In lieu of an abstract, here is a brief excerpt of the content:Eudora Welty House & GardenJessica RussellIf the past year had one theme, it would have been the gift of friendship. How heartening to reunite with fellow admirers of Eudora Welty on the grounds of her family home as our flagship events made their post-pandemic returns. Even so, among staff, 2022 brought challenges that, while unexpected, served to deepen our commitment to our mission and each other. Moreover, for every (...) achievement to follow in this report, there is a friendship to thank—whether with the Eudora Welty Foundation, our colleagues at the Mississippi Department of Archives & History (MDAH), individual volunteers, or community partners too numerous to list—each one a treasured marvel. For, in Eudora Welty's words, "as is true of all friendships, it might not have happened—and it did."Although we were saddened to say goodbye to our dear friend and former director Lauren Rhoades, to our delight she has returned time and again, as a volunteer, a guest, and even a guest speaker. Most impactful, Rhoades now supports sites like ours in an official capacity as the new director of grants at the Mississippi Arts Commission, where she connects arts-based organizations with potential funding opportunities. In this role, Rhoades informed the Eudora Welty Foundation about the Building Fund for the Arts Grant, to which they successfully applied. Because of this very grant, we can make perhaps our biggest announcement of 2022, which is that the Eudora Welty Foundation will break ground on the much-needed community arts building behind our Visitor Center. The report in this volume by the Foundation, which is supervising construction, contains more details on this exciting development.After Rhoades's departure, I had the great honor of transitioning to director. By December, we welcomed Lauren Claret to fill my former role as Garden Projects Specialist, ending a lengthy staff shortage. We even grew our team, adding Mary Atchley as a part-time Visitor Center Associate to handle our gift shop and ticket sales. All the while, my seasoned colleagues, Special Projects Coordinator Rachel Lott, and Education Specialist Jennifer [End Page 189] Rose, continued to shine in their respective roles: Lott coordinates volunteers and plans exhibits, events, and social media. Rose leads educational programs for students of all ages, in groups large and small, onsite and away.With such a small team, our museum depends heavily on volunteers to lead house tours and maintain the Welty garden, and recruiting new volunteers is our greatest need as we look ahead to 2023. We saw a precipitous drop in volunteers at the onset of the pandemic. Although visitation has started a noticeable rise, volunteer numbers have not yet picked up. (On that note, if you or someone you know is interested in becoming a Welty House volunteer, please email [email protected].) To each of our house docents and Cereus Weeders, we say a heartfelt "thank you."Fortunately, we had the support of two interns last fall. Victoria Richard (Millsaps College, via the Eudora Welty Foundation) led Welty House tours and updated our digital plant records database with an emphasis on the rose collection. Meanwhile, Nikki Maxwell (University of Southern Mississippi, via MDAH) worked primarily off-site with the MDAH Eudora Welty Collection, noting the numerous references to gardening in the recently unsealed Welty family papers.The annual teachers' CEU workshop took place virtually in February of 2022, comparing the works of Welty and Poe. Michael Pickard, Associate Professor of English and Creative Writing at Millsaps College, and Millsaps College Professor emerita Suzanne Marrs, led the course, and they will do so again on February 24, 2023—this time in person at the Eudora Welty House & Garden Visitor Center—comparing the work of Welty and Nathaniel Hawthorne. Thanks to support from MDAH and the Eudora Welty Foundation, teachers may attend the 2023 workshop at no charge.The in-person return of the Mississippi Book Festival in 2022 made for an exciting weekend in late August, when museum staff treated 110 festival panelists to private tours of the Welty House and Garden. We spent the next day seeing old friends, and making new ones, as 500 fellow book lovers visited our booth at the... (shrink)

Background Despite the growth of biomedical research in South Africa, there are few insights into the operation of Research Ethics Committees (RECs) in this setting. We investigated the composition, operations and training needs of health RECs in South Africa against the backdrop of national and international guidelines. Methods The 12 major health RECs in South Africa were surveyed using semi-structured questionnaires that investigated the composition and functions of each REC as well as the operational issues facing committees. Results Health RECs (...) in SA have an average of 16 members and REC members are predominantly male and white. Overall, there was a large discrepancy in findings between under-resourced RECs and well resourced RECs. The majority of members (56%) are scientists or clinicians who are typically affiliated to the same institution as the health REC. Community representatives account for only 8% of membership. Training needs for health REC members varied widely. Conclusion Most major health RECs in South Africa are well organized given the resource constraints that exist in relation to research ethics in developing countries. However, the gender, racial and occupational diversity of most of these RECs is suboptimal, and most RECs are not constituted in accordance with South African guidelines. Variability in the operations and training needs of RECs is a reflection of apartheid-entrenched influences in tertiary education in SA. While legislation now exists to enforce standardization of research ethics review systems, no provision has been made for resources or capacity development, especially to support historically-disadvantaged institutions. Perpetuation of this legacy of apartheid represents a violation of the principles of justice and equity. (shrink)

Two decades ago, in 1994, in the context of the 4th EU Framework Programme, ELSA was introduced as a label for developing and funding research into the ethical, legal and social aspects of emerging sciences and technologies. Currently, particularly in the context of EU funding initiatives such as Horizon2020, a new label has been forged, namely Responsible Research and Innovation. What is implied in this metonymy, this semantic shift? What is so new about RRI in comparison to ELSA? First of (...) all, for both labels, the signifier was introduced in a top-down manner, well before the concept that was signified by it had acquired a clear and stable profile. In other words, the signifier preceded the research strategies actually covered by these labels. Moreover, the newness of RRI does not reside in its interactive and anticipatory orientation, as is suggested by authors who introduced the term, but rather in its emphases on social-economic impacts. (shrink)

The notion that something can exist a se is central to Descartes’s overall metaphysics of causation. In the Meditations, divine aseity plays the role of explaining not only God’s existence but ultimately the existence of everything else apart from God. Yet in the Meditations proper, as well as in the early Replies, Descartes does little to clarify exactly what his view of divine aseity is and how it might differ from the sort of aseity commonly posited by the Scholastics. Despite (...) Descartes’s later attempts to assuage this worry and clarify his position, the positive aseity charge has not gone away. Here I shall argue that the charge is unjustified on all counts. Baldly stated, Descartes’s notion of aseity is no different than the negative sense of aseity endorsed by his Scholastic predecessors - especially Aquinas. Understanding this not only helps in clarifying the overall picture of Cartesian causality but also aids in seeing how commentaries on the Meditations, old and new, have obscured it. (shrink)

This grounded study investigated the negotiation of authorship by faculty members, graduate student mentors, and their undergraduate protégés in undergraduate research experiences at a private research university in the northeastern United States. Semi-structured interviews using complementary scripts were conducted separately with 42 participants over a 3 year period to probe their knowledge and understanding of responsible authorship and publication practices and learn how faculty and students entered into authorship decision-making intended to lead to the publication of peer-reviewed technical papers. Herein (...) the theoretical model for the negotiation of authorship developed through the analysis of these interviews is reported. The model identifies critical causal and intervening conditions responsible for the coping strategies faculty and students employ, which, in our study, appear to often produce unfortunate consequences for all involved. The undergraduate student researchers and their graduate student mentors interviewed in this study exhibited a limited understanding of authorship and the requirements for authorship in their research groups. The power differential between faculty and students, the students’ limited epistemic development, the busy-ness of the faculty, and the faculty’s failure to prioritize authorship have been identified as key factors inhibiting both undergraduate and graduate students from developing a deeper understanding of responsible authorship and publication practices. Implications for graduate education and undergraduate research are discussed, and strategies for helping all students to develop a deeper understanding of authorship are identified. (shrink)

Poor Eliza -- Pax Americana : the case of Show boat -- National brands, national body : Imitation of life -- Uncle Sam needs a wife : citizenship and denegation -- Remembering love, forgetting everything else : Now, voyager -- "It's not the tragedies that kill us, it's the messes" : femininity, formalism, and Dorothy Parker -- The compulsion to repeat femininity : Landscape for a good woman and The life and loves of a she-devil.

In the United States, sex education is more than just an uncomfortable rite of passage, it's an amorphous curriculum that varies widely based on the politics, experience, resources, and biases of the people teaching it. Most often, it's a train wreck, overemphasizing or underemphasizing STIs, teen pregnancy, abstinence, and consent. In Touchy Subject, philosopher Lauren Bialystok and historian Lisa M. F. Andersen make the case for thoughtful sex education, explaining why it's worth fighting for and which kind most deserves (...) our fight, despite all the inconveniences and compromises along the way. They argue that democratic and humanistic aims can be used to provide the tools to reason about the content and form of sex education. In practice, this amounts to a curriculum that meets what are currently considered highly comprehensive standards, incorporates ethics and civics education, and substantially modifies some aspects of teacher training and school design; it also assigns different responsibilities to different actors inside and outside schools, and it responds to the salient features of young people's evolving worlds, including the inequities that put some students at much higher risk of sexual harm than others. Throughout their inquiry, the authors show the reader how sex education has progressed and how the very concept of "progress" remains contestable. (shrink)

The semantic paradoxes are often associated with self-reference or referential circularity. Yablo (Analysis 53(4):251–252, 1993), however, has shown that there are infinitary versions of the paradoxes that do not involve this form of circularity. It remains an open question what relations of reference between collections of sentences afford the structure necessary for paradoxicality. In this essay, we lay the groundwork for a general investigation into the nature of reference structures that support the semantic paradoxes and the semantic hypodoxes. We develop (...) a functionally complete infinitary propositional language endowed with a denotation assignment and extract the reference structural information in terms of graph-theoretic properties. We introduce the new concepts of dangerous and precarious reference graphs, which allows us to rigorously define the task: classify the dangerous and precarious directed graphs purely in terms of their graph-theoretic properties. Ungroundedness will be shown to fully characterize the precarious reference graphs and fully characterize the dangerous finite graphs. We prove that an undirected graph has a dangerous orientation if and only if it contains a cycle, providing some support for the traditional idea that cyclic structure is required for paradoxicality. This leaves the task of classifying danger for infinite acyclic reference graphs. We provide some compactness results, which give further necessary conditions on danger in infinite graphs, which in conjunction with a notion of self-containment allows us to prove that dangerous acyclic graphs must have infinitely many vertices with infinite out-degree. But a full characterization of danger remains an open question. In the appendices we relate our results to the results given in Cook (J Symb Log 69(3):767–774, 2004) and Yablo (2006) with respect to more restricted sentences systems, which we call $\mathcal{F}$ -systems. (shrink)

A fundamental goal of research in neuroscience is to uncover the causal structure of the brain. This focus on causation makes sense, because causal information can provide explanations of brain function and identify reliable targets with which to understand cognitive function and prevent or change neurological conditions and psychiatric disorders. In this research, one of the most frequently used causal concepts is ‘mechanism’ — this is seen in the literature and language of the field, in grant and funding inquiries that (...) specify what research is supported, and in journal guidelines on which contributions are considered for publication. In these contexts, mechanisms are commonly tied to expressions of the main aims of the field and cited as the ‘fundamental’, ‘foundational’ and/or ‘basic’ unit for understanding the brain. Despite its common usage and perceived importance, mechanism is used in different ways that are rarely distinguished. Given that this concept is defined in different ways throughout the field — and that there is often no clarification of which definition is intended — there remains a marked ambiguity about the fundamental goals, orientation and principles of the field. Here we provide an overview of causation and mechanism from the perspectives of neuroscience and philosophy of science, in order to address these challenges. (shrink)

William Lane Craig's defence of the kalam cosmological argument rests heavily on two philosophical arguments against a past-eternal universe. In this article I take issue with one of these arguments, what I call the – namely, that the metaphysical absurdity of an actually infinite number of things existing precludes the possibility of a beginningless past. After explaining this argument, I proceed to raise some initial doubts. After setting those aside, I show that the argument is ineffective against proponents of presentism. (...) The remainder of the article considers and rejects possible replies on Craig's behalf. (shrink)

Anti-vascular endothelial growth factor therapy has revolutionised the treatment of a variety of ophthalmic conditions and has become the first-line therapy for a range of retinal diseases. Bevacizumab, a VEGF inhibitor first approved for the treatment of colorectal cancer, has been shown to be nearly or virtually as effective and safe as other anti-VEGF therapies in the treatment of certain retinal diseases but is not approved or registered by the Food and Drug Administration or European Medicines Agency. While other anti-VEGF (...) options are approved and registered, they are generally more expensive and less accessible. Accordingly, despite its off-label status, bevacizumab is frequently used for a variety of disabling retinal diseases. Indeed, bevacizumab is included on the World Health Organization’s list of essential medicines. However, its use in some parts of the world remains restricted due to its off-label status. How, then, should healthcare authorities approach this situation? What are the ethical and societal implications of adhering to a standard and generally effective evaluation and approval system while restricting access to a potentially cost-saving therapy? In countries where its use is not restricted, how should providers approach off-label treatment with bevacizumab? By examining the evidence behind bevacizumab’s efficacy and safety and evaluating the individual and societal implications of off-label use and restriction, this paper illustrates the ethical factors providers and policy makers must consider in the off-label use of bevacizumab and ultimately argues for increased access to bevacizumab in the treatment of retinal disease. (shrink)

Background: Biomedical research is influenced by many factors, including the involvement of stakeholder groups invested in research outcomes. Stakeholder involvement in research efforts raises questions of justice as stakeholders’ specific interests and motivations play a role in directing research resources that ultimately produce knowledge, shaping how different conditions (and affected individuals) are understood and treated by society. This issue is highly relevant to child psychiatry research where diagnostic criteria and treatment strategies are often controversial. Biological similarities and stakeholder differences between (...) attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) provide an opportunity to explore this issue by comparing research foci and stakeholder involvement in these conditions. Methods: A subset of ADHD and ASD research articles published between 1970 and 2010 were randomly selected from the PubMed database and coded for research focus, funding source(s), and author-reported conflicts of interest (COIs). Chi-squared analyses were performed to identify differences between and within ADHD and ASD research across time. Results: The proportion of ADHD research dedicated to basic, description, and treatment research was roughly similar and remained stable over time, while ASD research showed a significant increase in basic research over the past decade. Government was the primary research funder for both conditions, but for-profit funders were a notable presence in ADHD research, while joint funding efforts between nonprofit and government funders were a notable presence in ASD research. Lastly, COIs were noted more frequently in ADHD than in ASD research. Conclusions: Our study shows significant differences in research foci and funding sources between the conditions, and identifies the specific involvement of for-profit and nonprofit groups in ADHD and ASD, respectively. Our findings highlight the relationship between stakeholders outside the research community and research trajectories and suggest that examinations of these relationships must be included in broader considerations of biomedical research ethics. (shrink)

To call attention to and motivate action on ethical issues in business or society, messengers often criticize groups for wrongdoing and ask these groups to change their behavior. When criticizing target groups, messengers frequently identify and express concern about harm caused to a victim group, and in the process address a target group by criticizing them for causing this harm and imploring them to change. However, we find that when messengers criticize a target group for causing harm to a victim (...) group in this way—expressing _singular concern_ for the victim group—members of the target group infer, often incorrectly, that the messenger views the target group as less moral and unworthy of concern. This inferred lack of moral concern reduces criticism acceptance and prompts backlash from the target group. To address this problem, we introduce _dual concern_ messaging—messages that simultaneously communicate that a target group causes harm to a victim group and express concern for the target group. A series of several experiments demonstrate that dual concern messages reduce inferences that a critical messenger lacks moral concern for the criticized target group, increase the persuasiveness of the criticism among members of the target group, and reduce backlash from consumers against a corporate messenger. When pursuing justice for victims of a target group, dual concern messages that communicate concern for the victim group _as well as_ the target group are more effective in fostering openness toward criticism, rather than defensiveness, in a target group, thus setting the stage for change. (shrink)

_Twenty-First Century Inequality & Capitalism: Piketty, Marx and Beyond_ is a collection of critical essays on the economist’s iconic 2014 book, from the perspective of critical theory, global political economy or public sociology, mostly drawn from the Marxist tradition.

_Twenty-First Century Inequality & Capitalism: Piketty, Marx and Beyond_ is a collection of critical essays on the economist’s iconic 2014 book, from the perspective of critical theory, global political economy or public sociology, mostly drawn from the Marxist tradition.

In the last two decades few topics in philosophy of science have received as much attention as mechanistic explanation. A significant motivation for these accounts is that scientists frequently use the term “mechanism” in their explanations of biological phenomena. While scientists appeal to a variety of causal concepts in their explanations, many philosophers argue or assume that all of these concepts are well understood with the single notion of mechanism. This reveals a significant problem with mainstream mechanistic accounts– although philosophers (...) use the term “mechanism” interchangeably with other causal concepts, this is not something that scientists always do. This paper analyses two causal concepts in biology–the notions of “mechanism” and “pathway”–and how they figure in biological explanation. I argue that these concepts have unique features, that they are associated with distinct strategies of causal investigation, and that they figure in importantly different types of explanation. (shrink)

Slurring language has had a lot of recent interest, but the focus has been almost exclusively on racial slurs. Gendered pejoratives, on the other hand—terms like “slut,” “bitch,” or “sissy”—do not fit into existing accounts of slurring terms, as these accounts require the existence of neutral correlates, which, I argue, these gendered pejoratives lack. Rather than showing that these terms are not slurs, I argue that this challenges the assumption that slurs must have neutral correlates, and so that a new (...) approach to thinking about the meaning of slurring terms is required. (shrink)

The use of the symbol ∨for disjunction in formal logic is ubiquitous. Where did it come from? The paper details the evolution of the symbol ∨ in its historical and logical context. Some sources say that disjunction in its use as connecting propositions or formulas was introduced by Peano; others suggest that it originated as an abbreviation of the Latin word for “or,” vel. We show that the origin of the symbol ∨ for disjunction can be traced to Whitehead and (...) Russell’s pre-Principia work in formal logic. Because of Principia’s influence, its notation was widely adopted by philosophers working in logic (the logical empiricists in the 1920s and 1930s, especially Carnap and early Quine). Hilbert’s adoption of ∨ in his Grundzüge der theoretischen Logik guaranteed its widespread use by mathematical logicians. The origins of other logical symbols are also discussed. (shrink)

The idea that introspection is transparent—that we know our minds by looking out to the world, not inwards towards some mental item—seems quite appealing when we think about belief. It seems that we know our beliefs by attending to their content; I know that I believe there is a café nearby by thinking about the streets near me, and not by thinking directly about my mind. Such an account is thought to have several advantages—for example, it is thought to avoid (...) the need to posit any extra mental faculties peculiar to introspection. In this paper I discuss recent attempts to extend this kind of outwards-looking account to our introspective knowledge of desire. According to these accounts, we know our desires by attending to what in the world we judge to be valuable. This, however, does not deal satisfactorily with cases where my value judgments and introspective knowledge of my desires come apart. I propose a better alternative for the proponent of transparency, but one that requires giving up on the supposed metaphysical advantages. (shrink)

Kaplan and Craver claim that all explanations in neuroscience appeal to mechanisms. They extend this view to the use of mathematical models in neuroscience and propose a constraint such models must meet in order to be explanatory. I analyze a mathematical model used to provide explanations in dynamical systems neuroscience and indicate how this explanation cannot be accommodated by the mechanist framework. I argue that this explanation is well characterized by Batterman’s account of minimal model explanations and that it demonstrates (...) how relationships between explanatory models in neuroscience and the systems they represent is more complex than has been appreciated. (shrink)

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

According to mainstream philosophical views causal explanation in biology and neuroscience is mechanistic. As the term ‘mechanism’ gets regular use in these fields it is unsurprising that philosophers consider it important to scientific explanation. What is surprising is that they consider it the only causal term of importance. This paper provides an analysis of a new causal concept—it examines the cascade concept in science and the causal structure it refers to. I argue that this concept is importantly different from the (...) notion of mechanism and that this difference matters for our understanding of causation and explanation in science. (shrink)

Dispositional ascriptions do not entail the counterfactuals we might expect, as interfering factors may be poised to prevent the disposition from manifesting in its very stimulus conditions. Such factors are commonly called finks and masks. It is thought, however, that finks and masks cannot be intrinsic to the disposition bearer; if an intrinsic property of the object would prevent a particular response in certain conditions, the object fails to have the corresponding disposition. I argue that we should accept intrinsic finks (...) and masks if we think there are finks and masks at all, and also if we maintain that paradigmatic dispositions are intrinsic. This last point is particularly problematic for the claim that there cannot be intrinsic finks and masks, for if paradigmatic dispositions are not intrinsic then the central argument for the impossibility of intrinsic finks and masks is undermined. (shrink)

As interest in Owen Barfield grows, we aim to meet the need for a scholarly introduction to his thought. Our primary purpose is to present an overview, analysis, and synthesis of Barfield's most salient ideas in a manner that will be of interest to neophytes and initiates alike. Barfield's work can, at time, be difficult to understand; C. S. Lewis put it well when he described Barfield's style of argument as 'dark, labyrinthine,' and 'pertinacious.' But Lewis ardently promoted Barfield's work (...) because he knew that people who willingly walk in those dim and winding corridors are, in time, richly rewarded by the bright light at their end. We offer the present work in service to those who wish to undertake this adventure. While the present book will help those readers who wish to engage Barfield for the sake of achieving a greater understanding of and appreciation for other writers who have been associated with or influenced by him, we aim first and foremost to present Barfield as a profound and original thinker in his own right. (shrink)

This article explores the question of the role of religion in the public square through the lens of Richard Rorty’s more general public–private distinction. When we note his various positions over the years on the role of religion in the public square we observe a shift that yields a more favorable public role for religion so long as it limits itself to social action and refrains from making knowledge-claims that serve as tools of the powerful. But if, according to Rorty, (...) religion per se is no longer the problem, then what becomes of his efforts to endorse a more general public–private distinction? The argument set forth assesses the inadequacies and limitations of Rorty’s assumptions about the public–private split and suggests another way of framing the issue that will prove productive in debates concerning the role of religion in the public square. (shrink)

This book draws on the hermeneutics of Hans-Georg Gadamer to inform a feminist perspective of social identities. Lauren Swayne Barthold moves beyond answers that either defend the objective nature of identities or dismiss their significance altogether. Building on the work of both hermeneutic and non-hermeneutic feminist theorists of identity, she asserts the relevance of concepts like horizon, coherence, dialogue, play, application, and festival for developing a theory of identity. This volume argues that as intersubjective interpretations, social identities are vital (...) ways of fostering meaning and connection with others. Barthold also demonstrates how a hermeneutic approach to social identities can provide critiques of and resistance to identity-based oppression. (shrink)

In this paper, I identify a form of epistemic insensitivity that occurs when someone fails to make proper use of the epistemic tools at their disposal in order to bring their beliefs in line with epistemically relevant evidence that is available to them. I call this kind of insensitivity agential insensitivity because it stems from the epistemic behavior of an individual agent. Agential insensitivity can manifest as a failure to either attend to relevant and available evidence, or appropriately interpret evidence (...) that is attended to. The concept of agential insensitivity allows us to conceptualize the kind of not-knowing involved in forms of ignorance that are cultivated and maintained by individual agents, especially when this ignorance is enabled or encouraged by social structures. I use the skepticism about racial disparities in policing practices that is displayed by many white Americans as a lens for exploring this connection. Understanding agential insensitivity thus provides insight into both social and epistemic phenomena. (shrink)

While there is now considerable anxiety about whether the psychological theory presupposed by virtue ethics is empirically sustainable, analogous issues have received little attention in the virtue epistemology literature. This paper argues that virtue epistemology encounters challenges reminiscent of those recently encountered by virtue ethics: just as seemingly trivial variation in context provokes unsettling variation in patterns of moral behavior, trivial variation in context elicits unsettling variation in patterns of cognitive functioning. Insofar as reliability is a condition on epistemic virtue, (...) we have reason to doubt that human beings possess the cognitive materials required for epistemic virtue, and thereby reason to think that virtue epistemology is threatened by skepticism. We conclude that while virtue epistemology has resources for addressing this challenge, exploiting these resources forces tradeoffs between empirical and normative adequacy. (shrink)

In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical defensibility (...) of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient’s request is substantially autonomous. Although the broadly principlist ethical approach we take can be used to analyse other cases of non-binary adults requesting OPS apart from the case we evaluate, we highlight that the outcome will necessarily depend on the individual’s context and values. However, such clinical provision of OPS should ideally be within the context of a properly designed research study with long-term follow-up and open publication of results. (shrink)