This reflection item provides an edited account of human rights lawyer Harriet Wistrich’s conversation with Manvir Grewal, Visiting Lecturer and Ph.D. student, and Harriet Samuels, Reader in Law at the University of Westminster. It summarises the exchange which focused on Harriet Wistrich’s career trajectory and the many public interest law cases that she has brought on behalf her clients, mainly women, in both domestic and international forums. It also includes a condensed version of the question and answer (...) session with the audience. Questions included the broader issues around domestic violence, rape, coercive control, sex work and the nature of feminism. (shrink)

The ArgumentWritten as one book, Science, Technology and Society in Seventeenth-Century England has become two. One book, treating Puritanism and science, has since become “The Merton Thesis.” The other, treating shifts of interest among the sciences and problem choice within the sciences, has been less consequential. This paper proposes that neglect of one part of the monograph has skewed readers' understanding of the whole. Society and culture contributed to institutionalization of science and the directions it took, neither one exclusively. Four (...) aspects of the neglected chapters are examined: their theoretical underpinnings, the conceptions providing foundations for this part specifically and for the monograph as a whole; their comparative neglect, attributed partly to the absence of a cognitive constituency for their claims; the problem of problem choice in science in Merton's work; and the Merton monograph and later social constructionism:their differences and affinities. (shrink)

This paper explores the tension in Kierkegaard’s Christian discourses between Kierkegaard’s overt emphasis on Scriptural authority and Kierkegaard’s imaginative Scriptural use, through an analysis of the discourse series, “Thoughts That Wound from Behind—for Upbuilding.” The paper argues that Kierkegaard employs Scriptural language both imaginatively to create distanciation and directly to create confrontation, without differentiating how Scriptural authority functions in these two uses. The paper concludes that when Kierkegaard emphasizes Scriptural authority, he is really emphasizing the authority of “Christian concepts” stabilized (...) in Christian tradition, and that he utilizes Scripture freely and imaginatively to challenge readers with those authoritative concepts. (shrink)

In this paper, I offer a third way in debates over the scope of phenomenal consciousness, in the form of a novel synthesis of liberal and conservative introspective observations. My primary claim i...

According to the Argument for Autonomous Mental Disorder, mental disorder can occur in the absence of brain disorder, just as software problems can occur in the absence of hardware problems in a computer. This article argues that the AAMD is unsound. I begin by introducing the “natural dysfunction analysis” of disorder, before outlining the AAMD. I then analyze the necessary conditions for realizer autonomous dysfunction. Building on this, I show that software functions disassociate from hardware functions in a way that (...) mental functions do not disassociate from brain functions. It follows that mental disorders are brain disorders necessarily. (shrink)

In his presidential address (American Philosophical Association, Western Division), William Frankena sets himself against the relativist and irrationalist drift of our time in asserting that ?It is of the essence of a normative judgment to claim that it is justified, rational or valid?, and that fully informed men of reason will ultimately agree about value questions. Applauding the return to reason, this note finds a need for further clarification on the definition of normative terms, the justification of normative judgments, the (...) basis of obligation to be rational, and on the promise of agreement among men of reason in axiology. (shrink)

Part One. In our strife to express the meanings of moral terms, we have neglected the one transparently built?in meaning: ?A man ought to keep his promises? could mean ?A man owes it to other men to keep his promises. Such is his debt and duty ? just what is due or owed?. This proposal is supported by the evidence of major languages of the world, ancient and modern, in all of which identical or closely related words serve to express (...) both the idea of material debt and that of moral obligation. But on study the revealing model and analogue of ?moral debt? is found, not in debts of exchange, the simplest and most obvious class of debts, but in debts of shared responsibility. Working from such models we conclude that ?A ought to do X? means X is part of A's share in the cost of the good community, the common cause and stake of all mankind? (shrink)

This research investigates the perceptions of five constituent groups of an accredited business school — their perceptions of others'' ethics, of their own ethics and ideal values, and of how business ethics can be improved. Self-described behavior from the constituent groups is quite similar, yet is decidedly different from that which respondents felt others would do. Undergraduate business students tended to have the lowest estimation of others'' ethics in addition to the least ethical self-described behavior compared with other constituent groups. (...) All constituents were solidly in favor of improving ethics by developing principles of business ethics, requiring ethics courses in business schools and introducing industry codes of ethics. People are much more ethical than they are perceived to be. Knowing that others are more ethical may in turn cause other people to act more ethically. Similarly, believing that others are less ethical may encourage less ethical behavior. (shrink)

This study identifies and explores evolving concepts of trust and privacy in the context of user-generated health data. We define “user-generated health data” as data captured through devices or software and used outside of traditional clinical settings for tracking personal health data. The investigators conducted qualitative research through semistructured interviews with researchers, health technology start-up companies, and members of the general public to inquire why and how they interact with and understand the value of user-generated health data. We found significant (...) results concerning new attitudes toward trust, privacy, and sharing of health data outside of clinical settings that conflict with regulations governing health data within clinical settings. Members of the general public expressed little concern about sharing health data with the companies that sold the devices or apps they used, and indicated that they rarely read the “terms and conditions” detailing how their data may be exploited by the company or third-party affiliates before consenting to them. In contrast, interviews with researchers revealed significant resistance among potential research participants to sharing their user-generated health data for purposes of scientific study. The widespread rhetoric of personalization and social sharing in “user-generated culture” appears to facilitate an understanding of user-generated health data that deemphasizes the risk of exploitation in favor of loosely defined benefits to individual and social well-being. We recommend clarification and greater transparency of regulations governing data sharing related to health. (shrink)

This paper presents four arguments in favour of respecting Ulysses Contracts in the case of individuals who suffer with severe chronic episodic mental illnesses, and who have experienced spiralling and relapse before. First, competence comes in degrees. As such, even if a person meets the usual standard for competence at the point when they wish to refuse treatment, they may still be less competent than they were when they signed the Ulysses Contract. As such, even if competent at time 1 (...) and time 2, there can still be a disparity between the levels of competence at each time. Second, Ulysses Contracts are important to protect people’s most meaningful concerns. Third, on the approach defended, the restrictions to people’s liberty would be temporary, and would be consistent with soft paternalism, rather than hard paternalism: the contracts would be designed in such a way that individuals would be free to change their minds, and to change or cancel their Ulysses Contracts later. Finally, even if one rejects the equivalence thesis, this is still consistent with the claim that, in particular cases, it can be as wrong to allow a harm as to do a harm. Nevertheless, controversies remain. This paper also highlights several safeguards to minimise risks. Ultimately, we argue that people who are vulnerable to spiralling deserve a way to protect their autonomy as far as possible, using Ulysses Contracts when necessary. (shrink)

Justin Garson has recently advanced a Generalised Selected Effects Theory of biological proper function. According to Garson, his theory spells trouble for the Dysfunction Account of Disorder. This paper argues that Garson’s critique of the Dysfunction Account from the Generalised Theory fails, and that we should reject the Generalised Theory outright. I first show that the Generalised Theory does not, as Garson asserts, imply that neurally selected disorders are not dysfunctional. Rather, it implies that they are both functional and dysfunctional. (...) I argue on this basis that the Generalised Theory yields conflicting functional norms, and we that should reject it outright on these grounds. (shrink)

This paper asks when a natural disease kind is truly 'reactive' and when it is merely associated with a corresponding social kind. I begin with a permissive account of real kinds and their structure, distinguishing natural kinds, indifferent kinds and reactive kinds as varieties of real kind characterised by super-explanatory properties. I then situate disease kinds within this framework, arguing that many disease kinds prima facie are both natural and reactive. I proceed to distinguish ‘simple dependence’, ‘secondary dependence’ and ‘essential (...) dependence’ between a natural kind and its classification, and argue that a natural kind is only really reactive, in an important sense, under conditions of essential dependence. On this basis, I offer a principled hypothesis for why psychiatric kinds tend to be more metaphysically unstable than paradigm somatic disease kinds. (shrink)

To mark International Women’s Day the Research Group for Law, Gender and Sexuality at Westminster Law School held an evening conversation on 10 March 2016 on Women and Asylum. Speakers working in different areas of the asylum system shared their insights and experiences with an audience of staff, students, activists and other visitors. Harriet Samuels chaired the conversation and the speakers were Princess Chine Onyeukwu, Debora Singer, Priya Solanki and Zoe Harper. This article is an edited extract from the (...) transcript of the presentations and wide-ranging discussion, including the question and answer session. The discussion focused on the different steps in the refugee determination process and considered, in particular, the gendering of credibility and how women’s perceived lack of credibility has a significant impact on determinations and processes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Medical Tourism:Crossing Borders to Access Health CareHarriet Hutson Gray (bio) and Susan Cartier Poland (bio)Traveling abroad for one's health has a long history for the upper social classes who sought spas, mineral baths, innovative therapies, and the fair climate of the Mediterranean as destinations to improve their health. The newest trend in the first decade of the twenty-first century has the middle class traveling from developed countries to those (...) with emerging economies to avoid treatment delays, prohibitive costs for life-saving procedures, or simply high costs for elective surgery. Others leave to have access to assisted suicide in countries that have legalized it: Belgium, The Netherlands, and Switzerland. This new era of globalization in health care has arrived without the benefit of international standards, government oversight, or ethical and legal review.Howard Staab, a self-employed carpenter from North Carolina, flew to India for his medically necessary heart surgery, scheduled a side trip to the Taj Mahal, and returned home to work in North Carolina. He spent a total of less than $10,000, instead of the $200,000 required from the local hospital (I, Milstein and Smith 2006).At first blush, the outsourcing of medical care to India seems to be a particular solution for a particular problem. However, the particularity of Mr. Staab is not unique. His experience is emblematic of those patients in the United States with a medical need for major and elective procedures, but who also must bear the total cost of these procedures. These middle-class, under-insured Americans go abroad.In tandem with increasingly aggressive marketing campaigns, American hospitals and companies have begun to leverage their connections in Asia to grow the medical tourism business into a major economic force. What are the consequences of this?Several authors point to the effect on the host country's population, particularly the poor, to be pushed farther down the queue to receive adequate, affordable care. Resources are applied to the foreign trade instead of building the local [End Page 193] medical infrastructure. Another potential problem is the obligation of the home-country physician to provide follow-up care. What are the legal ramifications when the procedure was illegal to begin with? Are there opportunities for redress for medical errors?These factors may be converging into a "perfect storm" for health care in the U.S., in which the potential participation of the major insurance companies in promoting offshore care will be the tipping point in the precarious structure that represents the economic currents in health care. Third-party administrators and self-funded employers may be on the cutting edge in 2009 by providing incentives to employees to travel overseas for care.I. Economic ConsiderationsConnell, John. Medical Tourism: Sea, Sun, Sand and... Surgery. Tourism Management 27: 1093–1100, 2006.As evidence of the interest of traditional tour operators in this newer twist on the industry, the author explores medical tourism as an element of the growth of world tourism. In promoting medical tourism, he urges consideration of such issues as the privatization of health care, the foundational role of technology, and uneven access to health resources.Dunn, Philip. Medical Tourism Takes Flight. H and HN: Hospitals and Health Networks: 40–44, November 2007.Writing for U.S. health care executives, Dunn emphasizes that the reality of medical tourism competes with the local medical center for patients and their insurance dollars in a significant way. He examines the possibility that U.S. insurance plans soon may offer to pay for what is currently a cash only business and that the economic impact to the local medical center could be significant or even devastating.Frontiers of Health Services Management [Selected Articles] 24 (2), Winter 2007.In "Managing Healthcare Services in the Global Marketplace" (pp. 3–18), Bruce J. Fried and Dean M. Harris consider legal, ethical, and financial implications of the international workforce. In "Globalization of Health Care" (pp. 19–30), Lynn Schroth and Ruthy Khawahja point out that the transfer of comprehensive management expertise and intellectual property from U.S. medical centers to international sites is driving the success of collaboration between U.S. and foreign health care centers. In "Is... (shrink)

Defining Mental Disorder: Jerome Wakefield and His Critics, edited by Denis Forest and Luc Faucher, is essential reading for students and researchers in philosophy of medicine whose work is informed by that of Jerome Wakefield, or the disease debate in general. If you are anything like me, this book will open the door to a new depth of understanding of the harmful dysfunction analysis (HDA) and its methodical underpinnings, and an enriched appreciation of what is at stake in defining medical (...) disorder. To those confident that they understand Wakefield’s view and the surrounding debate, thinking perhaps that they do not need a refresher, I would say: perhaps you do not understand it as well as you think. Defining Mental Disorder provides much more than an overview of previously well-trodden ground. The chapters themselves, and Wakefield’s own detailed responses, help to elucidate a number of methodological nuances and peculiarities that have rarely been covered in such depth before. I was startled to learn how philosophically complex Wakefield’s position actually is, and how shallow my own understanding of it has been. It emerges as a far more nuanced and sophisticated account than I had given it credit for, and one that deserves serious reevaluation. (shrink)

This article explores the co-existence of, and relationship between, alternative education in the form of home education and mainstream schooling. Home education is conceptually subordinate to schooling, relying on schooling for its status as alternative, but also being tied to schooling through the dominant discourse that forms our understandings of education. Practitioners and other defenders frequently justify home education by running an implicit or explicit comparison with school; a comparison which expresses the desire to do ‘better’ than school whilst simultaneously (...) encompassing the desire to do things differently. These twin aims, however, are not easy to reconcile, meaning that the challenge to schooling and the submission to norms and beliefs that underlie schooling are frequently inseparable. This article explores the trajectories of ‘better than’ and ‘different from’ school as representing ideas of utopia and heterotopia respectively. In particular I consider Foucault's notion of the heterotopia as a means of approaching the relationship between school and other forms of education. Whilst it will be argued that, according to Derrida's ideas of discursive deconstruction, alternative education has to be expressed through the dominant educational discourse, it will also be suggested that employing the idea of the heterotopia is a strategy which can help us explore the alternative in education. (shrink)

Background Generally, there is unanimity about the value of community engagement in health-related research. There is also a growing tendency to view genetics and genomics research (GGR) as a special category of research, the conduct of which including community engagement (CE) as needing additional caution. One of the motivations of this study was to establish how differently if at all, we should think about CE in GGR. Aim To assess the perspectives of genetics and genomics researchers in Uganda on CE (...) in GGR. Method A cross-sectional qualitative study was conducted at Makerere University and Uganda Virus Research Institute. Twenty-five individuals participated, the majority being male (sixteen). Participants included nineteen genetics and genomics researchers (researchers and research coordinators), two CE officers, three nurses and one nursing counsellor. Data were collected using in-depth interviews and analyzed in a thematic manner using NVivo version 12 Plus. Study findings Thirteen of the respondents had conducted CE in their GGR in either a geographical and disease-specific community. Some respondents said CE principles are the same and there is no need for special consideration for CE in GGR. Others gave ethical issues in GGR that require special consideration for CE in such research and these were categorized into six themes: GGR is new to communities, Difficulty in communicating GGR by the researchers, Genes are shared in communities, Cultural sensitivities against GGR, Community attitude toward GGR, Some GGR studies take long to end, and Negotiation of research benefits. Special considerations for CE when conducting GGR were suggested and categorized into seven themes: creating awareness of GGR in communities, obtaining both community acceptance and individual consent, CE team composition, involve communities in solving GGR challenges, prolong CE in some GGR, develop guidelines for CE in GGR, and legal considerations on GGR. Conclusion GGR was characterized by special issues that require special CE considerations for such research. (shrink)

Is it unethical to advertise lotteries? Many citizens think that states should not be actively promoting and encouraging the public tospend hard-earned dollars on a bet that they are virtually guaranteed to lose. Perhaps more importantly, business ethicists are concerned that lottery advertising may be targeting the most vulnerable markets: households with the lowest income and education levels. If this were true, then it would increase the already disproportionately large burden of lottery taxes on the poor. Fortunately, our research finds (...) no evidence to support the contention that advertising is responsible for high rates of lottery participation and expenditures by lower income groups or that low-income groups are more affected by advertising than high-income groups. On the contrary, awareness of lottery advertising seems to be associated with a higher probability to play Lotto only for the middle income group. This means that lottery advertising may actually reduce the regressivity of lottery taxes. (shrink)

This paper argues that proper functions are proximal functions. In other words, it rejects the notion that there are distal biological functions – strictly speaking, distal functions are not functions at all, but simply beneficial effects normally associated with a trait performing its function. Once we rule out distal functions, two further positions become available: dysfunctions are simply failures of proper function, and pathological conditions are dysfunctions. Although elegant and seemingly intuitive, this simple view has had surprisingly little uptake in (...) the literature. Indeed, our position departs from that of almost every theorist who has engaged with the issue at any depth. We start by presenting three arguments for the position that proper functions are proximal: one from the specificity of functions, one from their relation to intervention, and one from their relation to pathology. We then consider two case studies evidencing the trouble that accepting distal functions causes for philosophical reflection on the nature of pathological conditions. Finally, we anticipate and respond to three objections: that there can be failure of function without dysfunction; that our account is unacceptably revisionary in respect of normal function-talk; and that our thesis over-generalises from a narrow set of cases. (shrink)

This article is an introduction to contemporary experimental poetry by women. It considers the reasons for the resistance to such work in this country. It refutes arguments made against it, for example that avant-garde writing is elitist or not related to women's experience. It further suggests why this writing, in particular in its complex engagement with issues of language, subjectivity and gender, should in fact be of great interest to the woman/feminist reader. In particular, it suggests parallels between the concerns (...) of this work and those of feminist poststructuralism. Above all, throughout the piece, it attempts to introduce the ‘provisional pleasures’ of the contemporary avant-garde to the reader, introducing, quoting and providing multiple interpretations of the work of several diverse writers in this tradition. It aims to provide a sense of the linguistic and formal innovations of these writings, alongside a sense of their relevance to questions of female subjectivity and of women's relationship to the dominant discourses of our time. (shrink)

This paper represents an attempt to indicate the idea of a logic slightly more general than sentential calculus, which is applicable to many philosophical issues. In particular, I shall use this generalized calculus to discuss a variation of the logic of imperatives. In part I, certain general considerations about indicative calculi provide the basis, as well as indicate the need, for the more formal construction of part II. Part III illustrates the analytical power of the tool constructed, and tries to (...) show its relevance for philosophy. (shrink)

This essay responds to Donna J. Haraway's (2016) provocation to ‘stay with the trouble’ of learning to live well with nonhumans as kin, through practice-based approaches to learning to care for nonhuman others. The cases examine the promotion of care for trees through mobile game apps for forest conservation, and kinship relations with city farm animals in Kentish Town, London. The cases are analysed with a view to how they articulate care practices as a means of making kin. Two concepts (...) are proposed, ‘learning from’ and ‘facing’ the Other, which are thickened through discussions of how caring takes place in each case in relation to a particular category of nonhuman other: animated tree and urban farm animal. Thus while attendant to situations of care involving a specific nonhuman subject, the cases also broker thinking on learning from and facing (the) other kinds of trees and animals, and the interspecies dynamics of which they are a part. The intersectional implications of the practice sites and participants are elaborated, to complexify and affirm situated but also reflexive approaches to caring. In doing this, the authors attend to their own positionalities, seeking to diversify Western-based ecofeminist engagements with caring, while asking what their research can do for the nonhuman other. They formulate and apply a collaborative methodological approach to the case studies, developed through cultivating attentiveness to the nonhuman subject of research. The authors consider in particular how attentiveness to the nonhuman other can facilitate practices of knowing that further a non-anthropocentric and non-innocent ethic of caring. By further interconnecting situations of caring for nonhuman animals and plants, the authors advocate for practices of care that antagonise how species boundaries are drawn and explore the implications for learning to care for nonhumans as kin. (shrink)

Utilising empirical ethics analysis, we evaluate the merits of systems proposed to increase deceased organ donation in South Africa. We conclude that SA should maintain its soft opt-in policy, and enhance it with ‘required transplant referral’ in order to maximise donor numbers within an ethically and legally acceptable framework. In SA, as is the case worldwide, the demand for donor organs far exceeds the supply thereof. Currently utilising a soft opt-in system, SA faces the challenge of how to increase donor (...) numbers in a context which is imbued with inequalities in access to healthcare, multiplicitous personal beliefs and practices, distrust of organ transplant and varying levels of education and health literacy. We argue that a hard opt-in, opt-out or mandated consent system would be problematic, and we present empirical data from Gauteng Province illustrating barriers to ethically sound practice in soft consent systems. Ultimately, we argue that in spite of some limitations, a soft opt-in system is most realistic for SA because its implementation does not require extensive public education campaigns at national level, and it does not threaten to further erode trust at a clinical level. However, to circumvent some of the clinical-level barriers identified in our empirical study, we propose a contextually sensitive option for “enabling” soft opt-in through “required transplant referral”. We argue that this system is legally defensible, enhances ethical practice and could also increase donor numbers as it has in many other countries. (shrink)

Some see health care as primarily an individual responsibility. Others see it as a public responsibility. Behind these approaches are strong conflicting beliefs about ethical matters, specifically about the kind of good that health care is. On the one side the underlying belief is that health care is no more than an individual good and hence calls for a distributive policy based on the market. On the other side the underlying belief is that it is a public good and hence (...) calls for a distributive policy based on widespread agreement.' There will be intermediate approaches which try with varying success to justify themselves by piecing together beliefs from both sides. I shall explain what is involved in calling something a public good. Then I shall try to show that, if health care is to satisfy some rather plausible criteria, it must have the character of a public good. (shrink)

The Making of a New Rural Order in South China, vol. 2: Merchants, Markets, and Lineages, 1500– 1700. By Joseph P. McDermott. Cambridge: Cambridgr University Press, 2020. Pp. xii + 468. $139 (cloth); $45 (paper).