Stigma is often encountered by recipients who receive food donations from charities, while the consumption of wasted food, also traditionally considered to be a stigmatized practice, has recently become part of a popular food rescue movement that seeks to reduce environmental impacts. These two stigmas—charitable donation and the consumption of waste—are brought together at the Open Table, a community group in Melbourne, Australia, that serves community meals cooked from surplus food. This paper examines how Open Table de-stigmatizes food donations through (...) food waste discourse to enable greater social inclusion. I draw on the experiences of donors, cooks, volunteers and eaters gathered from diverse Open Table sites. Taking a ‘follow-the-thing’ approach, I analyze how food ‘waste’ becomes re-valued by embracing goals of environmental justice enacted through local processes of care and conviviality. Relying on networks of volunteers and not-for-profit agencies, Open Table provides a simple, effective and adaptable model for possible replication for overcoming drawbacks of traditional charity practices. Critically though, as hunger in society continues to grow, this approach is increasingly threatened by the need to ‘single out’ disadvantaged recipients to justify continued supply. This paper contributes to food poverty, waste, and Alternative Food Network literature in two important ways: first, by analyzing the outcomes of community food redistribution approaches with regards to stigma and inclusion; and secondly, by arguing that such holistic approaches need to be acknowledged, valued and supported to shift current discourses and practice. (shrink)

Edward Said writes that Orientalism is a Western style for dominating the East. Richard Rorty proposes that intellectuals should be modern liberals in their politics but postmodern ironists in their intellectual lives. Rebecca Catz argues that Fern?o Mendes Pinto's Peregrination, a sprawling account of travels in the East first published in 1614, is a ?plea for toleration?. How do these theories stand up when confronted with the text? Once as well known as Cervantes's Don Quixote, this text has been undeservedly (...) overlooked in the study of political ideas, and that is a loss because it might make Saidians, Rortians and toleration theorists rethink some of their ideas. It is wrong to take Mendes Pinto's criticisms of Asians as Orientalism, partly because Mendes Pinto is equally critical of the Portuguese and other Europeans. It is wrong to think that irony can provide a comfortable intellectual home, partly because Mendes Pinto's life and text provide examples of a much more subtle and nihilistic irony than Rorty imagines. And finally, it is wrong to think that Mendes Pinto's text is a ?plea for toleration? in any but the most attenuated sense. (shrink)

This paper has three main aims. The first is to provide a critical assessment of two rival concepts of suffering, that proposed by Cassell and that proposed in this journal by van Hooft. The second aim of the paper is to sketch a more plausible concept of suffering, one which derives from a Wittgensteinian view of linguistic meaning. This more plausible concept is labeled an ‘intuitive concept’. The third aim is to assess the prospects for scientific understanding of suffering.

Eighteenth-century theologian_Jonathan Edwards remains a significant influence on modern religion, and this book constitutes his most important contribution to Christian thought. Edwards_raises timeless questions about desire, choice, good, and evil, contrasting the opposing Calvinist and Arminian views of free will and addressing issues related to God's foreknowledge, determinism, and moral agency.

Alethic pluralism, on one version of the view , is the idea that truth is to be identified with different properties in different domains of discourse. 1 Whilst we operate with a univocal concept of truth, and a uniform truth predicate, the thought is that the truth property changes from one domain to the next. So the truth property for talk about the nature and state of the material world may be different from the truth property for moral discourse .Tappolet (...) challenged alethic pluralism by asking how it can account for the truth of mixed compounds, such as a mixed conjunction like ‘this cat is wet and funny’, where each of the conjuncts are from different domains of discourse, and thus assessable in terms of different truth properties. She argues that the alethic pluralist is left in a dilemma: either admit of a ‘generic’ truth property, which can be possessed by propositions from all domains, thus rendering the plural ways of being true obsolete, or deny the truth of mixed conjunctions.In Edwards 2008, I argued that there is route out of Tappolet's dilemma. Briefly, I suggested that we acknowledge that the truth of a mixed conjunction is dependent on the truth of its conjuncts, and we should explain the truth of the conjunction by saying that it is true just in case each of its conjuncts is true. This, I argued, gives us an account of the truth of the conjunction without needing to appeal to a troublesome ‘generic’ truth property.Aaron Cotnoir criticizes my solution to Tappolet's problem. Cotnoir argues that my solution to the problem admits of an unacceptable ‘proliferation’ of truth properties, and smuggles in a generic truth property. I …. (shrink)

In this paper the authors argue that research ethics committees should not be paternalistic by rejecting research that poses risk to people competent to decide for themselves. However it is important they help to ensure valid consent is sought from potential recruits and protect vulnerable people who cannot look after their own best interests. The authors first describe the tragic deaths of Jesse Gelsinger and Ellen Roche. They then discuss the following claims to support their case: competent individuals are epistemologically (...) and ethically in the best position to say which risks are reasonable for them, so RECs should be no more restrictive than the “normal” constraints on people taking risks with themselves; RECs do not judge individual competence ; individual liberty is mostly limited by what serves the public interest, and RECs do not determine public interest; RECs may have a paternalistic role in preventing exploitation of competent people vulnerable to the use of incentives, and in protecting the interests of incompetent people; however, the moral and political authority of RECs has not been established in this respect. (shrink)

“The sleeper awakes” is a convention of many literary utopias from the late nineteenth and early twentieth centuries. The plots of Edward Bellamy’s Looking Backward, William Morris’s News from Nowhere, and H. G. Wells’sWhen the Sleeper Wakes all famously involve a sleeping modern everyman who awakens to a future where the conflicts and contradictions of the burgeoning capitalist society have been resolved. The Bleilers identify dozens of other speculative novels from the same period employing this very device, such as William (...) Hudson’s A Crystal Age and Alvarado Fuller’s A.D. 2000.1 Chris Ferns has argued that this trope constitutes something of a “consoling... (shrink)

The practice of prenatal screening for disability is sometimes objected to because of the hurt and offence such practices may cause to people currently living with disabilities. This objection is commonly termed “the expressivist objection”. In response to the objection it is standardly claimed that disabilities are analogous to illnesses. And just as it would be implausible to suppose reduction of the incidence of illnesses such as flu sends a negative message to ill people, so it is not plausible to (...) suppose prevention of disability sends a negative message to disabled people. The expressivist objection hinges, however, upon a view of the relationship between disability and self identity which sees disability as part of the identity of the disabled person, in a way in which illnesses such as flu cannot be. This possibility is generally not considered in critiques of the expressivist objection. In this paper, an “identity claim” to the effect that disabilities can be identity constituting is accepted and the force of the expressivist argument is reconsidered in the light of its acceptance. It is concluded that even when such an identity claim is accepted, the expressivist objection is still not morally compelling. (shrink)

The anchoring focus of this paper is a cluster of complaints that have been raised against reference-based approaches to semantics, in particular against the view defended by Scott Soames (2002). I am going to lump the complaints that I have in mind under the heading of the Threat of Collapse (or the Threat, for short). At the heart of the Threat of Collapse is the accusation that various moves referentialists make in dealing with well-known problems end up undercutting the motivations (...) for a reference-based semantics in the first place. (shrink)

The ethics of care still appeals to many in spite of penetrating criticisms of it which have been presented over the past 15 years or so. This paper tries to offer an explanation for this, and then to critically engage with three versions of an ethics of care. The explanation consists firstly in the close affinities between nursing and care. The three versions identified below are by Gilligan (1982 ), a second by Tronto (1993 ), and a third by Gastmans (...) (2006 ), see also Little (1998 ). Each version is described and then subjected to criticism. It is concluded that where the ethics of care is presented in a distinctive way, it is at its least plausible; where it is stated in more plausible forms, it is not sufficiently distinct from nor superior to at least one other common approach to nursing ethics, namely the much-maligned 'four principles' approach. What is added by this paper to what is already known: as the article tries to explain, in spite of its being subjected to sustained criticism the ethics of care retains its appeal to many scholars. The paper tries to explain why, partly by distinguishing three different versions of an ethics of care. It is also shown that all three versions are beset with problems the least serious of which is distinctiveness from other approaches to moral problems in health care. (shrink)

The appropriateness of economic valuations of the natural environment is defended on the basis of an objective analysis of individuals’ preferences. The egoistic model of “economic man” substantiates economic valuations of instrumental values even when markets do not exist and when consumption and use are not involved. However, “altruistic man’s” genuine commitment to the well-being of others, particularly wildlife and future generations, challenges economic valuations at a fundamental level. In this case, self-interest and an indifference between states of the world (...) are secondary and undefined respectively, since preferences are not based on tradeoffs between the welfare of others and self. The appropriateness of economic valuations rests solely with the empirical validity of the assumptions that give rise to economic man. (shrink)

This paper is prompted by the charge that the prevailing Western paradigm of medical knowledge is essentially Cartesian. Hence, illness, disease, disability, etc. are said to be conceived of in Cartesian terms. The paper attempts to make use of the critique of Cartesianism in medicine developed by certain commentators, notably Leder (1992), in order to expose Cartesian commitments in conceptions of disability. The paper also attempts to sketch an alternative conception of disability — one partly inspired by the work of (...) Merleau-Ponty. In particular, three key Cartesian claims are identified and subjected to criticism. These are as follows: (a) The claim that the body is an object, (b) what is termed here ‘the modularity thesis’, and (c) the claim that the body cannot be constitutive of the self (i.e. since the soul/mind/brain is). In opposition to these claims, it is argued that the body is properly viewed as a subject; that there are neither purely mental, nor purely physical disabilities; and that selves are constituted, at least in part, by their bodies. (shrink)

This “current controversies” contribution describes the recent case of a severely disabled six year old girl who has been subjected to a range of medical interventions at the request of her parents and with the permission of a hospital clinical ethics committee. The interventions prescribed have become known as “the Ashley treatment” and involve the performance of invasive medical procedures (eg, hysterectomy) and oestrogen treatment. A central aim of the treatment is to restrict the growth of the child and thus (...) make it easier for her parents to care for her at home. The paper below discusses the main objections to the treatment. It concludes that the most serious concern raised by the case is that it may set a worrying precedent if the moral principle employed in justification of the treatment is applied again to endorse it in similar circumstances. Finally, it raises the possibility that that same moral principle may even be invoked to justify more radical interventions than those that were actually performed in the Ashley treatment. (shrink)

In management research, theory testing confronts a paradox described by Meehl in which designing studies with greater methodological rigor puts theories at less risk of falsification. This paradox exists because most management theories make predictions that are merely directional, such as stating that two variables will be positively or negatively related. As methodological rigor increases, the probability that an estimated effect will differ from zero likewise increases, and the likelihood of finding support for a directional prediction boils down to a (...) coin toss. This paradox can be resolved by developing theories with greater precision, such that their propositions predict something more meaningful than deviations from zero. This article evaluates the precision of theories in management research, offers guidelines for making theories more precise, and discusses ways to overcome barriers to the pursuit of theoretical precision. (shrink)

An almost unbelievable amount of false philosophy has arisen through not realizing what ‘existence’ means…. [It] rests upon the notion that existence is, so to speak, a property that you can attribute to things, and that the things that exist have the property of existence and the things that do not exist do not. That is rubbish . I have dared to puncture several metaphysical balloons and nothing came out of them but hot air.

In this article we examine ethical aspects of the involvement of children in clinical research, specifically those who are incapable of giving informed consent to participate. The topic is, of course, not a new one in medical ethics but there are some tensions in current guidelines that, in our view, need to be made explicit and which need to be responded to by the relevant official bodies. In particular, we focus on tensions between the World Medical Association Declaration of Helsinki, (...) and the guidance offered by the British Medical Association, the Royal College of Paediatrics and Child Health , and the Council for International Organizations of Medical Sciences. We conclude with a call for these organisations to make their guidance explicit in relation to the World Medical Association Declaration. (shrink)

This article discusses the question of whether, as is often claimed, nursing is properly described as an art. Following critical remarks on the claims of Carper, Chinn and Watson, and Johnson, the account of art provided by RG Collingwood is described, with particular reference to his influential distinction between art and craft. The question of whether nursing is best described as an art or a craft is then discussed. The conclusion is advanced that nursing cannot properly be described as an (...) art, given acceptance of Collingwood’s influential definition of art. Moreover, it is shown that, due to difficulties inherent in specifying the ‘ends’ of nursing, nursing is only problematically described as a craft. (shrink)

This paper examines one particular justification for the screening and termination of embryos/fetuses which possess genetic features known to cause disability. The particular case is that put forward in several places by John Harris. He argues that the obligation to prevent needless suffering justifies the prevention of the births of disabled neonates. The paper begins by rehearsing Harris's case. Then, drawing upon claims advanced in a recent paper in the Journal of Medical Ethics, it is subjected to critical scrutiny, focusing (...) on Harris's “suffering claim” .1 It is argued that the suffering claim must be false if understood as an empirical claim. And, even if understood as a conceptual truth, it mistakenly assimilates the concepts of harm and suffering. Finally, again focusing on Harris's recent work in this area, his characterisation of disability as a “harmed condition” is shown not to apply in the case of at least some moderate forms of intellectual disability. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Changing Functions, Moral Responsibility, and Mental IllnessCraig Edwards (bio)Keywordsmental illness, responsibility, character, dysfunction, personhoodI thank both Wakefield and Tomasini for their illuminating comments. Both commentaries are thought provoking and warrant a full response. However, as always, space is limited and I must make the all-too-predictable apology for not addressing both commentaries in full. Wakefield's contribution more directly engages with, and challenges, my claims, and so I focus on (...) addressing his concerns.ClarificationsWakefield correctly notes that I am interested in how mental illness (and illness generally) operates to remove moral responsibility for one's actions. Despite this, it seems at several points that he and I are talking about two different, albeit related, concepts of mental illness. 'Mental illness' is used to both explain and excuse certain behaviors, but these two functions, explanatory and exculpable, do not always operate simultaneously. As we discover biological explanations for apparently immoral behaviors, the question arises as to whether the explanation should remove the immorality and liability for punishment. The 'sick role' can be divided into two aspects. One is the role of deserving and warranting medical treatment. The other is the negation of moral responsibility. Wakefield's own example, pedophilia, involves the first sense of the sick role but not the second. Wakefield's use of this example is unusual, because it deftly highlights the limitation of his HD account. Pedophilia is a mental disorder in the sense of warranting treatment, and is a mental illness under Wakefield's model, but it is not something that negates moral responsibility. There is a sense of the term 'mental illness'—an important and, as I argue, an objective sense—that is relevant to establishing one's moral responsibility for such behaviors.In addressing my account of mental illness as though it contained two distinct answers, 'mental illness as dysfunction of rational agency, or 'mental illness as moral judgment,' it is unclear whether Wakefield takes them to be conjunctive or alternative. Hence it is worth reiterating in point form the structure of my account:1. Illness involves dysfunction;2. The 'proper function' of a bodily or psychological mechanism is determined by the purpose that we impose upon that mechanism (within the constraints of our biological needs);3. Dysfunction of rational agency is necessary, but not sufficient, for 'mental illness' in the normative sense relevant to negating moral responsibility; and [End Page 105]4. The distinction between 'mental illness' (in the above sense) and the many dysfunctions of rational agency for which we are morally responsible, turns upon (objective) normative facts rather than features internal to the dysfunctions themselves.Functions and ValueWakefield misses the point when he criticizes my comment that, although bodily mechanisms are fairly uniformly valued, there is substantial historical and cross-cultural variation in the way people value personhood. He notes—accurately, but irrelevantly—that people almost always place great value on their capacity for rational agency, probably more so than many aspects of their physical health. My comment, taken in context, has nothing to do with how much people value personhood, but has everything to do with what kinds of purposes people want their mental and physical processes to achieve. A heart has the same function for a Londoner today as it did for a Japanese peasant a thousand years ago, and although it is possible for us to want it to achieve other purposes, any culture that seriously imputes a different set of vital functions on the heart is likely to be rather disappointed. By contrast, our species has experienced vast changes in the demands we make of our rational and intellectual capacities—dysfunctions like dyslexia and alcoholism were irrelevant before the availability of written communication and alcohol.Wakefield's HD account is unable to deal with the relevance of such change. The link between evolutionary function and illness is tenuous in any event. Evolutionary explanations of specific mechanisms are often untestable, simply positing some evolutionary purpose that happens to fit our understanding of what the mechanism does. If we were to discover that alcoholism evolved as a means of increasing birthrates, or (perhaps more plausibly) that anxiety disorders occur among those for whom... (shrink)

In his classic 1936 paper Tarski sought to motivate his definition of logical consequence by appeal to the inference form: P(0), P(1), . . ., P(n), . . . therefore ∀nP(n). This is prima facie puzzling because these inferences are seemingly first-order and Tarski knew that Gödel had shown first-order proof methods to be complete, and because ∀nP(n) is not a logical consequence of P(0), P(1), . . ., P(n), . . . by Taski's proposed definition. An attempt to resolve (...) the puzzle due to Etchemendy is considered and rejected. A second attempt due to Gómez-Torrente is accepted as far as it goes, but it is argued that it raises a further puzzle of its own: it takes the plausibility of Tarski's claim that his definition captures our common concept of logical consequence to depend upon our common concept being a reductive conception. A further interpretation of what Tarski had in mind when he offered the example is proposed, using materials well known to Tarski at the time. It is argued that this interpretation makes the motivating example independent of reductive definitions which take natural numbers to be higher-order set theoretic entities, and it also explains why he did not regard the distinction between defined and primitive terms as pressing, as was the distinction between logical and nonlogical terms. (shrink)

The ethics review system of research is now well-established, at least in the developed world, although there are many differences in how countries view it and go about managing it. The UK specifically is now seeking to revise its system by speeding up the process of ethics approval but only for some studies. It is proposed that only those studies which pose “no material ethical issues” should be “fast-tracked”. However, it is unclear what this means, who should decide and what (...) should be included in this category. In this paper, we go some way towards answering these questions. While we are certain that the debate is only just beginning, we are equally certain that it will continue to run long after the system has been reformed. To stimulate this conversation and to inform a pilot project of the new system directly, we review two candidates to help give some substance to the notion of “material” ethical issues. Firstly, material could mean a certain type or degree of risk. Second, material could mean how physically invasive the research is. We conclude that there is still much work to be done on making the system of governing health and social care consistent and practicable. (shrink)

This paper discusses the predicament of Oscar Pistorius. He is a Paralympic gold medallist who wishes to participate in the Olympics in Beijing in 2008. Following a brief introductory section, the paper discusses the arguments that could be, and have been, deployed against his participation in the Olympics, should he make the qualifying time for his chosen event (400m). The next section discusses a more hypothetical argument based upon a specific understanding of the fair opportunity rule. According to this, there (...) may be a case for allowing Pistorius to compete even if he should fail to make the official qualifying time. The final part of the paper reviews the situation at the time of writing and offers some assessment of the strategy of the IAAF in responding to it. It is argued below that the proper focus for assessment of Pistorius's eligibility to compete should not be on whether his blades lead to his having an unfair advantage over his competitors, but instead should focus on whether what he does counts as running. (shrink)

ABSTRACT Many people argue that disagreements and inconsistencies between Research Ethics Committees are morally problematic and there has been much effort to ‘harmonise’ their judgements. Some inconsistencies are bad because they are due to irrationality, or carelessness, or the operation of conflicting interests, and so should be reduced or removed. Other inconsistencies, we argue, are not bad and should be left or even encouraged. In this paper we examine three arguments to reject the view that we should strive for complete (...) consistency between committees. The first argument is that differences in judgement are not necessarily incompatible with ideas of justice for patients who are potential participants of research reviewed by different committees. We call this ‘the justice argument.’ The second argument is that such committees do not have access to a single moral truth, to which their judgement is supposed to correspond. We call this the ‘moral pluralism argument.’ The third argument is that the process of ethics committee review is also morally relevant and not solely the outcome. We call this the ‘due process argument.’ While we fall short of establishing exactly how much variation and on what substantive issues would be ethically permissible, we show that it is largely inevitable and that a certain amount of variation could be seen as a desirable part of the institution of medical research. (shrink)

This is the first wide-ranging, multi-authored handbook in the field of philosophy of medicine, covering the underlying conceptual issues of many important social, political and ethical issues in health care. It introduces and develops over 70 topics, concepts, and issues in the field. It is written by distinguished specialists from multiple disciplines, including philosophy, health sciences, nursing, sociology, political theory, and medicine. Many difficult social and ethical issues in health care are based on conceptual problems, most prominently on the definitions (...) of health and disease, or on epistemological issues regarding causality or diagnosis. Philosophy is the discipline that deals with such conceptual, metaphysical, epistemological, methodological, and axiological matters. This handbook covers all the central concepts in medicine, such as ageing, death, disease, mental disorder, and well-being. It is an invaluable source for laypeople, academics with an interest in medicine, and health care specialists who want be informed and up to date with the relevant discussions. The text also advances these debates and will set the agenda for years to come. (shrink)

Most ethics committees which review research protocols insist that potential research participants reserve unconditional or absolute ‘right’ of withdrawal at any time and without giving any reason. In this paper, I examine what consent means for research participation and a sense of commitment in relation to this right to withdraw. I suggest that, once consent has been given (and here I am excluding incompetent minors and adults), participants should not necessarily have unconditional or absolute rights to withdraw.This does not imply (...) that that there should be a complete absence of rights, or, indeed, an abandonment of the right to withdraw. The point of this paper is to show that the supposed unconditional or absolute nature of these rights may be self‐defeating and so fail to respect the autonomy of participants. In addition, and on a more positive note, I suggest that, attaching certain conditions on the right to withdraw, may better respect the autonomy of these participants by underlining the idea that autonomy is more than mere whim or indifference to the fate of others. On the contrary, research staff are currently unable to ‘push’ participants, who may merely have logistical difficulties unrelated to the research itself, but who really want to stay the course, for fear of coercing them. Furthermore, researchers now try to ‘screen out’ people they think may be unreliable to protect the science of the study and so groups at risk of dropping out may be unfairly denied access to research treatments. I conclude that on‐going negotiation between the relevant parties could be on balance the only truly acceptable way forward but concede certain important limitations to take into account. (shrink)

Dr Edwards' stimulating and provocative book advances the thesis that the appropriate axiomatic basis for inductive inference is not that of probability, with its addition axiom, but rather likelihood - the concept introduced by Fisher as a measure of relative support amongst different hypotheses. Starting from the simplest considerations and assuming no more than a modest acquaintance with probability theory, the author sets out to reconstruct nothing less than a consistent theory of statistical inference in science.

This paper enquires into the nature and the extent of the obligations of nurses. It is argued that nurses appear to be obliged to undertake supererogatory acts if they take clause one of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) Code of Professional Conduct seriously (as, indeed, they are required to do). In the first part of the paper, the nature of nursing obligations is outlined, and then the groups and individuals to whom nurses have (...) obligations are identified. Following a brief discussion of the moral foundation of the nurse's obligations to her/his employer, a common conflict of obligations is identified. Then a distinction is drawn between ordinary and extraordinary moral standards. Appreciation of this is necessary for an understanding of the criterion of what constitutes a supererogatory act. By the definition of supererogatory acts proposed below, it is suggested that actions such as whistleblowing satisfy that definition. (shrink)

The Alleged Turning Point in European Philosophy Existentialists, especially those who follow either Heidegger or Jaspers, find a great deal objectionable in what they variously call ‘scientism’, ‘scientific rationalism’, and ‘positivism’. In this article I shall discuss one of the alleged defects of scientific rationalism, that it recognizes only one kind of truth—the kind that existentialists call ‘objective truth’. ‘One great achievement of existential philosophy,’ writes William Barrett, ‘has been a new interpretation of the idea of truth in order to (...) point out that there are different kinds of truth, where a rigid scientific rationalism had postulated but one kind: objective scientific truth.’ Not only scientific rationalists but traditional metaphysicians from Plato to Aquinas and Hegel are judged to be equally at fault here: they too have failed to recognize any truth other than the objective variety. It was Kierkegaard who for the first time effectively challenged the assumptions shared by scientific rationalists and traditional metaphysicians. Kierkegaard, in Barrett's words, ‘had to re-open the whole question of the meaning of truth … his stand on the question may well have marked a turning point in European philosophy.’. (shrink)

In this paper, we respond to Andrew Avins's recent review of methods whose use he advocates in clinical trials, to make them more ethical. He recommends in particular, “unbalanced randomisation”. However, we argue that, before such a recommendation can be made, it is important to establish why unequal randomisation might offer ethical advantages over equal randomisation, other things being equal. It is important to make a pragmatic distinction between trials of treatments that are already routinely available and trials of restricted (...) treatments. We conclude that unequal randomisation could, indeed, be an ethical compromise between protecting the interests of participants and those of society. (shrink)