The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Research addressing the challenges emerging from the development and diffusion of digital technologies has grown rapidly in recent years. However, much of this literature tends to overlook the immersion of these technologies into our everyday lives. This everyday digitalization cannot be reduced to specific technological innovations and is obviously a crucial aspect of the social changes introduced by digital technologies. This themed issue sets out to explore the everyday dimension of digitalization, in the specific context of agri-food systems. We propose (...) a collection of papers that contribute to opening new approaches to digitalization in food and agriculture, by concentrating the attention on the mundane and ordinary aspects of digitalization and exploring their potential contributions to profound transformations in agri-food systems. The various forms of everyday digitalization that are presented in this symposium offer two particular ways of critically engaging with the digitalization of agriculture and food. Firstly, our everyday digitalization looks beyond examining the impacts of digitalization and positioning digital technologies in opposition to farmers, consumers, government, or other actors. Secondly, we shed light on the politics of uncertainty, which enables us to make anticipatory actions and see things beyond success and failure. What we observe is how these imaginaries participate in the co-production of digital realities through their encounter with the complexity of everyday life. Therefore, it remains essential to engage critically with both the imaginary and the everyday dimensions of digitalization in their multiplicity. (shrink)

Since the onset of the SARS-CoV-2 pandemic, an array of off-label interventions has been used to treat patients, either provided as compassionate care or tested in clinical trials. There is a challenge in determining the justification for conducting randomised controlled trials over providing compassionate use in an emergency setting. A rapid and more accurate evaluation tool is needed to assess the effect of these treatments. Given the similarity to the Ebola Virus Disease (EVD) pandemic in Africa in 2014, we suggest (...) using a tool designed by the WHO committee in the aftermath of the EVD pandemic: Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI). Considering the uncertainty around SARS-CoV-2, we propose using an improved MEURI including the Plan–Do–Study–Act tool. This combined tool may facilitate dynamic monitoring, analysing, re-evaluating and re-authorising emergency use of unproven treatments and repeat it in cycles. It will enable adjustment and application of outcomes to clinical practice according to changing circumstances and increase the production of valuable data to promote the best standard of care and high-quality research—even during a pandemic. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Pratt et al. (2020) tackle a seeming lack of consensus about the ethical goals of community engagement (CE) in global health research. Their paper “identifies an additional or complementary role fo...

This collection of original essays examines the relationship between women and religion in the history of political thought broadly conceived. This theme is a remarkably revealing lens through which to view the Western philosophical and poetical traditions that have culminated in secular and egalitarian modern society. The essays also give highly analytical accounts of the manifold and intricate relationships between religion, family and public life in the history of political thought, and the various ways in which these relationships have manifested (...) themselves in pagan, Jewish, Christian and post-Christian settings. (shrink)

This interchange explores the role of girl (ages thirteen to twenty-two) activism in the USA organisation SPARK (Sexualization Protest: Action, Resistance, Knowledge). Some of the many initiatives and programmes SPARK has enacted with girls, including online forums, blog spaces, marches, and summits directly address recent calls to attend to the complexity in understanding and resisting ‘sexualisation’ with teen girls. Several of the girls’ media appearances are explored in detail to illustrate the dynamics of girls’ agency and resistance that emerge in (...) their embodied engagements with ‘sexualisation’. (shrink)

The decline of empirical research on ethical decision-making based on ethical theories might imply a tacit consensus has been reached. However, the exclusion of virtue ethics, one of the three main normative ethical theories, from this stream of literature calls this potential consensus into question. This article investigates the role of all three normative ethical theories—deontology, utilitarianism and virtue ethics—in ethical decision-making of corporate executives. It uses virtue ethics as a dependent variable thus studying the interconnectivity of all three normative (...) ethical theories in specific circumstances. We find that managers use different ethical theories in different circumstances (business vs. private life, formal vs informal ethical leadership, etc.). A predictive model of ethical decision-making, however, cannot be established. We also find that only a limited number of variables influence the choice of ethical theory, which leans business ethics towards postmodern management paradigm. We suggest that moral pragmatism could provide the answer to ethical decision-making. (shrink)

Few empirical studies have explored how different types of knowledge are associated with diverse objectivities and moral economies. Here, we examine these associations through an empirical investigation of the public policy debate in Israel around medical cannabis, which may be termed a contested medicine because its therapeutic effects, while subjectively felt by users, are not generally recognized by the medical profession. Our findings indicate that beneath the MC debate lie deep-seated issues of epistemology, which are entwined with questions of ethics (...) and morality. Whereas some stakeholder groups viewed evidence-based medicine and mechanical objectivity as the only valid knowledge base, others called for recognition of a particular experience-based knowledge, championing regulatory, administrative, or strong objectivity. Stakeholders’ interpretations of what should be considered as ethical courses of action corresponded to their epistemological views, with most criticizing the regulators for relying on regulatory subjectivity instead of objectivity. Our in-depth mapping of this arena allowed us not only to shed light on the emergence of the new entity called “medical cannabis” but also to reexamine the link between epistemology, ethics, and action and to elucidate how heterogeneous groups view the validity and objectivity of knowledge and the interface between medicine, science, and policy. (shrink)

Theodor Adorno once wrote an essay to "defend Bach against his devotees." In this book Dana Villa does the same for Hannah Arendt, whose sweeping reconceptualization of the nature and value of political action, he argues, has been covered over and domesticated by admirers who had hoped to enlist her in their less radical philosophical or political projects. Against the prevailing "Aristotelian" interpretation of her work, Villa explores Arendt's modernity, and indeed her postmodernity, through the Heideggerian and Nietzschean theme (...) of a break with tradition at the closure of metaphysics.Villa's book, however, is much more than a mere correction of misinterpretations of a major thinker's work. Rather, he makes a persuasive case for Arendt as the postmodern or postmetaphysical political theorist, the first political theorist to think through the nature of political action after Nietzsche's exposition of the death of God. After giving an account of Arendt's theory of action and Heidegger's influence on it, Villa shows how Arendt did justice to the Heideggerian and Nietzschean criticism of the metaphysical tradition while avoiding the political conclusions they drew from their critiques. The result is a wide-ranging discussion not only of Arendt and Heidegger, but of Aristotle, Kant, Nietzsche, Habermas, and the entire question of politics after metaphysics. (shrink)

Hannah Arendt's rich and varied political thought is more influential today than ever before, due in part to the collapse of communism and the need for ideas that move beyond the old ideologies of the Cold War. As Dana Villa shows, however, Arendt's thought is often poorly understood, both because of its complexity and because her fame has made it easy for critics to write about what she is reputed to have said rather than what she actually wrote. Villa (...) sets out to change that here, explaining clearly, carefully, and forcefully Arendt's major contributions to our understanding of politics, modernity, and the nature of political evil in our century.Villa begins by focusing on some of the most controversial aspects of Arendt's political thought. He shows that Arendt's famous idea of the banality of evil--inspired by the trial of Adolf Eichmann--does not, as some have maintained, lessen the guilt of war criminals by suggesting that they are mere cogs in a bureaucratic machine. He examines what she meant when she wrote that terror was the essence of totalitarianism, explaining that she believed Nazi and Soviet terror served above all to reinforce the totalitarian idea that humans are expendable units, subordinate to the all-determining laws of Nature or History. Villa clarifies the personal and philosophical relationship between Arendt and Heidegger, showing how her work drew on his thought while providing a firm repudiation of Heidegger's political idiocy under the Nazis. Less controversially, but as importantly, Villa also engages with Arendt's ideas about the relationship between political thought and political action. He explores her views about the roles of theatricality, philosophical reflection, and public-spiritedness in political life. And he explores what relationship, if any, Arendt saw between totalitarianism and the "great tradition" of Western political thought. Throughout, Villa shows how Arendt's ideas illuminate contemporary debates about the nature of modernity and democracy and how they deepen our understanding of philosophers ranging from Socrates and Plato to Habermas and Leo Strauss.Direct, lucid, and powerfully argued, this is a much-needed analysis of the central ideas of one of the most influential political theorists of the twentieth century. (shrink)

In everyday life, we assume that there are degrees of blameworthiness and praiseworthiness. Yet the debate about the nature of moral responsibility often focuses on the “yes or no” question of whether indeterminism is required for moral responsibility, while questions about what accounts for more or less blameworthiness or praiseworthiness are underexplored. In this paper, I defend the idea that degrees of blameworthiness and praiseworthiness can depend in part on degrees of difficulty and degrees of sacrifice required for performing the (...) action in question. Then I turn to the question of how existing accounts of the nature of moral responsibility might be seen to accommodate these facts. In each case of prominent compatibilist and incompatibilist accounts that I consider, I argue that supplementation with added dimensions is required in order to account for facts about degrees of blameworthiness and praiseworthiness. For example, I argue that the reasons-responsiveness view of Fischer and Ravizza requires supplementation that takes us beyond even fine-grained measures of degrees of reasons-responsiveness in order to capture facts about degrees of difficulty to extend the reasons-responsiveness view by appealing to such measures). I conclude by showing that once we recognize the need for these additional parameters, we will be in a position to explain away at least some of the appeal of incompatibilist accounts of moral responsibility. (shrink)

Benardete paradoxes involve infinite collections of Grim Reapers, assassins, demons, deafening peals, or even sentences. These paradoxes have recently been used in arguments for finitist metaphysical theses such as temporal finitism, causal finitism, and discrete views of time. Here we develop a new finite Benardete-like paradox. We then use this paradox to defend a companions in guilt argument that challenges recent applications of patchwork principles on behalf of the aforementioned finitist arguments. Finally, we develop another problem for those applications by (...) examining the notion of exact duplication. (shrink)

Many critics bemoan the lack of civic engagement in America. Tocqueville's ''nation of joiners'' seems to have become a nation of alienated individuals, disinclined to fulfill the obligations of citizenship or the responsibilities of self-government. In response, the critics urge community involvement and renewed education in the civic virtues. But what kind of civic engagement do we want, and what sort of citizenship should we encourage? In Socratic Citizenship, Dana Villa takes issue with those who would reduce citizenship to (...) community involvement or to political participation for its own sake. He argues that we need to place more value on a form of conscientious, moderately alienated citizenship invented by Socrates, one that is critical in orientation and dissident in practice. Taking Plato's Apology of Socrates as his starting point, Villa argues that Socrates was the first to show, in his words and deeds, how moral and intellectual integrity can go hand in hand, and how they can constitute importantly civic--and not just philosophical or moral--virtues. More specifically, Socrates urged that good citizens should value this sort of integrity more highly than such apparent virtues as patriotism, political participation, piety, and unwavering obedience to the law. Yet Socrates' radical redefinition of citizenship has had relatively little influence on Western political thought. Villa considers how the Socratic idea of the thinking citizen is treated by five of the most influential political thinkers of the past two centuries--John Stuart Mill, Friedrich Nietzsche, Max Weber, Hannah Arendt, and Leo Strauss. In doing so, he not only deepens our understanding of these thinkers' work and of modern ideas of citizenship, he also shows how the fragile Socratic idea of citizenship has been lost through a persistent devaluation of independent thought and action in public life.Engaging current debates among political and social theorists, this insightful book shows how we must reconceive the idea of good citizenship if we are to begin to address the shaky fundamentals of civic culture in America today. (shrink)

The need for a better understanding of the role location plays in economic life was first and most famously made explicit by Bertil Ohlin in 1933. However it is only recently, with the development of computer packages able to handle complex systems, as well as advances in economic theory, that Ohlin's vision has been met and a framework developed which explains the distribution of economic activity across space. This book is an integrated, non-mathematical, first-principles textbook presenting geographical economics to advanced (...) students. Never avoiding advanced concepts, its emphasis is on examples, diagrams, and empirical evidence, making it the ideal starting point prior to monographic and journal material. Contains copious computer simulation exercises, available in book and electronic format to encourage learning and understanding through application. Uses case study material from North America, Europe, Africa and Australasia. (shrink)

In 1977 a seminal paper was published by Avinash Dixit and Joseph Stiglitz that revolutionized the modeling of imperfectly competitive markets. It launched what might be called the second monopolistic competition revolution, which has been far more successful than the first one, initiated by Edward Chamberlin and Joan Robinson in the 1930s. In this 2003 collection of essays experts in the fields of macroeconomics, international trade theory, economic geography, and international growth theory address the question of why the second revolution (...) was so successful. They also highlight what is missing, and look forward to the next step in the modeling of imperfectly competitive markets. The text includes a comprehensive survey of both monopolistic competition revolutions, and previously unpublished working papers by Dixit and Stiglitz that led to their famous 1977 paper. With contributions from Dixit, Ethier, Neary and Stiglitz amongst others, this collection will excite interest amongst researchers, advanced students and economists. (shrink)

Considerable attention has been paid recently to the gendering of organizations and occupations. Unfortunately, the gendered-organizations approach remains theoretically and empirically underdeveloped, as there have as yet been few clear answers to the question central to the perspective: What does it really mean to say that an organization itself, or a policy, practice, or slot in the hierarchy, is “gendered”? Reviewing literature in the gendered-organizations tradition, the author discusses three of the most common ways the perspective has been applied and (...) argues that all of these definitions pose potential problems for the project of meaningful social and organizational change. The article concludes with some suggestions about how a more useful conception of the gendered organization might be built. (shrink)

Routledge is now re-issuing this prestigious series of 204 volumes originally published between 1910 and 1965. The titles include works by key figures such asC.G. Jung, Sigmund Freud, Jean Piaget, Otto Rank, James Hillman, Erich Fromm, Karen Horney and Susan Isaacs. Each volume is available on its own, as part of a themed mini-set, or as part of a specially-priced 204-volume set. A brochure listing each title in the "International Library of Psychology" series is available upon request.

In The Second Sex, Simone de Beauvoir diagnoses “woman” as the “lost sex,” torn between her individual autonomy and her “feminine destiny.” Becoming a “real woman” in patriarchal societies demands that women lose their authentic, autonomous selves to become the “inessential Other” for Man. To better understand this diagnosis and how women might refind themselves, I rehabilitate the influence of Søren Kierkegaard and his concept of repetition as what must be lost to be found again in Beauvoir’s account of freedom (...) and, specifically, the liberation of women. Beauvoir offers a dual account of repetition, that of mundane repetition and sacrificial repetition, bringing them to bear both on her diagnosis of women’s oppression and her theorization of our liberation. Sacrificial repetition becomes a temporality for freedom—one must be able to repeat or retake their autonomy continuously toward an open future. For this to happen concretely, Beauvoir insists that we must sacrifice the (racist, classist) patriarchal ideals of the “real woman” and “real man” as we retake our autonomy and reconfigure the meaning of sex difference anew. (shrink)

It is argued that once biological systems reach a certain level of complexity, mechanistic explanations provide an inadequate account of many relevant phenomena. In this article, I evaluate such claims with respect to a representative programme in systems biological research: the study of regulatory networks within single-celled organisms. I argue that these networks are amenable to mechanistic philosophy without need to appeal to some alternate form of explanation. In particular, I claim that we can understand the mathematical modelling techniques of (...) systems biologists as part of a broader practice of constructing and evaluating mechanism schemas. This argument is elaborated by considering the case of bacterial chemotactic networks, where some research has been interpreted as explaining phenomena by means of abstract design principles. (shrink)

Nelkin presents a simple and natural account of freedom and moral responsibility which responds to the great variety of challenges to the idea that we are free and responsible, before ultimately reaffirming our conception of ourselves as agents. Making Sense of Freedom and Responsibility begins with a defense of the rational abilities view, according to which one is responsible for an action if and only if one acts with the ability to recognize and act for good reasons. The view is (...) compatibilist -- that is, on the view defended, responsibility is compatible with determinism -- and one of its striking features is a certain asymmetry: it requires the ability to do otherwise for responsibility when actions are praiseworthy, but not when they are blameworthy. In defending and elaborating the view, Nelkin questions long-held assumptions such as those concerning the relation between fairness and blame and the nature of so-called reactive attitudes such as resentment and forgiveness. Her argument not only fits with a metaphysical picture of causation -- agent-causation -- often assumed to be available only to incompatibilist accounts, but receives positive support from the intuitively appealing Ought Implies Can Principle, and establishes a new interpretation of freedom and moral responsibility that dovetails with a compelling account of our inescapable commitments as rational agents. (shrink)

A variety of cases of scientific misconduct have been documented since the 1980s among biological scientists. These cases have focused the attention of the public and scientific community on this behavior and made it the centerpiece of the concern about ethics in the biological sciences. In contrast, the ethics movement in clinical medicine, which arose in the 1960s, was not basically directed at the problems of wrong-doing. Instead it concentrated on the difficult ethical choices that had to be made In (...) the practice of medicine.In this essay, I discuss the two movements. The attention given to misconduct In the biological sciences has become excessive and diverts its ethics movement from exploring and teaching about the difficult ethical decisions scientists must make in weighing obligations to self, science, and society. A more balanced and selective approach to developing an ethical framework in the biological sciences is needed. (shrink)

This article surveys the history of labor- and middle-class-sponsored efforts to mobilize shopping on behalf of working people from the late nineteenth century through the present. It analyzes the class dynamics of these movements to, first, underscore workers' own ability to mount consumer campaigns and, second, critique middle-class campaigns in the present that can treat workers as unorganized, passive victims. It underscores the potential hierarchical dynamics inherent in consumer-labor campaigns, both between classes and within the labor movement, including dynamics of (...) race, gender, and space. (shrink)