The COVID-19 pandemic has foregrounded the significance of time to everyday life, as the routines, pace, and speed of social relations were widely reconfigured. This article uses rhythm as an object and tool of inquiry to make sense of spatio-temporal change. We analyse the Mass Observation (MO) directive we co-commissioned on ‘COVID-19 and Time’, where volunteer writers reflect on whether and how time was made, experienced, and imagined differently during the early stages of the pandemic in the UK. We draw (...) on Henri Lefebvre and Catherine Régulier's ‘rhythmanalysis’, taking up their theorisation of rhythm as linear and cyclical and their concepts of arrhythmia (discordant rhythms) and eurhythmia (harmonious rhythms). Our analysis highlights how MO writers articulate (a) the ruptures to their everyday rhythms across time and space, (b) their experience of ‘blurred’ or ‘merged’ time as everyday rhythms are dissolved and the pace of time is intensified or slowed, and (c) the remaking of rhythms through new practices or devices and attunements to nature. We show how rhythm enables a consideration of the spatio-temporal textures of everyday life, including their unevenness, variation, and difference. The article thus contributes to and expands recent scholarship on the social life of time, rhythm and rhythmanalysis, everyday life, and MO. (shrink)

This unique book explores Nietzsche’s philosophy at the time of Dawn’s writing and discusses the modern relevance of themes such as fear, superstition, terror, and moral and religious fanaticism. The authors highlight Dawn’s links with key areas of philosophical inquiry, such as “the art of living well,” skepticism, and naturalism. The book begins by introducing Dawn and discussing how to read Nietzsche, his literary and philosophical influences, his relation to German philosophy, and his efforts to advance his (...) ‘free spirit’ philosophy. Subsequent discussions address a wide range of topics relevant to Dawn, including presumptions of customary morality, hatred of the self, free-minded thinking, and embracing science and the passion of knowledge. (shrink)

Nietzsche's wider political thinking has been widely recognized as therapeutic in orientation, as part of its connection to the history of psychology. This chapter examines the remarks that Nietzsche does make with respect to the political in Dawn, focusing on his concern with the effects on humanity of capital and industrial development upon Europeans. It explores his remarks on migration as a therapeutic measure for the workers of Europe and considers some of the problematic claims involved in Nietzsche's appeal (...) to migration as a key part of his therapeutic approach. The chapter discusses whether or not Nietzsche's therapeutic politics in Dawn can be defended. Nietzsche contends that money substitutes for truth, and that the same fanaticism that previously drove truth‐seeking now drives people to the increasing, and increasingly rapid, acquisition of wealth. (shrink)

_Endless Night: Cinema and Psychoanalysis, Parallel Histories_ Edited by Janet Bergstrom Berkeley: University of California Press, 1999 ISBN 0-520-20747-5 (hbk); 0-520-20748-3 (pbk) 307 pp.

I provide a critical interpretation of Morgenröthe: Gedanken über die moralischen Vorurteile that identifies the key philosophical work done by Nietzsche in this text, as well as presenting the text as a type of medical narrative. I show how Nietzsche engages with three main questions, drawing thematic connections between themes of physical and psychological health and of ethics, in order to develop a foundation for his critical transvaluation project: First, what is the nature of, and relationship between psycho-physiological and cultural (...) health? Second, by which method of critical engagement may our health be diagnosed and promoted? And third, what virtues are required for such work? (shrink)

This chapter focuses on Nietzsche's analyses of religion and Christianity, as well as a religious figure such as Saint Paul, so as to highlight the character of his critical procedures and the probing manner in which he subjects so‐called “spiritual” phenomena and matters to psychological scrutiny. Nietzsche attempts to develop a purely psychological explanation of the religious states, including the need for salvation, one that will be free of mythology. One prejudice Nietzsche attacks in Dawn is that of “pure (...) spirit”. He seeks to expose the costs to the health of the body of a teaching of pure spirituality. An important point to note is that, on Nietzsche's account, Paul and Christianity both stand in opposition to science. According to Nietzsche, Christianity is said to be a religion out of touch with reality and is mortally opposed to the wisdom of the world or to “science”. (shrink)

This chapter considers how care of the self is a fundamental part of the task of experimenting with what the ethical, when freed from the constraints of moral fanaticism, might mean. Nietzsche provides a sustained critique of moral fanaticism that carries important implications for contemporary analysis of security. Through his psychological probing of the “fantastical instincts” and of the need for the feeling of power Nietzsche is led to cultivate skepticism about politics in Dawn and to favor instead a (...) program of therapeutic self‐cultivation. Nietzsche also admires Epictetus on account of his dedication to his own ego and for resisting the glorification of thinking and living for others. Nietzsche holds to the view that human beings need to be discouraged from making important decisions while in a condition of romantic love, observing how too much of life is easily squandered with the chanciness of marriages rendering any great advance of reason and humanity impossible. (shrink)

This chapter discusses how the final aphorism, 575, of Nietszsche's Dawn, presents a positive vision of humanity as future‐oriented and self‐cultivating. It explores how Nietzsche's vision of humanity as future‐oriented and self‐creating is taken up once again by him in his later writings. In the final aphorism Nietzsche's use of the symbolism of flight is significant. This final aphorism is entitled "We aeronauts of the spirit". As Duncan Large has pointed out, the aeronauts in the aphorism are flying an (...) "air‐ship", and their flying out over the sea indicates "how close is their kinship to their more earthbound, or at least sea‐bound mariner‐cousins". In addition to his use of the sea as a metaphor for both the infinity of the future and humanity's orientation toward this future, Nietzsche draws upon the metaphor of flight to elaborate on this continuation of human development. (shrink)

Many of Nietzsche's texts, particularly those that form part of his later writings, have received significant individual attention within English‐speaking Nietzsche studies. This chapter argues that Nietzsche's core critical innovations in Dawn are in identifying why customary morality is a significant problem for humanity, and in developing a sustained critique of this form of morality in order to motivate critical re‐engagement with the ethical. In Dawn, Nietzsche attacks the view that everything that exists has a connection with morality (...) and thus a moral significance can be projected onto the world. Nietzsche's project in Dawn focuses on addressing the presumptions and prejudices of customary morality. The challenge of understanding the philosophical contribution that Dawn makes is complicated by Nietzsche's writing styles: he combines innovative deployment of aphorism and punctuation with use of multiple voices or characters, and a range of rhetorical devices. (shrink)

This chapter examines the basis of Nietzsche's campaign against customary morality in Dawn. It consider what problems there are with mounting a successful campaign against morality, and to what extent Nietzsche's campaign against morality leaves room for a positive ethics. The chapter shows that Nietzsche's fundamental concern is that morality as it currently stands is bad for humans. The basic problem with the campaign against morality that Nietzsche pursues in the original aphorisms of Dawn can be developed in (...) greater depth by examining evidence from its 1886 Preface, which illustrates Nietzsche's awareness of the challenge that his campaign against morality faces. Aphorism supports Nietzsche's experimental disruption of the social and emotional systemic functioning of customary morality, and allows for exploration of alternatives to the mood of fear that Nietzsche shows to be pervasive to customary morality. (shrink)

This chapter clarifies several of the main aspects of Nietzsche's work on subjectivity, self, and drives in Dawn. It shows how Nietzsche's thinking on subjectivity, the self, and drives in Dawn emerges from his affirmation of the Enlightenment spirit, his hope for a new enlightenment, and his critical engagement with morality. The chapter examines the skeptical dimension of Nietzsche's thinking on subjectivity and the self. It points out how Nietzsche criticizes some of common presumptions about subjectivity and the (...) self, using the notion of drives to stimulate the critical engagement he is calling for. The chapter explores how Nietzsche maintains a commitment to the notion of self‐cultivation in Dawn. It also considers how Nietzsche's undermining of such presumptions leads him to make an important distinction between the subjectivity of an agent shaped by customary morality, and that of a free‐spirited ethical agent. (shrink)

This chapter examines the consequences of Nietzsche's campaign against morality for the pursuit of knowledge in philosophy, and specifically, on values and methods of the German Enlightenment. In Dawn, Nietzsche explores how an experimental approach to knowing and to knowledge involves us in adopting different ways of being toward things in the world, as well as toward ourselves and our experiences, and in using associated diverse methods of inquiry. Nietzsche's free‐spirit writings, including Dawn, are works of a particular (...) kind of enlightenment project that works against all expressions of fanaticism, especially religious and moral, and in an effort to temper emotional and mental excess. Nietzsche's primary commitment in Dawn is to experimentation in which the love of, or passion for, knowledge gives humanity back its right to engage in self‐experimentation. (shrink)

This chapter examines Nietzsche's thinking on the concept of Mitleid and discusses the complexities of translating this concept into English in Dawn. It describes how Nietzsche's critical engagement with this concept is importantly dependent on the role of drives in his wider moral psychology. The chapter also examines the role of mood and social transmission of feeling in his critique, arguing that these factors play key roles in Nietzsche's development of a substantial critique of an ethic of compassion, and (...) in his pursuit of an alternative ethic. It shows how Nietzsche's exposure of an ethic of compassion as fundamentally flawed opens up the possibility of a reconfiguration of the concept of moral imagination, and facilitates development of a more robust, creative, and experimental concept of ethical imagination as a part of Nietzsche's broader effort to provide a framework for ongoing moral therapy. (shrink)

This chapter examines Nietzsche's remarks on Epicurus in the earlier middle writings, to provide an interpretative framework through which to clarify Nietzsche's thinking on death in Dawn. It considers some points of continuity between Nietzsche's account of death in Dawn and in his later texts. Nietzsche champions Epicurus as a figure who has sought to show mankind how it can conquer its fears of death. The chapter contends that Nietzsche uses Epicurean thinking as a strategy to do his (...) work in Dawn, picking up the Epicurean doctrine on death and putting it to critical effect. Nietzsche's fundamental aim in writing about death, within the wider context of his project in Dawn, is to counter our socially conditioned yearning for immortality. A careful reading of Epicurus attests to the significance of Epicureanism as a strategy informing Nietzsche's thinking on death in Dawn. (shrink)

Christian realism is undergoing a renaissance in both American Christianity and around the world. Caught between globalist liberalism, on the one hand, and pragmatic realism on the other, Christians are in search of international ethics, a standard and tradition in foreign policy, that takes the two great books of life, the Christian Scriptures and the world we live in, seriously. This book is an extended, edited collection that mines the tradition of Christian realism in international relations and finds in it (...) voices and mentors urgently fresh for a new age. With classic authors like Reinhold Niebuhr, Herbert Butterfield, Paul Ramsey, and Jean Bethke Elshtain, and contemporaries like Marc LiVecche, Rebecca Heinrichs, and others, this collection offers for the first time an organization, periodization, and collection of primary Christian realist sources for the initiate and the expert in foreign relations."--Provided by publisher. (shrink)

The prelims comprise: Half‐Title Page Title Page Copyright Page Dedication Page Table of Contents Acknowledgments Editions of Nietzsche's Writings Used with Abbreviations.

“It's almost like putting salt in a wound, for this person who's already made a very difficult decision,” suggested Meghan Patterson, a licensed obstetrician-gynecologist whom we interviewed in our qualitative study of the experiences of North Carolina abortion providers practicing under the state's Woman's Right to Know Act. The act requires that women receive counseling with state-mandated information at least twenty-four hours prior to obtaining an abortion. After the law was passed, Patterson worked with clinic administrators, in consultation (...) with a lawyer, to write a script to be used in the state-mandated counseling procedure. She and her colleagues took particular steps to mitigate the effects of what she described as HB 854's “forced language”—such as referring to the “father of the child.” While HB 854 stipulated that patients must be informed of the medical risks associated with the particular abortion procedure as well as those of carrying the child to term, Patterson's script made explicit the magnitude of comparative risks, emphasizing that the risks of carrying a pregnancy to term are substantially greater than the risks of an early-term abortion. She felt that these contextualization strategies helped to facilitate trust and rapport in a clinical care situation that proved relationally and morally challenging. In this article, we take up and expand on this point by elucidating an empirically grounded approach to ethically justified care when health care providers face legal or institutional policy mandates that raise possible moral conflicts. Our approach builds on recent bioethics discourse addressing conscience in the practice of medicine. While the concept of conscience has broad philosophical underpinnings relating to moral judgment, agency, and discernments of right and wrong, debates in bioethics have tended to engage the concept primarily vis-à-vis rights of conscientious objection or refusal. Here, we suggest a broader frame for thinking about claims of conscience in health care. Our approach draws on the feminist bioethics and the ethics of care literatures to highlight how providers may be motivated by matters of conscience, including relational concerns, in the active provision of certain forms of care. What emerges are two possibilities: not only conscientious refusal to comply with a policy mandate but also conscientious compliance—working conscientiously within a mandate's confines. (shrink)

Although caution ought to be exercised when it comes to his retrospective assessment of his past works, Nietzsche’s EH accurately describes D as a significant beginning, and a preparatory work. The preparation in question is for a broad critical reappraisal of the function of morality. More specifically, the object of Nietzsche’s critique is that which he titles “customary morality.” It is D that got the ball rolling on this project, as well as on many familiar Nietzschean themes that find arguably (...) maturer exposition in later works, those more systematically studied on university syllabi. In this respect and others, Keith Ansell-Pearson and Rebecca Bamford are justified in their claim that D itself is a significant... (shrink)

Miranda Fricker claims that a “gap” in collective hermeneutical resources with respect to the social experiences of marginalized groups prevents members of those groups from understanding their own experiences (Fricker 2007). I argue that because Fricker misdescribes dominant hermeneutical resources as collective, she fails to locate the ethically bad epistemic practices that maintain gaps in dominant hermeneutical resources even while alternative interpretations are in fact offered by non-dominant discourses. Fricker's analysis of hermeneutical injustice does not account for the possibility that (...) marginalized groups can be silenced relative to dominant discourses without being prevented from understanding or expressing their own social experiences. I suggest that a gap in dominant hermeneutical resources is ambiguous between two kinds of unknowing: hermeneutical injustice suffered by members of marginalized groups, and epistemically and ethically blameworthy ignorance perpetrated by members of dominant groups. (shrink)

It is a truism that humans are social animals. Thus, it is no surprise that we understand the world, each other, and ourselves in terms of social kinds such as money and marriage, war and women, capitalists and cartels, races, recessions, and refugees. Social kinds condition our expectations, inform our preferences, and guide our behavior. Despite the prevalence and importance of social kinds, philosophy has historically devoted relatively little attention to them. With few exceptions, philosophers have given pride of place (...) to the kinds studied by the natural sciences, especially physics. However, philosophical interest in social kinds is growing in recent years. I critically examine answers to a cluster of related questions concerning the metaphysics of social kinds. Are social kinds natural kinds? Do social kinds have essences? Are social kinds mind dependent? Are social kinds real? (shrink)

The goal of this paper is to give an account of the pragmatic and social function of slurs, taken as speech acts. I develop a theory of the distinctive illocutionary force and pragmatic structure of slurs. I argue that slurs help to produce subjects who occupy social identities carved out by pernicious ideologies, and that they do this whether or not anyone involved intends for the slur to work that way or has any particular feelings or conscious thoughts associated with (...) using or being targeted by the slur. I offer an Althusser‐inspired account of what an ideology is, as well as of the mechanisms by which slurs can serve to cue and strengthen ideologies. A slur, I argue, is a kind of interpellation, which reduces its target to a generic identity and derogates and subordinates its target. I explore how slurs and ideologies work in tandem to constitute and fortify one another. I end by applying my account to see how well it fits and helps illuminate three quite different, especially complex slurs. (shrink)

When patients have progressive and incurable dementia, should their advance directives always be followed? Contra Dworkin, Dresser argues that when patients remain able to enjoy and participate in their lives, directives to hasten death should sometimes be disregarded.

This study analyzes the relationship between CEO values, leadership style and ethical practices in organizations. The ethical practices of formal statement of ethics and diversity training are included in the study, as well as four categories of values based on Rokeach's (1973) typology including personal, social, competency-based and morality-based. Results indicate that all four types of values are positively and significantly related to transformational leadership, with transactional leadership positively related to morality-based and personal values, and laissez-faire leadership negatively related to (...) competency-based values. When size of company and values are controlled, transformational leadership explains a significant amount of change in formal statement of ethics, and transactional leadership explains a significant amount of change in diversity training. (shrink)

Health promotion efforts are commonly directed towards encouraging people to discard ‘unhealthy’ and adopt ‘healthy’ behaviours in order to tackle chronic disease. Typical targets for behaviour change interventions include diet, physical activity, smoking and alcohol consumption, sometimes described as ‘lifestyle behaviours.’ In this paper, I discuss how efforts to raise awareness of the impact of lifestyles on health, in seeking to communicate the need for people to change their behaviour, can contribute to a climate of ‘healthism’ and promote the moralisation (...) of people’s lifestyles. I begin by summarising recent trends in health promotion and introducing the notion of healthism, as described by Robert Crawford in the 1980s. One aspect of healthism is moralisation, which I outline and suggest is facilitated by efforts to promote health via information provision and educational strategies. I propose that perceived responsibility plays a role in mediating the tendency to moralise about health and behaviour. Since I argue that states ought to avoid direct and indirect moralisation of people’s health-related behaviour, this suggests states must be cautious with regard to the use of responsibility-indicating interventions to promote health. (shrink)

This study uses data from the National Longitudinal Survey of Youth to explore the intersections of gender and race on fathers' labor market outcomes. Fixed-effects models reveal that for married whites and Latinos, the birth of a child is associated with an increase in hourly wages, annual earnings, and annual time spent at work. For married Black men, the birth of a child is associated with a smaller increase in hourly wages and annual earnings but not associated with an increase (...) in annual time spent at work. Furthermore, married Black men do not experience an increase in hourly wages or work hours because of a reduction in their wives' work hours. In contrast, married whites and Latinos earn more when their wives work less. These findings imply that gendered workplace and family experiences differ among fathers and that not all men benefit from specific family formations in exactly the same way. (shrink)

Peltokorpi and Hood provide a systematic review of theory and research examining the ways communication and conversations help dyads, groups, and teams form and maintain transactive memory systems (TMS; Wegner, Erber, & Raymond, 1991) through overlapping encoding, storage, and retrieval processes. Peltokorpi and Hood organized their systematic review of 34 articles published in psychology, communication and organization research and management into four main themes: i) communication frequency and quality; ii) communication medium and group development, iii) communication styles, and (...) iv) communication networks. (shrink)

Decentralized biobanking “de-bi” applies blockchain technology and web3 values to embed the procedural principles of transparency, accountability, and inclusion into the biomedical research ecosyst...

Servant leadership is increasingly gaining interest inside and outside academia. This article builds and extends current theorizing by describing the process that introduces compassionate love as a practical translation for the need to serve, which was positioned by Greenleaf as the core of servant leadership. This article takes a virtues perspective and shows how servant leadership may encourage a more meaningful and optimal human functioning with a strong sense of community to current-day organizations. In essence, we propose that a leader’s (...) propensity for compassionate love will encourage a virtuous attitude in terms of humility, gratitude, forgiveness and altruism. This virtuous attitude will give rise to servant leadership behavior in terms of empowerment, authenticity, stewardship and providing direction. (shrink)

Contemporary culture trivializes the "seven deadly sins," or vices, as if they have no serious moral or spiritual implications. Glittering Vices clears this misconception by exploring the traditional meanings of gluttony, sloth, lust, and others. It offers a brief history of how the vices were compiled and an eye opening explication of how each sin manifests itself in various destructive behaviors. Readers gain practical understanding of how the vices shape our culture today and how to correctly identify and eliminate the (...) deeply rooted patterns of sin that are work in their own lives. This accessible book is essential for any reader interested in spiritual disciplines and character formation. Excerpt Very simply, a virtue (or vice) is acquired through practice repeated activity that increases our proficiency at the activity and gradually forms our character. . . . We often need external incentives and sanctions to get us through the initial stages of the process, when our old, entrenched desires still pull us toward the opposite behavior. But with encouragement, discipline, and often a role model or mentor, practice can make things feel more natural and enjoyable as we gradually develop the internal values and desires corresponding to our outward behavior. Virtue often develops, that is, from the outside in. This is why, when we want to reform our character from vice to virtue, we often need to practice and persevere in regular spiritual disciplines and formational practices for a lengthy period of time. (shrink)

This paper is an exploration of the Thomistic vice of despair, one of two vices opposed to the theological virtue of hope. Aquinas's conception of despair as a vice, and a theological vice in particular, distances him from contemporary use of the term "despair" to describe an emotional state. His account nonetheless yields a compelling psychological portrait of moral degeneration, which I explain via despair's link to its "root," the capital vice of sloth. Cases in which sloth and its offspring (...) vices progress into full-fledged despair raise intersecting issues about whether and how despair might be remediable. I conclude by considering puzzles regarding despair's disordered effects on the intellect and will and weighing three possible means of remedying it. (shrink)

Background: Research involving adults lacking mental capacity relies on the involvement of a proxy or surrogate, although this raises a number of ethical concerns. Empirical studies have examined attitudes towards proxy decision-making, proxies’ authority as decision-makers, decision accuracy, and other relevant factors. However, a comprehensive evidence-based account of proxy decision-making is lacking. This systematic review provides a synthesis of the empirical data reporting the ethical issues surrounding decisions made by research proxies, and the development of a conceptual framework of proxy (...) decision-making for research. Methods: A systematic review was conducted according to PRISMA guidelines. Databases including MEDLINE, EMBASE, and CINAHL were searched using a combination of search terms, and empirical data from eligible studies were retrieved. The review followed the framework synthesis approach to refine and develop a conceptual framework. Results: Thirty-four studies were included in the review. Two dimensions of proxy decision-making emerged. The ethical framing criteria of decision-making used by proxies: use of a substituted judgement, use of a best interests approach, combination of substituted judgement and best interests, and ‘something else’, and the active elements of proxy decision-making: ‘knowing the person’, patient-proxy relationship, accuracy of the decision, and balancing risks, benefits and burdens, and attitudes towards proxy decision-making. Interactions between the framing criteria and the elements of decision-making are complex and contextually-situated. Conclusions: The findings from this systematic review challenge the accepted reductionist account of proxy decision-making. Decision-making by research proxies is highly contextualized and multifactorial in nature. The choice of proxy and the relational features of decision-making play a fundamental role: both in providing the proxy’s authority as decision-maker, and guiding the decision-making process. The conceptual framework describes the relationship between the framing criteria used by the proxy, and the active elements of decision-making. Further work to develop, and empirically test the proposed framework is needed. (shrink)

Translational science is a 21st century mission. Government officials and industry leaders are making huge investments in an attempt to transform more basic science discoveries into therapeutic applications. Scientists and policymakers express great excitement about the medical advances that could come with the current bench-to-bedside campaign.A key step in translational science is the move from animal and other preclinical studies to initial human testing. Researchers ability to predict human effects is limited, and first-in-human tests present significant uncertainty. Participants in this (...) form of research face risks and can experience serious, even lethal, harm. Well-known incidents involving Jolee Mohr and Jesse Gelsinger, as well as subjects in the 2006 study of the investigational agent TGN1412, show the dangers that can arise in early human research.The bench-to-bedside campaign will need many volunteers to participate in early human testing. Investigators and regulators must not allow the policy enthusiasm for translational science to overshadow the commitment to protect human subjects. Participants in exploratory research are diverse and as a group lack characteristics usually associated with vulnerable populations, such as impaired decisional ability or economic or educational disadvantage. (shrink)

Background: Informed consent in the modern era is a common and important topic both for the well-informed patient and to prevent unnecessary litigation. However, the effectiveness of informed consent in trauma patients is an under-researched area. This paper aims to assess the differences in patient recall of the consent process and desire for information by performing a comparative analysis between orthopaedic trauma and elective patients. Methods: Information from 41 consecutive elective operations and 40 consecutive trauma operations was collected on the (...) first post-operative day. Results: 100% of elective patients and 90% of trauma patients knew what operation they had received (p = 0.06). Overall recall of complications was poor, but was significantly lower in trauma patients compared with elective patients (62% vs 22%, p<0.001). 30% of trauma patients desired more information about their operation compared to 12% of elective patients (p = 0.049), although only 35% of trauma patients wanted written as well as verbal explanations, compared to 85% of elective patients p<0.001). Overall 100% of elective and 90% of trauma patients were happy with the consent process (p = 0.06). Subset analysis of neck of femur compared to other trauma patients showed that the above factors were not significantly different between the two groups. Conclusions: Recall of complications in the trauma patients is significantly lower than in elective patients, although both groups scored poorly overall. Repeated verbal explanations should be reinforced with the option of additional information leaflets for trauma operations. Further research into the usefulness of DVDs for commonly performed operations is warranted, although official internet resources may be more cost-effective. (shrink)

Legal battles continue in the UK over the Government’s plans to transport asylum seekers arriving on British shores to Rwanda in East Africa. Originally announced as a system for ‘processing’ asylum seekers, the Government has subsequently made it clear that there would not be an option for asylum seekers to return to the UK. The arrangement forms part of a deal between the UK and Rwanda, with the UK promising to invest £120 m in economic growth and development in Rwanda, (...) along with financing the cost of the ‘offshored’ asylum operation.1 The Government states that the policy is designed to break the business model of people traffickers involved in facilitating hazardous trips across the Channel in small, overcrowded and unseaworthy craft, leading to multiple drownings. Critics argue that the policy will do nothing to stop desperate people from seeking refuge in the UK, that transferring already traumatised people to Rwanda – which has been criticised for its human rights record – is inhumane and potentially outwith international law. Medical bodies, including the BMA, along with refugee organisations have expressed serious concerns about the health impact of such a system of ‘offshoring’. An equivalent system in Australia has been notorious for the devastating health impacts on those ‘offshored’ to the Pacific islands of Manus and Naura. Unusually in the UK the offshoring proposals have been greeted by unanimous condemnation by the Church of England. The lawfulness of the process is also subject to question. On the 14 July, a plane carrying a small number of asylum seekers to Rwanda was halted shortly before take-off following an intervention by the European Court of Human Rights. The ECtHR, part of the Council of Europe, of which the UK is still a member, said an Iraqi man known as KN faced ‘a real …. (shrink)

Under current U.S. law, physicians may prescribe drugs and devices in situations not covered on the label approved by the Food and Drug Administration. Those supporting this system say that requiring FDA approval for off-label uses would unnecessarily impede the delivery of benefits to patients. Patients do benefit from off-label prescribing that is supported by sound scientific and medical evidence. In the absence of such evidence, however, off-label prescribing can expose patients to risky and ineffective treatments. The medical community and (...) federal authorities should more actively promote patients' interests in receiving beneficial off-label treatments. To exercise responsible self-regulation, members of the medical community must determine whether available evidence justifies specific off-label uses and must promote information-gathering when the evidence is inadequate. Physicians should also discuss with patients the uncertainties accompanying off-label uses. Federal authorities should more closely monitor the effects of off-label prescribing and adopt other measures to reduce harm and enhance benefits produced by off-label prescribing. (shrink)

Courts and legislatures are increasingly being called upon to restrict the autonomy of pregnant women by requiring them to behave in ways that others determine are best for the fetuses they carry. The state should not attempt to transform pregnant women into ideal baby‐making machines. Pregnant women make decisions about their behavior in the context of the rest of their lives, with all the attendant complexities and pressures. Our interest in helping future children by improving prenatal care would best be (...) furthered by helping pregnant women to make informed, less constrained choices, not by punishing women or depriving them of choices altogether. (shrink)

David Chalmers supports his contention that there is a possible world populated by our zombie twins by arguing for the assumption that conceivability entails possibility. But, I argue, the modal epistemology he sets forth, ‘modal rationalism,’ ignores the problem of incompleteness and relies on an idealized notion of conceivability. As a consequence, this epistemology can’t justify our quotidian judgments of possibility, let alone those judgments that concern the mind/body connection. Working from the analogy that the imagination is to the possible (...) as perception is to the actual, I set forth a competing epistemology, ‘modal empiricism.’ This epistemology survives the incompleteness objection and allows some of our everyday modal judgments to be justified. But this epistemology can’t justify the claim that Zombie World is possible, which leaves Chalmers’s property dualism without the support it needs. (shrink)

The Nuffield Council on Bioethics (NCOB) is delighted to pick up the mantel of the Ethics briefings. For readers less familiar with the NCOB’s work, we are a leading independent policy and research centre, and the foremost bioethics body in the UK. We identify, analyse and advise on ethical issues in biomedicine and health so that decisions in these areas benefit people and society.1 Established in 1991, the NCOB has tackled a wide range of bioethics and medical ethics issues over (...) its thirty-two years, including issues relating to the beginning and end of life, health and society, data and technology, and research ethics. Early reports in the 1990s included, for example, ‘Genetics screening: the ethical issues’ and ‘Animal-to-human transplants: the ethics of Xenotransplantation’. More recent projects include setting out an ethical framework in the report ‘The future of ageing: ethical considerations for research and innovation’2 and a current joint project with the Ada Lovelace Institute3 considering the potential ethical implications of the convergence of AI and genomics technologies.4 In recent years, NCOB has increasingly focused on horizon scanning. What current and future national and international developments are likely to raise ethical issues in the short, medium and long-term? Insights for 2023 will soon be available at www.nuffieldbioethics.org/what-we-do/horizon-scanning, with new developments likely to be included alongside ongoing areas of medical and scientific research that we are tracking progress in, for example, in vitro derived gametes, surrogacy, biosafety and novel neurotechnologies. Disagreements between parents and healthcare teams about …. (shrink)