“Western” moral thought is often stereotyped as being (too) individualistic, Thatcher-like; communities are treated as mere assemblages of individuals, each of whom must look after their own welfar...

A major goal of this work is to specify some steps of the process by which participants maintain coherency in their conversations.The underlying element of the analysis is a construct called a “context space.” Roughly, a group of utterances that refers to a single issue or episode forms the basis for a context space. Superficially, a conversation is a sequence of utterances; at a deeper level it is a structured entity whose utterances can be parsed into hierarchically related context spaces.As (...) a conversation proceeds, each conversant builds a discourse model that includes the conversation's context space structure, a notion of the present discourse topic, and a list of items being focused upon. Conversational coherency depends upon a lack of conflict between the respective models of the participants. Conflicts are prevented by speakers following high level syntactic and semantic relational rules that enable listeners to identify their discourse models. These rules, given in the study, are highly integrated with the view of conversation presented here—a hierarchy of related context spaces. (shrink)

Bioethics has entered a new era: as many commentators have noted, the familiar mantra of autonomy, beneficence, nonmaleficence, and justice has proven to be an overly simplistic framework for understanding problems that arise in modern medicine, particularly at the intersection of public policy and individual preferences. A tradition of liberal pluralism grounds respect for individual preferences and affirmation of competing conceptions of the good. But we struggle to maintain (or at times explicitly reject) this tradition in the face of individual (...) preferences that we find distasteful, suspect, or even repugnant, especially where the broader social good or respect for equality is at stake. Directed donation presents us with such a dilemma: can we uphold the right of self-determination through respect of individual preferences regarding disposition of transplantable organs while at the same time maintaining an allocation system that reflects values of equity and justice claimed to underlie the socially negotiated practice of transplantation? Or are some preferences simply to be deemed unethical and not respected, even if that leads to a reduction in the number of transplantable organs available and to an apparent disregard for the autonomous decisions of the recently deceased? (shrink)

Autonomy and the Situated Self offers a critique of contemporary mainstream bioethics and proposes an alternative framework for the exploration of bioethical issues. It also contrasts two conceptions of autonomy, one based on a liberal model but detached from its political foundation and one that is responsive to the concerns of virtue ethics and connected to the concept of human flourishing.

Extensive and diverse conceptual work towards developing a definition of ‘mental disorder’ was motivated by the declassification of homosexuality from the Diagnostic and Statistical Manual in 1973. This highly politicised event was understood as a call for psychiatry to provide assurances against further misclassification on the basis of discrimination or socio-political deviance. Today, if a definition of mental disorder fails to exclude homosexuality, then it fails to provide this safeguard against potential abuses and therefore fails to do an important part (...) of the work it was intended to do. We argue that fact-based definitions of mental disorder, relying on scientific theory, fail to offer a robust definition of mental disorder that excludes homosexuality. Definitions of mental disorder based on values do not fare better: these definitions are silent on questions about the diagnostic status of individuals in oppressive societies and over-inclusive of mental or behavioural states that happen to be negatively valued in the individual's social context. We consider the latest definition proposed for the Diagnostic and Statistical Manual-5 in light of these observations. We argue that definition fails to improve on these earlier deficiencies. Its inclusion in the manual may offer false reassurance against repetition of past misclassifications. We conclude with a provocation that if candidate definitions of mental disorder are unable to exclude homosexuality, it might perhaps be preferable not to attempt a definition at all. (shrink)

Autonomy and the Situated Self offers a critique of contemporary mainstream bioethics and proposes an alternative framework for the exploration of bioethical issues.

This paper surveys recent trends in the history of science, using quotations from works published in the last decade. It suggests that philosophers of science have not yet come to terms with those changes, indicates which might or might not lead to productive interchange, and concludes that history and philosophy of science are now further apart than at any time since the early 1960's.

We discuss a case where medically optimal investigations of health problems in a donor-conceived child would require their egg donor to participate in genetic testing. We argue that it would be justified to contact the egg donor to ask whether she would consider this, despite her indicating on a historical consent form that she did not wish to take part in future research and that she did not wish to be informed if she was found to be a carrier of (...) a ‘harmful inherited condition’. We suggest that we cannot conjecture what her current answer might be if, by participating in clinical genetic testing, she might help reach a diagnosis for the donor-conceived child. At the point that she made choices regarding future contact, it was not yet evident that the interests of the donor-conceived child might be compromised by her answers, as it was not foreseen that the egg donor’s genome might one day have the potential to enable diagnosis for this child. Fertility consent forms tend to be conceptualised as representing incontrovertible historical boundaries, but we argue that rapid evolution in genomic practice means that consent in such cases is better seen as an ongoing and dynamic process. It cannot be possible to compel the donor to aid in the diagnosis of the donor-conceived child, but she should be given the opportunity to do so. (shrink)

Platonic arguments often have premises of a particular form which is misunderstood. These sentences look like universal generalizations, but in fact involve an implicit qua phrase which makes them a fundamentally different kind of predication. Such general implicit redoubled qua predications (girqps) are not an expression of Plato's proprietary views; they are also very common in everyday discourse. Seeing how they work in Plato can help us to understand them.

Four experiments and 2 corpus-based studies demonstrate that negation is a determinant factor affecting novel nonliteral utterance-interpretation by default. For a nonliteral utterance-interpretation to be favored by default, utterances should be potentially ambiguous between literal and nonliteral interpretations. They should therefore be (a) unfamiliar, (b) free of semantic anomaly or any kind of internal incongruity, and (c) unbiased by contextual information. Experiments 1–3 demonstrate that negative utterances, meeting these 3 conditions, were interpreted metaphorically (This is not a safe) or sarcastically (...) (Ambitious she is not) when presented in isolation and were therefore processed faster in contexts strongly biasing them toward their nonliteral than toward their (equally biased) literal interpretation. Experiment 4 reduces the possibility that it is structural markedness on its own that induces nonliteralness. Two corpus-based studies provide corroborating evidence, supporting the view of negation as an operator generating nonliteral interpretations by default. (shrink)

This paper attributes to Nietzsche a theory of cultural development according to which pyramid societies—steeply hierarchical societies following a unified morality—systematically alternate with motley societies, which emerge when pyramid societies encounter other cultures or allow their strict mores to relax. Motley societies contain multiple value systems due to individual innovation or intercultural contact, and are less stringent in dictating individuals' roles. Consequently, many people are torn between incompatible values and lack direction, so they are drawn to a morality of mediocrity, (...) which offers the modest goals of comfort and conformity. However, the need to mediate between conflicting values also tends to yield exceptional individuals who create new values, and can reshape the society into a new pyramid society governed by those values. I argue that Nietzsche favors neither type of society at the expense of the other, but believes the alternation itself is valuable: a pyramid society develops a value system to its full potential; then, when it encounters alternative values, the extraordinary individuals in the resulting motley society synthesize the competing systems into a fuller vision of human flourishing. (shrink)

It is necessary to recognize the variety of levels at which values and norms may inappropriately affect the equity of the transplantation process, including candidate selection. Using a revised, richer concept of objectivity, adopted from Longino's work in the philosophy of science and empirical studies of candidate selection, this paper examines what sort of objectivity can be obtained in the transplant candidate selection process, and the closely related question of how selection can occur in an equitable manner. This concept of (...) objectivity requires that transformative criticism occur so that (1) the conceptual and normative commitments underlying selection may be articulated and perhaps challenged, and (2) the relationship between those commitments and criteria for candidate selection may be examined and justified, or revised. Through such transformative criticism, a greater degree of objectivity may be attained, which in turn will increase the likelihood of equity. (shrink)

This article describes a new prenatal genetic test that is painless, early, and increasingly available. State legislatures have reacted by prohibiting abortion for reason of fetal sex or of fetal diagnosis and managing genetic counseling. This article explores these legislative responses and considers how physicians and genetic counselors currently communicate post-testing options. The article then examines the challenges ahead for genetic counseling, particularly in light of the troubling grip of abortion politics on conversations about prenatal diagnosis.

This paper presents results from a survey of 344 individuals who engage in climate change mitigation action, contributing to debates about whether it is necessary to promote 'nature experiences' and biospheric values to encourage pro-environmental behaviour. We investigate three factors - values, motivations and formative experiences - that underlie such behaviour, but that usually have been considered in isolation from each other. In contrast to previous studies of environmentalists' significant life experiences, outdoor/nature experiences were not frequently mentioned as being influential. (...) Altruistic concerns about climate change impacts on future human generations and on poorer or more vulnerable people were considered more motivating than other reasons for action. There was no significant difference in how respondents rated altruistic and biospheric values. Variations in responses from those involved in 'biospherically-oriented' organisations (such as traditional environmental or conservation organisations) versus those involved in climate change groups suggest that there are different routes into climate change mitigation action, and our results show that it is not essential to cultivate biospheric values or the love of nature to encourage such action. (shrink)

Cultural forces such as film create and reinforce rigidly-defined images of a doctor's identity for both the public and for medical students. The authoritarian and hierarchical institution of medical school also encourages students to adopt rigidly-defined professional identities. This restrictive identity helps to perpetuate the power of the patriarchy, limits uniqueness, squelches inquisitiveness, and damages one's self-confidence. This paper explores the construction of a physician's identity using cultural theorists' psychoanalytic analyses of gender and race as a framework of analysis. Cultural (...) theorists' politically-motivated work provides an excellent point of departure for destabilizing parts of the authoritarian medical hierarchy that can damage a student's professional development. Drawing on such discourse, this paper examines the processes by which a doctor's identity becomes rigidly defined and fixed by daily training. It finally proposes a way for a medical student to extrapolate himself from the current definitions of this identity and create a broader, more malleable concept of professional identity by defining himself from outside of, rather than through, difference. (shrink)

A first-person account of some victims of the virus, the author puts faces and circumstances to the tragedy of the Covid-19 pandemic. Told from a chaplain’s point of view, these narratives will take the reader beyond the numbers and ask questions like: What is the cost of keeping families separated at the end of life, and, if patient/family centered care is so central to healthcare these days, why was it immediately discarded? Is potentially saving human lives worth the risk of (...) damaging them beyond repair? (shrink)

The complex regulatory framework governing the U.S. health care system can be an obstacle to programming that address health-related social needs. In particular, health care fraud and abuse law is a pernicious barrier as health care organizations may minimize or forego programming altogether out of real and perceived concern for compliance. And because health care organizations have varying resources to navigate and resolve compliance concerns, as well as different levels of risk tolerance, fears related to the legal landscape may further (...) entrench inequities in access to meaningful programs that improve health outcomes. This article uses food and nutrition programming as a case study to explore the complexities presented by this area of law and to highlight pathways forward. (shrink)

In this article, I compare and evaluate R. D. Laing and A. Esterson’s account of schizophrenia as developed in Sanity, Madness and the Family, social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems. In this article, I consider the grounds on which such claims might be supported. I argue that problems should not (...) be located within an individual putative patient in cases where there is some acceptable test environment in which there is no problem. A number of cases where such an argument can show that there is no internal disorder are discussed. I argue, however, that Laing and Esterson’s argument—that schizophrenia is not within diagnosed patients—does not work. The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment. (shrink)

The stage is often a space where artists engage in experiments with identity politics. Plays like Welcome to Thebes appear to present global human engagement and a cultural exchange of ideas. However, using European narrative structures as a playground to explore Africana political issues highlights the limitations to cross-cultural exchange between aesthetic paradigms. This essay first articulates a conflict between European and Africana aesthetics and then offers an analysis of gender dynamics operating in the play Welcome to Thebes, arguing that (...) performative conditions not only constrain racialized realities, but also limit the possibility of cross-cultural performances of history. (shrink)

I set out to read the book of Joshua together with its most literal interpreters – those who enacted a version of the war for the Promised Land – and suggest that interpretations of the book are always bound up with current ideas about war and territorial rights. In particular, I analyze how David Ben-Gurion, the first Prime Minister of Israel, and his Bible study group parsed the book of Joshua and argue that their interpretations, like the book of Joshua (...) itself, represent projections of nationalist desire onto a varied, multifarious social setting. Joshua’s conquest and Israel’s founding narrative both involve military narratives generated in order to obscure the presence of non-nationals. In the next stage of the argument, I suggest that the story of the conquest itself attests to the very fluid social setting that it aims to overcome. Just as Ben-Gurion appealed to Joshua as precedent and the contemporary State of Israel looks to Ben-Gurion as a model, post-nationalists can locate a paradigm in the selfsame founding myths. (shrink)

Kant claims in the third Critique that one can make about wine the merely subjective judgment that it is agreeable but never the universally valid judgment that it is beautiful. This follows from his views that judgments of beauty can be made only about the formal (spatiotemporal) features of a representation and that aromas and flavors consist of formless sensory matter. However, I argue that Kant's theory permits judgments of beauty about wine because the experience displays a temporal structure: the (...) aromas and flavors evolve over the course of a tasting from the bouquet through the palate to the finish. An analogy with music, which Kant describes as 'a play of sensations in time', illuminates how wine qualifies as an object of pure judgments of taste: the 'structure' of a wine can be compared to harmonic structure, and its development throughout the taste can be compared to the unfolding of melody and harmonic progression. (shrink)

A medical student's ability to present a case history is a critical skill that is difficult to teach. Case histories presented without theatrical engagement may fail to catch the attention of their intended recipients. More engaging presentations incorporate ‘stage presence’, eye contact, vocal inflection, interesting detail and succinct, well organised performances. They convey stories effectively without wasting time. To address the didactic challenge for instructing future doctors in how to ‘act’, the Mayo Medical School and The Mayo Clinic Center for (...) Humanities in Medicine partnered with the Guthrie Theater to pilot the programme ‘Telling the Patient's Story’. Guthrie teaching artists taught storytelling skills to medical students through improvisation, writing, movement and acting exercises. Mayo Clinic doctors participated and provided students with feedback on presentations and stories from their own experiences in patient care. The course's primary objective was to build students' confidence and expertise in storytelling. These skills were then applied to presenting cases and communicating with patients in a fresher, more engaging way. This paper outlines the instructional activities as aligned with course objectives. Progress was tracked by comparing pre-course and post-course surveys from the seven participating students. All agreed that the theatrical techniques were effective teaching methods. Moreover, this project can serve as an innovative model for how arts and humanities professionals can be incorporated for teaching and professional development initiatives at all levels of medical education. (shrink)

In recent years there has been a powerful resurgence of settler colonialism as an interpretive framework through which to understand the Israeli-Palestinian conflict. Attached to the burgeoning field of settler colonial studies, this so-called ‘turn’ to settler colonialism has seen Israel-Palestine increasingly compared alongside New World white settler societies like Australia, Canada and the United States. In seeking to undercut the lens of exceptionalism through which the conflict has conventionally been viewed, the settler colonial paradigm has some important counter-hegemonic implications (...) for reframing Israel-Palestine, not least of which is its prescription for decolonization. However, it is paradoxically in the context of decolonization that the limits of the settler colonial paradigm become most apparent. I argue that these limitations are connected to the dominance of Patrick Wolfe’s structural account of settler colonialism, which leaves very little room for transformation, and to the particular connotations settler colonial studies has acquired from the New World contexts in which it is most often articulated. This is particularly the case in Israel-Palestine, where these connotations preclude engagement with the national aspects of the conflict and leave under-examined the unique resonances of the settler/native distinction, which need reckoning with in any serious account of decolonization. (shrink)

Normative reasons for action are considerations that count in favor of actions. They are the considerations that determine what an agent should do in a given situation. If the agent acts on these considerations, they justify her action. This paper concerns accounts of normative reasons that separate the explanation of why a particular reason counts in favor of an agent’s performing some action from the content of that reason. Elements of this explanation of why the reason is a reason are (...) “background conditions” on that reason, rather than part of the reason itself. (shrink)

In 1755, Lisbon was destroyed by an earthquake whose aftershocks were felt across Europe. One of the less well-known responses to this abyssal event is that offered by Kant in his three essays on earthquakes and their causes. According to Irigaray, Kant's concern with an earth that moves is not incidental, but central to the emergence of his critical project. The goal of this paper is to trace a line from Kant's earthquake essays, through his later writings on the sublime, (...) to Irigaray's critique of the Kantian project and her positive re-appropriation of a matter that moves, a well as the sublime figure of the abyss. I will suggest that, in her work, the abyss is transformed from a rupturing cleft into a shelter for sexuate difference, and from a site of terror into a space for wonder. (shrink)

This chapter begins with the discussion of one of the earliest texts in the Western tradition to explore the relations between philosophy and pedagogy, Plato's Symposium. In this text, love (or more properly, eros) plays the mediating role, turning a love of wisdom into a pedagogical erotics that enables a journey of enlightenment. The author refers to the work of more recent thinkers, including Hannah Arendt, Jean‐François Lyotard and Luce Irigaray. The author's suggestion is that by approaching Symposium through their (...) work, this text can yield insights that are helpful for contemplating the educational process in a more contemporary context. In Symposium, the initial expulsion of the flute‐girl is undercut by Diotima's later inclusion as an apparently privileged female voice. ‘Diotima's speech’ is intriguing for many reasons, not least because it is the only place in Plato's known oeuvre where a woman takes on the part of the philosopher. (shrink)

The only Israelis this generation of Palestinians know are soldiers and settlers. For them, Israel is no more than a subsidiary of an army that knows no limits and settlements that know no borders.Recipient of the UNESCO Guillermo Camo World Press Freedom Prize in 2003, Amira Hass is the only Jewish Israeli correspondent on Palestinian affairs to live among the people about whom she reports. The child of Holocaust survivors, Hass prefers the title "expert in Israeli occupation," and, as such, (...) is relentless in her quest for both truth and justice. (shrink)

The purpose of the current research was to examine strategies of persuasion used by Arabic-speaking and Hebrew-speaking boys and girls to determine the relative contributions of culture and gender in determining communication styles. Children were asked to write a letter to a male or female peer asking for a gender-stereotyped or a gender-neutral gift. Four meta-categories were identified: formality, self-focus, other-focus, and gift-focus. For each meta-category except gift-focus, there were significant main effects and interactions. Language group was significant for formality (...) and other-focus but not for self-focus. Importantly, there were several interactions between participant gender, target gender, and gender-stereotypy of gift, but these did not interact with language group. The results were discussed in the context of children’s socialization to the ethos of musayara and dugri in Arabic-speaking and Hebrew-speaking culture. (shrink)

Hume’s moral philosophy makes sentiment essential to moral judgment. But there is more individual consistency and interpersonal agreement in moral judgment than in private emotional reactions. Hume accounts for this by saying that our moral judgments do not manifest our approval or disapproval of character traits and persons “only as they appear from [our] peculiar point of view... ” Rather, “we fix on some steady and general points of view; and always, in our thoughts, place ourselves in them, whatever may (...) be our present situation” (T 581-82), in order to “correct” our situated sentiments. This seems to create two serious difficulties for Hume’s theory. First, moral evaluations become inductive, empirical beliefs about what we would feel if we really occupied the imagined common point of view, and hence are the deliverances of causal reason; this contradicts Hume’s claim that the making of a moral evaluation is not an activity of reason but of sentiment. Secondly, given Hume’s thesis that the passions do not represent anything else, he cannot say that our moral evaluations will better represent the object being judged if they are made from the common point of view. This leaves no clear reason to adopt it, rather than making judgments from our real position. Hume says that left to our particular points of view, we will encounter contradictions and be unable to communicate, but it is hard to see why.My interpretation resolves these two difficulties. I argue that every time we reflect upon someone’s character from the common point of view, we feel an actual sentiment of approbation or disapprobation, which may alter and merge with the situated sentiment or may fail to do so, leaving two different feelings about the same character. Furthermore, whenever we make moral evaluations we also simultaneously make objective, causal judgments about the love and hatred, pride and humility that the trait will produce. We routinely take up the common point of view in order to achieve truth and consistency in our causal judgments, to avoid grave practical problems. (shrink)

This article proposes to reconceive moral education on the model of spiritual practice. Such an education would be defined not by its content—that is, explicit instruction about moral rules or particular virtues—but rather by the form of its constituent activities. Drawing on the works of both Plato and Foucault, the article addresses questions about the epistemic complexity of virtue raised in Mark E. Jonas and Yoshiaka Nakzawa’s A Platonic Theory of Moral Education. It then goes on to suggest that the (...) form of spiritual practice is uniquely suited to the cultivation of virtue understood on their Platonic model. (shrink)

BackgroundPatients with COVID-19 may feel under pressure to participate in research during the pandemic. Safeguards to protect research participants include ethical guidelines [e.g. Declaration of Helsinki and good clinical practice (GCP)], legislation to protect participants’ privacy, research ethics committees (RECs) and informed consent. The International Committee of Medical Journal Editors (ICMJE) advises researchers to document compliance with these safeguards. Adherence to publication guidelines has been suboptimal in other specialty fields. The aim of this rapid review was to determine whether COVID-19 (...) human research publications report compliance with these ethical safeguards.MethodsA rapid systematic literature review was conducted in MEDLINE using the search term ‘COVID-19’. The search was performed in April 2020 with no start date and repeated to include articles published in November 2020. Filters were ‘Full free text available’ and ‘English Language’. Two reviewers assessed article title, abstracts and full texts. Non-COVID-19 articles and non-clinical studies were excluded. Independent reviewers conducted a second assessment of a random 20% of articles. The outcomes included reporting of compliance with the Declaration of Helsinki and GCP, REC approval, informed consent and participant privacy.ResultsThe searches yielded 1275 and 1942 articles of which 247 and 717 were deemed eligible, from the April search and November respectively. The majority of journals had editorial policies which purported to comply with ICMJE ethical standards. Reporting of compliance with ethical guidelines was low across all study types but was higher in the November search for case series and observational studies. Reporting of informed consent for case studies and observational studies was higher in the November search, but similar for case series. Overall, participant confidentiality was maintained but some case studies included a combination of details which would have enabled participant identification. Reporting of REC approval was higher in the November search for observational studies.ConclusionsWhile the majority of journal’s editorial policies purported to support the ethical safeguards, many COVID-19 clinical research publications identified in this rapid review lacked documentation of these important safeguards for research participants. In order to promote public trust, ethical declarations should be included consistently. (shrink)

Recognition theory attempts to conceptualize interpersonal relationships and their normative political implications. British social philosopher Gillian Rose developed her own version of recognition rooted in the work of Georg Hegel. This article applies Rose's theory of recognition to care, arguing that its emphasis on lack of identity, the dynamic process of recognition and the existential risks involved accurately describes the relationship between nurse and patient. Rose's version is compared to both contemporary notions of the interpersonal in healthcare literature, other forms (...) of recognition theory and Emmanuel Levinas's vision of intersubjective relationships, a traditional philosophical basis for nursing care. In each case, I will argue that Rosean recognition is a fuller, more complex and ultimately more satisfying view of the relationships involved. (shrink)

The author explores the role of Boston in the evolution of modern photography, examining the institutions, corporations, and artists who shaped the scene in that city in the last half of the twentieth century.

The 1960s witnessed a striking change in geology. Since at least the seventeenth century, one of the central problems of the subject had been the origin of the major irregularities of the surface of the globe—continents and oceans, mountain chains and ocean islands—irregularities that were not anticipated by most physical theories. Traditionally these features had usually been explained either as residual traces of events occurring during the very early history of the globe, or as the result of vertical movements of (...) the earth’s crust, caused, for example, by changes in the heat budget. The last two decades have seen an end to all this. The vast majority of geologists now believe that these irregularities largely result from the lateral movement of thin rigid plates covering the earth, a theory now known as “plate tectonics”, but a theory which also has obvious parallels with the hypothesis of continental drift, in which it was postulated that continents can move laterally. (shrink)