Self‐trust is essential to the well‐being of people with chronic illnesses and those who care for them. In this exploratory essay, we draw on a trove of health narratives to catalyze examination of this important but often overlooked topic. We explore how self‐trust is impeded at both personal and structural levels, how it can best be nourished, and how it is related to self‐advocacy. Because people's ability to trust themselves is intrinsically linked to the trust others have in them, we (...) pay particular attention to the role that allies such as clinical professionals play in the development of self‐trust, highlighting the importance of eliciting patient narratives, of curious listening, and of compassionately raising questions. We also contrast the self‐trust paradigm with that of self‐management, which tends to replace the former's attention to patients’ experiences, abilities, qualities, or judgments with a professionally dominated discourse dedicated to addressing illness through behavior changes prescribed by clinicians. We close with a call to action, exhorting readers to focus on supporting self‐trust in health care settings and on creative research in this critical yet heretofore underrepresented domain. (shrink)

The authors explore whether the need for ethical reflection on the part of designing engineers is dependent on the type of design process. They use Vincenti's distinction between normal and radical design and different levels of design hierarchy. These two dimensions are coupled with the concept of ill-structured problems, which are problems in which possible solutions cannot be ordered on a scale from better to worse. Design problems are better structured at lower hierarchical levels and in cases of normal design. (...) Better structured design problems require less ethical reflection on the part of designing engineers if such situations are characterized by the existence of generally accepted normative frameworks. Engineers could then deal with moral problems within the bounds of such frameworks and without the need for further reflection. On the basis of a number of empirical cases, the authors explore whether these ideas hold water. They discuss four cases ranging from a high-level radical design process to a low-level normal design process. (shrink)

Different methods have been developed to address ethical issues during research. Most of these methods were developed at universities. In this article ethical parallel research within a Research and Technology Organization is described. Within a European project about perceived security, CPSI, the ethical issues were identified by ethicists cooperating in the project. The project CPSI was aimed at developing a research method that can be used by (local) government to monitor or assess perceived and actual security. Together with the researchers (...) a way was sought to address the ethical issues. Several issues could be addressed by choices with regard to the design of the validation study, in this case a survey. The ethical and legal reasons that were relevant for choices in the design of the validation study were made an integral part of these decisions. Some issues were already identified during the writing of the proposal others were only identified during the research. Participating in the research gave the ethicists access to all relevant information. It made it possible to address the ethical issues when they became relevant. Ethical reasons were part of some of the discussions on research method. It proved possible to address most ethical issues satisfactorily during the research project. (shrink)

This paper starts from the presupposition that moral codes often do not suffice to make agents understand their moral responsibility. We will illustrate this statement with a concrete example of engineers who design a truck’s trailer and who do not think traffic safety is part of their responsibility. This opinion clashes with a common supposition that designers in fact should do all that is in their power to ensure safety in traffic. In our opinion this shows the need for a (...) moral philosophy that helps engineers to interpret their responsibility and think more critically about it. For this purpose we will explore the moral philosophy of Alasdair MacIntyre, which is particularly interesting because he locates the beginning of moral thinking in the daily practice of a profession. This is consistent with the history of moral codes, for codes are also the product of moral reflection by professionals. We will use MacIntyre’s philosophy to (1) explain what is wrong with the designers’ understanding of their responsibility and (2) show a possible way to bring their reflection to a more self-critical level. We will also inspect MacIntyre’s proposal critically. (shrink)

Entry of new organizations, including multinational enterprises from emerging markets, raises the ethical question of will they benefit society. The concept of legitimacy answers this question because it is the overall assessment of the appropriateness of organizational ends and means. Moreover, gaining legitimacy enables EMNEs to succeed in new host countries. Past work examined collective level indicators of the legitimacy of MNEs, but recent research recognizes the importance of individuals’ perceptions as the micro-foundation of legitimacy. This study first uses new (...) pragmatism, deontology, and utilitarianism to demonstrate that legitimacy is fundamentally an ethical concept—a perspective that has been overlooked in management research. Second, this study uses a seven-step procedure to develop and validate a measure of individuals’ perceptions of the legitimacy of Chinese EMNEs operating in The Netherlands, a developed country. Six dimensions of legitimacy were identified. The study also finds support for this legitimacy judgment process linking the dimensions: validating knowledge → propriety judgments → generalized judgment. This work provides additional micro-foundations to research on legitimacy and contributes to the ongoing process of construct validation. Future research could use the validated measure in other settings and use specific ethical theories in depth to refine the concept of legitimacy. (shrink)

In projects concerning big data, ethical questions need to be answered during the design process. In this paper the Value Sensitive Design method is applied in the context of data-driven health services aimed at disease prevention. It shows how Value Sensitive Design, with the use of a moral dialogue and an ethical matrix, can support the identification and operationalization of moral values that are at stake in the design of such services. It also shows that using this method can support (...) meeting the requirements of the General Data Protection Regulation. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)

How do we understand the agency and significance of material forces and their interface with human bodies? What does it mean to be human in these times, with bodies that are inextricably interconnected with our physical world? Bodily Natures considers these questions by grappling with powerful and pervasive material forces and their increasingly harmful effects on the human body. Drawing on feminist theory, environmental studies, and the sciences, Stacy Alaimo focuses on trans-corporeality, or movement across bodies and nature, which (...) has profoundly altered our sense of self. By looking at a broad range of creative and philosophical writings, Alaimo illuminates how science, politics, and culture collide, while considering the closeness of the human body to the environment. (shrink)

By insisting on the importance of materiality, this volume breaks new ground in philosophy, feminist theory, cultural studies, science studies, and other fields where the body and nature collide.

In Undomesticated Ground, Stacy Alaimo issues a bold call to reclaim nature as feminist space.

Book synopsis: The most debated issue in aesthetics today Written by an international team of leading experts Addresses growing methodological concerns in the field Includes an extensive introduction which illuminates key issues Through much of the twentieth century, philosophical thinking about works of art, design, and other aesthetic products has emphasized intuitive and reflective methods, often tied to the idea that philosophy's business is primarily to analyze concepts. This 'philosophy from the armchair' approach contrasts with methods used by psychologists, sociologists, (...) evolutionary thinkers, and others who study the making and reception of the arts empirically. How far should philosophers be sensitive to the results of these studies? Is their own largely a priori method basically flawed? Are their views on aesthetic value, interpretation, imagination, and the emotions of art to be rethought in the light of best science? The essays in this volume seek answers to these questions, many through detailed studies of problems traditionally regarded as philosophical but where empirical inquiry seems to be shedding interesting light. No common view is looked for or found in this volume: a number of authors argue that the current enthusiasm for scientific approaches to aesthetics is based on a misunderstanding of the philosophical enterprise and sometimes on misinterpretation of the science; others suggest various ways that philosophy can and should accommodate and sometimes yield to the empirical approach. The editors provide a substantial introduction which sets the scene historically and conceptually before summarizing the claims and arguments of the essays. (shrink)

What does it mean for a proposition to be "true in a fiction"? According to the account offered by Kendall Walton in Mimesis as Make-Believe (1990), what is fictionally true, or simply fictional, is what a work of fiction invites or prescribes that we imagine. To say that it is fictional that Okonkwo kills Ikemefuna in Chinua Achebe's Things Fall Apart, for example, is to say that we are supposed to imagine that event. Yet Walton gives no account of the (...) kind of imagining relevant to understanding fictionality. In this paper I argue that the relevant kind of imagining is imagining a storyworld. I propose an account of this sort of imagining, as well as the nature of the invitations or prescriptions to imagine generated by fiction. I show that this account can be defended against various criticisms of Walton's original view, including his own argument in 2015 that prescriptions to imagine provide only necessary conditions for fictionality. (shrink)

In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often (...) used to explicitly or implicitly reference interventions that do not fall under the standard account. The authors offer an alternative ‘schematic’ definition of invasiveness, whereby medical interventions entail an underlying context-independent property of ‘basic invasiveness’ and may be understood both relative to each other and to a context-specific threshold of what is ‘invasive’. 1 We propose that the meaning of terms such as ‘invasiveness’ is necessarily heterogeneous,... (shrink)

Deliberative democracy harbors a recurrent tension between full inclusion and intelligible speech. People with profound cognitive disabilities often signify this tension. While liberal deliberative theorists sacrifice inclusion for intelligibility, this exclusion is unnecessary. Instead, by analyzing deliberative locations that already include people with disabilities, I offer two ways to revise deliberative norms. First, the physical presence of disabled bodies expands the value of publicity in deliberative democracy, demonstrating that the publicity of bodies provokes new conversations similar to rational speech acts. (...) Second, the inclusion of people with profound disabilities necessitates a form of collaborative speech in which individuals make claims collaboratively. Habermas offers an ideal site to pursue this analysis because he recognizes the theoretical tension between inclusion and intelligibility and because his personal testimony reveals important insight into the lived experience of disability. (shrink)

Analytic aesthetics has had little to say about academic schools of criticism, such as Freudian, Marxist, feminist, or postcolonial perspectives. Historicists typically view their interpretations as anachronistic; non-historicists assess all interpretations according to formalist criteria. Insofar as these strategies treat these interpretations as on a par, however, they are inadequate. For the theories that ground the interpretations differ in the claims they make about the world. I argue that the interpretations of different critical schools can be evaluated according to the (...) truth or epistemic merit of these claims. (shrink)

I argue that judgments of what is ‘true in a fiction’ presuppose the Reality Assumption: the assumption that everything that is true is fictionally the case, unless excluded by the work. By contrast with the more familiar Reality Principle, the Reality Assumption is not a rule for inferring implied content from what is explicit. Instead, it provides an array of real-world truths that can be used in such inferences. I claim that the Reality Assumption is essential to our ability to (...) understand stories, drawing on a range of empirical evidence that demonstrates our reliance on it in narrative comprehension. However, the Reality Assumption has several unintuitive consequences, not least that what is fictionally the case includes countless facts that neither authors nor readers could ever consider. I argue that such consequences provide no reason to reject the Reality Assumption. I conclude that we should take fictions, like non-fictions, to be about the real world. (shrink)

Standard theories define fiction in terms of an invited response of imagining or make-believe. I argue that these theories are not only subject to numerous counterexamples, they also fail to explain why classification matters to our understanding and evaluation of works of fiction as well as non-fiction. I propose instead that we construe fiction and non-fiction as genres: categories whose membership is determined by a cluster of nonessential criteria, and which play a role in the appreciation of particular works. I (...) claim that this proposal captures the intuitions motivating alternative theories of fiction. (shrink)

This article focuses on how solidarity is negotiated in interactions during medical visits between nurse practitioners and patients. Drawing on data from ethnographic field notes, audio-recorded interactions and interviews involving one NP and 20 patients, the article outlines ways in which the NP creates a sense of solidarity by lessening the social distance between herself and her patients. These attempts at solidarity do not correlate with what has been noted in previous studies of medical visits involving medical doctors and may (...) represent a difference in how both the NP and the patients view the NP as a mid-level provider. As NPs are taking on a more prominent role in the healthcare landscape, it is important to understand what the interactional norms are and how these may deviate from the norm set by MDs. (shrink)

What does feminist disability studies contribute to feminist methods? Feminist disability scholars interweave life-writing about their experiences of disability or caring for a disabled person to challenge ableist stereotypes. As such, they foreground their own vulnerability to build disability identity and community. This style of life-writing, while essential, tends to calcify the dichotomy between the disabled and abled—a binary that the field of feminist disability studies aims to destabilise. Building on new work in feminist disability studies, I show how some (...) scholars use life-writing to cultivate an estranging sensitivity. This new sensitivity builds on prior feminist disability studies scholarship to estrange us from 1) the idea that disability is a cohesive identity and community, 2) that disability is always a socially desirable position, and 3) that allegiance to disability rights insulates us from ableist anxiety. By embracing the tension between solidifying and destabilising the meaning of disability, feminist disability scholars can leverage life-writing as a tool of resistance and thereby lessen the threat of conformity that life narratives tend to produce. (shrink)

I argue that greater attention to human agency and normativity in both researching and practicing service improvement may be one strategy for enhancing improvement science, illustrating with examples from cancer screening. Improvement science tends to deliberately avoid explicit normativity, for paradigmatically coherent reasons. But there are good reasons to consider including explicit normativity in thinking about improvement. Values and moral judgements are central to social life, so an adequate account of social life must include these elements. And improvement itself is (...) unavoidably normative: it assumes that things could and should be better than they are. I seek to show that normativity will always be implicated in the creation of evidence, the design of programs, the practice of healthcare, and in citizens’ judgements about that care, and to make a case that engaging with this normativity is worthwhile. (shrink)

Many works of fiction include portraits in their storyworlds. Some of these portraits are themselves fictional, such as the portrait of Dorian Gray in Oscar Wilde's novel. Others are real, such as the Darnley portrait of Elizabeth I in A. S. Byatt's The Virgin in the Garden. When authors invent portraits, they expect us to visualise them. When they refer to real portraits, they exploit our familiarity with how they actually look. Like representations of other real entities in fiction, references (...) to real portraits function to ground the story in the real world. But portraits are more than material entities; they are also representational in their own right. In contrasting the ways real portraits are used in Josephine Tey's The Daughter of Time and Orhan Pamuk's My Name is Red, I argue that authors can be criticised when they mischaracterise the representational features of real portraits. (shrink)

If there are no fictional characters, how do we explain thought and discourse apparently about them? If there are, what are they like? A growing number of philosophers claim that fictional characters are abstract objects akin to novels or plots. They argue that postulating characters provides the most straightforward explanation of our literary practices as well as a uniform account of discourse and thought about fiction. Anti-realists counter that postulation is neither necessary nor straightforward, and that the invocation of pretense (...) provides a better account of the same phenomena. I outline and assess these competing theories. (shrink)

What is empiricism and what could it be? Bas . van Fraassen, one of the world’s foremost contributors to philosophical logic and the philosophy of science, here undertakes a fresh consideration of these questions and offers a program for renewal of the empiricist tradition. The empiricist tradition is not and could not be defined by common doctrines, but embodies a certain stance in philosophy, van Fraassen says. This stance is displayed first of all in a searing, recurrent critique of metaphysics, (...) and secondly in a focus on experience that requires a voluntarist view of belief and opinion. Van Fraassen focuses on the philosophical problems of scientific and conceptual revolutions and on the not unrelated ruptures between religious and secular ways of seeing or conceiving of ourselves. He explores what it is to be or not be secular and points the way toward a new relationship between secularism and science within philosophy. (shrink)

This poem was written based on my experiences as an ED nurse.

Statements about fictional characters, such as “Gregor Samsa has been changed into a beetle,” pose the problem of how we can say something true (or false) using empty names. I propose an original solution to this problem that construes such utterances as reports of the “prescriptions to imagine” generated by works of fiction. In particular, I argue that we should construe these utterances as specifying, not what we are supposed to imagine—the propositional object of the imagining—but how we are supposed (...) to imagine. Most other theories of thought and discourse about fictional characters either fail to capture the intentionality of our imaginings, or else obscure the differences between imaginings directed toward fictional characters and those directed toward real individuals. I argue that once we have an account of prescriptions to imagine about real individuals, we can adapt the same framework to specify the contents of prescriptions to imagine about fictional characters, and thereby to account for the truth (or falsity) of statements about fictional characters. (shrink)

When two people move in synchrony, they become more social. Yet it is not clear how this effect scales up to larger numbers of people. Does a group need to move in unison to affiliate, in what we term unitary synchrony; or does affiliation arise from distributed coordination, patterns of coupled movements between individual members of a group? We developed choreographic tasks that manipulated movement synchrony without explicitly instructing groups to move in unison. Wrist accelerometers measured group movement dynamics and (...) we applied cross-recurrence analysis to distinguish the temporal features of emergent unitary synchrony and distributed coordination. Participants’ unitary synchrony did not predict pro-social behavior, but their distributed coordination predicted how much they liked each other, how they felt toward their group, and how much they conformed to each other's opinions. The choreography of affiliation arises from distributed coordination of group movement dynamics. (shrink)

Journal of Global Ethics, Volume 9, Issue 3, Page 293-310, December 2013.

Book synopsis: New work on a hot topic by an outstanding team of authors At the intersection of several central areas of philosophy It is the linguistic job of singular terms to pick out the objects that we think or talk about. But what about singular terms that seem to fail to designate anything, because the objects they refer to don't exist? We can employ these terms in meaningful thought and talk, which suggests that they are succeeding in fulfilling their (...) representational task. A team of leading experts presents new essays on the much-debated problem of empty reference and thought. In the 1960s and 1970s Keith Donnellan, David Kaplan, Saul Kripke and Hilary Putnam initiated a revolution in the then standard conception of reference—a concept at the core of philosophical inquiry. The repercussions of the revolution, particularly felt in metaphysics and epistemology, were soon refined by other influential writers such as Tyler Burge, Gareth Evans, and John Perry. They argued that some linguistic and mental representations have contents individuated by what they are about—by ordinary referents of expressions such as proper names, indexicals, definite descriptions and common nouns, i.e. by planets, people or natural kinds. The view was at odds with a central philosophical presumption at that time: that cognitive and linguistic access to objective reality is indirect and accidental, mediated by general descriptive characterizations, the only constitutive semantic feature of the expressions; hence its ontological and epistemological repercussions. A turning-point in the debate about how linguistic and mental representation reach external contents concerned the nature of empty mental and linguistic representations, framed by means of the very same expressions crucially invoked in the Donnellan-Kaplan-Kripke-Putnam arguments. The papers in this volume address different aspects of reference and thought about the non-existent. (shrink)