Public health ethics began to emerge in the 1990s as a development within bioethics. Public health ethics education has been implemented in schools of public health in recent years, and specific professionalism and ethics competencies were included in the Master of Public Health (MPH) competency set developed nationally and adapted by individual schools of public health around the country. The University of Texas School of Public Health approved the present set of MPH competencies in 2005. After 4 years of experience, (...) we now report information measuring the extent to which Professionalism and Ethics competencies and subcompetencies are being met in the MPH degree program. To this end we have audited the MPH Professionalism and Ethics competency forms for FY2009 MPH graduates (n = 61). Eight courses, including required MPH core courses plus the practicum and culminating experience, were found to have substantial professionalism and ethics content. Further, 67.2% of graduates met eight or more of the 13 competencies and subcompetencies, but only 36.1% met all thirteen, indicating a need to identify topic areas to be added to, or enhanced in, the MPH curriculum. In addition, these findings will inform ongoing efforts to enhance ethics education in our health science center. Assessment of these competencies and subcompetencies is an essential step in strengthening ethics education at our institutions and in better preparing our graduates for a challenging future. We report our efforts here to demonstrate one way of carrying out programmatic assessment of ethics education in a school of public health. (shrink)

A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The DIT contains certain (...) philosophical assumptions (“Kohlbergian” or “neo-Kohlbergian”) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric—which the authors have named the Health Professional Ethics Rubric—for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This rubric is also practical to use. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus-wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision. (shrink)

Limited research has been done among pregnant people participating in investigational drug trials. To enhance the ethical understanding of pregnant people’s perspectives on research participation, we sought to describe motives and risk perceptions of participants in a phase 1 trial of ledipasvir/sofosbuvir treatment for chronic Hepatitis C virus during pregnancy. Pregnant people with chronic HCV infection enrolled in an open-label, phase 1 study of LDV/SOF participated in semi-structured, in-depth interviews to explore their reasons for participation and experiences within the study. (...) Pregnant people took 12 weeks of LDV/SOF and were interviewed at enrollment and at the end of study. We recorded the interviews, transcribed them verbatim, coded them using NVivo software, and performed inductive thematic analysis. Nine women completed the study yielding 18 interview transcripts. We identified two themes regarding motives and one regarding risk perception. Motives— Women conceptualized study participation as part of the caregiving role they associate with motherhood; participating was viewed as an act of caregiving for their infants, their families, themselves, and other pregnant women with chronic HCV. Women also noted that they faced multiple barriers to treatment prior to pregnancy that created a desire to receive therapy through trial participation. Risk perception— Women acknowledged personal and fetal risk associated with participation. Acceptance of risk was influenced by women’s concepts of motherhood, preexisting knowledge of HCV and medical research, family members, intimate partners, or by the study design. Women enrolled in a phase 1 trial for chronic HCV therapy during pregnancy acknowledged risks of participation and were motivated by hopes for fetal and personal benefit and by lack of prenatal access to treatment. Ethical inclusion of pregnant people in research should acknowledge structural factors that contribute to vulnerability and data deficiencies for treatment in pregnancy. (shrink)

By exploring diverse and sometimes positive roles for ignorance, A Defense of Ignorance offers a revisionary approach to epistemology that challenges core assumptions about epistemic values. Townley contributes innovative ways of thinking about the practicalities and politics of knowledge and argues for an expanded domain of responsible epistemic conduct. All social scientists, especially those interested in knowledge and in feminist scholarship, stand to benefit from Townley's arguments.

In this engaged and engaging survey Piers Benn examines the major currents of ethical theory, concentrating on sound reasoning about morality. Benn's account offers a qualified defence of Aristotelian virtue theory, while bringing out what is distinctive and valuable in a broad range of approaches, such as those of Kant and the Utilitarians. His examples emphasize the ordinary choices of everyday life - gossip, friendship, honesty, sexual relations, work, and self-realization.

Across normative and empirical disciplines, considerable attention has been devoted to the prevalence and ethics of the non-medical use of prescription and illegal stimulants for neuroenhancement among students. A predominant assumption is that neuroenhancement is prevalent, in demand, and calls for appropriate policy action. In this paper, we present data on the prevalence, views and knowledge from a large sample of German students in three different universities and analyze the findings from a moral pragmatics perspective. The results of our study (...) indicate that neuroenhancement is a well-known phenomenon among German students, but not prevalent. 2.2 % of our sample reported having used a prescription medication for neuroenhancement. Exams and competitive situations were predominant motivators of use. Students were unenthusiastic and critical about neuroenhancement in the academic context and disapproved of neuroenhancement for professionals. The majority of respondents agreed that neuroenhancing substances should be regulated by the state. These stances were based on strong beliefs in resisting peer pressure, avoiding the creation of injustice and valuing of hard work. From a moral pragmatics standpoint, these results challenge the assumption that policy on neuroenhancement is necessary in academic environments. (shrink)

Objective Having failed to achieve adequate influenza vaccination rates among employees through voluntary programmes, healthcare organisations have adopted mandatory ones. Some programmes permit religious exemptions, but little is known about who requests religious objections or why. Methods Content analysis of applications for religious exemptions from influenza vaccination at a free-standing children’s hospital in Cincinnati, Ohio, USA during the 2014–2015 influenza season. Results Twelve of 15 260 employees submitted applications requesting religious exemptions. Requestors included both clinical and non-clinical employees. All requestors (...) voluntarily identified their religious affiliation, and most were Christian. Content analysis identified six categories of reasons used to justify an exemption: risks/benefits, ethical/political, lack of direct patient contact, providence, purity and sanctity of life. Individuals articulated reasons in 1–5 categories. The most frequently cited category was purity; the vaccine and/or its mode of administration were impure, or receiving the vaccine would make the individual impure. Two individuals asserted that the vaccine contained cells derived from aborted human fetuses. Individuals also volunteered information supporting the sincerity of their beliefs including distress over previous vaccination and examples of behaviour consistent with their specific objection or their general religious commitment. All requests were approved. Conclusions Less than 0.1% of employees requested religious exemptions. Partnering with religious leaders and carefully correcting erroneous information may help address requestors’ concerns. (shrink)

It is widely accepted that knowledge of certain of one’s own mental states is authoritative in being epistemically more secure than knowledge of the mental states of others, and theories of self-knowledge have largely appealed to one or the other of two sources to explain this special epistemic status. The first, ‘detectivist’, position, appeals to an inner perception-like basis, whereas the second, ‘constitutivist’, one, appeals to the view that the special security awarded to certain self-knowledge is a conceptual matter. I (...) argue that there is a fundamental class of cases of authoritative self-knowledge, ones in which subjects are consciously thinking about their current, conscious intentional states, that is best accounted for in terms of a theory that is, broadly speaking, introspectionist and detectivist. The position developed has an intuitive plausibility that has inspired many who work in the Cartesian tradition, and the potential to yield a single treatment of the basis of authoritative self-knowledge for both intentional states and sensation states. (shrink)

Like lynching and other mass hysterias, xenophobia exemplifies a contagious, collective wave of energy and hedonic quality that can point toward a troubling unpredictability at the core of political and social systems. While earlier studies of mass hysteria and popular discourse assume that cooler heads (aka rational individuals with their logic) could and should regain control over those emotions that are deemed irrational, and that boundaries are assumed healthy only when intact, affect studies pose individuals as nodes of biosocial networks (...) larger than themselves. Thus rather than suggesting that the individual can only prevent societal harm by gaining command and patrolling the borders of an autonomous self, we embrace the notion that affects can exert a positive and transformative force on a social reality that is resistant to top-down policy intervention and any straightforward moral or logical plea. (shrink)

According to Catharine MacKinnon, pornography itself subordinates women by ranking women as inferior to men and legitimating acts of violence and discrimination against us. As such, pornography is directly implicated in women's diminished moral and civil status. It follows that pornography is not a form of speech, but rather an action, and so does not deserve first amendment protection. I argue that MacKinnon does not adequately support her claim that pornography is an action but instead shows that it is harmful (...) speech. While this might be grounds for limiting it, MacKinnon does not adequately support the view that pornography is especially harmful in comparison to other sorts of misogynist and sexist speech. Hence we lack reasons to limit pornography alone. (shrink)

The experiences of 90 individuals who self-identify as “excessive” or “maladaptive” fantasizers are summarized in this report. Our sample consisted of 75 female and 15 male participants, ranging in age from 18 to 63 who responded to online announcements. Participants completed a 14-question emailed survey requesting descriptions of their fantasy habits and causes of potential distress regarding fantasy. Results demonstrated that participants shared a number of remarkably specific behaviors and concerns regarding their engagement in extensive periods of highly-structured, immersive imaginative (...) experiences, including the use of kinesthetic activity which accompanies the fantasies of 79% of participants. Participants reported distress stemming from three factors: difficulty in controlling the need or desire to engage in fantasizing; concern that the quantity of fantasizing interfered with actual relationships and endeavors; and intense shame and exhaustive efforts to keep this behavior hidden from others. It is hoped that this report will encourage interest in this elusive syndrome. (shrink)

The horizon for feminists studying horror films appears bleak. Since _Psycho_'s infamous shower scene, the big screen has treated us to Freddie's long razor-nails emerging between Nancy's legs in the bathtub (_A Nightmare on Elm Street I_), De Palma's exhibitionist heroine being power-drilled into the floor (_Body Double_), and Leather-face hanging women from meat hooks (_The Texas Chain Saw Massacre_). Even in a film with a strong heroine like _Alien_, any feminist point is qualified by the monstrousness of the alien (...) mother, the objectification of Sigourney Weaver in her underwear, and her character Ripley's forced assumption of a maternal role. Despite all this, there has been some feminist work on horror, and I believe there is room for more. In the first part of this paper I shall survey and criticize currently dominant psychodynamic feminist approaches to horror. In the second part, I propose an alternative framework for constructing feminist interpretations of horror films by critically interrogating their gender ideologies. My proposal focuses less on the psychology of viewers than on the nature of films as artifacts with particular structures and functions. In the third part I illustrate my recommended framework by sketching readings of _Jurassic Park_ (Spielberg 1993), _The Fly_ (Cronenberg 1986), and _Repulsion_ (Polanski 1965). (shrink)

Recent data show that human children (up to 8 years old) perform poorly when required to innovate tools. Our tool-rich culture may be more reliant on social learning and more limited by domain-general constraints such as ill-structured problem solving than otherwise thought.

In an era of global interdependence, the concept of autonomy may no longer name our core moral need. Shifting friendships and enmities across political boundaries bear significant consequences for the individual. Perhaps social alliances and hostilities have always had an impact on the flourishing of individuals and communities. But globalization (especially as viewed through the technology of the information age) magnifies the impact of external forces on sovereign bodies. These forces remind individuals of the need to establish the right kind (...) of connections, and diminish (but do not exclude) the relative importance of autonomy for moral and political discourse. (shrink)

Any interspecies ethics could do well to flip the claim of human exceptionalism several times on its head. Before entertaining a claim to re-naturalize human beings (with the risk of a reductive model of biology), the remarkable communicative, cultural, and cognitive skills of other creatures deserve more investigation. The usual line-up of metaphysical suspects for shoring up human superiority—impartial reason, moral or spiritual freedom, and self-awareness—have been used to gravely overstate our human capacities while obscuring genuinely mind-bending powers that cross (...) species barriers. If there is a common path for ethical and spiritual enlightenment, as an alternative to humanism’s rational enlightenment, it does not seem to originate in any cross-species capacity for high-level reason but in an affect-laden social intelligence instead. (shrink)

Effective altruism sounds so innocuous—who could possibly be opposed to doing good more effectively? Yet it has inspired significant backlash in recent years. This paper addresses some common misconceptions and argues that the core “beneficentric” ideas of effective altruism are both excellent and widely neglected. Reasonable people may disagree on details of implementation, but all should share the basic goals or values underlying effective altruism.

1 Department of Philosophy, University of Dundee, Dundee DD1 4HN. t.d.j.chappell@dundee.ac.uk.

In this paper, we argue that there are reasons to believe that an implicit bias for normalcy influences what are considered medically necessary treatments in psychiatry. First, we outline two prima facie reasons to suspect that this is the case. A bias for ‘the normal’ is already documented in disability studies; it is reasonable to suspect that it affects psychiatry too, since psychiatric patients, like disabled people, are often perceived as ‘weird’ by others. Secondly, psychiatry's explicitly endorsed values of well-being (...) and function are hard to measure directly, which is why we see simpler box-ticking conceptions of recovery used in large research studies. This need not be problematic, but might lead to researchers and clinicians focusing too much on treatments that promote easy-to-measure proxies for recovery, instead of what actually matters to psychiatric patients themselves. Next, we provide examples of treatments and treatment decisions within two areas – self-injury and psychosis – which are hard to explain unless we assume that an implicit and harmful normalcy bias is at work. We conclude with some suggestions for clinicians and future research. (shrink)

Timothy Chappell develops a picture of what philosophical ethics can be like, once set aside from conventional moral theory. His question is 'How are we to know what to do?', and the answer he defends is 'By developing our moral imaginations'--a key part of human excellence, which plays many roles in our practical and evaluative lives.

The paper outlines and explores a possible strategy for defending both the action/omission distinction and the principle of double effect. The strategy is to argue that there are degrees of actionhood, and that we are in general less responsible for what has a lower degree of actionhood, because of that lower degree. Moreover, what we omit generally has a lower degree of actionhood than what we actively do, and what we do under known-but-not-intended descriptions generally has a lower degree of (...) actionhood than what we do under known-and-intended descriptions. Therefore, we are in general less responsible for what we omit than for what we do—which is just what AOD says. And we are in general less responsible for what we do under known-but-not-intended descriptions than for what we do under known-and-intended descriptions—which is just what PDE says. (shrink)

What is introspective know ledge of one’s own intentional states like? This paper aims to make plausible the view that certain cases of self-knowledge, namely the cogito-type ones, are enough like perception to count as cases of quasi-observation. To this end it considers the highly influential arguments developed by Sydney Shoemaker in his recent Royce Lectures. These present the most formidable challenge to the view that certain cases of self-knowledge are quasi-observational and so deserve detailed examination. Shoemaker’s arguments are directed (...) against two models of ordinary perception, the “object perception model” and the “broad perceptual model”. I argue that the core theses that Shoemaker associated with them are either dubious in their own right or applicable to certain cases of self-knowledge. Overall the aim is to show that there is such a variety of patterns in each case that simple analogies or disanalogies are unhelpful. (shrink)

How much can morality demand of well-off Westerners as a response to the plight of the poor and starving in the rest of the world, or in response to environmental crises? Is it wrong to put your friends and family first? And what do the answers to these questions tell us about the nature of morality? This collection of eleven new essays from some of the world's leading moral philosophers brings the reader to the cutting edge of this contemporary ethical (...) debate. With essays from Kantians, utilitarians, rights theorists, virtue ethicists, and others, a wide variety of major ethical approaches are represented by distinguished authors. (shrink)

Cynthia Willett brings together diverse insights from social psychology, classical and contemporary literature, and legal and justice theory to redefine the basis of the moral and legal person. Feminists, communitarians, and postmodern thinkers have made clear that classical liberalism, with its emphasis on individual autonomy and excessive rationalism, is severely limited. Although she is sympathetic with the liberal view, Willett finds it necessary to go further. For her, attention to the social dimensions of the family and civil society is (...) critical if issues of race, gender, class, and sexuality are to be taken seriously. Interdependency, not autonomy, is of increasing significance in an era of globalization. Willett proposes an alternate normative theory that recognizes the impact of social forces on individual well-being. Citizenship in a democracy should not be defined solely on the basis of rights to autonomy, such as bare rights to property or free speech, she explains. Rather, citizenship should be defined first of all in terms of the rights, responsibilities, and capacities of the social person. It is within the African American tradition of political thought that Willett finds a more useful definition of human identity and political freedom. The African American experience offers a compelling vision of social change and a deeper understanding of what it means to be a social person. By focusing on everyday battles against racism, Willett contends, we can gain valuable insight into the meaning of justice. (shrink)

In this interview, Cynthia Hammond sits down with Marc Lafrance in order to discuss the 30-year sketching practice that led to her exhibition, Drawings for a Thicker Skin, in 2012. In this practice, Hammond made small, quick drawings of the clothes she would need for trips or key professional events. As she explains, the drawings were not just essential to knowing what to pack; they were essential to being able to pack. While she never conceived of the practice as (...) art, when invited to exhibit the drawings she found a way to relate this idiosyncratic and private practice to a larger set of ontological concerns. Clothing as a second skin is the key idea here, as Hammond and Lafrance explore what it means to navigate identity, idealized self-image, professional ‘passing’ and the skin ego. (shrink)

This paper draws on the 'Fitting Attitudes' analysis of value to argue that we should take the concept of fittingness (rather than value) as our normative primitive. I will argue that the fittingness framework enhances the clarity and expressive power of our normative theorising. Along the way, we will see how the fittingness framework illuminates our understanding of various moral theories, and why it casts doubt on the Global Consequentialist idea that acts and (say) eye colours are normatively on a (...) par. We will see why even consequentialists, in taking rightness to be in some sense determined by goodness, should not think that rightness is conceptually reducible to goodness. Finally, I will use the fittingness framework to explicate the distinction between consequentialist and deontological theories, with particular attention to the contentious case of Rule Consequentialism. (shrink)