Our collective enthusiasm for empathy reflects a sense that it is deeply valuable. I show that empathy bears a complex and surprisingly problematic relation to another social epistemic phenomenon that we have reason to value, namely testimonial trust. My discussion focuses on empathy with and trust in people who are members of one or more oppressed groups. Empathy for oppressed people can be a powerful tool for engendering a certain form of testimonial trust, because there is a tight connection between (...) empathy and a approval of another's outlook. I then argue that the qualities of empathy that make it such a powerful tool for bridging differences and building trust also have a problematic upshot: they make it the case that reliance on empathy will sometimes have a distorting effect upon the ways we extend testimonial trust. (shrink)

This paper examines Hannah Ginsborg's attempt to address the challenge raised by Saul Kripke's meaning sceptic. I start by identifying the two constraints that the sceptic claims must be met by a satisfactory answer. Then I try to show that Ginsborg's proposal faces a dilemma. In the first instance, I argue that it is able to meet the second constraint, but not the first. I then amend the proposal in order to make room for the first constraint. I go on (...) to argue that, under this new interpretation, it cannot meet the second constraint. (shrink)

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others’ emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need to be (...) humanely understood. Because we respond to others’ very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. (shrink)

Background:Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage.Objectives:The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors.Research design:In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ Moral Courage Scale and analysed (...) statistically.Participants and research context:The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses.Ethical considerations:The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital.Findings:Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity.Discussion and conclusion:Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)

Anna Wexler and Laura Specker Sullivan (2023) draw on their positionality as Global North early career neuroethics scholars to initiate a meaningful and timely conversation on Translational Neuroet...

In this article, it will be concluded that the major automotive racing league, Formula 1, is failing in its efforts to be a truly unisex sport. In the current Formula 1 series, there are no female drivers. Although women have never been officially prohibited from competing in Formula 1, there have been fewer than 10 female drivers since its inception. This inquiry focuses on why women drivers have been prevented from securing professional driving positions in Formula 1 and racing on (...) equal terms with men. I argue that there are five major barriers which perpetuate women’s exclusion from this league: historical and current attitudes, assumed physical and mental inferiority, sexualisation, money, and representation and visibility. In this cultural examination, I demonstrate that the situation for women in Formula 1 appears to be bleaker than in other sports that are making progress in their quest for gender equality. However, I also suggest that, despite ethical issues, W Series – a new, women-only, single-seater car racing championship – could potentially motivates positive change for women’s car racing by promoting gender equity through a new league which enables women to improve themselves in a protected category. This article also considers the impact of sex in Formula 1, which is pertinent to the discussion surrounding alleged biological differences. The discussion employs Simone de Beauvoir’s conceptualisation of ‘Otherness’, as well as Helmut Pflugfelder’s account of female embodiment in motorsport. The overall findings are that more focused research is required for gender issues in Formula 1 to be accurately addressed. (shrink)

Background:Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous.Objective:This article is an analysis of the concept (...) of moral courage in nursing.Design:Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis.Data sources:The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis.Ethical considerations:This study was conducted according to good scientific guidelines.Results:Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment.Discussion and conclusion:This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

Against the background of a deeply uneven package of work–family reconciliation measures and an increasing focus on engaging men in unpaid care work, in this article I discuss the extension of the Irish discrimination law framework to provide protection against family status discrimination to workers who are engaged in certain care relationships. While this development of the law to recognize a relational understanding of inequality is welcome, its confined definition of family status fails to capture the range of workers’ caring (...) relationships and networks. Adopting a contextualized assessment of 12 years of litigation generated under the ‘family status’ ground, with reference to complainants’ gender and work status, the study considers the types of experiences being litigated as ‘family status’ discrimination. The study show how much of the nature and forms of inequality presented before the tribunals are beyond the conceptual boundaries of the principle of equal treatment that depends upon a sameness of treatment model with the ‘care-less’ comparator. Despite its potential to question the neutrality of workplace structures predicated upon the division between paid work and unpaid care, the principle of indirect family status discrimination has been under utilised as a litigation strategy. The most successful dimension of family status discrimination protection has been in respect of its ability to capture the negative stereotyping of worker–carers who continue to perform as ideal workers. I suggest that this extension of a limited negative rights framework, when considered alongside the state’s extremely poor support for workcare reconciliation more broadly, places negligible obligations on employers, and that the gender neutrality implicit in its provisions have yet to impact on gender equality as regards work–care reconciliation. (shrink)

The study of rare diseases has long been an area of challenge for medical researchers, with agonizingly slow movement towards improved understanding of pathophysiology and treatments compared with more common illnesses. The push towards evidence-based medicine (EBM), which prioritizes certain types of evidence over others, poses a particular issue when mapped onto rare diseases, which may not be feasibly investigated using the methodologies endorsed by EBM, due to a number of constraints. While other trial designs have been suggested to overcome (...) these limitations (with varying success), perhaps the most recent and enthusiastically adopted is the application of artificial intelligence to rare disease data. This paper critically examines the pitfalls of EBM (and its trial design offshoots) as it pertains to rare diseases, exploring the current landscape of AI as a potential solution to these challenges. This discussion is also taken a step further, providing philosophical commentary on the weaknesses and dangers of AI algorithms applied to rare disease research. While not proposing a singular solution, this article does provide a thoughtful reminder that no ‘one-size-fits-all’ approach exists in the complex world of rare diseases. We must balance cautious optimism with critical evaluation of new research paradigms and technology, while at the same time not neglecting the ever-important aspect of patient values and preferences, which may be challenging to incorporate into computer-driven models. (shrink)

Are extremists (incels, neo-nazis, and the like) characteristically answerable for their moral and political convictions? Is it necessary to offer them reasoned arguments against their views, or is it instead appropriate to bypass that kind of engagement? Discussion of these questions has centered around the putative epistemic autonomy of extremists. The parties to this discussion have assumed that epistemic autonomy is solely (or at least primarily) a matter of epistemic independence, of believing based on epistemic reasons one has assessed for (...) oneself. Here, though, I make the case for shifting the terms of the debate. Epistemic independence is not sufficient to make one answerable for one’s beliefs. Epistemic autonomy, in the sense that matters for answerability, is also a matter of what I call epistemic receptivity. Extremists may be fiercely epistemic independent, but that commitment is characteristically paired with severe deficiencies in empathic orientation. Severe deficiencies in empathic orientation undermine extremists’ ability to adequately engage with competing evaluative perspectives, and thus compromise extremists’ epistemic autonomy. I consider how this conclusion should inform our thinking about what we owe to extremists. (shrink)

Étudier les actes de requête dans les discours prononcés aux Nations Unies s’avère d’une utilité certaine dans le travail de caractérisation de ce sous-genre diplomatique. La formulation indirecte des actes de langage et les procédés linguistiques qui éloignent les sources potentielles de confrontation révèle des discours contraints par l’exercice de la « politesse », au service de l’impératif institutionnel de valorisation du consensus. Ces discours qui s’éloignent du fonctionnement du langage ordinaire transfèrent la prise en charge de l’énonciation aux États-membres (...) qui sont ici de véritables locuteurs et qui partant parlent en leur propre nom. L’on observe alors l’impact d’un contexte socio-discursif sur le fonctionnement de langue. Les requêtes formulées dans ces discours reflètent les problématiques qui préoccupent les États membres, puisque dans bien des cas, une requête peut être l’aveu d’un manque. Les verbes illocutoires donnent un bon aperçu des « façons de parler » et témoignent d’ores-et-déjà d’une routinisation des pratiques langagières. (shrink)

Critics contend that Aristotelianism demands too much of the virtuous person in the way of knowledge to be credible. This general charge is usually directed against either of two of Aristotelianism’s apparent claims about the necessary conditions for the possession of a single virtue, namely that 1) one must know what all the other virtues require, and 2) one must also be the master of a preternatural range of technical/empirical knowledge. I argue that Aristotelianism does indeed have a very high (...) standard when it comes to the knowledge necessary for the full possession of a virtue, in both of these respects. However, focus on the necessary conditions for full virtue tends to obscure an important fact: some kinds of knowledge are much more important to various virtues than others are. A proper appreciation of the significance of this fact will go a long way toward answering critics’ worries about Aristotelianism’s knowledge requirements. (shrink)

In this article, the authors assess the still limited literature on domestic violence among immigrant women in major receiving countries so as to begin delineating a framework to explain how immigrant-specific factors exacerbate the already vulnerable position—as dictated by class, gender, and race—of immigrant women in domestic violence situations. First, a review of this scholarship shows that the incidence of domestic violence is not higher than it is in the native population but rather that the experiences of immigrant women in (...) domestic violence situations are often exacerbated by their specific position as immigrants, such as limited host-language skills, isolation from and contact with family and community, lack of access to dignified jobs, uncertain legal statuses, and experiences with authorities in their origin countries. The authors then examine the various responses at the national and local community levels to this issue in receiving countries. (shrink)

What is the cognitive role of things — sometimes but not always expressed as nouns — that appear in texts? What kind of literary affordances are the material furnishings that appear in a piece of literary writing? These questions are explored in this essay through the example of John Locke's Essay Concerning Human Understanding, a long work of literary philosophy that plays with the evolving conventions of its genre. Fusing methodologies borrowed from anthropology and linguistics, this essay reveals the extent (...) and type of work done by two of Locke's things, manna and porphyry. In doing so it tests a way of tracing the cognitive action of the Essay's contemporary readership without recourse to modern experimental methods. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

A sensibility is, on a rough first pass, an emotional orientation to the world. It shapes how things appear to us, evaluatively speaking. By transfiguring things’ evaluative appearances, a change in sensibility can profoundly alter one’s overall experience of the world. I argue that some forms of sensibility change entail (1) risking one’s knowledge of what experiences imbued with one’s prior sensibility were like, and (2) surrendering one’s grasp on the intelligibility of one’s prior emotional apprehensions. These costs have consequences (...) for Laurie Paul’s ‘problem of transformative experience.’ Paul has argued that when we are poised to become someone new, our inexperience generates problems for authentic choice about our own futures. By reckoning with the epistemic losses involved in sensibility change, I show that this problem must not be confined to novel transformations. Prior experience does not guarantee the knowledge or understanding necessary for choosing authentically (in Paul’s sense). If the problem Paul highlights is indeed a problem _at all,_ then, it is a still more pervasive and intractable one than it has been taken to be. (shrink)

We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Researchers want to offer carrots to incentivise participation. We (...) are proposing that research participation be viewed as a job with the full suite of financial entitlements of fairly remunerated work, including payment for risk and labour law protections. This would be a significant shift from current practice and standards. Ambuehl, Ockenfels and Roth have grasped this basic point and have beautifully elaborated how a fair price could be arrived at using economic theory. They build on our proposal helpfully and suggest ‘ salary for time involvement that is adjusted to account for the amount of discomfort experienced during participation, insurance against ex post adverse outcomes and ex ante compensation for risks that cannot be compensated ex post.’3 This effectively addresses Fernandez Lynch and Largent’s2 concern that compensation for risk is inappropriate for harms which do not eventuate. However, because death cannot be compensated for, there must be payment for risk of death, as Ambuehl, Ockenfels and Roth convincingly argue.3 Indeed, the three-part model suggested by Ambuehl, Ockenfels and Roth makes us realise that job model would be a better title for our model than a payment for risk model. The alternative to a properly remunerated job model is the original altruistic model. However, this …. (shrink)

Daniel D. Hutto and Glenda Satne expose, and suggest a way to resolve, what they see as an “essential tension” which has plagued what they take to be the most promising approach to the nature of contentful states, that is, the neo-pragmatist approach. According to this approach, an adequate account of content essentially appeals to the notion of a social practice. This paper is a critical assessment of their proposal. On their view, the tension stems from the fact that participation (...) in a social practice seems to require that, in order to participate in one, an individual must have contentful states. This entails that participation in social practices cannot explain the origin of contentful states. They argue that the tension dissipates once contentless forms of intentionality come into view. I show that the tension cannot be addressed in the way in which they suggest, for the intermediate steps between primitive intentionality and contentful intentionality cannot in fact fully be accounted for. Nevertheless, Hutto and Satne shed valuable light on the location and scope of the gap in the transition between mindlessness and contentful mindedness. (shrink)

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...) in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)