Public health ethics, like the field of public health it addresses, traditionally has focused more on practice and particular cases than on theory, with the result that some concepts, methods, and boundaries remain largely undefined. This paper attempts to provide a rough conceptual map of the terrain of public health ethics. We begin by briefly defining public health and identifying general features of the field that are particularly relevant for a discussion of public health ethics.Public health is primarily concerned with (...) the health of the entire population, rather than the health of individuals. Its features include an emphasis on the promotion of health and the prevention of disease and disability; the collection and use of epidemiological data, population surveillance, and other forms of empirical quantitative assessment; a recognition of the multidimensional nature of the determinants of health; and a focus on the complex interactions of many factors—biological, behavioral, social, and environmental—in developing effective interventions. (shrink)

The normative status of Michel Foucault’s critical method of genealogy has been the topic of much debate in secondary scholarship. Against the criticisms forwarded by Nancy Fraser and Jürgen Haberm...

This collection contains twenty-one thought-provoking essays on the controversies surrounding the moral and legal distinctions between euthanasia and "letting die." Since public awareness of this issue has increased this second edition includes nine entirely new essays which bring the treatment of the subject up-to-date. The urgency of this issue can be gauged in recent developments such as the legalization of physician-assisted suicide in the Netherlands, "how-to" manuals topping the bestseller charts in the United States, and the many headlines devoted to (...) Dr. Jack Kevorkian, who has assisted dozens of patients to die. The essays address the range of questions involved in this issue pertaining especially to the fields of medical ethics, public policymaking, and social philosophy. The discussions consider the decisions facing medical and public policymakers, how those decisions will affect the elderly and terminally ill, and the medical and legal ramifications for patients in a permanently vegetative state, as well as issues of parent/infant rights. The book is divided into two sections. The first, "Euthanasia and the Termination of Life-Prolonging Treatment" includes an examination of the 1976 Karen Quinlan Supreme Court decision and selections from the 1990 Supreme Court decision in the case of Nancy Cruzan. Featured are articles by law professor George Fletcher and philosophers Michael Tooley, James Rachels, and Bonnie Steinbock, with new articles by Rachels, and Thomas Sullivan. The second section, "Philosophical Considerations," probes more deeply into the theoretical issues raised by the killing/letting die controversy, illustrating exceptionally well the dispute between two rival theories of ethics, consequentialism and deontology. It also includes a corpus of the standard thought on the debate by Jonathan Bennet, Daniel Dinello, Jeffrie Murphy, John Harris, Philipa Foot, Richard Trammell, and N. Ann Davis, and adds articles new to this edition by Bennett, Foot, Warren Quinn, Jeff McMahan, and Judith Lichtenberg. (shrink)

This book is the first to offer a detailed analysis of Aristotelian and Kantian ethics together, in a way that remains faithful to the texts and responsive to debates in contemporary ethics. Recent moral philosophy has seen a revival of interest in the concept of virtue, and with it a reassessment of the role of virtue in the work of Aristotle and Kant. This book brings that re-assessment to a new level of sophistication. Nancy Sherman argues that Kant preserves (...) a notion of virtue in his moral theory that bears recognisable traces of the Aristotelian and Stoic traditions, and that his complex anthropology of morals brings him into surprising alliance with Aristotle. She develops her argument through close readings of major texts by both Aristotle and Kant, illustrating points of congruence and contrast. (shrink)

Bioethics needs an expanded moral vision. It is now time for bioethics to take full account of the problems of health disparities and structural injustice that are made newly urgent by the COVID-19 pandemic and the effects of climate change. Nancy M. P. King, Gail E. Henderson, and Larry R. Churchill make the case for a more social understanding and application of justice, a deeper humility in assessing expertise in bioethics consulting, a broader and more relevant research agenda, and (...) greater appreciation of the profound health implications of global warming. (shrink)

What does it mean to say that this person at this time is 'the same' as that person at an earlier time? If the brain is damaged or the memory lost, how far does a person's identity continue? In this book two eminent philosophers develop very different approaches to the problem.

This paper proposes an essentially theoretical reflection on initial training, a reflection based on four fundamental concepts: professional development, professional identity, well-being and strengths of character. More specifically, recognizing the complexity of the teaching profession, the authors argue that the teacher training in Quebec gives too little room for self-reflection. According to them, this reflection should be based on a search for meaning in terms of a vision of well-being. Positive psychology research on strengths of character may provide useful avenues (...) for rethinking teacher education. (shrink)

There is a takeover movement fast gaining influence in development economics, a movement that demands that predictions about development outcomes be based on randomized controlled trials. The problem it takes up—of using evidence of efficacy from good studies to predict whether a policy will be effective if we implement it—is a general one, and affects us all. My discussion is the result of a long struggle to develop the right concepts to deal with the problem of warranting effectiveness predictions. Whether (...) I have it right or not, these are questions of vast social importance that philosophers of science can, and should, help answer. (shrink)

An important consideration which runs through the adjudication process in each dimension is that of insight vs. blindness. Whether it is a question of deciding if one description is a persuasive critique of another, or which of two rivals is more adequate empirically, or which is a more plausible and convincing narrative, one is always involved in assessing how far and how much each of the accounts permits us to see. The centrality of this notion certifies the inescapably hermeneutical character (...) of social description adjudication. It precludes the possibility of a decision-procedure, but not of rationality. The alternative to a canonical method of description adjudication is not relativism but hermeneutics. ;My argument for a hermeneutical approach to social description adjudication is made largely via consideration of a series of examples. I look at a collection of rival accounts of the same portion of social reality and at the process of choosing between them. I consider the sorts of reasons and arguments that might be advanced for preferring one to another and I evaluate them. The descriptions I look at are accounts of the French Revolution of 1848 and they include Karl Marx's Eighteenth Brumaire of Louis-Bonaparte, Victor Hugo's Napoleon the Little, Gustave Flaubert's Sentimental Education and the works of two recent twentieth century social historians. ;I show that these descriptions are complexes of at least three analytically distinct components: critical, empirical and narrative. I show, therefore, that the choice between them can be made from at least three corresponding standpoints. But I also argue that these three dimensions are not independent of one another; each, rather, presupposes the others and none is foundational with respect to the others. Adjudicating between competing social descriptions, then, turns out to be a complex non-canonical process of weighing the relative merits within each dimension. ;I counterpose to the decision-procedure model of social description adjudication a hermeneutical model. I show that good and convincing reasons for preferring one social description or historical interpretation to another need not be strictly derivable from or translatable into a set of universal rules capable of being formulated independently of and in advance of the consideration of the particular case. I show, rather, that rational adjudication between competing social descriptions consists in creative rule-transcending judgment akin to Aristotelian phronesis or Kantian reflective judgment. ;It is often presupposed that choices between competing theories, interpretations, actions or whatever qualify as rational just in case they result from the application of some decision-procedure. I take issue with this assumption when what is at stake is choosing between competing descriptions of social reality. I argue that there is not and cannot be a decision-procedure governing such choices, but that such choices may nonetheless be rational and intersubjectively defensible. (shrink)

In this article, we argue that dominant norms of demographic data are insufficient for accounting for the complexities that characterize many lesbian, gay, bisexual, transgender, and queer lives. Here, we draw from the responses of 178 people who identified as non-heterosexual or non-cisgender to demographic questions we developed regarding gender and sexual orientation. Demographic data commonly imagines identity as fixed, singular, and discrete. However, our findings suggest that, for LGBTQ people, gender and sexual identities are often multiple and in flux. (...) An overwhelming majority of our respondents reported shifting in their understandings of their sexual identities over time. In addition, for many of our respondents, gender identity was made up of overlapping factors, including the relationship between gender and transgender identities. These findings challenge researchers to reconsider how identity is understood as and through data. Drawing from critical data studies, feminist and queer digital media studies, and social justice initiatives like Data for Black Lives, we call for a reimagining of identity-based data as “queer data” or “data for queer lives.” We offer also recommendations for researchers to develop more inclusive survey questions. At the same time, we address the ways that queer perspectives destabilize the underlying logics of data by resisting classification and “capture.” For marginalized people, the stakes of this work extend beyond academia, especially in the era of algorithms and big data when the issue of who is or is not “counted” profoundly affects visibility, access, and power in the digital realm. (shrink)

On the one hand, freedom is said to be the property of a subject. On the other, freedom only happens in the space of being-in-common. Freedom, then, is the place of a conflict between the “self” and the “with,” between independence or autonomy and dependence or sharing. Resolving this apparent antinomy requires showing how the with ontologically constitutes the self. This, in turn, allows for a rethinking of freedom beyond what liberal democracy and political economy have to offer, as the (...) renewed opening of existence onto nothing, or onto an “outside” that the opening itself constitutes. (shrink)

The paper argues that the practice of thought experintenting enables scientists to follow through the implications of a way of representing nature by simulating an exemplary or representative situation that is feasible within that representation. What distinguishes thought experimenting from logical argument and other forms of propositional reasoning is that reasoning by means of a thought experiment involves constructing and simulating a mental model of a representative situation. Although thought experimenting is a creative part of scientific practice, it is a (...) highly refined extension of a mundane form of reasoning. It is not a mystery why scientific thought experiments are a reliable source of empirical insights. Thought experimenting uses and manipulates representations that derive from real-world experiences and our conceptualizations of them. (shrink)

Abuses at Abu Ghraib prison in Iraq confront us with the question of how seemingly ordinary soldiers could have perpetrated harms against prisoners. In this essay I argue that a Stoic approach to the virtues can provide a bulwark against the social and personal forces that can lead to abusive behavior. In part one, I discuss Abu Ghraib. In two, I examine social psychological explanations of how ordinary, apparently decent people are able to commit atrocities. In three, I address a (...) series of questions: why should we turn to ethics for help with these problems, and why, in particular, to Stoicism instead of other ethical theories, such as utilitarianism or Kantianism? Given the power of situations in influencing behavior, is a turn to character ethics a viable response to problems such as those at Abu Ghraib? I argue in part four that character formation drawing on Stoic values can provide soldiers with the inner resilience to resist the situational factors that press them to unwarranted aggression. (shrink)

Stigmatization and sharming of healthcare workers in Japan during the coronavirus 2019 pandemic reveal uniquely Japanese features. Seken, usually translated as ‘social appearance or appearance in the eyes of others,’ is a deep undercurrent woven into the fabric of Japanese life. It has led to providers who become ill with the SARS-CoV-2 virus feeling ashamed, while concealing their conditions from coworkers and public health officials. It also has led to healthcare providers being perceived as polluted and their children being told (...) they were not welcome in schools. Although such experiences are not isolated to Japan and have appeared in other parts of the world, the cultural forces driving them in Japan are unique. Overcoming stigmatization and shaming of Japanese healthcare providers will require concerted efforts to understand cultural barriers and to view such practices as raising human rights issues affecting the safety and well-being of all. (shrink)

In Ending Midlife Bias: New Values for Old Age, I argued that dignity can give practical guidance for patient care, especially dementia care.1 Using a capability-informed analysis, I detailed threats to central human capabilities that undermine dignity for people with dementia and provide practical suggestions for managing these threats in paradigm cases. In an article in this issue, Hojjat Soofi argues that a capability-informed account of dignity is exclusionary of people with dementia and does not translate into practical ethics guidance.2 (...) Soofi maintains that people with intellectual impairment ‘might not be able to exercise (or even have access to)’ the capabilities in question (Soofi, p4).2 Focusing on Nussbaum’s capability view, Soofi cautions, it gives a narrow, blinkered assessment of what it means to live a full and flourishing human life. In this commentary, I argue that Soofi’s critique of the capability view hastily generalises from a narrow set of premises to expansive, unwarranted conclusions. Soofi’s first objection, that a capability view of dignity excludes people with dementia, is a sweeping and strong claim. In its support, Soofi cites dignity of the Kantian sort, which requires ‘cognitive competence to exercise rational agency,’ to argue that ‘if we want to include people with dementia in the circle of human beings …. (shrink)

Désirer, qu’est-ce que c’est? Quelle différence entre désirer, vouloir ou avoir besoin? Jean-Luc Nancy, auteur fidèle de la collection, s’attache à percevoir comment le désir travaille en nous, et comment nous vivons avec cette force toujours à l’oeuvre, quels que soient nos âges et nos situations.

In Total Truth, Nancy Pearcey offers a razor-sharp analysis of the split between public and private, fact and feelings.