There are few moral principles less controversial than “don’t touch people’s private parts without consent.” Though the principle doesn’t make explicit that there are exceptions, there clearly are some. Parents must wipe their infants. If an unconscious patient is admitted to the emergency room with a profusely bleeding laceration on their genitals, a doctor must give them stitches. The researchers who proposed the study in question, which would look for a connection between burn patients’ microbiomes and their clinical outcomes, presumably (...) believed they had identified an additional exception to the aforementioned principle. I argue that they did not. Rather, because of their tremendous inherent risks, we ought only to perform intimate procedures on those who can’t consent when the procedure is for their own good. -/- Intimate violations have been overlooked in both philosophy and medicine. Because of this, we have lacked an adequate conceptual framework for identifying certain kinds of harms research can inflict. When we understand these special risks, we see that the IRB was right to deny a waiver of consent. (shrink)

Accounts of sexual experience, sexual oppression, and sexual violation, if they are not to lend support to the problems they are invoked to address, require the foundation of a phenomenological description of the character of experience. Relying on Maurice Merleau-Ponty, I aim to provide this foundation, arguing that sexual experience is a domain not of detached, individual autonomy but of intrinsic susceptibility and exposure to the world. My description of sexual experience is intended to reveal the immanent norms that (...) sexuality projects and thereby to critique ways of inhabiting experience that disavow what is revealed in that description. The first section discerns three ambiguities that characterize our experience in Merleau-Ponty's notion of “flesh”: that between materiality and meaning, self and others, and self and world. The second section offers a phenomenology of sexual experience based on these ambiguities. The third section, on sexual oppression and suppression, identifies two stereotypical ways in which they are evaded: what I call the stances of “withdrawal from” and “control of” sexuality as flesh. Finally, the fourth section reveals the shortcomings of the legal-juridical domain in navigating our status as flesh, and warns against the proliferation of its terms, specifically the norm of consent. (shrink)

This paper seeks to vindicate a common but philosophically puzzling phenomenon: Sometimes, a person experiences extreme guilt in relation to a wrong that their loved one has committed, even though they are not at fault for that wrong. Guilt in these cases violates a foundational principle in our moral lives – viz., the fault principle. On that principle, one is blameworthy for a wrong only if one is at fault with respect to that wrong. Insofar as the family members explored (...) here are not at fault, their professed experience of guilt looks to be irrational. Against the charge of irrationality, I argue that it is sometimes morally appropriate, and perhaps even morally required, to judge oneself to be blameworthy for the wrong of a loved one in which one played no culpable part. Further, insofar as the first-personal experience ought to dictate the responsibility assessments of victims and third parties, I conclude that these other individuals will have reason to take the intimate to be blameworthy too. I end by extending the phenomenon of faultless guilt beyond the intimate context, to the experience of white guilt. (shrink)

This paper seeks to vindicate a common but philosophically puzzling phenomenon: Sometimes, a person experiences extreme guilt in relation to a wrong that their loved one has committed, even though they are not at fault for that wrong. Guilt in these cases violates a foundational principle in our moral lives – viz., the fault principle. On that principle, one is blameworthy for a wrong only if one is at fault with respect to that wrong. Insofar as the family members explored (...) here are not at fault, their professed experience of guilt looks to be irrational. Against the charge of irrationality, I argue that it is sometimes morally appropriate, and perhaps even morally required, to judge oneself to be blameworthy for the wrong of a loved one in which one played no culpable part. Further, insofar as the first-personal experience ought to dictate the responsibility assessments of victims and third parties, I conclude that these other individuals will have reason to take the intimate to be blameworthy too. I end by extending the phenomenon of faultless guilt beyond the intimate context, to the experience of white guilt. (shrink)

In recent decades, huge technological changes have opened up possibilities and potentials for new socio-technological forms of violence, violation and abuse, themselves intersectionally gendered, that form part of and extend offline intimate partner violence (IPV). Digital IPV (DIPV)—the use of digital technologies in and for IPV—takes many forms, including: cyberstalking, internet-based abuse, non-consensual intimate imagery, and reputation abuse. IPV is thus now in part digital, and digital and non-digital violence may merge and reinforce each other. At the (...) same time, technological and other developments have wrought significant changes in the nature of work, such as the blurring of work/life boundaries and routine use of digital technologies. Building on feminist theory and research on violence, and previous research on the ethics of digitalisation, this paper examines the ethical challenges raised for business, workplaces, employers and management by digital IPV. This includes the ethical challenges arising from the complexity and variability of DIPV across work contexts, its harmful impacts on employees, productivity, and security, and the prospects for proactive ethical responses in workplace policy and practice for victim/survivors, perpetrators, colleagues, managers, and stakeholders. The paper concludes with contributions made and key issues for the future research agenda. (shrink)

BackgroundSexual boundary violations in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.MethodsWe carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to (...) explore their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data.ResultsWe found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: setting rules and regulations, engaging in dialogue about sexuality, and addressing systemic and organizational dimensions.ConclusionOur findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations. (shrink)

As digital media becomes more central to the lives of adolescents, it also becomes increasingly relevant for their sexual communication. Sexting as an important image-based digital medium provides opportunities for self-determined digital communication, but also carries specific risks for boundary violations. Accordingly, sexting is understood either as an everyday, or as risky and deviant behavior among adolescents. In the affectedness of boundary violations gender plays an important role. However, it is still unclear to what extent digital sexual communication restores stereotypical (...) gender roles and restrictive sexuality norms or, alternatively, enables new spaces of possibility. In this sense, current research points to a desideratum regarding adolescents’ orientations toward sexting as a practice between spaces of possibility and boundary violations. This paper discusses the possibilities, but also the risks, of intimate digital communication among adolescents. The main question is, how adolescents themselves perceive sexting practices and how they position themselves between both spaces for possibility and for the exchange of unwanted sexual content. For this purpose, orientations toward normalities and gender of students are reconstructed. To answer these questions, twelve single-sex, group discussions were carried out with students aged 16 and 17 at five different secondary schools in northern Germany. A total of 20 boys and 22 girls took part. The group discussions were structured by a narrative generating guideline. The analysis draws its methodology from the Documentary Method, regarding implicit and explicit forms of knowledge and discourse. It results in a typology of three types with different orientations. The study shows, that most of the students consider sexting to be a risky practice; only one type shows normality in the use of sexting. At the same time, some of the young people are interested in experimenting with image-based intimate digital communication. Further, gender differences in use and affectedness are also documented. In this way, orientations toward gender stereotypes “favor” both the attribution of responsibility to girls, and overlook the responsibility of students who perpetrated the boundary violation. The orientations of adolescents should be taken more into account in research as well as in educational programs for the prevention of sexual violence. (shrink)

This issue considers the ethics of a healthcare provider intervening into a patient’s genitalia, whether by means of cutting or surgery or by ‘mere’ touching/examination. Authors argue that the permissibility of such actions in the absence of a relevant medical emergency does not primarily turn on third-party judgments of expected levels of physical harm versus benefit, or on related notions such as extensiveness or invasiveness; rather, it turns on the patient’s own consent. To bolster this argument, attention is drawn to (...) the status of the genitals as ‘intimate’ anatomy—a status that is not fully erased by being in a medical context. In this editorial, we draw on the work of Talia Mae Bettcher on ‘intimate agency’ to explore why unconsented interventions into the genitalia may constitute a distinctive sort of personal violation compared to unconsented contact with various other parts of the human body. In their feature article, Marit van der Pijl and colleagues1 argue it is unethical for healthcare providers to perform unconsented episiotomies on persons in labour. In particular, they suggest that, outside of certain rare emergencies in which, for example, the person giving birth is incapacitated1 and the procedure cannot be delayed until consent becomes possible without introducing a significant risk of serious harm (call these ‘medically necessary’2 procedures), ‘presumed consent’ is the incorrect standard to apply. Instead, they stress that, especially when a proposed intervention involves a person’s genital, sexual or reproductive organs, the need to obtain their explicit consent in advance of proceeding must be honoured. As the authors note, the broader social significance of our genitalia—widely regarded as ‘private’ anatomy—is not erased by being in a medical context (see also 2–4). Boundaries must still be observed. Ethically, this ‘leaves a very small margin for error because invasion of these body parts …. (shrink)

Why is it more violating to grab a stranger’s thigh or stroke their face than it is to grab their forearm? Why is it worse to read someone’s dream journal without permission than it is to read their bird watching field notes? Why are gestation mandates so incredibly intrusive? Intimacy is key to understanding these cases, and to explaining many of our most stringent rights. -/- I present two ways of thinking about intimacy, Relationship-First Accounts and the Intimate Zones (...) Account. I argue that only the Intimate Zones Account lets us cohesively understand intimacy’s importance, and the scope of our intimate rights. I characterize our intimate zones as meeting the Hiddenness and Importance Conditions. A feature’s meeting these conditions makes it a locus of special vulnerability by which our persons can be fundamentally altered. This special vulnerability explains why our duties to respect the intimate boundaries of others are so strict. (shrink)

It is common to think that our intimates are required to help us. But it can be problematic to appeal to certain kinds of facts (e.g., previous favors or prudentially relevant facts) in order to entice them to help us—even when those facts provide them with sufficient or decisive reason to help us. This is puzzling because, in these cases, our intimates have sufficient or decisive reason to act in the way we are trying to entice them to act. Moreover, (...) it generally seems more problematic to appeal to certain kinds of facts (e.g., previous favors or prudentially relevant facts) in order to entice our intimates to do things that help us than it is to appeal to these facts in order to entice nonintimates to perform the same actions. This too is puzzling because one is usually permitted to ask more from one's intimates than non-intimates. I argue that these enticements are intuitively problematic because they indicate that one violates a demand of good intimate relationships. In particular, they indicate that one violates a demand for a certain kind of doxastic partiality; that is, one should trust one's intimates to follow what one's intimates know are demands of good intimate relationships. More specifically, one fails to trust one's intimates to be sufficiently motivated to protect or promote one's needs, desires, interests, projects, and well-being for one's own sake. Making such requests of nonintimates is not usually intuitively problematic because one is not required to trust non-intimates to be motivated in this way. (shrink)

That an intimate connection exists between the notion of human dignity and the notion of humiliation seems to be a commonplace among philosophers, who tend to assume that humiliation should be explained in terms of (violation of) human dignity. I believe, however, that this assumption leads to an understanding of humiliation that is too "philosophical" and too detached from psychological reality. The purpose of the paper is to modify the above connection and to offer a more "down to (...) earth" account of humiliation that does not depend on metaphysical or axiological questions concerning the unique dignity enjoyed by all human beings qua human beings. The paper argues for a subjective-psychological notion of self-respect in the explication of humiliation, instead of an objective-normative one. To be humiliated means to suffer an actual threat to or fall in one's self-respect. (shrink)

This paper seeks to articulate a conception of justice in reparations for victims of human rights violations when the aim is to repair a large number of cases, as opposed to individual, isolated cases. It starts with an effort to establish some semantic clarity by trying to distinguish between two different contexts for the use of the term “reparations”. It discusses some of the problems with merely transplanting the ideal of compensation in proportion to harm from its natural home in (...) the resolution of individual judicial cases, and using it as a standard of justice for massive reparations programs. Instead, it argues in favor of thinking about justice in the context of massive cases in terms of the achievement of three goals, namely, recognition, civic trust, and social solidarity — three goals that are intimately related to justice. Finally, it tries to shed light on the basic trade-offs that accompany some of the choices that have to be made in the process of constructing a comprehensive and coherent reparations program. (shrink)

Unconsented pelvic exams under anesthesia are assaults cloaked in defense of healthcare education. Preemptive linguistic qualifiers “presumed” or “implied” attempt to justify such violations with flippancy toward their oxymoronic implications: to suggest a priori that consent can be assumed undermines its otherwise standalone social, ethical, and medico-legal reverence. In this paper I conceptualize “medical sexual assault” and argue that presumed consent for intimate exams exemplifies its definition. By bluntly describing pelvic exams as “penetration,” this work aims to reify the (...) intimate reality of the clinical label “pelvic exam” and to call attention to cisheteronormative and androcentric assumptions involved in its practice. Additionally, this scholarship seeks to create a foundation toward broader work in conceptualizing clinical rape culture. Given recent national survey data indicating a surprising frequency of unconsented intimate exams, detailed language as to their problematics is necessary for ongoing legal and ethical efforts. Explicit consent for intimate exams must be the standard of care for conscious and unconscious patients. (shrink)

Extant research has shown that ordinary causal judgments are sensitive to normative factors. For instance, agents who violate a norm are standardly deemed more causal than norm-conforming agents in identical situations. In this paper, we explore two competing explanations for the Norm Effect: the Responsibility View and the Bias View. According to the former, the Norm Effect arises because ordinary causal judgment is intimately intertwined with moral responsibility. According to the alternative view, the Norm Effect is the result of a (...) blame-driven bias. In a series of five preregistered experiments (N = 2688), we present evidence that predominantly favours the Bias View. In particular, and against predictions made by the Responsibility View, we show that participants deem agents who violate nonpertinent or silly norms – norms that do not relate to the outcome at hand – as more causal, and that this effect cannot be explained in terms of plausible mediators such as the agent’s foreknowledge and desire, or the foreseeability of harm. We close with a discussion regarding the implications of these findings, in as regards the just assessment of proximate cause in the law. (shrink)

When philosophers consider factors compromising autonomy in consent, they often focus solely on the consent-giver’s agential capacities, overlooking the impact of the consent-receiver’s conduct on the consensual character of the activity. In this paper, I argue that valid consent requires justified trust in the consent-receiver to act only within the scope of consent. I call this the Trust Condition (TC), drawing on Katherine Hawley’s commitment account of trust. TC constitutes a belief that the consent-receiver is capable and willing to act (...) as we expect from them. If such trust is not warranted, I argue, consent lacks the appropriate normative grounds. After establishing TC, I explore its application in the sexual arena, asserting that due to the non-contractual dimensions of sexual activity — such as the dynamic nature of sexual desires and the absence of external factors effectively binding sexual partners to the terms of consent—trust is warranted in sexual consent by means of care. I define care as a special sensitivity and attention toward the partner’s will and discuss how this approach leads to safer intimate relationships in practice. (shrink)

Entanglement was initially thought by some to be an oddity restricted to the realm of thought experiments. However, Bell’s inequality delimiting local - behavior and the experimental demonstration of its violation more than 25 years ago made it entirely clear that non-local properties of pure quantum states are more than an intellectual curiosity. Entanglement and non-locality are now understood to figure prominently in the microphysical world, a realm into which technology is rapidly hurtling. Information theory is also increasingly recognized (...) by physicists and philosophers as intimately related to the foundations of mechanics. The clearest indicator of this relationship is that between quantum information and entanglement. To some degree, a deep relationship between information and mechanics in the quantum context was already there to be seen upon the introduction by Max Born and Wolfgang Pauli of the idea that the essence of pure quantum states lies in their provision of probabilities regarding the behavior of quantum systems, via what has come to be known as the Born rule. The significance of the relationship between mechanics and information became even clearer with Leo Szilard’s analysis of James Clerk Maxwell’s infamous demon thought experiment. Here, in addition to examining both entanglement and quantum information and their relationship, I endeavor to critically assess the influence of the study of these subjects on the interpretation of quantum theory. (shrink)

This article examines the question of whether universities and colleges should attempt to ban all student-faculty relationships, as many have tried to do. It argues that, because adults have a fundamental right to engage in intimate relationships without interference, supporters of relationship bans must meet a high standard in defending them. But outright bans on such relationships cannot meet this standard. Though the desire to create a secure environment for students is legitimate and important, it cannot be shown that (...) relationship bans are necessary or proportional means of doing so. Besides being a violation of the rights of the people involved, relationship bans have a negative impact on the larger university community. The argument is not a defense of such relationships per se. Romantic interactions between students and faculty are invariably complicated and perilous, and should be approached with caution. (shrink)

The self-defense argument maintains that, even if a fetus is a person, abortion on demand is morally permissible on the grounds that the fetus is using his mother’s body in an intimate way, and, in an unwanted pregnancy, without her ongoing consent. According to the argument, this sort of use justifies lethal self-defense on the part of the mother against her unwanted fetus. I produce a counterexample to one of the premises of this argument and show that it cannot (...) be successfully revised. I further show the underlying commitments of the self-defense argument lead to the absurd conclusion that a woman who has consensual sex that results in pregnancy thereby violates the fetus’ right to bodily autonomy and so such an act would be morally impermissible. We thereby have good reason to abandon the argument. (shrink)

In the West, mainstream bioethicists tend to appreciate intimate relationships as a hindrance to individual autonomy. Scholars have even argued against approaching a mother to donate a kidney to save the life of her child; the request, they claim, is too manipulative and, thereby, violates her autonomy. For Chinese bioethicists, such a moral analysis is absurd. The intimate relationship between mother and child establishes strong mutual obligations. It creates mutual moral responsibilities that often require sacrifices for each other. (...) This paper argues that while aiding others is a moral duty, helping one’s family is a much stronger duty and poses no threat to one’s autonomy. For Confucianism, empathetic intimate feelings, the heart and mind of ren, rest at the root of morality. It requires that we, as moral beings, assume duties to relieve the suffering of others. The more intimate the relationship the stronger the obligation to assist. The family is a closely knitted moral community. Family members often share living resources, mutual experiences, and a sense of identity. Family members act as a social unit, and, ordinarily, mutual obligations among members have priority over duties to those outside of the family. For Confucian bioethics, family-based consent to medical treatment is regarded as natural and reasonable. Family-based decision making is a taken-for-granted norm of social life. While close family members have priority, Confucianism extends such obligations outward toward members of the extended family and the society at large. There is a general principle of gradation of love, which reflects different degrees of personal intimacy and, therefore, of moral obligation. In this fashion, Confucianism seeks to treat the whole of society as one extended family. Hence, in bioethics, mutual responsibility and family-based consent are regarded as basic principles. Through a series of case discussions, this paper illustrates that atomistic individual-based autonomy offers but a poor response to bioethical issues. (shrink)

This article reports on interviews conducted with 11 women at the Thohoyandou Victim Empowerment Programme, a centre located in Sibasa, Thohoyandou, in the Limpopo province of South Africa. The centre provides support and advocacy to female survivors of domestic violence. The participants were victims of gender-based violence and the study aimed at exploring the spiritual experiences of women assaulted by their partners. Interviews were conducted over 4 days and were held on the TVEP premises. This article discusses how women of (...) faith found meaning and support through their religious beliefs when experiencing violence in intimate spaces. Furthermore, the article drew insights from spiritual perceptions held by women that make them feel safer and assist them to find ways to cope with violence in intimate relationships. However, the study found that women prayed for divine intervention and change in their families and for God to help their husbands by removing all evil spirits from their lives. It was found that apart from prayer, the women do not have any other spiritual resources to combat gender-based violence. The authors suggest the deconstruction of harmful religious discourses towards healing religious discourses as a type of ‘intervention’ in the lives of the interviewees.Contribution: The article contributes towards understanding the harmful impact of religious discourses on the lives of women who are vulnerable towards domestic violence. Religious discourses that are either harmful or healing are here identified through the stories of women who have been violated in their intimate relationships, thus contributing to the body of knowledge in gender studies and to religious and social sciences in general. (shrink)

Marx, Nietzche, and Freud are among the most influential of modern atheists. The distinctive feature of their challenge to theistic and specifically Christian belief is expressed by Paul Ricoeur when he calls them the "masters of suspicion." While skepticism directs its critique to the truth or evidential basis of belief, suspicion asks two different, intimately intertwined questions: what are the motives that lead to this belief? and what function does it play, what work does it do for the individuals and (...) communities that adopt it.What suspicion suspects is that the survival value of religious beliefs depends on satisfying desires and interests that the believing soul and the believing community are not eager to acknowledge because they violate the values they profess, as when, for example, talk about justice is a mask for deep-seated resentment and the desire for revenge. For this reason, the hermeneutics of suspicion is a theory, or group of theories, of self-deception: ideology critique in Marx, genealogy in Nietzsche, and psychoanalysis in Freud.Suspicion and Faith argues that the appropriate religious response ("the religious uses of modern atheism") to these critiques is not to try to refute or deflect them, but rather to acknowledge their force in a process of self-examination. (shrink)

Doxing is the intentional public release onto the Internet of personal information about an individual by a third party, often with the intent to humiliate, threaten, intimidate, or punish the identified individual. In this paper I present a conceptual analysis of the practice of doxing and how it differs from other forms of privacy violation. I distinguish between three types of doxing: deanonymizing doxing, where personal information establishing the identity of a formerly anonymous individual is released; targeting doxing, that (...) discloses personal information that reveals specific details of an individual’s circumstances that are usually private, obscure, or obfuscated; and delegitimizing doxing, which reveals intimate personal information that damages the credibility of that individual. I also describe how doxing differs from blackmail and defamation. I argue that doxing may be justified in cases where it reveals wrongdoing, but only if the information released is necessary to reveal that such wrongdoing has occurred and if it is in the public interest to reveal such wrongdoing. Revealing additional information, such as that which allows an individual to be targeted for harassment and intimidation, is unjustified. I illustrate my discussion with the examples of the alleged identification of the creator of Bitcoin, Satoshi Nakamoto, by Newsweek magazine, the identification of the notorious Reddit user Violentacrez by the blog Gawker, and the harassment of game developer Zoe Quinn in the ‘GamerGate’ Internet campaign. (shrink)

In this paper we give additional arguments in favor of the point of view that the violation of Bell, CHSH and CH inequalities is not due to a mysterious non locality of nature. We concentrate on an intimate relation between a protocol of a random experiment and a probabilistic model which is used to describe it. We discuss in a simple way differences between attributive joint probability distributions and generalized joint probability distributions of outcomes from distant experiments which (...) depend on how the pairing of these outcomes is defined. We analyze in detail experimental protocols implied by local realistic and stochastic hidden variable models and show that they are incompatible with the protocols used in spin polarization correlation experiments. We discuss also the meaning of “free will”, differences between quantum and classical filters, contextuality of Kolmogorov models, contextuality of quantum theory and show how this contextuality has to be taken into account in probabilistic models trying to explain in an intuitive way the predictions of QT. The long range imperfect correlations between the clicks of distant detectors can be explained by partially preserved correlations between the signals created by a source. These correlations can only be preserved if the clicks are produced in a local and deterministic way depending on intrinsic parameters describing signals and measuring devices in the moment of the measurement. If an act of a measurement was irreducibly random they would be destroyed. It seems to indicate that QT may be in fact emerging from some underlying more detailed theory of physical phenomena. If this was a case then there is a chance to find in time series of experimental data some fine structures not predicted by QT. This would be a major discovery because it would not only prove that QT does not provide a complete description of individual physical systems but it would prove that it is not predictably complete. (shrink)

I argue that desires and emotions have a cognitive element that leaves them open to direct moral assessment. I maintain that a wide range of affects enter into moral reasoning as initial mappings of practical reasons onto the world. This suggests a way of characterizing conflicts between persistent desires and all-things-considered practical judgments. Such conflicts indicate that our considered judgments lack the status of wholehearted convictions. The dissertation culminates in a distinctive account of certain interpersonal obligations that builds upon this (...) idea of wholehearted conviction. ;In Chapter 1, I examine the conception of moral worth and the companion conception of virtue at work in Kant's seminal moral writings. I argue that these conceptions leave Kant without resources to explain the critical distinction between self-interested and malicious violations of duty. ;In Chapter 2, I ask how significant a revision must be made to Kantian moral theory in order to accommodate my criticisms. I argue that there are demanding affective preconditions for the full recognition of the equal moral standing of other humans, and that these provide the core of a more plausible conception of moral virtue than is usually associated with Kant. I maintain that the Kantian who accepts this picture of virtue must give up the attractive claim that we can always voluntarily will to do whatever morality requires. Such a Kantian might still preserve the essential Kantian equation of dutiful action and autonomy--here understood as self-governance in accordance with laws we wholeheartedly accept. ;In the course of Chapters 1 and 2, I argue that when there are conflicts between our desires and our all-things considered judgments of what we have reason to do, this shows that our considered beliefs are not wholehearted convictions. In Chapters 3 and 4, I attempt to show that the obligations which bind together intimates and fellow members of certain face-to-face communities are best analyzed in terms of wholehearted convictions. I argue that this approach is truer to the phenomenology of moral deliberation than rival analyses. (shrink)

Recent developments in neuroscience create new opportunities for understanding the human brain. The power to do good, however, is also the power to harm, so scientific advances inevitably foster as many dystopian fears as utopian hopes. For instance, neuroscience lends itself to the fear that people will be forced to reveal thoughts and feelings which they would not have chosen to reveal, and of which they may be unaware. It also lends itself to the worry that people will be encouraged (...) to submit to medication or surgery which, even if otherwise beneficial, alters their brain in ways that undermine their identity and agency. As Kenneth Foster notes, neural implants can have surprising and unintended adverse effects, even when they help to mitigate the loss of bodily control associated with Parkinson’s disease, or help to provide hearing for children who would otherwise be profoundly deaf. While the risk of adverse outcomes are scarcely specific to neuroscience, he thinks that ‘These issues are perhaps more acute’ with the latter than with other medical interventions, ‘because they are intimately and fundamentally related to a person’s communication with the outside world’. [ 2006 196] -/- Neuroscience, like genomic science, then, is likely to create new ways of harming people. Many of these will involve violations of privacy. However, these are unlikely fundamentally to challenge the reasons to value privacy, or our ability to protect it in the foreseeable future. Rather, I would suggest, the major threat to privacy comes from the difficulty of determining its nature and value and when, if ever, efforts to protect it are justified. So I will start by examining some threats to privacy, and their implications for neuroscience, before turning to philosophical problems in understanding the nature and value of privacy, and the practical consequences of those philosophical difficulties. (shrink)

Five different arguments for vegetarianism are discussed: the system of meat production deprives poor people of food to provide meat for the wealthy, thus violating the principle of distributive justice; the world livestock industry causes great and manifold ecological destruction; meat-eating cultures and societal oppression of women are intimately linked and so feminism and vegetarianism must both be embraced to transform our patriarchal culture; both utilitarian and rights-based reasoning lead to the conclusion that raising and slaughtering animals is immoral, and (...) so we ought to boycott meat; meat consumption causes many serious diseases and lowers life expectancy, and so is unhealthy. Objections to each argument are examined. The conclusion reached is that the cumulative case successfully establishes vegetarianism as a virtuous goal. (shrink)

A completely non-statistical non-linear non-unitary framework in which "God does not play dice..." that describes the physical foundations of consciousness is presented for the first time. At its core is the insight that the missing link between current physical descriptions of reality and a credible physical framework for consciousness is provided by post-quantum mechanics : the extension of statistical linear unitary quantum mechanics for closed systems to a locally-retrocausal[i] non-statistical non-linear non-unitary theory for open systems through the introduction of a (...) back-reaction potential and its implications. PQM is to orthodox QM as General Relativity is to Special Relativity. PQM and GR both share the same metaphysical organizing principle that one-way actions without a compensating reaction or back-reaction means an incompleteness in the theoretical model leaving out important physical phenomena. We gleaned the final piece in the puzzle of how consciousness arises from the material world from a result relating to long range collective excitations in microtubules described by Stuart Hameroff in a recent Fetzer Foundation conference in London. Herbert Fröhlich suggested that almost any many-particle system when properly pumped far off thermodynamic equilibrium can be put into a robust macro-quantum coherent state immune from environmental decoherence. Indeed, we suggest that all life forms are an example of Frohlich coherence that is intimately connected with locally-retrocausal PQM back-reaction's violation of the de Broglie guidance equation that was assumed by Bohm in his 1952 pilot wave theory. Using nature as a guide combined with nano-technology points the way to the construction of naturally conscious artificial intelligence machines capable of hacking into current-day quantum cryptographic networks. Furthermore, one can imagine attaining the transhumanist agenda. For example, the consciousness of a genius like Stephen Hawking could be uploaded to the post-quantum Cloud and then downloaded to a healthy body or android. (shrink)

This paper analyzes how Transitional Justice mechanisms might be deployed to redress injustices resulting from the perpetration of ecocide. It develops the notion of ecocide as social deathas a class of environmental harms severe enough to trigger a Transitional Justice response. If a state authorizes ecological destruction in a way that demonstrates wanton disregard for the cultures intimately connected to those ecosystems, then it has violated core liberal principles of respect for pluralism. Transitional Justice can be effectively utilized in overcoming (...) these harms to transform societies from ones that tolerate grave forms of environmental destruction to eco-friendly states that further environmentalist aims. This paper explores how the four kinds of transitional justice mechanisms can aid in abating and mitigating environmental problems: (1) punitive justice mechanisms (criminal trials, lustration, and sanctions); (2) reparative justice mechanisms(reparations, rehabilitation, memorialization, apologies, and guarantees of non-repetition); (3) truth-oriented mechanisms(truth commissions, reports, and education programs); and (4) institutional reform mechanisms(changing laws and amending constitutions). (shrink)

This paper argues that liberal states are wrong to forcibly separate through deportation the unauthorized immigrant parents of member children and that states must therefore regularize such unauthorized immigrants. While most arguments for regularization focus on how deportation wrongs the unauthorized immigrants themselves, I ground my argument in how deportation wrongs the state’s members, namely the unauthorized immigrants’ member children. Specifically, forced separation through deportation wrongs affected children by violating a basic right to sustain the intimate relationships with their (...) parents on which they rely for their development into fully autonomous agents. (shrink)

As controversial as Lockean interpretation relating to the ideas of the law of nature and natural rights has always been, few would dispute the inextricable connection between them in the context of John Locke's thought. The historical development of natural rights language out of the natural law tradition is mirrored to a certain extent in the order within and between Locke's own writings. Locke intimates a persuasive account of the concurrent univocal property of God and the human being in the (...) particular human being herself. The particular human being is the property of God and herself in the very same sense of the word "property", i.e. the product of workmanship or labor. Both slavery and suicide fall foul of Locke's doctrine of the law of nature and natural rights: slavery is a violation of self‐ownership, and suicide is as direct a violation of divine ownership as one can imagine. (shrink)

Dwayne Giles shot and killed Brenda Avie, his ex-girlfriend, and claimed self-defense. At trial, to rebut Giles's testimony that she was the aggressor, prosecutors introduced statements that Avie had made three weeks before the shooting to a police officer responding to a report of domestic violence. Crying while she spoke, Avie told the officer that Giles had choked, punched, and threatened to kill her. After he was convicted of murder, Giles claimed that the admission of Avie's hearsay statement was a (...) violation of the Confrontation Clause. The state responded that the defendant had forfeited his right to confront Avie by killing her. In the last week of its last Term, the United States Supreme Court considered these arguments in California v. Giles. The case was decided in the wake of Crawford v. Washington and Davis v. Washington, which together transformed the Confrontation Clause and, as a consequence, the prosecution of domestic violence. Giles, which generated five opinions and exposed a Court deeply ambivalent about the reinterpreted confrontation right, has done little to impose order on this chaos. This Essay, which will be published in Lewis and Clark's symposium issue on Giles, contemplates the future of domestic violence prosecution in a period of uncertainty. My analysis endeavors to guide lower courts in the task of application and to map a course for the evolution of prosecutorial approaches to battering. I conclude that Giles represents a significant opportunity for those concerned about the constraints Crawford and Davis had seemed to place on the prosecution of domestic violence. For the first time, the Court has identified "the domestic violence context" as a relevant construct, thereby compelling lower courts to grapple with the particularities of violence between intimates. This is a remarkable shift in relatively short order, and it allows us to glimpse the possibility of a jurisprudence informed by the realities of battering. (shrink)

Using Kohut's seminal paper "Forms and Transformations of Narcissism" as a springboard, Frank Lachmann updates Kohut's proposals for contemporary clinicians. _Transforming Narcissism: Reflections on Empathy, Humor, and Expectations _draws on a wide range of contributions from empirical infant research, psychoanalytic and psychotherapeutic practice, social psychology, and autobiographies of creative artists to expand and modify Kohut's proposition that archaic narcissism is transformed in the course of development or through treatment into empathy, humor, creativity, an acceptance of transience and wisdom. He asserts (...) that empathy, humor, and creativity are not the goals or end products of transformations, but are an intrinsic part of the ongoing therapist-patient dialogue throughout treatment. The transformative process is bidirectional, impacting both patient and therapist, and their affect undergoes transformation - for example from detached to intimate - and narcissism or self-states are transformed secondarily as a consequence of the affective interactions. Meeting or violating expectations of emotional responsivity provides a major pathway for transformation of affect. For beginning therapists, _Transforming Narcissism_ presents an engaging approach to treatment that incorporates the therapeutic action of these transformations, but also leaves room for therapists to develop styles of their own. For more experienced therapists, it fills a conceptual and clinical gap, provides a scaffold for crucial aspects of treatment that are often unacknowledged, or are dismissed and pejoratively labeled "countertransference." Most importantly, Lachmann offers a balance between therapeutic spontaneity and professional constraint. Focused and engaging, _Transforming Narcissism_ provides a bridge from self psychology to a rainbow of relational approaches that beginning and seasoned therapists can profitably traverse in either direction. Dr. Lachmann contributed to an article on empathy in the April, 2008 issue of _O_ magazine, pp. 230. (shrink)

Pourquoi de nos jours les opinions nationales et la communauté dite "internationale" manifestent-elles tant d'intérêt envers le concept de "droits de l'homme"? Que sont-ils, ces derniers, quant à leur essence, leur objet, leur finalité et leurs espèces, pour qu'ils soient mis aujourd'hui à l'ordre du jour des questions internationales, pour que plusieurs nations soient unanimes à les intégrer de plus en plus dans leurs arsenaux juridiques et politiques, et d'ériger leur respect en normes de comportement sous peine de sanctions internationales? (...) Quel est le fondement rationnel de "droits de l'homme" qu'ils bénéficient de tant d'attention dans un monde en quête de développement intégral et de paix durable? Ce livre tente de répondre à ces questions. L'intérêt de ce livre réside dans le fait qu'en dévoilant l'être intime des droits de l'homme, le lecteur saisira avec clarté leur lien avec la dynamique de l'action humaine sur laquelle repose tout développement intégral et la paix durable. Le lecteur comprend alors mieux pourquoi le respect des droits de l'homme renforce positivement cette dynamique et leur violation massive et permanente, son entropie. L'on comprend ainsi, en partie, la situation actuelle d'un grand nombre de pays africains en proie au sous-développement. (shrink)

I argue that the consumption of illegally shared pornography is often morally problematic. My argument is not based on any general condemnation of pornography or even illegal content sharing as such. Instead, my argument emphasizes that commercial pornography that is illegally shared risks violating the consent and thus the dignity of its performers. In this way, illegally shared pornography is akin to ‘revenge porn’, involving the non-consensual distribution and consumption of sexually intimate images or videos. The idea is that (...) if viewing sexually explicit content shared without the permission of the people featured within it is unethical, then the same is often true of the consumption of commercial pornographic content that has been shared illegally. My primary focus is on the commercial pornography produced and distributed by the performers themselves, but I also consider the moral status of more traditional forms of pornographic content. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Identity, Ritual and State in Tibetan Buddhism: The Foundations of Authority in Gelukpa MonasticismChristian P. B. HaskettIdentity, Ritual and State in Tibetan Buddhism: The Foundations of Authority in Gelukpa Monasticism. By Martin A. Mills. London: RoutledgeCurzon, 2003. 404 + xxi pp. with 12 black and white plates.In Tibetan Buddhism, there is a type of teaching called a dmar khrid, a "red instruction," wherein the lama brings students through (...) a teaching as a physician might dissect a corpse, pointing out and explaining the various parts and organs and their places and functions. In Identity, Ritual and State in Tibetan Buddhism, Martin Mills has done very much the same thing, with the exception that the body he examines is still very much alive, and emerges, to my eyes at least, as a new and wholly vital entity. Mills exposes the subcutaneous and sanguine body of Tibetan Buddhism, the bones and muscles that make up its structure, the blood that flows through it, and the organs that keep it alive, in "a plain and open manner," just as in a dmar khrid.1 The value of such a presentation truly cannot be overstated. An attempt to catalog the contents of each chapter would be both impossible and counterproductive, as the wealth of theoretical material and ethnographic detail is a large part of what makes this book so powerful. Instead, I will identify several topics, several of the vital organs alluded to, that are either not commonly noticed in the academic study of Buddhism, or that are given fresh perspective by Mills's anthropological and sociological methodology, and that are so crucial to understanding how it is that Buddhism lives in a typical Himalayan village. The latter portion of this review explains why I place such high value on this book and its potential place in Buddhist-Christian studies.Identity, Ritual and State is an ethnography of Kumbum Monastery in Lingshed, Ladakh (the eastern half of the Kashmir valley, located in Jammu and Kashmir, India), but its concerns are much more far-reaching than a single remote Himalayan village. The central question of the work is "how we are to understand the nature of religious authority in Tibetan Buddhist monasticism" (p. xiii), although it might more properly be the religious authority of Tibetan [End Page 187] Buddhist monastics. This answer is worked out in three overlapping areas of analysis: local ritual activity, ecclesiastical structure of the monastery, and the ritual foundations of Tibetan political thought (p. xvii).Mills convincingly asserts that there is a framework within which Buddhism happens in the Himalayas. The starting point of this framework is birth itself, which establishes the embodied person. The very physicality of personhood has several implications. First, the body is embedded in a very specific local space and place, and personhood is thus not only embodied, but also chthonic—intimately bound up with the earth or soil onto which it is born. At birth, persons are injected into a complex matrix of relations between people and various spirits, such as household gods and protectors, nāga, and itinerant demons. For example, Lingshed is divided into seven subterritories, each under the jurisdiction of a local deity whose physical abode and reign are well known to all in the village.2 These deities are associated with features of the local geography, and they regulate and influence local agricultural and social production, so birth in one area or another signifies a relation with the deity presiding over it. The land itself is imbued with a notion of personhood and agency. The human body is also the repository for pollution (sgrib), which comes about as a result of violating the established hierarchy of space and place and from bringing about changes to the local matrix of embodied persons. Both bodily pollution concerns and the need for proper relations with local spirit numina mandate definite, ongoing ritual attention. Rituals are occasioned in response to births, deaths, spirit possession, unintentional pollution of places or household objects, and movements within the monastic ecclesiastical structure, or happen regularly according to an astrologically and agriculturally influenced calendar.Rituals are performed by monks not only because they are trained specialists, but because... (shrink)

This paper critically interrogates the usefulness of the concept of violence regimes for social politics, social analysis, and social theory. In the first case, violence regimes address and inform politics and policy, that is, social politics, both around various forms of violence, such as gender-based violence, violence against women, anti-lesbian, gay and transgender violence, intimate partner violence, and more widely in terms of social and related policies and practices on violence and anti-violence. In the second case, violence regimes assist (...) social analysis of the interconnections of different forms and aspects of violence, and relative autonomy from welfare regimes and gender regimes. Third, the violence regime concept engages a wider range of issues in social theory, including the exclusion of the knowledges of the violated, most obviously, but not only, when the voices and experiences of those killed are unheard. The concept directs attention to assumptions made in social theory as incorporating or neglecting violence. More specifically, it highlights the significance of: social effects beyond agency; autotelic ontology, that is, violence as a means and end in itself, and an inequality in itself; the relations of violence, sociality and social relations; violence and power, and the contested boundary between them; and materiality-discursivity in violence and what is to count as violence. These are key issues for both violence studies and social theory more generally. (shrink)

Have you ever heard the phrase "It's easier to ask forgiveness than permission?" Violating consent isn't limited to sexual relationships, and our discussions around consent shouldn't be, either. To resist rape culture, we need a consent culture--and one that is more than just reactionary. Left confined to intimate spaces, consent will atrophy as theory that is never put into practice. The multi-layered power disparities of today's world require a response sensitive to a wide range of lived experiences. In Ask, (...) Kitty Stryker assembles a retinue of writers, journalists, and activists to examine how a cultural politic centered on consent can empower us outside the bedroom, whether it's at the doctor's office, interacting with law enforcement, or calling out financial abuse within radical communities. More than a collection of essays, Ask is a testimony and guide on the role that negated consent plays in our lives, examining how we can take those first steps to reclaim it from institutionalized power. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.2 (2002) 260-272 [Access article in PDF] Tragic Conflict and Greatness of Character Ariel Meira IT IS A SURPRISING FACT that some of our best literary examples of greatness of character are of persons acting in a way that involves them in a terrible burden of guilt. As spectators we perceive Oedipus, in Sophocles's Oedipus the King, 1 as one who upon discovering the identity of (...) his father and mother affirms that he bears guilt for killing the former and committing incest with the latter, and we typically concur in some vague way with his affirmation. 2 We do not, after all, think that his affirmation is merely the consequence of some confusion about morals on his part, and that he would have been more justified in treating his discovery with a light conscience. Furthermore, it seems that our conception of his greatness is intimately bound up with our being acquainted with him as someone who acted so as to render himself profoundly guilty in this way. What is paradoxical is that moral taint would be expected to reduce our admiration for a character and our attribution of greatness to it. Why then should noteworthy paradigms of greatness of character be morally tainted characters? Can we make sense of the idea that some kinds of guiltiness might be constitutive of greatness of character?As it is well-known, Aristotle says that in order for a tragedy best to achieve its desired effect, it should portray a protagonist "who is not pre-eminent in moral virtue, who passes to bad fortune not through vice or wickedness, but because of some hamartia...." 3 The term "hamartia" is variously translated as "piece of ignorance," "miscalculation," and "error of judgment," but as O. B. Hardison notes, it must be treated as designating a moral flaw, because it renders the protagonist [End Page 260] less than "pre-eminent in moral virtue." 4 However, even if the term is interpreted as covering what I have described as the moral taint associated with greatness of character, it should be clear that Aristotle does not provide here an answer to my question. At best he can be viewed as explaining why morally tainted characters of this sort are crucial to achieving tragic effect. He is not explaining how it is that such characters can be viewed as paradigms of greatness.I propose not to treat this paradox in its most general form, but rather by confining my attention to an interesting subclass of cases. What I have in mind are cases in which a protagonist finds himself or herself in what I shall call circumstances of tragic conflict. Such circumstances determine that a choice must be made between two (or perhaps more) courses of action, even though each of the courses involves the violation of an important moral claim, or the destruction of a crucial value. As spectators or readers, we typically perceive the protagonist as emerging with a heavy burden of guilt (much in the way noted above regarding Oedipus), and we recognize that he or she was bound to emerge guilty, no matter which course of action would have been chosen. Cases such as that of Agamemnon (bearing guilt for the sacrifice of his daughter Iphigenia in Aeschylus's Agamemnon), 5 of Jephthah (again bearing guilt for the sacrifice of his daughter, in Judges 11), 6 and of Orestes (bearing guilt for the murder of his mother Clytemnestra in Euripides's Orestes) 7 belong quite uncontroversially to this subclass. 8These protagonists make difficult choices, and carry them out with courage and resolution, qualities which explain to some extent our perception of them as possessing greatness of character. But in making their choice, they necessarily render themselves guilty, whether or not they have made the correct choice (assuming there is a correct choice in the circumstances). And we sense that suffering the peculiarly poignant pain which accompanies their guilty action is at least partly constitutive of their greatness. Clearly, we are faced again with the paradox of the association of guilt with greatness of character.In... (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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In lieu of an abstract, here is a brief excerpt of the content:Biting the Bullet:The Ethics and Aesthetics of ViolenceJonathan AllenThe Bullet's Song: Romantic Violence and Utopia, by William Pfaff. New York. Simon & Schuster, 2004, 368 pp.Regarding the Pain of Others, by Susan Sontag. New York, Picador, 2003, 131 pp.In the nineteenth century a broadly influential branch of Romantic philosophy insisted that goodness and beauty were intimately related. The goals of ethical and aesthetic education were taken to be one (...) and the same—the cultivation of the kalokagathos or "noble-and-beautiful" individual.1 This robust view of the relation between ethical and aesthetic education is now rarely defended; it was dealt a mortal wound by the inconvenient fact that highly cultured or Gebildete individuals have been implicated in the twentieth century's worst political crimes.This does not mean, however, that connections between ethical and aesthetic projects are no longer made. One such attempt to relate ethics and aesthetic—a bleak, somber, and deeply chastened attempt—is presented in the late Susan Sontag's Regarding the Pain of Others. In this small but dense book, Sontag assesses the hope that the reproduction of images, especially photographic images, of violence and atrocity might help to abolish war, or at least to play a role in combating genocide or the commission of gross violations of the laws of war. While she evidently wishes to find "an antidote to the perennial seductiveness of war," Sontag is doubtful that photography is equal to this moral burden.2Sontag's work concentrates on the aesthetic and ethical challenges that confront any attempt to convey the horrors of war to uninvolved observers. Her focus is thus trained on an attempt to exorcise what she refers to as the "seductiveness of war"; she is not primarily concerned to identify the source of war's allure (though she does have some interesting observations to make on the issue).3 William Pfaff, by contrast, is both repelled and fascinated by the modern embrace of violence. The Bullet's Song: Romantic Violence and Utopia offers an enthralling account of the intellectual and aesthetic forces that provoked the feverish modern love affair with violence and war. Pfaff is at least as doubtful as Sontag, however, that that love affair [End Page 100] is over and that we are in a position to forge a more pacific sensibility. Nevertheless, he insists that if we are to have the slightest hope of avoiding a full-scale repetition of the twentieth-century's "carnival of inhumanity," we need to understand the nature of its romance with violence.So how did that romance come about? The central theme of The Bullet's Song is the consequences of the loss of "chivalry." This, according to Pfaff, was a code that "held that what an individual or society could licitly do to another was limited by a morality linked to the essential values of Western civilization."4 Within this framework, it was expected that states would sometimes go to war with one another, but war was seen merely as an extreme means of settling disputes, not of eliminating entire societies or remaking the world. For individuals, war was presented as "a test of valor, rewarded by 'honor'"—in other words, it was seen as an occasion to test oneself in the light of a set of ideals of conduct that operated as constraints on permissible behavior in war.5 All of this came to a sticky end in the trenches of World War I, replaced by a morally nihilistic idea of total war. Pfaff claims that this moral vacuum proved intolerable to many individuals. They reacted in several different ways. Some attempted to construct "codes of individual transcendence" and "collective will," while others gave themselves over to "utopias based on historical fictions."6This is a very large story, and it is in fact too bulky for the confines of this book. First, it must be said that Pfaff fails to present his central claims clearly. He is unclear, for example, as to exactly what was lost with the destruction of the chivalric code, as well as what caused its destruction. At times, he seems to be suggesting that the rise of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Significant Interests and the Right to KnowReuven Brandt (bio)1. IntroductionDaniel Groll's book Conceiving People (2021) attempts a novel and insightful defence of why individuals ought to choose open over anonymous gamete donation, barring any special circumstances. In broad strokes, the overall argument proceeds by defending three main claims: (1) that failing to disclose to children that they are donor-conceived is morally problematic, (2) that children who are informed that (...) they are donor-conceived (either intentionally by their social parents or otherwise) are likely to have a worthwhile, significant, subjective interest1 in having knowledge about their gamete donor(s), and (3) that parents have a duty to advance their children's worthwhile subjective significant interests. Groll's account departs from other criticisms of anonymous gamete donation in that it does not rest on the view that knowledge about one's genetic progenitors is essential to self-knowledge, identity formation, or other elements of wellbeing for creatures like us. The view thus attempts to avoid the pitfalls plaguing other criticisms of anonymous gamete donation, which tend to rely on controversial (and likely false) claims of genetic essentialism and/or genetic exceptionalism.Groll's thesis rests on the much more modest (and likely correct) claim that seeking information about one's genetic progenitors is one of many permissible, fruitful, and valuable routes to identity formation. According to Groll, it just so happens that a large portion of donor-conceived individuals aware of the absence of biological ties to one or more social parents choose this route to identity formation. And this empirical fact combined with plausible views about parents' obligations to promote their offspring's wellbeing gives prospective pro-creators strong reason to choose open donors over anonymous donors.Although many aspects of the picture Groll paints are attractive, I remain unconvinced that the overall argument succeeds. My criticism of the argument is multipronged. I am skeptical that failing to disclose to a child that they were donor-conceived and/or failing to disclose information to a child that they are [End Page 201] likely to find important violates the parental duty to build intimate relationships with one's offspring. This shifts the force of Groll's argument to the empirical claim that donor-conceived children are likely to have a significant subjective interest in knowing information about their biological relations. As I will show, the empirical evidence for this claim is not as strong as Groll presumes. In the absence of a deontic argument for disclosure, Groll must provide more robust empirical evidence that anonymous gamete donation is likely to result in off-spring with their weighty interests frustrated, or else argue that the risk is not worth taking. These are not fatal flaws but show that more empirical and normative work needs to be done to defend this line of argument.A more serious set of worries arise in response to Groll's claim that the interest that donor-conceived individuals have in genetic information is likely to be significant. Little is said about what constitutes a significant interest, except that interests fall along a linear spectrum and that the significance of an interest is a factor of "the space, so to speak, it takes up in a person's mental economy (do they think about it a lot?) and the extent to which they organize their lives around it" (2021, 63). My worries here are three-fold. First, it is unclear whether the empirical data support the claim that donor-conceived individuals are likely to have an interest in genetic knowledge that is significant in the sense that it occupies a large portion of their mental energy and is a locus around which they organize their lives. Second, there is scant discussion about whether an interest can become morally problematic (and so no longer worthwhile on Groll's account) if it is given too much weight. I will argue that a plausible reading of Groll's account requires that we treat overvalued interests as no longer worthwhile. Consequently, Groll's argument risks presuming the kind of genetic chauvinism—the view that genetic knowledge is essential to wellbeing—that he seeks to reject. Third, if... (shrink)

The more intensely a person thinks about the final nature of life, the more he is bound to a moment in life that is limited in time. Death is a very personal and intimate process, which in most cases is not «beautiful». The reality of death in clinics, intensive care units and operating theatres is, by its human nature, cruel. The body at the «end of the road» is captured by funeral homes. Thus, death today is identical to a (...) long path of suffering. The article is dedicated to the author's reflection on a project by the German artist Gregor Schneider, which caused sensation and fierce reaction in Western art circles and beyond the art scene, creating him a reputation as «the most terrible contemporary artist» who has violated «existing» restrictions that cannot be exceeded if we do not want to question our civilization. The artist's vision is to allow a terminally ill person to die as part of an art project that represents a confrontation with death and that can remove the horror of death. As part of the project, the dying person defines everything in advance. Instead of a mass medical procedure of the same type, death, modeled on the artist's skill, Schneider argues, will create humane places for death and contribute to the creation of a space where people can die with dignity, creating personal protection and ensuring the ethical requirement of free will and self-determination. (shrink)

Suppose we agree to reject the view that privacy has narrow scope and consequently is irrelevant to the constitutional privacy cases. We then have (at least) these two options: (1) We might further emphasize and draw out similarities between tort and constitutional privacy claims in order to develop a notion of privacy fundamental to informational and Fourth Amendment privacy concerns as well as the constitutional cases. We can cite examples indicating this is a promising position. Consider consenting homosexuality conducted in (...) one's home, for instance. We view it as a private matter, whether the state is seeking to regulate the behavior, or if others are attempting to gain or exploit information about it. I believe basic conceptual similarities between tort and constitutional interests can be identified by showing that there is a range of similar reasons for protecting both tort and constitutional privacy concerns. We might worry, however, that a comprehensive concept of privacy may be too general to be very useful, given that privacy violations can be so diverse, and can arise, for example, from misuse of confidential information, from conduct that is intrusive even if no information is gained or disclosed, from disturbance of an intimate relationship, or from disruption of various other important aspects of one's life.(2) We could concede that whatever “privacy” means in the tort and Fourth Amendment cases, it means something different in the constitutional cases. Nevertheless, we might take that “something else” seriously as a distinct but legitimate use of the term which is not “spurious” but is reflected in our ordinary language. This appears to me to be a fruitful alternative. After all, contrary to Henkin's view that tort privacy is “what most people mean by privacy,” the term is often used in contexts beyond informational privacy and clearly related to the interests at stake in the constitutional cases. Thus, for example, in a pamphlet explaining how to protect children by teaching them how to say “No!” to strangers without making them paranoid or antisocial, parents and teachers are told, Children have a right to privacy. Teach it. Reinforce it. One of the ways to help children prevent sexual assault is to encourage them to develop a sense of physical integrity. A sense that they have a right to their own body space and privacy. Just as we allow them to close the door when they use the bathroom, we must allow them to say no to any unwanted physical affection and touch. Flora Calao and Tamar Hosansky, “The Key to Having Fun is Being Safe: Teaching Personal Safety to Children,” The Safety and Fitness Exchange, 1123 Broadway, N.Y., N.Y. 10010. Unfortunately, the most obvious starting point for identifying the sense of private relevant to the constitutional cases is extremely worrisome. The Court itself has said ... only personal rights that can be deemed “fundamental”...are included in this guarantee of personal privacy...the right has some extension to activities relating to marriage...procreation...contraception...family relationships... and child rearing and education.Roe v. Wade, 410 U.S. 113 (1973).The difficulty, of course, is that little more is offered by way of explanation of which rights are “personal” or “fundamental” or both. Focusing on marriage makes Roe v. Wade difficult to understand given that Ms. Roe was unmarried, and attending only to family issues does not help us make sense of the Stanley case protecting one's right to view pornography in one's home. It is perhaps more problematic that decisions such as what color shoes to wear are reasonably viewed as personal, yet are far from fundamental enough to warrant protection. And regulations governing the draft and employment, for example, are not viewed as privacy invasions although they might be said to interfere with matters of one's life that are both fundamental and personal in the vague sense described.Before we give up in frustration, however, I would urge that we recall that even in tort law the notion of privacy has been evolving through a constellation of judgments. Although there is no fixed way of using the term which we then proceed to analyze, the concept of privacy has not in those cases been taken to be meaningless or empty. Similarly, there is reason to believe that the scope of a “personal and fundamental” notion of privacy relevant to the constitutional cases can be further delineated through a consideration of cases, especially since it seems to me that in many cases application of the term is clear and unproblematic. A decision to have a vasectomy, for example, can uncontroversially be said to be a personal and fundamental one, and it is in that sense private. We fail to acknowledge the personal significance in an individual's life of forcing or refusing him the operation if we deny that this important sense of privacy is relevant to such a decision merely because an interest in determining for oneself what one ought to do is also at risk.Of course, once it is settled that something is a private matter, it is a separate issue to decide whether or not, in some social context, an invasion of it can be justified. Thus, I would claim, a mandatory sterilization program for male recidivists or for those in a country suffering grave poverty and overpopulation does invade privacy, and the social or legal question is whether or not the invasion can, in the particular circumstances, be justified. Although all will agree that both individual and social interests must be balanced by moral philosophers as well as the courts, in conflicts we will not always agree on the weight to be accorded individual claims.I have not provided a constitutional defense for citing privacy as one right at stake in the constitutional privacy cases. Nor have I attempted to enter the debate about how strictly to interpret the Constitution. But if I am correct, then we can agree there is an important interest in privacy at issue in those cases without merely conflating privacy and autonomy or liberty, and can continue the process of marking out its boundaries. If we reach such agreement, we will have made considerable progress. Moreover, the implications of this view are significant. Current constitutional standards, controversial though they may be, require “strict scrutiny” for cases concerning “fundamental values,” and privacy has been judged to be one such value. Thus these privacy claims have a greater chance of being protected when they conflict with other rights or general interests than they would have if only liberty, or freedom from governmental interference, were involved. (shrink)

The 1990 Visual Artists Rights Act (VARA) is a provision of U.S. copyright law that seeks to protect the noneconomic rights of artists, called "moral rights." These rights are due to the "presumed intimate bond between artists and their works."1 In the United States it protects rights of artistic attribution and integrity: the artwork cannot be claimed as the work of another, and it cannot be distorted. In some cases VARA protects artworks from destruction. But what is the nature (...) of this intimate bond? The underlying principle behind the legal construct of artistic moral rights is that the artwork is an extension of its creator such that any harm to the work is a violation of the personhood of the artist.2 Another .. (shrink)

This chapter contains sections titled: Lactational Burkas, Lactational Burdens Breastfeeding as Obscene The Intimacy of Breastfeeding “Breast is Best” Milkmen Conclusion Notes.

What is the ethical basis for democracy? What reasons do we have to go along with democratic decisions even when we disagree with them? When can we justly ignore democratic decisions? These three questions are intimately connected: understanding what is ultimately important about democracy helps us to understand the authority of democratic decisions over our personal views, and the limits of such authority. Thomas Christiano’s ambitious new book, The Constitution of Equality, aims to provide such an understanding through a discussion (...) of all three questions. Briefly put, in Christiano’s view, public equality is the moral foundation of both democracy and liberal rights, and it serves to explain the authority of democracy as well as its limits. The book aims first of all to ground the principle of public equality in a number of principles related to the nature of personhood, dignity, well-being and formal considerations of justice, on the one hand, and in the need for publicity for social justice, on the other (Chaps. 1 and 2). The book then aims to show how both democracy and basic liberal rights are grounded in the principle of public equality, which tells us that in the establishment of law and policy we must treat persons as equals in ways that they can see are treating them as equals (Chaps. 3 and 4). The account clarifies the nature and roles of adversarial politics and public deliberation in political life (Chap. 5). Finally, the book argues that democratic decisions have authority over personal views and that violations of democratic and liberal rights are beyond the legitimate authority of democracy, and that the creation of persistent minorities in a democratic society, and the failure to ensure a basic minimum for all persons weaken the legitimate authority of democracy (Chaps. 6 and 7). I shall begin by addressing Christiano’s view on the basis of equality, and then shall focus mainly on the central argument for public equality, democracy and its.. (shrink)

In Intimations of Christianity Among the Ancient Greeks , Simone Weil discusses precursors to Christian religious ideas which can be found in ancient Greek mythology, literature and philosophy. She looks at evidence of "Christian" feelings in Greek literature, notably in Electra, Orestes, and Antigone , and in the Iliad , going on to examine God in Plato, and divine love in creation, as seen by the ancient Greeks.

The importance of the hidden curriculum is recognised as a practical training ground for the absorption of medical ethics by healthcare professionals. Pakistan’s healthcare sector is hampered by the exclusion of ethics from medical and nursing education curricula and the absence of monitoring of ethical violations in the clinical setting. Nurses have significant knowledge of the hidden curriculum taught during clinical practice, due to long working hours in the clinic and front-line interaction with patients and other practitioners.

We show that Bell inequalities can be violated in the macroscopic world. The macroworld violation is illustrated using an example involving connected vessels of water. We show that whether the violation of inequalities occurs in the microworld or the macroworld, it is the identification of nonidentical events that plays a crucial role. Specifically, we prove that if nonidentical events are consistently differentiated, Bell-type Pitowsky inequalities are no longer violated, even for Bohm's example of two entangled spin 1/2 quantum (...) particles. We show how Bell inequalities can be violated in cognition, specifically in the relationship between abstract concepts and specific instances of these concepts. This supports the hypothesis that genuine quantum structure exists in the mind. We introduce a model where the amount of nonlocality and the degree of quantum uncertainty are parameterized, and demonstrate that increasing nonlocality increases the degree of violation, while increasing quantum uncertainty decreases the degree of violation. (shrink)

The power to promise is morally fundamental and does not, at its foundation, derive from moral principles that govern our use of conventions. Of course, many features of promising have conventional components—including which words, gestures, or conditions of silence create commitments. What is really at issue between conventionalists and nonconventionalists is whether the basic moral relation of promissory commitment derives from the moral principles that govern our use of social conventions.Other nonconventionalist accounts make problematic concessions to the conventionalist's core instincts, (...) including embracing: the view that binding promises must involve the promisee's belief that performance will occur; the view that through the promise, the promisee and promisor create a shared end; and the tendency to take promises between strangers, rather than intimates, as the prototypes to which a satisfactory account must answer.I argue against these positions and then pursue an account that finds its motivation in their rejection. My main claim is: the power to make promises, and other related forms of commitment, is an integral part of the ability to engage in special relationships in a morally good way. The argument proceeds by examining what would be missing, morally, from intimate relationships if we lacked this power. (shrink)