In 1999, Susan Wolf diagnosed what was missing in bioethics: “an analysis that places race, ethnicity, and gender at the center.” Since then, not enough progress has been made in “decentering” whiteness in bioethics. The use of assisted reproductive technologies in the United States, and the bioethical discussion surrounding it, provides a window into the problem. Recent surveys of ART usage show racial disparities in access to ART and treatment outcomes. A personal testimony about egg freezing suggests a perceptual (...) blindness when white experience is taken to be the norm. Nevertheless, bioethics, including feminist bioethics, has largely framed ART within the parameters of “normative whiteness.” This paper will argue that feminist bioethics needs to put race at the center of analysis and will suggest pathways for doing so. Decentering whiteness requires a consideration of epistemic limits and privilege, a reevaluation of the goals of feminism, and an embrace of empathy in service of a more responsive and flexible worldview. (shrink)

Sweeping in scope, penetrating in analysis, and generously illustrated with examples from the history of science, this new and original approach to familiar questions about scientific evidence and method tackles vital questions about science and its place in society. Avoiding the twin pitfalls of scientism and cynicism, noted philosopher Susan Haack argues that, fallible and flawed as they are, the natural sciences have been among the most successful of human enterprises-valuable not only for the vast, interlocking body of knowledge (...) they have discovered, and not only for the technological advances that have improved our lives, but as a manifestation of the human talent for inquiry at its imperfect but sometimes remarkable best. This wide-ranging, trenchant, and illuminating book explores the complexities of scientific evidence, and the multifarious ways in which the sciences have refined and amplified the methods of everyday empirical inquiry; articulates the ways in which the social sciences are like the natural sciences, and the ways in which they are different; disentangles the confusions of radical rhetoricians and cynical sociologists of science; exposes the evasions of apologists for religious resistance to scientific advances; weighs the benefits and the dangers of technology; tracks the efforts of the legal system to make the best use of scientific testimony; and tackles predictions of the eventual culmination, or annihilation, of the scientific enterprise. Writing with verve and wry humor, in a witty, direct, and accessible style, Haack takes readers beyond the "Science Wars" to a balanced understanding of the value, and the limitations, of the scientific enterprise. (shrink)

The Physician Payments Sunshine Act requires health care product manufacturers to report to the federal government payments more than $10 to physicians. Bringing unprecedented transparency to medicine, PPSA holds great potential for enabling medical stakeholders to manage conflicts of interest and build patient trust—crucial responsibilities of medical professionalism. The authors conducted six focus groups with 42 physicians in Chicago, IL, San Francisco, CA, and Washington, DC, to explore attitudes and experiences around PPSA. Participants valued the concept of transparency but were (...) wary of the law's design and consequences. They downplayed PPSA's potential and felt it undermined public trust. Showing broad unawareness of COI, they dismissed the notion of industry influence and welcomed company “perks.” Misapprehensions may leave physicians unprepared to advance the opportunities PPSA holds for professionalism. The authors offer recommendations for government and medicine to improve physicians' and other stakeholders' understandings and use of the data. (shrink)

This paper argues that the various approaches to ethics that bioethicists rely on are not adequate to provide effective moral guidance in how to avoid a series of looming human catastrophes (associated with such threats as environmental degradation, war, extreme poverty, and pandemics). It proposes development of a new approach to ethics, dubbed public ethics, that simultaneously investigates moral responsibilities at multiple levels of human organization from the individual to international bodies. It argues that feminist relational theory can provide guidance (...) to development of this new type of ethics, and it warns against obstacles bioethicists face in its pursuit. (shrink)

Public bioethics bodies are used internationally as institutions with the declared aims of facilitating societal debate and providing policy advice in certain areas of scientific inquiry raising questions of values and legitimate science. In the United States, bioethical experts in these institutions use the language of consensus building to justify and define the outcome of the enterprise. However, the implications of public bioethics at science-policy boundaries are underexamined. Political interest in such bodies continues while their influence on societal consensus, public (...) debate, and science policy remains ambiguous. This article presents a theoretical discussion of public bioethics bodies as boundary organizations and examines them in terms of relationship to the moral and cognitive authority of science and other forms of expertise, mechanisms for public participation in controversial science policy, and the deployment of consensus models. The theoretical discussion is examined in the case of the U.S. Human Embryo Research Panel. (shrink)

The rhetoric of reconciliation is common in situations where traditional judicial responses to past wrongdoing are unavailable because of corruption, large numbers of offenders, or anxiety about the political consequences. But what constitutes reconciliation?

Conversations on Consciousness is just that - a series of twenty lively and challenging conversations between Sue Blackmore and some of the world's leading philosophers and scientists. Written in a colloquial and engaging style the book records the conversations Sue had when she met these influential thinkers, whether at conferences in Arizona or Antwerp, or in their labs or homes in Oxford or San Diego. The conversations bring out their very different personalities and styles and reveal a wealth of fascinating (...) detail about their theories and beliefs. Why is consciousness such a special and difficult issue for twenty-first century science? Sue, herself a researcher into this controversial and difficult topic, begins by asking each of her colleagues this simple question and is immediately plunged into the depths of the debate: How do the subjective experiences we call consciousness arise from the physical brain? Is this even the right question to ask? Can zombies - people who behave outwardly just like others but have no inner mental life - exist? What can dreams tell us about consciousness? Should we all be learning to meditate? Do we have free will, and if not is it possible to live without it? With an introduction setting out the broad structure of the debate on consciousness, and an extensive glossary, this book provides an engaging and accessible account of the most challenging problem of all, through the words of some of the leading figures involved in seeking to solve it. (shrink)

A Teacher's Manual for this book will be available online at www.temple.edu/tempress.

This collection of thirteen new essays is the first to examine, from a range of disciplinary perspectives, how the new technologies and global reach of the Internet are changing the theory and practice of free speech.

Just as a stream of genetically modifiedcrops looked set to be approved for commercialproduction in the European Union, the approvalprocedure appears to have become bogged down onceagain by disagreements among and within member states.Old controversies have resurfaced in new forms. Theintractability of the issues suggests that theregulatory procedure has had too narrow a focus,leaving outside its boundary many of the morefundamental aspects that cause people in the EuropeanUnion most concern. Regulators have come underconsiderable pressure to ensure their risk assessmentdecisions are (...) soundly science-based. Ethical issueshave been deemed to lie beyond the scope of theregulatory procedure, as a matter to be consideredseparately by professional ethicists. Yet it has beensuggested that all environmental controversies at rootinvolve disputes about fundamental ethical principles.This paper examines how the ethical issues arecurrently suppressed or sidelined. It discusses how anappreciation of systems thinking and a check on thevalues that underpin decisions, using boundary testingquestions, might contribute to a more constructiveregulatory dialogue, with ethical issues considered asintegral in a way that takes better account ofpeople's concerns. (shrink)

The doctrine of abstract ideas contains Locke’s views on the nature of generality and how we think in general terms-the nature of universals, of general concepts, and how we classify. While Reid rejects abstract ideas, he accepts Locke’s insight that we have an ability to abstract. In this paper, I show how Reid preserves Locke’s insight, while providing a more versatile and forward-looking account of universals and concepts than Locke was able to give.Reid replaces abstract ideas with what he calls (...) “general conceptions.” But general conceptions are really three different things. First, they are universals---non-mental intrinsically general objects of acts of abstraction and conception. I show how Reid is able to make the claim that there are universals without being committed to holding that universals really exist. This claim, together with his type/token distinction, enables Reid to better explain how we have knowledge of attributes and use general terms meaningfully. The general features of our experience are not ideas and are not produced by the faculty of abstraction---but that faculty enables us to distinguish them.In the second sense, a general conception is an act of mind which takes universals as objects. Thinking in general tenns is not the manipulation of abstract ideas---it is engaging in acts of conceiving. Such acts are made possible by general conceptions in the third sense, namely, general concepts. While Reid does not distinguish this sense explicitly, I argue that he takes general concepts to be dispositions or abilities to distinguish general features of objects and to use the general terms of language as other users do. So rather than producing mental entities---abstract ideas---that act as standards to help us classify, abstraction makes possible the development of abilities to use general terms and classify objects. (shrink)

Successful preimplantation genetic diagnosis to avoid creating a child affected by a genetically-based disorder was reported in 1989. Since then PGD has been used to biopsy and analyze embryos created through in viuo fertilization to avoid transferring to the mother’s uterus an embryo affected by a mutation or chromosomal abnormality associated with serious illness. PGD to avoid serious and early-onset illness in the child-to-be is widely accepted. PGD prevents gestation of an affected embryo and reduces the chance that the parents (...) will be faced with a difficult decision of whether to terminate the pregnancy. More controversial have been PGD to select the sex of the child-to-be for “family balancing”, PGD for mere susceptibility to disease and for late-onset disorders such as Alzheimer diseas, and most controversially, PGD to create a donor child who is Human Leukocyte Antigen (HLA-matched with a preexisting sibling in need of stem cell transplant. (shrink)

Our urban problem is how to revive the reality of the outside as a dimension of human experience.Richard Sennett.

The doctrine of abstract ideas contains Locke’s views on the nature of generality and how we think in general terms-the nature of universals, of general concepts, and how we classify. While Reid rejects abstract ideas, he accepts Locke’s insight that we have an ability to abstract. In this paper, I show how Reid preserves Locke’s insight, while providing a more versatile and forward-looking account of universals and concepts than Locke was able to give.Reid replaces abstract ideas with what he calls (...) “general conceptions.” But general conceptions are really three different things. First, they are universals---non-mental intrinsically general objects of acts of abstraction and conception. I show how Reid is able to make the claim that there are universals without being committed to holding that universals really exist. This claim, together with his type/token distinction, enables Reid to better explain how we have knowledge of attributes and use general terms meaningfully. The general features of our experience are not ideas and are not produced by the faculty of abstraction---but that faculty enables us to distinguish them.In the second sense, a general conception is an act of mind which takes universals as objects. Thinking in general tenns is not the manipulation of abstract ideas---it is engaging in acts of conceiving. Such acts are made possible by general conceptions in the third sense, namely, general concepts. While Reid does not distinguish this sense explicitly, I argue that he takes general concepts to be dispositions or abilities to distinguish general features of objects and to use the general terms of language as other users do. So rather than producing mental entities---abstract ideas---that act as standards to help us classify, abstraction makes possible the development of abilities to use general terms and classify objects. (shrink)

The thesis of this paper encapsulates the deep suspicion postcolonial theory has of privileged identity claims while ignoring the manner in which identity is negotiated in a postcolonial context. The limits of identity claims with regard to theology and ethics is analyzed through Rahner’s presentation of “Indifferent Freedom” and its impact on gendered subalterns. A feminist postcolonial theological anthropology rejects the dehumanizing consequences of Rahner’s move to condone violence in the face of force in the world. What is needed rather, (...) is a non-violent and embodied response in the face of violence, initiated by the gendered subaltern, which simultaneously captures Rahner’s original intention of linking spirituality to ethics. Gayatri C. Spivak’s notion of the caress to interrupt the dehumanized discourses of exploitation and unequal power is forwarded as the way to being human in the postcolonial context, in order to make Rahner’s theology and spirituality more concrete for postcolonial societies. (shrink)

The human sensory system is continuously engaged in experiencing and interpreting every interaction with other living beings, objects, and the environment. The purpose of this article is to describe the impact limited opportunities for rich sensory experiences have on students with severe disabilities in two middle school classrooms situated in a public separate school in the southeastern USA. The study employed a postcritical ethnographic approach and grounded theory thematic analysis of fieldnotes gathered over a two-year period. Three major themes supported (...) by the data are presented and discussed in depth. They are: students are afforded limited sensory rich experiences, everyday routines make students passive recipients to school, and instructional approaches result in little interaction with extended periods of waiting. The implications of the findings for improved sensory experiences and possible future directions are described. (shrink)

In confronting the insalubrious ramifications of globalization, human rights scholars and activists have argued for greater national and international responsibility pursuant to the human right to health. Codified seminally in Article 12 of the International Covenant on Economic, Social and Cultural Rights, the right to health proclaims that states bear an obligation to realize the “highest attainable standard” of health for all. However, in pressing for the highest attainable standard for each individual, the right to health has been ineffective in (...) compelling states to address burgeoning inequalities in underlying determinants of health, focusing on individual medical treatments at the expense of public health systems. This article contends that the paradigm of individual health, focused on a right to individual medical care, is incapable of responding to health inequities in a globalized world and thereby hampers efforts to operationalize health rights through public health systems. While the right to health has evolved in international discourse over time, this evolution of the individual right to health cannot address the harmful societal ramifications of economic globalization. Rather than relying solely upon an individual right to medical care, envisioning a collective right to public health – a right applied at the societal level to address underlying determinants of health – would alleviate many of the injurious health inequities of globalization. (shrink)

In confronting the insalubrious ramifications of globalization, human rights scholars and activists have argued for greater national and international responsibility pursuant to the human right to health. Codified seminally in Article 12 of the International Covenant on Economic, Social and Cultural Rights, the right to health proclaims that states bear an obligation to realize the “highest attainable standard” of health for all. However, in pressing for the highest attainable standard for each individual, the right to health has been ineffective in (...) compelling states to address burgeoning inequalities in underlying determinants of health, focusing on individual medical treatments at the expense of public health systems. This article contends that the paradigm of individual health, focused on a right to individual medical care, is incapable of responding to health inequities in a globalized world and thereby hampers efforts to operationalize health rights through public health systems. While the right to health has evolved in international discourse over time, this evolution of the individual right to health cannot address the harmful societal ramifications of economic globalization. Rather than relying solely upon an individual right to medical care, envisioning a collective right to public health – a right applied at the societal level to address underlying determinants of health – would alleviate many of the injurious health inequities of globalization. (shrink)

Let us assume that we can hold at least some people morally responsible for at least some of their actions. What sort of picture of the self is compatible with that assumption? In particular, we need to ask the question of whether we can hold people responsible for actions which follow inevitably from their characters being what they are.

Clinical ethics, like the broader field of bioethics from which it emerged, is at a critical crossroads in its development, with conflicting paths ahead. It can either claim its distinctive place in the clinical arena, insisting unapologetically on certain minimal standards of professional training, practice and competence, addressing head on debates about various models of and methodological approaches to consultation, and establishing a shared vision of the purpose and meaning of the enterprise of clinical ethics itself. Or, it can devolve (...) into a hobby that untrained, albeit interested, and generally well intentioned individuals can dabble in for fun or even profit, as they see fit, and without regard to the deep history and rich disciplinary roots of the field, the serious debates in the academic literature of bioethics, the foundational case histories and legal theories, or even any sense of professional accountability. (shrink)

In this article, I argue that queer women – especially cis and trans lesbians – have more in common than contemporary fissures either allow for or acknowledge. Lesbians who recognised their queer sexuality in the 1970s have in common with trans women the shared condition of being, in the words of the 1970s radical feminist Marilyn Frye, ‘spat summarily out of reality’. We also share the experience of refusing to accept this condition. I make this argument by manoeuvring away from (...) questions of gender identity and focusing instead on gender’s ontoformativity: the astonishing, welcome and transformative fact that new social realities are brought into being by new social practices. I turn to experimental writing to explore this matter. Through this medium, the cis lesbian poet Nicole Brossard and the trans lesbian poet Trace Peterson wrote themselves into worlds, languages and social orders that refused to acknowledge their existence. Brossard was writing in 1970s Montreal, Peterson in early twenty-first-century New York, but what they have in common, indeed what radical lesbian theory from the 1970s shares with contemporary theorising by trans women, is the insight that identifying with men is expected. It is in identifying with women that we are most at risk. (shrink)

Background Ensuring individual free and informed decision‐making for research participation is challenging. It is thought that preliminarily informing communities through ‘community sensitization’ procedures may improve individual decision‐making. This study set out to assess the relevance of community sensitization for individual decision‐making in research participation in rural Gambia. Methods This anthropological mixed‐methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia. (...) Results/discussion Although 38.7% of the respondents were present during sensitization sessions, 91.1% of the respondents were inclined to participate in the trial when surveyed after the sensitization and prior to the informed consent process. This difference can be explained by the informal transmission of information within the community after the community sensitization, expectations such as the benefits of participation based on previous research experiences, and the positive reputation of the research institute. Commonly mentioned barriers to participation were blood sampling and the potential disapproval of the household head. Conclusion Community sensitization is effective in providing first‐hand, reliable information to communities as the information is cascaded to those who could not attend the sessions. However, further research is needed to assess how the informal spread of information further shapes people's expectations, how the process engages with existing social relations and hierarchies (e.g. local political power structures; permissions of heads of households) and how this influences or changes individual consent. (shrink)

In an age when "we are all multiculturalists now," as Nathan Glazer has said, the politics of identity has come to pose new challenges to our liberal polity and the presuppositions on which it is founded. Just what identity means, and what its role in the public sphere is, are questions that are being hotly debated. In this book Susan Hekman aims to bring greater theoretical clarity to the debate by exposing some basic misconceptions—about the constitution of the self (...) that defines personal identity, about the way liberalism conceals the importance of identity under the veil of the "abstract citizen," and about the difference and interrelationship between personal and public identity. Hekman’s use of object relations theory allows her to argue, against the postmodernist resort to a "fictive" subject, for a core self that is socially constructed in the early years of childhood but nevertheless provides a secure base for the adult subject. Such a self is social, particular, embedded, and connected—a stark contrast to the neutral and disembodied subject posited in liberal theory. This way of construing the self also opens up the possibility for distinguishing how personal identity functions in relation to public identity. Against those advocates of identity politics who seek reform through the institutionalization of group participation, Hekman espouses a vision of the politics of difference that eschews assigning individuals to fixed groups and emphasizes instead the fluidity of choice arising from the complex interaction between the individual’s private identity and the multiple opportunities for associating with different groups and the public identities they define. Inspired by Foucault’s argument that "power is everywhere," Hekman maps out a dual strategy of both political and social/cultural resistance for this new politics of identity, which recognizes that with significant advances already won in the political/legal arena, attitudinal change in civil society presents the greatest challenge for achieving more progress today in the struggle against racism, sexism, and other forms of oppression. (shrink)