and communities with resources will foster cooperation and adherence to policies that require solidarity, such as masking and vaccination. This is consistent with arguments illustrating how institutions such as Tribal governments promote the conditions needed for their group, and especially its most vulnerable members, to flourish.[23] Addressing social determinants of health with a social justice lens will create the circumstances under which more individuals and groups can find common causes and foster solidarity. In the long run, such efforts may result in the establishment of values and practices from the bottom up. There are societal and public health preconditions required before institutions can expect their audience to act in solidarity with one another. Through their great influence over information and resources, public institutions do have the power to impact what values are most widespread. Furthermore, public health may foster trust and hope, which are important psychosocial factors that influence collective action,[24] if policies increase access to resources that promote well-being. Messaging efficacy also depends on the context of public trust, education, and whether the institutions meet one’s basic needs. Disparate messaging across different public institutions may confuse or disillusion individuals. To apply our theory of solidarity to the decision to vaccinate, a policy would be to foster conditions that facilitate access to vaccines and information about vaccine efficacy instead of imposing a top-down mandate without first eliciting public trust. IV. Counterargument Some argue that discordant public health messaging, ineffective government, and inadequate social programs can also bring people together under pressure and foster solidarity. One may argue that the most powerful motivators towards solidarity are strife and disparity, as evidenced throughout history. During the pandemic alone, political struggle and personal hardship inspired solidarity in the US, from individual neighbors helping each other to mutual aid groups forming across communities. We thus do not claim that solidarity is possible only when our government programs and public health institutions are most effective. We instead point out that solidarity can be further hindered when people feel alienated, hopeless, and pitted against each other. CONCLUSION Many competing conceptualizations of solidarity persist in the bioethics literature, and Prainsack and Buyx offer one compelling framework that public health ethicists continue to draw upon.[25] However, their framework fails to acknowledge how public health institutions impact interpersonal and group solidarity. Public health institutions can foster solidarity through actions other than mere messaging, invoking catchphrases like “we are all in this together.” Efforts to address socioeconomic preconditions and alleviate health disparities can cultivate group solidarity. As we saw during the pandemic, cooperation and solidarity go hand-in-hand with disease mitigation efforts; solidarity has clear intrinsic value.[26] As this relationship becomes more apparent, we will continue to see attempts from public health institutions to foster or invoke solidarity. Therefore, public health institutions would be remiss to ignore their role in addressing the social determinants of health. Adopting a social justice lens when planning public health interventions will clarify and strengthen their role in facilitating solidarity. Ultimately, if health disparities continue to persist or widen, it is very hard to imagine how group solidarity can ever be achieved. The widescale adoption of many public health measures needed to promote health and well-being would be conducive to solidarity. - Disclaimer: The opinions expressed are the authors’ and do not represent the views of the NIH, DHHS, or the U.S. government. Funding Disclosure: This work was supported in part by the Intramural Program of the National Institutes of Health Clinical Center. - [1] John J Mulvihill et al., “Ethical Issues of CRISPR Technology and Gene Editing through the Lens of Solidarity,” British Medical Bulletin 122 (2017): 17–29, https://doi.org/10.1093/bmb/ldx002; Ben Saunders, “Altruism or Solidarity? The Motives for Organ Donation and Two Proposals,” Bioethics 26, no. 7 (September 2012): 376–81, https://doi.org/10.1111/j.1467-8519.2012.01989.x; -Vanessa Y Hiratsuka, “SPECIAL REPORT: A Critical Moment in Bioethics: Reckoning with Anti-Black Racism through Intergenerational Dialogue A Call for Solidarity in Bioethics: Confronting Anti-Black Racism Together,” 2022, https://doi.org/10.1002/hast.1380. [2] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [3] Bob Simpson, “A ‘We’ Problem for Bioethics and the Social Sciences: A Response to Barbara Prainsack,” Science, Technology, & Human Values 43, no. 1 (January 12, 2018): 45–55, https://doi.org/10.1177/0162243917735899. [4] Barbara Prainsack and Alena Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics (London: Nuffield Council on Bioethics, 2011). [5] Barbara Prainsack and Alena Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach,” Bioethics 26, no. 7 (September 2012): 343–50, https://doi.org/10.1111/J.1467-8519.2012.01987.X. [6] Bridget Pratt, Phaik Yeong Cheah, and Vicki Marsh, “Solidarity and Community Engagement in Global Health Research,” The American Journal of Bioethics : AJOB 20, no. 5 (May 3, 2020): 43–56, https://doi.org/10.1080/15265161.2020.1745930; Sara Chandros Hull, F. Leah Nez (Diné), and Juliana M. Blome, “Solidarity as an Aspirational Basis for Partnership with Tribal Communities,” The American Journal of Bioethics 21, no. 10 (October 3, 2021): 14–17, https://doi.org/10.1080/15265161.2021.1965258; Mbih J. Tosam et al., “Global Health Inequalities and the Need for Solidarity: A View from the Global South,” Developing World Bioethics 18, no. 3 (September 1, 2018): 241–49, https://doi.org/10.1111/DEWB.12182. [7] Peter West-Oram, “Solidarity Is for Other People: Identifying Derelictions of Solidarity in Responses to COVID-19,” Journal of Medical Ethics 47, no. 2 (February 1, 2021): 65–68, https://doi.org/10.1136/MEDETHICS-2020-106522; Barbara Prainsack, “Solidarity in Times of Pandemics,” Democratic Theory 7, no. 2 (December 1, 2020): 124–33, https://doi.org/10.3167/DT.2020.070215; F. Marijn Stok et al., “Social Inequality and Solidarity in Times of COVID-19,” International Journal of Environmental Research and Public Health 18, no. 12 (June 2, 2021), https://doi.org/10.3390/IJERPH18126339; Ming Jui Yeh, “Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics,” American Journal of Public Health 112, no. 2 (February 1, 2022): 255–61, https://doi.org/10.2105/AJPH.2021.306578; Barbara Prainsack, “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.,” Am J Public Health 112, no. 2 (February 1, 2022): 232–33, https://doi.org/10.2105/AJPH.2021.306619. [8] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [9] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [10] Yeh, “Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics”; Prainsack, “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.” [11] Ho, Anita, and Iulia Dascalu. "Relational solidarity and COVID-19: an ethical approach to disrupt the global health disparity pathway." Global Bioethics 32, no. 1 (2021): 34-50; West-Oram, Peter. "Solidarity is for other people: identifying derelictions of solidarity in responses to COVID-19." Journal of Medical Ethics 47, no. 2 (2021): 65-68. [12] Monica Webb Hooper, Anna María Nápoles, and Eliseo J. Pérez-Stable, “COVID-19 and Racial/Ethnic Disparities,” JAMA 323, no. 24 (June 23, 2020): 2466, https://doi.org/10.1001/jama.2020.8598. [13] Prainsack, Barbara. “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.” Am J Public Health 112, no. 2 (February 1, 2022): 232–33. https://doi.org/10.2105/AJPH.2021.306619. [14] Camille A Clare, “Telehealth and the Digital Divide as a Social Determinant of Health during the COVID-19 Pandemic,” Network Modeling Analysis in Health Informatics and Bioinformatics 10 (2021): 26, https://doi.org/10.1007/s13721-021-00300-y. [15] Patrick Nana-Sinkam et al., “Health Disparities and Equity in the Era of COVID-19,” Journal of Clinical and Translational Science 5, no. 1 (March 16, 2021): e99, https://doi.org/10.1017/cts.2021.23. [16] Kathryn M Leifheit et al., “Expiring Eviction Moratoriums and COVID-19 Incidence and Mortality,” American Journal of Epidemiology 190, no. 12 (December 1, 2021): 2503–10, https://doi.org/10.1093/aje/kwab196. [17] Barbara Prainsack, “Solidarity in Times of Pandemics,” Democratic Theory 7, no. 2 (December 1, 2020): 124–33, https://doi.org/10.3167/DT.2020.070215 [18] Maximilian Agostini and Martijn van Zomeren, “Toward a Comprehensive and Potentially Cross-Cultural Model of Why People Engage in Collective Action: A Quantitative Research Synthesis of Four Motivations and Structural Constraints.,” Psychological Bulletin 147, no. 7 (July 2021): 667–700, https://doi.org/10.1037/bul0000256. [19] Department of Health and Human Services (HHS) Centers for Disease Control and Prevention (HHS/CDC), “COVID Data Tracker,” 2023, https://covid.cdc.gov/covid-data-tracker. [20] Powers, Madison, and Ruth Faden. Social Justice: The Moral Foundation of Public Health and Health Policy. 1st editio. New York: Oxford Press, 2006, p. 9 and Chapter 4 [21] Powers and Faden, Social Justice: The Moral Foundation of Public Health and Health Policy; Madison Powers and Ruth Faden, Structural Injustice: Power, Advantage, and Human Rights (New York: Oxford University Press, 2019). [22] Powers, Madison, and Ruth Faden. Social Justice: The Moral Foundation of Public Health and Health Policy. 1st editio. New York: Oxford Press, 2006, p. 10 [23] Bobby Saunkeah et al., “Extending Research Protections to Tribal Communities,” The American Journal of Bioethics 21, no. 10 (October 3, 2021): 5–12, https://doi.org/10.1080/15265161.2020.1865477. [24] Agostini and van Zomeren, “Toward a Comprehensive and Potentially Cross-Cultural Model of Why People Engage in Collective Action: A Quantitative Research Synthesis of Four Motivations and Structural Constraints.” [25] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics. [26] Ruth Chadwick, “COVID‐19 and the Possibility of Solidarity,” Bioethics 34, no. 7 (September 8, 2020): 637–637, https://doi.org/10.1111/bioe.12813. (shrink)

There is considerable evidence that beliefs in supernatural punishment decrease self-interested behavior and increase cooperation amongst group members. To date, research has largely focused on beliefs concerning omniscient moralistic gods in large-scale societies. While there is an abundance of ethnographic accounts documenting fear of supernatural punishment, there is a dearth of systematic cross-cultural comparative quantitative evidence as to whether belief in supernatural agents with limited powers in small-scale societies also exert these effects. Here, we examine information extracted from the Human (...) Relations Area Files on cultural discourse about the recently deceased, local ancestor spirits, and mortuary practices across 57 representative cultures. We find evidence that in traditional small-scale societies ancestor spirits are commonly believed to be capable of inflicting harm, with many attendant practices aimed at mitigating this danger. However, such beliefs do not appear to promote cooperation, as ancestor spirits seem to be concerned with interactions between themselves and the living, and to prioritize their own welfare. Many attendant practices are inconsistent even with bipartite cooperation with ancestors that could be viewed as a model for other relationships. The broader implications of this research for the cultural evolution of religion are discussed. (shrink)

The term 'therapeutic misconception' (TM) was introduced in 1982 to conceptualize how some psychiatry trial participants perceived and interpreted their involvement in research. TM has since been identified in many settings and is a major component in research ethics discussions. A qualitative study included a subgroup of interviews with five parents (two couples, one mother) who declined to enrol their baby in a neonatal trial. Analysis suggested the possibility of a counterpart to TM which, given the original terminology, we term (...) the 'injurious misconception' (IM). While TM is closely linked to the elision of care and research, and involves an over-stated sense of benefit and protection, IM may be a product of a particularly keen and discomforting sense of distinctions between care and research and a correspondingly over-stated sense of risk and threat. (shrink)

Background: Discussion of the influence of money on bioethics research seems particularly salient in the context of research on the ethical, legal, and social implications (ELSI) of human genomics, as this research may be financially supported by the ELSI Research Program. Empirical evidence regarding the funding of ELSI research and where such research is disseminated, in relation to the specific topics of the research and methods used, can help to further discussions regarding the appropriate influence of specific institutions and institutional (...) contexts on ELSI and other bioethics research agendas. Methods: We reviewed 642 ELSI publications (appearing between 2003 and 2008) for reported sources of funding, forum for dissemination, empirical and nonempirical methods, and topics of investigation. Results: Most ELSI research is independent of direct grant-based funding sources; 66% reported no such sources of funding. The National Human Genome Research Institute (NHGRI) is the most dominant source of funding; 16% of publications acknowledged at least one source of NHGRI grant funding. Funding is acknowledged more frequently in empirical than nonempirical publications and more frequently in publications in public health journals than in any other ELSI research dissemination forums. Dominant research topics vary by publication forum and by reported funding. Conclusions: ELSI research is surprisingly independent of direct grant-based funding, yet correlations are apparent between this type of funding and publication placement, topics addressed, and methods used, implying a not insignificant influence on ELSI research agenda setting. However, given the relatively low percentage of publications acknowledging external grant-based funding, as well as other significant correlations between publication placement and topics addressed, additional institutional contexts, perhaps related to professional advancement or valuation, may shape research agendas in ways that potentially exceed the direct influences of grant-based funding in this area. In some cases, grant-based funding may actually counter other potentially problematic institutional influences. (shrink)

Academic freedom is seriously under threat. Here I will consider how the marketisation of Higher Education has exacerbated the decline of ‘academic freedom’. While the effects of a ‘cancel culture’ on university provision are difficult to ignore, threats to academic freedom raise a number of questions, such as: ‘who is allowed to speak on campus?’, ‘to whom?’, and ‘about what?’. These questions are fundamental to the academic profession, and therefore have clear implications for teaching and learning in Higher Education. Through (...) an analysis of Netflix’s The Chair (2021), and drawing on the works of Martin Buber, I argue that academics’ freedom to teach is implicitly constrained by student-consumer desires, and in turn this reduces the space for genuine dialogue on university campuses. Rather than closing down debate and the discussion of ‘controversial’ topics, universities instead need to cultivate a climate of trust, openness, and reciprocity on campuses, such that genuine staff-student dialogue can flourish. University campuses are precisely the places where academics should be able to engage in scholarly debate on matters of importance – where students may be exposed to radically different viewpoints and perspectives – and film and TV series can be used to initiate such conversations. (shrink)

Lack of attention to definitions of indigeneity is a problem in both political theory and practice. Defining indigeneity has at least two important consequences: it affects who has access to resources or rights reserved for Indigenous peoples; and it shapes the kinds of privileges and resources available to Indigenous peoples. In this article, I draw on Theodor Adorno’s concept of ‘nonidentity’ as a resource for exploring the power and limits of conceptions of indigeneity. I argue that recognizing the non-identical aspects (...) of indigeneity enables critical engagement with constellations of concepts that attend to the distinctive aspects of indigeneity in particular moments and locations. To illustrate my argument, I draw on one conception of indigeneity that could be characterized as non-identity thinking – a research approach called Kaupapa Māori. I suggest that non-identity is a promising resource for conceptualizing indigeneity as it has potential to respond to some of the key problems with current responses to indigeneity; notably, that universal definitions may not best represent what it means to be Indigenous, and that unreflective acceptance of current definitions fails to produce just outcomes. (shrink)

In this short response, I agree with Cavaliere’s recent invitation to consider ectogenesis, the process of gestation occurring outside the body, as a political perspective and provocation to building a world in which reproductive and care labour are more justly distributed. But I argue that much of the literature Cavaliere addresses in which scholars argue that artificial wombs may produce greater gender equality has the limitation of taking a fixed, binary and biological approach to sex and gender. I argue that (...) in taking steps toward the possibility of more just practices of caregiving and family making, we must look first not to artificial womb technologies but to addressing the ways that contemporary legal and social practices that enforce essentialising, binary ways of thinking about reproductive bodies inhibit this goal. (shrink)

Concerns about climate change have led to the development of legal frameworks, including national regulations and international protocols to limit the emissions of greenhouse gases. Current mitigation measures, however, may not be sufficient to limit global warming to an average of 2°C since the pre-industrial period. Other approaches may therefore be required, including adaptation measures and climate engineering initiatives. Only a few legal frameworks are available to regulate adaptation initiatives and to constrain climate engineering approaches whose potential side-effects are not (...) always sufficiently well known. This Article provides a brief overview of scientific progress made to better assess climate change and addresses possible societal responses, including the mitigation, adaptation and climate engineering strategies. It provides a brief summary of current knowledge about expected climate change as a basis for the definition of future international climate policies and associated legal frameworks. (shrink)

Heart Robot was a public engagement project funded by the Engineering and Physical Sciences Research Council. The aim of the project was to challenge cultural perceptions of robots, and to stimulate thought and debate in members of the general public around research in the field of social and emotional robotics. Fusing the traditions of Bunraku puppetry, the technology of animatronics and the field of artificial emotion and social intelligence, Heart Robot presented a series of entertaining, thought-provoking, and moving performances at (...) fourteen events in the south-west region of the UK between May and December 2008. This paper presents a summary of the independent evaluation of the project. Keywords: Robot, Puppet, Public Engagement, Social Robots, Science-art collaboration. (shrink)

In An Essay on the Vital and Involuntary Motions of Animals, Robert Whytt maintained that the muscular motions that perform the natural functions of the organism are caused by an immaterial power. Here we consider to what extent the philosophical criticism of power urged by Locke and Hume may jeopardize his thesis, how his response mobilizes the resources of the Scottish experimental theism and whether he makes an original use of such resources. First, we examine various pieces of experimental evidence (...) from which Whytt infers the need to evoke this power, before showing how they prompt him to stand by the immaterial power in the face of the empiricist criticisms. Following this, we explore the link Whytt makes between power and agency, in particular comparing his thought with Locke’s. Lastly, we examine his work in the light of Hume’s criticism regarding the question of whether a power may be felt. (shrink)

This article presents an interview method which enables us to bring a person, who may not even have been trained, to become aware of his or her subjective experience, and describe it with great precision. It is focused on the difficulties of becoming aware of one’s subjective experience and describing it, and on the processes used by this interview technique to overcome each of these difficulties. The article ends with a discussion of the criteria governing the validity of the descriptions (...) obtained, and then with a brief review of the functions of these descriptions. (shrink)

Background The impact of healthcare ethics educational interventions on participants’ ethical development is rarely reported on and assessed; even less attention is paid to educational interventions that focus on end-of-life ethical issues. Aim To evaluate the impact of the Ethical Framework for End-of-Life Care Study Sessions Programme on the moral development of healthcare staff who are delivering end-of-life care. Methods The EOLCSS was delivered to 20 multi-disciplinary health care staff in Ireland in May 2013. Effect on moral reasoning was measured (...) pre and post education using the Defining Issues Test 2. Inferential statistics were used to examine the relationships between change in DIT2 scores and demographic variables. Results Participants experienced moral reasoning development following receipt of EOLCSS. Age and previous ethics education contributed to the observed changes in moral reasoning. Conclusions Receipt of the EOLCSS may contribute to moral reasoning development in practicing healthcare professionals. (shrink)

Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines (...) may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate’s rights and the physician’s ethical and professional duties. A surrogate’s confidentiality must be maintained as it is an essential element of the physician–patient relationship. (shrink)

Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents. While the American Society for Reproductive Medicine guidelines (...) may support disclosure over the objections of the surrogate, the authors argue that such disclosure is a violation of the surrogate’s rights and the physician’s ethical and professional duties. A surrogate’s confidentiality must be maintained as it is an essential element of the physician–patient relationship. (shrink)

This article offers an analysis of texts which were written in 1802-3 and published in 1812 under the title Panopticon versus New South Wales, namely Jeremy Bentham’s first two letters to Lord Pelham and A Plea for the Constitution, arguing that, in his attempt to show the superiority of his Panopticon plan over the transportation scheme, the reformer depicted New South Wales as a Gothic dystopia. ‘Gothic’ is here understood as a literary genre, an ideological term and a critical tool. (...) Bentham upset the conventional cartography of his time by showing that the ‘archaic’ or ‘barbarian’ practices that Gothic novels located in Catholic Europe were actually present in British penal policies. In addition to drawing on the rhetoric and the dichotomies which underlay the Gothic novels published during his lifetime, Bentham anticipated scenarios – such as reverse colonization and contamination – which would be explored in Victorian fiction. By extrapolating in dystopian fashion from trends which were present in the British body politic, Bentham’s Australian writings show how a historical period may be haunted by its future potentialities. (shrink)

As the author himself notes in the prologue, the book – An Advanced Introduction to Law and Literature – seeks to “advance” the discussion. Written by Peter Goodrich, one of the leading and most prolific scholars on the topic, the work may not be suitable for first-comers to the Law and Literature movement looking for a systematic overview of the field. The latter may be found in the numerous already-existing handbooks, research guides or critical introductions. While the prologue mentions la...

System-level change is crucial for solving society's most pressing problems. However, individual-level interventions may be useful for creating behavioral change before system-level change is in place and for increasing necessary public support for system-level solutions. Participating in individual-level solutions may increase support for system-level solutions – especially if the individual-level solutions are internalized as part of one's social identity.

Bioethics, Volume 36, Issue 4, Page 388-402, May 2022.

The literature on rights in both moral and legal philosophy is voluminous, so voluminous that there may seem to be little justification for one more symposium to swell its ranks. But the discussion of rights has been fairly tightly organized around several narrow topics of debate, among them whether rights should be explained in terms of interests or choices, 1 whether rights are strictly correlative with duties, 2 and the relation between rights and utility. 3 The inspiration for the present (...) symposium is the sense that one topic of central importance has generally been given short shrift: the question of whether rights can conflict. There is, of course, a perfectly good explanation for why this topic has received so little attention; namely that contemporary rights theorists have generally assumed that rights cannot conflict. 4 But this assumption seems to be out of keeping with the way people commonly speak about rights as well as the way in which rights are usually understood in our constitutional tradition. (shrink)

Aims The purpose of this literature review was to explore the psychosocial implications of long-term survival for people affected by cancer by systematically examining published research evidence. Key findings 283 abstracts of papers were retrieved and checked and 33 studies relating to the implications of long-term survival subjected to detailed scrutiny. This review suggests that the majority of long-term cancer survivors cope well and enjoy good QoL. However, there are areas of concern which warrant attention. Whilst this review did not (...) set out to review physical problems experienced in the long-term, long-term physical consequences of cancer and its treatment were associated with poorer QoL and more psychological distress and sexual problems. Other long term concerns included anxiety regarding recurrence, financial difficulties and reduced social and emotional support. Long term survivors of lung, head and neck cancers appear particularly vulnerable to long term problems although there were few studies involving people with these cancers in this review. A number of limitations in the current evidence base were highlighted. Little research was conducted in the UK and raises questions as to the relevance of the findings for a different environment or culture where patients may have different attitudes to cancer survival and receive different treatments. Also, when looking at practical issues for long-term survivors such as ability to obtain insurance, or employment matters, then country-specific factors will be important. (shrink)

Nursing work centers around attending to a person's health during many of life's most vulnerable moments, from birth to death. Given the high‐stakes nature of this work, it is essential for nurses to critically reflect on their individual and collective impact, which can range from healing to harmful. The purpose of this paper is to use a philosophical inquiry approach and a critical lens to explore the potential influence of critical pedagogy (how we learn what we learn) on nursing praxis (...) (why we do what we do) with the aim of disrupting stigma and discrimination within the profession. This paper draws on the works of Paulo Freire, Henry Giroux, and bell hooks to alert readers to particular windows of opportunity where an intentional adoption of critical pedagogy in nursing praxis may help the profession think differently about two important and related topics: relational violence and peer‐led knowledge mobilization. As a practice‐based and theoretically grounded profession, nurses often strive to bridge the theoretical with the practical and the individual with the systemic. Thus, developing a robust and philosophically rooted disciplinary body of knowledge is particularly important to help us defensibly grapple with the notions of truth and ethics that shape our work's very essence and impact. (shrink)

I thoroughly enjoyed Dr. Freedman’s paper on “Akratic Believing.” Often, philosophy of psychiatry offers insights to clarify psychological and psychiatric concepts. Less frequently, it involves a real dialogue between philosophy and psychological science. Dr. Freedman’s account of what is bothersome, rather than just philosophically wrong-headed, about the concept of epistemic akrasia demonstrates that, at least where anxiety is concerned, the a posteriori world may have a great deal to offer theoretical philosophy. Freedman argues that understanding somatic responses to trauma, or (...) more broadly construed, to anxiety, dissolves the problem of why there seems to be more to the problem of epistemic... (shrink)

In this book, Claire Horisk argues that the real problem with so-called offensive jokes-such as racist, sexist, and ethnic jokes-is not that they are offensive but that they are harmful, because they transmit and reinforce stereotypes and ideas that contribute to a network of unjust disadvantage for the derogated group. She distinguishes between belittling jokes, which shore up unjust disadvantage for social groups, and disparaging jokes, which derogate powerful groups such as doctors but do not contribute to unjust disadvantage. (...) She uses philosophy of language and linguistics to argue that both belittling and disparaging jokes communicate ideas by generalized conversational implicature, and to argue that defenses of derogatory remarks as 'just a joke' are inadequate, because jokes can be used to convey what people believe to be true. She focuses on jokes in ordinary conversation, showing that canonical accounts of cooperative conversation need to be enriched: Some people have greater power to shift the common ground of a conversation, and to introduce new presuppositions, than others, and there are alliances that exclude some parties to the conversation, and yet are powerful in setting the future course of the conversation. She also gives a new account of the morality of listening, arguing that sometimes people who listen to derogatory speech may be culpable for doing so. Throughout, she draws on a wealth of interdisciplinary evidence to support the book's claims and to explain why humor is an especially effective means of unjust discrimination. (shrink)

Economists typically assume that preferences are fixed-that people know what they like and how much they like it relative to all other things, and that this rank-ordering is stable over time. But this assumption has never been accepted by any other discipline. Economists are increasingly having difficulty arguing that the assumption is true enough to generate useful predictions and explanations. Indeed, law and economics scholars increasingly acknowledge that preferences are constructed, and that the law itself can help construct preferences. Still, (...) fixed preferences are often treated as a normative ideal: Even if people don't have fixed preferences, they should. Behavioral law and economics scholars offer approaches to deal with this normative shortcoming. My article argues that preference construction, properly understood, is not normatively undesirable. Having fixed preferences means having a complete and stable rank ordering of what we want that dictates our choices. But we often do not have such an ordering, and rationally so. My article argues instead for an alternative process-based, account of preference construction. Rather than having a complete rank ordering, we have ways of making choices. We construct narratives, using evaluative criteria against a backdrop of wants, desires and inclinations, some of which we rank order and some of which we do not. The evaluative criteria embed a consideration of transaction costs: critically, where a decision is not very consequential, a formulaic decision rule that permits a ready choice among roughly comparable alternatives may serve our purposes better than a more considered alternative-by-alternative assessment. Our wants, desires and inclinations are for both traditional objects of choice and higher order values and desires; they are both previously constructed and constructed and elicited in the choice-making process. My article makes the case for such an account's potential explanatory power, as well as its tractability. (shrink)

In the paper “An archeology of corruption in medicine”, Miles Little, Wendy Lipworth, and Ian Kerridge present an account of corruption and describe its prevalent forms in medicine. In presenting an individual-focused account of corruption found within “social entities”, Little et al. argue that these entities are corruptible by nature and that certain individuals are prone to take advantage of the corruptibility of social entities to pursue their own ends. The authors state that this is not preventable, so the way (...) to remedy corruption is via management and, where necessary, punishment. This commentary will briefly lay out the key features and functions of corruption as presented by Little et al., before providing a critical discussion that will focus on whether corruptibility is a necessary feature of social entities. I will propose that it is not a necessary feature, though it may frequently arise where individualistic values are unchecked. Corruption can be prevented within social entities by enhancing structures that direct toward virtue and which promote and reward cooperation instead of competition. (shrink)

This article explores the consequences of failure to communicate early, as recommended in risk communication scholarship, during the first stage of the COVID-19 pandemic in Australia and the United Kingdom. We begin by observing that the principles of risk communication are regarded as basic best practices rather than as moral rules. We argue firstly, that they nonetheless encapsulate value commitments, and secondly, that these values should more explicitly underpin communication practices in a pandemic. Our focus is to explore the values (...) associated with the principle of communicating early and often and how use of this principle can signal respect for people’s self-determination whilst also conveying other values relevant to the circumstances. We suggest that doing this requires communication that explicitly acknowledges and addresses with empathy those who will be most directly impacted by any disease-control measures. We suggest further that communication in a pandemic should be more explicit about how values are expressed in response strategies and that doing so may improve the appraisal of new information as it becomes available. (shrink)

Based on recent insight into the thalamocortical system and its role in perception and conscious experience, a unified pathophysiological framework for hallucinations in neurological and psychiatric conditions is proposed, which integrates previously unrelated neurobiological and psychological findings. Gamma-frequency rhythms of discharge activity from thalamic and cortical neurons are facilitated by cholinergic arousal and resonate in networks of thalamocortical circuits, thereby transiently forming assemblies of coherent gamma oscillations under constraints of afferent sensory input and prefrontal attentional mechanisms. If perception is based (...) on synchronisation of intrinsic gamma activity in the thalamocortical system, then sensory input to specific thalamic nuclei may merely play a constraining role. Hallucinations can be regarded as underconstrained perceptions that arise when the impact of sensory input on activation of thalamocortical circuits and synchronisation of thalamocortical gamma activity is reduced. In conditions that are accompanied by hallucinations, factors such as cortical hyperexcitability, cortical attentional mechanisms, hyperarousal, increased noise in specific thalamic nuclei, and random sensory input to specific thalamic nuclei may, to a varying degree, contribute to underconstrained activation of thalamocortical circuits. The reticular thalamic nucleus plays an important role in suppressing random activity of relay cells in specific thalamic nuclei, and its dysfunction may be implicated in the biological vulnerability to hallucinations in schizophrenia. Combined with general activation during cholinergic arousal, this leads to excessive disinhibition in specific thalamic nuclei, which may allow cortical attentional mechanisms to recruit thalamic relay cells into resonant assemblies of gamma oscillations, regardless of their actual sensory input, thereby producing an underconstrained perceptual experience. Key Words: Charles Bonnet syndrome; gamma oscillations; hallucinations; late paraphrenia; Lewy body dementia; perception; schizophrenia; thalamocortical system. (shrink)