Background and AimsEnd-of-life discussions can be difficult for seriously ill adolescents and young adults. Researchers aimed to determine whether completing Voicing My CHOiCES —a research-informed advance care planning guide—increased communication with family, friends, or health care providers, and to evaluate the experience of those with whom VMC was shared.MethodsFamily, friends, or HCPs who the AYAs had shared their completed VMC with were administered structured interviews to assess their perception of the ACP discussion, changes in their relationship, conversation quality, and whether (...) the discussion prompted changes in care. Open-ended responses underwent thematic analysis.ResultsOne-month post-completion, 65.1% of AYA had shared VMC completion with a family member, 22.6% with a friend, and 8.9% with an HCP. Among a sample of respondents, family and friends reported a positive change in their relationship with the AYA. Participant descriptions of the experience fell into five themes: positive experience, difficult experience, appreciated a guide to facilitate discussion, provided relief, and created worry/anxiety. Only 1 HCP noted a treatment change. Family, friends, and HCP did not think the AYA would have discussed EoL preferences without completing VMC.ConclusionsVMC has potential to enhance communication about ACP between AYA and their family and friends, though less frequently with HCPs. Participants reported a positive change in their relationship with the AYA after discussing VMC, and described experiencing the conversation as favorable, even when also emotionally difficult. (shrink)

This letter responds to the letter “The Open Donor View and Procreative Beneficence,” by Daniel Groll, in the same, May‐June 2024, issue of the Hastings Center Report.

When fertility centers dispose of embryos, how should this be done? Current regulatory guidelines by the Human Fertilisation and Embryology Authority state that, when terminating the development of human embryos, a clinic should act with sensitivity, taking account of the embryo’s “special status” and respecting the interests of the gamete providers and recipients. As yet, it is unclear as to how and to what extent this achieved within fertility clinics in the UK. Resultantly, this paper examines the largely undocumented domain (...) of embryo disposal practice. By undertaking an empirical study into policy and procedure and noting divergence in clinic practice, it then comments on the ethical implications of these protocols for patients and practitioners. Specifically, this paper argues for a more holistic approach to embryo disposal. An approach that effectively meets the requirements of the lab, is respectful of the “special status” of the human embryo, and, perhaps most importantly, reflects the multifaceted needs of the patient. (shrink)

_A groundbreaking study of the development of form in eighteenth-century aesthetics_ In this original work, Abigail Zitin proposes a new history of the development of form as a concept in and for aesthetics. Her account substitutes women and artisans for the proverbial man of taste, asserting them as central figures in the rise of aesthetics as a field of philosophical inquiry in eighteenth-century Europe. She shows how the idea of formal abstraction so central to conceptions of beauty in this (...) period emerges from the way practitioners think about craft and skill across the domestic, industrial, and so-called high arts. Zitin elegantly maps the complex connections among aesthetics, form, and formalism, drawing out the understated presence of practice in the writings of major eighteenth-century thinkers including Locke, Addison, Burke, and Kant. This new take on an old story ultimately challenges readers to reconsider form and why it matters. (shrink)

Phenomenologically speaking, we perceive the present, recall the past, and anticipate the future. We offer an account of the temporal content of the perceptual present that distinguishes it from the recalled past and the anticipated future. We distinguish two views: the Token Reflexive Account and the Minimal Account. We offer reasons to reject the Token Reflexive Account, and defend the Minimal Account, according to which the temporal content of the perceptual present is exhausted by its direct reference to the interval (...) of time over which it occurs. (shrink)

Good decision-making requires reliable information. In medicine, relevant information comes from clinical trials and other forms of scientific research. In business, one source is in corporate annual financial statements. As for-profit, publicly traded companies whose business is discovering, manufacturing, and marketing drugs, pharmaceutical companies sit at the nexus of these two fields. Determining the safety and efficacy of a pharmaceutical product and determining the profitability of a complex enterprise are similarly difficult tasks: each is fraught with deeply ambiguous information that (...) requires sophisticated judgment to interpret reasonably. (shrink)

This new edition of Charles Fried's Medical Experimentation includes a general introduction by Franklin Miller and the late Alan Wertheimer, a reprint of the 1974 text, an in-depth analysis by Harvard Law School scholars I. Glenn Cohen and D. James Greiner, and a new essay by Fried reflecting on the original text and how it applies to the contemporary landscape of medicine and medical experimentation.

This book considers what responsibilities affluent individuals have toward global poverty, given that global poverty is a problem with structural, political causes, and one that generally requires collective action. By looking at the intersection of moral, political, and legal philosophy, this book gives a pluralistic and differentiated account of individual duties based on a person's moral agency, her roles within collective groups , and her institutional identities as citizen and consumer.

This article examines how sexual harassment has been conceptualized by French feminists in an increasingly global political environment, demonstrating how feminist ideas, politics and legal initiatives are transformed as they travel across space and time. I argue that feminist networks have been a central determinant of the ways in which ideas about sexual harassment have spread across the globe in the past 20 years. However, I further contend that there were basic national differences in political, legal and cultural traditions that (...) made it likely that feminist concepts and policies would be translated as they traveled. Moreover, I show how certain social actors heightened the importance of such cultural differences through `symbolic boundary work'. Finally, I discuss how feminist activists both distance themselves from negative stereotypes of American feminist approaches to sexual harassment and simultaneously draw on international networks and ideas to expand the scope of French sexual harassment law. (shrink)

My topic is authenticity in or perhaps as painting, not the authenticity of paintings; I know next to nothing about the problem of verifying claims of authorship. I am interested in another kind of genuineness and fraudulence, the kind at issue when we say of a person that he or she is false, not genuine, inauthentic, lacks integrity, and, especially when we say he or she is playing to the crowd, playing for effect, or is a poseur. These are not (...) quite moral distinctions (no one has a duty to be authentic), but they are robustly normative appraisals, applicable even when such falseness is not a case of straight hypocrisy but of lack of self-knowledge or of self-deceit. (A person can be quite sincere and not realize the extent of her submission to the other’s expectations and demands.) This sort of appraisal also has a long history in post-Rousseauist reflections on the dangers of uniquely modern forms of social dependence, and they are prominent worries in the modern novel. (shrink)

Background Human brain organoids are a valuable research tool for studying brain development, physiology, and pathology. Yet, a host of potential ethical concerns are inherent in their creation. There is a growing group of bioethicists who acknowledge the moral imperative to develop brain organoid technologies and call for caution in this research. Although a relatively new technology, brain organoids and their uses are already being discussed in media literature. Media literature informs the public and policymakers but has the potential for (...) utopian or dystopian distortions. Thus, it is important to understand how this technology is portrayed to the public. Methods To investigate how brain organoids are displayed to the public, we conducted a systematic review of media literature indexed in the Nexis Uni database from 2013–2019. News and media source articles passing exclusion criteria (_n_ = 93) were scored to evaluate tone and relevant themes. Themes were validated with a pilot sample before being applied to the dataset. Thematic analysis assessed article tone, reported potential for the technology, and the scientific, social, and ethical contexts surrounding brain organoids research. Results Brain organoid publications became more frequent from 2013 to 2019. We observed increases in positively and negatively toned articles, suggesting growing polarization. While many sources discuss realistic applications of brain organoids, others suggest treatment and cures beyond the scope of the current technology. This could work to overhype the technology and disillusion patients and families by offering false hope. In the ethical narrative we observe a preoccupation with issues such as development of artificial consciousness and “humanization” of organoid-animal chimeras. Issues of regulation, ownership, and accuracy of the organoid models are rarely discussed. Conclusions Given the power that media have to inform or misinform the public, it is important this literature provides an accurate and balanced reflection of the therapeutic potential and associated ethical issues regarding brain organoid research. Our study suggests increasing polarization, coupled with misplaced and unfounded ethical concern. Given the inhibitory effects of public fear or disillusion on research funding, it is important media literature provides an accurate reflection of brain organoids. (shrink)

In Darwinian Heresies, which was originally published in 2004, prominent historians and philosophers of science trace the history of evolutionary thought, and challenge many of the assumptions that have built up over the years. Covering a wide range of issues starting in the eighteenth century, Darwinian Heresies brings us through the time of Charles Darwin and the Origin, and then through the twentieth century to the present. It is suggested that Darwin's true roots lie in Germany, not his native England, (...) that Russian evolutionism is more significant than many are prepared to allow, and that the true influence on twentieth-century evolution biology was not Charles Darwin at all, but his often-despised contemporary, Herbert Spencer. The collection was intended to interest, to excite, to infuriate, and to stimulate further work. (shrink)

This book presents the concept of ‘unstaging’ war as a strategic response to the failure of the discourse and institutions of peace. This failure is explained by exploring the changing character of conflict in current and emergent global circumstances, such as asymmetrical conflicts, insurgencies, and terrorism. Fry argues that this pluralisation of war has broken the binary relation between war and peace: conflict is no longer self-evident, and consequentially the changes in the conditions, nature, systems, philosophies and technologies of war (...) must be addressed. Through a deep understanding of contemporary war, Fry explains why peace fails as both idea and process, before presenting ‘Unstaging War’ as a concept and nascent practice that acknowledges conflict as structurally present, and so is not able to be dealt with by attempts to create peace. Against a backdrop of increasingly tense relations between global power blocs, the beginnings of a new nuclear arms race, and the ever-increasing human and environmental impacts of climate change, a more viable alternative to war is urgently needed. Unstaging War is not claimed as a solution, but rather as an exploration of critical problems and an opening into the means of engaging with them. (shrink)

In 1892, the British agricultural authorities introduced a policy of slaughtering animals infected with foot and mouth disease (FMD). This measure endured throughout the 20th century and formed a base line upon which officials superimposed the controversial "contiguous cull" policy during the devastating 2001 epidemic. Proponents of the slaughter frequently emphasized its capacity to eliminate FMD from Britain, and claimed that it was both cheaper and more effective than the alternative policies of isolation and vaccination. However, their discussions reveal that (...) a less obvious but nonetheless important reason for maintaining the slaughter policy was the conviction that in its manner of operation and its outcomes, it benefited the state and status of the British nation. To its supporters, slaughter was far more than a method of disease control; it acted also as a moralizing and civilizing force, an indicator of veterinary ability and a "virility symbol" of British international leadership. This "cultural" rationale for FMD control by slaughter declined during the late 20th century and was wholly undermined by the 2001 epidemic, when extensive culling failed to convey the intended image of an organized, enlightened Britain. (shrink)

Barbara H. Fried presents a powerful critique of the nonconsequentialist approaches that have been dominant in recent Anglophone moral and political thought. She argues that nonconsequentialist theories have disastrous consequences in the political domain and are inadequate at dealing with conflicts of individual interests in the moral domain.

Objective: To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees.Design: Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted.Setting: Australia.Participants: Contacts in 84 key research organisations and select electronic listservers across Australia. A total of 100 completed questionnaires were received with representations from a variety of research areas .Main measurements: Open-ended and fixed alternative questions about type of research agency; type (...) of research; type of population under study; whether payment is standard; amounts and mechanisms of payment; factors taken into account when deciding on payment practices; and whether payment policies exist.Results: Reimbursement practice is highly variable. Where it occurs it is largely monetary and is for time and out-of-pocket expenses. Ethics committees were reported to be often involved in decision making around reimbursement.Conclusions: Research subject payment practices vary in Australia. Researchers who do provide payments to research participants generally do so without written policy and procedures. Ethics committees have an important role in developing guidelines in this area. Specific guidelines are needed considering existing local policies and procedures; payment models and their application in diverse settings; case study examples of types and levels of reimbursement; applied definitions of incentive and inducement; and the rationale for diverse payment practices in different settings. (shrink)

The development of nursing ethics as a field of inquiry has largely relied on theories of medical ethics that use autonomy, beneficence, and/or justice as foundational ethical principles. Such theories espouse a masculine approach to moral decision-making and ethical analysis. This paper challenges the presumption of medical ethics and its associated system of moral justification as an appropriate model for nursing ethics. It argues that the value foundations of nursing ethics are located within the existential phenomenon of human caring within (...) the nurse/patient relationship instead of in models of patient good or rights-based notions of autonomy as articulated in prominent theories of medical ethics. Models of caring are analyzed and a moral-point-of-view (MPV) theory with caring as a fundamental value is proposed for the development of a theory of nursing ethics. This type of theory is supportive to feminist medical ethics because it focuses on the subscription to, and not merely the acceptance of, a particular view of morality. (shrink)

The main goal of this paper is to revisit, synthesize, and critique John R. Searle’s thinking over time concerning social ontology and what it means for something to be a social construction. Primarily, I undertake this task by elucidating and problematizing aspects of John R. Searle’s _The Construction of Social Reality_ (herein, _CSR_) (1995), though attention is paid to his later and corollary works. Certainly, there are many other philosophers who attend to analyzing the very meaning of social ontology or (...) social constructionism considered as a program and many other philosophers who concern themselves with what it means to say that something is socially constructed. I focus largely on _CSR_ because it remains both immensely influential and because it represents one of the earliest attempts by an analytic philosopher to provide an analysis of the very meaning of what it means to say that “X is a social construction” or what “social ontology/social constructionism” entails. Although much of what follows constitutes a revisitation of the crucial elements of _CSR_, what is novel about my analysis is that I synthesize and organize the main aspects of Searle’s thinking through time in a single article. I also draw attention to others’ concerns and amendments to his positions and offer my own novel objections and possible improvements to his corpus. This is no small feat: Many details, as well as others’ appraisals, amendments, and so forth must be overlooked for this endeavor to be possible at all. This being so, I do my best to point readers in directions to follow for further exploration or arguments against Searle’s views as I proceed. (shrink)

This article examines the limitations associated with Irigaray’s concept of a culture of difference. I suggest that her concept of sexual difference depends upon a conservative fiction of sameness. I argue that a fiction of phallic sameness underpins her evangelical championing of difference, and that such a fiction retains a conservative blindness to the complexities of contemporary social relations and erases the positive effects oppositional discourses have had on the culture of modernity. I question the debt Irigaray disavows to other (...) non-difference feminism, her insistence that woman are radically marginalized and suggest that her culture of difference is prescriptive and normative. Egalitarian feminism, understood as a postmodern project, is far more strategic, insofar as it offers a multiply-situated analysis of the relationship between women and power within modernity. I replace Irigaray’s negative image of the egalitarian feminist as an unnatural woman with the figure of the cyborg who embraces ontological impurity and strategically works within culture. (shrink)

Control stimuli are key for understanding the extent to which face processing relies on holistic processing, and affective evaluation versus the encoding of low-level image properties. Luminance polarity reversal combined with face inversion is a popular tool for severely disrupting the recognition of face controls. However, recent findings demonstrate visibility-recognition trade-offs for LP-reversed faces, where these face controls sometimes appear more salient despite being harder to recognize. The present report brings together findings from image analysis, simple stimuli, and behavioral data (...) for facial recognition and visibility, in an attempt to disentangle instances where LP-reversed control faces are associated with a performance bias in terms of their perceived salience. These findings have important implications for studies of subjective face appearance, and highlight that future research must be aware of behavioral artifacts due to the possibility of trade-off effects. (shrink)

This paper will explore the notion of ‘poetic enthusiasm’ in early 18th-century verse. The representation of poetic enthusiasm—the claim to false inspiration, and the fanaticism that was perceived to accompany it—was frequently politicized in this period. Through a conflation of religious and literary discourses, poetic enthusiasm was seen to represent the sae kind of anarchy in the realm of literature that the religious enthusiasm associated with Dissent did in the context of the established church. This paper will establish first of (...) all the way in which Tory and Royalist authors such as John Oldham, John Dryden, and Alexander pope used the established satirical caricature of the religious enthusiast to attack their Whig contemporaries. It will go on to suggest, however, that the relationship between politics and enthusiasm is more complex than this equation between Toryism and anti-enthusiasm suggests. While the Tory attack on literary enthusiasm was premised on an elision of political and literary codes, writers such as Dryden and Pope were also trying to separate out an exclusively poetic meaning for the term. Enthusiasm remained and unstable term because although writers recognized that its religious and political applications were different from its literary sense, they could not easily keep the two apart. (shrink)

Most histories of livestock disease in Britain treat the development of control policy as a government responsibility, to which farmers made little constructive contribution. Similarly, farmers rarely appear in accounts of disease research. This paper uses the example of contagious abortion at the turn of the twentieth century to reveal that state-farming collaboration in research and policy did in fact occur, and that it operated in various ways, with often unexpected outcomes. The collaborative approach to contagious abortion is partly attributed (...) to its clinical and epidemiological features, which made it an unsuitable candidate for the existing, state-led policy of stamping out disease. It is claimed that such collaboration has been overlooked by historians on account of their focus upon diseases that were amenable to stamping out. This focus needs to change if history is to inform present-day disease governance in Britain, which is founded on the concept of ‘partnership’ between farmers and the state. (shrink)

Contract as Promise is a study of the philosophical foundations of contract law in which Professor Fried effectively answers some of the most common assumptions about contract law and strongly proposes a moral basis for it while defending the classical theory of contract. This book provides two purposes regarding the complex legal institution of the contract. The first is the theoretical purpose to demonstrate how contract law can be traced to and is determined by a small number of basic moral (...) principles. At the theory level the author shows that contract law does have an underlying, and unifying structure. The second is a pedagogic purpose to provide for students the underlying structure of contract law. At this level of doctrinal exposition the author shows that structure can be referred to moral principles. Together the two purposes support each other in an effective and comprehensive study of contract law. This second edition retains the original text, and includes a new Preface. It also includes a substantial new essay entitled Contract as Promise in the Light of Subsequent Scholarship--Especially Law and Economics which serves as a retrospective of the work accomplished in the last thirty years, while responding to present and future work in the field. (shrink)

Establishing healthy dietary habits in childhood is crucial in preventing long-term repercussions, as a lack of dietary variety in childhood leads to enduring impacts on both physical and cognitive health. Poor conceptual knowledge about food has recently been shown to be a driving factor of food rejection. The majority of studies that have investigated the development of food knowledge along with food rejection have mainly focused on one subtype of conceptual knowledge about food, namely taxonomic categories (e.g., vegetables or meat). (...) However, taxonomic categorization is not the only way to understand the food domain. We also heavily rely on other conceptual structures, namely thematic associations, in which objects are grouped because they share spatial-temporal properties or exhibit a complementary relationship (e.g., soft-boiled egg and soldiers). We rely on such thematic associations between food items, which may not fall into the same taxon, to determine the acceptability of food combinations. However, the development of children's ability to master these relations has not been systematically investigated, nor alongside the phenomenon of food rejection. The present research aims to fill this gap by investigating (i) the development of conceptual food knowledge (both taxonomic and thematic) and (ii) the putative relationship between children's food rejection (as measured by the Child Food Rejection Scale) and both thematic and taxonomic food knowledge. A proportional (A:B::C:?) analogy task, with a choice between taxonomic (i.e., bread and pasta) and thematic (i.e., bread and butter) food associates, was conducted on children between 3 and 7-years-old (n= 85). The children were systematically presented with either a thematic or taxonomic food base pair (A:B) and then asked to extend the example type of relation to select the respective thematic or taxonomic match to the target (C:?). Our results revealed, for the first time, that increased levels of food rejection were significantly predictive of poorer food identification and decreased thematic understanding. These findings entitle us to hypothesize that knowledge-based food education programs to foster dietary variety in young children, should not only aim to improve taxonomic understanding of food, but also thematic relations. (shrink)

This paper examines the efforts of contractualists to develop an alternative to aggregation to govern our duty not to harm (duty to rescue) others. I conclude that many of the moral principles articulated in the literature seem to reduce to aggregation by a different name. Those that do not are viable only as long as they are limited to a handful of oddball cases at the margins of social life. If extended to run-of-the-mill conduct that accounts for virtually all unintended (...) (in the sense of undesired) harm to others—noncriminal activities that impose some risk of harm on others—they would rule out all action. Moreover, because such conduct poses an irreducible conflict between freedom of action and freedom from expected harm, it can be regulated only by principles that accept the necessity of making precisely the sorts of interpersonal trade-offs that contractualism is foundationally committed to reject: trade-offs in which the numbers count, such that a risk of serious harm to one person can be justified by small benefits to the many. (shrink)

Empathy is a construct that is notoriously difficult to define. Murphy and colleagues ( 2022 ) argue for leaning into the construct's inherent fuzziness and reverting to what they term a classical definition informed by the observations of philosophers and clinicians: as a dynamic, “unfolding process of imaginatively experiencing the subjective consciousness of another person, sensing, understanding, and structuring the world as if one were that person.” Although consistent with some historical conceptualizations, this definition risks incorporating so many processes it (...) would make empathy difficult to operationalize or distinguish from any generally socially sensitive interaction. Defining empathy instead as the attempted representation, or simulation, of another's subjective internal experiences (whether sensory, affective, or cognitive) would increase its clarity and empirical utility. (shrink)

Contemporary egalitarian liberals—unlike their classical counterparts—have lived through many contentious events where the right to freedom of expression has been tested to its limits—the Skokie, Illinois, skinhead marches, hate speech incidents on college campuses, Internet pornography and hate speech sites, Holocaust deniers, and cross-burners, to name just a few. Despite this contemporary tumult, freedom of expression has been nearly unanimously affirmed in both the U.S. jurisprudence and philosophical discourse. In what follows, I will examine Ronald Dworkin's influential contemporary justification for (...) freedom of expression, which claims that a thoroughgoing right to freedom of expression is justified by the fact that it guarantees and preserves liberalism's commitment to equality by offering everyone an opportunity to speak, whereas any other policy, such as state regulation, would fail to offer this equal opportunity. This justification has been challenged by feminists and critical race theorists, who find the cases of pornography and hate speech to be sufficient threats to the freedom of expression and equality of their targets—women and minorities—to warrant limiting freedom of expression in these cases. I will argue that if Dworkin is to take equality as seriously as he claims to, then, by his own lights, he must back away from an unrestricted freedom of expression, in light of these distinctly contemporary challenges of the harms of systemic racism and sexism, which underlie hate speech and pornography. (shrink)

Last year, the Joint Commission on Accreditation of Healthcare Organizations for the first time included provisions in its Hospital Accreditation Manual requiring institutions to have mechanisms in place to consider ethical issues arising in the care of patients and to educate care givers and patients on bioethical issues. This new requirement is notably vague. There is no indication of what type of mechanisms would be appropriate or how those involved in considering ethical issues should conduct themselves. This vagueness is by (...) no means accidental, but it reflects a recognition that clinical bioethics is still in its formative stages and that there are currently almost as many different mechanisms for dealing with bioethical issues in the healthcare setting as there are institutions that have such mechanisms. The Joint Commission's action, however, also implies that the time for experimentation will soon be over. (shrink)