Endosex, in contrast to intersex, refers to innate physical sex characteristics judged to fall within the broad range of what is considered normative or typical for ‘binary’ female or male bodies by the medical field, or to persons with such characteristics1 (p. 437). In this short contribution, we explain the origins and increasing use of this little-known term and discuss its practical and ethical relevance to medicine as well as to scholarship from a range of disciplines concerned with individuals’ sexed (...) embodiment. There is growing awareness in many quarters of the term intersex— used within some discourses to refer to clusters of bodily attributes (as in ‘intersex traits’, also termed differences of sex development or variations of sex characteristics)1 or more broadly to persons (as in ‘intersex persons’) whose bodily attributes differ from the dominant clinical, biological, or legal paradigms that categorise and differentiate female and male bodies. Intersex traits have historically been stigmatised as monstrous, morbid or tragic, justifying surgical and hormonal ‘fixing’.2 Persons born with the attributes named with these terms, even if physically healthy, therefore risk unnecessary pathologisation and medicalisation, prompting interventions, often non-voluntary, into their bodies to make them appear or function in ways that are deemed more typically female or male. In addition, some legal and social systems automatically associate persons with these traits with third categories of sex—neither female nor male—which may or may not align with their sex designation at birth, sex of rearing, personal experience or self-conception (see Coda). Being seen as intersex or being judged to have …. (shrink)

Proposed educational outcomes for the health humanities in medical education range from empathy to visual thinking skills to social accountability. This lack of widely agreed-upon high-level curricular goals limits humanities educators’ ability to design purposeful curricula toward clear, common ends and threatens justifications for scarce curricular time. We propose a novel approach to the hoped-for outcomes of health humanities training in medical schools, which has the potential to encompass traditional health humanities knowledge, skills, and behaviors while also being concrete and (...) measurable: humanistic practice. Humanistic practice, adapted from the concept of ethical sensitivity, is an intentional process of applying humanities knowledge and skills to a clinical scenario by 1) noticing that the scenario requires humanities knowledge or skills, 2) informing one’s clinical and interpersonal strategy and behavior with humanities knowledge or skills, 3) reflecting on the effectiveness of the strategy and behavior, and 4) reorienting to develop new approaches for future practice. The construct of humanistic practice may help address some of the foundational problems in health humanities outcomes research since it transcends the traditional diverse content domains in the health humanities, can link patient and provider experiences, and may bridge the divide among the additive, curative, and intrinsic epistemic positions of humanities to medical education. (shrink)

The Ebola epidemic that broke out inWest Africa West AfricaAfrica towards the end of 2013 had been brought under reasonable control by 2015. The epidemic had severely affected three countries. This case study is about a phase I/II clinical trial Phase I/II clinical trial of a candidate Ebola virus vaccine in 2015 in a sub-Saharan AfricanSub-Saharan Africa country which had not registered any cases of the Ebola virus disease. The study was designed as a randomized double-blinded trialRandomized double blinded trial. (...) It was sponsored and funded by one of the biggest Northern multinational pharmaceutical companiesPharmaceutical companies. The protocol received ethics clearance from the relevantNational Ethics Committee national ethics committeeEthics committee. The study was coordinated and managed at the local branch of a big Northern diagnostic laboratoryDiagnostic laboratory and a laboratory of a local regional hospital. The overall study was a multi-countryMulti-country, multi-siteMulti-site trial aimed at recruiting a total of 3,000 research participantsResearch participants across four or five sub-Saharan African countries. For this country, the recruitmentRecruitment sites were two big cities, each aiming to recruit 200 participants: adults at the first site and childrenChildren at the second. The target sampleSample size was almost achieved at the first site but, before the study commenced at the second site, some members of raised the alarm that the governmentGovernment was carelessly risking the health, safetySafety and lives of citizens in the cause of an unproven vaccine that could precipitate a public health disaster. The trial was immediately suspended. A commentary on this case, and on the importance of trustTrust, is provided by Katharine Browne and Doris Schroeder at the end of this chapter. It highlights differences between this case and a phase I Ebola vaccine trial in CanadaCanada in 2014. (shrink)

: In this essay, I contend that feminist theories of citizenship in the U.S. context must go beyond simply acknowledging the importance of race and grapple explicitly with the legacies of slavery. To sketch this case, I draw upon W.E.B. Du Bois's "The Damnation of Women," which explores the significance for all Americans of African American women's sexual, economic, and political lives under slavery and in its aftermath.

Our gender identity is our sense of ourselves as a woman, a man, as genderqueer, or as another gender. Our gender is the property we have of being a woman, being a man, being non-binary, or being another gender. What is the relationship between our gender identity and our gender? Recently, much work has been done on ameliorative accounts of the gender concepts that we should accept and on the metaphysics of gender properties. From this work 4 views of the (...) relationship between having gender identity G (e.g. having a female gender identity) and being a gender G (e.g. being a woman) have emerged. A first, the no connection view, says that gender identity and gender are entirely distinct; Sally Haslanger’s ameliorative account of gender, as well as Theodore Bach’s account of gender properties, are instances of this view. A second, the gender-identity-first view, says that all there is to our gender is our gender identity; this view is at least similar to views that Talia Bettcher and R.A. Briggs and B.R. George have argued for. A third, contextualist view, says that in some contexts and relative to certain standards, our gender identity determines our gender, and that in others it does not; Ásta and Robin Dembroff have proposed and defended views along these lines. A fourth view, the two gender properties view, says that there are two properties that can make it the case that one is gender G (in any context), one’s having gender identity G and one’s being socially classed as a G; Katharine Jenkins and Elizabeth Barnes have proposed views along these lines. This article explains these 4 different views and spells out their prospects, and the problems they face, as both ameliorative and as metaphysical views. (shrink)

When it comes to using patient data from the National Health Service for research, we are often told that it is a matter of trust: we need to trust, we need to build trust, we need to restore trust. Various policy papers and reports articulate and develop these ideas and make very important contributions to public dialogue on the trustworthiness of our research institutions. But these documents and policies are apparently constructed with little sustained reflection on the nature of trust (...) and trustworthiness, and therefore are missing important features that matter for how we manage concerns related to trust. We suggest that what we mean by ‘trust’ and ‘trustworthiness’ matters and should affect the policies and guidance that govern data sharing in the NHS. We offer a number of initial, general reflections on the way in which some of these features might affect our approach to principles, policies and strategies that are related to sharing patient data for research. This paper is the outcome of a ‘public ethics’ coproduction activity which involved members of the public and two academic ethicists. Our task was to consider collectively the accounts of trust developed by philosophers as they applied in the context of the NHS and to coproduce an argumentative position relevant to this context. (shrink)

The major contributions of operationism have been negative, largely because operationists failed to distinguish logical theories of reference from empirical accounts of language. Behaviorism never finished an adequate formulation of verbal reports and therefore could not convincingly embrace subjective terms. But verbal responses to private stimuli can arise as social products through the contingencies of reinforcement arranged by verbal communities.

In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...) to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address. Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice. The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …. (shrink)

Between Saying and Doing aims to reconcile pragmatism with analytic philosophy. It investigates the relations between the meaning of linguistic expressions and their use. Giving due weight both to what one has to do in order to count as saying various things and to what one needs to say in order to specify those doings, makes it possible to shed new light on the relations between semantics and pragmatics. Among the vocabularies whose interrelated use and meaning are considered are: logical, (...) indexical, modal, normative, and intentional vocabulary. As the argument proceeds, new ways of thinking about the classic analytic core programs of empiricism, naturalism, and functionalism are offered, as well as novel insights about the ideas of artificial intelligence, the nature of logic, and intentional relations between subjects and objects. (shrink)

_The VaKE Handbook: Theory and Practice of Values and Knowledge Education_ presents a theoretical model and many examples in various fields of education and training for the realization of the principle "Values without knowledge are blind, while knowledge without values is irresponsible".

Daniel Dennett is arguably one of the most influential yet radical philosophers in America today. In this volume, Dennett is confronted by colleagues and critics, from philosophy, biology and psychology. His reply constitutes an extensive essay which clarifies, and develops further, central themes in his philosophy. The debate ranges over Dennett's whole corpus, but special attention is given to his major work on consciousness, Consciousness Explained. The volume includes a critical assessement of Dennett's views on behaviouralism and the subjectivity of (...) consciousness, the nature of perception and mental representation, intentional laws and computational psychology, the rationality of thought, culture as a virus, the architecture of mind, and the role of artifacts in thinking. Also included is an introduction to Dennett's philosophy and a full bibliography of his publications. (shrink)

The main result of this paper is Theorem 3.1 which is a criterion for weak o-minimality of a linearly ordered structure in terms of realizations of 1-types. Here we also prove some other properties of weakly o-minimal structures. In particular, we characterize all weakly o-minimal linear orderings in the signature $\{ . Moreover, we present a criterion for density of isolated types of a weakly o-minimal theory. Lastly, at the end of the paper we present some remarks on the Exchange (...) Principle for algebraic closure in a weakly o-minimal structure. (shrink)

There is currently a debate over whether cognitive architecture is classical or connectionist in nature. One finds the following three comparisons between classical architecture and connectionist architecture made in the pro-connectionist literature in this debate: (1) connectionist architecture is neurally plausible and classical architecture is not; (2) connectionist architecture is far better suited to model pattern recognition capacities than is classical architecture; and (3) connectionist architecture is far better suited to model the acquisition of pattern recognition capacities by learning than (...) is classical architecture. If true, (1)-(3) would yield a compelling case against the view that cognitive architecture is classical, and would offer some reason to think that cognitive architecture may be connectionist. We first present the case for (1)-(3) in the very words of connectionist enthusiasts. We then argue that the currently available evidence fails to support any of (1)-(3). (shrink)

La femme s'entête répond à La Femme sans tête (dite aussi Femme 100 têtes) de Max Ernst : loin de répéter les mêmes palinodies sur la créativité féminine (bridée, ou exaltée par le surréalisme), elle s'entête, passionnée tout en refusant la polémique à comprendre et à décrire. Voici donc, abondamment illustrés, un riche outil de travail et une série de portraits, souvent totalement inédits, d'artistes et d'écrivains.