BackgroundWith advances in sequencing technologies, increasing numbers of people are being informed about a genetic disease identified in their family. In current practice, probands are asked to inform at-risk relatives about the diagnosis. However, previous research has shown that relatives are sometimes not informed due to barriers such as family conflicts. Research on family communication in genetic diseases aims to explore the difficulties encountered in informing relatives and to identify ways to support probands in this.Main bodyResearch on family communication may (...) also reveal that participants did not inform their relatives about the risk of a serious genetic condition, even when preventive and treatment options are available. Researchers may then face a dilemma: Do they need to warn at-risk relatives about the finding? Or do they keep silent due to prior confidentiality agreements with study participants?ConclusionsWe believe that the absolute confidence promised to research participants outweighs the interests of their relatives, even though it can be claimed that relatives at risk of a genetic disease do, in principle, have a right to know information collected about their health. Not respecting confidentiality agreements could cause distrust between researchers and research participants and possibly harm the relationship between probands and relatives. Relatives' health interests can still be taken into account without jeopardizing participant trust, by considering alternative scenarios, including sharing general study findings on the barriers participants experience with their healthcare professionals and by offering participants psychosocial support for family communication. (shrink)

This paper motivates institutional epistemic trust as an important ethical consideration informing the responsible development and implementation of artificial intelligence (AI) technologies (or AI-inclusivity) in healthcare. Drawing on recent literature on epistemic trust and public trust in science, we start by examining the conditions under which we can have institutional epistemic trust in AI-inclusive healthcare systems and their members as providers of medical information and advice. In particular, we discuss that institutional epistemic trust in AI-inclusive healthcare depends, in part, on (...) the reliability of AI-inclusive medical practices and programs, its knowledge and understanding among different stakeholders involved, its effect on epistemic and communicative duties and burdens on medical professionals and, finally, its interaction and alignment with the public’s ethical values and interests as well as background sociopolitical conditions against which AI-inclusive healthcare systems are embedded. To assess the applicability of these conditions, we explore a recent proposal for AI-inclusivity within the Dutch Newborn Screening Program. In doing so, we illustrate the importance, scope, and potential challenges of fostering and maintaining institutional epistemic trust in a context where generating, assessing, and providing reliable and timely screening results for genetic risk is of high priority. Finally, to motivate the general relevance of our discussion and case study, we end with suggestions for strategies, interventions, and measures for AI-inclusivity in healthcare more widely. (shrink)

University students are at elevated risk for psychological distress, especially during the COVID-19 pandemic. The aim of this study was to warmly contact our students and investigate the psychological impact of the COVID-19 pandemic on the subjective wellbeing and levels of psychological symptoms of university students in Belgium. All bachelor and master students of the Vrije Universiteit Brussels were invited for a brief structured telephone interview in March, 2021. In total, 7,154 students were assessed by a structured interview, based on (...) the Kessler Psychological Distress Scale and the Anamnestic Comparative Self-Assessment. Compared to a representative sample, students considered their life during the pandemic as less satisfying compared to their life before the pandemic. Overall, all students have suffered from COVID-19 and the measures taken to contain the pandemic. Twenty percent of our sample of 7,154 VUB students scored above the K6 cutoff, indicating a heightened risk for having a diagnosable mental illness severe enough to cause functional limitations and to require treatment. This study highlights the need for psychological support for all students, during the COVID-19 pandemic. (shrink)

A groundbreaking, deeply personal, magnum opus on madness and philosophy from a psychotic patient turned philosopher.

In In Praise of Theatre, an interview with Alain Badiou held by Nicolas Truong, Badiou answers questions about his ideas on the value and purpose of theatre. He explains that he takes ‘real theatre’ to be theatre that consists of performances that aim at making the members of the audience to reflect critically on what they have just heard or seen and, more importantly, the possibilities that were only implied by the performance. Contrary to disciplines such as philosophy, politics and (...) literature, Badiou argues, theatre is uniquely suited for this purpose, because it takes place in a ‘here and now’ that is shared by performers and audience, which places the audience in a position to ‘grasp the relation between immanence and transcendence from the view of the idea’. In addition, it uses an indirect mode of representation, instead of a direct mode of teaching. While accepting Badiou’s claim that theatre performances form a valuable means to question social conventions by communicating and transforming subjectivity, in this article I will argue that Badiou’s enthusiasm about the possibilities of theatre lead him to exaggerate its uniqueness in relation to philosophy, politics and literature. That is to say, he stretches the differences between these disciplines too far by portraying them as opposites or even rivals. In what follows, I will show for each of the comparisons that Badiou makes between theatre and these other disciplines, that they are founded on a misunderstanding of theatre’s unique position when it comes to transforming subjectivity through communication. (shrink)

The objective of this doctoral dissertation is to interpret the explanation of akrasia that the Dutch philosopher Benedictus Spinoza (1632-1677) gives in his work The Ethics. One is said to act acratically when one intentionally performs an action that one judges to be worse than another action which one believes one might perform instead. In order to interpret Spinoza’s explanation of akrasia, a large part of this dissertation investigates Spinoza’s theory of emotion. The first chapter is introductory and outlines Spinoza’s (...) categorisation of mental states and his conception of the relation between the mind and the body. The second chapter deals with Spinoza’s epistemology and the relation between cognitive mental states and states of the brain. The third chapter argues that Spinoza holds that emotions are non-cognitive mental states that are caused by cognitive mental states. The fourth chapter interprets Spinoza’s discussion of the emotions of Joy and Sadness insofar as they are mental states. The fifth chapter suggests that when Spinoza says that the power of our body is increased or decreased when we are joyful or sad, he means that when we are joyful or sad then, at the same time, our heart and perhaps the organs of our digestive system are affected in such a way that our bodily health is increased or decreased. The sixth chapter points to three problems that concern Spinoza’s definitions of the psychophysical states of pleasure, pain, cheerfulness and melancholy, and offers slightly altered definitions of these states. The seventh chapter interprets the various aspects of Spinoza’s conception of the emotion of Desire, both insofar as it is a state of the mind and insofar it is a state of the body, as well as the relation between the emotion of Desire and man’s striving for self-preservation. The eighth chapter discusses what Spinoza writes on the strength of emotions and the way in which we make value judgments in order to finally interpret why it is, according to Spinoza, that ‘we so often see the better for ourselves but follow the worse’. (shrink)

Neuronal ceroid lipofuscinoses are a group of lethal inherited neurodegenerative disorders in humans and many animal species. Critical reflections on a range of ethical issues concerning NCL have been instigated by my research on sheep and cattle affected with NCL, the claim that these sheep and cattle are useful models for the disease in humans, and engagement with families and support groups. My reflections on moral status of animals and validity of animal models are outlined in this paper.

Philosophy & Social Criticism, Volume 48, Issue 6, Page 904-933, July 2022. In this article, I reconstruct Étienne Balibar’s work against the background of the debate on modern universal citizenship. I argue that universal citizenship is neither fundamentally emancipatory nor fundamentally oppressive but is rather both. In order to defend this position, I build on Balibar’s concept of the “citizen subject.” First, I parse this concept, showing how it allows us to think about the contradictions of modern universal citizenship. In (...) the second section, I elucidate its temporal logic and show how it undermines the telos of modern universal citizenship. In sections three to five, I show how citizenship’s universalism clarifies both its oppressive and its emancipatory thrust. The dialectic of universal citizenship, I argue, unfolds as a conflict between and within political universals. In the conclusion, I will tie up these different strands and end with some reflections on the conditions of possibility of this dialectic. (shrink)

This article’s guiding thesis is that the theory of radical democratic citizenship is built on a tension between a radical, conflictual element and a democratic element. As radical democrats, these philosophers point to the intimate relation between conflict and both emancipation and democracy. But as radical democrats, they also propose different methods that prevent conflict from breaking up the polis—the common ground that makes democratic conflict possible. I look at two radical democrats’ way of dealing with this tension: Chantal Mouffe (...) and Étienne Balibar. My claim is that the former ends up overemphasising the danger of division in her later democratic works and is therefore unable to account for more intense forms of democratic resistance (such as riots). In the work of Balibar, however, we find a way of dealing with this tension. (shrink)

In response to critiques of rights as moralistic and depoliticising, a literature on the political nature and contestability of rights has emerged. In this view, rights are not merely formal, liberal and moralistic imperatives, but can also be invoked by the excluded in a struggle against domination. This article examines the limits to this practice of rights-claiming and its implication in forms of domination. It does this by returning to Marx’s blueprint for the critique of subjective rights. This engagement with (...) Marx will, however, take a particular form. I will read Marx first through the eyes of Claude Lefort and thereafter against Lefort. The latter’s critique of Marx still constitutes the strongest case against the dismissal of subjective rights. Introducing a reading of Lefort into the argument allows us to discover what is dead and what is well alive in the Marxist theory of rights. What is dead, I will argue, is Marx’s early conception of subjective rights as ideology and illusion. However, the more mature Marx developed a theory and critique of the legal form that is able to explain why the politics of rights—despite its undeniable advances—has not been able to overcome certain forms of domination. (shrink)

In this paper I consider emotions as the ability to grasp meaningfulness, understood as an essential component of (social) reality, which is necessary for a rational discourse and which cannot be apprehended by means of a supposedly “sober” approach. I explicitly take into account the socio-cultural situatedness of feeling subjects and put epistemically relevant emotional abilities into perspective. This approach reveals that emotions can also contribute to questioning one’s own world view and to being able to correct it if necessary. (...) The ability tobe affectively disrupted, as I call it, enables one to see the contingency of one’s emotion repertoire and habitualised schemata of grasping meaningfulness. Further, a severe affective disruption can bring about a transformation of one’s emotion repertoire and habitualised schemata, thus permanently altering the subject’s epistemic position and epistemic practice. (shrink)

Many theories of global distributive justice are based on the assumption that all humans hold common ownership of the earth. As the earth is finite and our actions interconnect, we need a system of justice that regulates the potential appropriation of the common earth to ensure fairness. According to these theories, imposing limits and distributive obligations on private and public property arrangements may be the best mechanism for governing common ownership. We present a critique of the assumption that this issue (...) can be solved within the private–public property regime, arguing that the boundaries of this regime should not be taken for granted and that the growing literature on the democratic commons movement suggests how this can be accomplished. We consider that, if the earth is defined as a common, the private– public property paradigm must be open to questioning, and democratic commoners’ activities should be considered. (shrink)

The article advocates the importance of studying conceptual meaning and change in modern mass media and highlights the significance of conceptual intermediality. The article first analyzes anger in Hindi cinema as an audiovisual key concept within the framework of an Indian national ideology. It explores how anger and the Indian angry young man became popularized, politicized, and stereotyped by popular films and print media in India in the 1970s and 1980s. The article goes on to advocate for extending conceptual history (...) beyond language on theoretical grounds and identifies two major obstacles in political iconography: the methodological subordination of visuals to language in the negotiation of meaning, and the distinction of emotion and reason by assigning them functionally to different sign systems. (shrink)

Situated approaches to affectivity overcome an outdated individualistic perspective on emotions by emphasizing the role embodiment and environment play in affective dynamics. Yet, accounts which provide the conceptual toolbox for analyses in the philosophy of emotions do not go far enough. Their focus falls (a) on the present situation, abstracting from the broader historico-cultural context, and (b) on adopting a largely functionalist approach by conceiving of emotions and the environment as resources to be regulated or scaffolds to be used. In (...) this paper, I argue that we need totake situatedness seriously: We need (a) to acknowledge that emotions are not situated in undetermined “contexts” but in concrete socio-culturally specific practices referring to forms of living; and (b) to agree that not only are context and emotionsusedfor the sake of something else but also that the meaning-disclosive dimension of affective intentionality is structured by situatedness as well. To do so, I offer a multidimensional approach to situatedness that integrates the biographical and cultural dimensions of contextualization within the analysis of situated affective dynamics. This approach suggests that humans affectively disclose meaning (together) which is at once product and producer of specific forms of living – and these are always already subjects of (politically relevant) critique. (shrink)

Defensive medicine has become pervasive. Defensive medicine is often thought of as a systems issue, the inevitable result of an adversarial malpractice environment, with consequent focus on system-responses and tort reform. But defensive medicine also has ethical and professionalism implications that should be considered beyond the need for tort reform. This article examines defensive medicine from an ethics and professionalism perspective, showing how defensive medicine is deeply problematic. First, a definition of defensive medicine is offered that describes the essence of (...) defensive practice: clinical actions with the goal of protecting the clinician against litigation or some adverse outcome. Ethical arguments against defensive medicine are considered: defensive medicine is deceptive and undermines patient autonomy; defensive medicine subjugates patient interests to physician interests and violate fiduciary obligations; defensive medicine exposes patients to harm without benefit; defensive medicine undermines trust in the profession; and defensive medicine violates obligations of justice. Possible arguments in favor of defensive medicine are considered and refuted. Defensive practice is therefore unethical and unprofessional, and should be viewed as a challenge for medical ethics and professionalism. (shrink)

In order to explore how emotions contribute positively or negatively to understanding the meaning of complex socio-culturally specific phenomena, I argue that we must take into account the habitual dimension of emotions – i.e., the emotion repertoire that a feeling person acquires in the course of their affective biography. This brings to light a certain form of alignment in relation to affective intentionality that is key to comprehending why humans understand situations in the way they do and why it so (...) often is especially hard to understand things _differently_. A crucial epistemic problem is that subjects often do not even enter a process of understanding, i.e., they do not even start to consider a specific object, theory, circumstance, other being, etc. in different ways than the familiar one. The epistemic problem at issue thus lies in an unquestioned faith in things being right the way they are taken to be. By acknowledging the habitual dimension of affective intentionality, I analyze reasons for this inability and suggest that being affectively disruptable and cultivating a pluralistic emotion repertoire are crucial abilities to overcome this epistemic problem. (shrink)

Bacteria have developed an impressive ability to survive and propagate in highly diverse and changing environments by evolving phenotypic heterogeneity. Phenotypic heterogeneity ensures that a subpopulation is well prepared for environmental changes. The expression bet hedging is commonly (but often incorrectly) used by molecular biologists to describe any observed phenotypic heterogeneity. In evolutionary biology, however, bet hedging denotes a risk‐spreading strategy displayed by isogenic populations that evolved in unpredictably changing environments. Opposed to other survival strategies, bet hedging evolves because the (...) selection environment changes and favours different phenotypes at different times. Consequently, in bet hedging populations all phenotypes perform differently well at any time, depending on the selection pressures present. Moreover, bet hedging is the only strategy in which temporal variance of offspring numbers per individual is minimized. Our paper aims to provide a guide for the correct use of the term bet hedging in molecular biology. (shrink)

The article engages Bakhtin’s corpus with Nietzschean ideas in order to draw out critical resources for the social theory of ‘community’. It begins by considering both thinkers’ debt to neo-Kantianism, and proceeds to relate the ‘will to power’ to Bakhtin’s early intersubjective phenomenology of intentional acts. This interpretation is then extended to Bakhtin’s conception of art, where aesthetics stands in tensile relation to ethics in the exercise of authorial will. Bakhtin’s later work might be seen as elaborating more complex terms (...) for describing will and event, now as composite embodiments of multiple intentions within art, discourse and language, thus suggesting a novel approach to ‘communality’ in modern social life. (shrink)

There can be little doubt about the ethical imperative to ensure adequate vaccination uptake against certain infectious diseases. In the face of vaccine refusal, health authorities and providers instinctively appeal to coercive approaches or increased education as methods to ensure adequate vaccine uptake. Recently, some have argued that public fear around Ebola should be used as an opportunity for such approaches, should an Ebola vaccine become available. In this article, the author describes the difficulties associated with coercion and education when (...) addressing vaccine opposition. Both coercion and education can cause opposite effects than intended in certain circumstances. The correct area of focus is to address the breakdown in trust within clinical relationships. The author presents suggestions for an approach towards vaccine refusal that may be more promising. (shrink)

For many years the prevailing paradigm for medical decision making for children has been the best interest standard. Recently, some authors have proposed that Mill’s “harm principle” should be used to mediate or to replace the best interest standard. This article critically examines the harm principle movement and identifies serious defects within the project of using Mill’s harm principle for medical decision making for children. While the harm principle proponents successfully highlight some difficulties in present-day use of the best interest (...) standard, the use of the harm principle suffers substantial normative and conceptual problems. A medical decision-making framework for children is suggested, grounded in the four principles. It draws on the best interest standard, incorporates concepts of harm, and provides two questions that can act as guide and limit in medical decision making for children. (shrink)

Beneficence is a foundational ethical principle in medicine. To provide benefit to a patient is to promote and protect the patient’s wellbeing, to promote the patient’s interests. But there are different conceptions of wellbeing, emphasizing different values. These conceptions of wellbeing are contrary to one another and give rise to dissimilar ideas of what it means to benefit a patient. This makes the concept of beneficence ambiguous: is a benefit related to the patient’s goals and wishes, or is it a (...) matter of objective criteria that constitute wellbeing? This paper suggests a unified conception of wellbeing for use in medicine to determine what counts as a benefit. Two components of wellbeing are identified: (1) objective functioning/health and (2) the patient’s view of her own good. The paper explores how to apply, balance, and weigh these components in clinical situations to determine what counts as a benefit to a patient. (shrink)

In this paper, we criticize the current focus of the bio-based economy (BBE) on efficiency and control and demonstrate the contradictions that this causes. We elucidate these tensions by comparing the BBE to alternative conceptions of economy that emphasise the relevance of both the human condition and unfathomable nature in the macro ecological transition project. From Emmanuel Levinas’s philosophy, we take and extrapolate two major concepts—il y a and enjoyment—that help to re-evaluate the status of both nature and the human (...) subject involved in environmental instability. From this analysis, we evaluate current economic practice in close relation to the deteriorating environment to contribute to a conception of an economy that is truly based on principles of the biosphere. We conclude that humankind and nature are notions that must be always considered in this encompassing and topical effort and explain how they have been fundamentally overlooked in current thought on the bio-based and circular economy. (shrink)

Bernard Lonergan argued that a Thomist theory of intellect must begin with advertence to the act of understanding. He distinguished his cognitional theory from a conceptualism that neglects the experience of insight and reflection on it. Early in his career, he explained how the conceptualist approach misinterprets Aquinas and creates problems for the metaphysics of rational psychology. This article explains Lonergan’s position and illustrates the conceptualist alternative by analysing Joseph Owens’s view of cognition. By explaining the metaphysical differences between Lonergan’s (...) and Owens’s opposing views of human knowing in relation to their distinctive readings of Aquinas, this article contributes to a more accurate reading of Aquinas on the act of understanding. (shrink)

In an effort to inform the discussion surrounding existential risks from AI, we formulate Extinction-level Goodhart’s Law as “Virtually any goal specification, pursued to the extreme, will result in the extinction of humanity”, and we aim to understand which formal models are suitable for investigating this hypothesis. Note that we remain agnostic as to whether Extinction-level Goodhart’s Law holds or not. As our key contribution, we identify a set of conditions that are necessary for a model that aims to be (...) informative for evaluating specific arguments for Extinction-level Goodhart’s Law. Since each of the conditions seems to significantly contribute to the complexity of the resulting model, formally evaluating the hypothesis might be exceedingly difficult. This raises the possibility that whether the risk of extinction from artificial intelligence is real or not, the underlying dynamics might be invisible to current scientific methods. (shrink)

This work clarifies the role of the best interest standard (BIS) as ethical principle in the medical care of children. It relates the BIS to the ethical framework of medical practice. The BIS is shown to be a general principle in medical ethics, providing grounding to prima facie obligations. The foundational BIS of Kopelman and Buchanan and Brock are reviewed and shown to be in agreement with the BIS here defended. Critics describe the BIS as being too demanding, narrow, opaque, (...) not taking the family into account and not suitable as limiting principle. This work responds to these criticisms, showing that they do not stand up to scrutiny. They either do not apply to the BIS, only apply to misuses of the BIS or criticise a BIS that is not seriously defended in the literature. (shrink)

This article examines an argument which may negatively influence measles vaccination uptake. According to the argument, an individual child in a highly vaccinated society may be better off by being non-vaccinated; the child does not risk vaccine adverse effects and is protected against measles through herd immunity. Firstly, the conclusion of the argument is challenged by showing that herd immunity’s protection is unreliable and inferior to vaccination. Secondly, the logic of the argument is challenged by showing that the argument is (...) inherently self-defeating and therefore logically inconsistent. In practice the argument cannot be used to protect children against measles. Measles vaccination is undoubtedly best for children, even in highly vaccinated societies. Only if a medical contraindication to vaccination exists should vaccination be waived in favour of reliance on herd immunity. This places obligations on those who stand in care relationships with the child: parents, healthcare providers, and the state. (shrink)

In this paper, we explore a rationalistic orientation in Western society. We suggest that this orientation is one of the predominant ways in which Western society tends to frame, understand and deal with a majority of problems and questions – namely in terms of mathematical analysis, calculation and quantification, relying on logic, numbers, and statistics. Our main goal in this paper is to uncover the affective structure of this rationalistic orientation. In doing so, we illustrate how this orientation structures the (...) way not only individuals but society as a whole frames and solves problems. We firstly point towards some exemplary instances of the rationalistic orientation, specifically regarding science, society, and lifeworld practice. Crucially, we argue that the rationalistic orientation is not merely based on a set of beliefs we could easily correct; but rather, that it is an affective condition tacitly shaping our engagement with the world in an encompassing way. Relating to the work of Martin Heidegger, we argue that what we have called an orientation in the beginning is in fact a rationalistic attunement. This attunement fundamentally shapes the pre-reflective level of how individuals approach the world. We elaborate this claim by showing how the rationalistic attunement concretely manifests in tangible socio-material affect dynamics. In the end, we motivate a critical stance towards this attunement, providing the ability to reflect upon and question instances where this way of framing and solving problems is counterproductive. (shrink)