Providing in-utero treatments to target specific conditions in the fetus is a relatively new approach in perinatal care, with the vast majority of these treatments being used off-label. The high degree of off-label medication use in the perinatal and neonatal settings raises concern for the safety of both the fetuses and expectant mothers. This report presents two examples of intra-amniotic drug administration based on reported clinical cases. From the ethical framework of medical principlism, we examine the competing ethical duties of (...) autonomy, beneficence, and non-maleficence in this setting. We then lay out three fundamental ethical principles for obtaining informed consent and maximizing clinical benefit. (shrink)

This essay examines the thought that our right actions have moral worth only if we perform them for the right reasons. It argues against the view, often ascribed to Kant, that morally worthy actions must be performed because they are right and argues that Kantians and others ought instead to accept the view that morally worthy actions are those performed for the reasons why they are right. In other words, morally worthy actions are those for which the reasons why they (...) were performed (the reasons motivating them) and the reasons why they morally ought to have been performed (the reasons morally justifying them) coincide. The essay calls this the Coincident Reasons Thesis and argues that it provides plausible necessary and sufficient conditions for morally worthy action, defending the claim against proposed counterexamples. It ends by showing that the plausibility of the thesis, which it argues is largely independent of any particular ethical standpoint, gives us some reason to doubt a class of ethical theories that includes utilitarianism. (shrink)

This essay explores the question of how to be good. My starting point is a thesis about moral worth that I’ve defended in the past: roughly, that an action is morally worthy if and only it is performed for the reasons why it is right. While I think that account gets at one important sense of moral goodness, I argue here that it fails to capture several ways of being worthy of admiration on moral grounds. Moral goodness is more multi-faceted. (...) My title is intended to capture that multi-facetedness: the essay examines saintliness, heroism, and sagacity. The variety of our common-sense moral ideals underscores the inadequacy of any one account of moral admirableness, and I hope to illuminate the distinct roles these ideals play in our everyday understanding of goodness. Along the way, I give an account of what makes actions heroic, of whether such actions are supererogatory, and of what, if anything, is wrong with moral deference. At the close of the essay, I begin to explore the flipside of these ideals: villainy. (shrink)

Discussions about the morality of slavery are a central part of the history of early modern philosophy. This book explores the philosophical ideas, theories, and arguments that occur in eighteenth-century debates about slavery, with a particular focus on the role that race plays in these debates. This exploration reveals how closely Blackness and slavery had come to be associated and how common it was to believe that Black people are natural slaves, or naturally destined for slavery. The book examines not (...) just well-known authors like David Hume, Immanuel Kant, and Jean-Jacques Rousseau, but also less widely studied philosophers like Quobna Ottobah Cugoano, Lemuel Haynes, and Olympe de Gouges. By presenting philosophically important aspects of debates about slavery in eighteenth-century North America and Europe, the book aims to be a valuable resource for scholars, instructors, and students who are curious about a topic that historians of philosophy have so far neglected. (shrink)

Much ink has been spilled in the last years on whether voting is a duty that citizens ought to discharge in a democracy that aspires to be acceptably just. In this essay, I concentrate on whether a moral duty to participate in elections logically entails that people ought to vote simpliciter or well. I propose that voting well – i.e. with information and a sense of justice – is the electoral duty that we should value. Voting as such is not (...) – at least, not if we care about the substantive quality of democratic outcomes, not only about equality of participation. As a matter of fact, voting well seems to be a more adequate form of political participation than simply voting under varied normative conceptions of democracy, as I will show. At the same time, while we can't freely choose not to follow a moral duty to vote well just because we're not inclined to do so, we have to allow for the possibility that some individuals will not be in a good position to act on it. I conclude by discussing admissible reasons for this inability with respect to our citizenship responsibilities. (shrink)

What attitudes can we rationally take towards our philosophical views? In this paper, I offer a novel answer to this question that draws on the distinction between transitional and terminal attitudes (Staffel 2019). Terminal attitudes are the kinds of attitudes, such as beliefs and credences, that we form as conclusions of reasoning processes. Transitional attitudes, by contrast, are attitudes we form during ongoing deliberations, before we settle on an opinion about how our information bears on the question of interest. I (...) argue that we can rationally hold terminal attitudes towards local philosophical claims, but not global ones. Only transitional attitudes can be rationally held towards global philosophical claims, at least in most cases. (shrink)

The indexical thesis says that the indexical terms, “I”, “here” and “now” necessarily refer to the person, place and time of utterance, respectively, with the result that the sentence, “I am here now” cannot express a false proposition. Gerald Vision offers supposed counter-examples: he says, “I am here now”, while pointing to the wrong place on a map; or he says it in a note he puts in the kitchen for his wife so she’ll know he’s home even though he’s (...) gone upstairs for a nap, but then he leaves the house, forgetting to remove the note. The first sentence is false by virtue of “here” not necessarily referring to the place of utterance, the second sentence, by virtue of “now” not necessarily referring to the time of utterance. We argue that these sentences express falsehoods only because the terms are being used demonstratively, not indexically – the distinction pertains not to words simpliciter, but to uses of words. When used indexically, the terms refer in accord with the indexical thesis; but when used demonstratively, their referents depend on how devices of ostension are used with their utterance – pointings, and the like. Thus Vision’s first sentence really says, “I am there now”, referring to the place on the map the finger is pointing to. As for his second sentence, we distinguish the time of utterance or production of a sentence from the time of its uptake. Due to the pragmatics of interpretation, the sentence really says “I” – the person ‘uttering’ the note – “am here” – here where the note is, with the note serving as a kind of proxy ‘finger’ – “now” – where “now” refers to the time of uptake of the note, i.e., when it is read. “I” refers indexically, “here”, demonstratively, and “now”, indexically, but indexically to the time of uptake. Since the sentence is not purely indexical, its falsehood doesn’t threaten the indexical thesis. A similar treatment is given of teletyped messages about the typer’s location. (shrink)

This article documents a moment in history when poor and working-class white boys and men are struggling in their schools, communities, and workplaces against the “Other” as a means of framing identities. Drawing on two independent qualitative studies, the authors investigate distinct locations where poor and working-class boys and men invent, relate to, and distance from marginalized groups in an effort to create self. First the authors look at an ethnography of “the Freeway boys,” a community of urban white working-class (...) high school boys who must deal with the economic ravagement of their neighborhood and their insecure place in a world different than that of their fathers. Next, the authors draw from a large-scale survey of young adults to hear how a combined sample of urban poor and working-class white men narrate identities that are carved explicitly out of territory bordered by white women and African American men. Across sites, the authors theorize how high schools and workplaces both, in part, create white masculinities and interrupt them, at a time when white working-class boys and men feel under siege. (shrink)

This article examines why firms engage in Corporate Social Responsibility (CSR). Specifically, it investigates the relationship between a firm's motivation to engage in CSR and the depth of its commitment. I propose that the enduring debate over CSR and financial performance is misaligned, and that scholars should instead focus on the underlying components of CSR engagement. This research sheds light on the motivational antecedents of a firm's engagement in CSR and their effect on CSR commitment. Despite calls for scientific investigation (...) of this linkage, it has received scant attention in the literature. Pursuing this area of research requires the construction of measures of CSR motivation and CSR commitment, as prior work generally lacks objective analysis. I present measures and a research methodology that test hypotheses about how CSR motivation relates to different levels of CSR commitment. The results of this research both validate and challenge current theory. This refined understanding of CSR engagement may enhance firm transparency and accountability to stakeholders. It may reduce the uncertainty in both internal and external assessments of firm CSR and the potential for social and financial impact. (shrink)

Studies of linguistic synaesthesias in English have shown a range of fine-grained language mechanisms governing the associations between colours on the one hand, and graphemes, phonemes and words on the other. However, virtually nothing is known about how synaesthetic colouring might operate in non-alphabetic systems. The current study shows how synaesthetic speakers of Mandarin Chinese come to colour the logographic units of their language. Both native and non-native Chinese speakers experienced synaesthetic colours for characters, and for words spelled in the (...) Chinese spelling systems of Pinyin and Bopomo. We assessed the influences of lexical tone and Pinyin/Bopomo spelling and showed that synaesthetic colours are assigned to Chinese words in a non-random fashion. Our data show that Chinese-speaking synaesthetes with very different native languages can exhibit both differences and similarities in the ways in which they come to colour their Chinese words. (shrink)

Sharply in focus in the United States right now is the disproportionate COVID‐19 infection, hospitalization, and mortality rates of Black, Indigenous, Hispanic, and Pacific Islanders living in the United States in contrast to White people. These COVID‐19 disparities are but one example of how systemic racism filters into health outcomes for many Black, Indigenous, and other People of Color (BIPOC). With these issues front and center, more attention is being given to the ways that White medical professionals contribute to these (...) disparities, including their socialization to ignore or deny inequities. As such, the present study sought to understand how educating White health‐care pre‐professionals about systemic racism might influence their understanding of and responsibility for disrupting White supremacy. Data were drawn from 49 White‐identified nursing students who participated in a mapping project that uncovered instantiations of systemic racism in the United States. Participant written reflections were analyzed using thematic analysis. Findings revealed that mapping projects can develop White people's knowledge and understanding of systemic racism. We introduce the construct, transformative dissonant encounters, to describe how this project precipitated shifts in world view necessary for White people to confront systemic racism. Implications for nursing educators, psychological researchers, and antiracist activists are discussed. (shrink)

ZusammenfassungDer Artikel greift die Überlegung auf, dass sich die Bioethik auch deshalb der empirischen Forschung zuwenden solle, um ihre Anwendbarkeit und Kontextsensitivität zu erhöhen. Am Beispiel der Norm, dass Schmerzen zu lindern seien, und mit Hilfe eines allgemeinen Modells ethischer Urteilsbildung werden verschiedene Bedeutungen der Anwendung und der Kontextsensitivität unterschieden und es wird untersucht, welche Rolle deskriptive Annahmen hierbei jeweils spielen können. Es wird die These vertreten, dass Kontextsensitivität in den meisten ihrer Bedeutungen von fundamentalethischen Grundannahmen unabhängig ist und dass (...) deskriptive Annahmen einen Prozess der Spezifikation ethischer Urteilsbildung auslösen, der in dieser Form nicht von der ethischen Begründung von Normen und Werten aus initiiert und antizipiert werden kann, jedoch zu seinem (zumindest vorübergehenden) handlungsorientierenden Abschluss auf diese zurückverwiesen ist. (shrink)

Until relatively recently, researchers believed that synaesthetic sensations and their triggers were arbitrarily paired, and entirely idiosyncratic from one synaesthete to the next. Put differently, they believed that no two synaesthetes would have similar experiences from the same set of triggers, unless this had occurred by chance. This position likely arose because, prior to the internet, it was extremely difficult to recruit more than a small handful of synaesthete participants, and on the surface, synaesthetes do tend to disagree on their (...) associations when compared one-on-one. However, recent advances in communication have allowed researchers access to far larger groups of synaesthete participants, and this has changed our opinion about how similar synaesthetes might in fact be. A dedicated body of research has now shown that synaesthetic associations are built, to some extent, on a set of unconscious 'rules', shared across synaesthetes. These rules dictate the choice of sensation for certain triggers, and allow us to see patterns emerging which, although not absolute, provide a type of coherence across synaesthetes as a whole. I shall also show that some of these underlying rules operate in the population at large, to allow all individuals to make intuitive pairings across the senses. This chapter describes some of these rules, across a range of different modalities, and across different variants of synaesthesia. (shrink)

Our sense of obligation is evident outside of joint collaborative activities. Most notably, children and adults recognize that parents are obligated to care for and love their children. This is presumably not because we think parents view their children as worthy cooperative partners, but because special obligations and duties are inherent in certain relational dynamics, namely the parent-child relationship.

ABSTRACTReceived wisdom in most democracies is that voting should be seen as a political freedom that citizens have a right to exercise at their discretion. But I propose that we have a duty to vote, albeit a duty to vote well: with knowledge and a sense of impartiality. Fulfillment of this obligation would contribute to the epistemic advantages of democracy, and would thereby instantiate the duty to promote and support just institutions.

This paper critically explores the way in which ‘trafficking’ has been framed as a problem involving organized criminals and ‘sex slaves’, noting that this approach obscures both the relationship between migration policy and ‘trafficking’, and that between prostitution policy and forced labour in the sex sector. Focusing on the UK, it argues that far from representing a step forward in terms of securing rights and protections for those who are subject to exploitative employment relations and poor working conditions in the (...) sex trade, the current policy emphasis on sex slaves and ‘victims of trafficking’ limits the state's obligations towards them. (shrink)

This essay critically explores contemporary Euro-American feminist debate on prostitution. It argues that to develop analyses relevant to the experience of more than just a small minority of “First World” women, those who are concerned with prostitution as a form of work need to look beyond liberal discourse on property and contractual consent for ways of conceptualizing the rights and wrongs of “sex work.”.

The politics of precarity have emerged on the contemporary scene of critical theory with great social force in recent years. This paper looks at the risks and obstacles of positing precariousness and vulnerability as the basis of a universal ethics while also arguing for the socially transformative potential of such a model. More broadly, it considers the crucial question of what stands in the way of human relation and ethical life in an age of neoliberalism and biopolitics, and posits an (...) ethics of resemblance grounded in the commonality of flesh and in the at once singular and universal experience of loss. (shrink)

This paper examines whether certain workers have a moral claim to decent wages for work that contributes to the social surplus in a fundamental way. This "fundamental" way refers to work whose fruits other members of society need to live acceptably good lives (not maximally good ones). The paper argues that what is due to this type of worker is based on the nature of the benefit that her labor produces for others in society and on the returned value that (...) such labor should, by virtue of fair play considerations, command. The core of the argument in the paper is that such benefit is connected to an important dimension of human freedom, which is enabled by the absence of necessity to toil to secure subsistence in society. The paper also dwells on questions related to whose responsibility it should be to guarantee decent pay for contributions to society. (shrink)

This commentary on Elinor Mason’s _Ways to be Blameworthy_ considers Mason’s proposed reflexivity constraint on ordinary blame- and praiseworthy action. I argue that the reflexivity constraint leaves too many intuitively apt targets of praise and blame out of the reach of those attitudes, and the availability of their detached counterparts does not make up for this. I also suggest that Mason’s case for the constraint is open to question. This gives us reasons to prefer a moral concern account of ordinary (...) or communicative praise- and blameworthiness, an account that does not include a reflexivity constraint. Finally, I argue that the moral concern view has more resources to explain some of the nuances and complexities of our practice of moral judgment than Mason allows—nuances Mason turned to pluralism to capture. (shrink)

Per definition business sustainability demands the integration of environmental, social, and economic outcomes. Yet, managerial decision-making involving sustainability objectives is fraught with tension and the way managerial decision-makers frame sustainability issues in their mindset influences how sustainability tensions are managed at the organisational level. In the bid to better understand what types of managerial mindsets, or cognitive frames, foster integrative business sustainability practices that simultaneously advance environmental, social, and economic objectives, extant research has focussed on the underlying logics that drive (...) the acknowledgement of sustainability tensions. However, the existing logics-based constructs do not sufficiently explain this link, and it has been suggested that managers perceive and manage sustainability tensions based on the values that they hold. To clarify the roles of managerial values and logics as antecedents in business sustainability decision-making, we integrate Keeney’s value-focussed thinking approach with managerial and organisational cognition perspectives. Drawing on data from a survey with 169 senior procurement managers in Australia we found three types of cognitive frames which demonstrate that stronger sustainability values are associated with a more holistic perception of sustainability tensions and vice versa. We also found that managers’ cognitive framing of sustainability is strengthened by more holistic organisational cognitive frames and discuss according implications for managerial decision-making in theory and practice. (shrink)

Theories of reasons and other normativia can seem to lead ineluctably to a tragic dilemma. They can be personal but parochial if they locate reasons in features of the point of view of actual people. Or they can be objective but alien if they take reasons to be mind-independent fixtures of the universe. Kantian constructivism tries to offer the best of both worlds: an account of normative authority anchored in the evaluative perspectives of actual agents but refined by a procedure (...) that guarantees certain principles, like the moral law, will have universal and unconditional authority. This chapter considers motivations for such a view and chronicles the intrepid efforts of its adherents to make good on this guarantee - to show that the structure of practical reason commits reasoners to morality. -/- . (shrink)

Staging and stratification are two diagnostic approaches that have introduced a more dynamic outlook on the development of diseases, thus participating in blurring the line between the normal and the pathological. First, diagnostic staging, aiming to capture how diseases evolve in time and/or space through identifiable and gradually more severe stages, may be said to lean on an underlying assumption of “temporal determinism”. Stratification, on the other hand, allows for the identification of various prognostic or predictive subgroups based on specific (...) markers, relying on a more “mechanistic” or “statistical” form of determinism. There are two medical fields in which these developments have played a significant role and have given rise to sometimes profound nosological transformations: oncology and psychiatry. Drawing on examples from these two fields, this paper aims to provide much needed conceptual clarifications on both staging and stratification in order to outline how several epistemological and ethical issues may, in turn, arise. We argue that diagnostic staging ought to be detached from the assumption of temporal determinism, though it should still play an essential role in adapting interventions to stage. In doing so, it would help counterbalance stratification’s own epistemological and ethical shortcomings. In this sense, the reflections and propositions developed in psychiatry can offer invaluable insights regarding how adopting a more transdiagnostic and cross-cutting perspective on temporality and disease dynamics may help combine both staging and stratification in clinical practice. (shrink)

Julián Marías abordó, a finales de los años ochenta, la tarea de narrar tres cuartos de siglo de su vida en estas Memorias, ahora recuperadas en un solo volumen.

This article presents Mencius' concept of human dignity in the Chinese Confucian moral tradition, focused on the context of long-term care. The double nature of Mencius' notion of human dignity as an intrinsic quality of human beings qua being human is analyzed and contrasted with the dominant Western account of human dignity as grounded in personhood. Drawing on the heuristic force of an interview with an elder person in Hong Kong, the insights of the Mencian theory of human dignity are (...) used to provide a moral foundation for long-term care for elder persons in a context of diminishing personhood and shrinking autonomy. (shrink)

© JNCCN-Journal of the National Comprehensive Cancer Network.Background: Next-generation tumor sequencing panels, which include multiple established and novel targets across cancers, are emerging in oncology practice, but lack formal positive coverage by US payers. Lack of coverage may impact access and adoption. This study identified challenges of NGTS coverage by private payers.Methods: We conducted semi-structured interviews with 14 NGTS experts on potential NGTS benefits, and with 10 major payers, representing more than 125,000,000 enrollees, on NGTS coverage considerations. We used the (...) framework approach of qualitative research for study design and thematic analyses and simple frequencies to further describe findings.Results: All interviewed payers see potential NGTS benefits, but all noted challenges to formal coverage: 80% state that inherent features of NGTS do not fit the medical necessity definition required for coverage, 70% view NGTS as a bundle of targets versus comprehensive tumor characterization and may evaluate each target individually, and 70% express skepticism regarding new evidence methods proposed for NGTS. Fifty percent of payers expressed sufficient concerns about NGTS adoption and implementation that will preclude their ability to issue positive coverage policies.Conclusions: Payers perceive that NGTS holds significant promise but, in its current form, poses disruptive challenges to coverage policy frameworks. Proactive multidisciplinary efforts to define the direction for NGTS development, evidence generation, and incorporation into coverage policy are necessary to realize its promise and provide patient access. This study contributes to current literature, as possibly the first study to directly interview US payers on NGTS coverage and reimbursement. (shrink)